A WORD FROM THE EXPERT: Cured meats

Cured meats and the MEDITERRANEAN diet

A relationship that has never been broken

Giuseppe L. Pastori – Food Technologist

The belief that the Mediterranean diet is only based on a vegetable regimen is wrong. The contribution of animal proteins, meat, fish and cured meats, is essential for the nutritional equilibrium of a food regimen that is among the most complete in the world.

When we look at a picture or watch a video, only who has made it can connect the memory of that event and its history. He knows the background behind the scenes and the feelings he had in that moment. If those scenes represent a lifestyle or a group of people, there is no need for who looks at that scene to contextualize the moment (even if he was not present and knows the setting and its history): he perfectly knows what it is about. If there is a title or a caption, it will be easier to remember the event and understand it with the right interpretation, even after years. Sometimes the author or the protagonists may omit the title, which is then added by people who are foreign to the context, who have perceived it indirectly, reported by others. In this case the interpretation will not be univocal: whoever looks at the document at a later time can’t understand its full meaning. He can only restrict himself to a few superficial aspects, without examining in depth. When we talk about Mediterranean Diet, we – Italians – don’t have to clarify what we are talking about, because we live in this local context. It’s obvious that the food regimen of our diet takes inspiration from our culinary tradition, though our environment is now more urbanized. The strong connection with our agricultural production and with the excellence of our land remains and gives life to a variety of foods and to their balanced combinations. The concept of Mediterranean Diet appeared in the ‘50s last century (though it was not known with that name; it will become popular in 1975, when the Americans gave it this qualification). In 1945 the Ministry sent an American physiologist and nutritionist, Ancel Keys, to follow the US troops in Italy during the Second World War and study human performances in hypo nutritional conditions (he will later develop the so called K ration, which has been named after him and will be widely used by the US and allied troops). Keys was studying the relation between body configuration and blood pressure, and between diet, cholesterol and coronary disease. Keys was the first to emphasize the relation between energy intake, energy waste and metabolic rate at rest, which enabled to understand the waste of calories in an activity and the phenomena that lead to obesity and type 2 diabetes. In the early ‘50s he took part in the first FAO meeting on Food and Agriculture in Italy and was impressed by the low effect of cardiovascular pathologies and gastrointestinal upsets among Campania inhabitants. This observation required a scientific explanation. He compared the Mediterranean Countries’, Italy’s and Crete’s diets with northern Europe’s, Japan’s and US diets, and discovered that the mortality rate for ischemic heart disease was lower in the Mediterranean populations, and they even lived longer. He settled in Italy with his wife Margaret, in Pioppi in Cilento area to be precise, and after decades-long investigations he concluded that a diet based on bread, pasta, fruit, vegetables, beans, extra virgin olive oil, fish and very little meat was responsible for the extraordinary healthy effect on the local

population. This type of food regimen was named ‘Mediterranean Diet’. The results of all his studies were clarified in educational form and published in 1975 in the popular book entitled ‘Eat well and stay well’ (1). The book was revolutionary starting right from the United States. He tested the benefits of the Mediterranean Diet himself and died in Minneapolis few months before turning 101 years old in 2004! This longevity linked to lifestyle and diet was certified in 2017 by Bloomberg. According to Bloomberg Global Health Index, Italy is the place to live if you wish to live long. The Italian boot ranks first out of 163 countries with the healthiest populations worldwide (health index of 93.11 out of 100), considering a few variables like life expectancy, causes of death and hazards for health, calculated on blood pressure, smoke, malnutrition and drinkable water accessibility. This means that Unesco was right when they declared the Mediterranean Diet ‘an intangible cultural heritage of humanity’ in 2010 (2) and acknowledged that the Mediterranean populations (Italy, Spain, Greece, Morocco, and in 2013 also Portugal, Croatia and Cyprus) have knowledge and expertise, use social practices and traditions, good agricultural and ecological practices, from the landscape to the table, including farming, harvesting, fishing, preservation, processing, preparation and consumption of food. The grounds of the Mediterranean Diet remain always fixed while it updates to current lifestyles, to food quality improvements through new processing and preservation technologies, to the application of scientifical knowledge on primary fruit and vegetable production, of breeding farms and secondary processing of food. This model is founded on the respect of food diversity and on their balanced combination, and includes mainly extra virgin olive oil, cereals, fresh and dried fruit, vegetables and moderate amounts of fish, dairy products and meat, with addition of dressings and spices, wine and infusions, always respecting the traditions of every community. While on the one hand scientists all around the world began to study the Mediterranean Diet in the ‘50s last century and they still consider it among the diets that have positive effects on our health, especially when combined with a suitable lifestyle and exercise, the role of the different classes of foods is not clear yet, as some structural foods like meat are excluded from the context of the diet. So it is perceived outside the scientifical field. Some Institutes even exclude meat-based foods from the Mediterranean Diet for a number of reasons (policies of interest, the choice of vegetable foods for ethical and environmental reasons), and confuse the consumers who are little used to deal with technical and scientifical subjects.

THE MEDITERRANEAN DIET DOES NOT RESTRICT ITSELF TO ONLY CONSUMING FEW FOODS

The Mediterranean food model involves the consumption of all foods, no single food or groups of food is predominant in this nutritional model. The effect of the combination of the different nutrients is very important in the diet. And we can’t forget that in the Mediterranean Diet good nutrition is associated with water intake and exercise. In this context the Italian Food Pyramid (3) that represents the basics of the Mediterranean Diet for our Country, is the symbol of healthy and balanced nutrition, the point of reference for the daily choice of nutrients. The pyramid highlights consumption regularity, the nutrients that we take in every day are in the base, the nutrients that we take in once a week are in the tip. The top includes protein-based foods. Meat, cured meats, fish, eggs, milk and dairy products are a source of high-quality proteins, are easily digestible and rich in essential micronutrients like iron, zinc, A vitamin, B12 vitamin, and D vitamin, which guarantee a suitable diet and prevent nutritional deficits. These foods also positively affect growth, cognitive functions, and exercise, above all for children. Moderate consumption is enough, as digestion makes the essential micronutrients easily bioavailable. The cuisine we use in Italy, even everyday cuisine, is often based on these concepts; as you move from the coast to the backcountry or to the north, fish is replaced by meat and cured meats, while milk, dairy products and eggs keep their position. If we go back to the syllogism of the picture, when someone who lives outside our Country hears about the Mediterranean Diet, he goes to the diet of Southern Italy, which is mainly vegetable-based and with large consumption of fish; in fact he will connect it to the Countries that overlook the Mediterranean Sea (the same happens for Spain and Greece, the other refer-

REAL CONSUMPTION AND APPARENT CONSUMPTION OF FISH AND MEAT IN ITALY

In Italy the apparent consumption of fish is approximately 30,9 kg per person per year (2017, source EUMOFA), and comprises preserved and frozen products. Italians are more inclined to eat fresh fish, farmed fish as well; the 25-39 and 40-54 age ranges are the largest consumer. On the other hand, the apparent consumption of meat (cattle, pork, poultry, sheep, goat and rabbits altogether) is around 76.0-77.0 kg per person per year (2019, source ISMEA/ISTAT). Let’s pay attention to the different use of ‘real consumption’ and ‘apparent consumption’ of a food, because the official data report the apparent consumption which can be more easily deduced from the economic data of national supplies. However, the apparent consumption refers to the raw weight: in case of meat, the raw weight is the weight of the carcass and comprises inedible parts like bones, cartilages, fat; in case of fish, it’s the weight of the just fished animal (live weight) and comprises head, fishbone, fins and gills, and entrails. In addition, the apparent consumption includes processing decreases and losses due to spoilage of meat and fish. Real consumption is always an approximate estimate of the edible part of a food, and it’s more difficult to calculate. The real consumption of meat is approximately 38 kg per person per year, fish less that 18 kg per person per year (11). These figures differ from the numbers reported by several sources that mention the apparent consumption to justify the exaggerate consumption of meat and animal proteins in the diet.

ence countries for the Mediterranean diet). Americans are the example, having coined the term ‘Mediterranean Diet’ with reference to a diet that is based only on food and does not consider lifestyle and the cultural traditions that characterize it. According to Mayo Clinic, a respected academic non-profit organization in the USA committed in clinical practice and health assistance, the Mediterranean Diet (4) is a “…healthy nutritional plan. It is based on vegetables and involves the tastes and the traditional cooking methods of the Mediterranean region …Vegetable-based foods, like whole cereals, vegetables, beans, fruit, nuts, seeds, herbs and spices are the grounds of the diet. Butter is replaced with healthy fats, like olive oil and rapeseed oil. Fish, seafood, dairy products and poultry are included with moderation. Red meat and sweets are only occasionally consumed”. It immediately stands out that true Mediterranean people do not consume large amounts of whole cereals, that nuts are quite uncommon and rapeseed oil is never used; in addition, the real consumption of fish as protein-based food is remarkably inferior to meat (see BOX), cured meats, cheese and dairy products. And the Italian cuisine that uses local products has larger consumption of meat or fish within the same region depending on the availability of the two ingredients, if they live near the coast or in the backcountry. Cured meats and cheese are well-known specialities and Italians always have them in the pantry. Even the reference to ‘vegetable-based’ foods is quite unclear and vague. An American who comes to Italy and wishes to taste the Mediterranean gastronomical tradition will eat less pasta than he expects, and will find that pizza is an alternative: in general we eat a portion of pasta at the beginning of the meal (lunch or dinner), but infrequently it’s an abundant dish; pasta can come with sauces that often contain meats and are used as a dressing (like in ragout lasagna), not just with tomato. Bread is white and only seldom it’s made of whole cereals. Meat is always present: it can be a starter with cured meats and local cheese, or a main course. Sometimes fish is proposed alternatively. The Mediterranean Diet has always included the consumption of animal proteins, especially meat and cured meats considering Italy’s vocation for meat processing and preservation since ancient times. Italians limit meat consumption at 450 grams per person a week (which corresponds to an average daily consumption of approximately 65 grams). We are abundantly below the weekly amounts recommended by WHO and IARC, who fix the risk threshold for cancer at a daily consumption of 100 grams per person: this is absolutely natural and in line with the basics of the food pyramid where portions and regularity depend on age, sex and exercise levels. It is true that the quality of meats and dairy products we eat today is much different from the past. In fact animals are fed with balanced and selected fodder which produce leaner meats with unsaturated fatty acids surpassing saturated fatty acids, and with a gradual reduction of salt – maybe not enough yet – in meat- and cured meat-based products. And finally, what would Italian food be without cured meats like ham, cheek lard, bacon, bresaola, salami, mortadella or soppressata, just to name some very popular varieties, the production of which is often regulated by PDO and PGI protocols? The cured meat industry has lived a strong development in Italy and in the Mediterranean Countries, where even the Ancient Romans were used to process and preserve meats. Some specialities date back to the Middle Ages, so they have a very long tra-

dition. Obviously, this means that seasoned and processed meats were popular in the ‘50s last century - when the effects of the Mediterranean diet on health were studied – as they are now. Greengrocer, butcher and cured meat shops have always been close in almost every Italian town.

HUMAN EVOLUTION AND MEDITERRANEAN DIET ARE CONNECTED WITH THE WORLD OF MEATS

The relation between meat and human nutrition has always been the ground for the sustenance; meat and its derivatives have brought many nutritional benefits to our organism, which had a weight on the species’ evolution in physical and cognitive terms. The early men were hunters and pickers, they depended on the environment where they lived for their survival. We can say they were opportunist carnivores because meat was not easy to hunt; when fire was discovered, they learned to cook it and to make it more digestible. When men evolved from nomadic hunters to resident hunters, they learned to practice agriculture and to tame some animal species, to select and breed them for working in the fields, then our ancestors became omnivorous; they had regular food and used animal skins to produce garment and shoes. The need to preserve food drove men to process primary food into preserved food, to protect it from spoiling and to make provisions for less favorable times of the year. They developed many preservation techniques, from seed storage to make flours to the processing of grapes into wine and of olives into oil, from the production of cheese from milk and of cured meats from meat. The products obtained from meats, especially from pork, have always been many: whole pieces produced from anatomical cuts, and sausages, obtained by pressing different parts of pig together and stuffing them in cases obtained from the intestines, with addition of salt and herbs, which were let dry. Salting has such an ancient origin that we can find a description of products similar to sausages and salami even in the Egyptian tombs of the XII century B.C. A first classification of meat preservation techniques based on salting was due to the Ancient Romans, while smoking was of Barbarian influence. The spread of this technical know-how, the abundant availability of salt and the spread of pig farms, opened the way to the production of cured meats on a family basis, and reinforced the idea that the consumption of meat was a fundamental point for a healthy diet. Consumption habits have changed a lot in the following historical periods, lands became poor due to famine and wars ,and there was a clear distinction between social classes. Fresh read meats (mainly from game) were always available on nobles’ tables, while the rural people were used to eat white meat or pork meat (pigs were easily farmed) processed into cured meats, or cheese, only during celebrations. Anyway, the production of local specialities and the farming of native species did not fail in the peninsula. From the XIX century onwards, mechanization applied to the production of preserves enabled to develop an early industry for cured meats, though still tied to craft. We will have to wait until the economic growth of the second post war period for the full development of cattle farming for the production of meat, and for the production of cured meats on industrial basis with better safety and healthy requisites. Animal proteins are now essential, pediatricians suggest them as the ideal food for the growth and the phyco-physical development of children, and for the different stages of life. The history of Italian and of the Mediterranean Countries’ nutrition has always found a reference in animal production which binds it to the cultural tradition of different areas. Farming practices and the different processing techniques played a role in rural development and in its economy. Italy is homeland to many qualitative productions, right thanks to the bond with its lands. Our productions based on the excellence of products with controlled designation of origin, or our typical traditional products, niche production and Slow Food products are recognized especially abroad, and many farming lines have preserved the local characteristics that distinguish them from more general farming. Suffice it to say that Italy boasts the highest number of meat-based PDO and PGI products in Europe: there are 43 protected specialities based on meat (23% of total) (5) and 6 specialities in the category of fresh meats (living animals) and entrails (6), in addition to many hundreds of other regional traditional products that are part of the list of Traditional Agricultural Products completed by the Ministry of Agricultural, Food and Forestry Policies (7). Considering the European Countries that have been acknowledged by UNESCO as owners of the Mediterranean Diet (Italy, Cyprus, Croatia, Greece, Portugal and Spain), we can see that PDO and PGI products that belong to class 1.2 “Meat products (cooked, pickled, smoked, etc.)” [8] are 113 out of 186, equal to more than 60% of the total; the fresh meats recognized in the excellence sphere are 63 out of 153 (Italy has 6), this, means more than 41% (source: EU data bank eAmbrosia [9]). Most of the certified products based on meat come from pork. Many native cattle and pig breeds are farmed from northern to southern Italy (and of other animal species), which represent a unique heritage in historical, social, cultural,

biological and economic terms, and are the result of a long relation between man and the environment. Often these animals are farmed in marginal areas of the Apennines and the islands, where they can live in the wild. Pigs have genetical and breeding characteristics that make their meat particularly precious, as well as the cured meats produced from them. In addition to the popular Cinta Senese (PDO certified), the best known Italian native pig breeds are Nero dei Nebrodi (or Nero Siciliano) and Mora Romagnola. Among the minor breeds, though still refined, there are Nera Casertana and Nero di Calabria; Sardinia has its own native pigs. The former five breeds above are the officially recognized native breeds; ANAS (the national association of pig farmers) has even filed all their genetic profiles in a book to protect the breed. In recent times more than 30 additional breeds or varieties of pigs have been described on the whole Italian territory.

CONCLUSIONS

Even though the Mediterranean Diet is now characterized by a large availability of food which makes us live in good psychophysical conditions despite poor physical exercise (few hours a week maximum), and our lifestyle is not so plain as it was among the postwar Italian people, its grounds remain based on the consumption of bread, pasta, fruit, vegetables, oil and wine. Animal proteins, including meat and cured meats, cheese, eggs and fish are not excluded. Together with longer life expectancy, our time period has witnessed increasing obesity problems, cardiovascular diseases, cancer and type-2 diabetes (bound to overweight conditions). However, the nutritional contribution of meat in a balanced diet can’t be questioned. There is no scientific evidence that these hazardous conditions exclusively depend on the consumption of animal meats and fats. Overweight is not simply caused by the intake of fatty foods; it’s the result of an anomalous energetic balance. The replacement of fats with alternative sources of energy, maybe with a higher intake of carbohydrates, is among the causes of obesity (10). choose leaner cuts and alternate red meats (cattle, lean pork), white meats (poultry, calf) and cured meats. The right amount of meat and cured meats, in line with the rules of the Mediterranean nutritional model that suggests a moderate consumption, has positive effects on our health and wellness, they should never be lacking in any stage of life, especially in growing teenagers and elderly people. The meat industry plunges its roots in the past and often keeps the typical features of the past, uses modern technologies and suitable farming and animal feeding practices to make meats healthier and safer. They are carefully controlled and traceability allows to trace the history of a product from the consumer back to primary agricultural production. Meats and cured meats are an important calling card for anybody visits our Country and wishes to understand the culture of our land, from the Alps to the Apennines. From North to South, the culinary journey will meet products like Bresaola della Valtellina PGI, Speck dell’Alto Adige PGI, Prosciutto di S. Daniele PGI and Prosciutto di Parma PDO, Mortadella Bologna and Mortadella Prato PGI, many salami, Capocollo PDO and Salsiccia PDO produced from Nero di Calabria pigs. Quality meats, in Italy, are always there. 

Meat owns a great value even in little amounts because it’s an important source of proteins, easily digestible essential amino acids and other useful micronutrients, like B-group vitamins (above all B1, niacin and B12) and minerals (like zinc, iron, selenium and copper), more easily bioavailable to the human organism. Cured meats are an alternative to meat in the second course, and due to their content of fats and salts (necessary for their preservation) we can’t exceed with consumption. However, starting from the ‘80s the content of fats has been cut by 30% and polyunsaturated fats (Omega-3 included) have surpassed saturated fats; products with lowered salt content are also available. When we buy a piece of meat, we should

BIBLIOGRAPHY

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Perdite. Milano, Franco Angeli Editore

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