Social Eating and the French Paradox Explained?
By Dr. Allen Lim
Adapted with permission of VeloPress from Feed Zone Table by chef Biju Thomas and Dr. Allen Lim.
We mentioned in this earlier post that one way to understand differences in social eating is by asking those who have little choice in how dinner is served—our children. We showed that Americans have a lot of room for improvement at the dinner table, but that the British are perhaps in even worse shape.
One culture that’s getting it right, though, is the French. The French excel as a nation when it comes to creating consistent and structured meal patterns. A five-year study on French eating patterns found:
- 97% of the children ate breakfast.
- 100% had lunch, with most (67 percent) having lunch at home and the rest (33 percent) in their school cafeteria.
- 88% had a traditional snack after school.
- And 99% had dinner, almost always at home with all family members (87 percent).
Compared to data from the United States, the French statistics are utopian, especially if we believe that family meals are important to our children’s health and well-being.
Though it’s hard to argue against the benefits of family meals for children, how this relates to the greater public health is another question.
The Heart Speaks Truth
Most studies show that physical inactivity, diabetes, smoking, obesity, hypertension, family history, and a high-fat diet are risk factors for cardiovascular disease. The “French paradox” is the observation that the French have extremely low rates of cardiovascular disease despite a high intake of dietary cholesterol and fat.
There are reports that place the total fat consumption of the French in the range of 38–40 percent of total caloric intake, with saturated fat in the realm of 15 percent.50 Despite this high fat consumption, the World Health Organization reports that from 2000 to 2007, the average age-standardized mortality rate in France from heart disease was 8.3 per 100,000. This is second only to Japan, which had a mortality rate from heart disease of 6.4 per 100,000 from 2000 to 2009. In contrast, from 2000 to 2005, the United States had a mortality rate from heart disease of 26.4 per 100,000—a death rate more than three times higher than the French and four times higher than the Japanese.51
There are many explanations for the French paradox which include
- the possibility of underreporting deaths related to cardiovascular disease,
- a higher polyphenol intake from red wine, which may be protective to the heart,
- a higher consumption of fruits and vegetables,
- more consistent physical activity (i.e., not sitting all day),
- and a more holistic attitude about food that emphasizes higher quality, more diverse foods, and sharing meals.53
Although all of these factors are important and likely play a role in explaining the French paradox, it’s the cultural differences in our attitudes about food and its role in community that I find most interesting. I write more about this in the Introduction to Feed Zone Table.
What’s fascinating is that the differences in cardiovascular disease between the French and Americans aren’t explained by what we eat, especially with respect to total fat and saturated fat. It’s likely that the differences in our cultural attitudes about food play a more important role in this health disparity because they directly shape how we eat.
If there’s one single or culminating behavior that best explains the French paradox, it’s simply that the French eat less than Americans do. In French restaurants, portion sizes are smaller, as are individually wrapped portions of food in French supermarkets. Even French cookbooks list a higher serving number for a given amount of food.
Of note, not only do the French eat less than Americans do, they also take much longer to eat, relishing in the experience rather than just trying to get on with their day.55 How is it that the French eat less but take longer to eat? The simple answer is that the French eat together.56
Eating Alone & Quickly
In fact, as studies on French and American family meal frequency and structure clearly demonstrate, the French eat together in orders of magnitude more than Americans do. I can’t help but think that this is a critical though rarely discussed explanation for why Americans die from heart attacks at a rate three times higher than the French. Rarely does someone just linger over a small meal by themselves.
Given the countless factors that are responsible for cardiovascular disease, it may seem far-fetched that one behavior—eating together—may be a key to preventing cardiovascular disease. Certainly the people we eat with can reinforce both negative and positive behaviors.57 So just coming together isn’t enough. Still, France isn’t the only place in the world where the combination of eating with family and a positive social dynamic is linked with a diet-health paradox. Japan’s food culture includes a lot of fast-food eating, but those restaurants are filled with families sharing food and conversation instead of people eating alone and quickly.
What We Eat May Matter Less than How We Eat
What diet-health paradoxes in places like France and Japan demonstrate is that it’s not solely about what one eats when it comes to a society’s health. It’s also about how we eat and who we eat with—that we need both people and food to be fully satiated.
Complete footnotes and references for studies cited above are available in the print edition of Feed Zone Table.