Healthy Aging

Living to Age 100: Are Fermented Foods the Answer?

Many patients want to know what steps they can take to live longer, more healthful lives. My research team at the University of Idaho currently is conducting a qualitative study involving in-depth interviews with centenarians from around the world to identify their dietary and lifestyle patterns responsible for their longevity. These centenarians are based in Italy, Japan, Singapore, Cuba, and the United States.

One of the common elements we’ve identified is that these centenarians eat fermented foods daily, leading us to believe there may be an association between daily consumption of these foods and a long, healthful life, as these centenarians appear to have maintained healthy immune systems and gut function. They don’t seem to develop many of the gastrointestinal illnesses the elderly in the United States often suffer from such as diverticulitis, slow gut motility, constipation, and gastroesophageal reflux disease.

It’s possible that the probiotics consumed from daily diets that include fermented foods may contribute to longevity and healthy aging. There are many factors correlated with healthy aging (including genes), but diet seems to play a huge role in the formula for aging well and in maintaining quality of life.

Due to the probiotic content of fermented foods, recent studies suggest they may help alleviate diarrhea, irritable bowel syndrome, and Crohn’s disease.1-3 Though more research is needed to find which strains of probiotics work best for certain conditions, clients still may have good reasons to consider getting a daily dose of probiotics from a fermented food source.1,4 But how can you help your patients add these stinky fermented foods to their daily diets?

Some fermented foods are more accepted such as yogurt (eg, varieties labeled with live and active cultures), sauerkraut (homemade or found in the refrigerated section of the grocery store—processing destroys bacteria), and miso. Some not so widely consumed fermented foods include kefir milk, kombucha tea, tempeh, kimchi, and fermented cheeses, like Pecorino. These foods may be an acquired taste, but they’re relatively easy to incorporate into the diet. Make sure your patients purchase these products in the refrigerated section of the grocery store, because the bacteria will still be alive. Any type of canning or pasteurizing kills all of the bacteria.

For extremely motivated clients, suggest they make their own fermented foods. A great starter is sauerkraut or other vegetables. Here’s a video segment with Ali Miller, RD, LD, CDE, who discusses probiotics in fermented foods and how to make fermented vegetables:

When counseling clients, share the following delicious ideas for adding fermented foods to their daily diet:


  1. Make yogurt parfaits with fruit and Greek yogurt with live active cultures.
  2. Create smoothies using yogurt or kefir and fruit.
  3. Top scrambled eggs with cultured sour cream and fermented salsa and pecorino cheese.
  4. Add cultured butter (eg, Vermont Cultured Butter With Sea Salt Crystals) or homemade fermented fruit chutney to toast (recipe available at:


  1. Add sauerkraut to corned beef, roast beef, or meat alternative sandwiches.
  2. Try homemade, fermented mayonnaise on sandwiches and in tuna and chicken salads.
  3. Add tempeh to salads and stir-fry recipes.
  4. Incorporate miso or cultured sour cream to soups (eg, Wallaby Cultured Sour Cream).
  5. Drink kombucha tea for a beverage.
  6. Eat peanut butter and fermented fruit chutney sandwiches.

SeAnne Safaii-Waite, RDN, LD, is an associate professor of the coordinated program in dietetics at the University of Idaho and president of Nutrition and Wellness Associates, LLC. Her research emphasis includes the dietary habits of centenarians, diabetes.



  1. Duncan SH, Flint HJ. Probiotics and prebiotics and health in ageing populations. Maturitas. 2013;75(1):44-50.
  2. Makino S, Ikegami S, Kume A, Horiuchi H, Sasaki H, Orii N. Reducing the risk of infection in the elderly by dietary intake of yoghurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1. Br J Nutr. 2010;104(7):998-1006.
  3. Woodmansey EJ. Intestinal bacteria and aging. J Appl Microbiol. 2007;102(5):1178-1186.
  4. Zeratsky K. Do I need to include probiotics and prebiotics in my diet? Mayo Clinic website. Updated October 15, 2014. Accessed July 31, 2016.

7 Comment

  1. Great post! I really like the meal time suggestions you list. Sometimes it’s hard to think beyond yogurt for breakfast, although I’ve been finding that the more fermented foods I eat and add to my diet, the easier time I have finding ways to incorporate them into meals creatively.

  2. I tried making kefir one time, but just couldn’t bring myself to drink it. Maybe I’ll be more adventurous in time. Thanks for the great ideas for adding fermented foods to meals; I’ll have to try some of those myself so I know what I’m getting clients to try =D

  3. I used to drink a small amount of orange juice in the morning, but now I drink a combo of a couple of ounces of plain kefir mixed with an ounce or two of OJ. It’s delicious and a little like a more sour Creamsicle. Just another way to get in a little bit of fermented food in a way that offsets the tang of the kefir.

  4. Great post! I’d like to know if sourdough bread is something that was included in your research as well? I’m a dietitian who has completely switched to only sourdough and I bake every week for my family.

    1. Yes Sourdough bread was consumed a lot in Italy. However the live Lactobacillus and other probiotic bacteria are killed in the process of baking. By this time though, through the fermentation process the bacteria have already created lactic acid, which allows the vitamins and minerals present in the flour to be more easily digestible.

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