Doctor's Review: Medicine on the Move

January 24, 2022
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Balsamico Belissimo!


In 16th-century Italy, aceto balsamico was a gift presented from one esteemed duke to another; barrels containing the prized delicacy could be found in palaces and castles across the country. Eventually, balsamico became an everyday condiment made by families who nurtured their supply over several generations. Each recipe was as unique as the family and the region they lived in. Balsamico was indeed a valued commodity and a very different substance from the balsamic vinegar found on local supermarket shelves today. Only recently has traditional balsamic become a commercial product.

We learned all about aceto balsamico tradizionale on a recent trip, organized by Oldways Preservation and Exchange Trust, to Modena, in the heart of the region of Emilia Romagna. This area is famous for providing the world with Parmigiano Reggiano, a Parmesan cheese, Prosciutto di Parma, sports cars (Ferrari and Maserati) and even Pavarotti, who was born in Modena.

Aceto balsamico tradizionale is still made at facilities known as acetaias. It's prepared as it was in the days of the dukes of the Este family -- rulers who believed it was a potion that could fight off plagues. At Acetaia Malpighi, the family tradition of making balsamic dates back five generations to the 1850s. Ermes Malpighi, now in his early 50s, runs the family business which produces 10,000 bottles each year. As he escorted us through the property, showing us the elaborate steps involved, we could see the pride he takes in producing his supply of balsamico.

Authentic balsamic begins with cooking ripe, sweet, unfermented grapes. Trebbiano is a standard grape that's used with other varietals added, depending on the producer. At Acetaia Malpighi, lambrusco is added, a grape normally used for sparkling reds, and only certain producers of balsamico like to add it. Other Modenese producers may include grapes like Ancellotta, Sauvignon and Sgavetta, all of which are cultivated in the province of Modena.

This "must," as the grape juice is called, is then reduced (without any additives) in an open pot over a direct flame for about 24 hours. Once the concentrate has settled it's transferred to a series or "battery" of barrels for fermentation. The first fermentation takes place in the largest barrel for about two to three years, during which time evaporation occurs. In the autumn, some of the fermented mixture is taken from the smallest barrel or "queen" for bottling.

The queen is then topped off with a small amount of the fermented must decanted from the slightly larger barrel in the battery. The process continues each autumn as the must is moved to progressively smaller barrels made from various kinds of wood (oak, cherry, mulberry and juniper), which contribute to the flavour of the finished product. It can take anywhere from 12 to 25 years for the complete fermentation to take place; 25 years will produce a bottle of "extra vecchio," or the extra-old variety.

Acetaia Malpighi is an active member of the Consortium of the Producers of Traditional Balsamic Vinegar of Modena. This group works together to guarantee that all products are made using age-old techniques. They've recently been granted denomination of a controlled origin (DOC), which appears on the bottle's label. In order to qualify, a balsamic must undergo a rigorous process. A panel of master tasters -- who must be involved in at least 80 tastings a year to obtain their title -- examines each sample with painstaking attention to detail and uses specific criteria.

Real balsamic has an amber or caramel colour and has an almost syrupy or molasses-like consistency. Unlike imitations, it should have a rich, complex taste -- a balance of sweet and sour. The older the vinegar, the more intense the flavour. If it meets the special criteria, it's then labelled as a 12-year or 25-year-old product, depending on the score.

The process is a far cry from how industrial balsamic vinegar is made. Some are quickly fermented using low-quality ingredients, which leads to a tart and vinegary liquid. Sugar and caramel colouring are sometimes added to obtain the look of the real thing. It's easy to see why many people who've tried a balsamic, puckered up and wondered what all the fuss was about.

But the real stuff doesn't come cheap. In Italy, a traditional 12-year-old 100-ml bottle with a DOC can cost around $50, while the 25-year-old can cost $80. If you're looking for an everyday balsamic, there's a variety of traditionally made products that haven't been aged but are affordable and quite tasty. While it may seem that a higher price means greater quality, it's often not the case. Fancy bottles bearing high price tags and a promise of aging can contain industrial vinegars like those that come in litre containers and cost just a few dollars.

For an affordable bottle that you don't have to ration, visit your local specialty food shop and ask a knowledgeable employee for some guidance. If price is no object, then the best product to purchase is one with a DOC label. But as most consumers do have a budget, the DOC balsamico can be saved for special occasions. Only a drop or two is needed to make a dazzling salad. For everyday use, a more economical product makes sense. Look for a vinegar that has been made in the traditional way, using the must, but also mixed with wine vinegar. The greater the percentage of must, the more pleasing the product. Essentially, it's buyer beware, since without the DOC label, price isn't an indication of quality; some bottles labelled as balsamic may simply be wine vinegars. If you decide to invest in the real thing, you can enjoy balsamic in a number of ways.


Here's a trio of recipes that highlight balsamico. If you elect to use an aged traditional product, simply cut down on the amounts called for in the recipe.

An intensely flavoured sauce that's simple to make.

1 medium head of garlic
2 tablespoons (25 ml) extra-virgin olive oil
2 pounds (900 g) plum tomatoes, quartered (about 10-12 tomatoes)
2 tablespoons (25 ml) balsamic vinegar
Salt and fresh ground pepper
Fresh basil leaves for garnish
1 pound (500 g ) spaghetti
1/3 cup freshly grated Parmesan cheese
Preheat oven to 450oF/230oC.
Serves four to six.

Cut top off the head of garlic. Remove any loose skins. Place garlic, head-side up, in a piece of aluminum foil. Sprinkle with 1 tsp/5 ml olive oil. Wrap and bake in oven about 40 minutes. Remove from oven, unwrap and allow to cool. In the meantime, place tomato quarters in a 3-litre baking dish; sprinkle with 2 tsp/10 ml olive oil; place in oven and roast 40 minutes. Remove from oven. During the last few minutes of vegetable roasting, cook spaghetti according to package instructions.

Place tomatoes in bowl of food processor. Squeeze garlic from cloves into the bowl; add remaining tablespoon of olive oil and the balsamic vinegar and purée the mixture until smooth. Season with salt and fresh ground pepper. Remove from food processor and keep warm if using immediately. Otherwise refrigerate and heat up when ready to use. Serve warm and tossed with spaghetti. Garnish with fresh grated Parmigiano Reggiano and basil.

This recipe works well with a variety of fish, including halibut, salmon and swordfish.

1 tblsp (15 ml) extra-virgin olive oil
1 large onion, thinly sliced
1 teaspoon (5 ml) sugar
1/3 cup (75 ml) orange juice
1/4 cup (50 ml) balsamic vinegar
4 fish fillets, each about 6 ounces/150 g
Extra-virgin olive oil to brush fish
Salt and fresh ground pepper

To prepare onions, heat the olive oil in a heavy skillet over a medium-high heat. Add onions and sauté until translucent, about 10 minutes. Add sugar and stir through. Turn heat down to medium and continue to cook another 5 minutes, stirring occasionally. Add orange juice and vinegar; stir through. Continue cooking until the mixture evaporates. Season with salt and pepper. Meanwhile preheat grill. Grill fish brushed with olive oil until cooked through. Serve fish topped with caramelized onions. Serves four.

For a variation, serve these berries over vanilla frozen yogurt or ice cream.

3 cups (750 ml) fresh strawberries, sliced
2 tblsp (25 ml) balsamic vinegar
Sugar, to taste

Toss strawberries with balsamic vinegar. Season with sugar if necessary and serve. Serves four.


This article was accurate when it was published. Please confirm rates and details directly with the companies in question.


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