[Coronary risk factors. The French paradox]

Concordant data suggest that the frequency of ischaemic heart diseases in France is relatively moderate and noticeably lower than in most industrial European or English-speaking countries. This fact is documented by mortality statistics and planned surveys (Parisian Prospective Study, Records, ENIM). This peculiarity does not seem to be ascribable to the level of the classical coronary risk factors in France. Thus, the incidence of ischaemic heart diseases observed in the Parisian Prospective Study is much lower than that of similar American studies, even after adjustment to risk factor levels. The dietary lipid intake of the French seems to be about the same as that of nationals of high coronary mortality countries. The French paradox lies in the contrast between a food rich in saturated fatty acids and a moderate coronary mortality rate, fairly similar to that observed in Mediterranean countries where the dietary fat intake is much smaller than in France. The high mean level of alcohol consumption in France might be one of the factors responsible for this French peculiarity.