French paradox

Source: Wikipedia, the free encyclopedia.

Cheese, like this Brie de Meaux, is high in saturated fats, and is a popular food in French cuisine.

The French paradox is an apparently paradoxical

widely held belief that the high consumption of such fats is a risk factor for CHD
. The paradox is that if the thesis linking saturated fats to CHD is valid, the French ought to have a higher rate of CHD than comparable countries where the per capita consumption of such fats is lower.

It has also been suggested that the French paradox is an illusion, created in part by differences in the way that French authorities collect health statistics, as compared to other countries, and in part by the long-term effects, in the coronary health of French citizens, of changes in dietary patterns that were adopted years earlier.[2]

Identifying and quantifying the French paradox

In 1991, Serge Renaud, a scientist from

Bordeaux University, France—considered today the father of the phrase—presented the results of his scientific study into the term and actual scientific data behind the perception of the phrase.[3] This was followed by a public documentary broadcast on the American CBS News television channel, 60 Minutes
.

In 1991, Renaud extended his studies in partnership with then junior researchers,

omega-3 oils, antioxidants and includes "moderate consumption" of red wine) created lower cases of cancer, myocardial infarction and cardiovascular disease; partly through increasing HDL cholesterol whilst reducing LDL cholesterol.[3]

Statistical illusion hypothesis

In 1999, Malcolm Law and Nicholas Wald published a study in the

British Medical Journal,[2] using data from a 1994 study of alcohol
and diet to explain how the French paradox might actually be an illusion, caused by two statistical distortions.

First, Law and Wald attributed about 20% of the difference in the observed rates of CHD between France and the United Kingdom to the under-certification of CHD in France, relative to the UK.[2][4]

Second, Law and Wald presented a time-lag hypothesis: if there were a delay in serum cholesterol concentrations increasing and a subsequent increase in

ischaemic heart disease mortality, then the current rate of mortality from CHD is more likely to be linked to past levels of serum cholesterol and fat consumption than to current serum cholesterol levels and patterns of fat consumption. They wrote,[2]

We propose that the difference is due to the time lag between increases in consumption of animal fat and serum cholesterol concentrations and the resulting increase in mortality from heart disease—similar to the recognised time lag between smoking and lung cancer. Consumption of animal fat and serum cholesterol concentrations increased only recently in France but did so decades ago in Britain.

Evidence supports this explanation: mortality from heart disease across countries, including France, correlates strongly with levels of animal fat consumption and serum cholesterol in the past (30 years ago) but only weakly to recent levels. Based on past levels, mortality data for France are not discrepant

In addition, the French population has become increasingly overweight. A study published by the

French Institute of Health and Medical Research (INSERM) revealed an increase in obesity from 8.5% in 1997 to 14.5% in 2009, with women showing a greater tendency toward obesity than men.[5]

Impact

Cultural impact

The overall impact of the popular perception, in the English-speaking world, that the French paradox is a real phenomenon, has been to give added credibility to health claims associated with specific French dietary practices.

This was seen most dramatically when, in 1991, an early account of the then-novel concept of the French paradox was aired in the United States on

health food."[7]

The cultural impact of the French paradox can be seen in the large number of book titles in the diet-and-health field that purport to give the reader access to the secrets behind the paradox:

  • The Fat Fallacy: The French Diet Secrets to Permanent Weight Loss (William Clower, 2003);
  • The French Don't Diet Plan: 10 Simple Steps to Stay Thin for Life (William Clower, 2006)
  • French Women Don't Get Fat (Mireille Guiliano, 2004, which became a #1 best-seller in 2006)
  • Cholesterol and The French Paradox (Frank Cooper, 2009);
  • The French Women Don't Get Fat Cookbook (Mireille Guiliano, 2010).

Other books sought to boost their credibility by reference to the French paradox. The American edition of The Dukan Diet, written by Pierre Dukan, a Paris-based doctor, is marketed with the subtitle, "The real reason the French stay thin".

Scientific impact

The existence of the French paradox has caused some researchers[who?] to speculate that the link between dietary consumption of saturated fats and coronary heart disease might not be as strong as had previously been thought. This has resulted in a review of the earlier studies that suggested this link.

Some researchers[who?] have thrown into question the entire claimed connection between natural saturated fat consumption and cardiovascular disease. In 2006, this view received some indirect support from the results of the Nurses' Health Study run by the Women's Health Initiative. After accumulating approximately 8 years of data on the diet and health of 49,000 post-menopausal American women, the researchers found that the balance of saturated versus unsaturated fats did not appear to affect heart disease risk, whereas the consumption of trans fat was associated with significantly increased risk of cardiovascular disease.[8]

Similarly, the authors of a 2009 review of dietary studies concluded that there was insufficient evidence to establish a causal link between consumption of saturated fats and coronary heart disease risk.[9]

Possible explanations

Explanations based on the high per capita consumption of red wine in France

It has been suggested that France's high red wine consumption is a primary factor in the trend. This hypothesis was expounded in a 60 Minutes broadcast in 1991.[10] The program catalysed a large increase in North American demand for red wines from around the world. It is believed that one of the components of red wine potentially related to this effect is resveratrol;[11] however, the authors of a 2003 study concluded that the amount of resveratrol absorbed by drinkers of red wine is small enough that it is unlikely to explain the paradox.[12]

Red wine was considered a possible explanation, but proved unlikely to explain the paradox.

Explanations based on multiple factors

In "Lifestyle in France and the United States" (2010), one study reviewed identifies three major factors likely to be involved in the paradox:

  • Walking (On average, French people walk briskly much more often than Americans.)
  • Water (On average, French people drink more water and fewer sweetened drinks than Americans.)
  • Fruit and vegetables (On average, French people consume more fresh fruits and vegetables than Americans do.)[13]
Extra virgin olive oil and baguette
, often considered a symbol of French culture

In his 2003 book, The Fat Fallacy: The French Diet Secrets to Permanent Weight Loss, Will Clower suggests the French paradox may be narrowed down to a few key factors, namely:

Clower tends to downplay the common beliefs that wine consumption and smoking are greatly responsible for the French paradox. While a higher percentage of French people smoke, this is not greatly higher than the U.S. (35% in France vs. 25% in U.S.) and is unlikely to account for the weight difference between countries.

Mireille Guiliano, author of the 2006 bestseller French Women Don't Get Fat,[14] agrees that the weight differences are not due to French smoking habits. She points out that the smoking rates for women in France and the U.S. are virtually identical.[15] Guiliano suggests that the key factors are:

  • Smaller portion sizes: – she advocates the 50% rule, i.e. asking for half of whatever food one is offered, "la moitié, s'il vous plaît" in French[16]
  • Savoring food to increase the feeling of satisfaction, choosing a small amount of high quality food rather than larger amounts of low quality food
  • Eating 3 meals a day and not snacking
  • Taking in plenty of liquid such as water, herbal tea and soup
  • Sitting down and eating mindfully (no multitasking and eating while standing up, watching TV, or reading)
  • Emphasizing freshness, variety, balance, and, above all, pleasure
    promotion?
    ]

Early life nutrition

One proposed explanation of the French paradox regards possible effects (

Boer War). It has been suggested that the particular timing of this historical intervention might help explain the relatively low rates of obesity and heart disease found in France.[17]

See also
  • French cuisine – Cuisine originating from France
  • Israeli paradox – Paradox of high CHD incidence among Israeli Jews
  • List of paradoxes – List of statements that appear to contradict themselves
  • Mediterranean diet – Diet inspired by the Mediterranean region
  • Mexican paradox – Paradox regarding low birth weight among Mexicans
  • Saturated fat and cardiovascular disease
     – Fat in which the fatty acid chains have all or predominantly single bonds
  • Stroke Belt – Region in United States
  • Health effects of wine – Potential health effects resulting from drinking wine

References

Citations

  1. S2CID 6738125. Archived
    (PDF) from the original on 10 August 2021. Retrieved 21 November 2021.
  2. ^
    PMID 10346778
    .
  3. ^
    S2CID 8142036
    .
  4. PMID 86901
    .
  5. ^ Matthew Saltmarsh (7 March 2010). "Nestlé Bringing American-Style Diet Plans to Europe". The New York Times.
  6. ISBN 978-1-4696-1760-2
    .
  7. ^ "Surgeon General Wine | Wine ads draw Surgeon General's ire Claim that mild drinking benefits heart is criticized BALTIMORE CITY – Baltimore Sun". Archived from the original on 22 May 2014. Retrieved 14 October 2012.
  8. S2CID 36484516
    .
  9. PMID 19364995
    .
  10. ^ The French Paradox, CBS News, 23 January 2009
  11. ^ Potentially Universal Mechanism Of Aging Identified, ScienceDaily, 27 November 2008
  12. PMID 12554065
    .
  13. PMID 20497772
    .
  14. ^ Paperback best sellers, The New York Times, 9 April 2006
  15. ^ a b Archive.org
  16. ^ "La fille prodigue – French Women Don't Get Fat". Frenchwomendontgetfat.com. Retrieved 12 April 2022.
  17. PMID 19501311
    .

Sources

Further reading

External links
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