Personally, I find American food too greasy - for instance, vegetables are served swimming in butter. I end up tilting the plate so all the butter collects on one side, and eat the vegetables clinging to the other end - not very elegant but it works. In Italy vegetables are prepared with almost no butter and taste better, in my opinion.
I lived in Colorado for a few years and vacation in Northern California every summer but the area I know really well is Washington. There, seafood, Vietnamese and Japanese restaurants are great , but Italian ones are not. They smother everything in oregano, which kills all other flavors.
But Maryland crab cakes are to die for. Just thinking of them gets me salivating like Pavlov's dog.