Exposing the French paradox

Dear Dr. Roach: A friend told me that her husband, who is 80, is claiming that the French eat a lot of butter, cream, cheese, pastries and red meat, and have the lowest rate of heart disease in the world. I’m wondering if there’s any truth to it. She does all of the food shopping and cooking, and he is complaining that their meals are boring and that their diet is unnecessarily strict.

France does not have the lowest rate of heart disease in the world — Japan and South Korea are lower — but it does have the lowest rate in Europe. France also has a high rate of saturated fat consumption, and that discordance is called “the French paradox.”

Some interpret the paradox to mean that these rich foods are not bad for you at all, andthere are many other proposed reasons why French have lower rates.

Wine has long been proposed, and while it is true that moderate wine drinkers have lower rates of heart disease, there aren’t definitive data supporting wine reducing heart disease risk. Since wine is definitely harmful in excess, I recommend no more than modest wine drinking.

Obesity rates are much lower in France (24%) than the U.S. (34%), and the French eat far more fruits and vegetables. French exercise more as a part of their daily lives. French consume far less sugar. French eating has traditionally emphasized quality over speed and quantity.

Diets in France have changed over time, and it takes decades to see the changes in heart disease reflect dietary changes. Many authorities expect that heart disease rates in France may increase as their diets trend closer to less-healthy North American norms.

A healthy diet does not need to be boring, and it can include all of the foods your friend’s husband wants, but in proper proportion, appropriate in size and combined with exercise.