If you have diabetes, probiotic and fermented foods may be a wise addition to your eating plan. A healthy microbiome can help boost your immune system and fight off inflammation, which plays a significant role in the development and progression of diabetes.
“Emerging research shows that people with type 2 diabetes often have imbalances in their gut microbiome, which may contribute to inflammation, insulin resistance, and blood sugar dysregulation,” says Kimberlain.
“While not a standalone treatment, these foods can complement a balanced diet, medications, and other lifestyle changes in diabetes care,” says Kimberlain.
There is also a lot of research on individual fermented and probiotic foods showing similarly encouraging results. But some of those positive results may be because these foods are nutritionally sound rather than any probiotic activity.
Yogurt
One study of 72 people with type 2 diabetes found that consuming 200 grams (g) of probiotic yogurt per day (less than 1 cup) for 12 weeks led to a reduction in A1C levels, total cholesterol, and LDL cholesterol compared with placebo.
That said, not all research on the health benefits of probiotics in yogurt is consistent. An earlier meta-analysis on the effect of probiotic yogurt on glucose control found no benefits when the study authors compared probiotic yogurt with conventional yogurt’s ability to improve glucose control in patients with diabetes or obesity.
But beyond the probiotic potential, yogurt — especially Greek and skyr types — is rich in protein, which helps slow down digestion of the carbohydrate in yogurt, says Smithson. Kimberlain says people with diabetes should opt for varieties that are plain or unsweetened, and add sweetness with fresh fruit, cinnamon, and vanilla extract.
Kimchi
Sauerkraut and Pickles
Alongside kimchi, sauerkraut and pickles are other nonstarchy options for a diabetes-friendly menu, says Smithson. She provides a few caveats: Both can be high in sodium, so balance your plate out with healthy veggies like broccoli and cauliflower when you eat them.
And not all sauerkraut and pickles have probiotics. If you want some that do, look for those that are jarred in the refrigerated section and check the label for words like “fermented with cultures.”
Kombucha
Kombucha is a fermented, fizzy drink made with tea, sugar, and bacteria, and yeast. One small study found this beverage lowered average fasting blood glucose levels in people with diabetes after drinking 8 ounces (oz) a day with dinner for four weeks.
Kombucha is naturally sour, so it can be flavored with juices, added sugars, or sugar substitutes to make it more palatable. Kimberlain says to make sure you choose a brand (or make your own) that aligns with your diabetes diet goals. When you’re reading labels, also consider how much sugar is in the entire bottle or can, since some contain more than one serving.
Tempeh
Tempeh is made from fermented soybeans, and you can purchase it packaged in the refrigerated section of your grocery store near the tofu. One animal study found that when tempeh was a part of a regular diet it improved both blood glucose and body weight.
Tempeh is diabetes-friendly in other ways, too. Kimberlain points out it’s naturally low in carbs. A 3.5 oz serving has 195 calories and less than 8 g of carbohydrates. Use it as a plant-based meat substitute in meals like stir-fries, or baked and tossed onto a salad. Like tofu, it can take on whatever flavors from spices or marinades you add to it.
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