The Mediterranean Diet

Thanks to high cholesterol, I recently spent an hour at the Ospedale Universitario in Siena, listening to a cardiologist preach the importance of diet, exercise and stress management, whereupon I confessed partially to my sins: the occasional morsel of cheese, the obligatory wine business dinners, the impossibility of scheduling time for exercise. The doctor gave me a knowing smile and pointed out that Clinton, Bush and Obama had regularly gone jogging on the White House grounds. Was I busier than the leaders of the free world?

Nothing the doctor said was news to me. Although my mother’s mother had been a meat-and-potatoes devotee, my own mother is not a particularly keen cook. I remember dinners of spaghetti with meat sauce, picnics with broiled chicken and the right to ask for steak and peas on my birthday, but my childhood memories are free of the intense associations today’s foodies claim. I had a sweet-tooth, which Mom’s orange juice-wheat germ cake (the only dessert in her repertoire) addressed, as did my father, who ate rows of Fig Newtons while watching the ball game on TV.

Although she was not into cooking, my mother had strong views on health. My childhood was peppered with snide references to “glop” (her term for any packaged food), as well as with her various tenets: “Shop the outer aisles of the supermarket—where the fresh foods are kept;” or, “Park as far from the shop as you can. The walk is good for the heart.” The messages seeped in, such that, in front of the Director of Cardiology at the hospital, I could not claim ignorance of the facts.

During high school, I made myself a peanut-butter-and-jelly sandwich every day for four years, picked at my dinner and ate pizza and drank grape soda in the dormitory at 9pm, but I played soccer, ice hockey or lacrosse six days a week, and thus managed to maintain a strange “health” equilibrium. As a young adult in college and afterward, while I was working in New York City, I lived on coffee, plain bagels and non-fat frozen yogurt and worked out only sporadically. I am not sure I was unusual in my habits: does anyone think about cardiovascular health for its own sake at age 23?

Ever since au-pairing in the southwest of France at age 15, I had had my eye on Europe. I remember Madame Geoffroy, whose children I looked after—rail thin, deeply tanned, her movements so graceful and deliberate that she seemed to be on the verge of dozing off—padding into the house from the pool in her red one-piece bathing suit and strand of pearls to pull a rôti de porc out of the oven and uncork a bottle of Graves Blanc. She was just what I wanted to be—luxe, calme, no volupté.

My fantasy bloomed when I moved to France in 1994 and was told not to hold back, that my body would “get used” to eating a cheese course after every meal, and, a year later, to Germany, where the young couples my first husband and I were friends with loved eating the dishes I had perfected since that summer at the Geoffroys’: creamy coq au vin, meaty daube and buttery gratin dauphinois. Occasionally, I jogged with a friend in the Englischer Garten; more often I dined out on an expense account. In theory, my move to Tuscany in 2001 brought me to the epicenter of Mediterranean living: excellent weather year round and the consequent active lifestyle; rivers of olive oil and oceans of red wine; seasonal, home-grown vegetables and pasta anchoring every meal. I had all of that, but while true to the letter, that description misses the point.

A typical Italian breakfast consists of cookies and coffee, or “orzo,” a caffeine-free coffee facsimile given to children, a meal my mother would call “empty calories.” Lunch is pasta, which, if served with tomato sauce, elicits the question (in our home), “Who’s dieting?” Dinner is a roast with potatoes; dessert is cookies again, this time with wine instead of coffee. Weekend lunches and dinners are often preceded by an aperitivo—a glass of wine, a few slices of ham or cheese, a handful olives. As a friend of mine succinctly puts it, in Tuscany, the bread is white and the meat is pork.

There is nothing immoderate about our routine: no snacking, no fast food, almost no butter. And vegetables do play a role, especially in summer when they are eaten, occasionally, neither fried nor beaten into a flan. But all the while the cardiologist spoke that day in the hospital, a pyramid loomed in the back of my mind—you know, the one from the FDA, with the layers of foods—whole grains at the wide base, fruits and vegetables just above, and all the “glop” at the tip? My mom taped a picture of that pyramid to our refrigerator door sometime around 1974, and referred to it throughout my childhood and adolescence, whenever my sister, father or I asked for junk food or sweets. Listening to the doctor, I started to realize that the three months of eating our garden tomatoes each summer may not be fully cancelling out the effects of the other nine months of the year’s diet of pecorino, prosciutto and Prosecco.  

The results of my blood test confirmed this: my cholesterol was 260. It turns out, staying well is not only a matter of mindset or balance or luck. I cannot see my blood vessels clogging, but they probably are. My bones and muscles feel fine, but then, I sit at a desk all day! How would I know how they are doing? Eating healthily and exercising never feel like urgent “to dos,” which is why I have put them off, for too long.

“Three months to improve,” Dottore Mondelli told me, “or you’ll need to start taking statins.” So I am trying: no spare ribs or salami, no Fiorentina steak and no cheese (ouch)—and I am looking to my dad for inspiration. He is 98 years old, and his cholesterol is 147. He listens to my mom and mostly follows her advice as far as eating is concerned. Still, he has lived in the country for years. Could it be that the real reason he’s so healthy is simply all that fresh air?