Fermented Foods

Fermented foods are all the rage these days. If you haven’t noticed them yet, after reading this blog post you’ll be noticing them everywhere. In fact, food bloggers predicted that fermented foods would be the number one food trend for 2018. Funny- because when I think of ‘trends’ I often think of new, fresh ideas but fermented foods couldn’t be further from ‘new.’

Fermented foods can be traced back to biblical times with sour milk mentioned in the bible on multiple occasions. The Ancient Greeks and Romans had various recipes for fermented milk. In India, at 800 years B.C. fermented milk drinks were consumed on the regular. In 1907, a Russian scientist won the Nobel Prize for his work on fermented foods and immunology.

So, as you can see, fermented foods are certainly trendy – but by no means a new concept. We have been aware of the many health benefits of consuming fermented foods for years. In the 1950’s, we believe a researcher during his study of ‘useful bacteria’ named them ‘probiotics’ from the Greek language meaning ‘for life.’ Flash forward to 2002, the World Health Organization defined probiotics as ‘live strains of strictly selected microorganisms which, when administered in adequate amounts, confer a health benefit to the host.’

We have around 10 trillion microbes (aka. very tiny bacteria) colonized in the human GI tract. If we were able to extract them all, they would weigh 2 1/2 – 5 pounds! All these microbes are a combination of helpful and not-so-helpful bacteria. We want a healthy balance of these microbes in order to promote overall health. Your personal gut microbial balance and composition is as unique as you are an individual person. It’s nearly impossible (for us average joes) to know what our own balance looks like – but we do know there are a TON of different microbes colonizing in there daily. So when we look at foods to eat to help build a healthy GI tract, variety of probiotic sources cannot be stressed enough. We want to introduce different strains of probiotics through the foods we eat on a daily basis.

Alright, so we know we need probiotics from fermented foods for a healthy GI tract but what else? You may have heard that a significant portion of our immune system is actually housed in our gut. We know that our gut secretes massive amounts of antibodies into our gut each day and researchers are fascinated studying this interplay. This connection is HUGE and worth eating up all the probiotics in itself, but there is more. Specific strains of probiotics have been studied to help with antibiotic associated diarrhea, infant colic, IBS, Crohn’s disease, Ulcerative colitis, lactose intolerance, immunomodulation, high cholesterol, cardiovascular disease, cancer, obesity, bowel regularity, and the list continues to grow.

Probiotics are living organisms that need food (prebiotics) to stay alive. Ingesting our probiotics through whole foods gives these healthy bacteria the optimal environment to thrive and colonize in our gut.

Ideally, we would consume 1-2 servings of probiotic-rich foods each day. But anything new you incorporate into your eating is beneficial. Check out the fermented foods below with servings and suggestions for incorporating into your daily eating.

Six Fermented Foods to Add to Your Eating Routine:

1. Kefir

Kefir is a fermented milk drink so aptly called ‘the champagne of dairy’ for it’s slight effervescence. It is fermented by a combination of bacteria and yeast which creates the ‘kefir grain’ – no worries, it’s not an actual grain and is gluten free. It has a tart and tangy flavor with the mouthfeel of a drinkable yogurt. With kefir, you will get the biggest probiotic bang for your buck. Kefir contains the largest variety of live strains of probiotics than any other food product, 12 strains total. Kefir also contains a significant amount of protein – 10-11 gm per 1 cup serving.  Flavored kefir contains a small amount of added sugar but I strongly feel the benefits of the large dose of probiotics outweigh this – but they do make unflavored with no added sugar. Kefir is nearly lactose free (many claim 99% lactose free) so many with lactose intolerance can totally handle kefir.

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How-to-Use: Drink a cup of kefir with a piece of avocado-egg toast for breakfast. Drink a cup after your workout to help repair muscles and immunity. Use kefir to make your overnight oats instead of milk and yogurt. Add kefir to your smoothie instead of your usual liquid -great way to try the unflavored variety. 

2. Kombucha

Kombucha is a fermented black or green tea drink that has been around for many years yet the research on it is lacking. This may be related to the fact that the composition of the beverage is quite complex and varies between fermentation site- but kombucha typically contains different strains of yeast and bacteria. Kombucha is effervescent, tart yet slightly sweet with some brands having a more sour, vinegar taste. You can also make kombucha at home by obtaining a SCOBY (Symbiotic Culture of Bacteria and Yeast) which acts like the coral reef of the kombucha ‘sea,’ except it floats on the top of your tea while fermenting and making your magical kombucha come to life. Literately! (minus the sea monkeys…….. i kid!) Store bought kombucha comes in a variety of different flavors, some better than others. So try a few different flavors and brands until you find what you like best. Kombucha requires some sugar to ferment and feed the probiotics but the amount added varies dramatically between brands – 4-12 gm of sugar per 8 oz serving. 

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How-to-Use: Kombucha is a nice choice for someone who cannot consume dairy products. Drink 8-12 oz for a serving of probiotics any time of day. It’s a great post endurance run drink to potentially help enhance the immune response post hard effort. If you want to be doubly trendy, you could make a cocktail out of kombucha (think Moscow Mule with Ginger Kombucha instead of Ginger Beer or Kombucha Sangria) 

3. Sauerkraut

Sauerkraut is shredded cabbage that has been fermented with lactic acid. Gone are the days of your boring sauerkraut and in comes super trendy, super delicious varieties that taste phenomenal on just about everything. Make sure you choose the unpasteurized versions as the heat of pasteurization kills the probiotics. Sauerkraut is also a great source of fiber, iron, and Vitamin C. It is typically fairly high in sodium – so watch your portion if this is an issue or eat more if you’re a super salty sweater! 

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How-to-Use: Visit Cleveland Kraut’s website and find a store that sells in near you and buy them out of every flavor. Seriously – you won’t find anything better! (And, no they aren’t paying me to say this. It’s just that amazing.) Put it on avocado toast or eggs at breakfast. Add it to quinoa and other grain based dishes for extra flavor. Top chicken sausage or grilled chicken/pork loin with it. My favorite way to enjoy it is on a sandwich, really any sandwich. It’s the best condiment around. I suggest layering it on top of some mashed avocado so it really sticks to the sandwich for equal distribution in every bite. Not that I’ve studied this or anything… 

4. Tempeh

Tempeh is a fermented soybean food. It is much more dense than tofu, but it can be found in the same section in the grocery store. It is made up of individual soy beans, sometimes with added grains, so it has a lumpier look and darker color than tofu. Soybeans are fermented with phytic acid to create this probiotic rich food. Tempeh has a mildly nutty flavor and tastes more earthy than tofu.

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How-to-Use: Raw tempeh will contain the most nutrition and probiotics, however most people eat it cooked. Crumble it into spaghetti sauce while heating it for a faux meat sauce. Slice thin, marinate, and bake to make vegan bacon. (Recipe coming soon – it’s delish!) Cut into strips and pan fry. Cut into cubes and substitute for meat in stir fry.

5. Yogurt

Yogurt is the most prevalent source of probiotics in Americans diet. All yogurt has been treated with probiotics to create this popular diary food. If the yogurt is heat treated after this step, it will not contain many probiotics. Yogurt also varies in the number and strains of probiotics, so look for the Live and Active Cultures seal which means there are over 100 million good little buggers per gram of yogurt. Greek yogurt will contain 3 times the protein as regular, but when it comes to probiotics, both can be good sources.

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How-to-Use: Eat it straight out of the individual serving cups (~6 oz) as a snack or addition to a meal. Stash some in the work fridge (with your initials on it for the food thieves) for a quick snack. Add 3/4-1 cup plain Greek yogurt to smoothies instead of protein powder. Make yogurt parfaits and smoothie bowls and top with your favorite muffin or granola. Use plain yogurt as a base for sauces and dips.

6. Kimchi

Kimchi is a fermented cabbage, and sometimes additional vegetables, side dish. It’s safe to describe this as Korean sauerkraut. Fermented with lactic acid and spices are added such as red pepper, ginger, garlic, and scallions. It is often fairly spicy with a strong odor. Kimchi is often made a home. Traditional kimchi is kept underground to keep cool while the fermentation process was underway.

How-to-Use: Kimchi is a phenomenal condiment for tacos, burgers, and sandwiches. It’s also amazing on eggs. Our local farmer’s market often has a make-your-own kimchi station on Saturdays – great idea to get people familiar and eating probiotics!



Verna EC. Lucak S. Use of probiotics in gastrointestinal disorders: what to recommend? Therap Adv Gastroenterol 2010 Sep;3(5):307-319.

Markowiak P. Slizewska K. Effects of probiotics, prebiotics, and synbiotics on human health. Nutrients 2017;9:1021-1052.

Pandey KR. Naik SR. Valik BV. Probiotics, prebiotics and synbiotics- a review. J Food Sci Technol 2015;52(12):7577-7587.

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