A Tale of Two Cuisines

Where would you rather eat? Greece? Or France? A doctor says the Mediterranean Diet isn’t the gold standard. Instead, he says, Viva la France! And pass the butter.

Dr. Michael Aziz wants you to ditch the dolmades and tzatziki for beef bourguignon and wine sauce.

Dr. Aziz doesn’t mince words. “The French diet wins in every category,” says the New York City doctor whose methodology encompasses traditional, alternative, and complementary medicine. Dr. Aziz has written two books, one on aging, or rather anti-aging, and another on the role hormones have on dieting. This is the first time he’s spoken out about the merits of the Mediterranean diet.

For several decades now we’ve heard that if you want to live a long and healthy life, eat like the Greeks. Or the Spanish. Or the Moroccans, Egyptians and Lebanese. That means beans, legumes, nuts, fish, whole grains. Extra virgin olive oil is the main source of fat. Conventional medical wisdom says the Med Diet can lower your risk of cardiovascular disease and other chronic conditions.

And Aziz agrees. Only he says it’s not the best diet for Americans, because we’re too sedentary to benefit.

The flaw in the study, he says, was that researchers cherry-picked the data. “The [Mediterranean] Seven Countries study was done on farmers who were very active in the fields working out hours to burn those excess calories from bread.”

Americans generally don’t live that way. And so the Mediterranean Diet, he says, is overloaded with carbs. “It is easy to eat seven to 11 servings of whole wheat bread a day from sandwiches as in the Mediterranean diet,” he says. “I have never seen anyone eating seven to 11 croissants a day.”

Those farmers burned those carbs off. Americans won’t, he argues. The French diet, meanwhile, while higher in saturated fat and other “bad” things, emphasizes smaller portions and longer mealtimes—slower eating. He maintains that this is more important for health than beans, legumes and fish.

He adds, “The French diet includes more full-fat dairy like cheese and yogurt, which provides calcium and vitamin D. These nutrients are great for bone health.” He says the diet can also reduce the risk of developing colon cancer. “The Mediterranean diet limits dairy. Calcium plays a role in colon cancer prevention, which is an epidemic in men below 50 in the US.”

For evidence he cites the difference in longevity. The French live longer than those in Mediterranean countries, despite all the stereotypical rich eating. The average life expectancy in France is currently around 83.1 years. The average life expectancy in Greece is 81.8 years. In Italy it’s 82.9. But those are minuscule differences, and they can be explained by other factors, such as smoking, physical activity, genetics and so on. Aziz says “This data suggests that despite consuming rich, fatty foods, the French stay slimmer and healthier, likely due to portion control and meal timing,” but I don’t think the evidence is anything close to compelling, variables aren’t taken into consideration.

So what other evidence does Aziz’s diet have to recommend it over the long-established Club Med? Is there a compelling reason to change what has been the gold standard for years if not decades?

There’s little consensus—at least so far. “We use the Mediterranean diet and it works,” says registered dietician Linda Michaelis. “So we’d probably just stick to that.”

Danica Cowan, an integrative dietitian at UCSF, has an interesting response. “I think these sorts of comparisons are generally losing the forest for the trees. This is getting too granular for most people's needs.” She says there’s no reason to change horses, unless the other horse suits your personal digestive needs more.

However “granular" it might be, however, there are some differences between the two approaches that should be examined.

Dr. Aziz’s first point is how much slower the French eat. Americans in particular eat bigger portions, and we eat them very quickly. “We were not in the house above twenty minutes, but we sat out two sets of company at least,” observed British traveler Basil Hall way back in in 1829. His wife made the same observations in her own writings, marveling at the “seven platters of as many meats served at one meal.” Another writer from England, Fanny Trollope, echoed these claims. “Americans...eat with the greatest possible rapidity, and in total silence.”

French traveler and author Edouard Montulé feared he “ran the risk of dying of hunger” because of “the speed with which my neighbors made the food disappear.” He says people ate breakfasts “with a rapidity altogether unexampled,” and lunches where the diners “seemed to pitchfork his food down his gullet.” Alexis de Tocqueville blamed it on Americans’ propensity to be forever appearing busy, to project prosperity or at least industriousness.

Our eating habits haven’t changed much. After all, the U.S. is the nation that proudly invented “fast food.” Could you imagine the British, French or Italians flaunting such an accomplishment?

There’s lots of research to back up the claim that slower and smaller is healthier. Studies suggest slower eating and smaller portions lead to improved satiety, and thus better appetite regulation, which reduces calorie intake. And being “mindful” of your food as you eat it improves digestion, may reduce IBS cases, and according to some studies lifts your mood.

Aziz then points to the calcium benefit to the French Diet. It’s no secret they favor lots of dairy. Recently dairy has become a red flag for a lot of nutritionists: it’s fatty and can lead to stomach upset, bloating and gas, and even joint pain and recurrent infections. With some people that is true. It can also raise blood sugar levels. But the latest research also indicates there are numerous benefits.

Aziz cites several studies, most famously the “Million Women Study,” a large UK project suggesting that increased calcium intake reduces risk of colorectal cancer. This reduction is estimated to be a stunning 17 percent.

Researchers analyzed data from 542,000 women, tracking dietary habits and medical records for an average of 16 years. Calcium was found to have a similar effect in both dairy and non-dairy sources, though dairy sources appeared to work better.

So apparently we have another check mark for the French Diet.

Third, Dr. Aziz says the French habit of drinking moderate quantities of wine with meals rather than apart from them stabilizes blood sugar and enhances polyphenol absorption from foods. Polyphenols are beneficial antioxidants.

And finally both diets are rich in vegetables and unprocessed foods. Both cultures eat more fruits and vegetables than Americans typically do. Says Cowan, “I advocate for an anti-inflammatory diet, which is essentially a generalized Mediterranean Diet, and I suspect the French Diet would largely fall under that umbrella. There may be some individuals that benefit from more of a ‘French’ approach, and others that benefit from a more ‘Mediterranean’ approach. For instance, if you're lactose intolerant or otherwise don't do well with dairy, eating more dairy is probably not great advice.”

So in the end it may be a win-win. Both diets are healthy, so long as fresh, wholesome foods and moderation are a part. And while wine as a stealth health ingredient may have fallen out of far in recent years, it appears best to pair it with your meal if you indulge. But the biggest takeaway for me is you can turn your Mediterranean Diet into a French Diet by eating smaller portions more slowly, and adding additional dairy. (Yogurt anyone?) Whichever you choose, eat slowly…and savor.