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The Benefits of Probiotics –Teaser Excerpt from The Paleo Approach

February 12, 2013 in Gut Health, Supplements, The Paleo Approach Excerpts

The Paleo Approach by Sarah BallantyneThere are many topics that I am researching and writing about for the book that I’ve been meaning to write about for the blog for ages (the book just gives me a firm deadline).  I have decided take some of these topics (especially the more blog-sized ones) and publish them as teaser excerpts for the book (also because I think this information should be here too).

The book also contains a detailed (yet easy-to-follow) description of the components of the immune system, so when you read the book, you’ll already know why modulating Th1 versus Th2 versus regulatory T-cells is important and you’ll know what dendritic cells, antigen presentation and cytokines are. For a quick primer: Th1 and Th2 cells are over-activated in autoimmunity and cause damage (typically one or the other is over-activated).  Regulatory T-cells are supposed to keep all the other immune cells in check and suppress both over-activation of the immune system and autoimmunity (they tend to be deficient in autoimmune disease).  Cytokines are chemical messengers of inflammation.  Dendritic cells are a type of sentinel cell that detects foreign invaders.  Antigens are small sequences of amino acids on foreign invaders that are recognized by the immune system.   When a dendritic cell detects foreign invaders, they “show” the antigens to B-cells and T-cells (cells of the adaptive immune system).  Gut-Associated Lymphoid Tissue is the collection of immune cells and other tissues just inside the intestinal barrier in the gut.  Enterocytes are the cells that line the small intestine and form the barrier between inside the gut and outside the gut.

So, forgive the references to Chapters 2, 3, 8 and 12.  While you’ll have to wait until the book is out in September to read those sections, in the meantime, please enjoy this part of my section of probiotics (actually, probiotics are talked about in 4 separate sections-this section is from the chapter on healing foods).

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Consumption of probiotics, either as a supplement or in the form of unpasteurized fermented foods, can dramatically help modulate the immune system.  A vast number of scientific and clinical studies have evaluated the various effects of the commensal bacteria in the gut (those healthy gut bacteria) and/or probiotic supplement of specific bacterial strains on various aspects of the immune system.  The cliff notes?  It’s all good.

The exact mechanisms behind the many observed benefits of probiotics remain largely unknown.  This may be because different bacterial strains have different effects on the body and interact differently with the immune system.  For example, some probiotic strains stimulate production of cytokines (those chemical messengers of inflammation) that promote Th1 cell development (which may augment the immune system to help fight infection and prevent cancer).  Other probiotic strains stimulate production of cytokines that promote regulatory T-cell development, thereby providing that all important immune system modulation needed in autoimmune disease (see Chapter 2).  Yet other probiotic strains, including several lactobacillus strains, are beneficial both in diseases of compromised immune systems and diseases of excessively activated immune systems.

It has been shown that probiotics interact with dendritic cells during antigen presentation during the initiation of adaptive immune responses, meaning that probiotics are useful in preventing immune-related diseases (see Chapter 2).  However, they also affect the effector phase of adaptive immunity, so they can be used as a treatment for established immune-related diseases (this applies to both immune-related diseases like asthma and allergies but also autoimmune diseases).  In fact, probiotic supplementation has been shown to be beneficial in a variety of autoimmune conditions, including:  autoimmune myasthenia gravis, inflammatory bowel diseases, rheumatoid arthritis, multiple sclerosis, and autoimmune thyroid disease.

It used to be believed that probiotic supplementation and the consumption of unpasteurized fermented foods provided health benefits by re-inoculating the gut with beneficial strains of bacteria and yeast.  Having a healthier variety and types of gut microorganisms would then be responsible for the positive benefits of probiotic supplementation.  However, recent scientific research puts this explanation into doubt—at least in some cases.  A recent study of diarrhea-predominant Irritable Bowel Syndrome demonstrated that the administration of probiotic supplements did not to alter the composition of the gut microflora.  It’s important to emphasize that probiotic supplementation was still beneficial.  This implies that the benefits of probiotic consumption might be directly due to the interaction of those probiotic bacteria (and yeast) with the gut-associated lymphoid tissue (see Chapter 2) as it passes through the body, at least in some cases.

There are clearly still some situations where probiotic supplements do have profound effects on the gut microflora.  For example, studies have shown differences in the composition of the gut microflora after taking antibiotics in people who supplemented with probiotics compared to those who didn’t.  There may also be more impactful effects on those with bacterial overgrowths.  Probiotic microorganisms have the capability to affect the gut microflora through a variety of mechanisms, including: reducing the acidity in the intestinal lumen (the area in the middle of the “tube” that forms the gut), competition for nutrients, secretion of antimicrobial compounds by the probiotics themselves, stimulating the production of antimicrobial compounds by your cells, and preventing adhesion and interaction of other bacteria with gut epithelial cells.  In these ways, probiotics may help to “correct” gut dysbiosis.

Beyond restoring balance to the gut microflora and modulating the immune system, research has shown that administration of probiotics can have a direct effect on the tight junctions between enterocytes in the gut—resulting in decreased intestinal permeability.  So, taking a probiotic or eating food naturally rich in probiotic organisms can directly help heal a leaky gut.

As already mentioned in Chapter 3, what you eat has a profound effect on the types, relative quantities and location of different bacteria growing in your gut—this effect is largely independent of the benefits of consuming fermented foods or taking probiotic supplements.  However, consuming probiotics has the great potential to speed healing and modulate the immune system and should not be underrated in importance when dealing with autoimmune disease.

Some researchers are taking on the task of characterizing the precise effects of each probiotic strain on the human body (recall that there are approximately 35,000 of them among all humans).  Certainly some strains have already been isolated for their anti-inflammatory and immune modulatory properties, yet others for their abilities to improve the barrier function of the gut or the ability to reduce visceral hypersensitivity.  It is completely possible that in the future, probiotic supplements will be tailored to address specific health problems by providing specific strains known to counteract those issues.  However, until then, the best focus is on variety.

Because different probiotic strains have slightly (and sometimes vastly) different effects (which may also depend on your genetics, level of inflammation, and current gut health), the best way to ensure complete modulation/regulation of the immune system is to consume as many different probiotic strains as possible.  So, where do you get variety?  You actually get far more variety from fermented foods and soil than you do from most supplement available (that doesn’t mean that probiotic supplements aren’t useful—see chapter 8 for more information specific to probiotic supplements).  Every time you make a new batch of homemade sauerkraut, the probiotic organisms within it will be slightly different.

So, what are good food sources of probiotics?

  • Raw unpasteurized sauerkraut
  • Raw unpasteurized lactofermented vegetables (kimchee, beets, carrots, pickles)
  • Raw unpasteurized lactofermented fruits (green papaya, chutneys)
  • Raw unpasteurized lactofermented condiments (relishes, salsas)
  • Water kefir
  • Milk kefir grown in coconut milk
  • Kombucha
  • Beet Kvass

Some form of probiotic should be consumed every day.  It is typically understood that a small amount several times per day is more beneficial than a large amount at one sitting.  When you first start consuming probiotic foods, it’s a good idea to keep the amount very small (as little as 1 teaspoon) and see how you feel.  Some people with severe gut dysbiosis can have dramatic gastrointestinal symptoms from probiotics.  If one probiotic food doesn’t work for you, try another.  If none of them work for you, you may have more luck with a supplement or just might need more time to heal your gut before introducing probiotics.  It’s okay if you need to follow The Paleo Approach for a couple of weeks before adding probiotic foods (for more information, see the Troubleshooting section in Chapter 9).  The amount you eat at any given time can then be slowly increased over the course of several weeks.  And of course, you can skip ahead to Chapter 12 to start making probiotic foods in your own home.

An often underrated source of probiotics is soil.  Soil-based organisms (SBOs) have not been as extensively studied as the lactobacillus and bifidus genus of bacteria.  However, they are normal residents of a healthy gut, have been shown to be potent modulators of the immune system, and supplementation with SBOs has been shown to be beneficial in diabetes, chronic fatigue syndrome, insomnia and Irritable Bowel Syndrome.  Soil-based probiotic supplements are available (see Chapter 8 for more information).  You can also get exposure by playing in the dirt (a good excuse to take up gardening as a hobby!) and by growing your own vegetables organically (or buying locally-grown organic vegetables) and eating them without washing them.  Okay, you can rinse the big clumps of dirt off.

 

Barbara, G., et al., Mucosal permeability and immune activation as potential therapeutic targets of probiotics in irritable bowel syndrome, J Clin Gastroenterol. 2012 Oct;46 Suppl:S52-5

Bittner, A.C., et al., Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial, Clin Ther. 2007 Jun;29(6):1153-60.

Chae, C.S., et al., Prophylactic effect of probiotics on the development of experimental autoimmune myasthenia gravis, PLoS One. 2012;7(12):e52119.

Corridoni D, et al., Probiotic bacteria regulate intestinal epithelial permeability in experimental ileitis by a TNF-dependent mechanism, PLoS One. 2012;7(7):e42067

Fooks LJ and Gibson GR Probiotics as modulators of the gut flora. Br J Nutr 2002 88(Suppl 1):S39–S49.

Gerritsen, J. et al., Intestinal microbiota in human health and disease: the impact of probiotics, Genes Nutr. 2011 August; 6(3): 209–240.

Kiseleva, E.P., et al., The role of components of Bifidobacterium and Lactobacillus in pathogenesis and serologic diagnosis of autoimmune thyroid disease, Benef Microbes. 2011 Jun;2(2):139-54.

Kobayashi T, et al.,  Probiotic upregulation of peripheral IL-17 responses does not exacerbate neurological symptoms in experimental autoimmune encephalomyelitis mouse models, Immunopharmacol Immunotoxicol. 2012 Jun;34(3):423-33

Le Bert, N., et al., DC priming by M. vaccae inhibits Th2 responses in contrast to specific TLR2 priming and is associated with selective activation of the CREB pathway, PLoS One. 2011 Apr 1;6(4):e18346

Michail, S. & Kenche, H., Gut microbiota is not modified by Randomized, Double-blind, Placebo-controlled Trial of VSL#3 in Diarrhea-predominant Irritable Bowel Syndrome, Probiotics Antimicrob Proteins. 2011 Mar;3(1):1-7

Ng SC, et al., Mechanisms of action of probiotics: recent advances. Inflamm Bowel Dis. 2009;15(2):300–310.

Ruemmele F.M., et al., Clinical evidence for immunomodulatory effects of probiotic bacteria, J Pediatr Gastroenterol Nutr. 2009 Feb;48(2):126-41.

Shida, K. & Nanno, M., Probiotics and immunology: separating the wheat from the chaff, Trends Immunol. 2008 Nov;29(11):565-73.

Shida K, et al., Flexible cytokine production by macrophages and T cells in response to probiotic bacteria: a possible mechanism by which probiotics exert multifunctional immune regulatory activities, Gut Microbes. 2011 Mar-Apr;2(2):109-14

Schiffer, C., et al., A strain of Lactobacillus casei inhibits the effector phase of immune inflammation, J Immunol. 2011 Sep 1;187(5):2646-55

Tlaskalová-Hogenová, H., et al., Commensal bacteria (normal microflora), mucosal immunity and chronic inflammatory and autoimmune diseases, Immunol Lett. 2004 May 15;93(2-3):97-108.

Tsilingiri K & Rescigno M., Postbiotics: what else?, Benef Microbes. 2012 Dec 27:69-75.

Soil-based organisms improve immune function: shift cytokine profile from TH2 to TH1, Posit Health News. 1998 Spring;(No 16):16-8

http://www.old-herborn-university.de/literature/books/OHUni_book_8_article_4.pdf

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The Great Dairy Debate

October 13, 2012 in FAQ, Foods in Moderation, The WHYs of the AIP

The value (or lack thereof) of dairy products is the second most fiercely debated topic within the paleo community (after carbohydrate intake).  Opinions vary dramatically from consumption of no dairy whatsoever, to only consuming dairy fat (such as ghee, butter and heavy cream), to only consuming raw grass-fed dairy, to only consuming fermented dairy or aged cheeses, to including any dairy on a regular basis.

The reason for this diversity of opinions is that the science is not clear cut.  There are strong arguments to be made both for and against.

Let’s start with the arguments against dairy.  Prof. Loren Cordain dedicates an entire well-cited chapter in his most recent book The Paleo Answer (a fantastic book for describing the nitty gritty scientific details behind the paleo diet) to the many reasons why milk should not be consumed in any form.  To summarize, what I view the strongest parts of this argument:

  • Milk is not as nutrient-dense as meat, fruits and vegetables.
  • Milk is highly insulinogenic, meaning it causes a large spike in blood insulin levels, disproportional to the amount of sugar and protein in milk.  This may contribute to the development on insulin resistance, at least in the context of a high carbohydrate diet.  Insulin is also pro-inflammatory.
  • Milk contains active bovine (cow) hormones which have the potential to alter our hormone levels.  The effects of dietary intake of most of these hormones have not been studied.  However, other hormones have been studied.  For example, the milk hormone Insulin-like Growth Factor-1 (IGF-1) has been linked to risk of breast, colorectal and prostate cancer, with the strong indication that consumption of dairy protein is a large contributor to blood IGF-1 levels 1.
  • Milk contains protease inhibitors which may contribute to the development of a leaky gut (see this post for a more in depth explanation as to why)
  • Milk increases mucus production.  This may aggravate conditions such as asthma but also creates excess mucus in the gastrointestinal tract which may irritate the gut lining and inhibit nutrient and mineral absorption.
  • Lactose is poorly tolerated by adults.  Approximately 25% of Caucasians (American and European) are lactose intolerant.  97% of Native Americans are lactose intolerant.  This argument does not apply to drinking raw milk since raw milk contains enzymes to help digest lactose.
  • Dairy is highly allergenic.  This is where I believe the chief argument against dairy lies and I will discuss this further below.

There are also some very compelling arguments for including dairy products in our diets.  Studies have shown that consumption of dairy, especially full-fat dairy products and fermented dairy products, can protect against Metabolic Syndrome (cheese, full-fat dairy, and fermented dairy), Type II Diabetes (fermented dairy only) and Cardiovasular Disease (cheese, full-fat dairy, and fermented dairy) 2-6.

Grass-fed dairy, especially the fat from grass-fed dairy, is an excellent source of fat-soluble vitamins and Conjugated Linoleic Acid, an anti-inflammatory and healing fat.  Fermented dairy is an excellent source of probiotics.  There are also some valuable proteins in dairy, such as glutathione (very important for reducing inflammation and protecting against oxidative stress) and whey (which may help prevent cancer).

There is also evidence that dairy proteins are beneficial for children due to their growth-promoting effects.  Traditionally, children would have received some breast milk until approximately 5 years of age.  In our current society, most children are weaned by age 1.  The current scientific view is that, provided cow’s milk is not introduced too early, it is a good substitute for human milk in terms of its growth promotion 7.

Yes, the science is not clear, although there seems to be a good case for including dairy fat in our diets.  This is why the standard paleo diet allows for ghee and butter, and in many cases heavy cream and full-fat sour cream.  Many people also include fermented dairy in their diets with great success.

However, one thing that is abundantly clear is that milk allergy is common.  Beyond lactose-intolerance, which can be treated with the aid of digestive enzymes or consumption of raw milk, allergy to milk proteins is very common.  Epidemiological reports of cow’s milk allergy (IgE antibody reactions to cow’s milk proteins) range between 1 and 17.5% in preschoolers, 1 and 13.5% in children ages 5 to 16 years, and 1 to 4% in adults 8.  It is not known how prevalent cow’s milk sensitivities are (IgA and IgG antibody reactions to cow’s milk proteins).  It’s important to note that goat’s milk is not as allergenic as cow’s milk.

Cow’s milk proteins are also known gluten cross-reactors, which means that those with gluten intolerance may produce antibodies against gluten that also recognize dairy proteins.  For these people, eating dairy is the same as eating gluten (more information in this post).  Very importantly, for people with allergy, intolerance or gluten cross-reactions to dairy proteins, even the trace dairy proteins in ghee can be a problem.

So, what do I recommend?  Caution.  I believe that dairy is probably okay for many healthy adults, especially full-fat, grass-fed dairy.  In fact, for healthy individuals, the benefits likely outweigh the risks.  However, for those battling autoimmune disease or other conditions where a leaky gut is a potential contributing factor, it makes the most sense to omit dairy from your diet for now.  As is my standard recommendation for all of the gray-area foods, I suggest leaving it out of your diet for at least 1 month, then try reintroducing it and see if you notice any obvious symptoms (this is the best way to determine if you are allergic or sensitive).

I am still trying to gauge my own tolerance for grass-fed butter.  My daughters both seem to do better without cow’s dairy in their diets (except grass-fed butter, which seems okay), but I have reintroduced grass-fed goat mineral whey protein powder into their diets and they seem to do really well with that (especially my oldest).  I also have intentions to try them with some grass-fed goat’s whole milk.  This is another highly individual aspect of a paleo diet and you really don’t know whether or not milk is good for you until you try living without and then try living with.

1. Crowe FL et al “The association between diet and serum concentrations of IGF-I, IGFBP-1, IGFBP-2, and IGFBP-3 in the European Prospective Investigation into Cancer and Nutrition.” Cancer Epidemiol Biomarkers Prev. 2009 May;18(5):1333-40.

2. Louie JC et al “Higher regular fat dairy consumption is associated with lower incidence of metabolic syndrome but not type 2 diabetes.” Nutr Metab Cardiovasc Dis. 2012 Sep 26. pii: S0939-4753(12)00193-7. doi: 10.1016/j.numecd.2012.08.004. [Epub ahead of print]

3. Warensjö E, et al. “Biomarkers of milk fat and the risk of myocardial infarction in men and women: a prospective, matched case-control study.” Am J Clin Nutr. 2010 Jul;92(1):194-202. Epub 2010 May 19.

4. Sonestedt E et al. “Dairy products and its association with incidence of cardiovascular disease: the Malmö diet and cancer cohort.” Eur J Epidemiol. 2011 Aug;26(8):609-18. doi: 10.1007/s10654-011-9589-y. Epub 2011 Jun 10.

5. Sluijs I et al “The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study.” Am J Clin Nutr. 2012 Aug;96(2):382-90. Epub 2012 Jul 3.

6. Bonthuis M et al. “Dairy consumption and patterns of mortality of Australian adults” European Journal of Clinical Nutrition (2010) 64, 569–577; doi:10.1038/ejcn.2010.45; published online 7 April 2010

7. Agostoni C and Turck D. “Is cow’s milk harmful to a child’s health?” J Pediatr Gastroenterol Nutr. 2011 Dec;53(6):594-600.

8. http://www.worldallergy.org/publications/WAO_DRACMA_guidelines.pdf

Chris Kresser has a terrific post Dairy: food of the Gods or neolithic agent of disease?

The Paleo Answer by Prof. Loren Cordain is an excellent resource.

 

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Coconut Milk Kefir “Yogurt”

April 25, 2012 in Breakfast, Breakfast, Fermented Foods

I have been making my own coconut milk Kefir for quite a while now.  But recently, I began to crave the thicker creamier consistency of yogurt.  So, I did some experimenting.  Coconut milk yogurt is very easy to make (almost as easy as coconut milk kefir, but perhaps not quite so forgiving).  Empty a can of full-fat Coconut Milk (or equivalent volume of homemade coconut milk) into a 1 pint mason jar.  Heat to 115F (that is exactly 1 minute with my microwave).  Many recipes suggest heating to 180F first and then letting it cool to 115, which I don’t bother doing because I’m either using freshly made coconut milk which is still warm or canned Coconut Milk.  Next, add 1 Tbsp of store-bought coconut milk yogurt (I used plain So Delicious coconut milk yogurt that I bought at Whole Foods).  You could also use a non-dairy yogurt starter or a spoon of regular yogurt.  Either way, for future batches, just use 1 Tbsp of the previously made batch of yogurt.  Place in a warm place for 8-24 hours (I put mine into my oven, off but with the oven light on, ideally it should incubate between 105F-112F;  you can also use crock-pots, food dehydrators or yogurt makers).  It produced a lovely tasting sour yogurt.  However, much to my dismay, coconut milk yogurt does not thicken on its own(it doesn’t have the right proteins). 

Every recipe I found online either used thickeners or suggested straining the yogurt afterward.  So, once again, I experimented.  I tried thickening with Pectin, but didn’t like the fact that I had to add honey or sugar to the coconut milk in order for this to work (even with pectin designed for no sugar added applications) and pectin without added preservatives are hard to find.  Also, I felt that it changed the taste (maybe it was the preservatives).  I tried thickening with Gelatin (I actually like the idea of adding those great gelatin amino acids to my food), but really disliked the texture it created (more like jello than yogurt).  Last, I tried straining my homemade yogurt through a folded piece of Cheesecloth.  Success!  The result is creamy yogurty goodness.  But, then I got thinking.  Given all the extra work it is to make yogurt compared to the kefir I was already culturing, couldn’t I just strain the kefir?  The answer was yes!  Plus, kefir is richer in diverse probiotics compared to yogurt, so it’s even better for you.  Best of all, using kefir as a starting point compared to yogurt is much more fool proof and controllable. (I have tried to give you enough details here to culture yogurt instead of kefir if you happen to have yogurt starter or a yogurt maker in your home that you are dying to use.  The staining steps are the same.)

I bought my starter Kefir Grains from amazon (you also might be able to find them in your local health food store).  Following the directions from the manufacturer and from Mark’s Daily Apple, I initially got my kefir grains going with organic whole cow’s milk.  They grew in a glass mason jar in ½ cup of milk and a folded piece of cheesecloth held over the top with the ring part of the lid (an elastic band and a piece of paper towel or coffee filter work too).  I changed the grains by pouring the milk through a metal sieve and then dumping the Kefir Grains into a clean glass jar with fresh milk.  I changed the milk daily for 5 consecutive days and then I just dumped those little kefir grains into half a can of Coconut Milk and let them go for 48 hours.  It worked!  The result was a sour, tangy, and very pleasant beverage which I liked to pour over a bowl of fresh berries.  Initially I used light coconut milk (it’s just so temptingly cheap at Trader Joe’s but it really can’t compete with full-fat coconut milk so I don’t buy it anymore).  I enjoyed the beverage even more when I moved to homemade coconut milk or full-fat canned coconut milk.  And my kefir grains started growing much faster once I started growing them in the full-fat milk.  My grains have more than quadrupled in size since I bought them about three months ago (I now have some dormant kefir grains sitting in cow’s milk in my fridge) and they can ferment a can of coconut milk to the very sour that I enjoy in 24 hours or 2 cans in 48 hours (I like to do the latter since it’s less work).  Please note that if you want to make yogurt without the use of thickeners like pectin or gelatin, you need the fat content of either homemade or full-fat canned coconut milk to get that creamy texture.

Straining coconut milk kefir is very easy.  If you don’t want to invest in a Yogurt Cheese Strainer or a Kefir Cheese Strainer, you can simply use a clean linen tea towel, a square of muslin or about 12-14 layers of Cheesecloth lining a metal sieve.  All of them work.  What does not work is a nut-milk bag or a paint straining bag because the weave is just too big.  I have typically been using cheesecloth but just ordered myself a Yogurt Cheese Strainer, which I’m very excited about because it will be more sustainable.  When my kefir is ready (you can test simply by tasting it and see if it’s yummy), I first pour the culture through a metal sieve to catch the kefir grains for the next batch (if I have alot of curd, I gently push it through the metal strainer with a rubber spatula to separate out the kefir grains).  Then I pour the kefir sans grains into whatever straining method I am using suspended over a bowl to catch the whey.  I then place it in the fridge (if you strain at room temperature, it will continue to get more sour and end up more like a fresh cheese than a yogurt).  It takes 1-12 hours to drain enough of the whey to make the thick, creamy yogurt that I prefer, depending on exactly what strainer I’m using (linen takes the longest, close to 24 hours with canned coconut milk, and cheesecloth takes less time, 1-2 hours with homemade coconut milk) and depending on whether I’m using canned Coconut Milk (takes longer due to the guar gum content) or homemade coconut milk (separates more easily, sometimes the curd is so thick you can even skip the straining step, see note at bottom of recipe).  When it’s done, I use the whey for smoothies and scrape that yogurt into a jar and store in the fridge until I’m ready to eat it.

What I like about making yogurt this way is that, even though it takes a couple of days to make, it’s actually very little work.  It’s nearly fool-proof since kefir is so easy to grow.  And it’s completely controllable.  You can culture your kefir for as little as 6 hours or as much as 48 (or even 72!) depending on how sour you like it.  You can strain a little of the whey out or alot depending on how thick you want your yogurt.  I sometimes even strain my yogurt overnight because even if I strain too much whey and end up with cream cheese consistency instead of yogurt consistency, I can always just stir a little of the whey back in until it’s as thick as I want it!  What I love most about this yogurt is that there are no additives (especially if you use homemade coconut milk or a guar gum-free canned Coconut Milk) and no added sugar!  And once you have plain yogurt, you can flavor it any way you want!  Feel free to experiment with other methods out there (I like the recipes from here and here).  Really, coconut milk yogurt is pretty easy to make no matter how you do it.  But, this way is by far my favorite.  So, if you don’t have enough details to get started already, here is my recipe:

Ingredients:

Equipment:

1.    Place room temperature coconut milk into a glass jar.  Add kefir grains.  Cover with paper towel or cheesecloth secured with the ring of a mason jar lid or an elastic band.
2.    Let the kefir grains do their thing for 24-48 hours (tasting periodically to see if the culture has reached your desired sourness).
3.    Strain the kefir culture through a metal strainer.  Place the strained kefir grains into fresh milk to start the next culture.
4.    Line a metal sieve, colander or funnel with 12-14 layer thick cheesecloth (alternately you could use a yogurt cheese bag, a kefir strainer, a piece of muslin cloth or a clean linen tea towel).  Place sieve over a medium-sized bowl to catch the whey.
5.    Pour strained kefir culture into the cheesecloth-lined sieve and place the entire bowl and sieve into the refrigerator.  After 1 hour, check the liquid in the bottom of the bowl and make sure that it is mostly clear (it will have a little opaque white swirling around in it, but it should look alot like the liquidy whey from the top of a yogurt container).  If it isn’t clear, dump it back into the cheese cloth and add another few layers of cheese cloth or a second nut-milk bag or even a coffee filter to strain out the whey.
6.    Check how thick your yogurt is after about 4 hours.  It will take anywhere between 4-24 hours to strain enough whey to have thick, creamy yogurt consistency (you can actually continue straining to make a fresh kefir cheese, although if you are going to attempt this, it’s better to strain at room temperature).  Once the desired consistency is reached, scrape the yogurt into a bowl or container for storage and discard the whey (or better yet, use for another purpose).  The yield is approximately 1 cup of yogurt for 1 can of coconut milk.
7.    Enjoy the yogurt plain (maybe with some berries or paleo granola) or flavor with honey, vanilla and/or pureed fruit.  To make a lovely vanilla yogurt, add 1 Tbsp honey and 1 tsp alcohol-free vanilla extract.  For fruit yogurts, I typically add ¼ cup pureed fresh or frozen fruit to 1 cup of yogurt.  Stir to incorporate and enjoy!

Note on straining kefir when using homemade coconut milk:  The curd/fat layer of my kefir can be so solid when I use homemade coconut milk that the straining step can be avoided.  Instead, I carefully spoon the thick top layer into my metal sieve, and push the curd through to separate out my Kefir Grains for the next batch.  If the curd is really thick, I might even thin a bit with the whey that naturally separates out to the bottom (I always save this whey for smoothies).  If the yogurt has a bit of a curdled texture (this can happen in a cooler kitchen), a quick blend in a blender will smooth it out.  So, not only is homemade kefir “yogurt” cheaper and better tasting when made with homemade coconut milk, but it’s easier too!

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