Once a food-preserving necessity for our refrigeration-less ancient ancestors, fermentation is experiencing a true revival, led largely by the fermented drink, kombucha. 

The drink's popularity is due in large part to their beneficial bacteria called probiotics, which are believed to help balance our gut microbiome, the collection of microbes that naturally reside in our gastrointestinal tract. And a growing body of research is linking a balanced gut microbiome with all sorts of benefits for gut health, weight maintenance, immunity, mental health, skin, and more.

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So should we all add fermented drinks to our daily hydration regimen?

“They do have potential benefits, but like most nutrition trends, they’re not a magic bullet,” registered dietitian Anne L’Heureux says.

Read on to learn more about whether fermented drinks fit into your particular meal plan, and which of the most popular fermented drinks — including kombucha, sparkling probiotic beverages, apple cider vinegar, and sipping vinegar — might be right for you.

What Are the Benefits of Fermented Drinks?

The health benefits of these beverages can vary depending on what ingredients are being preserved, but here are some of the biggest global ones, according to L’Heureux:

1. Fermented drinks improve food digestibility.

The process of fermentation is akin to early digestion because the bacteria “predigest” certain components of food (meaning they convert carbohydrates into alcohol or acids). For instance, in yogurt, the bacteria convert lactose into lactic acid, making it easier for people with lactose intolerance to consume.

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2. They increase concentrations of vitamins and bioactive compounds.

For instance, certain strains of lactic acid bacteria are known to synthesize water-soluble vitamins such as folate, riboflavin, and vitamin B12. And studies have shown that the fermentation process causes chemical changes such as creating phytochemicals and enriching peptides.

3. They reduce anti-nutrients.

Fermentation reduces the concentration of anti-nutrients such as lectins and phytate, which can block the normal absorption of nutrients in your GI tract. For example, studies have shown lower levels of lectins in fermented lentils and cornmeal.

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4. Fermented drinks increase food safety and shelf life.

Fermentation is basically the OG of preservatives. The process promotes the growth of good bacteria and prevents the growth of bad, spoilage-causing ones.

How to Choose the Best Fermented Drink for You

If you decide to start adding fermented drinks into your nutrition plan, you may see some benefits. Follow these smart guidelines for integrating them into your diet safely:

• Check the label for added sugars. Aim to keep added sugars to a minimum, while still allowing the taste you enjoy. A good rule of thumb is 6 grams per serving or less.
• Look for natural ingredients, such as sugar from natural fruit juices and beneficial spices.
• Get your primary hydration from plain water, the best and most natural source of hydration.
• Make this just one part of a larger nutritious diet that includes a variety of vegetables, fruits, healthy fats, fiber, and whole grains.

The Best Types of Fermented Drinks to Try

With those guidelines in mind, here are four fermented beverages to consider working into your hydration mix:

Kombucha

Made from a mixture of regular black or green tea, a sugar source, and a symbiotic culture of bacteria and yeast, kombucha’s unique flavor can be polarizing. Some love its sharp and sour effervescence; others, not so much.

“Drinking too much may also cause gastric distress, as some people simply don’t tolerate fermented foods well,” L’Heureux says. “If you're taking in five or more servings of a variety of vegetables and fruits each day, you may not take away any additional benefits from drinking kombucha, especially if you are swapping in kombucha for water.

"But if you’re using kombucha to reduce your intake of sugary beverages like soda, then swapping in kombucha would be more beneficial.”

As a general rule, limit yourself to one 12-ounce serving per day.

Sparkling Probiotic Beverages

The primary difference between these and kombucha is that sparkling probiotic drinks are fermented with water — not tea extracts — so they’re caffeine-free. Otherwise, their nutritional profiles mostly align in terms of overall calories, sodium, and sugar, though slight differences will emerge when you venture into different flavors.

“You can also look for additional benefits in the form of spices used for flavor, though keep in mind that the actual amounts are limited,” L’Heureux says.

Consider ingredients like turmeric, which is well loved for its anti-inflammatory powers, and ginger, best known for easing nausea.

Apple Cider Vinegar

Making apple cider vinegar takes two steps: First, crushed apples are combined with yeast to ferment the natural sugars into alcohol. Then, bacteria are added for additional fermentation, turning the alcohol into acetic acid (the acid that gives vinegar its signature taste).

Early research suggests that drinking apple cider vinegar has some protective benefits for diabetes, heart disease, and weight management, L’Heureux says (though longer studies on bigger groups of participants are still needed to fully understand these effects).

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“Vinegar does contain polyphenols, which are antioxidants that we know assist the body in reducing cell damage and therefore reducing the risk of cancer,” she says.

Standard serving sizes range from 1-2 teaspoons to 1-2 tablespoons a day, mixed with water. (It’s highly acidic and can cause damage to your teeth, throat, and stomach, so diluted is best.)

Sipping Vinegars

These are just apple cider vinegar mixed with natural sweeteners such as honey or blueberry juice, which makes the flavor much more pleasing. The benefits are the same as those you get from apple cider vinegar except — you guessed it — the sugar content is higher (somewhere in the realm of 5 grams of sugar per serving, depending on the brand and flavor).

Finally, if drinking kombucha or any of these fermented drinks causes you to feel worse instead of better, stop drinking it. Results will always vary by person, and your body will give you signs if it isn’t tolerating it well. Ultimately, they’re just one potential part of what should be an overall consistent healthy lifestyle.