7 Must-Eat Fermented Foods for a Healthy Gut

Fermented foods like sauerkraut make great sandwich toppings, but did you know that you're also adding probiotics to your Reuben when you top it with the fermented cabbage? Probiotics are good bacteria that like to hang out in our guts and may improve digestion, boost immunity and support a healthy weight.

Research is still emerging on just how important these mighty microbes are for our health, and the results are promising. According to the National Institutes of Health's (NIH) National Center for Complementary and Integrative Health, research shows that probiotics may be helpful for a number of conditions, including diarrhea, irritable bowel syndrome (IBS), hay fever, infant colic and periodontal (gum) disease.

Fermented foods are packed with probiotics—the good bacteria grow during the fermentation process—and eating them is one way to boost your gut health (eating more foods that are high in fiber, particularly prebiotic-rich foods, is important for gut health, too).

Here are seven fermented, probiotic-packed foods. Add them to your diet for a healthy dose of good bacteria.

1. Sauerkraut

Recipe to Try: Simple Sauerkraut

Sauerkraut is good for more than just topping a hot dog. Made from just cabbage and salt, this fermented food delivers a healthy dose of probiotics and fiber. A 2018 study in Foods found that sauerkraut's microbiome (the colonies of bacteria) grows rapidly during the fermentation process and stays stable during packaging for commercial sale.

You can make your own or buy sauerkraut at the store. The kind sold in the refrigerated section will have more probiotics than shelf-stable canned or jarred varieties because it's not pasteurized. Pasteurization kills bad, and good, bacteria in sauerkraut and other fermented foods.

2. Kimchi

Recipe to Try: Homemade Kimchi

This spicy Korean-style side dish made from fermented cabbage and other vegetables is touted as having anticancer properties and other health benefits. For example, a 2018 review in the Journal of Nutrition and Health found that in human trials, kimchi showed numerous health benefits including lowering blood lipid levels, supporting a healthy weight, reducing blood pressure and reducing inflammation.

Look for kimchi in the refrigerated section near pickles and sauerkraut. Eat it on its own or try it as a burger topper or atop tacos.

3. Kefir

Recipe to Try: Berry-Mint Kefir Smoothie

A fermented milk drink similar to drinkable yogurt, kefir is full of calcium and probiotics. A 2021 review in Frontiers in Nutrition suggests that kefir may be useful for diabetes, cardiovascular disease, immunity and neurological disorders.

Just as with yogurt, the probiotics in kefir help break down lactose, so it may be easier to digest for people with lactose intolerance. Kefir is delicious in smoothies or by itself.

4. Kombucha

Recipe to Try: Lemon-Ginger Kombucha Cocktail

Kombucha is a tangy, effervescent, fermented tea that's rich in good-for-you yeast and bacteria. The drink is often flavored with herbs or fruit. You can find kombucha in natural foods stores, farmers markets and your regular grocery store. A 2019 study in the journal Nutrients highlights kombucha's antioxidants, in addition to its good bacteria. However, there are no randomized clinical trials on the effects of kombucha on humans.

A tiny amount of alcohol is sometimes produced during fermentation—usually less than 0.5% alcohol by volume (although some have been found to have closer to 2%-3%), and pregnant women should avoid unpasteurized kombucha, according to a 2018 CyTA Journal of Food article. If you're not into the sour taste, try different brands and flavors—you might find one that works for you.

5. Miso

Recipe to Try: Miso Vegetable Soup

A fermented paste made from barley, rice or soybeans, miso adds a nice umami flavor to dishes. It's a bold taste, so a little goes a long way (which is good because it's also high in sodium). A 2020 BMJ study found an association between higher intakes of miso and a reduced chance for dying early.

Miso is typically found in soups but also makes salad dressings and marinades even more delicious and gut healthy.

6. Tempeh

Recipe to Try: Gochujang-Glazed Tempeh & Brown Rice Bowls

Tempeh is made from naturally fermented soybeans. It's similar to tofu in that it's a plant-based protein made from soy, but unlike tofu, tempeh is fermented. It also has a firmer texture and a slightly nuttier flavor profile. Because it contains all the essential amino acids, it's a complete source of vegetarian protein.

According to a 2021 review in Comprehensive Reviews in Food Science and Food Safety, tempeh has shown potential health benefits for numerous conditions, including gut health, cancer, cognitive function, lung health, cardiovascular health, liver health, bone health and type 2 diabetes.

7. Yogurt

Recipe to Try: Ricotta & Yogurt Parfait

Yogurt is made by fermenting milk. Yogurt labeled with the "Live & Active Cultures" seal guarantees 100 million probiotic cultures per gram (about 17 billion cultures in a 6-ounce cup) at manufacturing time, according to the International Dairy Foods Association. Even yogurts without this seal contain probiotics. The probiotics in yogurt help digest some of the lactose (milk sugar), so if you're lactose intolerant you may still be able to enjoy yogurt. Many companies also make dairy-free and vegan yogurt options that contain probiotics.

A 2021 review in Nutrition Reviews states that there are consistent associations between yogurt consumption and reduced risk of breast and colorectal cancers and type 2 diabetes, as well as improved cardiovascular, bone and gut health.

The Bottom Line

Fermented foods contain probiotics, which are good bacteria. Bacteria like to hang out in our guts and they influence our health. Fermented foods also often contain other health boosters, like protein, fiber, vitamins, minerals and antioxidants. Including fermented foods in your diet can mean better overall health, so try adding some to your plate each day.