Elsevier

Medical Hypotheses

Volume 79, Issue 6, December 2012, Pages 746-749
Medical Hypotheses

Could cheese be the missing piece in the French paradox puzzle?

https://doi.org/10.1016/j.mehy.2012.08.018Get rights and content

Abstract

The low rates of cardiovascular mortality which have existed in France for decades despite high saturated fat consumption constitute an epidemiological phenomenon called the “French paradox”. This phenomenon was originally attributed to consumption of red wine and its major constituent resveratrol. However, recent studies have revealed the limitations of this link outside France. These observations indicate that consumption of red wine alone cannot explain the paradox and perhaps some other constituents of the typical French diet could be responsible for reduced cardiovascular mortality. We hypothesize that cheese consumption, especially of molded varieties, may contribute to the occurrence of the “French paradox”. This assumption is well supported by newly discovered facts revealing the positive effect of cheese ingestion on lipoprotein turnover and plasma lipid profile, haemorheological parameters and inflammatory status. Recent advances in cheese proteomics have allowed the identification and isolation of novel peptides capable of inhibiting the angiotensin-converting enzyme which controls systemic blood pressure. A complex time-dependent enzymatic transformation of the cheese core controlled by probiota, temperature and humidity during the ripening process has been shown to result in the formation of substances reducing major pro-inflammatory markers and cytokines (C-reactive protein, interleukin 6, tumor necrosis factor alpha). Molded cheeses, including Roquefort, may be even more favorable to cardiovascular health due to the presence of secondary metabolites produced by Penicillium roqueforti and other fungi. Among them are andrastins A–D and roquefortine, whose ability to inhibit cholesterol biosynthesis and bacterial growth may be a key mechanism in the prevention of cardiovascular disease.

Section snippets

Background

How can anyone govern a nation that has two hundred and forty-six different kinds of cheese?

Charles De Gaulle

Despite high consumption of saturated fat France still enjoys one of the lowest rates of cardiovascular mortality in the world, only falling behind Korea and Japan. According to the World Health Organization 2009 Mortality Database, the mortality from heart disease and stroke in France was 50 cases per 100,000 of population, whereas the rate in the USA approached 129/100,000. The

French dietary pattern and Mediterranean diet

In general, French dietary pattern is characterized by meal preparation from basic/natural ingredients, structured mealtimes and less between-meal snacking [9]. Although there is significant diversity predetermined by regional, educational and socio-demographic factors [10], a typical French meal includes a significant amount of saturated fat originating from butter, cheese, whole milk and other dairy products, cured meats and pastries supplemented with some fruit and vegetables and moderate

From milk to fermentated dairy and ripened cheese

At present the consumption of whole fat dairy products is severely disapproved of by the medical community since there is a strong correlation between consumption of unmodified dairy products and coronary heart disease which has been traced for decades [20]. In contrast, the ingestion of reduced fat dairy products has recently been proven to be beneficial in counteracting obesity as well as other manifestations of metabolic syndrome [21]. It has been claimed recently that the link between dairy

Molded cheese, fungi and cardiovascular health

Roquefort, Camembert and Gorgonzola are only a few among many other varieties of popular molded cheese. In general, their production starts with the addition of rennet and a starter culture of Penicillium roqueforti or Penicillium camemberti, fungi which promote flavor formation in the full cream sheep’s milk [42]. The biochemistry of the ripening of these cheeses is far more complex than that of bacterial-ripened varieties such as Cheddar or Gouda and is characterized by more intense

Conclusion

The link between wine consumption and reduced cardiovascular mortality is not straightforward. Despite the persistent nationwide decline in wine consumption [46], France continues to show remarkably low levels of cardiovascular mortality. On the other hand, growing demand for red wine in the countries of Eastern Europe (Wine Annual Report and Statistics, U-27, 2011) does not affect the alarmingly high rates of cardiovascular disease in the region [47]. Therefore, “French paradox” seems to be a

Conflict of interest statement

None declared.

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