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Ciao'ing Down in Florence
By Judith J. Wurtman, PhD,
Co-Author of The Serotonin Power Diet: Eat Carbs -- Nature's Own Appetite Suppressant -- to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain

The first course, a pasta dish, arrived and my husband and I looked at each other in surprise. There couldn't have been more than a cup of skinny spaghetti on the small, salad-size plate. The waiter came over, sprinkled some freshly grated cheese on the sauce and left us to enjoy the first course of our first meal in Florence. We looked at each other and laughed. "I guess we both forgot what normal size portions look like," I said. Neither of us had been in this beautiful Italian city for decades, and after a day of exploring the streets and museums on foot, we were hungry. We were eager to sample the varieties of pasta and seasonal vegetables recommended by our guide books and made our way to a neighborhood restaurant suggested by a friend. Normally, we would have ordered only one course but the second courses (what Americans would call the entrées) looked too tempting to pass up. My husband ordered an eggplant dish with tomatoes and all sorts of wonderful herbs and I had the seasonal specialty of porcini mushrooms poached in a flavorful broth. 

Like the pasta dish, our second courses were also small and easily fit on a salad plate. Chewy slices of bread were on the table but no butter and no olive oil for dunking. We decided to split a dessert, assuming it would be too big for one person. It was tiny, a sliver of intensely rich chocolate cake. The plate on which it sat was even smaller, about the size of a saucer.

As we walked back to the hotel, stuffed and happy, we compared this meal to the typical meal we would have eaten at an American-Italian restaurant. A saucer of olive oil would be on the table so bread could be dunked (at about 100 calories a dunk), the pasta portion would be large enough to feed a family of five, and the "main course" would consist of eight or more ounces of protein. Were there any Italian restaurants that would have offered poached mushrooms, or eggplant and tomatoes, as the main course? And could the restaurant have gotten away with serving a dessert that was only a taste?

Most of the people we saw on the streets during our earlier hours of walking were thin. This was confirmed by clothing sizes in the stores. It was hard to find men's pants in sizes over 38-40 and women's clothes on the racks rarely went above American size 12 or 14. Yet here was a population that ate lots of carbohydrates. They enjoyed not only pasta but also rice and polenta (corn meal) and bread. Indeed as an Italian friend told me, "A meal without carbohydrates is not considered a meal."

Here in the states we have been told, over and over again, by self-appointed weight loss experts that carbohydrates will make you fat and avoiding them will make you thin. And yet we Americans are growing more obese by the minute. The years of avoiding carbohydrates in the interest of weight loss has done nothing but make us fatter.

How do we make sense of this? Look at the meal we were served. Carbohydrates were the first course. They were served with only small amounts of fat from the cheese so we digested them pretty rapidly. While we were waiting for our second course, our brain was busy making serotonin, the brain chemical which not only turns on a good mood but also shuts off appetite. The small second course was perfectly adequate because we were not very hungry by the time it had arrived. The serotonin was working to diminish our need to eat. And the dessert was just a taste treat, something to compliment the intense flavor of the small cups of espresso we drank along with it. 

The portion sizes were normal, at least normal for anyone not living in the U.S. We looked around at the other diners and every course we saw being served was just as small. We have grown so used to absurdly large portion sizes in our country that we forget how inappropriate they are. Rather than convincing us to accept smaller portions, many restaurants, especially fast-food chains, lure customers by offering enormous portion sizes.

We will never stop gaining weight as a country and start to lose it until we are willing to change our perceptions of what is normal food intake. We will never stop overeating until we are willing to give up the notion that eating lots of protein and avoiding carbohydrates will make us thin. Unfortunately, we can't all go to Florence and experience first-hand what it is like to eat extremely good food served in small portions. But we can follow the food customs: Start a meal with carbohydrate and follow it with a small portion of protein or vegetables. And who knows, the money you save on food may pay for a trip to Italy.

©2009 Judith J. Wurtman, PhD, co-author of The Serotonin Power Diet: Eat Carbs -- Nature's Own Appetite Suppressant -- to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain

Author Bios
Judith J. Wurtman, PhD, co-author of The Serotonin Power Diet: Eat Carbs -- Nature's Own Appetite Suppressant -- to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, has discovered the connection between carbohydrate craving, serotonin, and emotional well-being in her MIT clinical studies. She received her PhD from George Washington University, is the founder of a Harvard University hospital weight-loss facility and counsels private weight management clients. She has written five books, including The Serotonin Solution, and more than 40 peer-reviewed articles for professional publications. She lives in Miami Beach, Florida.

Nina T. Frusztajer, MD, co-author of The Serotonin Power Diet: Eat Carbs -- Nature's Own Appetite Suppressant -- to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, counsels private weight management clients and is a practicing physician and certified professional life coach. She received her master’s degree in Nutrition from Columbia University and her medical degree from George Washington University. She lives in Boston, MA.

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