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Does diet or alcohol explain the French paradox?
1Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla 92093-0607.
Lancet (London, England)
|December 24, 1994
Summary
The French paradox shows that while wine ethanol intake correlates with lower coronary heart disease (CHD) rates, it does not impact overall longevity. Alcohol abuse, not moderate consumption, is linked to reduced lifespan.
Area of Science:
- Cardiovascular epidemiology
- Nutritional science
- Public health
Background:
- The 'French paradox' describes the low rate of coronary heart disease (CHD) in France despite comparable dietary intake to other developed nations.
- This phenomenon warrants investigation into lifestyle and dietary factors, particularly alcohol consumption.
Purpose of the Study:
- To explore the French paradox by examining the relationship between alcohol intake (wine, beer, spirits), diet, and mortality rates.
- To determine the specific impact of different alcohol types and dietary components on CHD and overall mortality.
Main Methods:
- Analysis of alcohol, diet, and mortality data from 21 developed countries across multiple years (1965-1988).
- Separate assessment of wine, beer, and spirits consumption.
- Univariate and multivariate statistical analyses to identify correlations.
Main Results:
- France exhibited the highest wine and total alcohol intake alongside the second-lowest CHD mortality rate.
- Wine ethanol showed the strongest inverse correlation with CHD, more so than total wine volume.
- Animal fat intake correlated positively with CHD, while fruit consumption showed an inverse correlation.
- Beer and spirits had only weak inverse correlations with CHD.
- Wine ethanol was not associated with total mortality.
Conclusions:
- Ethanol, especially from wine, is inversely associated with CHD but not with overall longevity in populations.
- While moderate alcohol may offer some longevity benefits, alcohol abuse significantly reduces lifespan.
- Promoting alcohol for cardioprotective purposes is not advisable as a public health measure due to varying individual risk/benefit ratios and the link between average consumption and abuse.