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Thu, 14 Nov 2002 20:37:25 EST |
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A very intriguing article that suggests that CHD is less about what we eat
than how we eat:
WHAT PROTECTS THE FRENCH FROM HEART DISEASE?
It's Not What You Think!
By Malcolm Kendrick MbChB, MRCGP (email - [log in to unmask] )
However you look at heart disease, those pesky French throw a huge spanner in
the works. They should get heart disease, and they don’t, at least they
don’t get very much; about one quarter the rate in the USA and UK, despite
virtually identical ‘classical’ risk factors. This was first noticed by Hugh
Tunstall-Pedoe in 1978. He called it the ‘French Paradox,’ a term that flits
in and out of favour.
But what are the French figures exactly? I think they are worth looking at
because they are extremely interesting. However, rather than looking at the
figures in isolation, I think it is a good idea to compare France with
another country, to highlight the almost perfect disparity between the French
risk factors and their rate of CHD.
The best country to compare with France directly, is Britain, as these are
two countries that have virtually the same population, and GDP, and are
geographically very close. This removes a few variables.
The figures I have used come from the British Heart Foundation and the BMJ.
CLASSICAL RISK FACTORS vs. HEART DISEASE
(UK & FRANCE MEN AGED 45 - 64)
Average total cholesterol level
France 6.1mmol/l
UK 6.2mmol/l
Average HDL ‘good cholesterol’
France 1.3mmol/l
UK 1.3mmol/l
Average systolic blood pressure
France 150mmHg
UK 148mmHg
Average body mass index (BMI)
France 26.6kg/m2
UK 26.6kg/m2
Rate of smoking
France 33%
UK 29%
Consumption of saturated fat % of calories
France 25.7%
UK 27.0%
Rate of type II diabetes (amalgamation of a number of studies)
France ~2.0%
UK ~2.0%
Death rate from CHD ICD 414 classification
France 128/100,000/year
UK 487/100,000/year
Now that’s what I call a paradox.
In truth, I don’t call it a paradox at all. Because a paradox is an
apparently inexplicable finding for which there really is an explanation - if
only we could find it. This is akin to the wobble in the orbit of Neptune,
inexplicable until it was realised that there was another planet out there.
But if you don’t believe that the classical risk factors are that important
in CHD, then you aren’t looking at a Paradox at all. What you are looking at
is proof that the generally accepted risk factors can only play a minor part
in causing CHD. As Magritte would say ‘ce n’est pas un paradox.’
For the rest of the article go to:
http://www.redflagsweekly.com/kendrick/2002_nov14.html
Namaste, Liz
<A HREF="http://www.csun.edu/~ecm59556/Healthycarb/index.html">
http://www.csun.edu/~ecm59556/Healthycarb/index.html</A>
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