
What the Germans are getting right about gut health
But while our supermarket shelves might be groaning with trendy kefir 'gut health shots' and 'super-beet kimchi', a recent study shows we might be missing a trick when it comes to healthy ferments.
The study from the University of California suggests that an old-school staple – sauerkraut – packs an equally powerful probiotic punch, delivering myriad health benefits.
It's affordable, easy to make and teaming with gut-healthy live bacteria. Dr Hannah Richards, a gut nutrition specialist, explains that ferments like sauerkraut, 'support immune regulation and reduce inflammation, which can help prevent cancer'.
Literally translated as 'sour cabbage' in German (though the dish first originated in China over 2000 years ago) sauerkraut has been a beloved staple in Germany and Eastern Europe for hundreds of years, after it was brought to Europe by the Mongols in the 13th and 14th centuries.
Shredded, salted and fermented in its own brine before being ladled into stews and soups by devoted fraus to their young. Its cultural impact was so powerful that during the First World War, 'Kraut' became slang for German soldiers.
But don't be deterred by the name – or its ration-era connotations.
Tangy, salty, and with just the right bite, sauerkraut offers the same zing as any trendy pickle. But unlike the pickle (which is usually soaked in sugary vinegar) the health benefits are impressive. It all comes down to the fermentation process.
1. It improves digestion
As it ferments, sauerkraut becomes loaded with natural enzymes produced by the lactic acid bacteria. These enzymes help break down food into simpler, more absorbable forms, making it easier for your body to access all the vitamins and minerals in your meal, giving more bang for your nutritional buck.
Dr Richards explains, 'You want a really good varied amount of bacteria in your gut, the more you have, the better your digestion is going to be.'
On top of this, cabbage itself is a cruciferous vegetable, meaning it is naturally rich in the non-digestible fibres known as prebiotics. Unlike probiotics, which are live bacteria, prebiotics help your existing gut microbes thrive. Think of them as fertiliser for your gut ecosystem.
2. Boosts your immune system
As over 70 per cent of our immune system lives in the gut, a balanced gut microbiome – the millions of microbes including bacteria, viruses, and fungi that naturally live inside us – is essential. Research shows that sauerkraut's probiotic strains aid just that, and, in the process, strengthen the gut lining. This reduces the leaking of inflammatory toxins, such as lipopolysaccharides (LPS), into the bloodstream.
Dr Richards breaks it down: 'By having more bacteria, you have a more balanced microbiome and stronger immune system. Less LPS equals less immune activation, which then equals less inflammation.' Left untreated, inflammation can seriously damage our cells, leading to various health issues including an increased risk of cardiovascular disease, cancers, diabetes, and autoimmune disorders.
3. Can make you happier
There is no instant fix or miracle supplement when our mental health dips. Serotonin is the hormone responsible for mood regulation, sleep and appetite amongst other things; those deficient in it often experience symptoms of anxiety or depression. Since a staggering 95 per cent of our bodies' supply is made in the gut means that caring for our microbiomes should be a top priority when it comes to mental wellbeing.
Studies have also pointed to the fact that certain strains of probiotic bacteria, such as lactobacillus helveticus and bifidobacteria, longum, found in fermented food like sauerkraut, may also improve symptoms of anxiety and depression. This is because these bacteria produce compounds called short-chain fatty acids which help reduce inflammation. Studies suggest that increased inflammation can lead to higher levels of anxiety.
Sauerkraut is also rich in mood-balancing probiotics and minerals such as magnesium and zinc, commonly used by nutritionists to manage mood disorders.
4. Supports heart health
'The gut microbiota plays a really important role in regulating and lowering cholesterol,' says Haworth. 'They do this through the compounds they produce when breaking down the prebiotics found in sauerkraut.'
These compounds (short chain fatty acids) help regulate blood fat levels, including lowering LDL cholesterol, the so-called 'bad' kind that can clog up arteries and raise the risk of heart disease. At the same time, a healthy gut can support levels of HDL cholesterol – the 'good' kind – which helps sweep excess cholesterol back to the liver for processing.
A happier gut means a healthier heart – and all the more reason to keep an eye on your diet.
5. May reduce cancer risk
Cabbage is naturally rich in glucosinolates, found to have 'anti-cancer properties,' says Richards. They are powerful compounds that survive the fermentation process and help detoxify carcinogens, protecting cellular DNA in the process.
Research also points to sauerkraut's role in shielding colon cells from oxidative stress, thanks to its anti-inflammatory fibre content and antioxidant vitamins C and K.
It is no coincidence, Richard notes, that 'the natural diet, traditions, and culture of food in eastern Europe and parts of Asia are responsible for the lower prevalence of cancer'.
So yes please, pass the bigos (a Polish stew made from chopped meat and sauerkraut).
A spoonful will do…
While delicious, sauerkraut isn't a vegetable to heap onto your plate. Save the serving spoons for the leafy salads.
Dr Richards advises that less is more: 'Ferments are great for the gut, but too much can be an overload. You want it to be a pleasant surprise or aftertaste as opposed to overpowering and sour.'
Highly fermented foods are potent and medicinal and can have greater side effects than a few ginger shots or a kale binge. If overdone, they can trigger digestive issues like bloating and acid reflux, especially in people with small intestinal bacterial overgrowth (SIBO).
'They need to be seen as a supplement or as a medicinal offering,' advises Richards. 'A tablespoon [roughly 10g] mixed through your salad is enough.'
How to include sauerkraut in your diet
While perhaps a little scarier than the gut health titans sourdough and Greek yogurt, this superfood can be incorporated into your diet as a sprinkling or a dollop on most everyday dishes. Here's how:
As a topping: Sprinkle it on green salads, avocado toast, or a loaded baked potato for an extra zing.
In sandwiches or wraps: Pair with sliced chicken or turkey in a hearty sandwich, or add to a falafel and hummus wrap for some delicious depth.
In stews and soups: Stir into your pork stroganoff or chicken casserole with a dash of stock or wine.
As a replacement for ketchup: You will get the same vinegary hit, without the refined sugar.
How to maximise its benefits:
Pair it with a varied diet: You need lots of different bacteria in your gut for optimum health. This is achieved by eating a healthy diet varied in colour, texture and taste.
Build up slowly: Start with small amounts less often to let your digestive system adjust.
Look in the chilled section: Many varieties are pasteurised to extend their shelf-life, killing the majority of the bacteria within. Supermarkets will keep 'live' probiotics chilled.
Put the table salt down: Sauerkraut is high in sodium so be careful with over-seasoning the rest of your meal. If your recipe requires salt, use good quality sea salt rather than the processed alternatives.
FAQs
Is it OK to eat sauerkraut every day?
Sauerkraut is incredibly nutritious, and eating a tablespoon, roughly 10g, a day will strengthen your gut microbiome.
Is sauerkraut anti-inflammatory?
Sauerkraut is highly anti-inflammatory. It contains antioxidants like sulforaphane which help combat inflammation induced by cellular damage. This is because they combat the molecules that damage cells known as 'free radicals'.
What is the healthiest way to eat sauerkraut?
Raw and in small amounts, preferably just before or during meals to ensure probiotic benefits.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


Daily Mail
35 minutes ago
- Daily Mail
The doctor will see you online now! A third of GP consultations are now carried out remotely
One in three GP appointments is now carried out remotely - the highest proportion since the pandemic. The latest NHS England figures show 33.3 per cent of consultations were conducted over the phone or online in June. This is up from 30.9 per cent a year earlier and 28.3 per cent in June 2023. Patient groups described the 'slipping back into old ways' as 'very worrying' and warned serious diseases such as cancer are once again at increased risk of being missed. But family doctors said remote consultations 'offer convenience and flexibility that many patients value', and the majority of appointments are still delivered face to face. As many as four in 10 appointments were carried out by phone or online during the pandemic, but the proportion fell once the impact of Covid-19 eased and had dropped to 27.7 per cent in January 2023. In the past two years the figure has risen slowly but steadily, driven by a sharp increase in consultations taking place online. These accounted for only 1.5 per cent of all GP appointments in June 2023 but had jumped to 4.9 per cent by June 2024 and 8.0 per cent in June this year. This has helped push up the combined figure for phone and online appointments to its current post-pandemic high. The figure just for telephone appointments has remained broadly unchanged over this period, at about 25 per cent. Dennis Reed, director of Silver Voices, which campaigns for elderly Britons, said: 'These figures showing GPs slipping back into old ways are very worrying. 'Phone and online appointments are more convenient for the doctors, so receptionists are keen to push people down that route but is is manifestly unsafe. 'I'm still hearing from people who are told they can have a telephone appointment the same day or the next day but they will have to wait two weeks if they want to be seen face-to-face - that's not a fair choice and it's why I think there should be a legal right to a timely in-person appointment for anyone who wants one. 'Remote appointments exclude people who cannot access technology or are not able or comfortable using it. 'And remote appointments prevent GPs from assessing the entire patient and their overall health. 'If you are doing a video consultation they can only see the bit of you on the screen and if it is via telephone it is even worse - as they only have your voice to go on. 'With in-person appointments, the GP is assessing how you present when you walk in the door and as you sit down. They can spot things they would not see remotely. 'I'm concerned about serious diseases, such as cancer, being missed as a result of this rise in remote care.' Professor Kamila Hawthorne, chairwoman of the Royal College of GPs (RCGP), said: 'Remote consultations, whether delivered over the phone or via video, can offer convenience and flexibility that many patients value, and evidence has shown that in the vast majority of cases, remote care is safe. 'Often a GP might initially consult with a patient remotely and then ask them to come into the practice if it's necessary to see them in person. 'However, we also know that many patients prefer to access their care in-person, and this is how the majority of appointments are still delivered. 'Over the last 12 months, GPs and their teams have delivered a record-breaking number of appointments, and nearly 250 million were carried out in person.' Some 63.3 per cent of GP appointments in June in England were in person, data shows, down from 65.3 per cent a year earlier and 68.4 per cent in June 2023. Online appointments include those carried out using live chat tools or non-video apps, as well as video-based calls. The proportion of appointments taking place by phone or online varies across the regions, with the figures for June ranging from 38.2 per cent in London to 28.4 per cent in North East and Yorkshire. Professor Hawthorne said the college 'supports a mixed-method approach to delivering care' in general practice and decisions on how appointments are carried out are between clinicians and patients. 'What's key is that when GPs are consulting with their patients remotely, they have access to the robust and up-to-date IT systems that allows them to do so safely and effectively,' she added. A Department of Health and Social Care spokesperson said: 'This Government is clear that patients should have access to health and care when they need it and people who prefer a face-to-face appointment should have one, so we are transforming the NHS app to make managing your healthcare online easy and flexible.' An NHS England spokesperson said: 'Every GP practice must offer face-to-face appointments where patients want or need them, and many patients choose remote appointments where it is clinically appropriate and more convenient for them. 'GP teams are working hard to offer better access for patients, with a record number of appointments being carried out in the last year and recent findings showing the number of patients who are satisfied with their practice has improved.'


The Independent
2 hours ago
- The Independent
The diet with so many benefits health experts always recommend it
The Mediterranean diet is widely recognised for promoting longevity due to its nutritious value and anti-inflammatory ingredients. Its benefits stem from reducing chronic inflammation, which is linked to serious conditions like heart disease, cancer, and dementia. Key anti-inflammatory foods include oily fish rich in omega-3s, extra-virgin olive oil, dark leafy greens, nuts, tomatoes, and various fruits. Experts recommend incorporating foods like salmon, olive oil, and beans, while avoiding ultraprocessed items high in saturated fats, sugar, and sodium. The diet's components, such as antioxidants in olive oil and greens, help protect cells and maintain bodily harmony, contributing to overall health.


Times
2 hours ago
- Times
The ten ways cardiologists avoid heart disease
Coronary heart disease (CHD) remains one of the biggest killers in the UK, responsible for more than 66,000 deaths a year, with one person dying every eight minutes from the condition. It is the single biggest killer disease for men — one in eight dying from CHD — but the mistaken perception that heart attacks are not a big risk for women costs lives. According to the British Heart Foundation (BHF), heart disease kills more women each year than breast cancer, with signs from studies that cases are rising among women under the age of 65. The BHF forecasts there could be one million more people living with heart disease in the UK by 2030. We are all aware of basic matters of the heart, that its normal healthy functioning can be harmed by big risk factors such as smoking and drinking, being overweight and underactive, making poor dietary choices and having high blood pressure. Over time, one or more of these can contribute to the narrowing of the arteries as fatty materials (called atheroma) such as cholesterol accumulate inside them. It is when arteries become narrowed by plaque to the extent that blood flow to the heart and brain is restricted that heart disease is diagnosed. • How to protect your heart — the cardiologist's guide Yet most cases — about 70 per cent according to the BHF — are preventable and cardiologists are convinced that if more of us were aware of the simple steps we can take to reduce our risk, the death toll would fall. 'By managing their lifestyle risk factors and keeping tabs on health, people can dramatically reduce their risk of heart disease,' says Oliver Guttman, consultant cardiologist at the HCA Wellington Hospital in London. 'This is true even for those who currently feel well, as early metabolic changes often occur silently.' So, what are the rules for heart disease prevention? Here, Guttman and Hannah Douglas, consultant cardiologist at Guy's and St Thomas' NHS Foundation Trust, spell out their evidence-based recommendations for warding off CHD. Blood pressure is one of the most important controllable risk factors for cardiovascular disease, yet hypertension is ignored or remains undiagnosed. A normal or ideal adult blood pressure is considered to be between 90/60mmHg and 120/80mmHg. 'Blood pressure is critically important and is truly a 'silent killer',' Douglas says. 'High blood pressure puts the entire vascular system under constant pressure and is a very significant risk factor for heart disease.' Having your blood pressure checked by your local pharmacy free of charge is the first step to take. Also investing in a home DIY monitor is an option and the BHF has a list of approved devices Blood pressure does ebb and flow, so a one-off high reading is usually nothing to worry about, but if it remains high for two or three weeks, see your doctor or nurse. 'Weight management and regular exercise are two of the easiest lifestyle methods that we know help to manage blood pressure,' Douglas says. 'But sustained high blood pressure should always be treated to reduce risk.' Wearable devices such as smartwatches with ECG features, such as the Apple Watch and Fitbit, can be useful for detecting atrial fibrillation (AFib), an irregular heart rhythm that increases the risk of stroke and can contribute to heart failure. 'For people over 65 or those with symptoms such as palpitations or dizziness, these tools may help flag episodes of AFib early,' Guttman says. 'Do be aware that they can also give false positives, so any alerts should be followed up with proper clinical assessment.' Routine monitoring for most under-65s is not necessary, he says, but if you are concerned about AFib speak to your GP. 'These trackers are best thought of as screening tools, not diagnostic devices, and their usefulness increases with age,' Guttman says. Measuring cholesterol and blood triglycerides — or your lipid profile — should be done every 4 to 6 years and considered at low risk of CHD, Guttman says. 'You will need to have it checked more often if your lipid profile is abnormal, you are genetically at a high risk of raised cholesterol or if you are on medication,' he says. • Read more expert advice on healthy living, fitness and wellbeing Finger-prick cholesterol checks can be carried out by your GP or your local pharmacy, or as part of the NHS health check in England. According to the BHF, below 4mmol/L (below 2.6mmol/L if you have had a heart attack) is a healthy level of non-HDL, bad cholesterol, the type that builds up in your arteries. Above 1mmol/L is a healthy level of good HDL cholesterol for men and above 1.2mmol/L is a healthy level for women. Healthy total cholesterol levels are below 5mmol/L, (4mmol/L if you've had a heart attack). 'Chronic inflammation is one of the key drivers of atherosclerosis, the plaque build-up in arteries,' Guttman says. 'A diet rich in anti-inflammatory, whole foods is ideal for helping to prevent this and is not only heart-protective but supports gut health, brain function, and long-term weight management.' He recommends a Mediterranean-style diet with plenty of vegetables, fruits, whole grains, legumes, healthy fats, particularly extra virgin olive oil, and nuts, and a regular consumption of fish and seafood, which are high in heart-healthy omega-3 fats. A review of clinical evidence in the journal Nutrients showed the approach is beneficial in reducing inflammation that is a risk factor for CHD. 'By also reducing or eliminating ultraprocessed, pre-packaged foods such as ready meals from the diet, we instead use more whole ingredients to cook at home, so it is an important step to take,' Douglas says. 'Whole food ingredients are going to be largely anti-inflammatory provided we balance the food groups and take care with not adding too much extra fat and salt.' Given its benefits for muscles, bones and the waistline, there is a trend for favouring weight training over cardiovascular exercise among the over-50s. But Douglas stresses that one is not necessarily better than the other for the heart. 'I tend to advise a 50:50 mix of cardio and light weight training for optimum cardiovascular health,' Douglas says. 'Weight training has many benefits for blood pressure, general vascular health and bone density, but keeping active with cardiovascular, or aerobic, exercise is amazing for heart rate and blood pressure optimisation, weight management and has the secondary benefits of reducing the risk of other conditions such as type 2 diabetes which, in itself, is closely linked with poor heart health.' Guttman says that, as a minimum, we should aim for the government targets of at least 150 minutes of moderate aerobic activity per week, and muscle-strengthening activities on two or more days per week. 'A mix of the two offers the best protection for cardiovascular and overall health,' he says. Being overweight is a risk factor for CHD, but central adiposity — fat around the middle — is generally more telling than the scales. Getting a tape measure out every 4-6 weeks is the best approach. 'The body mass index [BMI] is still commonly used, but it doesn't reflect body composition or fat distribution,' Guttman says. 'For most people, keeping an eye on waist circumference is the easiest and most reliable way to monitor central fat, which is metabolically harmful and strongly linked to CHD risk.' High-risk waist measurements are over 102cm (40in) for men and over 88cm (35in) for women, although the numbers shouldn't be taken in isolation. 'We are all built so differently with different compositions of body fat and muscle,' Douglas says. 'We know that waist circumference has been linked with cardiovascular risk, so is definitely a useful gauge, but for those at higher risk of CHD an approach agreed between you and your clinician is best.' Sleep is a key component in managing general health. 'There are very few conditions, medical, physical and psychological, that aren't worsened by poor sleep,' Douglas says. 'And this definitely includes heart disease.' Poor or insufficient sleep is associated with high blood pressure, obesity, type 2 diabetes and irregular heart rhythm, all of which are risk factors for CHD. 'Sleep apnoea, which causes pauses in breathing during sleep, is another serious and underdiagnosed condition that significantly raises cardiovascular risk,' Guttman says. 'Most adults need 7 to 9 hours of good-quality sleep per night and prioritising a regular sleep schedule, reducing evening screen time, and managing stress can all help improve your sleep and consequently support heart health.' Smoking remains one of the most powerful preventable risk factors for heart disease. 'It damages the arteries, increases blood pressure, promotes blood clotting, and accelerates plaque build-up,' Guttman says. 'Even light or occasional 'social' smoking and passive smoking increase CHD risk.' There is no safe form of smoking. Research presented to the American Heart Association by cardiologists at the University of Wisconsin reported significant negative heart health impacts after vaping and smoking cigarettes. • Heart disease — the six things to consider to protect yourself Immediately after vaping or smoking, increases in blood pressure, heart rate and blood vessel constriction were identified, and people who used e-cigarettes consistently performed worse than non-nicotine users on treadmill exercise tests used to predict CHD risk. 'I do worry about the long-term effects of vaping,' Douglas says. 'Although easier said than done, all smokers need to work their hardest to become ex-smokers, with any support available.' The heart benefits of quitting begin within days, and over time, the risk of CHD can fall to near that of a non-smoker. Most CHD risk comes from a combination of genes and lifestyle. If you have a family history of heart disease, Guttman says you should always discuss with your GP or cardiologist whether additional testing is appropriate for you. 'Genetic testing can be helpful, especially in cases of strong family history of premature heart disease [heart attack or stroke before age 55 in men or 65 in women],' he says. 'Certain inherited conditions, such as familial hypercholesterolaemia, which is characterised by very high levels of non-HDL cholesterol in the blood, greatly increase heart disease risk and often go undiagnosed without testing.' However, routine genetic screening is not recommended. 'In asymptomatic patients it often raises more questions than it answers unfortunately,' Douglas says. And even if you do have a genetic predisposition, there is no escaping the truth that healthy behaviours — not smoking, regular exercise, a balanced diet — will significantly reduce your CHD risk. 'Always discuss concerns with your GP or cardiologist, who will help to determine whether testing is appropriate for you,' Douglas says. Women — be extra aware of symptoms around the menopause Menopause is a key window for reassessing heart health and 'it's an ideal time for women to get their blood pressure, cholesterol, and glucose checked to ensure they're on track for the years ahead,' Guttman says. Some of the symptoms associated with the perimenopause and menopause, including sweating, palpitations, breathlessness, intolerance of exercise and panic attacks, are also symptoms of heart disease and, as such, can get overlooked. 'Understanding signs that can be associated with fluctuating hormone levels is key to recognising the difference between perimenopause and, for example, a cardiac arrhythmia,' Douglas says. 'Women should always seek medical help for worrying symptoms early. And if not satisfied with the outcome, seek a second opinion.' HRT isn't prescribed to prevent CHD, but it may play a helpful role in managing menopausal symptoms in some women. For some of those under 60 or within 10 years of their menopause who are otherwise healthy, it might improve quality of life as well as improving some metabolic risk factors. 'I am a proponent of HRT for many peri and post-menopausal women for whom benefit outweighs risk,' Douglas says. However, HRT is not suitable for everyone, particularly women with a history of stroke, blood clots, or known CHD. 'Decisions about HRT should be personalised, weighing the risks and benefits with a healthcare professional,' Guttman says.