Sunday, 9 December 2012

Le topic du jour: Gout qui importe

In the two or so decades that the so-called French paradox has been discussed widely [1], a variety of explanations for the lower rates of heart disease in France and some other Mediterranean countries have been examined. Yes, consuming wine (and probably specifically red wine) does offer some protection. Beyond that, at least outside of academic epidemiology, it seems a little hazy. The paradox in popular accounts has also come to encompass obesity. Look at all that rich food they eat! Those cheeses! Creamy desserts! It’s amazing that the French aren’t popping the buttons on their Chanel suits!

 As a current visitor to a research institute in the lovely medieval town of Dijon, I have been experiencing my own French food paradox. Eating lunch at the lab canteen is a daily ritual in which an entrée, main course and most often dessert and yoghurt are consumed. My colleagues here reliably inform me that the evening meal is somewhat similar in structure, except that an additional cheese course is always included. Wine is a regular feature of the evening meal if not lunch. Back at home, I would be anxious that this sort of regular intake would permanently double my already ample frame. Perhaps it's the change of scene but after a couple of weeks here, this is starting to seem normal. Certainly, from a weight perspective, none of my colleagues have to worry. But, why not?

 In terms of sensory palatability, the food consumed is neither boring nor lacking in those ingredients that tend to make us worry, especially fat and sugar (although the canteen’s main strength is probably its low prices). My colleagues and I are not eating lettuce leaves and celery, and the (evening) wine is definitely not low alcohol. What does this tell us about those in the US, Britain, Australia and elsewhere desperately trying to control their weight by eating rye crackers and low fat cheese for lunch? The most obvious answer, discussed often previously, is that the French eat smaller portions during meals than we would. If that seems an easy solution, then there is also the fact that eating for the French is a mealtime activity that you undertake in company, and snacking between meals is relatively rare.

 But these two phenomena create their own little paradox. If you eat less food, won’t you be hungry before the next meal and inclined to want to snack? Perhaps, but we know that so-called between meal hunger has, most of the time, little to do with the body demanding required nutrients. It is about habit and the search for pleasure from food.

 And then there’s the question of the healthiness of the food. The obesity ‘epidemics’ in Western countries have led to worries about the energy content of individual foods. While I would argue that the issue ought to be about diet rather than ingredients, there is a popular belief that obesity can be beaten if only delicious foods can be reduced in fat and sugar, and that notion generally supports an underlying attitude that delicious foods are commonly intrinsically unhealthy. Hence, surveys in the USA show that Americans tend to worry a lot about food and its health consequences.

 What about the French – don’t they worry about food and health? The answer seems to be no, or at least not in the way that many other nationalities do. Their focus seems to be much more on the pleasure afforded by food [2]. If you don’t need to worry too much whether the food you eat satisfies your need for pleasure, then you can clearly let your body tell you when you have had enough, and this is what the French appear to do [3].

 Most importantly, the French do not have to worry excessively about whether to eat either healthy food or delicious food, a major concern for American consumers. A recent study has shown that, in contrast to Americans, the French see no conflict between food pleasure and health. Werle and colleagues [4] used the Implicit Association Test (IAT) as of way of determining how closely related the concepts of healthy/unhealthy were to tasty/untasty for male and female French undergraduate students. The advantage of the IAT is that it requires no overt statement from participants about these relationships. Instead, it relies on comparisons of the speeds to respond to different combinations of the concepts being investigated. Using both pictures and words presented on a screen, items reflecting tastiness could be paired with different key presses for healthy and unhealthy (and the same for untasty). For example, a strong association in the participant’s mind between tasty and unhealthy would mean that such key presses should be faster than for tasty and healthy. In other words, congruent concepts when tied to the same response (key press) are responded to more quickly that incongruent concepts.

 These researchers found no difference in the meaning of unhealthy foods; as in the USA, the French idea of unhealthy food involves fat and sugars. However, their IAT results revealed that French participants were faster to respond to a combination of healthy and tasty than they were to healthy and untasty. In a second study, as a direct test of these results, they provided a novel milk-based fruit juice, labeled as either “generally considered healthy” or “generally considered unhealthy”. Consistent with the first study’s conclusions, those participants in the healthy label condition rated the drink as tastier than did the participants in the unhealthy label group.

 What are the origins of the contrasting views of tastiness and healthiness between French and American consumers? Paul Rozin, and more recently Oakes [5], have shown that many American consumers have adopted very simplistic approaches to categorizing foods. In the consumer mind, foods are broadly either good (healthy) or bad (unhealthy) and this distinction is typically made in terms of fat content. To a large extent, this results from long-stranding government and media-based emphases on fat intake as the major cause of both obesity and heart disease. From the consumer’s perspective, adopting undemanding rules about foods is understandable given the potential complexity of nutritional information, but may have unforeseen consequences, beyond simply a guarantee of boring mealtimes.

 Putting foods into good and bad baskets may also be counterproductive in attempts to loose weight. Thus, the notion of tasty = unhealthy = fat is sufficiently ingrained in the USA that consumers can ignore the potentially greater weight gain from a higher calorie “good food” if it is contrasted with an obviously fat containing, but lower calorie “bad food”. One study of US college students who were given cookies to eat reveals where this can lead. The researchers assigned the students to receive information about the healthiness of the cookies. Those students who were told that the cookies were a ‘healthy snack’ ate 35% more than did those told that they were unhealthy [6]. Dieting never tasted so good!

 The link between dieting and equating tastiness with unhealthiness is even evident among the French participants in the Werle et al. study. There, the strength of the association between healthy and tasty was found to be weaker for highly restrained eaters (that is, those who try to consciously restrict their food intake) than for less restrained eaters. It is not clear in which direction(s) the arrow of causation points here, but such a finding does make us wonder whether the process of food restriction acts to distort attitudes towards foods and health.


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