Yep, This Hot Dog Topping Is Actually Great for Your Gut Health

Not to shade your standard summer salads, crudités, and basic grilled veggies, but adding a bit of funk to your produce—by way of fermentation, that is—could go above and beyond in yielding gut-health gains. A new study published in the journal Applied and Environmental Microbiology investigated raw cabbage, sauerkraut (fermented cabbage), plus the brine left over from fermentation. The researchers found that sauerkraut specifically helped maintain the integrity of intestinal cells, chiefly thanks to an increased amount of gut-friendly metabolites including lactic acid and amino acids.

According to Will Bulsiewicz, MD, a board-certified gastroenterologist and the author of Fiber Fueled, these results aren’t surprising. He cites a study by Stanford researchers, published in the journal Cell in 2021, which found that a diet enriched with fermented foods (specifically, six servings daily) resulted in better gut diversity and lower inflammatory markers within 10 weeks.  “This was highly predictable, though, because when you improve the gut microbiome and you lower inflammation, this implies that the gut barrier is getting healthier—and this new study confirms that thesis,” he says.

Ahead, we’re diving deeper into why sauerkraut and other fermented foods are veritable all-stars for your gut, immunity, and beyond. Plus: Creative ways to eat more of these tangy goods this summer that aren’t limited to throwing it on a Reuben sandwich or a hot dog (though that’s totally fair game, as well).

What are the benefits of fermentation?

Fermentation ultimately transforms a raw food into a new and improved version of itself. Take, for instance, raw cabbage evolving into sauerkraut. Per Dr. Bulsiewicz, fermentation makes protein and fiber more bioavailable, typically reduces the carbohydrates, and allows for (good) bacteria and yeasts to grow. “What we see in this study is that those microbes are producing bioactive chemicals, and that combination of bioactive chemicals is able to do things in our body, such as repair and restore the gut barrier,” he shares. 

The benefits associated with eating fermented foods are plentiful. Their friendly bacteria and probiotic cultures “have been linked to various health benefits, such as reducing symptoms of lactose intolerance, inflammatory bowel disease (IBD), Crohn’s disease and ulcerative colitis, irritable bowel syndrome (IBS), gastroenteritis, diarrhea and even cancer,” says Kenneth Brown, MD, a board-certified gastroenterologist. 

Additionally, he notes that the Stanford study cited above found that fermented foods were more effective in increasing gut diversity and reducing inflammation more effectively than high-fiber diets alone. “Furthermore, the probiotics in fermented foods are protected from the harsh environment of the GI tract by the food itself, making them more effective than taking probiotics alone,” he adds.

So, are fermented foods always “better” for you?

Despite their vast benefits, fermented foods aren’t necessarily superior to unfermented fare. “I wouldn't argue for fermented foods as a replacement for plant-based foods, like unfermented vegetables,” says Dr. Bulsiewicz. “Most Americans aren't eating much of either, and they're both so healthy that we shouldn't view them as competing.” Instead, he advocates for swapping in more fermented foods and plant-based foods in general. He also reminds us that the gut microbiome thrives on a diverse eating plan—so the more of either tends to be the merrier.

Note: Some exceptions do exist. “Some people may have difficulty digesting fermented foods due to sensitivity, allergies, or because their digestive systems cannot properly break down and absorb the nutrients in these foods,” notes Dr. Brown. He adds that fermented foods are high in histamine, which some people may not tolerate well (and potentially not even know it). Others with chronic digestive distress may find relief from eating low-FODMAP foods, so some items may be better kept off the proverbial and literal table.

How to get more fermented foods on your plate

In light of this new research, you might be inspired to get more sauerkraut onto your plate to help fortify your gut barrier. However, both gastros also champion the likes of other fermented fare as well, such as kimchi, pickles, tempeh, miso, kefir, and yogurt. A moderate intake of kombucha also gets the green light; just be sure to keep tabs on its sugar content. “It's not a replacement for water, but it does make a fine replacement for soda,” says Dr. Bulsiewicz.

The GI doc is reluctant to advise aiming for a specific amount of fermented foods per week, so as not to make doing so feel like a chore or an impossible goal. Instead, he recommends using fermented foods as a garnish or a complement to your go-to meals. “Much like wine pairs well with certain foods, so too does a small serving of fermented foods,” Dr. Bulsiewicz explains. “The acidity often helps to clear the palate, or to soften or enhance other flavors and textures.” A winning bet is to keep a variety of these mouth-puckering goodies in your fridge, mixing and matching them from one meal or snack to the next.

Dr. Bulsiewicz also suggests trying out fermentation for yourself. He likens the process to slow cooking a crockpot meal: “Most of the work is done up front,” he says. “Once the initial work is complete, you step back while the microbes step up.” Each summer, he enjoys fermenting green beans, cauliflower, and even watermelon rinds. “Yes, the outer part of the watermelon that you've been throwing away can be fermented to make a crunchy dill and garlic flavor that's like a pickle,” he shares. Less food waste, more dietary diversity, new flavors, and gut-boosting gains aplenty? Consider this doctor’s orders to put your Mason jars to good use.