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  • Has The So-Called French Paradox Vanished, Or Just Obscured By A Tobacco Smoke Screen?

    May 15, 2014: by Bill Sardi

    A recently published study claims to reverse decades of research studies which invariably show moderate wine drinking (3-5 glasses/day) results in a dramatic decline in coronary artery disease mortality. Does this recent study erase the so-called French Paradox where the wine drinking French in the 1990s were reported to have a far lower rate of mortality from coronary artery disease (90 per 100,000) than North Americans (240 per 100,000 at the time)? [British Medical Journal May 6, 1995]

    For decades now epidemiologists (those who study disease in human populations) have reported that both alcohol and wine produce a U-shaped risk curve, that is, teetotalers do not live longer than wine drinkers, and the mortality rate for wine drinkers drops dramatically when 3-5 glasses of wine are consumed daily but rises when more than 5 glasses a day are consumed. The lower mortality risk among the modest wine drinkers when charted on a line looks like a “U.” (See chart below)

    The recent study involved 783 adults over age 65 living in a wine-drinking area of Italy. [Source: JAMA Internal Medicine May 12, 2014] Contrary to many prior studies, the death rate did not follow alcohol consumption rates. The death rate appears to better follow the rate of smoking. Tobacco use was about 3-fold greater among those who consumed the most wine (see chart below).

    Wine, alcohol, resveratrol intake/excretion & smoking among 783 subjects 65-years of age and over, Tuscany Region, Italy, over 9 years

    [Source: JAMA Internal Medicine May 12, 2014]

    % consumes alcohol





    Amount alcohol/day

    Up to 2.4 grams

    8.8 grams

    16.3 grams

    31.1+ grams

    Amt. alcohol/day

    2/10ths/glass or less


    1.35 glasses

    2.6+ glasses

    Resveratrol excretion

    Nanomole/gram creatinine

    Less than 1554



    More than 15010

    Resveratrol intake (wine)

    2-3 mg/day

    2-3 mg/day

    2-3 mg/day

    2-3 mg/day

    Current smoker





    Died during 9-year period





    The fact that smoking negates the health and lower mortality rates associated with wine drinking is well established. Two published studies show that smoking demonstrably raises mortality rates in the face of alcohol consumption.

    Among those who drank a moderate amount of alcohol (1-21 drinks per week), the more tobacco use the greater the mortality rate (mortality risk was 1.0 for non-smokers; 1.4 for moderate smokers and 1.9 for heavy smokers). In other words, alcohol intake did not erase the adverse health effects of tobacco. [Preventive Medicine Oct. 2007]

    Another study published in the British Medical Journal noted the effect of smoking among alcohol drinkers, particularly those smokers who are obese. Take note, the participants in the recent study in Italy had a Body Mass Index of 27 (overweight). The relative mortality risk rose 4-fold among obese smokers who drank alcohol, though you can see that alcohol intake still created a U-shaped risk curve and produced greater survival among those who drank moderate amounts of alcohol (14-27 drinks/week). [British Medical Journal Jan 29, 1994] ©2014 Bill Sardi



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