You may know sauerkraut as the tangy cabbage that sometimes appears on a hot dog, but there is much more to this fermented food than its traditional pairing with sausages!
Sauerkraut is made by fermenting finely shredded cabbage, usually with salt. Naturally occurring microorganisms ferment carbohydrates in the cabbage and produce lactic acid, which gives sauerkraut its characteristic sour flavour and helps preserve the food.
Fermented cabbage has been enjoyed for centuries and remains popular today, with supermarkets and specialty stores offering many different varieties and flavours.
So, what makes sauerkraut an interesting addition to your diet?
Sauerkraut Is a Fermented Food
The fermentation process changes the cabbage in several ways.
During fermentation, microorganisms grow and convert some of the carbohydrates in the cabbage into compounds including lactic acid.
This helps:
- Create sauerkraut’s distinctive sour flavour
- Preserve the cabbage
- Alter its texture
- Produce a range of fermentation-derived compounds
- Introduce microorganisms that may be present in the finished food
But there is an important distinction when talking about gut health.
Sauerkraut is a fermented food — it isn’t automatically a probiotic food.
Some sauerkraut contains live microorganisms, particularly when it has not been heat-treated after fermentation. However, the number and types of microorganisms can vary considerably between products.
The International Scientific Association for Probiotics and Prebiotics also distinguishes fermented foods from probiotics: a probiotic has a specific scientific definition and involves a live microorganism demonstrated to provide a health benefit when consumed in an adequate amount.
So if you’re choosing sauerkraut for the live microorganisms, look for products that state they contain live cultures and have not been pasteurised after fermentation.
What Nutrients Does Sauerkraut Provide?
Sauerkraut is made from cabbage, so it retains many of the nutritional qualities of the original vegetable.
It can provide:
- Fibre
- Vitamin C
- Vitamin K
- Folate
- Potassium
- Other vitamins, minerals and plant compounds
The fermentation process can also change the bioavailability and composition of some nutrients and plant compounds.
Sauerkraut is also generally low in energy, making it an easy way to add flavour and vegetables to meals without adding a large amount of energy.
There is one important consideration, though:
Sauerkraut can be high in sodium
Salt is an important part of traditional sauerkraut fermentation, so some varieties can contain quite a lot of sodium.
If you’re managing high blood pressure or have been advised to limit sodium, compare nutrition panels and choose a lower-sodium product where available.
Can Sauerkraut Support Your Gut?
This is one of the most interesting reasons to include fermented foods in your diet.
Research is investigating how fermented foods may influence the gut microbiome, gastrointestinal function and the compounds produced during fermentation.
A 2025 systematic review and meta-analysis involving 25 studies and more than 4,300 participants found that fermented-food consumption was associated with improvements in several gastrointestinal outcomes, including bowel-movement frequency, stool consistency, abdominal symptoms, bloating and intestinal transit time. The certainty of the evidence varied and was often low.
Research specifically examining sauerkraut has also found interesting results.
In a 2025 crossover trial, 87 healthy adults consumed either fresh or pasteurised sauerkraut daily for four weeks. The researchers found changes in individual gut bacterial species, although the overall gut microbiome remained relatively resilient.
A separate 2026 randomised crossover trial used 100 g of fresh or pasteurised sauerkraut per day for four weeks. Both types were associated with a small reduction in systolic blood pressure, although there was no meaningful improvement in gut-barrier integrity or overall systemic health markers in the healthy participants. Interestingly, the potential blood-pressure effect did not appear to require live bacteria.
This suggests that the benefits of fermented foods may come from more than their live microorganisms alone. Fermentation can also create bioactive compounds and alter the food’s existing nutrients and plant compounds.
What About the “Good Bacteria”?
Sauerkraut can contain lactic acid bacteria, including microorganisms from the Lactobacillus group.
But we need to be careful with the phrase “good bacteria”.
Your gut microbiome isn’t simply divided into good bacteria and bad bacteria.
Instead, your gut contains a complex ecosystem of microorganisms, and what matters is the overall community, its function and how it interacts with your diet and body.
Also, bacteria found in fermented foods don’t necessarily permanently colonise your gut.
Studies show that microorganisms from fermented foods may survive passage through the gastrointestinal tract for varying lengths of time, but their persistence differs between people and foods.
So sauerkraut can be a useful part of a varied diet without needing to claim that it “replaces” or “adds” a permanent population of beneficial bacteria.
Could Sauerkraut Help With Depression or Anxiety?
This is where the original blog went too far.
There is interesting research investigating relationships between fermented foods, the gut microbiome and the gut–brain axis.
However, there is currently not enough evidence to say that eating sauerkraut treats depression, anxiety disorders, obsessive-compulsive disorder or Parkinson’s disease.
Research into fermented foods and mental health is an emerging area, and findings from studies involving a range of fermented foods cannot automatically be applied specifically to sauerkraut.
Sauerkraut can certainly be part of a nutritious diet that supports overall health, but it should not be presented as a treatment for mental-health or neurological conditions.
What About Sauerkraut and Irritable Bowel Syndrome?
There is some interesting early research here.
A small randomised pilot study involving people with IBS found that six weeks of lacto-fermented sauerkraut was associated with improvements in IBS symptom scores and changes in gut microbial composition. Interestingly, similar symptom improvements occurred with both pasteurised and unpasteurised sauerkraut, suggesting that factors other than the live bacteria may have contributed.
This doesn’t mean sauerkraut is a treatment for IBS.
Some people with IBS may also find cabbage and fermented foods difficult to tolerate depending on their individual symptoms and dietary pattern.
As always, your individual response matters.
How Can You Include Sauerkraut?
Sauerkraut doesn’t have to be reserved for hot dogs!
Try adding it to:
- Sandwiches and wraps
- Grain bowls
- Salads
- Burgers
- Toast
- Potato dishes
- Eggs
- Fish
- Meat dishes
- Vegetarian meals
A small amount can add a lot of flavour.
And because sauerkraut can be salty, you don’t need a huge serving.
Think of it as an addition to a balanced meal, rather than something you need to eat in large quantities to obtain a health benefit.
Fresh or Pasteurised?
This depends on why you’re choosing it.
If your priority is enjoying sauerkraut as a fermented vegetable, both fresh and pasteurised products can have nutritional value.
If you’re specifically looking for live microorganisms, choose a product that states it contains live cultures and hasn’t been pasteurised after fermentation.
Interestingly, recent human research suggests that some of the potential effects of sauerkraut may occur even when the food has been pasteurised, reinforcing the idea that fermented foods can provide benefits beyond live bacteria alone.
Are There Any Reasons to Be Careful?
For most people, sauerkraut can be included as part of a varied diet.
There are a couple of situations where individual advice is worthwhile.
Sodium
Because sauerkraut is traditionally made with salt, check the sodium content if you’re following a lower-sodium diet.
Vitamin K
Sauerkraut contains vitamin K. If you’re taking warfarin, sudden changes in your intake of vitamin-K-containing foods can affect anticoagulation, so discuss dietary changes with your healthcare professional.
Certain medications
Fermented foods such as sauerkraut can contain tyramine, which can be relevant for people taking monoamine oxidase inhibitor (MAOI) medications. Anyone taking these medicines should follow the dietary advice provided by their prescriber or pharmacist.
Do You Need to Eat Sauerkraut Every Day?
No.
There is no established recommendation that everyone needs to eat sauerkraut once or twice a day.
Instead, think about variety across your diet.
You might enjoy sauerkraut one day, yoghurt with live cultures another day and another fermented food later in the week.
Your overall dietary pattern matters much more than reaching a particular daily target for one fermented food.
Sauerkraut Is Part of the Bigger Picture
One spoonful of sauerkraut isn’t going to transform your gut microbiome.
What matters more is what your diet looks like overall.
Pair sauerkraut with other foods that support a nutritious dietary pattern, such as:
- Wholegrains
- Vegetables
- Fruit
- Legumes
- Nuts and seeds
- Fish and other nutritious protein foods
- Extra virgin olive oil
- Yoghurt and other fermented foods you enjoy
This gives you a combination of fibre, vitamins, minerals, protein, healthy fats and a wide range of plant compounds.
Sauerkraut can be one small but tasty part of that bigger picture.
Take Home Message
Sauerkraut is much more than a topping for a hot dog.
It is a fermented vegetable that can provide fibre, vitamins, minerals and plant compounds, and some products also contain live microorganisms.
Emerging research suggests fermented foods may support aspects of gastrointestinal health, while studies specifically involving sauerkraut have found interesting changes in gut microorganisms and some health markers.
However, sauerkraut isn’t a magic treatment for gut disease, depression, anxiety or neurological conditions.
Instead, enjoy it as one part of a varied and balanced diet.
The next time someone offers you sauerkraut with your hot dog, you can certainly say yes — just remember that the rest of your meal and your overall diet matter too!
How Feed Your Future Dietetics Can Help
Gut health can become confusing when social media turns fermented foods into miracle cures or tells you that you need a specific number of probiotic foods every day.
At Feed Your Future Dietetics, I help you separate evidence-based nutrition from the latest health trends and develop practical strategies that fit your individual needs.
Whether you’re looking to improve your gut health, increase your fibre intake, manage gastrointestinal symptoms or simply build a more balanced eating pattern, nutrition can be personalised without unnecessary restriction.
With over 10 years of experience supporting Australians with their nutrition and health goals, Feed Your Future Dietetics provides individualised dietetic support Australia-wide via Telehealth using Zoom or Microsoft Teams.
To learn more or book an appointment:
ashleigh@feedyourfuturedietetics.com
References
- Marco ML, Sanders ME, Gänzle M, et al. The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on fermented foods. Nature Reviews Gastroenterology & Hepatology. 2021;18:196–208.
- Mukherjee A, Farsi DN, Garcia-Gutierrez E, et al. Impact of fermented foods consumption on gastrointestinal wellbeing in healthy adults: a systematic review and meta-analysis. Frontiers in Nutrition. 2025;12:1668889.
- The impact of regular sauerkraut consumption on the human gut microbiota: a crossover intervention trial. 2025.
- Fermented foods and inflammation: a crossover intervention trial with fresh and pasteurized sauerkraut. 2026.
- Nylund L, et al. Lacto-fermented sauerkraut improves symptoms in IBS patients independent of product pasteurisation: a pilot study. Food & Function. 2018.
- Fermented Foods as a Dietary Source of Live Organisms. Annual Review of Food Science and Technology. 2019.
- Lacto-fermented fruits and vegetables: bioactive components and effects on human health. Annual Review of Food Science and Technology. 2025.
- Health benefits and risks of fermented foods – the PIMENTO initiative. Frontiers in Nutrition. 2024.
- Bioactive compounds in fermented foods: a systematic narrative review. Frontiers in Nutrition. 2025.
- Raak C, Ostermann T, Boehm K, Molsberger F. Regular consumption of sauerkraut and its effect on human health: a bibliometric analysis. Global Advances in Health and Medicine. 2014;3(6):12–18.
- Tyramine content of previously restricted foods in monoamine oxidase inhibitor diets. Journal of the American Dietetic Association.
