CHAPTER FOURTEEN

EAT OLD (FERMENTED) FOOD

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It takes a sour woman to make a good pickle.

—MICHAEL CHABON, THE YIDDISH POLICEMEN’S UNION

It is not sufficient, he emphasized, to colour (colorare) the mind with wisdom; it must be pickled (macerare) in it, as it were, soaked in it (inficere), and entirely transformed by it.

—PETER SLOTERDIJK, YOU MUST CHANGE YOUR LIFE

IN BRIEF: Fermented foods such as pickles, sauerkraut, and other fermented vegetables and homemade yogurts are rich in nutrients and help power our microbiome with a variety of good bacteria, helping to reduce digestive issues and ward off a host of other health conditions.

Growing up in Brooklyn, Harry would run around the corner to the local appetizing store. These legendary delis and bagel shops, which are part of New York City lore, featured giant wooden barrels filled with pickled cucumbers, the quintessential companion to any deli sandwich. You could just reach into the barrels, grabbing incredibly delicious, naturally fermented pickles.

The pickling process not only preserved the cucumber and gave it that delightful tartness but also helped turn it into a “superfood” that should be a large part of most people’s diets. That’s because when it comes to our health, being in a pickle is a good thing.

Humans have been fermenting food and drink for thousands of years, but it is only recently that we’ve begun to understand the process, at least a little bit. Broadly speaking, fermentation is the chemical breakdown of molecules such as glucose by bacteria, yeasts, or other microorganisms. It has been happening naturally for untold millennia and under the direction of humans for culinary purposes for at least ten thousand years, when the first alcoholic beverages we have evidence of were produced. It wasn’t until the mid-1800s that we began to understand the invisible forces—the yeast and other microorganisms—that power the process of fermentation. Much of this new understanding came thanks to Louis Pasteur, the famed French chemist and biologist.

These tiny organisms, invisible to the naked eye, also play an active role in our health. Billions of bacteria are present within our bodies at all times and make up what is called the microbiome. This complex ecosystem plays a key role in our digestion and overall health in ways that we are only just beginning to understand. An unhealthy microbiome might be linked to autism, various emotional disorders, and a wide range of other conditions and illnesses. Consuming fermented food may help keep our microbiome in good working order.

We’ve already talked about the joys and potential health benefits of various fermented beverages (alcohols) in previous chapters; here we’ll look at the fermentation process when applied to fruits and vegetables and explain why eating real pickles is good for your health.

In wine, spirits, and beer, fermentation occurs when yeast breaks down sugars (found in grapes and other fruits and grains) into alcohol. When it comes to fermented foods, the most common type of fermentation is lacto-fermentation, which does not, as the name might imply, have anything to do with either milk or lactation.

Lacto refers to lactobacillus, a species of bacteria found on the surface of many plants and in the gastrointestinal and genitourinary tracts of humans and other animals. During the process of fermentation, lactobacillus converts sugars into lactic acid, giving fermented foods their signature sour flavors. Lactobacillus also is used as a souring agent in many sour beers and is one of the bacteria used to sour yogurt. In addition to creating this delicious tartness, lactic acid is a natural preservative that prevents the growth of harmful bacteria, which extends the life of various foods. At the same time, the process preserves vitamin and enzyme levels and can provide our bodies with healthy bacteria.

In fact, fermented vegetables are one of nature’s incredible health secrets. As mentioned earlier, the process takes normally incredibly healthy foods like vegetables and supercharges them. Fermented vegetables are more easily digested and can replenish and nourish the good bacteria in your gut.

Unsweetened natural whole-milk yogurt also is a superfood nutriment that is easily digested and loaded with probiotic live cultures and important vitamins and minerals like calcium, potassium, B5, B12, riboflavin, and of course, protein.

We have seen so many patients improve by simply eating naturally fermented homemade yogurt and various fermented vegetables. In particular, many patients with gastrointestinal disorders, including irritable bowel syndrome and inflammatory bowel disease, have seen dramatic improvements after adding lots of fermented foods to their diet.

In 2016, a paper in Current Opinion in Biotechnology noted that “although only a limited number of clinical studies on fermented foods have been performed, there is evidence that these foods provide health benefits well beyond the starting food materials.”1

In 2014, researchers argued in the Journal of Physiological Anthropology that “fermented foods may be particularly relevant to the emerging research linking traditional dietary practices and positive mental health.” They added, “The extent to which traditional dietary items may mitigate inflammation and oxidative stress may be controlled, at least to some degree, by microbiota. It is our contention that properly controlled fermentation may often amplify the specific nutrient and phytochemical content of foods, the ultimate value of which may be associated with mental health; furthermore, we also argue that the microbes (for example, Lactobacillus and Bifidobacteria species) associated with fermented foods may also influence brain health via direct and indirect pathways.”2

Some of this research yields evidence that those who consumed more traditional diets had better mental health and a decreased chance of suffering from depression. One study looked at 1,046 women age twenty to ninety-three, randomly selected from the population, and found that after adjustments for age, social and economic status, education, and health behaviors, “a ‘traditional’ dietary pattern characterized by vegetables, fruit, meat, fish and whole grains was associated with lower odds for major depression or dysthymia and for anxiety disorders.”3

A separate study conducted in Spain looked at more than ten thousand adults and found that those who followed a Mediterranean diet were less likely to develop depressive disorders. This makes sense, as the diet is thought to reduce adverse inflammatory and vascular processes, which are considered risk factors in clinical depression.4

Though the last two studies mentioned above did not look at fermented foods in particular, traditional cultures historically consume large amounts of fermented foods, a practice that began as a necessity, since refrigeration is a relatively recent invention.


Unfortunately, not all fermented foods are created equal. Modern mass-produced sauerkraut and pickles offered at supermarkets are too often pickled or preserved in vinegar with added sugar and preservatives, or they might not be fermented at all. As a result, they may not contain all the good bacteria or be as healthy as the traditional pickles, sauerkraut, and other fermented foods mentioned above.

Thanks to the renewed interest in more natural diets, there has been a resurgence in traditionally fermented foods. Therefore delicious pickles and sauerkraut, as well as many other naturally fermented vegetables, are available at many farmers’ markets and grocery stores. Ask for natural lactic-acid-fermented vegetables.

If you can’t find high-quality fermented vegetables or just want to experiment with the world of fermentation, the process is easy to do in your own kitchen. You can pickle almost any vegetable; it doesn’t have to be cucumbers. You can ferment beans, string beans, broccoli, cauliflower, and many other vegetables in hardly any time at all.

If possible, it’s best to make your own yogurt from raw unhomogenized milk. When purchasing yogurt, look for whole-milk yogurt from pasture-raised cows.

Once you’ve found a good source of regular fermented foods, enjoy them with a fermented beverage. Kombucha is a popular fermented tea that traditionally is nonalcoholic. Beer and hard apple cider are great fermented beverages, and sour beers, as mentioned earlier, are often made with wild yeasts and lactobacillus bacteria the same way yogurt is, and like yogurt, they potentially can improve gut health.

Modern-day people would do well to follow in the footsteps of their ancestors and consume more fermented foods. Try to add that pickle, fermented vegetable, or yogurt to almost any meal, and you might just be healthier. And if it’s as good as the pickles we used to enjoy in Brooklyn, you’ll be a whole lot happier. Trust your gut and help it at the same time by eating and drinking delicious fermented foods.