Proponents of the “French paradox” would have you believe that the French get away with smoking, drinking and devouring meat and cheese without suffering the same rates of heart disease as other nations.
A report by the French Public Health Agency has debunked the claim. It revealed that only 11 per cent of the French enjoy “ideal” cardiovascular health. By comparison, according to a survey compiled in January by the health lobby group Forth, 14 per cent of Britons are blessed with “excellent” heart health.
Far from being exemplars of the virtues of the Mediterranean diet, more than 70 per cent of French adults do not eat enough fruit and vegetables and more than 80 per cent eat too much salt, according to the agency.
Its report made no reference to the supposed benefits of a glass of red wine with a meal but said 30 per cent of men and 10 per cent of women increase their risk of heart disease by drinking more than the recommended amounts.
The agency advises drinking no more than the equivalent of two glasses of wine a day and several alcohol-free days each week. In Britain, the NHS recommends drinking no more than 14 units of alcohol a week, the equivalent of six medium (175ml) glasses of wine or six pints of beer, spread over three or more days.
Cardiovascular disease is the second leading cause of death in France after cancer. The report, based on statistics up to 2022, highlighted “the need to improve care and strengthen prevention”.
The agency recommends drinking a maximum of two glasses of wine a day
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It emphasised socioeconomic and geographical disparities in heart disease — poor cardiovascular health was linked to lower educational levels. It also pointed out a rise in the number of women who smoke, which increases their risk of heart disease by 25 per cent more than it does for men. According to the agency, 27.4 per cent of French men and 21.7 per cent of women smoke.
“Smoking has increased among certain generations of women,” according to the report. “Over the past 15 years this has led to an increase in coronary heart disease among women below the age of 65.”
Lifestyle-related risks are compounded by a tendency for doctors to misdiagnose heart disease in women, the report said. “Women get worse treatment than men … [and] they are less often hospitalised in intensive care units.”
Martine Gilard, professor of cardiology at the University of Western Brittany, said: “Cardiovascular disease is the leading cause of mortality in women, yet it remains overlooked and is often under-diagnosed. Women are not taken seriously but told that their pains are ‘in their head’ or ‘to get some rest’ because heart problems are thought to be more of a male disease.”
Another risk factor is that nearly half of French women and a third of men do not do the recommended levels of exercise, the report said.
Half of French women and a third of men are falling short of the recommended levels of exercise
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French medical care may lead to lower death rates than in the UK, however. In 2022, cardiovascular diseases led to about 1.2 million hospital admissions in France and 140,000 deaths, more than a fifth of the total. In the UK, heart and circulatory diseases cause more than 170,000 deaths each year, a quarter of the total, according to the British Heart Foundation.
The two countries have roughly equivalent populations, estimated at 68.4 million for France and 68.3 million for the UK.