The French Paradox and the Japanese Paradox

The French paradox and red wine

By now, you’ve cer­tain­ly heard about the “French Para­dox,” a dream that entered Amer­i­can con­scious­ness in 1991, when it was described on the tele­vi­sion pro­gram 60 Min­utes. Accord­ing to this dream, drink­ing red wine will pro­tect you from heart dis­ease, even if you eat lots of high-fat, high-cho­les­terol food. Although the risk of heart dis­ease was low­er in France than in Britain, the dif­fer­ence was not due to some mag­i­cal prop­er­ties of wine. It was due part­ly to under-report­ing of coro­nary artery dis­ease as a cause of death and part­ly due to a time-lag effect. It takes a while for a fat­ty diet to clog up your arter­ies, and the French hadn’t been eat­ing as much fat as the British had been eat­ing for as long as the British had been eat­ing it. These expla­na­tions had been pub­lished in the British Med­ical Jour­nal in 1999. You can read the arti­cle for free here.

If you want to elim­i­nate your risk of heart attack, not just decrease it a lit­tle, you’d eat a low-fat, pure­ly plant-based diet.

Alco­holic bev­er­ages, includ­ing wine, can have sev­er­al effects that influ­ence a person’s risk of dying of a heart attack. Winos who die of cir­rho­sis of the liv­er often have amaz­ing­ly clean arter­ies. That’s because their liv­er lost the abil­i­ty to make cho­les­terol. Even mod­er­ate intake of alco­holic bev­er­ages can have sev­er­al effects on coro­nary artery dis­ease. The antiox­i­dants in some alco­holic bev­er­ages, includ­ing wine, could pre­vent LDL cho­les­terol from becom­ing oxi­dized, and thus could help reduce the buildup of ath­er­o­scle­rot­ic plaque. Of course, you could get these same antiox­i­dants from plant foods that haven’t been fer­ment­ed. Alco­hol can also thin the blood, and thus help to decrease the chance of a fatal heart attack or ischemic stroke. On the oth­er hand, it would increase the risk of a fatal hem­or­rhage. I haven’t seen any con­vinc­ing evi­dence that adding any form of alco­hol to a low-fat, plant-based diet would pro­vide any health ben­e­fits.

The French para­dox turned out to be a myth. How­ev­er, there are some Japan­ese para­dox­es that are real. One involves cig­a­rette smok­ing. The oth­er involves obe­si­ty and dia­betes.

Japan­ese smok­ers are less like­ly than Amer­i­can smok­ers to get lung can­cer. This is called the Japan­ese Smok­ing Para­dox. Some peo­ple think that it’s because Japan­ese are smok­ing safer cig­a­rettes or have some mag­i­cal pro­tec­tive genes. The more ratio­nal expla­na­tion is that the Japan­ese have been eat­ing less fat and ani­mal pro­tein and more veg­eta­bles than Amer­i­cans have been eat­ing. Eat­ing the tra­di­tion­al Japan­ese diet, as opposed to the stan­dard Amer­i­can diet, helps to pro­tect peo­ple against many kinds of can­cer, not just lung can­cer.

Anoth­er para­dox involves Japan­ese chil­dren. Over the past few decades, Japan­ese chil­dren have been get­ting fat­ter, and the inci­dence of type 2 dia­betes among Japan­ese chil­dren has been going up. This has been hap­pen­ing even though their calo­rie intake hasn’t increased sig­nif­i­cant­ly. They have been eat­ing a lot more fat and ani­mal pro­tein. In oth­er words, they’ve been get­ting a small­er per­cent­age of their calo­ries from car­bo­hy­drates, which were main­ly in the form of white rice. So why do the low-carb gurus keep telling me that we need to eat more fat and less car­bo­hy­drate? Is this anoth­er para­dox? If so, what should we call it?

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