How Italians Stay Thin Eating Pizza & Pasta All the Time

A plate of spaghetti con vongole (spaghetti with fresh clams) in Naples, Italy. ©KettiWilhelm2020

If you look at a menu in Italy, it seems like everything is carbs cooked in oil or heavy cream, then covered in cheese, with a side of cured meat. (Or at least those are the dishes that jump out at you.) Then you look around at the people in the restaurant, and you wonder: How do Italians stay so thin?

Why aren’t more Italians overweight, when they’re always eating pizza and pasta? And wine and dessert.

That’s the question I get all the time from Americans who’ve been to Italy, and from other Europeans, too. And with good reason!

The way Italians eat basically goes against everything we learn about food in the US – and the results are the opposite too.

The answer is more straightforward than I expected before I lived in Italy, but it’s definitely not as simple as “the Mediterranean diet,” either.

We think of the Mediterranean diet as one singular thing: Fresh fruit, vegetables, olive oil, fish, nuts and wine. Not so much meat or cheese. No processed foods. Some parts of that are accurate, but it really isn’t how most people eat in Italy, either.

And of course, calling anything a “Mediterranean” diet is a major oversimplification of the way people eat in the diverse countries around the Mediterranean. From my experience, in Greece people eat tons of red meat. In Italy there’s a lot of cheese, and in France lots of cheese and butter.

Simple cheese and salami Italian sandwiches in front of my favorite cheese stall at the market in Milan. ©KettiWilhelm2020
Simple (two-ingredient!) sandwiches at my favorite stall at the market in Milan.

Even going up and down Italy, you’ll find wild variations in the cuisine from one region to the next, and different specialties from one town to the next. (This is one of my absolute favorite things about traveling in Italy.)

Some general differences: The South has much more fried and spicy food and (historically) more fresh olive oil. The North, especially up in the Alps, has more butter and dishes that are covered in melted cheese (and also, now, lots of fresh olive oil).

But there are several things that tie together the Italian way of eating, and they’re really different from how we’re taught to eat in the US.

After three years in Italy, these are the 13 things I’ve learned about how Italians stay thin while eating decadent, delicious food.

There’s something on this list for everyone – from meat and beer, to snacks and vacations!

1. They Eat Food – Not Nutrients

You know how if you order a salad in the US, the server will probably ask if you want to “add some protein” to it? (Usually in the form of beef, chicken, salmon or tofu.) Italians don’t think of food this way, breaking it down to scientific components.

For the most part, people in Italy eat foods that have evolved over centuries for nutrition and taste. They probably started as recipes based on what was available and people’s tastes evolved with the dishes.

For example, fresh mozzarella, fresh tomatoes and extra virgin olive oil (a caprese salad) are a classic light lunch in Italy, maybe with some bread and/or greens. But Italians don’t order this thinking in terms like protein + vegetable + omega 3s + carbs for energy, etc. They eat it because it’s what they grew up eating and it tastes good.

Food is food in Italy, not macronutrients.

And Italian food culture is really strong and really traditional, which means people don’t have to think so hard about what to eat. It’s programmed from birth by mothers and grandmothers.

2. Breakfast is Light… But Sweet

Italians eat a sweet breakfast that feels almost decadent by American standards. It’s pleasurable, but still pretty low-calorie compared with a breakfast sandwich, or a plate of eggs, bacon and hash browns.

But it’s not like Italians eat a “diet” breakfast, either. Breakfast is always sweet – not light or low-fat – but it just isn’t a large meal.

Eggs are an ingredient in Italy, not a meal. There’s no meat at breakfast (ever) and no omelets, oatmeal, pancakes or waffles. (When you see those offered at hotels, they’re for North American and British tourists. The cold cuts, hard boiled eggs, and cucumbers on the breakfast buffet are for Northern Europeans.)

Italian breakfast options are actually really limited:

Breakfast at a bar (which is like a coffeeshop, but also offers lots of other services) is coffee and a pastry. The coffee is either a cappuccino (about 6 ounces, max), or an espresso – with or without a dollop of milk foam (an espresso macchiato).

A bar might have non-dairy milk (I’ve only ever seen soy), but don’t even bother asking for skim.

The most common pastry is something like a French croissant – called a brioche in the North, and a cornetto in Central and Southern Italy. But it’s often filled with chocolate, jam, cream, pistachio cream… the list of possibilities goes on. (While the French are 100% against filling croissants with anything but air and butter.)

Other options might be a narrow slice of cake (unfrosted), or a crostata – a tart made with jam or fruit.

Except in Sicily, where people slurp fresh granita (a frozen slushy-type treat) flavored with coffee or with local lemons, berries, pistachio or almonds for breakfast. It feels like eating ice cream for breakfast, because Sicily is heaven.

At home, Italian breakfast is coffee with a few plain, dry, hard cookies. I know ­– that’s not a very appetizing description. But you won’t find oatmeal or chocolate chips or jam or coconut or nuts in Italian cookies, at least not the breakfast ones. (Actually, you don’t find oatmeal of any kind, ever, in Italy.) No frosting or sprinkles, either.

When I first moved to Milan, I saw nothing to like in these cookies. But they grew on me. They’re plain and simple, but light and crumbly and perfect for soaking up coffee. 

If you’re thinking, but how do they get enough protein? then don’t worry about it. That’s not a very Italian way to think.

3. They Eat One Food at a Time

I wrote a whole post about the art and structure of Italian meals, but this is the main idea: One food per plate, and one plate at a time.

If the most stereotypical, 1950s, home-cooked American meal is mashed potatoes, peas and meatloaf, you’d expect to find them all on the same plate. This is a foreign concept in Italy.

Even at home-cooked meals in Italy, you generally eat a first course (pasta, risotto or something carb-based) then clear away the plates. Then a second course (meat or fish) and a contorno, a vegetable side dish, which is served either with the second course or after – but not on the same plate.

Part of how Italians stay thin is by eating vegetables, like this plate of sautéed greens – a contorno in Rome. ©KettiWilhelm2020
People eat vegetables in Italy! Because they’re delicious, like these sautéed greens as a contorno at my favorite restaurant in Rome.

I have no proof, but I think this way of eating makes people eat less of each food.

Here’s why: When you have everything together, you continually change the flavor in your mouth, and never get sick of eating. But when you eat one food at a time, you either get satisfied by the flavor or you just realize more quickly that you’ve eaten enough, and end up eating less in total.

This is just my theory but I think it makes sense, no?

Be warned, though, that this can totally backfire – as happened to me more than once when I first moved to Italy. Like when you’re at a dinner party and don’t know what to expect, so you eat too much of one course because you didn’t realize how many more were coming up. Lesson learned: It’s okay to ask.

4. Italians Don’t Snack

Snacking just isn’t done – except for little kids, of course. There are several reasons for this.

Meals are sacred in Italy. People make plans to sit down and eat with other people, they don’t just eat whenever they’re hungry (and then end up eating again when they meet up with people).

So you don’t grab a sandwich in the middle of the afternoon if you’re hungry. You generally just deal with being hungry until it’s dinner time. (Or aperitivo time.)

An abundant aperitivo with colorful cocktails in Milan, Italy. ©KettiWilhelm2018
An aperitivo like this usually takes the place of dinner in Milan.

But I don’t think this is because Italians are all righteous and full of self-control. It’s because there’s a strong cultural taboo against eating outside of meal times. They feel like they really shouldn’t do it, even if maybe they’d like to.

Plus, meal times are really specific and inflexible. Lunch is 1pm to 2pm for basically everyone in Milan. Dinner is usually not before 8pm.

And when Italians do snack, it’s much more likely to be a piece of fruit or a couple of crackers than a bag of chips or candy. What are most snack foods in the US? Processed foods.

5. Italians Eat Fewer Processed Foods

Sure, this is changing a bit, as the whole world is changing. No culture remains the same forever, and Italy is starting to see more corporate influence from both foreign and Italian snack food and fast food brands. (Including Starbucks, which I wrote about when the very first one in Italy opened in Milan in 2019.)

There’s also more and more fast food available in Italy, and some people are starting to have those sedentary lifestyles centered around a computer with no exercise. These are definitely not good things but they’re still the exception, not the rule.

When you go to the grocery store in Italy, the selection of snack foods and candies available is just nothing like in the US. These foods are a much smaller part of people’s daily habits.

6. There Are No “Beverages” 

Italians very rarely have drinks besides water between meals. (Point #4 about no snacking throughout the day includes lattes.)

You just don’t see people walking down the street with a soda, a coffee cup, a milk tea or a smoothie. And a coffee break at work is a simple espresso (or a macchiato with a tablespoon of milk) down at the coffee bar, not a big sugary beverage that comes back to the desk.

But this goes beyond drinks between meals.

I’ve written before about how people will look at you funny if you order a cappuccino with savory food. Well, not only do Italians not drink coffee with food (except at breakfast) but they don’t drink almost any beverages with meals, except beer and wine. There’s no smoothie, milk, juice with lunch and definitely not with dinner. One exception is a small Coke for kids, or for adults who aren’t drinking beer or wine. (And it’s mostly as a way to not be left out.)

Not drinking sugary beverages helps Italians stay thin. Most beverages they do drink grow in vineyards, like this one in Valdobbiadene.  ©KettiWilhelm2020
Most beverages in Italy grow on a vine. (Like this one in the town of Valdobbiadene.)

The drink of choice is usually sparkling or still mineral water, no ice.

(It’s tough to get a glass of plain tap water in Italy. You almost always have to buy a bottle, although restaurants often use glass bottles, which are sometimes refilled over and over again at the source. You can tell by the horizontal ring of scratch marks at the shoulder of the bottle, from where it’s rubbed repeatedly against other bottles.)

Eliminating drinks with meals cuts a bunch of calories – but that’s usually not why Italians do it. They do it because they don’t want flavors competing with the delicious food they’re eating. The calories are just a bonus.

7. … And Way Less Beer

Italians don’t drink more than two beers in one casual setting. There are always exceptions (I have one friend in Italy who’s an exception) and, like everywhere else I’ve been in the world, clubs are a different story.

But I realized this when I first moved to Milan and went over to a friend’s house for a casual aperitivo gathering. I popped open a beer and started drinking from the bottle, then I realized what everyone else was doing: Opening a bottle, pouring a quarter of it into a glass, and putting the rest back on the table for someone else.

Sure, they might drink several of these servings, but no one in the States would think of sharing a 12-ounce light beer any more than an Italian would think of sharing an espresso.

And it’s not because Italians make up for beer by drinking way more wine. They don’t. Heavy drinking just isn’t part of Italian culture.

A note for the Europeans reading this: Back in Chicago, where I’m based now, it’s not uncommon for people (mostly men) to go out for three or four pints after work. Maybe they get to half a dozen if they stay out for dinner.

8. The Food System is Built on Seasonality, Freshness & Quality

Interest is growing in seasonal, local, and fresh foods in the US, but our food system as a whole doesn’t prioritize those things, and people expect to eat the same foods year-around.

The idea of restaurants serving a menu that changes with what’s in season is pretty new in the US. But it’s very standard in Italy. What’s more, I think people in Italy are educated from birth to recognize quality – and complain about bad quality.

For more about this fascinating topic, I cannot recommend highly enough Michael Pollan’s book The Omnivore’s Dilemma. I love all of his writing, and this is one of the first books that got me interested in food.

It covers how the US food systems works, and explores what ideas like organic, local, and plant-based actually mean, in a way that’s both rigorously researched and totally entertaining. (You can order it at the link above through Amazon, or here via local book stores. And I have more book recommendations at the end of this post!)

Fruit and vegetables for sale at a market in Milan, Italy. Eating lots of fresh produce is part of how Italians stay thin.  ©KettiWilhelm2017
Beautiful veg at the market in Milan.

9. People Cook Really Simple Food at Home

There are two parts to this:

  1. People cook at home, and
  2. Lots of Italian recipes are really simple, which is probably part of the reason people cook at home.

Of course not everyone in the country knows how to cook, or bothers.

But when Italians do cook at home, it’s often from scratch – but it’s not that complicated! A lot of Italian dishes are really simple and don’t require the oven, a chunk of meat or multiple spices.

My favorite meals that we cook at home are easy, vegetable-heavy and meat-free.

A pasta sauce is often just five ingredients: Salt, water (do those even count as ingredients?), olive oil, garlic and/or onion, one spice or herb, and a vegetable. The vegetable could be anything – maybe tomatoes, broccoli, or zucchini – but not all at the same time.

If you know what you’re doing, that’s all it takes to make a delicious sauce out of exclusively fresh ingredients. No meat needed. And if you skip the freshly grated cheese on top, it’s even vegan.  

10. Italian Cuisine Uses Meat For Flavor

Often dishes with meat use just a very small amount to add flavor, not as the focus of the dish. When I say small, I mean like one ounce of cured pork (like guanciale or pancetta) in a serving of pasta.

Yes, there are exceptions. Italy has lots of famous meat dishes, like Tuscany’s Bistecca alla Fiorentina – a cut of steak that can be four inches thick. Or Milan’s Cotoletta alla Milanese – basically chicken-fried veal.

But those specific dishes are more like special treats. They’re definitely not what people eat every day.

I’ve said for years that Italian cuisine is mostly carbs covered in cheese.

And it’s true, but I also think Italy is the easiest place in the world to avoid eating meat, and avoid most dairy if you want to. (The couple ounces of milk in a cappuccino are probably the hardest to avoid, as not all bars offer an alternative.)

Whereas in many European countries, most items on most menus include meat. In Italy, it’s much more balanced.

And the meat-free items are just as traditional as everything else – not tokens options for vegetarians.

There are even plentiful pizzas without cheese. But when a meal is carbs covered in cheese, another thing is different:

11. Portions Are Way Smaller

Portions in Italy are not what I would call small. But one thing I realized when we moved to Chicago is that my husband and I can share almost any restaurant meal. This is not the case in Italy. It’s a whole different scale, and US portions are simply way bigger.

Yes, it’s true that everyone eats their own entire pizza in Italy – but everything about that pizza is completely different.

Napoli’s original pizza has a soft but very thin crust, cooked by a real fire on dry brick or stone – so no grease in the pan. The central flavor, the base of the pizza, is either fresh tomatoes or olive oil and garlic (which is called pizza bianca, or white pizza). On top of that are just two or three toppings – not six or eight. If it has meat, it’s almost certainly one kind and not very much of it. If it has cheese, it’s scattered out in a few spots on top – not smothering the entire pizza.

A classic pizza margherita in Naples, Italy – lighter than you might expect! ©KettiWilhelm2020
A classic pizza margherita in Naples. Lighter than you might expect!
Many varieties of tomatoes and the man selling them at a vegetable market in Sicily. ©KettiWilhelm2017
Sicilian tomatoes: Flavor!

12. Not Every Meal is Big

After a small breakfast, no oversized coffee + milk + sugar beverage, a reasonable lunch, and no snacks all day… yeah, dinner might be several courses.

But dinner isn’t always a big meal. And when it is, it’s the only meal of the day that’s big.

One exception to this is Christmas, when all bets are off.

And by Christmas, I mean the period from early December through January 6th. Meals during the holidays in Italy can become frequent, outrageous, never-ending feasts that are almost too much to even be enjoyable.

This past Christmas was my second one in Italy, and one day I watched an episode of an Italian talk show about food. One of the guests said something brilliant about stressing over holiday weight gain:

“You don’t gain weight between Christmas and New Year’s, you gain weight between New Year’s and Christmas.”

I love this philosophy. Italians allow themselves to indulge without feeling bad about it – but indulgence is the exception, not the rule.

Typical treats from the town of Asolo for “la Befana,” the last of Italy’s Christmas-season feast days, on January 6th. ©KettiWilhelm2020
Typical treats from the town of Asolo for “la Befana,” the last of the Christmas-season feast days, on January 6th.

13. La Dolce Vita: More Vacations & Less Stress

There are a lot of differences between life in Italy and life in the US around stress, cash flow, and simplicity versus opportunity. That’s a topic for another post.

But I will say that I’ve experienced first-hand how much less stressful life is in Italy. (Even after the honeymoon effect wore off, and while I was unemployed, learning the language from scratch, going through the immigration process, and eventually being in grad school!)

Italians spend a lot more time on vacation than Americans. Things are simpler. The paychecks are nothing to write home about, but people don’t have to worry about health insurance or saving for retirement on their own. Fresh, local food is far less expensive, and families often live closer together.

If you’re still stressed after all that, hardly a month goes by without at least one long weekend. (Plus almost everyone takes at least a couple of weeks off both at Christmas and in August – without feeling guilty about it.)

This stuff adds up, and there are tons of studies about the effect of stress hormones on body weight. Being less stressed helps people focus on what’s important in life – like taking time to relax and enjoying good food.

More of My Favorite Food Books:

In addition to The Omnivore’s Dilemma, which I mentioned in #8, here are a couple more books about food that I love.

(The first links are for Amazon, while the second ones are for IndieBound. Both are affiliate links, which means if you buy anything through them, I may earn a commission at no additional cost to you.)

  • Heat, by Bill Buford. The story of an American magazine editor who moves to Italy to learn the secrets of Italian food. It’s hilarious and full of Italian culture and history, too! (On IndieBound here.)
  • In Defense of Food, by Michael Pollan. If The Omnivore’s Dilemma is Pollan’s all-around look at the food industry, this is more of a deep-dive into the more nutritional side. (On IndieBound here.)
  • Food Rules, also by Michael Pollan. I told you I love everything he writes! This is like a bullet-point version of In Defense of Food – most of the chapters are less than a page. It’s a very simple yet brilliant set of ideas for how to eat more healthily. (On IndieBound here.)
  • Gumbo Tales: Finding My Place at the New Orleans Table, by Sara Roahen. This is semi-unrelated, but not as much as it seems! Gumbo Tales is an entertaining, inside look at New Orleans cuisine – including its Italian influence, which also highlights the differences between Italian and Italian-American food. (On IndieBound here.)

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16 Comment

  1. Francesca says: Reply

    Ciao Ketti. it’s a fun to know how foreign eyes see us. And I’m glad that Italy is still a source of curiosity (It makes me feel special like our food). Thank you and congratulation

    1. Ketti says: Reply

      Grazie Francesca. Italy will probably always be a source of curiosity for me. 🙂

  2. Ms Q says: Reply

    This was really well-written and I unequivocally agree. (un’ americana a Roma)
    Would love to connect with you on IG: @everflymsq

    1. Ketti says: Reply

      Grazie, Ms Q! Glad to hear it. I followed you back on ig. 🙂


  3. Andrea Romito says: Reply

    This article is basically flawless.

    1. Ketti says: Reply

      Grazie Andrea! I’m glad you enjoyed it. 🙂


  4. Kara says: Reply

    Love it! I’ve always wondered this, and when I was in Italy for a week, I definitely “went for it” with food – trying to eat everything and anything. It’s cool to see an accurate depiction of life. Side note, the Margherita pizza I had from Naples was hands down the best pizza of my life

    1. Ketti says: Reply

      Thanks Kara! Yeah, I’ve definitely had a similar Naples experience… or several of them. 🙂


  5. Tortellino says: Reply

    As article, but with some inaccuracies (cotoletta alla milanese is not with chicken meat but with by far more precious veal).
    And about the stress and life style: From what you wrote it seems we in Italy have so much holiday and free time, with job and working time in the background. This is not true, we have to (and love) to work hard like in any other place, the real difference is the approach we have with life.

    1. Ketti says: Reply

      Ciao Tortellino,

      Thanks for your comment! Let me clarify:

      In the US, we have a famous dish called “chicken-fried steak,” which is also not made with chicken. It’s steak. “Chicken-fried” is a style or method of pan-frying something. (While fried chicken is, of course, chicken. 🙂 ) That’s why in the article I called Cotoletta alla Milanese “chicken-friend veal.”

      As for vacation, it’s all a matter of perspective.

      I lived in the working city of Milan for three years, so I definitely do know how much Italians can also work, and I certainly didn’t say (or mean to imply) otherwise. But in the US, most people take 2 weeks or less of vacation every year. So compare that with Italy’s average 5 weeks of vacation (not counting the many long weekends for saints’ days and other things) and yeah, it’s a little different.

      Thanks for reading!


      1. Tortellino says: Reply

        Deaf Ketty, thank you for the clear explanation. I get the point better now. I found out your blog nowadays and let me say it’s really good.

        1. Ketti says: Reply

          Grazie Tortellino! That’s very good to hear. Thanks for checking out the blog more – and feel free to subscribe if you want to keep in touch! I’ll always be writing more about Italy. 🙂


  6. Greg says: Reply

    I love how you broke this out; what a great piece! Traveling Europe, I’ve had similar thoughts/conversations about people’s physical differences in relation to their diet and you’re spot on.

    1. Ketti says: Reply

      Thanks, Greg, glad you enjoyed it! I agree, I do think it’s fascinating how it’s a whole different way of eating and thinking about food in many places, especially in Western Europe.


  7. Joyce says: Reply

    This is so informative and wonderful. Great read.
    Thank you.
    Joyce O’Hara

    1. Ketti says: Reply

      Thank you, Joyce! I’m glad you enjoyed it. 🙂


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