July 2012 Issue

Fermented Foods — Are They the Next Big Nutrition Trend?
By Lindsey Getz
Today’s Dietitian
Vol. 14 No. 7 P. 32

The buzz about fermented foods and their probiotic properties is getting louder. But the category has been slow to take off. If RDs continue to educate the public, however, this may change.

Fermented foods have been inching into the spotlight lately as more and more consumers learn about their inherent probiotic health benefits.

But while naturally fermented foods such as kimchi, kefir milk, miso, and kombucha are poised to potentially become the “next big thing” to hit grocery store shelves, supermarket dietitians say the fermented foods category has yet to live up to that expectation. Upscale grocery stores, such as Whole Foods Market, which tend to be leaders of health and nutrition trends, are making more room for fermented products. But the average supermarket chains are carrying only select choices of these items to meet what seems like a modest consumer demand. Still, as more consumers learn about these foods, the interest likely will continue to grow.

Probiotic Power
Fermented foods provide good bacteria that the gastrointestinal (GI) tract needs to usurp the not-so-beneficial bacteria, says Jill Nussinow, RD, “The Veggie Queen” who is the author of The New Fast Food: The Veggie Queen Pressure Cooks Whole Food Meals in Less Than 30 Minutes. “The fermentation process allows the nutrients in the foods to be more easily absorbed since they’re already predigested by beneficial bacteria,” she explains. “The cell walls of the vegetables get broken down. For instance, the vitamin C in cabbage becomes more bioavailable.”

In scientific terms, the lacto-fermentation process involves microbes that use good bacteria, such as Lactobacillus and Bifidobacterium spp, as well as other lactic acid bacteria called probiotics. The process enhances digestibility of the fermented food. Studies suggest that probiotics can help treat everything from diarrhea and irritable bowel syndrome to more serious conditions such as heart attack and hypertension. Though more research is needed, current evidence still gives clients good reasons to consider getting a daily dose of probiotics from a fermented food source.

From History Books to Grocery Shelves
While fermentation is gaining more followers in our modern-day culture, it’s nothing new. Fermentation is one of the oldest forms of food preservation. Because the fermentation process increases the shelf life of food, it remains economically significant in many parts of the world. Fermented foods also remain strongly tied to culture and tradition. “Fermenting has been a traditional food practice for a variety of cultures around the world for centuries,” notes Jeannie Gazzaniga-Moloo, PhD, RD, a spokesperson for the Academy of Nutrition and Dietetics. “It was and still is a way to prolong the [life] of foods and preserve quality without refrigeration or adding chemicals. Fermented foods are gaining in popularity, in part, as consumers are trying to find ways to get back to eating more whole foods.”

Some fermented foods that seem to be more accepted include yogurt, sauerkraut, and soy sauce. Many consumers already are eating these foods without the full knowledge of their health benefits. Other good “starter” fermented foods that Gazzaniga-Moloo suggests RDs recommend to clients include kefir milk, kombucha tea, tempeh, kimchi, and fermented cheeses. These foods are relatively easy to incorporate into the diet. Even beer and wine fall into the fermented food category, but Gazzaniga-Moloo says clients shouldn’t view them as a reason to start drinking or increase the number of alcoholic beverages they consume each day.

While the interest in fermented foods is growing, most traditional grocery stores are dedicating only a limited amount of shelf space to certain items. “As a retailer, we’re always looking for the next big thing and want to be established in a category, so we’re ready for it to take off,” says Caroline Whitby, MS, RD, LDN, corporate dietitian and manager of dietitian initiatives for Giant Eagle. “We haven’t found that fermented foods have become a big trend yet—they’re still in the upswing. They’re holding their own and treading water. There’s definitely more buzz about them, and we keep hearing they may be the next big thing. The bottom line is that we only have so many feet of shelf space, so we have to focus on the items that are most popular.”

Still, some supermarket chains report that consumers are more interested in fermented foods than ever before. According to Natalie Menza, MS, RD, corporate dietitian at ShopRite, “[Our] retail dietitians are seeing an increase in interest in products containing probiotic qualities, such as yogurt, kefir, and tempeh. Some of these customers are looking to manage specific health issues, such as irritable bowel syndrome and other gastrointestinal distress, while others are simply looking to improve overall health.”

Barbara Ruhs, MS, RD, LDN, corporate dietitian for Bashas’ Family of Stores, agrees there’s greater interest but says there’s a need for more education and understanding for the category to grow. “There’s definitely a lot more information out there about probiotics, but whether consumers understand what they’re hearing is a different story,” Ruhs says. “We’re hearing about fermented foods in the popular media, online, and through social media. Even though the buzz is there, I’m not sure consumers really understand what types of foods are out there or even grasp exactly what probiotics are.”

Drinking Your Probiotics
Some of the biggest fermented food sellers at Giant Eagle stores include kimchi and fermented beverages such as kefir milk, fermented coconut milk, and kombucha tea. “I’d say we’re getting more people asking questions than we did in the past, but it’s nothing that’s overwhelming to our dietitians and produce managers,” Whitby says. “Most of the questions are about kefir. People have heard about it, and they may want to know which aisle they can find it in and what it is. If consumers are choosing kefir, it’s absolutely for the digestive benefits and not for the taste.”

Many consumers would agree that kefir is an acquired taste, while others prefer the distinct flavor. Kefir is available in many flavors, from blueberry to pomegranate. For new kefir drinkers, dietitians recommend adding a little bit to their morning cereal to get used to the taste instead of drinking it alone.

“A lot of times consumers hear about something like kefir and decide they want to try it based on what they’ve heard or read,” Ruhs says. “The texture sounds good and the great flavors like pomegranate are enticing, but once people actually drink it and realize it’s a very thick liquid, they might be turned off. To drink it straight isn’t something the average person will find acceptable. I recommend perhaps blending it into a drink with other ingredients.”

For those who prefer to drink fermented foods, Nussinow recommends kombucha tea or probiotic drinks. Kombucha tea is made with tea, sugar, bacteria, and yeast. Probiotic drinks such as Yakult (a Japanese milklike product), CocoBiotic (a naturally fermented drink made from young coconuts), and GoodBelly’s line of probiotic juices are receiving increased recognition, though many of the companies that make these beverages haven’t marketed them as well as the yogurt manufacturers, Whitby says, so yogurt is likely still the most well-known and most frequently consumed fermented food.

For the Do-It-Yourselfers
Just as the interest in store-bought fermented foods is growing, so is the desire of some to ferment their own foods at home. Pamela Schoenfeld, RD, owner of Reinvent Your Diet, LLC, a private practice in Randolph, New Jersey, has been fermenting her own foods for years. “Once you realize the process is pretty simple, there’s more interest in doing it yourself,” Schoenfeld says. “You can save a little bit of money, and you have control over the process.”

Schoenfeld says pickles are one of the easiest foods to ferment. Her best advice is to buy fresh Kirby cucumbers from a local farmer or farmers’ market. “I tried making them with supermarket cucumbers, but they didn’t come out very good,” she recalls. “A farmer told me the wax sprayed on supermarket cucumbers to help prevent them from dehydrating also makes the fermentation process difficult.”

Because there are several variations of fermentation recipes and processes, Schoenfeld suggests clients do some online research or buy a good book about the subject. She recommends Wild Fermentation: The Flavor, Nutrition, and Craft of Live-Culture Foods by Sandor Ellix Katz and Sally Fallon. Schoenfeld says there are many different tricks to learn depending on what you’re making, and you must be accurate with your salt ratios. She says one of her favorite fermented food creations is salsa. “It’s a neat concept to be able to eat fresh, raw food that came from your garden or local farmers’ market when it’s six months later,” she says. “Fermented green beans also are quite tasty and something to try. It can be very rewarding for people to make their own fermented foods.”

Encouragement From RDs
Since the lack of knowledge about the health benefits of fermented foods may be the reason more consumers aren’t buying them, this is a great opportunity for dietitians to spread the news. RDs can tell clients what fermented foods are and why they may want to incorporate them into their diet. “The best way to get clients to try fermented foods is to start with the foods they already know and enjoy,” Gazzaniga-Moloo suggests. “For example, cheese and yogurt are fermented foods. Also first try the more daring fermented foods yourself. Maybe it’s kimchi or tempeh that’s pushing the envelope for you. Before recommending them to clients, get some first-hand experience eating and cooking with the fermented foods you’re suggesting.”

Nussinow agrees, adding that while the interest in fermented foods is growing, many consumers don’t realize the health benefits come from the living organisms. “Fermented foods are alive and must be refrigerated to be kept alive,” she says. “Because of the high salt content in a product like miso, it will last quite a long time, but some of the vegetables are a bit more finicky and are best used in a shorter [period of] time.”

As consumers begin to eat more fermented foods, Nussinow warns that it’s possible to overdo it. “If you do, your gut will let you know—sometimes in painful and embarrassing ways,” she says. So RDs should encourage clients to take it slowly. “Go easy on eating fermented foods when you start out,” Nussinow says. “Incorporate them gradually into the diet and you may start to enjoy some of the benefits as well as the distinctive flavors.”

— Lindsey Getz is a freelance writer based in Royersford, Pennsylvania.


Lacto-Fermented Dilly Beans

One-quart Mason jar
1- or 2-piece lid

1 1/4 lbs young green beans (beans should be crunchy and not fully formed)
3 to 4 tsp sea salt (It’s important to use noniodized salt. This includes sea salt, land salt, and kosher salt without additives. Hawthorne Valley Farm uses unrefined sea salt in all of its lacto-fermented products.)
2 to 4 garlic cloves, crushed
1 to 2 flowering dill heads (substitute 1 tsp dried dill if you have no fresh dill)
1 tsp mustard seed
Fresh or dried hot pepper to taste
(Optional) Add coriander, cloves, black pepper, cinnamon, or ginger to taste

1. Boil 2 to 3 quarts of water with a little noniodized salt.

2. Submerge green beans for 2 to 3 minutes (until they turn bright green); remove from heat and cool completely with cold water.

3. Place cooked, cooled beans in a clean, 1-quart Mason jar and add salt, garlic, and spices.

4. Cover beans, spices, and salt with water to top of jar.

5. Put a 1- or 2-piece lid on the jar; shake to dissolve salt.

6. Place jar in a room where the temperature is steadily 65˚F to 75˚F (If the temperature fluctuates, the fermentation will be mediocre.)

The beans should be done in about 14 days. After this initial fermentation, the beans should be stored in the refrigerator. They will continue to mature and age for several months, but you can eat them any time.

— Recipe Courtesy of Hawthorne Valley Farm