The French Paradox

 

 

There is a strong link between consumption of saturated fat and mortality by myocardial infarction. But in France, the incidence of the disease is a third, even a quarter of that in northern Europe and the USA.

 

Level of mortality adjusted for age (for 100 000 men)

City

Dead by coronary
heart disease

Middle level
of Cholesterol

% of consumed Lipid

U.S.A. 240 2.09 46
France 91 2.33 45
 

Mortality for 100 000 people

City Country Mortality by coronary heart disease
Glasgow United Kingdom 380
Toulouse France 78
Out of 100 000 people - WHO - 1981 - (MONItoring CArdiovascular diseases)
 

In the late 1980s two researchers, Jacques-Lucien Richard and Pierre Ducimetière, sought to understand what has become known as the French Paradox, which was revealed to the entire world by the WHO in 1991 after years of research.

Working from the observation that France has the highest alcohol consumption of any country, studies established a link between these data.

 

Alchohol consumption in 10 Western countries since 1961 (in litres)

Country Spirits Beer Wine Total of pure alcohol
(in litres)
FRANCE
1961 2.17 37.2 126.1 17.7
1970 2.30 41.2 109.1 16.2
1980 2.50 44.3 91.0 14.9
1990 2.49 41.5 72.7 12.6
1994 2.49 40.0 63.0 11.4
BELGIUM
1961 0.72 115.4 8.6 6.5
1970 1.32 132.4 14.2 8.9
1980 2.37 131.3 20.6 10.2
1990 1.20 101.6 24.0 9.0
1994 1.20 101.6 24.0 9.0
GERMANY
1961 2.12 101.6 12.2 7.4
1970 3.01 141.1 16.0 10.3
1980 3.05 145.7 25.5 11.4
1990 2.33 143.1 26.1 10.6
1994 2.40 139.6 22.6 10.3
LUXEMBOURG
1961 1.12 118.6 32.7 8.6
1970 1.73 127.0 37.0 10.0
1980 1.69 114.4 48.2 10.9
1990 1.57 121.4 58.2 12.2
1994 1.60 122.9 60.5 12.5
NETHERLANDS
1961 1.19 26.4 2.34 2.8
1970 2.09 57.4 5.15 5.7
1980 2.72 86.3 12.85 8.9
1990 1.98 87.7 14.54 8.1
1994 1.77 86.6 14.54 7.9
SWEDEN
1961 2.46 36.8 3.58 4.1
1970 2.64 57.5 6.37 5.8
1980 2.74 47.2 9.54 5.7
1990 1.72 59.8 12.24 5.5
1994 1.50 64.2 12.60 5.3
SWITZERLAND
1961 1.58 68.5 36.7 9.6
1970 1.94 70.5 41.9 10.7
1980 2.05 69.5 47.5 10.8
1990 1.78 69.8 49.4 10.8
1994 1.55 64.3 44.3 9.7
UNITED KINGDOM
1961 0.80 89.2 1.82 4.5
1970 0.94 103.0 2.89 5.3
1980 1.78 118.3 7.19 7.3
1990 1.71 109.5 11.56 7.6
1994 1.56 102.3 12.65 7.5
U.S.A.
1961 2.08 56.9 3.55 5.1
1970 2.87 70.0 4.97 6.7
1980 3.07 92.0 7.87 8.2
1990 2.29 90.8 7.69 7.4
1994 1.96 85.2 6.00 6.6
JAPAN
1961 ----- 12.9 ----- 0.5
1970 1.07 28.1 0.32 4.6
1980 1.83 37.5 0.55 5.4
1990 2.20 52.3 1.09 6.5
1994 2.00 57.3 1.10 6.6
 

This link, which has been verified on several occasions, is called the U graph. On average, in the populations studied, moderate consumption of alcohol reduced the risk of coronary heart disease and high consumption increased the risk, as did no consumption.

 

Graphique 2 US

 

The Bofetta study - 1990

 

Consumption

 

Risk of mortality by cardio-vascular disease

1 glass/day 0.79
2 glasses/day 0.80
3 glasses/day 0.83
4 glasses/day 0.74
5 glasses/day 0.85
6 glasses/day 0.92
Occasional drinker 0.86
No drinker 1
 

One of the main factors is High Density Lipoprotein (HDL) cholesterol, or "good cholesterol", (LDL is the "bad cholesterol"); its level rises in line with alcohol consumption (particularly HDL2, which acts on the artery walls, unlike HDL3 which has no particular effect).

 

 

Total HDL HDL 2 HDL 3
No wine 43.4 mg/l 5.7 37.7
75 cl of wine/day 49.4 (+ 14%) 10.4 (+ 82%) 39.0
(Source : Contaldo 1989)
 

We do not all react in the same way to HDL cholesterol. Men respond better than women, obese people less well than others, and the picture is made yet more complex by genetics, especially the polymorphism of the protein CETP (Cholesterol Ester Transfer Protein), which helps HDL's transformation into triglycerides. If wine modulates how the CETP gene is expressed, then new there are fresh prospects in the struggle to prevent genetic diseases.

These vinous benefits are only obtained by moderate daily consumption, suited to the morphology of the person in question.

 

 

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