The French Paradox

Author: Winston Craig, MPH, PhD, RD.

A high intake of saturated fat is normally associated with increased rates of heart disease. This correlation does not hold true for certain regions of France. For example, people living in the Toulouse region have a high saturated fat intake and elevated blood cholesterol levels, and yet have quite low rates of heart disease compared to the U.S.

This discrepancy is referred to as the French Paradox. Dr Renaud has attributed the paradox to the regular use of red wine by the French. Some have shown that alcohol may actually increase HDL cholesterol levels, although HDL levels are not higher in the French population.

While some are recommending the use of alcohol to lower one's risk of heart disease, many scientists are very reluctant to support this idea. And rightly so.

The use of alcohol has been extensively shown to be associated with a greater risk of many cancers, hypertension, serious birth defects, and osteoporosis. The use of alcohol is associated with numerous highway accidents and deaths, as well as causing major family disruptions.

Explanations for the French Paradox have now shifted away from the alcohol theory. New data has focused attention upon components of red wine other than the alcohol, in particular the potent antioxidant phenols.

Phenolic compounds such as epicatechin, quercetin and other isomers are found in high quantities in red wine. Such substances strongly inhibit the oxidation of LDL cholesterol to a much greater degree than vitamin E. The phenolic flavonoids in red wine also inhibit the formation of blood clots. Furthermore, the anthocyanins in red wine (and red grapes) are also protective against coronary heart disease, since these red pigments inhibit cholesterol synthesis.

Clearly, one doesn't need to consume wine to obtain protection against heart disease provided by the phytochemicals mentioned above. Grapes and grape juice contain all the protective flavonoids, phenolics and other antioxidants found in wine, nunus the alcohol. In fact, many other fruits and vegetables contain these and other phytochemicals (carotenoids, etc.) that protect against both heart disease and cancer. It appears then, that the high fat diet of the French is compensated for by their more liberal use of fruits, vegetables and beverages that are rich in the protective phytochemicals.

Curtis Ellison of Boston University has suggested another reason for the French Paradox. The French eat their big meal at midday (consuming 60% of their daily calories before 2 pm) while Americans eat their largest meal late in the day, followed by an evening of very sedentary activities such as watching TV. This means, says Ellison, that Americans would metabolize fat less efficiently and platelets would be more likely to clump and form blood clots.

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