French Paradox?

A long time ago I read that the French diet is as unhealthy as the North American diet but they were not as fat, on average as North Americans. Is this linked to the wines they drink?

Posted Answers

A:

It has to do with the RED wine they drink, some studies have suggested.
The term French paradox refers to the observation that although the French eat similar amounts of high-fat foods, exercise less, and smoke more than Americans, they appear to have a markedly lower mortality rate from heart disease. Medical experts generally agree that a low-fat diet, exercise, and not smoking minimize the risk of heart attacks, which makes this paradox difficult to understand. Studies suggest that one of the reasons the French have a lower rate of heart disease may be their regular consumption of red wine.

The specific mechanism by which the French paradox operates has not yet been identified. Some research suggests that antioxidants called flavonoids, natural chemical compounds found in red wine, may confer important health benefits to the heart and blood vessels. Red grapes are one of the richest sources of flavonoids, which may make red wine more heart-healthy than white wine, beer, or other spirits. Other research suggests that pigments in red wine called polyphenols are responsible for explaining the French paradox. Polyphenols, found in red grape skins, are believed to act as antioxidants, control blood pressure, and reduce blood clots. Some research indicates that red grape juice is markedly less potent than wine in conferring health benefits. Researchers suggest that something in the winemaking process changes the polyphenols' properties.

Not all scientists believe in the French paradox. Some believe that it is a health myth caused by errors in health-data reporting on the incidence of heart disease in France. Also, some scientists argue that there is no scientific consensus over the protective effect of any alcoholic beverage on heart disease.

Dr. Serge Renaud, a scientist from Bordeaux University in France, coined the term French paradox after completing his 1992 landmark report that indicated France's low incidence of heart disease might be caused by wine consumption.

Researchers say they have discovered the key component in red wine that explains the so-called French Paradox, or the way the French can eat lots of cheese, buttery sauces and other rich foods and still suffer less heart disease than Americans.

The explanation is pigments known as polyphenols. The pigments are not present in white wine or rose, and they seem to be less potent when they are present in grape juice.

Polyphenols inhibit the production of a peptide that contributes to hardening of the arteries, researchers report in Thursday's issue of the journal Nature. In laboratory dish experiments, polyphenols in red wine decreased the amount of the peptide endothelin-1 produced by cells taken from the blood vessels of cows.

Endothelin-1 is a potent blood vessel constrictor, and overproduction of the compound is thought to be a key factor in why arteries clog with fatty deposits, said the researchers from the William Harvey Research Institute at the London School of Medicine & Dentistry.

In the study, the cow cells were exposed to extracts from 23 red wines, four white wines, one rose and one type of red grape juice. Researchers found the decrease in endothelin-1 levels was related to the amount of polyphenols in the wines.

The white and rose wines - which contain little or none of the pigment - had no effect on endothelin-1 levels. Red grape juice, which has plenty of the pigment, was markedly less potent in reducing endothelin-1 than red wine. The researchers said that suggests that something in the winemaking process changes the pigment's properties. Researchers believe the pigment comes from red wine skins. In white wine and rose, the grape skins are taken out before fermentation.

The type of grape also appeared to matter. Four of the six most effective red wines used in the study were made entirely or partially from cabernet sauvignon grapes.

"The key message is moderate consumption of red wine is likely to prevent heart disease, but we have no evidence that white wine or rose would have a similar benefit," said Roger Corder, who led the study. The lower incidence of heart disease in France, despite a diet rich in butter and other fats, has led researchers to look to the consumption of red wine, another staple of the French diet.

Other studies have shown red wine helps fight heart disease, and scientists have theorized that the benefits are caused by antioxidant compounds that prevent or slow the damaging effects of oxygen on the body. Corder's research shows a different mechanism altogether. He said it is a more plausible explanation for the French Paradox.

David Klurfeld, a researcher at Wayne State University who linked red wine and a reduction in heart disease in 1981, noted that the cells were tested in a dish and said it is unclear how polyphenols work in the body. However, he said, the research opens another pathway that should be pursued.

"Is this the only mechanism, or is it a combination? There's not enough evidence that points us in any direction," Klurfeld said. "We're basically playing spin the wine bottle here."

How, scientists wonder, do the French get away with a clean bill of heart health despite a diet loaded with saturated fats?

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The answer to the so-called "French paradox" may be found in red wine. More specifically, it may reside in small doses of resveratrol, a natural constituent of grapes, pomegranates, red wine and other foods, according to a new study by an international team of researchers.

Writing June 3 in the online, open-access journal Public Library of Science One, the researchers report that low doses of resveratrol in the diet of middle-aged mice has a widespread influence on the genetic levers of aging and may confer special protection on the heart.

Specifically, the researchers found that low doses of resveratrol mimic the effects of what is known as caloric restriction - diets with 20-30 percent fewer calories than a typical diet - that in numerous studies has been shown to extend lifespan and blunt the effects of aging.

"This brings down the dose of resveratrol toward the consumption reality mode," says senior author Richard Weindruch, a University of Wisconsin-Madison professor of medicine and a researcher at the William S. Middleton Memorial Veterans Hospital. "At the same time, it plugs into the biology of caloric restriction."

Previous research has shown that resveratrol in high doses extends lifespan in invertebrates and prevents early mortality in mice given a high-fat diet. The new study, conducted by researchers from academia and industry, extends those findings, showing that resveratrol in low doses and beginning in middle age can elicit many of the same benefits as a reduced-calorie diet.

"Resveratrol is active in much lower doses than previously thought and mimics a significant fraction of the profile of caloric restriction at the gene expression level," says Tomas Prolla, a UW-Madison professor of genetics and a senior author of the new report.

The group explored the influence of the agent on heart, muscle and brain by looking for changes in gene expression in those tissues. As animals age, gene expression in the different tissues of the body changes as genes are switched on and off.

In the new study - which compared the genetic crosstalk of animals on a restricted diet with those fed small doses of resveratrol - the similarities were remarkable, explains lead author Jamie Barger of Madison-based LifeGen Technologies. In the heart, for example, there are at least 1,029 genes whose functions change with age, and the organ's function is known to diminish with age. In animals on a restricted diet, 90 percent of those heart genes experienced altered gene expression profiles, while low doses of resveratrol thwarted age-related change in 92 percent. The new findings, say the study's authors, were associated with prevention of the decline in heart function associated with aging.

In short, a glass of wine or food or supplements that contain even small doses of resveratrol are likely to represent "a robust intervention in the retardation of cardiac aging," the authors note.

That finding may also explain the remarkable heart health of people who live in some regions of France where diets are soaked in saturated fats but the incidence of heart disease, a major cause of mortality in the United States, is low. In France, meals are traditionally complemented with a glass of red wine.

The new resveratrol study is also important because it suggests that caloric restriction, which has been widely studied in animals from spiders to humans, and resveratrol may govern the same master genetic pathways related to aging.

"There must be a few master biochemical pathways activated in response to caloric restriction, which in turn activate many other pathways," explains Prolla. "And resveratrol seems to activate some of these master pathways as well."

The new findings, according to Weindruch and Prolla, provide strong evidence that resveratrol can improve quality of life through its influence on the different parameters of aging such as cardiac function. However, whether the agent can extend lifespan in ways similar to caloric restriction will require further study, according to the new report's authors.

The ”French Paradox”

Resveratrol - Natural Anti-Aging Elixir
F
or the past 40 years, it has been virtually a dogma of Western medicine that a diet high in saturated fat and cholesterol, and/or a high blood cholesterol level, is the primary cause of heart disease.

Atherosclerosis: Heart Disease Dogma
The high blood-cholesterol so typical of Western peoples is alleged to cause atherosclerotic plaques to develop over a lifetime, eventually plugging up heart arteries and leading to death by heart attack i.e. myocardial infarction (MI) or coronary thrombosis. The so-called fatty/cholesterol plaque that can block arteries is called atheroma; the gradual development of atheroma in heart arteries is referred to as coronary atherogenesis; and the chief culprit in the process of atherogenesis is alleged to be cholesterol/saturated fat. More recent refinements of the atherogenesis dogma implicate high LDL cholesterol and/or low HDLL cholesterol as the chief culprits in atherogenesis.

Thrombi vs. Atheroma
Yet there is a mass of evidence dating back 40 years that clearly points to atheroma/atherogenesis as being secondary phenomena in the 20th-century epidemic of heart-attacks. In a 1984 review article summing up the case against atheroma as the primary cause of infarction, Wayne Martin noted that Keely and Higginson in 1957 reported widespread atheroma among the Bantus of Africa, even though they seemed to be free from heart-attacks. The researchers suggested that thrombi (abnormal blood clots) rather than atheroma may be the major cause of MI. In 1959 Gore et al. found the same degree of atheroma in Japan and in the United States, despite widely different infarction rates.

They, like Keeley and Higginson, said that it was high time more concern should be given to the danger of thrombi, with less concern about atheroma. Strong et al. are continuing a study comparing men in New Orleans, USA, with men in Tokyo, Japan. The atheroma characteristics are very little different between the two groups; but in New Orleans the death rate from MI is very high, while among the Tokyo men it is much lower. In 1980 Sinclair noted that in Jamaica, where there is severe atheroma (caused presumably by coconut oil in the diet), atheroma does not seem to cause coronary thrombosis. He stated that thrombosis, and not atheroma, is the major causal factor of myocardial infarction.
There is now abundant evidence that although man worldwide is afflicted with atheroma, many populations in Africa and Asia seem to co-exist with atheroma without being afflicted with heart-attacks.

The FRENCH PARADOX:
The French exhibit an astonishing 42% lower incidence of heart disease than Americans while consuming one of the highest fat diets on the planet

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The French Paradox
Grapes and wine contain a natural antidote to MI and cancer, scientists report. This discovery could help explain the so-called “French paradox’ - the lower rates of heart disease and cancer in nations such as France, Italy, Spain.

Platelet Aggregation and not Atheroma - main cause of MI
In a classic 1992 article about the French paradox for heart disease, Renaud and de Lorgeril present evidence that dietary fat and blood cholesterol are not primary MI villains, at least among the French. They note that the annual mortality rate per 100,000 population from coronary heart disease (CHD) is 78 in Toulouse, France, and 105 in Lille, France (for men), compared to 182 in Stanford, USA, 348 in Belfast, UK, and 380 in Glasgow, UK. Yet the saturated fat intake is about the same for these groups - 15% of the total calories. The mean serum cholesterol for men is notably lower in Stanford (209 mg%) than in France (230 in Toulouse, 252 in Lille), while Belfast (232) and Glasgow (244) levels are similar to France; yet all three have much higher MI mortality rates than France.

Renaud and de Lorgeril note that stepwise multivariate analysis shows that in the 17 countries that reported wine consumption, wine was the only foodstuff in addition to dairy fat that correlated significantly with mortality. Wine had a negative correlation, indicating a protective effect. They then present evidence that it is not through inhibitory effects on atherosclerotic lesions (atheroma) that wine provides MI protection, but rather through a decrease in the tendency of platelets to pathologically aggregate and plug up heart arteries. They compared farmers from Var, Southern France (low in CHD mortality), with farmers from south-west Scotland for platelet-aggregation tendencies. Platelet aggregation was strikingly lower in Var. Secondary aggregation to ADP, the test that undergoes the greatest decrease with alcohol, was 55% lower in Var than in Scotland, whereas mean levels of HDL cholesterol (allegedly MI-protective) were very similar (69 mg/dl in Girvan, Scotland, 66 mg/dl in Stranraer, Scotland, and 63 mg/dl in Var). Consumption of alcohol was greatest in Var (45g per day vs. 20g per day in Scotland), mostly in the form of wine.

Resveratrol
Researcher David Goldberg rhetorically asked, “Does red wine contain a biological component that is present only in limited amounts in a typical diet?” Indeed it does: resveratrol. This trihydroxystilbene is synthesized by grapes, being present in the canes, leaves and the skin of the berries. Other than peanuts, no other human-consumed foodstuff contains significant amounts. The resveratrol story does not begin with its recent discovery in wine. It actually started in the early 1980s among Japanese scientific re-searchers. Reporting in 1982, Arichi et al. noted that the dried roots of Polygonum cuspidatum have been used in traditional Japanese and Chinese medicine in a product called Kojo-kon, used to treat a wide range of afflictions, including fungal diseases of the heart, liver, and blood vessels. Resveratrol and its glycoside, polycoside polydatin have been shown to be the primary active ingredients of Kojo-kon.

The World Health Organization indicates that Resveratrol, an organic compound found in red wine, is one of the active ingredients which reduces the risk of coronary heart disease in red wine drinkers by up to 40%. One of the highest concentrations of the Resveratrol molecule is found in the Muscadine grape. Muscadine wine has 10 - 12 times higher resveratrol concentration compared to French red wine RED WINE capsules

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Free radicals and Antioxidants
Antioxidants inhibit lipid oxidation by reducing general [hydroperoxide] tone. The polyphenolics including Resveratrol and Quercetin, commonly found in wine, are potent antioxidants. De Whalley et al. (1990) reported that flavonoids act by protecting (and perhaps regenerating) the primary antioxidant, tocopherol [Vitamin E], by direct antioxidant effects, and by scavenging free radicals. Frankel et al. in 1993 reported both Resveratrol and Quercetin to be more powerful antioxidants than Vitamin E in protecting human LDL against oxidation.

In 1994, Stavric wrote that it appears that a number of the biological effects of quercetin and other flavonoids may be explained by their antioxidant activity and the ability to scavenge free radicals. The antioxidative function of quercetin, found in red wine, was enhanced by ascorbate (vitamin C). And even more potent beneficial effects of quercetin, as a radical scavenger and/or as inhibiting lipid peroxidation were found in its combination with Vitamin E and Vitamin C.

Conclusions for blood
Thus, a combination of resveratrol (RSV), quercetin (QRC), vitamin E (E), vitamin C (C), and the trace mineral selenium (Se) may be expected to have a highly synergistic effect in reducing pathological platelet-aggregation (thrombogenesis), maximizing PGI2/minimizing TXA2 (thus dilating arteries for healthy blood flow, as well as opposing platelet aggregation) and minimizing free-radical damage/disruption to blood vessel lining (i.e. preventing/minimizing atherogenesis).

Resveratrol, red wine and cancer
There are three stages of cancer development. First stage - “trigger stage”. This is the early stage when cells starts an abnormal reproduction cycle. An immune system usually destroys these abnormal cells. Second stage - “promotion stage”, when your immune system is not able to destroy all cancerous cells, and they reproduce rapidly. Third stage - “growth stage”. In this stage the number of cancerous cells is huge, they expand rapidly while impairing the functioning of the body. Each of these stages can last for several years.

It was shown that resveratrol content in ordinary French red wines is approximately 5 parts per million, while in Muscadine wine from North Carolina it is ten times greater - up to 50 parts per million.

Anti-cancer evidence
These previously mentioned five compounds RSV, QRC, E, C and Se also have a similar beneficial effect in preventing cancer, or even aiding in its cure. In 1997 Jang et al. reported the results of a series of biochemical, cell culture, and animal studies with RSV in the prestigious journal Science. They reported that Resveratrol inhibits cellular events associated with all three stages of tumor development: initiation, promotion and progression. They also wrote that “...we studied tumorigenesis in the two-stage mouse skin cancer model in which a special chemical (DMBA) was used as initiator and another chemical (TPA) as promoter. During an 18-week study mice treated with DMBA-plus TPA developed an average of two tumors per mouse with 40% tumor incidence. Application of 1, 5, 10 or 25 [micromoles] of resveratrol together with TPA twice a week for 18 weeks reduced the number of skin tumors per mouse by 68, 81, 76 or 98% respectively, and the percentage of mice with tumors was lowered by 50, 63, 63 or 88%, respectively. No overt signs of resveratol-induced toxicity were observed.” They also note in their paper the importance and potency of RSV’s antioxidant and anti-mutagenic activity in preventing tumor initiation.

QRC has also shown potent anti-cancer activity. QRC has been shown to inhibit the growth of cells derived from human and animal cancers, such as leukemia and Ehrlich ascites tumors, the estrogen receptor-positive breast carcinoma (MCF-7), squamous cell carcinoma of head and neck origin, gastric cancer and colon cancer, as well as human leukemia HL-60 cell in culture. Vang et al. reported RSV to be active in normalizing HL-60 cells in culture back into normal cells. QRC has antiproliferative activity against breast and stomach cancer primary cultures. Several studies report that Vitamin E reduces tumor growth and exerts an anti-cancer effect in both the initiation and promotion stages because of its antioxidant and immuno-enha-ncing actions. Vitamin E appears more effective in conjunction with other nutrients (such as selenium and Vitamin C), than by itself in the prevention of tumor growth.


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