Fermented foods take the top spot in Today’s Dietitian annual list of superfoods for the 6th year in a row.
Registered Dietitian Nutritionists (RDNs) were polled by Today’s Dietitian and Pollock Communications on their views on superfood predictions and grocery shopping habits. The results, published in the 11th annual “What’s Trending in Nutrition” survey, predict how and what consumers will eat. Since 2019, health became the key focus of the superfood list. Striking this year is the new focus on affordable and accessible food.
“After years of keeping immune health and comfort top-of-mind during the COVID-19 pandemic, consumers are back to prioritizing affordability and convenience when shopping for food,” Pollock Communications shared in a statement.
This shift is attributed to the higher cost of groceries “as consumers navigate the cost-of-living crisis.” RDNs predict top purchase drivers are affordability and value (70.4%), ease of accessibility and convenience (59.1%) and immunity support (57.6%).
“Consumers are more aware than ever of the benefits food can provide for gut health and immune function. As consumers face higher costs at the grocery store, they’ll be looking for affordable food and snacks that still provide valuable health benefits,” says Louise Pollock, president of Pollock Communications. “Our survey findings reflect how consumer behaviors are shifting as Covid-19 restrictions loosen, remote work remains and inflation rises – from prioritizing affordable foods to continued interest in snacking.”
The survey highlights fermented food products yogurt, kimchi, kombucha and pickled vegetables. Also noteworthy is that, for the first time in 11 years of conducting the survey, the entire superfoods list is plant-based. The top ten include:
- Fermented Foods
- Seeds, such as chia and hemp
- Nuts, including pistachios, almonds and walnuts
- Leafy Greens, such as spinach
- Aquatic Greens, such as algae, seaweed and sea moss
- Green Tea
- Ancient Grains
- Non-Dairy Milks
Plant-based diets are becoming more popular, and RDNs note it’s the third most popular diet after intermittent fasting and keto. However, only 1% of RDNs say they would recommend meat alternatives because they are highly processed products.
RDNs are also concerned about where consumers are getting their nutrition information. Social media platforms such as TikTok, Instagram and Facebook are “rife with nutrition misinformation,” but they’re where many consumers turn for nutrition advice.
“Social media influencers are talking about wellness and nutrition at rates never seen before, but people struggle to differentiate between credible information and myths. This only supports the need to amplify credible sources of nutrition information, like registered dietitian nutritionists,” says Mara Honicker, publisher of Today’s Dietitian. “With the survey in its 11th year, we are excited to continue to share insights from these experts in food and nutrition, at a time where the value of food is subject to more scrutiny.”
Pickle and yogurt brands are speaking out against new labeling rules proposed by the U.S. Food and Drug Administration. The FDA’s new guidelines say some brands of the fermented products cannot be marketed as healthy because pickles are too salty, while some yogurt has too much sugar.
The guidelines are being updated for the first time since the 90’s. They redefine what can be labeled as “healthy” on a food package. Healthy products have high amounts of key nutritious ingredients, like fruits and vegetables, and low amounts of added sugar, sodium and/or saturated fat. Those updated nutrient content claims would go into effect in 2026. They wouldn’t ban “unhealthy” foods, but prevent the use of “healthy” on a label.
“Pickles have a role to play in a healthy diet because they are predominantly comprised of vegetables and serve as a delicious condiment to other nutrient-dense foods,” Pickle Packers International said in a statement.
Though pickles are made from low-sodium cucumbers, they are either fermented through a brine made of water, salt and seasonings or preserved in a brine of vinegar, salt and seasonings. Without enough salt in the brine, bacteria can grow and spoil the pickles. The new guidelines put the limit for sodium from a vegetable product at 10% of the daily value per serving (230 milligrams per serving). But most pickles include 11% sodium per serving.
Yogurt, too, is under fire. The new guidelines outline that a ¾ cup of yogurt should only include 5% per serving of the daily value of sugar (2.5 grams of added sugar per serving). Chobani’s plain greek yogurt includes 5.5 grams of sugar per serving. Chobani has actively protested the FDA’s ruling, noting that “reducing sugars to the level proposed by FDA for the ‘healthy’ claim would result in significant, deleterious effects to product quality, taste, and texture.”
Other companies are protesting the FDA’s guidelines – like General Mills, Kellogg’s, SNA International, the National Pasta Association and the Consumer Brands Association. The FDA guidelines put tighter restrictions on cereal and pasta, too.
“Hardly anything would qualify, so of course food manufacturers don’t like the idea,” says Marion Nestle, emeritus professor of nutrition and public health at New York University. She told nutrition and medicine publication STAT that the FDA’s regulation “automatically excludes the vast majority of heavily processed foods in supermarkets, as well as a lot of plant-based meat, eggs, and dairy products,” from bearing the healthy claim.
The publication notes nutrition experts gave “overwhelmingly positive remarks.” The new guidelines are supported by the American Society for Nutrition, the Association of State Public Health Nutritionists and the Robert Wood Johnson Foundation. Some experts argued the GDA could go further in restricting the healthy label.
Read more (STAT)
Sourdough is being researched for its effectiveness in helping people with celiac disease and gluten sensitivities. Charlene Van Buiten, PhD, an assistant professor of food science and human nutrition at Colorado State University, shared how sourdough can alleviate problems with gut health in an article she wrote for Baking Europe.
The live, active cultures contained in fermented foods like kimchi, pickles, kombucha and yogurt have been scientifically proven to increase the diversity of microorganisms in the digestive tract. A recent study from researchers at Stanford found a diet rich in fermented foods decreases markers of inflammation.
The same health benefits cannot be attributed to sourdough, though, because the live microorganisms are killed during baking.
“As a result, the health benefits associated with sourdough bread are derived not from probiotics, but from the actions of the starter culture over the course of fermentation,” Van Buiten writes. The microorganisms present in starter cultures “have been shown to improve mineral bioavailability in sourdough bread in comparison to conventional yeast-fermented bread through the production of organic acids and enzyme phytase, which promote the degradation of anti-nutritional phytates found naturally in flour. “
Sourdough bread has other positive effects, too. The increased acidity of sourdough forms resistant starch, so starch is not converted to sugar by the gastrointestinal tract but instead “acts more like fiber.” Sourdough fermentation also increases the amount of free amino acids in bread, improving the protein digestibility. Sourdough bread made from starter cultures are also lower on the glycemic index.
Van Buiten points out case studies “have suggested that traditional sourdough fermentation can improve gastrointestinal tolerance to bread in comparison to conventional yeast fermentation,” but only for individuals with non-celiac gluten sensitivity. Few studies have explored how sourdough would impact someone with celiac. A study would need to explore gluten degradation within sourdough fermentation, a key sensitivity for individuals with celiac.
“Though no evidence currently exists where traditional artisanal sourdough fermentation provides protection against the harmful gluten peptides associated with celiac disease pathogenesis, scientists are exploring novel strategies to employ the known gluten-degrading capabilities of sourdough-derived microorganisms in the production of baked goods,” Van Buiten adds.
Read more (Baking Europe)
We cannot write-off pasteurized ferments as the dead, less healthy cousin to its unpasteurized, live relative. All fermented foods provide health benefits, pasteurized or not. We also need to avoid getting caught up in superfluous health claims around fermentation’s benefits. Instead, we should focus on including fermentation as part of a regular diet.
David Zilber explored how the microbial transformation of food intersects with our gut microbes during Stanford University’s Center for Human Microbiome Studies Fermentation & Health Speaker Series. With growing scientific interest in fermentation – and increasing interest from consumers – the health benefits become cloudy in marketing claims.
“If you eat regularly foods full of life, life that lives regularly in the foods you consume but also inside of you, then you can be said to be a ranger taking care of a healthy forest,” Zilber said. “The health benefits of fermented foods should equally be viewed as being meaningful when they turn into a regimen, like exercise.”
A 2021 study by Stanford researchers published in the journal Cell found regularly eating fermented foods boost microbiome diversity, improves immune response and decreases inflammation. But marketing of fermented products is often shrouded in hearsay.
“As far as health claims go…(there are) sometimes outlandish claims made by Westerners about cure-all superfoods that disproportionately, and I quote from one study I found, ‘Seemed to benefit the individuals that sell them the most,’” Zilber said.
Take kombucha, for example. He rattled off a list of health problems kombucha founders have claimed the fermented tea has cured, from AIDS to cancer to constipation.
“The problem is that all these claims seem to come, in one form or another, from anecdotes of people who drink kombucha and have lived a life,” he added. They’re not researched in reputable cohort studies. “This is why it’s sometimes hard to separate the wheat from the chaff when it comes to fermentation. The people who want to believe the benefits only decry its Praises when a positive correlation is made but they also tend to speak the loudest.”
Zilber pointed out that consuming fermented foods, whether or not it’s a product with proven health benefits, is certainly still beneficial. Eating fermented foods regularly means “you’re also omitting a whole slew of other foods” prevalent in a Western diet, like highly-processed and chemically-preserved foods.
“If you put kimchi on your plate at dinner, you leave off mashed potatoes. If you use water kefir as your drink with it, you aren’t drinking Coke,” he said. “And that’s an important link we also can’t forget, when it comes to thinking about the health benefits of fermented foods, they are in many means inherently healthy.”
Many cultures have fermented for thousands of years to preserve food. In Tibet, yak herders rely on cultural wisdom passed down from generations to ferment yak’s milk for milk and butter.
“We’ve evolved alongside our microbes both evolutionarily and culturally,” Zilber added. “To Tibetans their folk knowledge of what leads them to Long lives and health is intrinsically tied to the practices of preservation that have allowed them to thrive in some of the most rarified air on Earth.”
Pasteurized vs. Unpasteurized
What about purchasing pasteurized vs. unpasteurized ferments? Unpasteurized ferments include live microbes, but that doesn’t mean pasteurized ferments aren’t healthy.
“Sometimes in cooking, if you’re looking to achieve a great flavor, sometimes you have to kill microbes because you have to pasteurize them for whatever number of reasons,” Zilber added. But it doesn’t mean that the food is somehow not worth eating, it just means that it’s not live, but it still contains lots of benefits. … There is a benefit to consuming something that microbes have lived through, even if it’s not pasteurized.”
Elisa Caffrey, the speaker series host and a Stanford PhD candidate, agrees. The benefits of unpasteurized ferments have not been studied. During fermentation, Caffrey notes, the microbes are producing metabolites still present during pasteurization. A complete study would characterize the metabolites over the course of the fermentation process, identify chemical compounds and then analyze the compounds for their benefits.
“That landscape we don’t understand at all and it’s a very, very interesting world to start exploring,” she said. “Until we start understanding all the different components of these foods and the way that they interact with not only the microbes in fermented foods with each other but also with the body, it’s really hard to then make these very generalized health claims.”
Caffrey, Zilber and Justin Sonnenburg, PhD, professor of microbiology and immunology at Stanford, host the Fermentation & Health Speaker Series. The series will explore the topic over the next few months with different speakers ranging from a scientist, food researcher and pickle producer. Registration is free.
Fermentation intersects several major food movements – it’s natural, artisanal, sustainable, innovative, functional, global, flavorful and healthy. Now is an ideal time in the food market for fermentation producers.
“Fermentation is not a trend. It’s experiencing a resurgence, a renaissance,” says Amelia Nielson-Stowell, editor of The Fermentation Association. “Fermentation never went away. It just became less of a common type of food craft, especially in the U.S. where Americans became accustomed to other types of food processing.”
Nielson-Stowell was a speaker at the Specialty Food Association’s Winter Fancy Food Show in Las Vegas. Her remarks touched on growth opportunities and challenges for the fermentation industry. It was well-received by the audience. Two food business news magazines wrote articles about it. The show’s keynote speaker, author Paco Underhill, was also in attendance and brought up Nielson-Stowell’s presentation during his keynote.
Fermentation is a growing industry, slated to reach $846 billion in global sales by 2027. Kvass, pickles, kimchi and hard cider are the products experiencing the largest growth.
There’s no denying fermentation’s popularity – “there’s widespread scientific agreement that eating fermented foods will help the microorganisms in your gut,” Nielson-Stowell explains. But reputable clinical trials proving the health benefits of fermented foods are few and far between because they’re incredibly expensive to conduct. There are plenty of studies on the health benefits of yogurt because there’s a lot of money in the dairy industry. Other ferments don’t have the monetary backing, she adds.
Nielson-Stowell points to the 2021 Stanford study as a “watershed moment” in fermentation. It’s one of the first clinical trials proving diet remodels the gut microbiota. The research, published in the journal Cell, found a diet high in fermented food like yogurt, kefir, cottage cheese, kimchi, kombucha, fermented veggies and fermented veggie broth led to an increase in overall microbial diversity.
“This microbiome world we are in right now is a real opportune time to talk to consumers about fermented foods and health,” Nielson-Stowell said. “Humans have long consumed fermented foods for thousands and thousands of years, but now we have the scientific techniques to dive into fermented foods and analyze their nutritional properties, their microbial composition and better understand how they may improve a person’s health.”
Educating consumers is another major challenge. Nielsen-Stowell encourages brands to focus on simple messaging, then delve deeper into the science on their webpage for consumer’s that want to know more about the intricacies of their food.
“Many consumers are confused about fermentation. They know it’s good for them, but they don’t understand why or what products are fermented,” she said.
Tradition, too, should be shared.
“Fermented foods have a unique story to them compared to other foods,” she adds. “Every culture in the world has a traditional ferment. We are here today because, thousands of years ago, our ancestors fermented.”
Plenty of anecdotal evidence lauds sourdough as the healthier bread alternative for those with wheat or gluten intolerance, but there is little research providing data on the topic. Now new research proves the longer a sourdough ferments, the better the bread.
Sourdough is a fermented bread fortified with dietary fibers, increased mineral bioavailability, lower glycemic index and improved protein digestibility compared to its unfermented counterparts. And, as more people shun traditional bread because of a wheat or gluten intolerance, sourdough is increasing in popularity.
Researchers at the University of Minnesota are studying the effects of dough fermentation and wheat varieties to create a bread that’s easier to digest. They found the longer fermentation time makes a more digestible bread. The results, published in November in the Journal of Cereal Science, found a 12 hour ferment versus a four hour ferment dramatically reduces the short-chain carbohydrates that aren’t absorbed properly in the gut.
“Wheat sensitivity seems to be getting worse,” says James Anderson (pictured, left), professor and wheat breeder at the University of Minnesota and one of the study authors. “The motivation for me as a wheat breeder to get involved in this research is the wheat sensitivity issue.”
Those short-chain carbs – FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) and ATIs (amylase/trypsin-inhibitors) – are what causes digestive problems in some people.
“There is evidence to document that sourdough processing or fermentation in general is able to reduce these FODMAPs and ATIs,” said George Annor (pictured, right), a professor of cereal chemistry and technology at the University of Minnesota and another of the study’s authors.
While fermentation time makes a difference in digestibility of sourdough, so do wheat varieties. Ancient grains such as Einkorn and Emmer performed well, same with the modern Linkert variety.
Though the study proves sourdough and other slow-rising breads can help those who are sensitive to wheat, the modern baking industry is dominated by sped up processing techniques. Like most commercial breads, frozen pizza crust and other convenience foods. Annor says he wants “them to keep those processes as much as they can,” but using a better wheat variety will aid digestibility.
“There’s more that we don’t know about fermentation than we do know, and it’s a wonderfully complex world,” says Brian LaPlante, a fellow Minnesotan and owner of Back When Foods.
LaPlante and his wife began making their own sourdough with ancient grains from his brother’s farm when LaPlante’s son began experiencing digestive problems. By incorporating sourdough and other fermented foods into his diet, his son’s health dramatically improved. LaPlante started his business Back When Foods that develops slow food with less processing – and hooked up with Anderson and Annor to help with their research. LaPlante provided the dough samples of varying ferment times that the UofM analyzed for their study.
“When you have fermented food in your diet, it has a profound impact on your microbiome,” he adds. “And I think that will be the trend, is food will become your medicine again.”
A new study published in Nature reveals some new insight into the gut-to-brain pathway. Certain bacteria types boost our desire to exercise.
The study, performed on mice by researchers at the University of Pennsylvania, found differences in running performance based on the presence of gut bacterial species Eubacterium rectale and Coprococcus eutactus in the higher-performing mice. The metabolites known as fatty acid amides that the bacteria produce stimulate the sensory nerves in the gut, enhancing activity in the motivation-controlling region of the brain.
“If we can confirm the presence of a similar pathway in humans, it could offer an effective way to boost people’s levels of exercise to improve public health generally,” says Christoph Thaiss, PhD, an assistant professor of microbiology at Penn Medicine and a senior study author.
Researchers were surprised to find genetics accounted for only a small portion of performance differences in the mice. Gut bacterial populations were “substantially more important,” reads the study. Giving the mice antibiotics to get rid of their gut bacteria reduced the mice’s running performance by half.
“This gut-to-brain motivation pathway might have evolved to connect nutrient availability and the state of the gut bacterial population to the readiness to engage in prolonged physical activity,” says J. Nicholas Betley, PhD, an associate professor of Biology at the University of Pennsylvania’s School of Arts and Sciences and a study author. “This line of research could develop into a whole new branch of exercise physiology.”
Read more (Science Daily)
Korean ferments are gaining popularity amongst U.S. consumers, and Korean agriculture leaders are trying to increase exports of Korean-made fermented foods to the U.S. At the first Korean Fermented Food Forum this month in Washington D.C., industry leaders shared their expertise on the future of Korean ferments in the American market.
“If you’re going to look at and work with fermented foods, you really have to look at Korea because that’s where all the action is, that’s where all the good food is,” says Fred Breidt, PhD, microbiologist with the USDA (and a TFA Science Advisor). Breidt was the keynote speaker at the event. “It’s becoming more and more popular to use these kinds of foods for their tremendous flavors that they can impart to food products and their health benefits as well.”
The forum was sponsored by Korea’s Ministry of Agriculture and the Korea Agro-Fisheries & Food Trade Corporation (aT Corporation). It coincided with celebrations earlier that week for November 11 being designated as Kimchi Day being in Washington D.C. and Virginia. They join New York and California, which ratified Kimchi Day in the respective states in 2021. The aT Corporation is actively leading efforts for all U.S. states to designate a Kimchi Day.
“With the growing global popularity of Korean food, I am delighted and eager to promote awareness and educate consumers on the health benefits of kimchi and Korean fermented food products, such as kimchi, fermented soybeans, salted seafood and vinegar,” says Choon Jin Kim, president of the aT Corporation. He called kimchi “Korea’s staple fermented soul food. I believe the reason that Americans enjoy kimchi so much is that the many qualities of Korean fermented foods, such as its excellent nutritional value, health benefits and taste, are beginning to shine.”
Sales of Korean fermented foods are growing exponentially in the U.S. According to U.S. retail sales figures tracked by The Fermentation Association and SPINS data, kimchi increased in sales by 22% in 2022, totaling $37.56 million in sales. Sales of gochujang grew 8% in 2022, totaling $6.57 million in sales.
“It’s a wave that’s been coming for a long time,” said Rob Rubba, executive chef and partner at Oyster Oyster restaurant in D.C. “Where someone who was previously omnivore like myself, who is seeking depth of flavor in something you might not associate with a vegetable, you can achieve that through fermented foods.”
When asked why fermentation grew so much during the Covid-19 pandemic, Amelia Nielson-Stowell, TFA’s editor, says fermentation touches multiple global food movements. Fermented foods are healthy, natural, green, innovative, artisanal, flavorful and functional.
“Fermentation is not a trend, it’s the oldest food craft, it’s a traditional food art with history in every culture around the world and it’s absolutely having a resurgence here in the U.S.,” Nielsen-Stowell says.
She points out that, while kimchi grew 22% in sales this year, it’s increased market size to 16% of the fermented vegetables category. In 2021, kimchi sales grew 90%, but were only 7% of the fermented vegetables category.
“More brands tuned into kimchi’s popularity, so we’re seeing more market saturation,” Nielsen-Stowell says. “There’s huge opportunities for more Korean fermented foods here in the U.S.”
Kheedim Oh attribute’s part of kimchi’s success to Korean agricultural leaders. Oh, the chief minister of New York-based brand Mama O’s Premium Kimchi, says “We have to give credit to the Korean government and groups like the aT because the Korean government recognizes the soft power of promoting.”
When he began Mama O’s 20 years ago, there were few American-made kimchi companies. Now, “there’s like a new kimchi company everyday. I don’t think it’s going to stop because kimchi is the best food ever, it goes with everything.”
Julie Sproesser agrees. Sproesser, the Interim Executive Director of Restaurant Association Metropolitan Washington, says she’s seen Korean ingredients and Korean hybrid restaurants across the D.C., Maryland and Virginia areas increase in the last seven years.
“It seems like it’s not an accident and not going anywhere,” she adds.
During his presentation, Breidt shared an overview on Korean fermented foods, including kimchi, gochujang, ssamjang and doenjang.
Kimchi’s origin begins 11,000 years ago to the start of one of the world’s “first technologies invented” – pottery. Koreans discovered adding veggies with salt and water could preserve food during a time there was no refrigeration.
Scientists are continuing to learn about the significant health benefits of the probiotic-rich, lactic acid bacteria in fermented foods. Breidt says kimchi is especially beneficial because it has 10 million to 1 billion live lactic acid bacteria per gram. Through emerging genomic tools, science is now linking specific lactic acid bacteria strains in fermented foods to health benefits.
There are challenges to selling in the U.S. market, though. Briedt says many Americans like a lightly-fermented kimchi (with a pH in the high 3’s or low 4’s), but once fermentation has begun, it’s hard to stop unless it is refrigerated.
“It’s difficult to get lightly-fermented kimchi that’s imported from somewhere else. You pretty much have to get it locally or near the source of where it’s being produced,” he says, noting because kimchi is a live, fermented product, it doesn’t travel well. “The flavors will change over time, and the evolution of these microbial communities is going to proceed unless you somehow sterilize the product, which is really counter to the whole idea of what excites people about kimchi.”
The environmental factors around fermented vegetables must be meticulously monitored to produce a consistent product. Like the freshness of the ingredients, the correct size of the fermentation vessel, the cut of cabbage and the proper sterilization of cutting machines.
“Having access to high-quality products here I think is really boosting this, and it’s going to keep going as long as we continue those efforts,” Breidt adds.
The 2022 Korean Fermented Food Forum was the first, though it is expected to recur annually, coinciding with Kimchi Day. Jeanie Chang was the moderator of the forum, a licensed clinician who uses Korean dramas as a way to explore mental health through her Instagram, Noona’s Noonchi.
How important are microbes in the human diet? And does it matter which ones we eat?
“Maybe we’re not too far from proving the following; the dietary guidelines, the My Plate guidelines, should include fermented foods, including those that contain live microorganisms, as part of a healthy diet,” says Bob Hutkins, PhD, a professor at the University of Nebraska (and TFA Advisory Board member). Hutkins explored this hypothesis during his standing-room only presentation at FERMENTATION 2022 titled The Microbes We Should (or Shouldn’t) Be Eating.
He estimates, just like the daily fiber recommendations were granted based primarily on epidemiological studies, fermented foods are going through the same process. And one day there may be a daily fermented food recommendation.
Why Should We Be Eating Live Microbes?
Highly processed foods, prolific use of antibiotics, and overly hygienic environments have resulted in significantly less exposure to microbes. This includes those microbes that help to maintain a healthy gut microbiome and that keep our immune system functioning properly. Indeed, according to the so-called Old Friend’s Hypothesis, exposure to microbes is necessary for proper development of the immune system. This is especially true for Western countries. One highly-cited study published in Lancet found Inflammatory Bowel Diseases (IBDs) like Crohn’s Disease and Ulcerative Colitis — “are predominantly associated with Western populations. You rarely see these diseases in other parts of the world,” Hutkins says.
“In the Covid era, we have certainly learned that preventing infectious diseases remains a major challenge, and being a bit germophobic is understandable. Certainly, modern food technology that includes pasteurization has significantly reduced pathogen risk, improved food safety, enhanced shelf life, and reduced food waste. Nonetheless, our environment has often become too clean, too hygienic and we are no longer exposed to microbes,” he adds.
Another study based on research in Finland found the Old Friend’s Hypothesis holds true for development of allergies, asthma, and eczema. As the authors noted “changes in environment and lifestyle, affecting microbial exposure and immune regulation, seem to play a major role in the so-called post-war allergy epidemic”. Indeed, in a 2002 editorial in the New England Journal of Medicine, three “old-school” lifestyle approaches were mentioned for protecting against the development of allergies: supplementing with lactobacillus (the bacteria found in fermented foods), owning a dog in your home and attending daycare.
Consuming Live Microbes Benefits Human Health
To address this situation, Hutkins and other food scientists are proposing adding fermented foods to the Recommended Dietary Guidelines, along with the daily dose of nutrients and vitamins.
“One of the main challenges however, will be to distinguish between nutrients and microbes,” Hutkins says.
The International Scientific Association for Probiotics and Prebiotics (ISAPP) has explored this further. A panel of ISAPP microbiologists, nutritionists, doctors and statisticians (including Hutkins) used the National Health and Nutrition Examination Survey (NHANES) to deep dive into the American diet. The NHANES database catalogs what adults and children are eating, then collects health indicators for associated diseases.
ISAPP researched the estimated live microbes in foods to find sufficient evidence that a live dietary microbe intake should be a part of a dietary recommendation. It was a big undertaking, since there are 9,388 foods inNHANES. ISAPP ranked each food’s microbial count. They found microbial count was low for processed, heat-processed foods, medium level for fresh fruit and vegetables and high for fermented foods, like fermented dairy (yogurt, fresh cheese) and fermented vegetables.
“Ninety-six percent of the foods we eat are in the low” count for microbes, he said. “Hardly any were in the fermented category, around one percent.”
Still, not all live microbes are the same. The microbes considered healthy – lactic acid bacteria and bifidobacteria – are only dominant in fermented foods. Most of the live microbes consumed in the average diet are proteobacteria from fresh fruits and vegetables.
The Institute for the Advancement of Food and Nutrition Sciences, which catalogs nutrition labels for all USDA food data, now has a space for a brand to enter the amount of live microbes in their product. There’s a dropdown menu to add genus and species of a probiotic strain, too.
“This new effort is a way to introduce the live microbes in the database,” Hutkins says, noting a company would have to enter it voluntarily. “They’re offering a noncompetitive, objective, transparent mechanism for stakeholders to understand live microbe intake and eventually link intake to health outcomes.”
The modern consumer is not disconnected with fermented foods, they’re disconnected with the fermentation process. In a discussion between fermentation revivalist Sandor Katz and well-renowned epidemiologist Tim Spector, the two experts agree that, if gut health is going to improve, humans need to eat a diet rich in fermented foods.
“The thing that has disappeared from most people’s lives is familiarity with the process of fermentation. And because it has largely disappeared into factories, we imagine that it must require sterile conditions, require a microscope or a knowledge of microbiology,” says Katz, fermentation author and educator. “We project all of our anxiety about the idea of cultivating bacteria onto the process of fermentation, when in fact fermentation is a strategy for safety and people have been doing it with the simplest of facilities without any knowledge of microbiology for literally thousands of years.”
Katz and Spector, professor at King’s College London and author of the book “The Diet Myth,” discussed fermented foods on an episode of the ZOE Science & Nutrition Podcast. Listener questions revolved around safety. Consumers understand fermented foods are good for them, but are still leery about eating live bacteria.
“Fermentation is the hot craze in fancy restaurants across the western world. But these foods make us uneasy,” said Jonathan Wolf, podcast host and CEO of Zoe. “The idea of letting food rot and then eating it goes against everything our parents taught us. …Five years ago, when I started Zoe, I really had no idea what fermentation was. To be honest, fermented foods sounded like something I would have to throw in the trash.”
Wolf asked Katz why even talk about fermentation if it’s a niche. Katz, credited with revitalizing fermentation in the U.S. and Europe, disagreed.
“Every person in every part of the world eats and drinks products of fermentation almost every day. I’m not sure how you could call that a niche type of food,” Katz said, listing off popular fermented foods: bread, cheese, cured meats, condiments, olives, pickles, coffee, chocolate, vanilla, wine and beer. “Foods that are really everyday foods are products of fermentation.”
Most of today’s consumers are victims of what Katz calls the “war on bacteria…the indoctrination that bacteria are our enemies.” Fermentation, though, is an integral part of foodways all over the world. He adds: “Fermentation is an essential part of how people everywhere have been able to make effective use of whatever kinds of food resources are available to them.”
Fermented foods and beverages are experiencing a popularity boost in part because of the growing health and wellness trend. Ferments have a high amount of nutrients and live microbes, which improve gut health. While there are some cases of proven health benefits of consuming fermented foods, Spector points out fermented foods have not all been fully tested.
Still, there’s enough evidence to indicate we should be eating fermented foods. Korea, Spector says, has one of the healthiest westernized populations. They’re eating an average of 36 kilograms a year per person. That’s an extra probiotic supplement of 20 species, including yeasts and fungi, things you won’t find in a health food store, Spector says.
“It helps your gut microbes (because)…you’re getting the prebiotic and the probiotic. The fertilizer and the seeds both at the same time,” Spector says. “That’s what’s unique about those sorts of types of fermented vegetables that we don’t often talk about. And that’s probably why they potentially have greater health benefits than just the pure microbes on their own. … It’s that double system of both feeding the original contents of your gut microbes, stimulating new ones to grow more of the good guys, and consuming these probiotic microbes that don’t live in humans. Just passing through has a beneficial effect.”
Spector compares those commensal microbes to a rich, American cruise ship passing through a poor, island community. They come in, spend loads of money to dispense through the local economy, then leave.
Live vs. Shelf Stable Products
Though products like bread and sauerkraut are fermented, that doesn’t mean all bread and sauerkraut are fermented. Highly processed, shelf-stable versions kill off the beneficial live microbes.
“There’s been an explosion in the UK of things like kefirs and kombuchas that you can buy in stores, and there’s a suspicion that many of them do not contain live microbes,” Spector says. Brands use ultra-fine filtration systems to get rid of microbes; they pasteurize products to ship it around the country; they add lots of sugars that inhibit the microbes; they make vinegars with such high acidification that it kills the microbes and the mother.
“It’s great to have these products, but I feel they could be exploited,” he adds.
Spector said there’s not a word for a true fermented food yet – he suggested using the term “live fermented food” – so consumers need to read labels at the grocery store. A kefir or kombucha can have between 10-30 varieties of microbes, but you may only be getting only one depending on what brand you buy.
Live ferments will generally be in the refrigerated food section. Heat processed, shelf stable foods are usually on the grocery store shelf.
Katz encourages consumers to steer away from bigger, national brands when purchasing ferments and instead buy from smaller, regional brands who don’t need to process their ferments to ship.
“The more educated you are, the more quality products you can find,” he says, advocating for people to research their food.
He points out the trend of the “lightly fermented soft drinks” can fool consumers, too. These drinks often have a high sugar content with no real benefit to the microbiome, Katz says. Though they can be a great replacement for traditional, sugar-filled sodas, you’re still drinking a lot of sugar.
“Anything sugar-sweetened, you really want to exercise restraint and moderation,” he says.
Katz ended the podcast with his five tips for anyone wanting to try fermented products.
- Don’t be afraid to try it. Katz: “Do not project all of the anxiety you’ve ever had about bacteria onto the process of fermentation. Understand that these are ancient practices that have been tested over time and that they are extremely safe.”
- Understand the conditions. Fermentation is about manipulating the environment for optimal growing conditions. Understand what they are to support lactic acid bacteria and avoid spoilage organisms.
- Don’t overthink it. Accept the simplicity of the fermentation process. Don’t obsess over what could go wrong.
- Experiment. Katz points out there are unlimited variations of fermented food combinations. “Don’t be afrait to play around.”
- Be creative. There are many fermented foods to incorporate in the diet. The hard part for beginners is getting accustomed to them. Try combinations that work for you – kimchi on eggs or pickles in salad dressings, for example.