Fermented food and drink may help people suffering from osteoarthritis, according to Dr Michael Mosley.
With his no-nonsense attitude to health, the pro regularly dishes out advice on his podcast series 'Stay Young' - using each episode to explore "one simple, scientifically-proven thing you can start doing today to rejuvenate yourself from the inside out". And it was during one of these shows that he sang the praises of fermented food.
"Today I'm making something that it's claimed could boost my mood, improve my immune system, deepen my sleep and reduce those niggling aches and pains that come with age," he explained on the BBC Radio 4 podcast.
"I'm making Kombucha, a fermented fizzy drink. I've looked into the health benefits of gut-friendly fermented foods like sauerkraut, kimchi and kefir before. This time I want to look at claims specifically that fermented foods can help with healthy ageing."
And in news that is sure to delight Kombucha lovers, he went on to explain that fermented food and drink could really make a difference. "The idea is that as we get older the number and diversity of our gut microbes declines, which contributes to chronic inflammation and a host of age-related diseases."
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Not everyone should give them a go, however, as Dr Mosley warned: "A note of caution. They're not suitable for everyone. If you're immuno-compromised, or on certain types of medication do check with your doctor before adding lots of live microbes to your diet."
But for those who can eat fermented foods, he said he "really would recommend you give them a try." "You get a wonderful range of new flavours and the health benefits are impressive," the pro added.
So, what are these benefits? The doctor cited a recent randomised trial in which 25 men and women were asked to drink a daily glass of kefir or a non-fermented dairy alternative. "After just four weeks those drinking kefir had more than doubled the number of beneficial lactobacillus bacteria in their gut, and they performed better on memory tests," he said.
"In another study where they looked at stress, volunteers were asked to include 2-3 servings of fermented foods into their daily diet plus a good helping of fibre. After four weeks those who followed this gut-friendly diet reported feeling less stressed and, importantly, the result was dose dependent. Those who ate more fermented foods than fibre saw a bigger reduction in their stress levels. Interestingly, the quality of their sleep also improved."
Fermented food could also help with pain, according to Dr Mosley. "Topping up your gut microbiota with friendly microbes may also help relieve aches and pains. In a randomised control trial, 500 patients with osteoarthritis were asked to drink two daily servings of milk containing lactobacillus bacteria," he explained.
"After six months they reported less pain and stiffness in their knees and blood tests showed reduced signs of inflammation. That's important because one of the reasons why fermented foods are said to have such widespread beneficial effects is because of their impact on our immune system - damping it down when it overreacts.
"An overactive immune system can lead to chronic inflammation which in turn can cause many of the diseases which we associate with ageing such as joint pain, type 2 diabetes, and depression."
Dr Mosley also spoke to Professor Justin Sonnenburg from Stanford University, who found that eating fermented foods can increase your gut microbiome diversity and reduce inflammation, during a recent clinical trial.
"How would you recommend people start adding more bacteria to their diet?" the host asked. Professor Sonnenburg explained that live yoghurt "is a very safe place to start." "It is usually the gateway to fermented foods," he added.
"Kombucha is another one that we had a lot of people in our study really like. If you like fermented vegetables, sauerkraut is really fantastic."
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When Dr Mosley followed up by asking how people could introduce such foods into their diets and what changes they could expect to see, the expert added: "What's likely is that as you increase fermented foods you probably increase the effect of those fermented foods and the benefit that they are having. So my guess is that if you had two servings of fermented foods per day, there would probably be significant benefit from that."
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