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When it comes to weight, it's clear the Italians know something we don't. According to the International Association for the Study of Obesity, just 9% of people in Italy are heavy enough to be considered obese, compared to 32% of Americans. It's not that Americans are unfamiliar with Italian food.

In Italian restaurants across the country, Americans enjoy heaping plates of spaghetti and meatballs, pasta smothered in Alfredo sauce, and slabs of buttery, cheese-coated garlic bread. Italian food is tied with Mexican as the most popular ethnic food in the U.S., and is served regularly in American homes, according to market research firm NPD Group in its 21st Annual "Eating Patterns in America" report. But is the Italian food we know and love in the U.S. the same food people eat in Italy?

Far from it, experts say. So forget everything you think you know about Italian cooking. Here's the real story behind this healthy cuisine.

Not just pizza and pasta. In Italy, pasta is never intended to be an entire meal, says Susan McKenna Grant, author of Piano Piano Pieno: Authentic Food From a Tuscan Farm. Instead, it's eaten as a small first course, and either preceded by an antipasto -- salami, olives, and maybe some crostini (small, thin slices of toast with toppings such as olive oil, garlic, and diced tomatoes), or followed by a "secondo" -- meat, fish, or even a plate of fresh, seasonable vegetables, such as grilled mushrooms or asparagus -- or both. Fresh, seasonal vegetables -- not pasta -- are the mainstay of Italian food.

Lighter fare. American portions of Italian food are much larger than those in Italy, agrees Eldo E. Frezza, MD, chief of general surgery and director of the Bariatric Weight Loss Center at Texas Tech University Health Science Center, and author of Slim the Italian Way. The sauces here are much heavier, too, nearly drowning the pasta instead of simply enhancing its flavor. Italians do eat American favorites like meat sauce and Alfredo sauce, but during a normal week, most pasta dishes are served in a light sauce with basil or a small amount of meat.

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