New Findings

Cardiovascular disease, which mainly includes coronary heart disease and stroke, is a worldwide health concern. In coronary heart disease, fatty deposits build up in the heart’s blood vessels, slowing the blood supply and potentially leading to a heart attack (myocardial infarction). A stroke occurs when narrowed blood vessels interrupt the blood supply to the brain. Genetic predisposition affects an individual’s risk for developing cardiovascular disease, but ongoing research continues to show the importance of environmental factors, such as diet, physical activity, and smoking.1 So why are we talking about heart health in a gastrointestinal article? Recent research into the preventative effects of certain dietary behaviour indicates that some of the same fibre-rich foods that are good for gastrointestinal health also promote a healthy heart.

Fruit and Veggies

A large international study, funded by the Heart and Stroke Foundation of Ontario, and recently published in PLoS Medicine, showed that individuals who carry genes that put them at a higher risk for heart disease than the general population may be able to mitigate that risk by consuming a diet rich in vegetables and fruit.1 The researchers studied 8,114 individuals through a global case-control study and analysed relevant data from 19,129 participants in a Finnish prospective study. The analysis showed that individuals across numerous ethnic groups who consumed a diet with a high content of fresh fruit and vegetables, whether they were genetically predisposed to cardiovascular disease or not, had the same lower risk for developing cardiovascular disease. Future research should attempt to replicate these results, but this study, the largest of its kind, offers hope that a diet rich in fresh fruits and vegetables, which is also beneficial for gastrointestinal health, may be able to overcome genetic risk factors for cardiovascular disease.


Many individuals who experience bowel irregularities rely on psyllium, a type of soluble dietary fibre found in some foods, especially breakfast cereal, and as a supplement (e.g., Metamucil), to improve stool frequency and consistency. It works by absorbing water in the small intestine to help food pass through more easily. Research shows that psyllium also lowers low-density lipoprotein (LDL) cholesterol levels; lower levels are associated with a decreased risk of heart disease.2 This is significant, as approximately 40% of Canadians aged 20-79 have unhealthy total cholesterol levels, increasing their risk of heart disease.1

After reviewing 21 studies involving people from 1996 to 2005, Health Canada approved the food industry’s request to include a health food label claiming that psyllium improves heart health, but with specific requirements. The literature review revealed that the minimum daily intake of psyllium required to sufficiently lower cholesterol is 7g. Based on this figure, Health Canada will allow manufacturers to include a heart health claim if their products contain at least 1.75g of psyllium per serving and contain no (or limited amounts of) ingredients known to increase a person’s risk of heart disease, such as cholesterol, sodium, and saturated fatty acids.

There are currently few food products available in Canada containing psyllium, but that may change with these new regulations. Health Canada hopes that manufacturers will include psyllium in larger amounts than the minimum required, and in a broader variety of food products, since an individual is unlikely to consume four servings of a single product (e.g., breakfast cereal) in order to obtain the recommended daily intake of 7g of psyllium.


Barley is a fibre-rich whole grain included in many soups, breads, and other foods. Like psyllium, barley is a form of soluble fibre and, when included as part of a high-fibre diet, can help with some bowel irregularities and lower the risk for developing diverticular disease. Alcohol manufacturers use barley to make whiskey and most types of beer. People in regions around the world appreciate barley water as a healthier alternative to soft drinks (see recipe below). Steeped in hot water, roasted barley grain is a tasty tea or, when ground and percolated just like coffee beans, is an excellent, warm caffeine-free beverage.

Following an extensive research literature review, Health Canada recently concluded that food manufacturers may use the claim that barley grain products are associated with a reduction of blood cholesterol.3 The minimum daily intake of beta glucan from barley that research has shown to reduce total and LDL cholesterol is 3g, which is in 208ml (almost 1 cup) of cooked barley. In order to use the claim, a food product must contain at least 1g of beta-glucan from barley grain products per serving. Food manufacturers who meet these requirements may also include specific statements on their packages, such as “Barley fibre helps reduce/lower cholesterol, which is a risk factor for heart disease.”

Dietary Changes

Making drastic changes to your diet can have an effect on your gastrointestinal system, and such changes could potentially be dangerous for individuals with certain gastrointestinal or liver diseases. Moderation, even of specific healthy foods, is usually beneficial. For more information about fibre, the effect of diet on a number of GI and liver conditions, and information on how to find dietitian resources in your region, visit our online information centre at You can also contact our office if you wish to receive a specific information package mailed to your home.

Try this Hearty Classic

Fibre-rich for your gut and with cholesterol-lowering properties for your heart, this once-popular drink is worthy of a comeback. Barley water is sometimes available in health food stores, but it’s easy to experiment at home to make your own customized version of this classic drink.

Old-Fashioned Fruit Barley Water


8 cups water

1 cup washed pearl barley

1-2 whole lemons

4-8 tbsp honey, cane sugar, or sweetener of your choice



Bring water and barley to a boil.

While letting this simmer for 10-20min, peel rinds from lemon and add to heat-proof bowl.

Strain barley water over rinds into bowl.

Add fresh-squeezed lemon juice to bowl and stir.

Sweeten to taste.

Refrigerate until cold


Experiment by adding other types of fruit, such as berries, oranges, or limes. For an extra kick, boil the barley with some fresh ginger.

Tip: Those boiled barley grains don’t have to go to waste. Add them to your favourite soup or sauce, or save them for breakfast and mix with fruit and yogurt.

First published in the Inside Tract® newsletter issue 183 – 2012
1. Do R et al. The Effect of Chromosome 9p21 Variants on Cardiovascular Disease May Be Modified by Dietary Intake: Evidence from a Case/Control and a Prospective Study. PLoS Medicine. 2011;8(10):e1001106.
2. Health Canada. Psyllium Products and Blood Cholesterol Lowering: Summary of Health Canada’s Assessment of a Health Claim about Food Products Containing Psyllium and Blood Cholesterol Lowering. December 2011.
3. Health Canada Summary of Health Canada’s Assessment of a Health Claim about Barley Products and Blood Cholesterol Lowering. July 2012.