French Paradox Explained

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The French population has been reported to have a relatively low rate of coronary artery disease (CAD) despite eating lots of cheese, croissants, and liver pate and having blood lipid levels similar to other Westernized countries.

Much has been made of this seeming paradox by the U.S. media. However, the unusually low rate of CAD now appears to be more myth than paradox. According to British cardiologist Hugh Tunstall-Pedoe, who did an exhaustive analysis of the WHO mortality data, “The truth is not that heart disease is less prevalent among the French, but that many deaths from heart attacks simply aren’t reported that way”. It turns out that the French have an unusually high death rate from “sudden death” that is not further classified. According to Dr. Tunstell-Pedoe “when French heart disease statistics are adjusted to take into account this discrepancy, the incidence of cardiovascular disease (CVD) mortality is not much different from other Westernized nations.”

The French, the highest wine consumers among Westernized nations, may receive some protection from their consumption of red wine. As we have seen, much of the beneficial effect of red wine is probably the result of the alcohol itself. However, there is some evidence that phenolic compounds in red wine may reduce LDL oxidation.There is also evidence that red but not white wine improves blood flow to the heart by causing vasodilation of small blood vessels. It is interesting to note that several glasses of purple grape juice can also produce similar effects but with all that extra sugar, you may see a modest increase of cholesterol and triglycerides.

The French have a very high incidence of cirrhosis of the liver. Alcohol also is the cause of many accidents and increases the risk for several types of cancer so a recommendation to consume more wine is questionable.
A sure and safer way to reduce the risk of CVD and overall morbidity and mortality is to reduce saturated fat and cholesterol intake and consume more soluble fiber-rich foods. A more vegetarian diet with more beans in place of meat and poultry appears ideal for lowering cholesterol and decreasing CAD. In addition, an increased intake of phenolic compounds from fruits and vegetables has also been shown to reduce the risk of CAD, probably because consumption of fruits and vegetables increases the plasma antioxidant capacity in humans.
(Excerpted from our upcoming diet and heart disease CPE course.)

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