Have you heard of the French Paradox? It’s an interesting conversation. A mystery to some. The common discussion among people being, “They eat bread, drink wine, and use butter on everything.” But staring us in the face straight from the NIH website, “The French Paradox is the observation of low coronary heart disease (CHD) death rates despite high intake of dietary cholesterol and saturated fat”. Now they go on to say that this is due to under-reported cases of CHD, but, reading further, that is just a theory. Saturated fat is demonized and has been since the 50’s, thanks to cherry-picked data and a one-size-fits-all approach. So is saturated fat really so bad? Why is the NIH theorizing why a country is healthier than the US? It’s all fairly complicated. Or wait, is it? Let’s look at some stats.
First, let’s look at diabetes. In the US, the rate is around 15.8% in adults. In France, we see around 6%. Almost 3 times the amount. Then we look at obesity in France at 17%, versus the US rate of over 40%. That should shake everyone to their core. Nearly half of the population in the United States is obese. What is the main difference? Well, for starters, nutrition therapy from dietitians is COVERED BY INSURANCE! What a wild concept. Doctors refer patients routinely for nutrition guidance. 70% of type 2 diabetes cases start with 3-6 months of supervised nutrition therapy before drugs.
Campaigns like the Programme National Nutrition Santé (PNNS) embed nutrition education in schools, workplaces, and clinics. Doctors use tools like Nutri-Score labels during visits to guide choices, reducing reliance on meds by addressing root causes early. So you’re telling me, nutrition is taught in school and in the workplace? And in clinics? What in the world! And you can argue, its taught in the US school system, sure, valid, but what is taught, the food pyramid? Telling us fats are bad, minimize protein, and eat carbs. Mypyramid is outdated. There is also cultural buy-in. Patients trust it. Compliance with diet advice is 65% higher than med adherence elsewhere (per WHO), Why? French docs are trained in med schools with mandatory nutrition modules of 200+ hours. A 2024 Lancet review credits France’s model with 25-30% fewer “preventable” med starts for metabolic diseases, saving €2-3 billion annually while boosting quality of life. Contrast this with the US, where only 30% of medical schools require nutrition training (per a 2023 Tulane study), with around 20 hours of curriculum. And insurance often doesn’t cover dietitians unless it’s post-diagnosis. Result? US diabetes management leans 60-70% on meds (ADA data), vs. France’s 40% initial med-free rate (HAS 2022)
General practitioners conduct free annual checkups for adults, including BMI assessments, blood sugar tests, and dietary history reviews. If risks like pre-diabetes show up, the first line is often a “nutrition prescription”. Tailored meal plans emphasizing Mediterranean-style eating. Only if lifestyle tweaks fail do meds like metformin come in.
The US has programs like the National School Lunch Program (NSLP) and Dietary Guidelines for Americans, but they often lack the enforcement, cultural emphasis, and sustainability focus of France’s model. France prioritizes fresh, locally sourced meals with minimal processing, while US school lunches frequently include more ultra-processed items and have looser nutritional standards. The programs for school lunches in the US are a phenomenal program. Many of them provide children with their meals for the day. But wow, there is a lot of sugar and processed foods in there. It could be done much better.
Another aspect to consider, there are many more banned food ingredients in the European Union than in America. The European Union is significantly stricter on food additives than the U.S., with the EU following a precautionary principle that bans or restricts ingredients until their safety is proven. While the U.S. often follows a risk-based approach, it permits additives unless definitive proof of harm emerges. Interesting, it seems the US food industry follows a similar model of the medical system, don’t worry about the problem until it causes drastic harm. There is also an interesting price to pay in France for sugar-laced beverages.
The sugary soda tax. Yep, there’s a tax on sugary beverages. But we don’t want more taxes. Agreed, but here’s an interesting concept. The tax on this soda is put back into the nutrition program. The tax generates around €400-500 million annually, directed toward public health programs like the Programme National Nutrition Santé. Therefore, if you decide to partake in digging your own hole and drowning in a moat of sugar-laden drinks, you’ve invested your soda tax into the program that’s going to help you. Not so bad. Now, people who choose to take health seriously aren’t paying money into taxes being routed to care for someone who decides not to take responsibility for their health. This also holds the food industry accountable. Manufacturers have reduced sugar content in some drinks to avoid higher tax brackets, improving overall nutritional profiles. Americans consume about 152 pounds of added sugar per person annually and drink approximately 38 gallons of soda per person annually. Maybe it’s time to be open to suggestions.
There is a lot that could be implemented in the US. So why hasn’t it? Well, there is the argument that we have way more people, and it’s not scalable. Large countries like Germany and Japan have figured out the system, so what’s the holdup? Perhaps it is the fact that we build so many systems and regulations that the amount of money it would take upfront to adapt these things would be astronomical. Well, is anyone interested in investing in the future of American health, or not? If so, maybe reduce Congress’s salary of $174,000 a year, plus pension eligibility after 5 years? You get all this and work 130 days a year? Who voted on that rule? Sure, there’s more to it, but 95 million dollars in salaries per year is a lot of tax money from the Treasury’s federal budget.
Then start smaller, the US could adopt a national sugar-sweetened beverage (SSB) tax to mirror France’s approach, reducing sugar intake by 5-10%, based on global studies. However, political and lobbying resistance is real. Big Pharma, insurers, and food industries (spending billions on lobbying) would slow it down, as it threatens profits (fewer meds, stricter regs). Since 2009, the beverage industry has spent at least $67 million opposing soda taxes and warning labels in 19 cities/states, plus $14 million annually on federal lobbying. Claiming taxes hurt low-income families and will raise hundreds of grocery items. Alright, probably shouldn’t be consuming those items then.
Little things build and gain momentum. Doctors have less than 19 hours of nutrition training in medical school. There are actions being taken to increase this in the US, which is needed. Why not be proactive? The fact that up to 57% of individuals in France who start nutrition training when at risk for Type-2 Diabetes achieve remission is amazing. Focus on nutrition, it is worth it. Teach children, make it as normal and as familiar as sports are to people. Teach portion control. And at the end of the day, there has to be consideration that Big Pharma funds 60-70% of US medical research and ads, prioritizing treatments over prevention. The food industry does the same, and includes lobbying to influence, you have an interesting tornado to face.
You can make a difference. The world of education is in the palm of our hands. We can invest a bit of our time in ourselves. Health can be simplified, and you can relieve yourself from the suffering of concern.
