A Healthy Microbiome & Sauerkraut Recipe

Acupuncturist Philippa Summers delves into the world of healthy bacteria - microbiome - and gives some helpful insights and tips as to how this can benefit us along with a delicious saurkraut recipe to help us along.

Did you know that your body contains roughly as many bacterial cells as human cells? Along
with viruses and fungi, and their collective DNA, they make up our microbiome. The
microbiome varies hugely from person to person and plays a crucial role in determining our
health. There is a whole eco system living on your skin and within you, in your respiratory
tract, your reproductive tract, in breast and other tissue, but primarily in the intestines – the
gut microbiome. Among them are vitally important beneficial microbes that help to keep
the disease-causing pathogens at bay, while also enhancing and interacting with many of
the vital internal processes that work to keep us well.

The Benefits of a Healthy Gut Microbiome
A healthy gut microbiome has benefits that extend throughout the body and is considered
by some to be equivalent to an additional organ, such is its importance. It plays a crucial role
in helping to maintain and support metabolic function, immunity, plus cardiovascular,
respiratory, reproductive and menopausal health, as well as helping with sleep, mental well-
being and brain function. It is an area of intense research, with more being discovered all
the time.

The scope of its influence cannot be overstated. A healthy gut microbiome is anti-
inflammatory and helps to combat the development and progression of a whole range of
chronic health issues and to reduce infections throughout the body, helping in the fight
against antibiotic resistance. Type 2 diabetes, obesity, kidney disease, Parkinson’s,
atherosclerosis, high cholesterol, hypertension, dementia, urinary tract infections,
respiratory infections, vaginal infections, asthma, allergies, autoimmune diseases, IBS, IBD,
some cancers...the list goes on... have all been shown to have an association with an
unhealthy balance in the gut microbiome. It is the subject of ongoing research to determine
the processes and balance of cause and effect between disease and the microbiome.

A High Fibre Diet supports the Microbiome
Our environment, where we live, who we live with, how we interact with our environment
but particularly our diet has a huge influence on the microbiome, and for each of us our
microbial fingerprint will be unique and changing dynamically all the time.
A poor low fibre diet of refined carbohydrates like white flour, white rice and particularly
simple sugars will encourage inflammation and take the balance of good bacteria to bad inan unhealthy direction. A healthy high fibre diet on the other hand will help to support the
community of beneficial bacteria, which ferment more complex carbohydrates that we
cannot otherwise digest, into nutrients with anti-inflammatory and metabolic health
benefits.

The beneficial bacteria lie mainly in the colon at the far reaches of our intestines and to feed
and support them we need a diet where the carbohydrate portion of what we eat can pass
through the upper reaches of the intestines to the colon without previously being
completely broken down. Simple and refined carbs get broken down too high up in our guts
but high fibre complex carbohydrates (wholegrains, vegetables, nuts, seeds and fruit) make
it all the way to where they are needed. Aim for a wide variety of colourful plant foods
including herbs and spices to aid digestion, and of course include proteins and healthy fats
for a balanced diet.

We feed these bacteria and they in turn feed us with the beneficial by-products of their
meal. Think good housemates - you provide the healthy ingredients, and they cook up a
feast! The healthy foods we provide them with are the prebiotics, the healthy ‘bugs’ are the
probiotics.

Choosing Probiotic Foods and Supplements
Some species of these healthy bacteria will have established themselves as long term
residents of our gut, beginning at birth and supported early on by breastfeeding. We can
augment this existing population by eating fermented foods containing other beneficial live
bacteria, or for convenience and maybe for specific health issues by taking them as
supplements. To reap the benefits, we need to choose those that are alive and can survive
through the upper reaches of the gut all the way to the colon as many cannot survive the
acid of the stomach.

How our individual microbiome interacts with our own metabolism and diet is complex and
more in-depth studies that take a personalised approach are the subject of ongoing
research, one of the largest being the Zoe PREDICT studies. A peek at these studies will
show you how complicated a field it is. People with a histamine sensitivity may not tolerate
probiotics and care should be taken by people with bowel conditions like IBS and IBD.
Deciding which strains are most beneficial is a complex subject which varies from person to
person and according to the health issues being addressed, and I suspect is obscured by the
commercial nature of supplements and the influence on research. Lactobacillus and
Bifidobacterium are the most widely recommended in supplements, with many species and
strains of each offering different benefits. A little more of that below in relation to women’s
health and gut health but to go into more detail is beyond the scope of my experience or
this blog.

If you prefer to take supplements in my opinion Optibac are a reliable good value brand and
provide a simple useful guide with formulas for a variety of situations: every day, after
taking antibiotics, for women’s health including during pregnancy and for gut health.
Symprove receives wide recommendation but is much more expensive and is limited to a
single multi-strain formula. I am not suitably knowledgable to offer any wholeheartedrecommendations but those are a couple of reliable options. You can eat fermented foods
as well or instead.

For Women’s Health including fertility and menopause
Lactobacillus species support a healthy vaginal microbiome where they help to keep disease
causing yeasts and bacteria at bay, by maintaining a favourable protective acidic
environment. From the research so far, implantation and reduced incidence of early
pregnancy loss are also supported when the predominant species in the uterus are
Lactobacilli. They are of benefit when taken orally, even for colonising the reproductive
tract.

Lactobacillus species can also be helpful at alleviating some of the symptoms of menopause
via the two-way interaction between oestrogen levels and the gut microbiome.
Yoghurt, kefir and Sauerkraut are all high in Lactobacillus species and other lactic acid
bacteria.

For Gut Health
For people with gut issues like IBS and IBD I would recommend seeking guidance from a
dietary or nutritional specialist. Some of the otherwise healthy prebiotic foods can
contribute to symptoms, and some probiotic strains can be helpful while others may
exacerbate symptoms.

Probiotic Fermented Foods
For general health benefits why not try a range of different live unpasteurised probiotic
foods such as kefir, yoghurt, kombucha, kimchi, miso or sauerkraut to see which you like
and which suit you? Or try making your own. They can be more potent than probiotics
supplements and much cheaper, too, and all have different microbial profiles and benefits.
Some ferments like kefir and kamboucha contain a range of yeast and bacteria while others
like yoghurt, sauerkraut and kimchi are predominantly bacterial. Additionally, as they have
fermented over a period of time the fermented product will contain high amounts of more
easily digestible nutrients that are a by-product of the fermentation process.

Making your own fermented foods
If you fancy making a home-made ferment you can try the simple sauerkraut recipe below.
Incidentally, I was surprised to learn that sauerkraut, despite its German name, originated
around 2000 years ago in China and came to Europe in the 1600s. Making Kimchi, a spicy
Korean ferment, is similar and there are plenty of recipes online. If you really want to get
into ferments then I recommend Fermentation by Asa Simonsson which covers a whole
range of fermented foods and drinks including vegan dairy, or check out the many websites
and blogs on fermenting.

Sauerkraut Recipe

You will need a container in which to ferment the veg before transferring it to smaller jars
for storage, and you will also need weights to hold the veg below the surface of the liquid
while it ferments. You could use a large wide necked jar with a lid but you will need to keep
an eye on it and keep releasing the gas that will build up inside. Or you may wish to buy a
fermenting jar or a crock pot which allow the gas to release automatically. Some come with
weights, others don’t.

Ingredients
1kg finely chopped white or red cabbage (you can substitute some of the cabbage with
grated carrot, beetroot and apple to make a total of 1kg veg)
15g sea salt
Optional spices:
1 tbsp chopped garlic/ginger
1 tsp caraway seeds, chili flakes, peppercorns, seaweed etc

Method
• Place the veg, salt and spices in a large clean bowl mix well and massage with your
hands for 5 mins. Leave for 5 mins.
• Massage and squeeze again for about 20-25 mins until you have plenty of juice and
the veg has softened.
• Pack into the fermenting jar or crock, add the weight so that all the veg is completely
submerged in the briny liquid. This is very important as the fermentation will spoil if
the veg is exposed to the air.
• Put on the lid and leave at room temperature to ferment. The fermenting jars have a
valve, the crock has a sunken rim that you fill with water so the gases release
automatically. Keep checking that the water level around the rim is above the notch
in the lid.
• Leave for anything from 5 days to 4 weeks depending on the room temperature and
how sour you like it. I leave mine for about 10 days.

As the sauerkraut ferments is becomes more acidic which most bugs can’t tolerate and
you’ll end up with a tasty ferment rich in acid tolerant Lactobacillus. The result should be a
crisp, slightly sour, flavoursome kraut. If it becomes mouldy, slimy or smells rotten then
something has gone wrong, so discard.

Pack into clean jars, pressing the veg below the surface of the liquid and store in the fridge.
Keeps for weeks, months according to the experts but I’ve never left it that long. Great in a
sandwich, salad or as a meal accompaniment.A word of warning - as your body adjusts to fibre and probiotics you may find you are a bit more flatulent, but it should settle down after a few days, start with a little and build up. In any case, a little every day is better than larger quantities less frequently.