The French Paradox
Red wine is good at preventing heart attacks right?
The idea that red wine prevents heart attacks came about in the 1980’s because of an observation coined the “French Paradox.”
The “French Paradox?” Does that explain why French military tanks have 5 gears? They have four gears to go in reverse and one gear to go forward.
That makes no sense.
Hah. The gear to go forward is in case they get attacked from the rear!
Oh brother. No. The “French Paradox” is the observation that the French had much lower rates of heart attacks in spite of eating a high saturated fat diet. Many felt that their high consumption of red wine prevented heart disease.
Is the “French Paradox” the only argument for the heart benefits of red wine?
One diet that has been shown to prevent heart disease is the Mediterranean Diet which traditionally includes red wine. Red wine also contains high amounts of the anti-oxidant Resveratrol, which has been hypothesized to prevent heart disease. Red wine also increases good HDL cholesterol.
Sounds good–bottoms up?
Put your drink down—you know this is a family website. The problem with the “French Paradox” is that French doctors probably under reported heart attacks. Furthermore, the idea that saturated fat causes heart attacks is not so cut and dry. Also, Resveratrol, hasn’t really been shown to be a heart wonder drug. In fact, to get the benefits seen in mice, a human would have to drink over 100 glasses of red wine daily. If you want to get your Resveratrol fix, you don’t have to drink red wine as it is also found in grapes, blueberries, peanuts, and cranberries.
As far as red wines effect on raising HDL, our medications that raise HDL have never made it out of research studies because they either didn’t work, or they caused harm to the study participants.
Hmmm. You’re no fun at a party. Aren’t there medical studies saying alcohol prevents heart disease?
Yes. Probably one of the most comprehensive studies evaluating over a million people concluded that 1-2 drinks/day was better at preventing heart disease than not drinking alcohol at all. FYI, an average drink is about 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80% proof liquor.
Great. Case Closed. Bottoms up, right?
No. A brilliant study several years later challenged that result. A minority of people are born with a genetic defect that causes facial flushing when they drink alcohol. People with the mutation drink less. Would you want to go through a hot flash every time you swigged a beer? If alcohol protected you from heart disease, individuals with the gene problem would have more heart attacks. The researchers found that those with the mutation had LESS heart attacks. Another study showed that the more alcohol one drinks, the more the arteries around the heart develop calcification and plaques.
Seriously though, there’s no way a study with over a million people can be wrong?
The problem with that study is that almost every study on alcohol and heart disease is done so alcohol “wins.” Most studies combine people that were prior drinkers with the “never-drinkers.” People who no longer drink, however, have much higher death and illness than “never drinkers.” When you mix in “prior drinkers,” those who drink appear more healthy than non-drinkers.
Okay, so is there any good science that looks at “healthy never drinkers” and those who drink alcohol?
As a matter of fact—there is a remarkable one. This study evaluated thousands of studies looking at alcohol and health. They found only 7 studies compared “real” non-drinkers to drinkers. The 7 studies together showed NO protective effect of alcohol on heart disease, even compared to the “healthy drinkers” who consume 1-2 drinks per day.
Okay fine. Answer me this: I know a lot of people who drink alcohol and they’re not dying or getting sick. In fact, your study says there’s no harm to drinking when it comes to the heart. What do you have to say about that?
Let’s pretend that alcohol prevents heart disease and that alcohol is a medication I can prescribe to you. You come to my office and want a prescription. You are a smart patient and ask me about the side effects. I tell you that this medication may cause liver disease, pancreatitis, heart failure, atrial fibrillation, high blood pressure, obesity, depression, dementia, violent behavior, suicide, strokes, and more than 100 other illnesses. Furthermore, this medication can cause cancer of the breast, colon, rectum, liver, stomach, throat, and esophagus. It will increase your chance of death. It can cause birth defects (side note: If it harms a fetus, why is it good for you?). It will interact with your medications, may complicate your family relationships, and while taking it you may harm others. Let’s be honest, you’d look at me with an open mouth and then slowly and with perfect pronunciation say “H….E….Double Toothpicks….No.”
Wow. Never thought of it that way before.
Right. The problem with the whole discussion about alcohol and heart disease is that the argument is too focused on one illness. In a worldwide analysis of alcohol use in 2016, alcohol directly caused 2.8 million deaths (not including harm to others), and was the 7th leading cause of death and disability in the world. In spite of the harmful effects of alcohol, 1 in every 3 people on the planet drink it. Their conclusion from this analysis was: “the safest level of drinking is none.”
So, even if there is any heart benefit to alcohol (big stretch there), that advantage is absolutely negated by the harmful effects.
Okay, what’s the bottom line?
Alcohol does NOT prevent heart disease. If you abstain from alcohol, don’t start drinking. If you drink….stop.