Top fermented foods you can add to your diet

Fermented foods are made by adding microorganisms, like bacteria or yeast, to a food source. For example, when you add yeast to sweetened tea, it ferments and becomes kombucha. Similarly, bacteria react with milk to create yogurt. 

While people first used this ancient practice for its preservative effects, eating fermenting foods has recently gained popularity because of its reported health-promoting effects.  

Many fermented foods — such as kefir, kombucha, and fermented vegetables — contain probiotics, but not all do.

Probiotics are foods with living microbes that can travel to your gut and provide some benefit to your health. Prebiotics serve as food for the good microbes living in your gut. 

Fermented foods can benefit your health in a variety of ways, such as improving digestion and lowering your risk for certain diseases, like type 2 diabetes and heart disease. 

Crucially, they promote a healthier and more diverse gut microbiome, the collection of microorganisms living in your gut.

Everyone’s gut microbiome is unique. The ZOE at-home test gives you a breakdown of the bacteria that live in your gut, as well as personalized recommendations on how to boost your gut health.

Take this free quiz to get started today.

Best fermented foods for your health

Not all fermented foods benefit your health in the same way. Here are nine of the best fermented foods to include in your diet. 

1. Kefir

Kefir is a fermented milk drink believed to have originated in the Caucasus region thousands of years ago. 

You can drink kefir on its own or use it in place of buttermilk, milk, or water in dishes for a nice sour flavor. Thick kefir is similar in consistency to yogurt. You can eat it in the same way, for example, as a breakfast or dessert.

This tart, lightly carbonated drink is made by adding kefir grains to room temperature milk and allowing it to ferment for 10–24 hours. 

Kefir has an abundance of diverse microbes, and evidence suggests that it could benefit your health in many ways.

While human research is limited, there is some evidence that kefir may benefit:

• blood sugar control in type 2 diabetes 

• gut health

• weight loss

• inflammation

However, more research is needed to understand these effects fully.

Kefir is also a good source of many important vitamins and minerals. This includes vitamins B, C, A, and K, as well as magnesium, calcium, and phosphorus.  

2. Kimchi

Kimchi is a fermented vegetable mixture of spices and vegetables like cabbage, radishes, leeks, cucumbers, or sweet potatoes. Originating in Korea almost 1,000 years ago, this traditional Korean food is now popular across East Asia and all over the world.

Although typically a salty and sour mixture, kimchi comes in a variety of flavors depending on the spices, seasonings, and vegetables used.

Some kimchi can also include meat, such as beef, pork, or seafood. Kimchi is often a side dish, but you can also mix it into other dishes, like dumplings, stew, or rice.

Evidence suggests that eating kimchi may help lower cholesterol and improve blood sugar levels.

The probiotics in kimchi may also help improve gut health and relieve certain digestive issues, such as abdominal pain, bloating, and irregular bowel movements. Other reported potential health benefits include the prevention of certain types of cancer and supporting brain and skin health. 

The vegetables commonly used in kimchi are good sources of vitamins A and C, as well as calcium, magnesium, potassium, fiber, and other beneficial nutrients.

3. Kombucha

Kombucha, or fermented sweet tea, is thought to have originated in Northeast China over 2,000 years ago. 

Lightly carbonated and distinctively tart, kombucha is made by fermenting sweet tea with a SCOBY, a symbiotic culture of bacteria and yeast. People often add fruits or herbs to create a variety of flavors.

Despite the many health claims about kombucha, evidence involving humans is limited.

In one analysis of 15 animal studies, evidence suggested that drinking kombucha may help promote a more diverse gut microbiome. Another study found links between kombucha and anti-inflammatory effects and a healthier skin microbiome.

Other studies, however, found that some components in kombucha may worsen gastrointestinal problems, such as irritable bowel syndrome. 

Animal studies have also suggested that kombucha may help improve:

• heart disease risk

• cholesterol levels

• blood sugar control

• cancer progression

• neurodegenerative disease risk

It’s important to be mindful of the sugar content in kombucha. Industrially produced versions can be high in sugar or sweeteners and other additives. 

4. Sauerkraut

Sauerkraut is fermented cabbage. Although the name sauerkraut is German for “sour cabbage,” it’s believed to have come from China almost 2,000 years ago. 

A little salty and a touch sour, this crunchy condiment may be a good option for people who are new to fermented foods. You can eat it on sandwiches, with meat, or on its own.

Raw, uncooked sauerkraut is a good source of probiotics, which may be beneficial for your gut health. In multiple studies involving people with irritable bowel syndrome, eating sauerkraut was associated with reduced symptoms after only 6 weeks. 

The microbes in sauerkraut may also help lower cholesterol, according to one animal study. 

Sauerkraut is also rich in other health-benefiting nutrients, such as fiber, vitamins C and B6, and iron.

5. Yogurt

Yogurt is a common food in many cuisines around the world. It dates back to around 8,000 years ago when herdsmen in the Middle East used animal intestines to keep milk from spoiling in the heat. Today, yogurt is made by mixing bacteria into milk.

The slightly sour taste allows yogurt to be used in a variety of ways, including as a marinade, in sauces or smoothies, or on its own. There are different types of yogurt available, but those with no added sugar are best. Add fruit, herbs, rolled oats, or a small drizzle of honey for added flavor.  

An analysis of over 100 studies found that yogurt might be associated with many health benefits, including:

• improved gut health

• better heart health, including cholesterol levels, blood fat, and blood pressure

• promoting a healthy body weight

• reduced risk of cancers, particularly colorectal, breast, and prostate cancer

• reduced risk of type 2 diabetes and better outcomes for those with type 2 diabetes

• improved bone health

Lactobacillus acidophilus is the most common probiotic in yogurt. This bug is present in many Greek, Icelandic, traditional, and other yogurts. You may not always see it on the label, but you can look for a “live and active cultures” statement to check if a yogurt contains probiotics.

Yogurt is also a good source of protein, calcium, phosphorus, and B vitamins.

6. Miso

Miso is thought to have originated in China before making its way over to Japan some time during the 7th century.

It’s made by mixing soybeans, fermented rice, and salt, before allowing it to ferment for several months. 

Miso has a rich, savory flavor and can be used in soups, sauces, and salad dressings, among other dishes.

There is some evidence that miso has health benefits. This includes better blood sugar control, a lower risk of certain cancers and heart disease, and better gut health. 

7. Some cheeses

The first cheese is thought to have been created about 4,000 years ago when a merchant left a sheep-stomach pouch filled with milk out in the Arabian sun.

Today, most cheeses undergo fermentation. Aged cheddar, parmesan, Swiss cheeses, and some cottage cheese contain probiotics.

Some evidence suggests that fermented cheese may help promote gut health and healthy cholesterol levels.

Cheese is also a good source of calcium but can be high in sodium and saturated fat. It is best to eat it in moderation and as part of an overall healthy diet.

8. Sourdough bread

Sourdough bread is thought to have originated in ancient Egypt. 

The sourdough starter is made by fermenting a mixture of flour, water, and salt. A portion of this starter is then mixed with more flour and water to leaven the bread dough.

While sourdough starters do contain probiotics, they are killed by the heat in the baking process. However, the baked bread does contain prebiotics.

Similar to other fermented foods, sourdough bread has a slightly sour and salty flavor and is a delicious way to add a little tang anywhere bread features. 

Sourdough bread may be a good option for people with moderate gluten intolerance, but this depends on the individual. Despite the fermentation, however, it is not safe for people with celiac disease.

Not all store-bought sourdough bread is actually fermented. You can learn more in our ZOE Science & Nutrition podcast episode about bread with ZOE co-founders Tim Spector and Jonathan Wolf, as well as sourdough expert Vanessa Kimbel. 

9. Apple cider vinegar

The first record of vinegar dates back almost 7,000 years to when the Babylonians used it for food preservation. In ancient Greece, Hippocrates used to prescribe apple cider vinegar for many ailments, like the common cold.

Apple cider vinegar is made by adding yeast to apple juice and allowing it to ferment. It can be used in salad dressing, baking, pickling, soups, or any other dish needing a little tartness.

Unfiltered or raw apple cider vinegar contains live bacteria, some of which may be probiotic. The possible health benefits include better blood sugar control and cholesterol levels.

Where can you find fermented foods?

Many fermented foods are widely available at most grocery stores. Some foods like yogurt, kombucha, and sauerkraut are very common, with others becoming increasingly available. 

If you choose to buy fermented foods at the store, it's important to read the label. Some products contain unnecessary additives or high amounts of sugar. 

It can also be tricky to know whether a product has live microbes in it. Sometimes the type and amount of live bacteria are on the label, but not always. 

You can also ferment foods at home if you prefer. If you do, make sure to stay safe by using the right sterilization and storage techniques.

How to include them in your diet

Thankfully, the wide range of fermented foods available makes it possible to fit them in to most eating patterns.

ZOE’s co-founder, Tim Spector, recommends consuming small amounts of a variety of fermented foods each day rather than large amounts every once in a while. 

If you’re looking to increase your fermented food intake, start slowly and increase gradually to avoid bloating.

Fermented foods are just one part of an overall balanced diet, though, along with plenty of fruits, vegetables, whole grains, and healthy fats.

Summary

Fermented foods come in a wide range of guises, but they all have one thing in common: They are made by adding microbes to their raw ingredients. 

Many fermented foods contain probiotics, which are beneficial live bacteria. 

Regularly eating fermented probiotic foods — such as yogurt, kefir, sauerkraut, and miso — may positively affect your health. But not all fermented foods contain probiotics. 

Fermented foods are just one part of a balanced diet. And at ZOE, we know the best foods for your body are unique to you. 

Our at-home test gives you insights into your blood sugar and blood fat responses to food, as well as a breakdown of the bacteria that currently live in your gut. Using this information, we provide you with personalized nutrition advice to help you reach your long-term health goals.

To find out more, take our free quiz today.