Dr. Michael Ruscio, DC is a clinician, Naturopathic Practitioner, clinical researcher, author, and adjunct professor at the University of Bridgeport. His work has been published in peer-reviewed medical journals and he speaks at conferences around the globe.
Fermented foods vs. probiotic supplements compared.
Hi, this is Dr. Ruscio. Let’s discuss the question:
Can you obtain adequate probiotic health benefits from probiotic-rich foods like fermented foods sauerkraut, kimchi, kombucha, miso, or kefir?
The answer is yes, probiotic foods are definitely an important aspect to a healthy diet and—in my opinion—you should at least attempt to routinely consume them, as long as you aren’t having any kind of symptomatic reaction when consuming a given fermented food. These do seem to be healthy and health promoting because of the live bacteria they contain, and because these beneficial bacteria tend to have a favorable impact on our digestive systems. The health benefits of probiotics include being anti-inflammatory, helping repair leaky gut, and also providing or assisting in the creation of certain vitamins. So consuming fermented foods and the live cultures they contain is good health practice. This practice seems to have dropped off in Western societies, even though more traditional cultures appear to have made fermented foods a routine part of their diet.
Probiotic-rich foods promote a healthy diet and gut.
Probiotics found in fermented foods are great for maintenance and to sustain a healthy microbiome.
Do Fermented Foods Have a Clinical Dose of Probiotics?
Now, a deeper question is, can you obtain a clinical dose of probiotics from fermented foods?
How we define “enough” is a challenge. There’s not necessarily one magical intake of probiotics in the diet that is going to be right for everyone. So perhaps another way we can look at this question is, if you have a gut health imbalance or symptoms—if you have irritable bowel syndrome, if you have reflux, if you have a presumed overgrowth of bacteria or fungus, or even a diagnosed imbalance, or something like inflammatory bowel disease—can you get a clinically impactful amount of probiotics for gut health from your diet?
This is where the answer leans in the direction of no. When you look at most of the research studies that have used probiotic supplements, the amount contained in these trials is actually significantly north of what you can obtain from foods. Now, this is not to say that we should just throw the fermented foods out the window. They are a foundation, but supplemental probiotics do seem to have merit as something to try for a term to overcome imbalances.
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Fermented Foods vs. Probiotic Supplements Compared
Let me show you an actual breakdown so you can see the food sources of probiotics and the probiotic bacteria they contain. This chart shows the amount of probiotic bacteria, and then the amount of bacteria in a similar probiotic supplement. This is quite enlightening.
Sauerkraut Probiotics: 1 cup contains about three billion CFU or colony forming units.
How much would be found in a typical probiotic capsule? For our Lacto-Bifido blend probiotic, one cup of sauerkraut equates to 1/8th of a capsule.
Considering this, we see that we’re really not getting a clinical dose from the sauerkraut. Knowing that one may use anywhere from two to four probiotic supplement capsules in a day, one cup of sauerkraut equaling 1/8 of a capsule falls a little bit short of what may be needed in order to create a robust clinical effect for gut health rebalancing, healing, and symptoms.
Probiotic Yogurt: 1 cup containing 2.5 billion CFU = about 1/10th of a capsule.
Lacto-Fermented Pickles: Each pickle contains 1.3 billion CFU = about 0.05 of a capsule.
Probiotic Kefir: 2.5 billion CFU -= about 1/10th of a capsule.
Kimchi: (the winner) 1/2 cup containing 11.5 billion CFUs = about one half of a capsule of our Lacto-Bifido blend probiotic.
Leuconostoc mesenteroides Lactobacillus brevis Pediococcus pentosaceus Lactobacillus plantarum
There isn’t a magic number of probiotics that works for everyone.
Probiotic supplements can offer even more benefit, especially for those struggling with gut health
If you have gut health issues, you are more likely to see benefit from probiotic supplements due to the high dose of probiotics they contain.
Probiotics vs. Fermented Foods Recommendation
Certainly fermented foods are part of and promote a healthy diet and gut health. However, we may not be able to get everything that we need—at least from a perspective of trying to remedy, rebalance, and heal the gut—from fermented foods alone.
This is where, at least in the short term, considering a probiotic supplement may really amplify what you are able to do with your diet. Adding probiotic supplements will ideally help:
to combat something like small intestinal bacterial overgrowth (SIBO)
to remedy the symptoms of IBS
to help reduce leaky gut
to help facilitate healthy intestinal motility
to help support balance in the microbiota
So, we want to do both. But it does look like, for clinical effect, that fermented foods may fall a little bit short from ideal. I think it’s reasonable to start with bringing these fermented foods into your diet, and then reevaluate. If you’re not feeling better, then consider adding a well-formulated probiotic supplement. This is Dr. Ruscio and I really hope this helps you get healthy and get back to your life.
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