Who in the world doesn’t know Italy is shaped like a boot?

The oldest Gen Zers, maybe. Or should I say probably?

They attended elementary school at a time when the teaching of world geography was deemphasized or even eliminated. School districts were doubling up on math and reading instruction because the No Child Left Behind Act of 2001 now tied federal Title I funding to the districts achieving what Uncle Sam deemed to be AYP, adequate yearly progress, in standardized test scores in both subjects.

Despite legions of detractors who argued this led to “teaching to the test” and something far less than real learning, the law remained in place for the next 14 years.

Now I did not pose the opening question to lay the foundation for a rant about this ill-conceived legislation and its subsequent ramifications, but simply because the sea surrounding the Boot is called the Mediterranean. And that word’s also used to denote the rather healthy way Italians and others in that region eat.

Or at least the way they used to.

For two separate studies have reached the same conclusion. That Italians have given the Mediterranean diet the boot.

In the study published by Frontiers in Nutrition in February 2024, researchers had 3,732 Italian adults between the ages of 17 and 40 (87.7 percent of whom were female) complete a self-administered questionnaire to determine if they did indeed follow the Mediterranean diet. It’s a way of eating that features “a high intake of vegetables, fruits and nuts, cereals (especially whole-grain cereals), legumes, and olive oil; a moderate-to-high intake of fish; a low-to-moderate intake of dairy products; a low intake of saturated fats, meat and poultry; and a moderate intake of wine.”

After analyzing the questionnaires, the researchers found that only 4.85 percent of participants had a “high” adherence to the Mediterranean diet. (FYI: That percentage includes vegetarians and vegans even though it probably shouldn’t.)

As a result, the researchers suggest it may be necessary “to implement tailored public health intervention strategies to improve food habits” in Italy.

A second study published in the International Journal of Food Sciences and Nutrition, also in February 2024, had 10,916 Italian adults answer the Medi-Lite questionnaire, a validated, nine-item literature-based tool specifically designed to assess an individual’s adherence to the Mediterranean diet. These results uncovered a “significant decline” in the “adherence level” to the diet from 2019 to 2022 due in large part to “an overconsumption of fresh red meat, cheese and poultry” and “an underconsumption of vegetables, bread, legumes, and milk and dairy products.”

In a recent review about this change in Italy’s eating habits, Domenico Praticò, M.D., a professor at Temple University’s Lewis Katz School Of Medicine, dubs it the “Mediterranean diet paradox.” Praticò does so because Italians are moving away from this healthy eating pattern and eating more like the typical American even though the rest of the world, including America, now recognizes the Mediterranean diet as “one of the healthiest dietary patterns available” and more in the world are now following it.

Now whether or not you’re following the Mediterranean diet is not really at question here. Neither is the one posed in today’s title, “Is what’s happening in Italy happening to you?”

Instead, the $64,000 question on this never-ending game show called “Your Health & Well Being,” is “Do you continue to experiment with the healthy things you already do to make them even healthier?”

Because isn’t the real goal of every day you’re on this Earth to get — in some way shape or form — just that little bit better?

While you ponder all that, consider one more study involving the Mediterranean diet that illustrates the benefit of making the already healthy even healthier. Published in the August 2025 issue of Annals of Internal Medicine, researchers had 4,746 adults between ages 55 and 75, all of whom had overweight or obesity and metabolic syndrome (but not diabetes or cardiovascular disease), follow one of two lifestyle patterns.

One group, as noted in a summary of the study by Science Daily, followed a calorie-reduced Mediterranean diet (about 600 fewer calories per day), added moderate physical activity to their weekly schedules (a combination of brisk walking, strength and balance training), and received professional guidance as to how to do the latter. The other group followed a traditional Mediterranean diet without calorie restriction and didn’t receive any exercise advice.

At a final checkup six years later, those in the lower-calorie Mediterranean diet group were on average 7.3 pounds lighter than when the study began. And their waists had a shrunk a collective 1.4 inches.

Just as importantly, they were 31 percent less likely to have developed type 2 diabetes when compared to those eating the traditional Mediterranean diet — even though that group still lost an average of 3.7 pounds and 0.1 inches from their waists during the same time frame.