Many avoid fermented foods on low-carb diets due to carb concerns, but properly fermented foods are low in carbs and rich in probiotics. Fermentation reduces sugars and supports digestion, immunity, and gut health. Unlike pickling, fermentation enhances food with beneficial microbes. Low-carb options include yogurt, kefir, kimchi, cheese, and more—especially when fermented longer for reduced carbs and increased sourness.