Fermented Food, benefits for bariatric health

Dawn (00:00):

Hello and welcome to the Gastric Health Show. My name is Dawn Boxell, Registered Dietitian, and this week’s topic is on fermented food, the benefits for bariatric health. So this week I just really wanted to quickly cover some of the benefits of including fermented food in your diet. So I really like to, especially when I have someone who is struggling with digestive issues and we don’t really know what the driver is, I’d like to have them, especially if they’re not taking a probiotic. And this is an easy way to introduce those friendly gut bacteria that can really help support a lot of areas after bariatric surgery. I mean, it’s not a surprise really that digestive issues become a problem after Roux-en-y gastric bypass, sleeve gastrectomy, they’re very common to have digestive issues. Because of the nature of the surgery and how we are altering your anatomy, we are messing with your intestines that truly do impact your gut microbiome.

Fermented Foods for Gut Health

(01:27):

So adding fermented foods can help introduce those friendly bacteria so that you can kind of slowly do it and not have a lot of digestive upset. And then move into an actual probiotic is kind of how I like to do it. For some individuals, sometimes it’s the probiotic is first, but really to sustain long-term, to sustain your gut microbiome, you need fermented food. You need those good microbes coming into your daily diet. So if you have some digestive issues and we have the ability to kind of correct and resolve ’em and they’re no longer an issue, then adding the fermented food for some people, we’ll allow you to get away from taking a probiotic on a daily basis. For most, I would say for most bariatric patients, it’s going to be that you will probably need both. And you may find that’s the only way that you get the best support and that you can feel your best.

Role of Fermentation

(02:46):

So what is fermentation and fermentation is just a naturally occurring process that involves breaking down food substances with the help of beneficial bacteria, yeast or even fungi. What happens is the microbes consume the sugars and other compounds in the food that results in the byproduct like organic acids, gases, and alcohol. And this process not only imparts kind of unique flavors, but it also preserves the food. So if you’ve listened to my podcast from the very beginning, I talked a lot about fermented food and how important it is and how it’s kind of a lost art in our today’s culture. And this is part of it. No one has fermentation crocs, or I shouldn’t say no one, but most of us don’t have fermentation crocs in our homes that we are continuously brewing some type of fermented food on a regular basis. And I remember in my grandparents’ basement them having crocs that they would ferment things in.

Lost Art of Fermentation

(04:04):

So again, it’s one of those things that we’ve just lost the art of, and with everything being so readily available that we really have little to do, to have access to food, whether it be really super nourishing or not, the food is there. So it’s one of those things that we know longer use those practices because someone else has done it for us. But what some of the benefits of fermentation are is that it enriches the food with the probiotics and digestive enzymes that can really support a healthy body after bariatric surgery. So just a few quick things, probiotics, these are the beneficial bacteria introduced or generated during fermentation. So these are the beneficial or the good bacteria that the byproducts from this setting, this food product out to ferment with some salt and water for like a sauerkraut, something so simple, there’s really nothing to it, and it produces these naturally occurring microbes that are already on the food.

Bariatric Benefits of Fermented Foods

(05:34):

And then enzymes, these are the proteins that kind of speed up the chemical reactions aiding in digestion and then preservation. The acidic or alcoholic environment created by fermentation kind of deters the spoilage so it deters the ability for the bad microbes to be taken over that food product. So let’s talk about some of the bariatric benefits of fermented food. One is gut health, and we all understand that bariatric surgery does disrupt this balance of bacteria in the gut. And fermented food can really help restore this balance, which is really essential for overall digestive health and can prevent issues like gas and bloating and irregular bowel movements. And the probiotics that are found in fermented food contribute to the big ecosystem that aids in digestion and nutrient absorption. Additionally, they also outcompete the harmful bacteria helping to maintain a balanced gut microbiome. So the more opportunities that you’re introducing these fermented foods into your diet regularly, and for me, I recommend at least once a day and I challenge you to go beyond yogurt as it’s great a great option and we’ll kind of go through some of these options shortly.

Microbial Balance for a Healthy Gut

(07:08):

But I, tapping into the other type of microbes will give you a more balanced approach to keeping fermented foods and balancing out your gut. But essentially, if you really just continue to put these microbes in on a daily basis at least one time per day, that truly can make a huge difference with supporting a healthy gut microbiome after bariatric surgery. The next one is it aids in digestion, and this is because of the enzymes that this produces with the fermentation. So when you are fermenting foods, then it has the byproduct that is produced is all of these digestive enzymes, which can be super helpful in assisting you to break down food naturally with using this on a regular basis. And because you have altered digestion after bariatric surgery, these enzymes that the fermented foods produce can kind of ease the process and improve nutrient absorption and kind of reduce digestive discomfort.

Digestive Aid through Enzymes

(08:33):

The next one is immune support, and 70 to 80% of our immune system resides in our gut. And by enhancing your gut health with probiotics can play really a crucial role in fortifying your immune system. And several studies have shown that a healthy gut microbiome can help fend off pathogens and reduce the frequency of infections. So again, something so simple as one time a day, making sure that you’re consuming some type of fermented food is just a simple way to keep you healthier during the cold and flu season as well as throughout the year. It just ramps up that natural ability for your immune system to support your health better. The next one is anti-inflammatory properties. So not something that you really think about when it comes to fermented foods, but they do have properties that can help calm down inflammation that you could be experiencing any way that you can improve your body’s response to inflammation.

Immune Support via Probiotics

(09:50):

To me, it seems like a no-brainer because it’s easy for any person to get in a state where they have this low grade inflammation and sometimes during certain seasons of your life, like in menopause that you inflammatory response goes up naturally. That’s just part of the process with that estrogen and progesterone dropping and it creates this environment that inflammation is now at the core brewing and kind of spinning off all of these other problems that can occur because of inflammation. So again, including fermented foods is a great way to help keep inflammation kind of chilled out. Not all inflammation is going to be resolved with just eating a few fork fulls of fermented sauerkraut and a few containers of yogurt. That’s not going to solve your problem. Sometimes inflammation needs some higher hitting things, but think of it this way, if you’ve had bariatric surgery and you start incorporating these things early on, it can really help set the scene because the inflammation is all chilled out with bariatric surgery.

Anti-Inflammatory Properties

(11:16):

So the key is to keep that and to help keep that balance long-term, and that’s where the fermented foods really do come in to help support you and prevent that returning of the inflammation. So again, just a simple way to help calm out an inflammatory response. Another one is blood sugar regulation. And this is something that we see a lot with bariatric patients is bariatric surgery truly does magic in the world of blood sugar and it happens before you’ve even lost any weight. So we see as soon as the surgery is done with you’re still in the hospital, we see blood sugars for a lot, not a hundred percent of you, but for a lot of you become immediately normalized and no longer need insulin, no longer need metformin, no longer need these aids to help maintain a stable blood sugar. And again, you haven’t lost any weight.

Blood Sugar Stability with Fermented Foods

(12:31):

So we know that there is a connection with your gut microbiome and the surgery that helps this occur. So we know that fermented food also plays a role because of the microbes that they provide. Those bacterias and fungi and yeast that are naturally occurring in the food products from this fermentation process, it really helps stabilize your blood sugar long-term. And I did a podcast and a blog post. You can go to gastric health.com and probably just type in blood sugar. And I did a whole post on this and it’s titled Why Bariatric Patients Should Care about Blood Sugar. And in this I talk about a study that shows it brought all the studies together explaining that blood sugar regulation is super improved immediately after surgery, but then as they reevaluate at year one and year five, the incidence of returning is it does become significant.

Mood Enhancement through Gut-Brain Connection

(13:50):

So they did find it year one for the Roux-en-y gastric bypass. It was 8.4% had a return of their diabetes and 11% for the sleeve gastrectomy. And then after five years, they found that 33% of the run white gastric bypass patients and 41% of the sleeve gastrectomy patients had a recurrence of their diabetes returning. So again, one of those things that you have to consider that it’s not magically gone forever if you’re not actively preventing it. This to me is a simple way to help support that is by adding the fermented food because you can help stabilize your blood sugar better by incorporating some type of fermented food on a daily basis. And the last one is mood enhancement. And we do know that there is a gut brain communication and we know that things that are occurring in your gut, occurring in your brain.

Recurrence of Diabetes after Bariatric Surgery

(15:01):

So if your gut is a mess, then you could have some brain inflammation which can really impact your mood. Anxiety, depression, all of that stuff is it really is driven out of having a gut dysbiosis or really just having bad gut health. Additionally, we know that the gut microbiome can impact neurotransmitters like dopamine and serotonin and really impact those mood regulating hormones and just incorporating and keeping that gut healthy can really help support your mood in a positive way. So let’s talk about the different types of fermented food. So what qualifies a food to be considered as fermented? Because you have to think about in this instance that you want these bacteria to be alive. You want them living. So say you look at a yogurt and it says No live cultures, you would want to put it back because you want it to have those lactobacillus species and it’ll have probably some bacillus or bifidobacteria species as well, but definitely the lactobacillus species, a bee, a dominant one in the yogurts and then kimchi.

Types of Fermented Foods

(16:28):

So kimchi is just kind of a traditional Korean dish that’s made from fermented vegetables, mostly cabbage. They’ll use the Chinese cabbage with a bunch of different spices and seasonings and really turns into a little bit of a kick. A little spice with it is usually included, so it is tasty, it has a different unique flavor, but it is great to add to dishes to kind of enhance the flavor, but then also you get the byproduct of supporting your gut microbiome because of all the healthy good bacteria that are going to be alive in the kimchi. The next one is sauerkraut. So this one gets a little bit tricky because you can buy sauerkraut on the shelves and you can buy it in bags up by the deli. I want to tell you that none of those types of sauerkraut are fermented. They have vinegar in ’em, and you’re not looking for vinegar in any type of sauerkraut when it comes to fermentation.

Homemade Sauerkraut Fermentation Process

(17:36):

So truly when you are fermenting sauerkraut, it is you are taking cabbage, you’re chopping up a whole head of cabbage into just fine textures. You can use a mandolin, but it is chopping it up and then you’re adding about one and a half tablespoons of salt, and what you’re doing is you’re just crushing the salt into the cabbage and the water then separates and comes out of the cabbage and then you put it in this jar. Now, when I do it at home, I would actually just kind of with my fist take the cabbage and pound down the cabbage in the jar and I would have a wide mouth jar that I could kind of punch it down and squish it down in there and the water would release. And then you put the whole head in this 32 ounce jar and you get the whole head in there and you just adding salt as you go, you’re adding salt, squishing it down, adding some more cabbage, then you add some more salt, and you just kind of do that until the whole head is in this jar.

Brands for Store-Bought Sauerkraut

(18:45):

And then there should be a little layer of water it comes to the top. Now usually I have to put a small jar with water in it and as a weight, and I just put that in the top of this jar and then put a coffee filter over top and put just a rubber band around the top to keep it sealed. And then you just let it sit out on the counter for a week, sometimes two weeks, depending on you just check as the days go by and you just watch it, you’ll start seeing bubbles rise to the top, and that’s showing you that the bacteria from the cabbage and that salt and water combo is allowing and creating that environment for those microbes to flourish. And so that is the type of fermented sauerkraut you’re looking for. So you will only find that pre-made in the coolers.

Importance of Cold Consumption

(19:46):

So if you don’t have an interest in making it for yourself, which there’s absolutely nothing wrong with that, but you would want to look in the coolers at your local grocery stores. Bubbies is a brand that I’ve used. Wild Brine is another one that’s pretty nationwide. I would say they’re shipped nationwide. That would be an option you could probably find in maybe a health food store if your area is more of like a food desert. So you might have to travel a little bit if you don’t have health food type stores that offer supplementation and stuff. So it just depends in your area. You can always ask your grocer if they can carry it, if they know you’re going to buy it, they can get it in. So if you’ve never had that available, talk to your grocer and see if they can get some in so you can have it available.

Kefir as Liquid Yogurt Alternative

(20:43):

But again, that sauerkraut super simple, and I will tell you it’s great to use the liquid once all the cabbage you’ve eaten. All the cabbage, you can use the liquid to make salad dressings or other sauces. The key is though you’re not heating it, you wouldn’t want to put this with sausage like a traditional German dish where you’re putting it with some sausage and sauerkraut. You don’t want to heat it. You want this to be cold and chilled because the heat will kill those bacteria species and prevent you from getting the benefits of it. Then the yogurt, we’ve talked about that. The next one is kefir. So kefir is, think of it like a liquid yogurt and. It has 12 to 14 different strains and species of bacteria. And I tell my patients to just do little shots of it. Get like one of those kids’ medicine cups and do a shot of kier.

Diverse Bacterial Strains in Kefir

(21:44):

It’s a great way to get started with adding a whole bunch of good bacteria. Into your digestive tract if you’ve only just done yogurt. Because yogurt doesn’t have that many different species. Whereas Kifer does. It has a great way to add a whole bunch of bacteria into your digestive tract and give you the benefits. Tempe is another thing, it’s just a fermented soy product and is a complete protein. So something to consider if you’re also needing to boost your protein intake. Another one is miso paste. It’s really just a Japanese seasoning made from fermented soybeans and you can add it. They add it to soups and things. But you could add it to other vegetables as you’re cooking a great way. Again, to get that fermentation from something so simple. The next one is kombucha. My favorite and something I like to drink. It’s a fizzy drink, but it is made by fermenting. Sweetened tea with kind of this scoby is what it’s called.

Tempeh for Protein Boost

(22:51):

A symbiotic culture of bacteria in yeast is what a SCOBY stands for. And it’s something that does have a little effervescent fizz to it. But not powerful in any way, but it is something that is super tasty. You just have to pay attention to the grams of sugar. Because some companies will add a lot of sugar after the fermentation process. There is sugar for it to ferment. But then the bacteria in the yeast actually consume that sugar to thrive and grow. And then if the manufacturers are adding additional sugars, then that’s what you want to avoid. You want to keep it to where the sugars are eight or less is. What I typically find 10 or less grams for sure. When you get into above 10, they’re adding sugar. They’re adding sugar after the fermentation process. And then the last one is pickles. So you can ferment pickles in really any vegetables on the counter, just like sauerkraut.

Miso Paste as Japanese Seasoning

(23:57):

So you could do pickles, you could even do carrots, you could do beets. You could pickle them in a fermentation style. So there’s lots of options when it comes to that. And it’s literally just the brine water, salt and spices, and that allows it to ferment on the counter. So again, and if you check out the blog posts, there are a couple of recipes. The Greek yogurt veggie dip, and then we also did a kombucha vinegarette.Where we have that for you to consider. But just some simple ways for you to get some additional fermented foods in your diet regularly. So let’s wrap this up. I know this was a quick topic, but I really just wanted to keep this simple and keep it. So you have some thoughts when you’re at the grocery store of, okay. I’m going to challenge myself. How can I get fermented foods in my diet regularly?

Kombuchas’ Effervescent Appeal

(24:58):

Again, one time a day is efficient. And it is a great way for bariatric patients to keep that gut microbiome healthy. It’s a great way to keep those friendly bacteria winning inside. Your gut where you have adequate numbers of the good guys as you continue to consume those fermented foods. You’re adding to that army. So when any bad guy comes along that you get exposed to. Then your body’s able to fight it off because. You have enough of the good guys in your environment to fight all the bad guys. So it really prevents a lot of negative things that can occur when you have an imbalance in your gut. Just simple ways by adding kefir, kombucha, yogurts, sauerkraut, kimchi, any of these, you’re never going to go wrong. So I would say this week’s topic of fermented foods for bariatric health. My challenge to you is at the grocery. Find one fermented food that you’re willing to try and go through the list until you’ve tried them all. Especially if you’ve never done it. If you’ve never had some of these. Go through the list and try them and. Just have fun experimenting with different flavors of kombucha or different recipes. With the miso paste or kefir. How can I add this into my smoothies or maybe already into my yogurt or some type of oatmeal.

Conclusion

(26:42):

Just simple ways so that it’s really keeping this piece simple. And it’s providing all of those beneficial gut microbes. That can make a huge difference in your digestion and your immunity and. Your blood sugar and all of those benefits that you want to stay on top of. So I hope this has helped, and you guys have a great week and we’ll see you next time. Bye-Bye.

Listen, Learn, Enjoy…

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