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The Other French Paradox: Why Are Americans So Obese?


A trip to Europe provides perspective on the size of Americans and whether it is what’s in our food that’s making us obese, vs. how much of it we consume.

The French Paradox is the observation that French people suffer a relatively low incidence of coronary artery disease (CAD) despite having a diet relatively rich in saturated fats and cholesterol The term “French Paradox” was coined by Dr. Serge Renaud, a scientist in France and made popular when described on the CBS news show 60 Minutes in 1991.

The theory goes that the French people’s large consumption of red wine helps to decrease the incidence of CAD by as much as 44 percent compared to other Western countries, in particular the United States. Other theories such as low genetic predisposition to CAD in the population and generous consumption of fresh fruits and vegetables were largely ignored. Also not mentioned was the leading cause of death in adult French males -cirrhosis of the liver.

But this is a curious topic for another time. I have recently observed something else about the French while my wife and I traveled for two weeks in Europe. We were in five countries: Germany, Switzerland, France, Belgium, and the Netherlands.

My wife made the interesting observation that most of the obese people we saw were Americans and not the natives. Our friends, who live in Amsterdam, also said many were Eastern Europeans. Nonetheless, I too was struck by the relative slimmer size of the Western European people. As a cardiologist, I started to ponder the paradox. Here were people who lived on bratwurst, beer, pretzels, chocolates, and pastries, and yet compared to pot-bellied Americans, you would think they were all vegans.

Maybe it was because so many of them smoked I mused. Then I envisioned all of my obese patients who were smokers, and tossed that theory out. Next was the portion theory. Sure our portions are huge here, but what we ate at restaurants in Europe was far from tiny. There were some other clues. Here in the states, I suffer, as many adults do, with lactose intolerance. Yet, in France, I ate cheese, butter, and cream with little indigestion or flatus - yet another puzzle.

My wife, the artist, has a theory. She is convinced that food additives and preservatives are the culprit. Indeed a quick Internet search revealed that there are over 1,400 man-made chemicals added to the American food supply today. There are “natural sweeteners” as in high fructose-corn syrup, artificial sweeteners, and “natural flavorings,” meaning annatto or guar gum, etc. A whole cottage industry of “chemical cuisine” has taken over much of our foodstuffs today. In my mind, the health impact and contribution to our obesity epidemic is unknown, undefined, and suspect.

So as we made our way through a veritable gustatory journey of overtly high fat and high caloric food, my thoughts turned toward my waistline. Since age 40 I have added about a pound a year, and my self-image as a “slim” person has been in jeopardy. I weighed myself before leaving for Europe and two weeks later upon return.

Despite sinful indulgences such as pretzels, beer, Belgian French fries, (or pom frites, minus their traditional mayonnaise), French bread, pastries, and hot chocolate so thick you could stand a spoon up in the cup, I was stunned at my weigh-in. I had gained only one pound!

I don’t think I’m any closer to an answer about this paradox than I was before our trip. However, I am starting to agree with my wife - the food industry is poisoning us. I can’t back this up with science but my anecdotal travel experience has me concerned that something seriously wrong is happening with our food supply on this side of the pond.

So now I read labels like a detective, shunning anything that is packaged with more than five ingredients. And if you think that is easy to do, then just try grocery shopping sometime and reading all of the food labels. It will be a real eye-opener.

In the meantime, we will continue to shop at farmer’s markets, grow veggies out back in our Earth Boxes, and eat out as little as possible. I don’t care if it is high fat, lo carb, no fat, etc. What might be more important is and how and where our foods are produced than anything else.

Find out more about David M. Mokotoff and our other Practice Notes bloggers.

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