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The Dallas Morning News
PARIS - Does this diet seem healthy? Steak and other red meat topped by heavy sauces, large helpings of salted French fries and bread slathered with butter, plenty of wine with meals and a pack of cigarettes a day. Breakfast, of course, is chocolate pastry.
It may sound like a recipe for heart disease, lung cancer and an early death. But the French live on average two years longer than Americans.
While many Americans are using skimmed milk in their cappuccino and scouting out tasteless low-fat muffins, the unperturbed French are still eating rich, buttery croissants and drinking their morning coffee with warm whole milk.
How can they eat all this saturated fat and live so long? Shouldn't the French pay a price for all this indulgence? What is the reason for this anomaly, which doctors have dubbed the "French paradox"? Are there lessons that extend beyond the boundaries of France, where eating and drinking well are a national passion?
"It's the wine," said Jacky Larsonneur, who with his wife, France, runs the small restaurant Je The Me in the Vaugirard neighborhood of Paris. "The red wine is very important. It has calcium, magnesium, potassium, all the mineral elements. You should have two or three glasses of wine a day, with your meals."
It has become French custom to credit the health-giving properties of red wine for the low rates of heart disease that are a contributor to their longevity. It is a national credo that benefits the country's many wine-producing regions and furthers the image of France as a haven for enjoying the good life.
The view that red wine helps prevent heart disease has been supported by numerous studies and endorsed by several leading cardiologists throughout the world. Nonetheless, many doctors are reluctant to advise patients to drink wine for fear of contributing to alcoholism.
The French believe the benefits of their diet extend beyond the wine that is served with most meals. Many also believe that French food is much less likely to be treated with additives and preservatives than food found in American supermarkets. French consumers can usually consume meat, produce and fruit grown locally.
"We have a lot of small markets here, and we can buy things very carefully to make sure the meat doesn't have hormones added, and we know how the meat has been raised and how the produce has been grown," said France Larsonneur, interrupting her husband's impassioned praise of red wine. "Here farming is done on a small scale, and the food is much better."
The Larsonneurs, and many French people, agree that Americans simply eat too much junk.
"We went to America and we could not eat like that," said Jacky Larsonneur. "Americans eat things that are too sweet and too heavy and too fat and soft drinks filled with additives. It's disgusting for a French person to watch."
One indication of the commitment to fresh food can be found in the fact that the Larsonneurs do not have a freezer at their hole-in-the-wall restaurant. Freezing causes food to lose quality and nutritional value, they believe.
France Larsonneur said the French also benefit because leisurely family meals are still a tradition, even during the busy workweek. "We take our time to prepare a very nice table, and we eat calmly and slowly," she said. "In the U.S. they eat on the street; they eat very fast. I would rather not eat at all if I can't sit down. We may take an hour and a half to eat. It's important for your equilibrium."
This attitude carries over to the business lunch. It is common in central Paris to see men and women in suits lingering over their last coffee and cigarettes after finishing a three-course meal. The classic lunch is still steak and fries, often served with a fried egg on top of the beef - cholesterol be damned.
And don't expect them to skip dessert. Profiteroles, chocolate mousse and scoops of rich Berthillon ice cream are popular.
Another cultural difference can be found in the attitude toward wine. While American parents typically try to keep children from all alcohol, French parents usually start giving their children sips of wine when they are 5 or 6 years old.
Dr. Serge Renaud, a prominent cardiologist whose research has helped establish a medical basis for the "French paradox," said there is now conclusive statistical evidence showing that wine can help prevent heart disease and also reduce cancer rates.
"The polyphenols in wine have a very important antioxidant effect throughout the body," he said. "But to be beneficial you have to drink moderately - for a man, two or three sizable glasses a day, for a woman, one or two. And to be beneficial, you should drink it with meals and not become intoxicated."
Some researchers believe the polyphenol molecules inhibit a peptide called endothelin-1, which is known to contribute to heart disease by causing blood vessels to narrow. Others, such as the late Dr. Christiaan Barnard, a pioneer heart transplant surgeon, maintain that the benefits of red wine cannot be easily understood and should simply be enjoyed.
Skeptics say it is not surprising that Renaud of Bordeaux, France, famed the world over for its quality wines, believes that wine has health benefits. But Renaud cites many studies reported in prestigious medical journals in the last 11 years to back his claim.
And he freely concedes that many French people drink far too much wine, not only losing the beneficial effect but also descending into life-threatening alcoholism. He said French life expectancy would be even higher if many men did not die at relatively early because of alcohol abuse.
"If you drink five or six glasses a day, you lose the benefit to your heart and your health, and if you drink more than that it has a negative effect," he said.
Renaud said the health benefits of wine can be amplified by modifying eating habits to conform to the so-called Mediterranean diet that emphasizes fish, whole grains, nuts, olive oil, fruits and vegetables along with moderate wine consumption.
A survey of more than 22,000 Greeks released in late June found that this diet led to a 33 percent reduction in the death rate from heart disease and a 24 percent lowering of cancer rates. Doctors said the findings emphasized the importance of diet for overall health, not just the prevention of heart disease.
None of this is news to devotees of French wine.
Philippe Ansot gave up a career as a waiter to open a small wine shop in Paris. He credits French longevity not just to the wine, but also to the overall quality of food that the French consume. He said they identify with their food and wine in a way that other cultures do not.
"These local foods and products bring a lot of pleasure," he said. "The whole idea of taking pride in local cuisine and getting pleasure from locally raised food in combination with a local wine creates a kind of joy that maybe Americans don't have.
"It creates a universe in which you really live well."
But there are indications that this healthy French lifestyle is starting to fade. A new study of 25,770 people released in June indicated that more and more French are overweight, in part because a sedentary lifestyle is taking hold. The study found that more children are drawn to fast food and spend their free time watching television or playing computer games.
Doctors analyzing the results predicted that rates of heart disease, diabetes and other serious illnesses would likely rise in the coming decades as a result. In effect, this would mean the end of the "French paradox."
It's a change that can be seen on the streets of Paris, said France Larsonneur, the restaurant owner who believes in serving the freshest of foods. She has started to notice women carrying home ready-made dinners and - horrors! - frozen food from the supermarket.
"We are trying to keep the traditions, but things are changing," she said.
(c) 2003, The Dallas Morning News. Distributed by Knight Ridder/Tribune News Service.