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Fermented Foods: Worth The Hype?

Photo credit: istetiana - Getty Images
Photo credit: istetiana - Getty Images

Got a question for the Women's Health Collective? Send us a DM @womenshealthcollectiveuk and we'll call on our experts. We're getting your questions answered.

Carly from Amersham asks:

'Fermented foods: worth the hype?'

Expert: Laura Tilt, registered dietitian and health writer

You’d be forgiven for thinking fermented foods are new. Kombucha, kefir and kimchi are seen as heath food stables in the wellness world. But fermentation has deep roots.

It’s an age-old practice used to preserve food and enhance its flavour, texture and nutritional make-up. Cheese, chocolate and soy sauce are all store cupboard staples that are actually fermented foods.

How does fermentation work?

During the fermentation process, microbes (naturally present or added) consume sugars in food substrates like vegetables or dairy, producing various byproducts like gases and acids.

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Microbial end products give fermented foods their characteristic tangy flavours and fizz (consider the tartness of yoghurt or the bitterness that makes kombucha a decent Prosecco stand-in).

They also create a preservative effect by lowering the pH, preventing the growth of harmful microbes and extending shelf life.

How healthy are fermented foods?

While preservation was what attracted people to fermented foods historically, these days it's their potential health benefits that do much of their PR for them.

Epidemiological studies (which look at why diseases occur in different groups of people) have shown links between fermented food consumption and the risk of various conditions. For example, yoghurt with a lower risk of metabolic syndrome in Mediterranean adults; kimchi with lower incidents of asthma in Koreans.

It's also widely accepted that fermentation improves the digestibility of some foods. Take the fermented milk drink kefir. It’s made with bacteria that break down lactose, making it more digestible for people with an intolerance to the milk sugar.

But the alleged benefits for the gut microbiome - the trillions of microbes and genetic material that live in the gut - are fermented foods' biggest draw.

Why does the microbiome matter?

Kept in balance, these tiny organisms form part of your immune system, helping you digest food and influencing mood and behaviour through the various neurotransmitters they produce.

But exposure to antibiotics, stress and low-fibre diets disrupt this community, which has led to increasing interest in probiotics - live microbes that can have multiple health benefits when consumed in the right quantity.

And, because fermented foods are made with live beneficial microbes, it's assumed that these microbes reach the gut when consumed. But, while some studies support this theory, it’s not clear yet what physiological effect this has.

The assumption that fermented foods are automatically 'probiotic' needs addressing, too. While some retain living microbes, many undergo processing which renders the microbes inactive - soy and sauerkraut are made shelf-stable by heat processing, sourdough is baked - and, at present, there aren't enough high-quality studies looking at the health effects of fermented foods to draw any solid conclusions.

So are fermented foods worth the hype?

The absence of live microbes doesn't preclude benefit. Sauerkraut is rich in fibre and vitamin C. Naturally carbonated fermented drinks contain less sugar than fizzy drinks. And their flavour can bring dishes alive.

Don’t like spicy kimchi? Try a carrot kraut. Dairy fan? Try milk kefir on your cereal. While we wait to learn more about the specific physiological effects of ferments, they still have much to offer.

Ready to add to basket? Here are three ways to incorporate fermented foods into your diet:

  • Kefir is the most researched of all fermented foods, with evidence suggesting it can be more easily digested by those with lactose intolerance than milk. Cultured dairy products have also been shown to have consistently higher levels of live microbes than other fermented foods.

  • Consider fermented vegetables a good gateway ferment - easy to make at home and you can usually find a dish to please all palates. If sauerkraut (fermented cabbage) isn’t your thing, try a carrot kraut or fermented salsa.

  • Tempeh, made from fermented soybeans, is a traditional Indonesian food. It’s rich in protein and fibre, plus a source of calcium and iron.

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