Big. That's how many Italians sum up their impressions of the US -- from the Grand Canyon to the jumbo burgers to the backsides.
But Italians no longer have to cross an ocean to gape at flab.
This country of the good-for-your-waistline Mediterranean diet has somehow produced a generation of chubby children -- among Europe's fattest -- who have doctors worried about the nation's health future.
"In the 20 years of my practice, the number of overweight and obese children has increased enormously," said Andrea Vania, a pediatric nutritionist in Rome.
He said he sees patients as young as 5 with weight problems. "We never used to see this."
Curiously, southern European children in general are far chubbier than their counterparts in the north, whose traditional diets are fatty ones.
Experts say the blame for the extra kilos is twofold.
Not only have Southern Europeans increasingly abandoned traditional diets rich in vegetables, fruits and grains for fatty ones, but also indulgent parents are letting children lead some of the most sedentary lifestyles in Western Europe.
"You [Americans] colonized us. Italian children don't follow the Mediterranean diet any more," said Margherita Caroli, an expert in pediatrics and diet and a member of the European Child Obesity Task Force.
While calories are mounting, calorie-burning is not.
"Italian mammas coddle their children," said Caroli, who is based in southern Italy.
Italian youngsters of a generation ago whiled away the hours kicking soccer balls. Now they're being enrolled by their parents in computer courses or English lessons.
And while grandparents might have walked children to school a few decades back when cars were scarce in postwar Italy, students these days are driven to school, or, if they're old enough, zip there on their own motorscooters.
Surveys of European young-sters' daily physical activity have found that Italian and Portuguese children are the least active, said Laura Rossi, a researcher at Italy's national nutrition institute INRAN.
Italians are eating more meat and moving away from Mediterranean staples such as pasta, rice and barley.
In the years right after World War II, many Italians went hungry and "meat was seen as a luxury that was good for you," Rossi said.
The notion still sticks. The first question many Italian mothers ask their children after school is, "Did you eat your meat today?"
Children's midmorning snacks used to be simple foods, like focaccia, a kind of chewy bread. Jumbo bags of greasy potato chips are the current playground status-symbol.
Thirty-six percent of Italian children aged 6 to 11 are overweight, compared with 34 percent in Spain, 31 percent in Greece, 20 percent in England, 15 percent in Denmark and 13 percent in Finland, said Caroli.
She was citing figures compiled by pediatric and nutrition experts over the past five years in the European nations and furnished to the task force for a study to be published soon.
Vania "prescribes" activity and dietary changes for his young patients, among them Azzurra Cariola, who was 10 years old and 57kg when she asked her mother to take her to a doctor.
"The kids made fun of me. They called me `fatso,"' said Azzurra, now 14, in high school and no longer overweight.
Her mother, Anna Maria D'Angelo, said Azzurra used to wolf down cookies when at friends' homes. D'Angelo quit preparing traditional vegetable dishes for her family because she was the only one who would eat them.
Vania said many parents resist the label of overweight for their children.
"Children with a little bit of fat on them are considered cute and healthy," said Vania, who practices in a country where the command "Mangia!" (Eat!) is often equated with maternal love.
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