Pasta is healthy

Pasta is healthy

Federico Germani

Federico Germani

Federico is a geneticist and molecular biologist at the University of Zurich, Switzerland. He grew up in Senago, a town near Milano, Italy. Because of his interest in geopolitics, geography and social sciences, he studied International Relations at the University of London. He is a former swimmer and swimming instructor. He believes that sports educates people in thinking critically.

Pasta is generally categorised among unhealthy foods. However, Italians – large consumers of pasta – are among the healthiest populations of the world. This study digs into the properties of this highly caloric food to unveil its potential benefits and to debunk the general misconceptions of pasta-based recipes.

It is widely known that excessive consumption of fats (especially animal fats) and simple sugars has numerous detrimental effects for our health.
However, people wanting to lose body weight often avoid pasta in their diet. There is, indeed, a general belief that pasta is unhealthy and contributes to weight gain because it is highly caloric.
However, pasta is the most important dish in the Italian Mediterranean Diet, widely considered as one of the healthiest worldwide. On average, an Italian adult consumes 23.5 kg of pasta each year, far above the per capita consumption of any other country. In a distant second and third place are Venezuelans and Tunisians; it is worth mentioning that they consume less than the half (13.2 and 11.9 kg respectively) of what the average Italian consumes.
Considering these numbers, one would expect Italians to be high in obesity and diabetes rankings. However, Italy has low rates of obesity (9.8%, USA for comparison: 40%), low rates of diabetes (4.8%, USA for comparison: 10.8%) and a high life expectancy (82.7 years, USA for comparison: 79.3).

Considering these numbers and the fact that pasta is consumed on a daily basis in Italy, should pasta still be considered unhealthy?
Pasta is a highly caloric and carbohydrate-rich food source. Carbohydrates are complex sugars that are divided into simple sugars during digestion, and are more filling than other nutrients, such as sweets (1). Simple sugars are quickly absorbed into the bloodstream and cause a fast rise in blood glucose levels. Pasta instead, like other foods containing complex carbohydrates, has a low glycemic index, which causes a lower and slower spike of glucose in the blood. The reason for this is the complex structure of pasta, composed of starch (a polymeric carbohydrate made up of glucose molecules) intermingled within a spongy network of gluten proteins.
Because of its inherent nature, it is a simple and obvious conclusion that pasta itself is not unhealthy. In fact, Italians consume small portions of pasta daily (about 80-100 grams), generally with a tomato sauce, pesto or other sauces (for a very long catalogue of Italian pasta recipes look here) that are not high in fat content. More fatty sauces (such as “Carbonara”, for instance) are generally consumed on special occasions.
Outside of Italy, cream, milk and butter are often added to many sauces, but in Italy these products are rarely used for this purpose. Further, unlike other culinary cultures, Italians prefer to use olive oil as a fat source, which is well known to be far healthier than animal sources. The idea that Italian cuisine is fatty is therefore a general misconception due to the misinterpretation and misuse of Italian recipes. The success of many Mediterranean dishes worldwide has also been the cause of their boorish imitations: what the hell is Alfredo sauce (American invention)? What is Piccata alla Milanese (German invention)? These were just two examples among a very long list (a few here).

A practical example: the aforementioned “Carbonara” is a simple sauce made with fresh eggs and guanciale, a special meat product prepared from pork cheeks, similar to bacon for non-Italian palates. Raw eggs mixed with the fat of the meat produce a creamy consistency, highlighted by the presence of Pecorino cheese. In this simple dish there is no space for additional fatty elements, but outside of Italy this dish is thought to contain a lot of cream sauce (here is one of the many examples).

In essence, the unhealthiness of pasta is given by the way pasta is consumed, rather than pasta itself.

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Tom Reed for Culturico. Tom Reed @tomreedstudio.com (copyright)

But what does science say about pasta?
A recent correlation study has shown that BMI inversely correlates with the amount of daily-consumed pasta (2), and more generally carbohydrate intake is associated with a better regulation of body weight (3).
Since scientific research has not produced much more than this, in this article we investigated whether the consumption of pasta correlates with markers of the health of a population. As a sample we have analyzed countries within the European Union and we correlated – using pre-existing data generated from reliable sources (here1, 2, 3, 4) – the consumption of pasta in each country with the percentage of obese and diabetic people, but also with life expectancy (Figure 1).
As a positive control we analyzed obesity and life expectancy and, as hypothesized, these two parameters are inversely correlated (Fig. 1A).
Interestingly, pasta consumption positively correlates with life expectancy (Fig. 1B) and negatively correlates with the percentage of obese and diabetic people in the population (Fig. 1C-D).

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Figure 1. Pasta positively correlate with general markers of the health of a population. Life expectancy negatively correlates with obesity (positive control). Two examples: Switzerland has very low levels of obesity and a long life expectancy (red dot), Slovakia has high rates of obesity and a rather short life expectancy for EU standards (orange dot) (A). Pasta consumption correlates with life expectancy. Two examples: Italians consume large amounts of pasta and live extremely long (red dot). Romania has low rates of pasta consumption and the life expectancy is short for EU standards (orange dots) (B). Pasta consumption negatively correlates with the percentage of obese (C) and diabetic people in a population (D). Examples: Italy has low rates of obesity and diabetes, whereas in the UK, although people on average consume only a sixth of the pasta consumed by Italians, obesity rates are much higher. Romania has a large percentage of diabetic people, although pasta consumption is minimal.

We therefore conclude that, although further research is required, nothing indicates that pasta is unhealthy, but rather that pasta consumption is associated with wellbeing and health.

There are additional components determining the impact of pasta on health (and potentially further improving its benefits):

1. Portion size: despite the frequent consumption, Italians generally consume small portions, whereas in other countries portions are less frequent but larger (typically 80-100 grams in Italy versus 150-200 grams elsewhere).

2. Time of consumption: consumption of pasta should be confined to the early hours of the day (4, 5, 6), possibly because daily activity helps to burn calories. During the night, when the activity is minimal, unutilized sugars may be more easily converted into fatty acids (7).
Interestingly, pasta is the typical lunch dish in Italy, whereas an evening meal is often based on proteins (meat, cheese, fish), vegetables and fruit.

3. Sports and activity: high consumption of complex and simple sugars is well tolerated when an organism undergoes intense and constant sports activity.
Doing sports and eating caloric food is therefore a healthy combination. In line with what has been discussed so far, Italy ranks 5thamong OECD countries for daily sports activity, with an average of 59 minutes of activity per day (USA for comparison: 37 minutes). For instance, professional athletes require a high intake of carbohydrates to sustain their intense activity: pasta consumption is therefore a valid option (even in large amounts).

What do we learn from this story?
A society that consumes more carbohydrates, fewer fats and fewer simple sugars is a healthier society, with a longer life expectancy.
More importantly, people should be encouraged to constructively criticize their own perception about what is healthy and what is not, experiencing and learning from what other cultures do, while preserving their culinary traditions and moving towards what is healthier. Absorbing knowledge from other cultures is a good thing, also when it comes to cuisine. Though, people should invest time to understand how certain negative lifestyles can be quickly transferred from one culture to another, in order to prevent this from happening.
In our fast-food society we need to run (fast), slow down and eat a big portion of pasta (without cream, please!).

 

Federico Germani

 

References:

  1. Holt, S., et al., “The effects of high-carbohydrate vs high-fat breakfasts on feelings of fullness and alertness, and subsequent food intake”, Int J Food Sci Nutr, 1999.
  2. Pounis, G., et al., “Association of pasta consumption with body mass index and waist-to-hip ratio: results from Moli-sani and INHES studies”, Nutrition & Diabetes, 2016.
  3. Aller, E.E.J.G., et al., “Starches, Sugars and Obesity”, Nutrients, 2011.
  4. Romon, M., et al., “Circadian of diet-induced thermogenesis”, Am. J. Clin. Nutr, 1993.
  5. de Castro, J.M., “The time of day of food intake influences overall intake in humans”, J Nutr, 2004.
  6. de Castro, J.M., “The time of day and the proportions of macronutrients eaten are related to total daily food intake”, Br J Nutr, 2007.
  7. Glimcher, L.H. and Lee, A., “From sugar to fat”, Ann N Y Acad Sc, 2017
Received: 05.12.18, Ready: 17.12.18, Editors: BK, RG.

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