Consumption of fresh or pasteurized sauerkraut both delivers a modest impact on blood pressure (BP) in healthy individuals, suggesting that pasteurization does not remove the physiological impact of this fermented food, reveals a study.
“However, the results of the present study do not support a clear metabolic or immunologic benefit of sauerkraut consumption in healthy individuals,” the investigators said. “Benefits may be more pronounced in metabolically or immunologically compromised individuals, particularly in persons with obesity, type 2 diabetes, and inflammatory bowel disease.”
Eighty-seven healthy individuals participated in this randomized crossover intervention trial. They consumed 100 g/day of fresh and pasteurized sauerkraut for 4 weeks. Prior to each intervention phase, the participants had a washout phase of 4 weeks, during which no fermented foods were eaten. Parameters before and after each intervention were compared using mixed regression models.
No significant results were noted in hypothesis-testing for carry-over effects using the methods by Wellek and Blettner for several parameters, including systolic BP (p=0.2210), fructosamine (p=0.9151), interleukin-6 (p=0.2312), and fatty acid binding protein 2 (p=0.9690). [Eur J Clin Nutr 2026;80:928-935; https://doi.org/10.3238/arztebl.2012.0276]
Fresh and pasteurized sauerkraut contributed to a significant decrease of about 1.5 to 2.5 mm Hg in systolic BP, but not for changes in blood markers in the overall study population.
Compared with pasteurized sauerkraut, consumption of fresh sauerkraut appeared to have a more noticeable effect on inflammatory markers, particularly high-sensitivity C-reactive protein (hsCRP) and tumour necrosis factor alpha receptor 2. The ‒13.2-percent decrease in hsCRP, however, did not reach statistical significance.
On the other hand, the consumption of pasteurized sauerkraut resulted in a decrease in levels of fructosamine, glucose, and insulin. Selected markers of inflammation and glycaemic control showed modest changes following stratification by age, estimated daily fibre consumption, BMI, and sex. Gut barrier integrity showed no significant change.
“Overall, the combined results in assessed strata do not support the existence of clear responders and nonresponders in our study population,” the investigators said. “However, participants younger than 50 years of age showed small but significant changes in some coherent markers following the pasteurized sauerkraut intervention, suggesting greater responsiveness in this subgroup.”
Small but relevant
The risk of cardiovascular events can be reduced by nearly 10 percent for each 5-mm Hg decrease in systolic BP, according to the investigators, noting that while the clinical implication of eating sauerkraut was modest, small reductions in systolic BP could still help prevent cardiovascular diseases. [Lancet 2021;397:1625-1636]
Younger participants showed the most noticeable changes in BP. The lower response observed in older participants could have been driven by age-related vascular damage. [Adv Nutr 2020;11:1150-1160]
“The underlying mechanism may involve the renin-angiotensin system, as some lactic-acid producing bacteria secrete ACE inhibitors during fermentation,” the investigators said. [J Cereal Sci 2016;69:57-63]
“Antihypertensive phenolic peptides and ACE-inhibitory peptides have been detected in lacto-fermented soybean compared to unfermented soybean and may also be present in sauerkraut,” they added. [Fermentation 2023;9:152]
Sauerkraut is produced from cabbage fermented by lactic-acid producing bacteria and contains fibre, vitamin C, and organic acids, promoting potential antioxidant and anti-inflammatory properties. [Foods 2021;10:2639; PLoS ONE 2018;13:e0203501]