The “good bacteria” your gut needs — and where to find it

You’ve probably heard that yogurt is good for you, but did you know it’s because of the bacteria?

Fermented foods — like yogurt, sauerkraut, kimchi and kefir — contain bacteria that helps support a healthy human gut biome.

Adding them to the mix of bacteria in the gut has healthy benefits, said Geeta Maker-Clark, MD, a family medicine physician at Endeavor Health.

“Fermented foods improve gut health by increasing microbiome diversity,” Dr. Maker-Clark said. “Regular consumption of fermented foods may decrease gut inflammation, improve digestion and increase the bioavailability of some vitamins.”

It’s important to choose foods with live and active cultures, which are usually found in the refrigerated section. Jarred foods like pickles or sauerkraut that are not refrigerated don’t contain active cultures.

“Look for the phrases ‘live active cultures’ or ‘naturally fermented’ on the label, and ensure the food was made using natural fermentation (salt, water, vegetables) rather than being acidified with vinegar,” Dr. Maker-Clark said.

Most people can tolerate up to three servings of fermented foods per day with no digestive problems.

“Start by adding small servings, one or two tablespoons, of fermented foods to your daily routine to give your gut biome time to adjust, and to avoid bloating and digestive discomfort,” Dr. Maker-Clark said.

Try some of these fermented foods:

• Yogurt. Choose plain yogurt (Greek or regular) with no sugar added, then sweeten with fruit or a bit of honey.
• Kefir. Look for a low-sugar version of this fermented drink. Also verify “live active cultures” on the label.
• Kombucha. Kombucha tea is another fermented drink with probiotics. It’s important to start slowly with kombucha, drinking a half cup a few times a day, to see how your body reacts. Drinking too much at once can lead to side effects like nausea, gastrointestinal upset and headaches.
• Sauerkraut. Look for refrigerated sauerkraut labeled with “live cultures,” “raw” or “probiotic.” Sauerkraut pickled with vinegar is not fermented.
• Kimchi. Kimchi is a Korean dish of fermented vegetables, most often cabbage. Find kimchi with live active cultures in the refrigerated section.
• Pickles. Pickles that are fermented with salt will contain live, active cultures — typically not unrefrigerated pickles on the shelf that are pickled with vinegar.
• Miso. Look for this fermented soybean paste in the refrigerated section.

People with histamine intolerance, certain gut conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), or weakened immune systems should ask their doctor about adding fermented foods to their diet first.