The French Paradox

The French Paradox is a theory that summarizes the apparently paradoxical observation that French people have a relatively low incidence of coronary heart disease (CHD), while having a diet relatively rich in saturated fats. This is in apparent contradiction to the widely held belief that the high consumption of such fats is a risk factor for CHD. The paradox is that if the thesis linking saturated fats to CHD is valid, the French ought to have a higher rate of CHD than comparable countries where the per capita consumption of such fats is lower.
The French paradox implies two possibilities. The first is that the hypothesis linking saturated fats to CHD is not completely valid (or, at the extreme, is entirely invalid). The second possibility is that the link between saturated fats and CHD is valid, but that some additional factor in the French diet or lifestyle mitigates this risk.

So, which additional factor in the French diet is the most likely? It has been suggested that France's high consumption of wine is a primary factor in the trend. Some research implies that that moderate drinkers are less likely to suffer heart attacks than are abstainers or heavy drinkers. Therefore, the alcohol in wine might be a factor in the French paradox. However, several studies found no real difference between alcoholic beverages (beer, wine, spirits).

These days, science mainly looks to antioxidants, such as resvertrol, to explain the cardioprotective effects of wine, though definite proof is still lacking[1]. But the bitter tannin in grapes has been largely overlooked. Tannic acid has shown to be antimutagenic, anticarcinogenic and antibactericidal. Tannic acid also displayed cardioprotective effects [2].

In conclusion, the most repeated result of wine consumption is on lipid metabolism (the synthesis and degradation of lipids in cells), attributed mainly to ethanol, while wine's micro-constituents seem to have a role mainly in reducing sub-clinical inflammation[3].

[1] Weiskirchen, Weiskirchen: Resveratrol: How Much Wine Do You Have to Drink to Stay Healthy? in Advances in Nutrition - 2016
[2] Wu et al: Cardioprotective Effects of Tannic Acid on Isoproterenol-Induced Myocardial Injury in Rats: Further Insight into 'French Paradox' in Fytotherapy Research - 2015
[3] Fragopoulou et al: Wine and its metabolic effects. A comprehensive review of Clinical Trials in Metabolism - 2018

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