Fermented Foods: Health Benefits + 15 Delicious Recipes

Wondering if the benefits of fermented foods are hype, or science? Let this dietitian break it down for you, including the difference between fermented foods and probiotics, as well as 15 delicious fermented food recipes so you can get more of these healthy plant foods into your life.

Fermented foods, despite being around for literally thousands of years, are pretty damn hot these days. It seems like if marketers add the word ‘fermented’ to just about anything, we’ll think it’s healthy…but is it?

As a dietitian, I do think there is a big difference between a healthy food that has been fermented and a hyper-processed food that has been touched by some form of fermentation. So a protein bar that contains fermented protein is NOT the same as eating tempeh. It’s kinda like the difference between eating an apple for microbiome-boosting soluble fibre and prebiotics versus eating apple-flavoured candy that has prebiotic fibre added to it. 

So let’s start by talking about what fermented foods actually are, what the evidence tells us about the benefits of fermented foods and then finally, some yummy fermented foods recipes to enjoy.

What is a fermented food? 

The International Association of Prebiotics and Probiotics (ISAPP) recently released a consensus statement on fermented foods where they suggested the following definition: “foods made through desired microbial growth and enzymatic conversions of food components”

Essentially, you make a fermented food when you let microbes, like bacteria or yeasts, transform a food on purpose. They might be naturally occurring, like the lactic acid bacteria (LAB) that transform sauerkraut, or added, the SCOBY culture you use to make kombucha. But that lettuce growing slime mould in the back of your vegetable drawer? Not the kind of fermented food you want to eat!

Many of our most beloved foods and drinks are also fermented, such as wine, chocolate, cheese, beer and sourdough breads. But since they don’t contain live microbes, we’re going to leave them out in favour of foods that do because the health benefits are different.

Here are some examples of living fermented foods:

• Kombucha
• Yogurt
• Kimchi
• Sauerkraut
• Miso
• Kefir
• Lacto-fermented pickles
• Tempeh

Benefits of Fermented Foods

You might be surprised to know, since there is so much talk about the benefits of fermented foods, that there is very little research done with actual humans. So, most of the health claims made for fermented foods are based on lab or animal-level trials…and therefore they’re WAY overblown. 

But that doesn’t mean they’re not good for you! Just don’t expect to drink one kombucha and cure your IBS, okay? It’s the same way a single salad won’t make you healthy – but committing to a plant-rich anti-inflammatory dietary pattern will. The process of fermentation transforms a food from its natural state in a few ways:

• increasing, or enhancing the bioavailability of certain nutrients or phytochemicals found in the food
• increasing the stability of the food through the production of organic acids or antimicrobial substances that help preserve it
• decreasing substances that can bind minerals, such as phytates
• enzymatic transformation for better digestion, such as breaking down lactose from dairy
• creating short-chain fatty acids may help improve gut function and support the gut-associated immune system

Some of the benefits of the fermented food will come from the nutrients present in the food itself, such as the l-glutamine or sulphur-based phytochemicals found in cabbage, while others will be due to the presence of the microbes themselves, like organic acids.

In the human research, it has been shown that fermented foods have the ability to impact the gut microbiome as they transit through the gut and that their fermentations by-products such as short-chain fatty acids may also have a positive impact. 

Of all of the fermented foods, traditional dairy yogurts have the most human clinical trials. Dairy kefir and kimchi also have interesting clinical trials. In one trial, drinking 800ml (over 3 cups!) of kefir was able to increase lactic acid bacteria in the stool of those with Crohn’s Disease. In another, 2-4 servings a day of kimchi appeared to be associated with a lower incidence of atopic dermatitis in the Korean population.

What you’ll notice here, or in any of the other trials you look into, is that dose matters. A tablespoon of kraut won’t cut it! Which is why the type of fermented food – and what is in that food – matters. Like added sugars. 

Added sugars and salt in fermented foods

The other thing you want to keep in mind is how much sugar or salt can be in some fermented foods. I’m looking at you, kombucha! As popularity of kombucha grows, we’re seeing a lot of products on the market with a higher sugar content – old school kombucha used to be pretty funky. These new versions are more like fermented sodas. Aim for a variety that only has about 10g of sugar per large bottle if you can find one.

Fermented Foods vs Probiotics

Prepare for your mind to be BLOWN: fermented foods are NOT probiotics. Huh? How is that possible? 

Well, probiotics are very specific microbes with research-demonstrated benefits to human health. Not just any microbe can be called a probiotic, even if it belongs to the same species as other probiotics. If you ferment sauerkraut on your counter, you have no way of knowing what is in there, how many live microbes are present or whether there will be any health benefits. So unless a fermented food manufacturer is adding a known evidence-based probiotic, they shouldn’t be making any probiotic claim on their product. But they do, ALL THE TIME. Sigh.

Fermented Foods for Gut Health

If you’re creating a gut-friendly lifestyle, I absolutely recommend enjoying fermented plant foods like sauerkraut, lacto-fermented pickles and miso as part of a healthy anti-inflammatory diet for gut health. However, I do not go so far as to say that fermented foods are all you need when there is evidence that a probiotic might help, for example, in irritable bowel syndrome because fermented foods have nowhere near the dosage of live microbes required to shift the gut microbiome. So if you are curious about a probiotic for a specific health condition, ask your doctor or dietitian for their recommendations. But if you just want to keep your gut well, go for fermented foods!

Something else we should talk about is histamines – fermentation can increase the histamine content of foods that, while not an issue for everyone, may further aggravate inflammation for those who are sensitive to histamine, including a subsection of those with digestive issues.

15 Delicious Fermented Food Recipes

So there you have it! Now you know everything you need to know about the benefits of fermented foods. So let’s get cooking! I wanted to give you a bunch of recipes to help you work more fermented foods into your life. It’s all too common to buy something new because you read about it on the internet, and then it just sits there in the back of your fridge.

Instead, try these recipes…and if you’re looking for more inspiration, Eat More Plants Cookbook has plenty of ideas too!

1. Togarashi-roasted broccoli with miso-cashew dip

This is a great snack for movie night! Roasted broccoli gets a little kick from Japanese togarashi spice and it gets dipped into a rich and savoury miso-cashew dip that is SO easy to make!

2. Vegan Kimchi Pancakes from Okonomi Kitchen

I LOVE kimchi…and it’s more than just a condiment! Use this garlicky, spicy treat in these crisp and chewy pancakes.

3. Pumpkin Miso Soup

This light take on pumpkin soup relies on mild white (shiro) miso for a delicate umami flavour.

4. Spicy Italian Tempeh Sausage Pasta from Lindsay Pleskot RD

This Italian sausage pasta takes full advantage of the meaty texture and rich flavour of tempeh. A great way to try tempeh for the timid!

5. Tempeh Stir-fry with Miso-Peanut Sauce by Walder Wellness

You get TWO fermented foods in this one, meaty tempeh and umami-packed miso! Tofu is great and all…but tempeh deserves more dinnertime spotlight!

6. Miso Chocolate Chunk Cookie Bars by Wholehearted Eats

Hear me when I say that you have not LIVED until you have put miso in a cookie. Like salted sweets? I promise you will LOVE miso sweets.

7. Vegan Tzatziki by Pick Up Limes

I couldn’t forget yogurt! This simple dip is SO refreshing…tzatziki is one of my faves.

8. Tempeh Reuben by A Couple Cooks

This classic Reuben is completely vegan when you use vegan mayonnaise and cheese. Add a kale caesar and it’s posh deli food for a dinner WIN.

9. Kimchi-fried Rice with Tempeh + Broccoli by The First Mess

Kimchi-fried rice is SO flavourful…and a great way to sneak extra veggies in. With protein-rich tempeh and broccoli, it’s a complete comfort food dinner.

10. Spicy Miso Eggplant by Plant-based RD

My family hates eggplant…but I LOVE it!!! And I like it spicy most of all. It’s a great side, or anchor to a nourish bowl.

11. Smashed Chickpea Tacos with Kimchi

Yep. I put chickpeas AND kimchi in a taco. And it’s DELICIOUS! This is a super quick and yummy meal to shake up your Taco Tuesday.

12. Kefir Kiwi Grape Smoothie

Use coconut kefir for a fully vegan take on this popular and unique smoothie from my show, The Urban Vegetarian.

13. DIY Sauerkraut

Just in case you want to make your own kraut, here is a simple how to!

14. Creamy Miso Ramen by Woon Heng

I could honestly eat ramen every day…this recipe is the (umami!) bomb.

15. Vegan Sauerkraut + Sweet Potato Pierogi by Hot for Food

I saved the project for last…make your own pierogi! All of Lauren’s recipes are so amazing…and what a fun way to use your kraut.