wine

French and Japanese Paradoxes

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?