Earlier this year when the PREDIMED study was published in the New England Journal of Medicine, the Mediterranean diet was back in the news.The study concluded a Mediterranean diet supplemented with either olive oil or nuts reduces the risk of major cardiovascular events by 30 per cent in comparison with a low-fat control diet (1). It is important to note the individuals in the study were people at high cardiovascular risk but with no cardiovascular disease at enrollment in the study. The traditional eating habits of the Mediterranean region, specifically Greece and Crete, garnered attention and have been studied since the 1960’s. People in the region have been shown to have the greatest life expectancy and the lowest incidence of CVD and cancer in the world (2).

The traditional Mediterranean diet is characterized by a high intake of olive oil, fruit, nuts, legumes, vegetables, and whole grains; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and red wine in moderation. In addition the regular diet features local, minimally processed, fresh plant based foods. This highly varied diet and an active daily lifestyle has been further researched as to how it might provide healthy changes for those of us in the West, specifically in decreasing the risk of cardiovascular disease (3).

How does barley fit into the Mediterranean food pattern? In The Barley Balance post – Fibre Part Two: What is soluble fibre beta-glucan and why it is important for heart health? The connection of barley to heart health was identified. Specifically the daily consumption of beta-glucans found in barley has shown to decrease total and low-density lipoprotein (LDL) cholesterol, which are both risk factors for heart disease (4). The Mediterranean diet emphasizes whole grains (something I like to call smart ‘carbs’ and barley is definitely a smart carb) and since the beta-glucans in barley lower the risk factors for heart disease, it is a natural fit.

What does this mean to you? Obviously it means eat more barley! And now that we are in the summer season, I recommend a delicious Mediterranean barley salad you can add to any meal. The salad is barley tabbouleh. Tabbouleh originated in Lebanon and has become a Mediterranean favourite. It is made with parsley, a whole grain (that is where the barley fits in), tomatoes, cucumber, onion, mint leaves, lemon juice and of course – olive oil. Barley tabbouleh will make a healthy addition to any of your meals. Enjoy it as an appetizer, as a garnish on your sandwich at lunch or as a delicious side dish at your next BBQ – perhaps with a glass of red wine.

References:
1) Estruch R, Ros E, Salas-Salvado J, Covas M, Corella D, Aros, F et. al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. New England Journal of Medicine. 2013;368:1279-1290.
2) Willett W, Sacks F, Trichopoulous A, Drescher G, Ferro-Luzzi A, Helsing, E, et. al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nut. 1995;61:1402S-6S.
3) Lorgeril M, Salen P, Martin J, Monjaud I, Delaye J, Mamelle N. Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction: Final Report of the Lyon Diet Heart Study. Circulation. 1999;99:779-785.
4) AbuMweis SS, Jew S, Ames NP. Beta-glucan from barley and its lipid –lowering capacity: a meta-analysis of randomized, controlled trials. Eu J of Clin Nutr. 2010;64:1472-1480.