Men's Health

 

The mediterranean diet has saved millions of lives. Was its biggest booster gunned down trying to defend it?

A gray Audi station wagon weaves smoothly along a nameless cliffside road in the Salerno province of southern Italy.

The driver, 56-year-old Angelo Vassallo, is so familiar with the drop-off, centimetres from the edge of the blacktop, that he barely brakes at the rosemary-shrouded corners.

The ripeness and plenty of the late Italian summer is all around: figs, lemons, olives, walnuts, and tomatoes are plump and abundant. By day, baby goats bleat by this roadside; their mothers’ milk is transformed by local farmers into wheels of savoury cheese. Vassallo’s passage sends bits of dry earth skittering thousands of feet down to the Mediterranean Sea below.

At this moment Vassallo himself is in the ripe late summer of his own life. Weathered looking and unassumingly handsome, he wears blue jeans, an open-neck shirt, and slip-on loafers. He is aware of being surrounded by his own personal harvest. This paved road is just one of his achievements as mayor of his town. It leads up to his house, a much larger home than the fisherman’s shack he grew up in. At home waiting are his wife and two grown children. It’s around 10pm on September 5, 2010, and completely dark. As the Audi rounds the second-to-last corner about 100 metres from the house, its headlights illuminate a person standing in the road. Vassallo has to downshift, pull to a stop, and jerk on the hand brake. He probably intends to get out of the car to offer aid, but before he can put both feet on the pavement, the person in front of him pulls the trigger.

At least nine shots are fired. Bullets pierce Vassallo’s heart, cut through his neck, and rip through his head. Spent shells will later be found on the road. The fusillade of bullets leaves nothing to chance. The killer disappears into the darkness. It is hours before a man drives up the road and discovers the cold corpse of his brother, the mayor of Pollica.

When Dr Ancel Keys, set his sights on southern Italy, his intention was not to investigate how one man had died, but to find out why hundreds of people had not.

In 1951, Keys, an American physiologist, was doing research at Oxford University when an Italian colleague told him that many of the working-class men in Naples seemed to be strangely immune to heart disease. Intrigued, Keys decided to set up a makeshift lab in the city to study the men. It turned out that their heart health was better than that of the Minnesota businessmen Keys also studied, men who enjoyed a higher standard of living than the Neapolitans did. The question was why. What was unique about this region that defied all epidemiological expectations?

Keys had some ideas, but he needed proof. So throughout the 1950s and ’60s he traveled the world to collect data on heart-attack frequency and local diets. He eventually completed enough research to support his theory: that what filled the plates of the men in Naples, often dismissedas “poor man’s food” – vegetables, legumes, whole grains, olive oil, and fruit – was in fact the key to southern Italians’ remarkable resistance to heart disease. The resulting “Seven Countries” study made the case for eating the Mediterranean way. The profits from Keys’s bestselling books, including How to Eat Well and Stay Well the Mediterranean Way, made it possible for him to settle in Pollica. He lived there for decades, and his findings gained worldwide fame as the ultimate eating strategy for heart health.

In fact, Keys’s findings are still informing the research of today’s nutrition pioneers, including Dr Walter Willett, a professor of epidemiology and nutrition at Harvard’s school of public health. “While our understanding of saturated fat, cholesterol, and heart disease has become more complex since Keys,” Dr Willett says, “we’ve learned that there are many paths now connecting the benefits of the Mediterranean diet to lower health risks.”

For instance, a 2011 study review from Italy and Greece found that people who followed the diet reduced their risk of metabolic syndrome, a group of conditions linked to heart disease and diabetes. A 12-study review by researchers in Spain linked adherence to the diet with lower risks of developing cancer or dying of it, and other research suggests that it may help ward off prostate and colon cancers. As further affirmation, a study in the Journal of Sexual Medicine found that Mediterranean-style eating habits can help decrease the rate of erectile dysfunction in diabetic men and reverse the condition in obese men.

There’s also the case study of one man: Keys himself. He lived to be 100. Given the renown that Keys brought to Pollica, it’s hard to believe that while the Mediterranean diet was being exported to the rest of the world, life in its place of origin was deteriorating.

By the 1990s, corruption, pollution, and the speed of modern life had transformed Pollica. It was run-down. The anchovies – alici to the locals – that formed one of the pillars of the region’s diet still lived in the Mediterranean, but now they were bathed in raw sewage and swam amid the garbage tossed from the tourist boats and yachts that plied the waters off Positano, to the north. The region was no longer self-sustaining, and young people were moving away from the farms to find work in the cities. Those who did stay abandoned the food of their ancestors, succumbing to the lure of factory-made, processed products that were ruining diets and expanding waistlines throughout the Western world. And this deterioration of healthy eating was not unique to the Pollica area: the U.N.’s Food and Agriculture Organization reported in 2008 that the Mediterranean diet was becoming less popular in its home region, and that people there were becoming fatter as a result. In fact, more than half of Italy’s residents were found to be overweight.

When Angelo Vassallo was elected in 1995 to the first of his four terms as mayor of Pollica, he vowed to resurrect the town’s heritage of healthy eating. “For Angelo, everything had to be balanced,” recalls his brother Dario, a dermatologist in Rome who organised the Angelo Vassallo Foundation in his brother’s memory and who has written a book about his life. “If one rope is too long, the net will not fish. He tried to bring this idea of balance into the town’s politics. He was about the middle. If you walk on one side, you start leaning and you get scoliosis. He was also a righteous man. He practiced a different sort of politics, not in the town hall, but on the streets.”

Vassallo’s first step was to install infrastructure that would stop sewage from flowing into the sea he had been fishing in since childhood. He later transformed the port area into a pedestrian piazza, where small shops and restaurants provided jobs, sold local produce, and served up healthy Mediterranean meals.

This led to the installation of a massive public kitchen in a nearby 13th-century castle, a place where local cooks could teach those recipes to visitors. Vassallo also presided over the opening of the Ancel Keys Living Museum of the Mediterranean Diet.

But he wasn’t just turning the area into a Disney World for locavores. Vassallo’s ultimate goal was to restore the professional standing of the region’s artisanal food producers, and with it the market for their goods, says Mariacarmela DiFeo, a local cheesemaker. “People in our area aren’t into the philosophy of living to make money, and he understood that. He made it sustainable.” Vassallo was heavily involved with the Italian branch of Cittaslow International, an organization dedicated to the green community and local food agenda. Through his activism, agronomists came to Pollica and taught farmers how to grow food without using pesticides.

One of the beneficiaries was the local cooperative; its olive oil was eventually certified biologico, or organic.

“The Cittaslow philosophy teaches us that the environment is not ours but everyone’s, and that agriculture has great social responsibilities,” says Marioantonio Marrocco, controller of the cooperative’s olive oil production. The cooperative has also been able to guarantee small farmers a living for the first time. Take that, international agri-business. Before Vassallo’s efforts, Marrocco says, “ Small farming was considered an occupation for poor people. There was no dignity in it. Now there is. It has become a source of pride, and we see young people coming back.”

As Vassallo’s clean-up efforts became known beyond the region, people again found reasons to visit the town of Pollica. As mayor, Vassallo worked closely for more than a decade with Legambiente Turismo, an organisation that promotes environmentally friendly tourism.

The group gave the town its highest award while Vassallo was in office. Through Cittaslow, the mayor interacted with larger towns in the Mediterranean region as well as with China, proselytising for his region and its products and healthy lifestyle.

He invited Chinese representatives to travel to Pollica to learn about local olive oil production methods and the Mediterranean diet. “They knew him in China,” says Dario Vassallo. “They called it the Angelo Vassallo development model.”

The mayor even lobbied UNESCO to give his beloved Mediterranean diet a cultural heritage designation.

Vassallo had a grand vision – but bringing it to reality meant overcoming a lot of obstacles. The apathy that had overtaken Pollica was difficult enough to contend with, but Vassallo also faced a powerful culture of corruption.

When the contractor hired to build the port extension did a shoddy job and overbilled the town, Vassallo bucked the local trend of simply turning a blind eye. He sued, and the contractor was forced to return more than a million euros. When the mayor learned that road contractors had been paid 500 000 euros for doing 150 000 euros’ worth of work and then failing to finish the job, he took them to court too.
And while these improvements dramatically increased tourism in the town, they also attracted criminal elements from the Mafiainfested areas near Naples. Maybe the criminals didn’t approve of all that the activist mayor hoped to accomplish.

In the summer of 2010, Vassallo shuttered a bustling seaside disco that had been catering to drug users, complaining that the port was “a world apart” during the summer and that the local police had lost control. That night, the mayor told Dario, “I went up to a drug dealer and said, ‘Leave or I’ll break your legs.’” Several days after the beach confrontation, Angelo Vassallo drove the winding Cliffside road to his house for the last time.

Six months after Vassallo’s death, the Pollica community gathered to honour the town’s first new mayor in 16 years. The scene on this warm May evening was more memorial service than inaugural celebration; sun-baked fishermen sobbed openly. As church bells tolled six, all eyes turned toward the Saracen tower. Three men unfurled a massive poster of Vassallo, shown draped with the official green, white, and red sash of the Italian nation. He had been photographed standing at the edge of the sea, holding aloft a wine glass of clean seawater, a fitting pose for the man the Italian press had taken to calling il sindaco pescatore, the fisherman mayor.

Vassallo would often urge his fellow fishermen to haul in and recycle the garbage they pulled up in their nets, instead of simply pitching the trash back into the sea. The fishermen scoffed, but after he died they initiated a program to do just that in his honour. Now six Pollica fishing boats return daily to port with their catch – along with about 136 kilograms of garbage, which is then sorted into the various portside recycling bins. But perhaps the greatest recognition of the mayor’s efforts came two months after his death.

As a result of his persistent petitioning, UNESCO added the Mediterranean diet to its Representative List of the Intangible Cultural Heritage of Humanity, a recognition of its economic and social value to other countries and future generations.

The new mayor, Stefano Pisani, made his rounds among the mourners, alternately accepting congratulations and consoling the crowd. Antonio DiMatteo, one of Vassallo’s lifelong fisherman buddies, stood quietly off to the side. Sorrow and resignation were etched equally on his round, sunburned face. His friend’s murderer had still not been caught; Vassallo’s work remains unfinished. “Life is filled with injustices,” DiMatteo said quietly. “We just have to wait.”