French paradox

People in France eat a lot of fatty foods but suffer less from fatal heart strokes than people in the northern regions of Europe or in North America, where wine is not consumed on a regular basis ( French paradox ). There is an increased favorable effect from red wine. The unique cardioprotective properties of red wine are due to the action of flavonoids, which are minimal in white wine. The best-researched flavonoids are resveratrol and quercetin, which confer antioxidant properties more potent than a-tocopherol. 

Interest in the health effects of anthocyanins was piqued by the French paradox in which the mortality from cardiovascular disease was lower than that predicted from the intake of dietary saturated fatty acids. The beneficial effects were greater in association with alcohol taken in the form of wine suggesting that there may be a protective effect of other components of wine. Needless to say the wine industry was pleased with this research. 

There is a more interesting, and possibly more important, explanation. A principal difference between American and French diets is the consumption of wine, specifically red wine. Could there be something in wine that accounts for the French Paradox Attention has been focused on a class of compounds found in red wine called polyphenols (they are found in white wine as well but in much smaller amounts). These have potent antioxidant properties. Most of the attention has been focused on resveratrol ... 

De Lorgeril, M., Salen, P., Paiilard, F., etal. (2002). Mediterranean diet and the French paradox two distinct biogeographic concepts for one consolidated scientific theory on the role of nutrition in coronary heart disease. Cardiovascular Research 3,503-515. 

Alcohol abuse and dependence, widely known as alcoholism, is a major cause of morbidity and mortality. Its acute and chronic toxicity spreads across multiple systems and organs, from child abuse to domestic or public violence to traffic accidents and from cirrhosis to hypertension. Mean life expectancy of alcohol abusers is around 55 years. Alcohol seems involved in several hundred thousand deaths each year in Europe, with considerable added social and health care costs. This is in clear contrast with the little attention paid to the treatment of alcohol dependence and abuse. On the other hand, much is made of the French Paradox , the J curve and the demonstrated cardiovascular benefits of regular moderate wine intake. 

Renaud, S. and de Lorgeril, M., Wine, alcohol, platelets and the French paradox for coronary heart disease. Lancet, 339, 1523, 1992. 

Dietary anthocyanins have gained much attention based on the recognition of the French paradox which led to the suggestion that some components of red wine (in particular anthocyanins) may protect against coronary heart disease. 

In a prospective study of 3454 men and women (age 55 years and older), a significant inverse association between the intake of catechin-rich tea and radiographically quantified aortic atherosclerosis was found [200], Similarly, inverse association between the consumption of red wine and CHD mortality (French paradox) have been suggested [201]. This beneficial effect of red wine may be due to the antioxidant ability of the wine phenolics to inhibit the oxidation of LDL to an atherogenic form [202],... 

Furthermore, polyphenolics present in wine, of which flavonoids are important components, have been suggested to be responsible of the so called French paradox, that is, the unexpectedly low rate of mortality from coronary heart disease in French population despite an unfavourable exposure to known cardiovascular risk factors such as high saturated fat consumption [19-21]. Epidemiological studies in USA [22] and Denmark [23] reported that moderate red wine drinkers had a lower risk of coronary artery disease than participants with no alcoholic beverage preference. However, controversial results about the antioxidant capacity of human serum after red wine consumption have been reported [24-27]. It is therefore uncertain whether wine constituents other than alcohol add to the cardioprotective effects of red wine. 

It was postulated that the inhibition of LDL oxidation by red wine may help to explain the French paradox. Since Frankel and co-workers [73] showed that red wine inhibit the oxidation of LDL, several in vitro studies have confirmed this finding [26,74,75]. There is controversy over whether or not the consumption of red wine by humans reduces the oxidation of LDL ex vivo. While several studies found resistance of LDL oxidation after 2 weeks of red wine consumption in healthy subjects [75,76], others found no effect on the oxidation of LDL ex vivo [26,77]. Recently, Stein and coworkers [78] showed that short-term ingestion of purple grape juice (7.7 1.2 mL/Kg/day for 14 days) reduced the susceptibility to oxidation in coronary artery disease patients and that this is a potential mechanism by which flavonoids in purple grape products may prevent cardiovascular events, independent of alcohol content. 

An interesting case is the prevention of cardio-vascular diseases as a result of the consumption of wine. Like most fruits grapes are rich in polyphenols, and the process of wine making results in the concentration of polyphenols. Wine polyphenols are considered to have beneficial effects on coronary heart disease and atherosclerosis. The presence of polyphenols in wine are thought to be the reason for the French paradox France was shown to have a coronary mortality rate close to that of China and Japan in spite of the high amount of saturated fat and cholesterol levels in the French diet. The consumption of red wine in France, however, is considerably higher than in either China or Japan (Staggs, 1996). 

The well-known French paradox was first noted by Irish physician Samuel Black in 1819. Back in the nineteenth century, he was the first to observe the fact that people in France suffer relatively low incidence of coronary heart disease, despite their diet being rich in saturated fats. It was proposed that France s profound red wine consumption is a primary factor contributing to the protective effect. The first scientific evidence, however, for the cardiovascular benefits of red wine was put forward by Renaud and his associates in 1992 [Renaud and Lorgeril, 1992]. In this study, popularly known as the French paradox, the researchers found that there had been a low mortality rate from, and incidence of, coronary heart disease among French men above the age of 40 years compared to men in the United Kingdom and the United States, despite their high consumption of saturated fats and the prevalence of other... 

Koop P, 1998. Resveratrol, a phytoestrogen found in red wine. A possible explanation for the conundrum of the French paradox Eur J Endocrinol 138 619-620. 

Sun AY, Simonyi A, Sun GY. 2002. The French Paradox and beyond Neuropro-tective effects of polyphenols. Free Radic Biol Med 32 314-318. 

The reactivity of Amadori compounds can also be lowered nonenzymically, potentially in vivo. Thus, compounds, such as acetaldehyde, can stabilise Amadori compounds (see Structure 107).603 Indeed, diabetic rats fed an ethanol diet for 4 weeks showed a 52% decrease in HbAGE compared with diabetic rats not exposed to ethanol,621 HbAlc being left unaffected. This provides a possible mechanism to explain the French paradox. 

The efficiency of the carbene-based systems has led to their application in total synthesis. For example, Andrus and co-workers [74] recently reported a new synthetic approach to resveratol, the probable causative agent of the French paradox [75]. A decarbonylative Heck reaction was the key step of this concise and cost-effective synthesis [76-78]. 

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