Mar. 18th, 2010

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In the early 1990s, a French scientist (Dr. Serge Renaud) coined the term The French Paradox, to describe a weird statistical anomaly in world health. Many others credit the Vogue food critic (and culinary gadfly) Jeffrey Steingarten for independently and simultaneously reaching the same conclusion while researching an article for Vogue (Steingarten is among those who credits himself -- see his collection of essays: "The Man Who Ate Everything").

When it comes to world incidences of per-capita coronary heart disease, the Japanese tend to be the lowest in the world. This fits in with modern nutritional science as the Japanese tend to eat lots of fresh fish and fruits and greens, with small amounts of red meat and almost zero saturated fats from cream and cheese. Which country comes in second in lowest coronary heart disease? France.

Hence the paradox. French cuisine is a diet stereotypically based on cream and goose liver and alcohol and cigarettes and bitter coffee and butter and all the wonderful forms of meat that the pig provides. To make it even weirder, the French tend to have pretty much the same blood cholesterol levels as Americans. In the States, a blood cholesterol level over 200 (in general, ignoring HDL, LDL, etc.) is usually a trigger for a physician to start treating a patient for early warning signs of heart disease. In France, high cholesterol is a lot farther down the list...around 6th or 7th in warning signs.

20 years later, the paradox is still controversial. Some don't believe the French report coronary heart disease as accurately as the rest of the world. Some believe that the French diet may have changed recently, which causes a time-lag of heart disease. Many arguments have been tested and discarded, but, since the French diet is fairly threatening to theories of modern nutritional science, the questions still arise as to the validity of the rate of French heart disease.

The French diet does differ from the diet of the US in several ways:
* The French drink a lot of wine, especially red wine. Per capita, the French don't drink that much more than Americans (and a lot of other countries drink much more than the French). Perhaps there's a sweet-spot of not-too-much and not-too-little. The French tend to drink locally produced wines. Some place the entire explanation of the paradox on red wine and its antioxidants, though science has tended to show the levels of the antioxidants themselves are too low to account for the rate of heart disease.
* The French don't snack. They may eat three hearty meals a day of several leisurely courses, but in between, they don't pull out potato chips or Twinkies. They rarely drink soda (either sugar, or high fructose corn syrup), as compared to most Americans.
* When they do eat, it tends to be a social occasion, the food tends to be enjoyed and savored, and the French tend not to eat alone while working at their desk or watching TV.
* The French tend to be big on liquids -- wine, water, soup, coffee, tea.
* The French eat much more fish than the average American.
* Diet fads are ignored -- low-fat and no-fat foods tend to increase carbs/sugars to offset the lack of fat. The French abstain from low-fat/no-fat and eat foods right out of the animal/ground.
* 80% of fat in the French diet is dairy -- cream, milk, cheese. The dairy is almost never low-fat or skim dairy, but whole milk dairy.
* The French, like the Japanese, tend to enjoy lactic acid fermented foods -- vinegar and pickled foods like cucumbers and onions.
* The French choose their fried foods, again, much like the Japanese. French fries are a way of life, especially with steak. But, frites tend to be fried in animal or vegetable fats or both, with no trans fats or artificially hydrogenated oils. They tend not to experimentally fry food like candy bars or Oreos, or to batter items before frying.

Michael Pollan, in his book: "In Defense of Food", points out that whole foods are still a vastly misunderstood science. While some food manufacturers attempt to create healthy food alternatives (through altruism or, more likely, a profit motive), these tend to backfire in unintended ways. Skim milk is a good example -- calcium needs to be mixed with fat to be absorbed by the human body. If you drink a nearly fat-free milk, the calcium (and several other nutrients) in it is virtually useless and gets excreted immediately. Pollan's hypothesis is to eat "real" foods -- that is, foods that haven't been altered from basic whole ingredients. Even though there's a McDonald's in almost every city in France, (and they do quite well), the French in general tend to avoid making such processed foods a major factor of their diet.

Some have taken the French Paradox as a roadmap to a healthy (though unorthodox) diet. I'm generally one of those roadmap followers, though the lack of soda is my weakness (I'm also not a fan of wine, though I do like beer and spirits). Does it work? I don't know. I tend to trust it more for long term health rather than faddish short term diets like South Beach or Atkins. Florida is a generally healthy area, however -- lots of chance for exercise year-round, with locally fresh seafood and fruits/vegetables throughout the year as well.

Just don't take away my bacon, and no one gets hurt.

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