Once Again France Has the
st Rate of Heart Disease and
No One Knows Why

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May 31, 2018

Susan Callahan, Associate Editor and Featured Columnist

[Health and fitness articles are reviewed by our team of
Doctors and
Registered Nurses, Certified fitness trainers and other members of our
Editorial Board.]

This year, again France tops the list of countries with the
Lowest rates of heart disease. France's low rates of heart
disease have baffled doctors for over 50 years, since global
records have been kept. How, doctors ask, can a people
who eat the fatted livers of ducks and who lather their
meat with heavy cream and butter have low rates of heart
disease.  Called the "French Paradox', this disconnect
between traditional predictors of heart disease and the
results that France experiences, has persisted since World
War II.  What gives?  What's going on? What is behind the
robust health of the French; despite the rich food and high
rates of smoking?

Actual Statistics By Country Are Hard to Come By

If you google heart disease rates by country, you will most
likely land on a list of countries put together by healthline.
com. But the list does not link to an actual academic study
or a governmental source. These are harder to come by.

Heart disease rates are expressed per 100,000 people. So,
if a country has a heart disease rate of 88, as it is in
Kyrgyzstan,  it means that 29 people out of 100,000 are
having coronary disease.

France is reported to have a heart disease rate, after
adjusting for age, of only 6.8 people per 100,000,
according to a 2013 study jointly conducted by the National
Heart and Lung Institute, London, UK and Imperial College
School of Public Health, a part of the Imperial College

This study is the source of that stat on Kyrgystan. That
same study found that we Americans have a heart disease
rate of 23.1, over 3 times (3.39) higher than the French.

Japan actually has a lower heart disease rate than France,
as of 2012 to 2013, reporting a rate of 6 per 100,000 so it
can also lay claim to heart disease King of the Hill.

I spend a good deal of my year in Europe and France and I
have had an opportunity to observe the much-beloved
French way of life up close. Here is why I think France
leads or co-leads the league in terms of heart disease.

The French Eat Way More Vegetables Than We Do

I love vegetables in general so when I travel, I am always
on the lookout for a good plate of them, sometimes with a
side of fish.  In Spain, for example, a plate of greens is
hard to come by. The Spaniards eat plenty of delicious red
meat and starch. Vegetables? Not so much. You're lucky to
find a tomato or a piece of iceberg on a typical lunch plate.

In the US, you will find vegetables. But the serving sizes for
vegetables often is dwarfed by the serving size of the
meats and bread. Vegetables are definitely not the star of
the plate. Moreover, some vegetables, such as radishes and
artichokes, are often missing on American plates.

In the US, we eat on average 145 pounds of vegetables per
year, according to
statista. This compares with 228.8
pounds per person in France, according to the

In France, as we've written about here, radishes are a
staple. Radishes have fallen out of favor in the US over the
past 40 years. Why is this important?

Radishes can dramatically lower blood pressure. Eating
radishes, especially radish eaves, has been associated with
48 point drop in systolic blood pressure in lab animals.

The French Move a Lot More Than We Do

The French move their bodies--- a lot. Most French walk or
bike or ride their scooters everywhere. On the trams,
people of all ages will often decline an invitation to take a
seat. They prefer to stand. They prefer to move.

The statistics on average walking steps bear this out
Nokia started tracking average number of steps
taken by working people and reported that the French walk
an average of 6330 steps per day, while Americans walk an
average of 5815 steps per day. I don't believe the stats
based on my personal observations of the French.  I walk
10,000 steps a day and they walk way more than I do.
Moreover, they
walk fast, a fact that has been associated
with increased longevity
. Other studies have found that
Europeans walk on average about 3 times more than we do.

The French walk to pen air markets. We drive to grocery
stores. The French carry bags of groceries home. We drive
our groceries home. In the US, the difference adds up in
missed opportunities to burn calories and build up our
muscles, including our heart muscle.

Moreover, even if you accept the Nokia stats as indicative of
movement in general, it would mean that the French move
8.8% more than we do everyday. That adds up over the
course of a lifetime.

The French Eat or Drink More Antioxidants Than We Do

Inflammation is a precondition to heart disease and other
chronic diseases. At the molecular level, high levels of free
radical oxygen atoms cause inflammation. Eating or
drinking antioxidants help to scavenge these free radicals
and lower inflammation.

Fruits and vegetables are rich in antioxidants. Red wine is
also a scavenger of free radicals. Red wine is high in
resveratrol, a powerful antioxidant. The French consume an
average of 43.1 liters of wine each year, compared with
just 9.9 liters per person in the US.

What I have seen is that the French don't just drink wine,
they also use it to cook. They use wine to de-glaze pots of
meat and chicken and even add some wines in pasta and
vegetable dishes.  Coq au vin, anyone?

So, if you put it all together --- eating or drinking more
antioxidants, moving around more and in general living a
less stressful life -- the disparity in heart rates is not as
surprising as yo think.

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