Read Online The Man Who Ate Everything by Jeffrey Steingarten - Free Book Online
Authors: Jeffrey Steingarten
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French do not “code” their death certificates as World Health Organization protocols instruct: when the French have the choice between attributing somebody’s death to cancer or to heart disease, they incorrectly favor the former. But how often do these errors occur? The answer is critically important to the WHO’s MONICA project (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease), whose purpose is to standardize and compare cardiac risk factors and fatalities across national boundaries. An emergency meeting was held, a study was performed, and a resulting MONICA report demonstrated that the French inclination to undercount heart fatalities is too small to matter. Correcting for it does not budge France from its standing right behind Japan in the coronary heart disease sweepstakes.
Just the idea that French cholesterol levels are the same as ours—while their rate of heart attacks is less than half—is enough to drive American nutritionists crazy. But not the Europeans, who, though taking cholesterol and saturated fat very seriously, assign to them only about one-sixth the influence we do here. Whether blood lipids end up as arterial plaques depends partly on whether they are oxidized; a major MONICA study, largely ignored in this country, showed that circulating levels of vitamin E, an antioxidant, statistically overwhelmed the influence of circulating levels of cholesterol in our bloodstreams. Besides, serum cholesterol may contribute to narrowing of the arteries, but for a heart attack to occur, the blood must clot—thrombosis must occur. Fat intake seems to have no connection with thrombosis. And other blood factors, such as circulating levels of the amino acid homocysteine, are now believed to be at least as important as cholesterol; consumption of folic acid (which occurs in greatest quantity in the liver of web-footed fowl!) effectively lowers homocysteine, but whether this is an effective therapy or merely suppressing the messenger has yet to be discovered.
A large number of heart attacks appear to result from spasms of the blood vessels, or unexplained ischemia; the causes are unknown, and diet has not been implicated. Finally, a group at Harvard has recently characterized the arterial damage that can lead to a heart attack as an inflammatory disease; again, the marker for this inflammation is as highly correlated with coronary disease as is serum cholesterol. All of this may finally explain why regular intake of aspirin fights heart disease. The suspected inflammation apparently has nothing to do with diet.
The French Paradox cannot be dismissed. It should have been noticed decades ago. And its contribution is to encourage researchers to discover the many other common causes of heart disease besides the saturated fat in our diets. The French Paradox is an embarrassment only to those nutritionists and physicians who had refused to recognize the obvious. We have known for some time that half of all heart attacks occur in people with average or low cholesterol, and that half of all people with high cholesterol never have heart attacks.
Totally Mashed
For some time now, I have been unhappy with my mashed potatoes. This is a pivotal difference between me and Omar Sharif, who is so pleased with his mashed potatoes that, according to the glossy magazine on my desk, he always has a second helping. His mashed potatoes really belong to Joel Robuchon, the brilliant chef-owner of the Paris restaurant Jamin, and for several years they have been the most honored mashed potatoes in the world. They are also an escapade in animal fat. Judging from the recipe in Robuchon’s Ma cuisine pour vous (Laffont, 1986), he beats a half pound of butter into each pound of boiled potatoes. In the ten minutes it takes Omar Sharif to clean his plate, he will have swallowed ten times the maximum daily dose of animal fat allowed by the U.S. surgeon general, before he gets to his main course. This is
Just the idea that French cholesterol levels are the same as ours—while their rate of heart attacks is less than half—is enough to drive American nutritionists crazy. But not the Europeans, who, though taking cholesterol and saturated fat very seriously, assign to them only about one-sixth the influence we do here. Whether blood lipids end up as arterial plaques depends partly on whether they are oxidized; a major MONICA study, largely ignored in this country, showed that circulating levels of vitamin E, an antioxidant, statistically overwhelmed the influence of circulating levels of cholesterol in our bloodstreams. Besides, serum cholesterol may contribute to narrowing of the arteries, but for a heart attack to occur, the blood must clot—thrombosis must occur. Fat intake seems to have no connection with thrombosis. And other blood factors, such as circulating levels of the amino acid homocysteine, are now believed to be at least as important as cholesterol; consumption of folic acid (which occurs in greatest quantity in the liver of web-footed fowl!) effectively lowers homocysteine, but whether this is an effective therapy or merely suppressing the messenger has yet to be discovered.
A large number of heart attacks appear to result from spasms of the blood vessels, or unexplained ischemia; the causes are unknown, and diet has not been implicated. Finally, a group at Harvard has recently characterized the arterial damage that can lead to a heart attack as an inflammatory disease; again, the marker for this inflammation is as highly correlated with coronary disease as is serum cholesterol. All of this may finally explain why regular intake of aspirin fights heart disease. The suspected inflammation apparently has nothing to do with diet.
The French Paradox cannot be dismissed. It should have been noticed decades ago. And its contribution is to encourage researchers to discover the many other common causes of heart disease besides the saturated fat in our diets. The French Paradox is an embarrassment only to those nutritionists and physicians who had refused to recognize the obvious. We have known for some time that half of all heart attacks occur in people with average or low cholesterol, and that half of all people with high cholesterol never have heart attacks.
Totally Mashed
For some time now, I have been unhappy with my mashed potatoes. This is a pivotal difference between me and Omar Sharif, who is so pleased with his mashed potatoes that, according to the glossy magazine on my desk, he always has a second helping. His mashed potatoes really belong to Joel Robuchon, the brilliant chef-owner of the Paris restaurant Jamin, and for several years they have been the most honored mashed potatoes in the world. They are also an escapade in animal fat. Judging from the recipe in Robuchon’s Ma cuisine pour vous (Laffont, 1986), he beats a half pound of butter into each pound of boiled potatoes. In the ten minutes it takes Omar Sharif to clean his plate, he will have swallowed ten times the maximum daily dose of animal fat allowed by the U.S. surgeon general, before he gets to his main course. This is
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