Does diet or alcohol explain the French paradox?

doi:10.1016/S0140-6736(94)92883-5

The Lancet

Volume 344, Issues 8939–8940, 24 December 1994, Pages 1719-1723

https://doi.org/10.1016/S0140-6736(94)92883-5 Get rights and content

Abstract

Summary

The low rate of coronary heart disease (CHD) in France compared with other developed countries with comparable dietary intake has been called the French paradox. We explored this paradox by looking at alcohol, diet, and mortality data from 21 developed, relatively affluent countries in the years 1965, 1970, 1980, and 1988. We assessed wine, beer, and spirits intake separately.

France had the highest wine intake and the highest total alcohol intake, and the second lowest CHD mortality rate. In univariate analyses, ethanol in wine was slightly more inversely correlated with CHD than total wine volume. In multivariate analyses, animal fat tended to be positively correlated, and fruit consumption inversely correlated, with CHD. Beer and spirits were only weakly inversely correlated with CHD. The strongest and most consistent correlation was the inverse association of wine ethanol with CHD. However, wine ethanol was unrelated to total mortality.

We conclude that ethanol, particularly wine ethanol, is inversely related to CHD but not to longevity in populations. Although light to moderate alcohol consumption may improve longevity, alcohol abuse—which sharply reduces longevity—is correlated with average alcohol consumption in populations. Thus, while the risk/benefit ratio varies for individuals, the use of alcohol for cardioprotective purposes should not be encouraged as a public health measure.

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Does diet or alcohol explain the French paradox?

Abstract

Lancet

Am J Clin Nutr

Am J Cardiol

Lancet

Lancet

Lancet

Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine

Lancet

Differences in coronary mortality can be explained by differences in cholesterol and saturated fat intakes in 40 countries but not in France and Finland: a paradox

Circulation

World Tables 1993. The World Bank

World Drink Trends

The reduction of coronary heart disease with light to moderate alcohol consumption: effect or artifact?

Br J Addict