Can French Paradox hypothesis explain the observed different trends of mortality from ischemic heart disease and stroke in Western Europe?

The “French paradox” has been postulated to be related to the widespread consumption of wine. However, this French paradox is being questioned and the results from the MONICA studies showed that France is not lowest among populations for cardiovascular disease. Thus, France would not be an exception but would follow that geographic gradient. While numerous epidemiologic studies have provided evidence for a French exception, some studies have not found any difference between beer, wine, and spirits in their relation to CVD or CVD risk factors.In our study on mortality trends of ischemic heart disease (IHD) and stroke in Denmark, Finland, France, the Netherlands, Norway, Sweden and England and Wales, the IHD mortality increased between the 1950s and 1970s in all countries for both men and women, except for France with relatively less peak and more stable mortality trend compared to other countries. For stroke, the France mortality was similar to other countries first, but started to decline much faster than other countries. This French advantage would be repeated in the future too.It seems that our results support the “French Paradox; however, the question still remains: is this difference due to French paradox or other factors?