There are many myths on this subject! I hope that by sharing my familiarity of recent research coupled with my experience as a nutritional therapist working with hundreds of people with gut issues using kefir as medicine, this article will help you.
I remember the first client I recommended it to in 2012 - a lady with chronic constipation, and stubborn weight loss. She drove straight from our meeting, to a local Eastern European corner shop in London. There she bypassed the shelves of tinned Eastern European comfort foods, straight to the fridge and bought a couple of weeks’ worth. The trouble with sending clients to this particular shop was that it was then out of stock whenever I went there myself to stock up! My client soon was losing weight – laughing that her trousers were falling down and she had to buy new clothes, and digestive issues were getting better.
I couldn’t understand why I felt like a lone voice advocating kefir. My literary agent’s view (and I agree) was to include foods people could easily get hold of in regular supermarkets, so he was a bit hesitant about me including kefir which wasn’t widely available yet. Anyway, we forged ahead and DID include kefir, an essential component of the Gut Makeover, even though it was mainly only available in Eastern European corner shops and independent health food shops in the UK at the time.
Within months of the book coming out, more supermarkets started to stock it and many more people are now making it at home cheaply and enjoying all the health benefits too.
For more ideas of how to incorporate it in your diet, how to make it, and recipes using it from salad dressings to breakfast ideas, see my book The Gut Makeover Recipe Book.
Kefir is the name given to drinks which have been fermented using kefir grains. Kefir grains contain beneficial bacteria, yeasts and some fungi. You can use milk from cow, goat, sheep, camel, or buffalo to make it. Coconut, walnut, or almond milks are great dairy alternatives. You simply add kefir “grains” (which look like a squidgy cauliflower growth) to your liquid and leave them to ferment for between 12 and 40 hours depending on the room temperature till the liquid thickens and goes fizzy. Water kefirs can be made by adding the grains and a little sugar and fruit to give the bacteria something to grow on. With dairy milk, you don’t need to add sugar, as the lactose, the type of sugar naturally found in animal milks, does the job for you.
What are probiotics?
Probiotics are bundles of bacteria and yeasts with health benefits. They are found in fermented foods, and supplements. In this article I will show why fermented foods such as kefir are so much more beneficial to long term gut health than supplements, and hopefully answer all the burning questions you have been searching for on this topic.
It comes originally from the Caucasus Mountains which include Georgia, Armenia, and Azerbaijan.
It has been drunk as a staple food in Russia, central Asia, and all over Eastern Europe for centuries for its health benefits before all this microbiome talk!
I gave a presentation about diet and sleep to a group of Russian fashion magazine journalists a few years ago and mentioned some interesting research at the time linking kefir with good sleep. They said that in Russia women use kefir to lose weight. They substitute dinner for a glass of kefir when they need the kilos to come off!
How does kefir help gut health?
Each of us has about a kilo and half (three to four pounds) of bacteria in our digestive system, the long tube which goes from mouth to anus. The highest density of this bacteria, known as the microbiome, or microbiota, is found in the colon, which is the last chamber of the digestive tract. This bacteria used to be considered benign and of no medical interest, until recently when scientists discovered otherwise. There is still no clear consensus on exactly what a healthy microbiome looks like, but what everyone does seem to agree on, is that a microbiome full of lots of different types of bacteria (known as having high diversity), and showing presence of particular ones such as lactobacilli and bifidobacteria, usually goes hand in hand with good gut health and a strong immune system, healthy skin and weight, and healthy brain.
Where kefir comes into all of this is two fold. It contains lactobacilli and bifidobacteria in high doses, and also helps diversity too – more than 50 different types of bacteria can be found in kefir. When you drink kefir (it has the consistency of a drinking yoghurt), these bacteria travel through the digestive tract to colonise the colon. The immune system resides in the gut too, so these friendly bacteria are in constant dialogue with your immune system, making sure it is working right to keep you healthy.
The bacteria in your gut is also in constant cross talk with your brain via a nerve, which is like a long phone line running from gut to brain, called the vagus (this is a very new and exciting area of research). So when your microbiome is teeming with good bacteria, and lots of different types, it can help support your brain health – mood, helping you think straight, sleep, and protect your brain from ageing too.
How do you know if you have good gut health?
Your microbiome may not have much diversity, or presence of friendly bacteria if you eat a diet low in fibre and phytonutrients (the chemicals in vegetables and fruit usually found in their colours, the pigments), and eat lots of processed foods, for example the type of dairy foods that have been highly-processed – think of cheeses that look like plastic, and yoghurts which are not live and are full of sugar and stabilisers and gums. Unfortunately these are often the ones marketed at children and found on the bottom shelves of fridges in supermarkets, covered with popular cartoon figures to catch their attention at their eye level.
Your microbiome is also likely to need help if you have had antibiotics and don’t eat many plants nor fermented foods to build the bacteria up again afterwards. Antibiotics commit a cull on your microbiome leaving gut bacteria depleted of diversity and friendly types for years, which in turn can lead to digestive problems and difficulty controlling weight. One of the reasons farm animals are routinely fed antibiotics in some parts of the world, is for the weight gain they produce. The microbiome is involved in modulating our weight through controlling hunger hormones and metabolism.
Signs your microbiome is out of balance, or needs feeding better is if you are suffering chronic constipation, loose stools, suffering heart burn (acid reflux), bloating, and embarrassing gas.
You may have been labelled “IBS” the term the medical profession gives patients with gut issues when there is no physical sign of disease present. However, in my clinical practice using PCR stool testing regularly to look at the microbiome, IBS patients I observe usually have microbiomes which are low in diversity and lacking beneficial strains of bacteria. Feeding the microbiome the right foods, can help to correct the landscape of bacteria in the colon, and the symptoms of IBS with it.
Can kefir cure IBS?
In my experience it can be a player in helping to correct it for some people. It is also a good idea to look at other stressors in your life as well as diet if you have IBS. This is because your brain will be shouting down the vagus nerve telephone line that life is difficult, and deranging your gut bacteria causing symptoms (bloating, irregular stools etc). However, pouring some kefir into the colon can be a great way to counter-balance the scene. Doing this then can help rebalance the microbiome to shout up the phone line (vagus) that everything is going to be ok. Keep working on breathing techniques, managing your work load, protect yourself from toxic relationships, join a group or hobby you love and socialise with like -minded people – in person too.
How does kefir help other areas of health?
Studies show all of the following beneficial mechanisms. You can find several recent scientific reviews at the end of this article if you are interested in digging deeper into this subject. Here are the highlights:
- Anti-allergenic – eg less asthma, and helps protect you from developing a food allergy.
- Antibacterial – so can eradicate pathogenic bacteria which may be causing problems in your gut (such as chronic embarrassing wind and difficulty losing weight).
- Hypocholesterolaemic – yes, who would have thought, it reduces “bad” cholesterol, even when you drink the full fat type of kefir (which also tastes better)!
- Controls blood sugar levels – ie stops you getting type 2 diabetes.
- Antioxidant – can make your skin look young and beautiful.
- Anti-carcinogenic – may counteract the carcinogenic effect of fried foods/smoked cold cuts/alcohol we might be eating and drinking so less risk of getting cancer!
- Immunomodulatory – ie it helps your immune system protect you from getting ill.
What other goodies are contained in dairy milk kefir in addition to the bacteria and yeast you mentioned?
Protein – makes you feel full up and less likely to snack. Also helps repair muscles after exercise and builds neurotransmitters in the brain to keep you in good mental health. It is also the raw material for building enzymes in your digestive tract so you digest and absorb nutrients from your food well. What a winner!
Calcium – for strong bones and healthy teeth.
Potassium – healthy nervous system, brain and bones.
Magnesium – healthy nervous system (you need a lot of this mineral if you are constantly stressed for up to 300 different enzymatic processes in the body), and it helps support brain and bones
Vitamin K2 – good bones, and teeth. This vitamin helps carry the above minerals into the bones and teeth. The above are rather useless without vitamin K2 and
Vitamin D – good bones, teeth, brain (ie good mental health) and strong immune system. It also helps the uptake of minerals into bones and teeth.
If like me you’re getting on a bit, the bones, teeth, and brain benefits of foods becomes a big selling point. We need to receive minerals such as calcium, potassium, and magnesium in the right ratios, as nature intended so that they are deposited correctly into our bones and teeth. If you try to supplement with just calcium for example, the body receives it in a mega dose, and not in concert with the other minerals it is supposed to go with, so the body doesn’t know exactly what to do with it. This can lead to calcium being laid down in your arteries instead of your bones, and lead to a heart attack.
All this to say, if you compare a probiotic supplement which can have between one, three, six, or 30 different types of bacteria, you’re still probably not getting as much diversity as having a glass of kefir in the morning, nor has the pill or potion any of the other benefits as described above. It’s basically a very poor relation.
But that’s not all. Kefir will also coat the inside of your mouth, to keep your mouth microbiome healthy which reduces chance of developing tooth decay. See dentist Dr Steve Lin’s fantastic book The Dental Diet, if you are interested in more about the mouth microbiome and fermented foods.
A spoonful of kefir grains (a tablespoon) is typically placed in 500ml (about 2 American cups full) of liquid – eg milk from dairy, (or milk mixed with a big splash of single cream if like me you like it thicker), or a nut or coconut milk, in a glass bottle or jug, partially covered for between 10 and 40 hours depending on the room temperature. The warmer the room temperature, the less time the fermentation usually takes. I usually put a piece of kitchen paper on top of the jug with an elastic band (you don’t want an air tight lid as it could blow off during the fermentation process). When the liquid has become thick like a fizzy, drinking yoghurt, it is time to strain the grains out and place the kefir in your fridge to store, as and when you want to have it. I usually give the kefir a good stir when a head (like you see when beer brews) starts to form on top of the milk and give it a couple more hours. Put the leftover kefir grains in a small container with a bit of milk, and leave in the fridge for a few days till needed again. I find it lasts about a week in the fridge out of service. Leave it longer, out of work, and it loses its potency. Every time you use the grains to ferment your milk they grow bigger and bigger. You can break these off from time to time, and give to other people. Spread the kefir love!
Pic 1) pour the milk and grains into a jar.
Pics 2 +3) leave at room temperature till the milk thickens and pour through a sieve before drinking
A slightly effervescent drinking yoghurt. A kefir with lots of bacteria (and by that I mean more than 10 billion per American cup size, the minimum amount needed to do its job in your gut daily according to consensus among researchers), should be slightly fizzy to taste, and sound active when you open the lid (eg you’ll notice the pressure).
If using animal milks, must the milk be raw to make kefir?
You can use pasteurised milk with success in texture and fizz (which indicates the bacteria is flourishing). In my experience if the milk has been homogenised (processed to make all the particles the same size and stop the cream rising to the top) it does not flourish as well. You can use raw milk to make kefir too, which means in theory you could end up with a more diverse set of bacteria in the final product than using pasteurised milk.
If using pasteurised milk, where bacteria has been killed in the milk before you add the kefir grains, does that mean the finished kefir will be low in friendly bacteria?
No, you can produce kefir with a high number of bacteria, known as colony forming units, using pasteurised milk with the starter grains. What you don’t want, is to buy a kefir which has been pasteurised AFTER the fermentation process, meaning the friendly bacteria made by the kefir have been killed off. Sadly labels on commercial kefirs don’t tell you if pasteurisation has happened before or after being made. I recently contacted Biotiful Dairy in the UK, a brand now found in most big supermarkets and they confirmend their kefir is NOT pasteurised after fermentation, meaning it should have a few billion bacteria in every bottle.
How do I know which ones have or haven’t been pasteurised AFTER fermentation?
You don’t unless you contact the manufacturer to find out. In the US the number of colony forming units of bacteria are stated on the label and to have high numbers (eg above 10 billion) is an indicator the bacteria haven’t been killed off by post manufacturing pasteurisation. Making your own is an easy and cheap way to go.
Is dairy mucus forming? What is your experience of using kefir in this context as a nutritional therapist working with people with food intolerances, gut issues, and skin disorders?
I’ve never seen a convincing study which links dairy with causing mucus formation. However, if you notice that when you eat dairy your immune system goes into overdrive – eg you get a runny nose, or your eczema flares up, this may indicate that you have a food sensitivity to one of the elements in dairy foods such as casein or whey. You can usually establish this through diet eg eliminating the suspect food for at least a couple of weeks, then reintroducing it, and monitoring your symptoms. My book The Gut Makeover will show you how to do this. Or you can do food intolerance testing which I offer in my clinical practice. https://kbmodiagnostics.com
There are no perfect food intolerance tests around – even the most expensive ones, but in my experience they can give pointers as to which foods may be troublemakers when there are several involved.
Is it better to take a probiotic pill or liquid supplement rather than drinking kefir?
Foods are rich complexes of hundreds of different health benefiting compounds and many are working synergistically together as a team – just see the list above of nutrients in kefir to see what I mean. Supplements are reductionist (ie an extract of one type, or a handful of goodies into a pill or liquid). Without all the other dozens, sometimes hundreds of other players involved. Even if you find a probiotic pill or liquid which seems to improve your symptoms, they are, in my experience, a short-term fix. In my clinical experience, probiotic supplements seem to stop working after a few months and you have to move onto other probiotic supplements with different bacteria to keep seeing effects. And that is even if the probiotic bacteria are managing to get past your stomach acid! Many of my clients do stool tests, and I ask them to take their regular probiotic, if they are on one, before performing the test. This means that when we see the results, we can see if the probiotic bacteria are making their way to the colon and appearing in the stool. I was shocked recently when a client told me she had been taking a very expensive probiotic for three years and we found her lactobacilli was zero on the stool result test. This means she was literally throwing money away on this supplement and could have bought a lot of fermented foods with that money which would have been more effective.
Another benefit of fermented foods, eg kefir, is you constantly keep adding new, interesting, diverse bacteria to your gut. No one batch is ever exactly the same. When you make your own, the taste, the smell, the texture, even the strength of fizz, are all completely different depending on the time of year, the season, which room of the house you left it to ferment in. This signifies that the end of product is constantly different to the last, and adding new and different bacteria to your gut and constantly presenting you with variety to keep you healthy. We are designed to give our gut real food made in a kitchen, not pills or potions made in a lab.
How do I know the kefir I’ve bought is potent and viable?
You know it will be high in colony forming units of bacteria if you have made it yourself from a live kefir grain. The labels in the UK don’t tell you the bacteria levels. US labels do. You will get an idea of potency if there is a pop or slight sign of pressure when you open the lid. It’s potent if it feels slightly fizzy on your tongue when you taste it. You know it is the strong stuff the more sour it tastes.
Should I take a course of kefir, and if so, for how long?
Forget a course, this is a food many people benefit from by incorporating it into the diet for the long term and establishing it as a staple, like in Eastern Europe. Probiotic bacteria are passing travellers in the gut. In-out. In-out. They travel through, populate the colon, then come out in your stool. You need to keep topping them up daily. Preferably through food, which depending on the weather and place made each day, are constantly different to the day before. Kefir is a chance to present lots of different types of bacteria to your gut continually – remember the gut loves diversity.
Can I take kefir at the same time as antibiotics?
It is a good idea to drink/eat kefir daily while on antibiotics and in the months after taking antibiotics, to replenish depleted numbers killed by them. If having kefir while ON antibiotics, make sure to consume them a couple of hours apart from the antibiotics so the good bacteria in the kefir is more likely to survive.
Should kefir be taken on an empty stomach for maximum impact?
What size portion of kefir would you recommend each day to be of help to my health?
If you drink one American cup size (240ml a day) containing at least 10 billion colony forming units of bacteria, there is a good chance the bacteria are in high enough numbers to make it past your stomach acid to the colon. This review recommends 10 billion colony forming units of bacteria to be helpful to health. Kefir bacteria show good resistance to stomach acid and bile salts, and get through to the colon and stick to the gut wall.
I am lactose intolerant. Can I have animal milk kefir?
Yes! The fermentation process reduces the lactose (the milk’s natural sugar) content, so if you don’t have much lactase (the chemical scissor enzymes needed to break down and digest milk sugars) in your particular gut (eg due to your genes) you may find you comfortably drink milk kefir. Also by parachuting lactobacilli bacteria contained in the kefir into the colon, you colonise your gut with a helpful bacteria which will help you digest and break down lactose generally better – a massive bonus. Many lactose intolerant individuals I have worked with, comfortably digest kefir from dairy well. Just make sure you introduce kefir very gradually in small quantities to the diet to get used to it.
I am whey/casein intolerant. Can I have kefir made with dairy?
No. Try coconut or water kefirs instead.
Where can I get the starter grains to make my own kefir
Is yeast from kefir bad for my gut?
New emerging research is showing that our gut is supposed to have some yeast. You just don’t want it colonising the gut and getting greedy with the space in there, otherwise gut symptoms (sugar cravings, irregular stool pattern, wind, brain fog) and poor health can appear. In the old days we nutritionists were taught to “kill” yeast “infections” with antimicrobials. Nowadays I don’t use that approach. I use fermented foods such as kefir to crowd out opportunistic yeast infections, if they are present in high numbers on stool results, and seem to be causing unwanted symptoms. What I hadn’t appreciated till I read about it recently in the reviews (see below) is that the yeast found in kefir is friendly, and can help crowd out pathogenic yeast infections. I am seeing great results with clients using this approach.
Any tips for making the beneficial bacteria eg the lactobacilli in my gut flourish even more?
You can make the beneficial bacteria in your gut flourish more eg the lactobacilli and bifidobacteria planted there from your kefir drink, by adding prebiotic foods to your diet. These foods are food for the good bacteria such as lactobacilli and bifidobacteria in your gut and contain fibres and colours they like to have a feeding frenzy on. Prebiotic foods include bananas and apples, onions, garlic, leeks, mushrooms, chicory root, Jerusalem artichokes, broccoli and cauliflower stems, aubergines, raw unpasteurised honey. Or berries with their deep dark colours containing lots of polyphenols which are prebiotic too. (This is the short list). See recipe below for an ideal probiotic-prebiotic breakfast.
Why kefir and not plain yoghurt?
Live yoghurt has a much lower number of bacteria in it than kefir (usually several billion less), hence I use kefir therapeutically in my practice. A recent client referred to kefir as “the hard stuff” if you know what I mean, and it’s the one people see results with in my experience.
Is it true that if you mix kefir in a blender eg with fruit and nuts, that you kill lots of the beneficial bacteria in the kefir?
In theory if you heated the kefir to boiling temperature - e.g. by switching on your Vitamix with its metal blades and kept it running for 10 minutes so the kefir heated up to a high temperature in the jug, bacteria would be killed and therefore the kefir would lose its potency. But how many people do this?
I’ve used Chuckling Goat kefir with lots of clients and their gut symptoms have improved, so I suspect that even with stainless steel in their blades, it is potent. If anyone finds a piece of evidence to back up the stainless steel killing bacteria concern, please leave a message in the comments below. Thank you.
Kefir Blueberry Breakfast Bowl – my recipe
- A handful of blueberries (fresh or defrosted from frozen)
- 240ml fermented kefir
- 1 tablespoon of flax seeds (also known as linseeds)
- A handful of chopped walnuts
- A teaspoon of raw honey (raw honey is prebiotic so can help feed up the bacteria in your gut too)
Method: Put the berries in a bowl, pour over the kefir, sprinkle the flax seeds and walnuts over, and top with the honey.
This recipe is included in my book The Gut Makeover Recipe Book.
References
Arslan, S. (2014). A review: chemical, microbiological and nutritional characteristics of kefir. CyTA – Journal of Food. doi.org/10.1080/19476337.2014.981588
Bourrie, B et al. (2016). The microbiota and health promoting characteristics of the fermented beverage kefir. Frontiers in microbiology. doi: 10.3389/fmicb.2016.00647
Fathi et al. (2017). Kefir drink causes a significant yet similar improvement in serum lipid profile, compared with low-fat milk, in a dairy-rich diet in overweight or obese premenopausal women: A randomized controlled trial. J Clin Lipidol. doi: 10.1016/j.jacl.2016.10.016
Golowczyc et al. (2008). Characterization of homofermentative lactobacilli isolated from kefir grains: potential use as probiotic. J Dairy Res. doi: 10.1017/S0022029908003117
Kim, D et al. (2017). Dual function of Lactobacillus kefiri DH5 in preventing high-fat-diet-induced obesity: direct reduction of cholesterol and upregulation of PPAR-α in adipose tissue. Mol Nutr Food Res. doi: 10.1002/mnfr.201700252
Mello Costa Pereira, T, et al. (2016). Coadjuvants in the diabetic complications: nutraceuticals and drugs with pleiotrophic effects. Int J Mol Sci. doi: 10.3390/ijms17081273
Makowiak and Slizewska. (2017). Effects of protiotics, prebiotics, and synbiotics on human health. Nutrients. doi:10.3390/nu9091021
Rosa et al, (2017). Milk kefir: nutritional, microbiological and health benefits. Nutrition Research Reviews 30 (1), 1-15.
doi: 10.1017/S0954422416000275.
Rosa et al. (2016). Kefir reduces insulin resistance and inflammation cytokine expression in an animal model of metabolic syndrome. Food Funct. doi: 10.1039/c6fo00339g
Toscano et al. (2016). Ability of Lactobacillus kefiri LKF01 (DSM32079) to colonize the intestinal environment and modify the gut microbiota composition of healthy individuals. Digestive and Liver Disease. 49. 261-267.