They call it “the French Paradox “

I first heard this expression around the end of my surgical residency, when I hung out sometimes with some professorial internal medicine types. The real question was, how come the French with all their rich sauces had so much less heart disease than the Americans?

I lived in France for over 7 years, but this was a crowd that never would have thought to ask me.  I was only an “FMG” or “foreign medical graduate,” so I was only asked questions like “Did you have fun with the wine and the ooh-la-la?” (I don’t drink at all now, and didn’t much then, although they usually poured it into my glass and I had to get a token touch to the lips so that caring hosts would finally shut up.)  By now everyone should know that eating fat does not put on weight or give you heart disease, or any of the horrible things it has been alleged to do. It is basically a belief that came from a bulldozer type academic named Ancel Keys (I think, not unlike, the ones who enjoyed putting down a female foreign medical graduate) who started researching countries before choosing 7 to prove his hypothesis about  human metabolism with conscientious objectors in WWII, and seems never to have given his desire to prove he was correct. Dr. Keys surveyed 22 countries before cherry-picking 7 to present in his “Seven Countries Study.”  He dumped the French from his list pretty quickly, as I recall learning, even then, that they had less heart disease than any country in Europe, and with more than a little Chauvinism, generally said it was so because they had such a sweet lifestyle.

Flash forward to Southern California.  One of the delightful community coffeehouses where my husband and I love to plug in our computers when we go for an herbal tea. There is a tall thin painting of a woman on a bicycle, seen mostly from the back, with (shopping) baskets containing veggies and a “baguette,” a long thin loaf, driving along the side of a road. In seven years in France I never, not even once, saw that scene. I know enough now to understand more. In France, women eat little bread and fewer sweets.  I have heard women told in earliest youth you go easy on the sweets if you like the “ooh la la” — and when I did see someone serve a dessert formally at table, it was about the size of a “petit four,” the kind of cakes (not over 2 inches on any of its four sides) they use to carpet tables with at a Bar Mitzvah reception. And I saw plenty of them because my father, in his pre-diabetic days, prided himself on “scoring” as many cakes as he could for both himself and his nauseatingly good little girl (me!) who deserved “lots and lots of cakies.”

I remember a very glamorous young Italian neurosurgeon’s wife who served dinner and told us all she had “no real interest” in the (ubiquitous, and therefore not terribly interesting) pasta course. For obvious reasons, I have no idea what French males tell each other.  They seemed a bit less heavy than American men, currently. I know only that they talk to each other about women a lot. Breakfast was generally coffee and a roll.  Sometimes (heaven help us all) with something sugary as part of the deal. I told folks even then that a bit too much of their lifestyle seemed to trace back to the entire nation being hypoglycemic by noon. Noon to 2pm lunches were certainly social, leisurely, and relaxed. Dinners were light.  I remember being invited to someone’s house for soup (rich and creamy), the “cheese plate,” and a piece of fruit from the “fruit plate,”  all delightfully social, leisurely, and relaxed. So I haven’t exactly done a research study, but it sounds healthier than what I see here. Not exactly everyone in delirious ketosis, but  it doesn’t sound anywhere near the state of American nutrition.

Still, time changes all things.  I know from the French press, there are shorter lunch breaks now, and far more American style fast food than when I was there. I am hoping that the French can avoid following the American lead on this one as so many other countries have.  Time will tell. Me, I still sometimes miss the fatty, delicious duck pate from Amiens, city of my medical education.

@MedicalMaverick