A healthy living blog from Marshfield Clinic Health System

Worth the wait: Fermented foods and gut health

Fermented Foods 6-11 inside

The probiotics fermented foods contain help replace healthy gut bacteria.

Topping your next summertime bratwurst with sauerkraut may do more good for your health than you think.

What makes fermented foods like sauerkraut healthful?

It’s the probiotics they contain that help replace healthy gut bacteria. According to Kari Mizgalski, a Marshfield Clinic registered dietitian, research being done on gut health shows probiotics may promote intestinal health and play a role in preventing autoimmune disease.

Similar findings also have been cited by the National Institutes of Health, “There’s preliminary evidence that some probiotics are helpful in preventing diarrhea caused by infections and antibiotics, and in improving symptoms of irritable bowel syndrome (IBS), but more needs to be learned.”

“Some probiotics could help people with IBS and improve overall digestion in the long run,” Mizgalski said.

Foods like sauerkraut can cause gas in some individuals, so if you have IBS, you may be sensitive to this.

You may think of sauerkraut first when identifying fermented foods, but other such foods include kimchi (a Korean pepper cabbage mix), yogurt, kombucha (a fermented tea) and a yogurt drink called Kefir.

Be careful when fermenting food

The fermenting process includes using a higher amount of salt, so talk to your cardiologist before making and eating fermented food if you are on a low sodium diet.

Fermenting foods also must be done under proper sanitation.

According to the UW-Extension, critical factors in making fermented foods include using the correct amount of salt and proper fermentation temperature.

Most products are fermented at temperatures between 68 and 75 degrees Fahrenheit. In this temperature range, fermentation generally takes three to four weeks. At 60 to 65 degrees F, fermentation will proceed more slowly and may take five to six weeks. Fermentation at temperatures above 75 degrees F may result in spoilage.

Try this recipe

You can make and ferment your own sauerkraut. Be patient. This process takes a few weeks to ferment but will be worth the wait.


Fermentation time: 3-4 weeks

Servings: 5-gallon container holds about 25 pounds of cabbage


  • Cabbage
  • Salt (pure canning or pickling)


  • Sharp knife or food processor
  • A large container or old-fashioned earthenware crock


Remove defective and coarse outer leaves from cabbage. Rinse heads lightly in cold water and drain.

Cut heads into halves or quarters and core. Slice or shred the cabbage.

Weigh cabbage. Place the first 5 pounds in a sterilized pan or bowl. For every 5 pounds of cabbage, sprinkle with 3 tablespoons of salt. Mix well and allow salted cabbage to stand 5 to 10 minutes to wilt. Pack cabbage into container and pound cabbage firmly with a wooden tamper until enough juices are drawn out to cover cabbage. Repeat layer by layer until container is filled and cabbage is covered with one to two inches of juice. Leave four to five inches between the cabbage and the top of the container.

Use a water filled plastic bag that is heavy duty, watertight, intended for food and not colored. Fill the bag with salt water (6 tablespoons salt to one gallon water) to a depth of three to four inches, allowing the bag to completely cover the cabbage. Close securely. AIR CANNOT GET INTO THE CABBAGE AND LIQUID.

Place container in a well ventilated place with a constant temperature. If kept at room temperature (68 to 72 degrees F), the sauerkraut should be ready in three to four weeks. The higher the temperature, the sooner it will ferment. Fermentation may be incomplete if temperature drops below 60 degrees F.

Check the container daily. If film yeasts or molds form during fermentation, skim them off. Remove any discoloration at the top of the sauerkraut.

Long-term storage


Heat fermented sauerkraut to simmering (185 to 200 degrees F). Do not boil. Pack into clean, hot canning jars and cover with hot juice.


Pack sauerkraut and juice in rigid plastic moisture or vapor proof freezer containers, in glass freezing jars or in tight sealed freezer bags.

Short-term storage


Keep in a tight jar or bag for up to several months.

Leaving in the crock

Keep in cool storage area, but do not expose top surface to air.

Nutrition information

Each serving (1 cup) contains about: 27 calories; .02 g fat (0 g sat); 6 g carbs, 939 mg sodium; 2.5 g sugar; 1.3 g protein; 4.1 g fiber; 0 mg cholesterol.

Source: UW-Extension

Print sauerkraut recipe

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