Natto, Bacillus subtilis and Gut Health
Natto is not fermented by the lactic acid bacteria that make yogurt, kefir and sauerkraut. It is made by Bacillus subtilis var. natto, a bacterium that can wrap itself in a tough spore — a little survival capsule that rides through stomach acid and wakes up in the small intestine. A fresh pack carries hundreds of billions of these live cells. This page explains what that means for your gut, what human studies actually show (less than the marketing, more than nothing), and the small group of people for whom those same live bacteria are a real risk.
Table of Contents
- A Spore-Former, Counted by the Billion
- Surviving Stomach Acid: A Spore’s Journey
- What Human Studies Show
- Poly-γ-Glutamate and Other Natto Compounds
- Vitamin K2: Made by the Microbe
- Natto vs Sauerkraut, Yogurt and Kefir
- How Much Natto, and Pairing It With Other Ferments
- Who Should Be Careful
- Key Research Papers
- Connections
- Featured Videos
A Spore-Former, Counted by the Billion
Bacillus subtilis is a rod-shaped bacterium that has lived alongside people for as long as there has been soil, hay and rice straw. The natto variety, B. subtilis var. natto, is the strain line that Japanese cooks selected over centuries because it turns steamed soybeans into the sticky, stringy, savoury food we call natto. For the history of how that happened, see the Natto History page; for the full food-microbiology view, see Natto and Other Foods Made with Bacillus subtilis.
What makes this microbe unusual among food bacteria is the endospore. When conditions turn hostile — heat, dryness, acid, no food — the cell builds a thick, layered coat around a dehydrated copy of itself and goes dormant. Think of it as a seed rather than a plant: it does nothing, needs nothing, and can wait a very long time. When it lands somewhere warm, wet and nutritious, it germinates back into an active, dividing cell. Yogurt and sauerkraut bacteria cannot do this. They are always “awake”, and their survival through the stomach depends on sheer numbers and the protection of the food around them.
How many live bacteria are in a pack?
This number is often quoted loosely, so it is worth going to a measurement. A 2021 natto-quality study from a Japanese food-technology institute made natto the industrial way (spore solution sprayed on steamed soybeans, fermented at 39 °C, packed in 50 g cups) and counted living B. subtilis on agar plates. Freshly made natto held 7.5 × 109 colony-forming units (CFU) per gram — 7.5 billion live cells in every gram. After 20 days of refrigerated or cool storage the count fell about ten-fold, to 7.4–9.0 × 108 CFU per gram, and was still alive at every temperature tested (evidence tier: laboratory food measurement).
Multiply that out for a normal serving. A 40–50 g pack of fresh natto delivers roughly 300–375 billion live cells; an older pack near the end of its shelf life still delivers about 30–45 billion. For comparison, the B. subtilis probiotic capsules tested in the trials below gave 2 billion spores (in older adults) or 5 billion CFU (in a bloating trial) per day. One pack of natto, in other words, contains somewhere between several times and more than a hundred times the dose of a typical spore probiotic capsule. That is the single most important fact about natto as a “probiotic food”: the dose is enormous.
A plate count cannot tell you how many of those cells are spores and how many are active cells; both grow into colonies. In practice the coat of natto is a mix, and the spores are the part built to survive the trip through you.
Surviving Stomach Acid: A Spore’s Journey
For most of the twentieth century B. subtilis was described as a soil organism that simply passed through animals. That picture changed when researchers started looking for it inside the gut itself. The most direct human evidence comes from a clever 2021 study in 11 people with an ileostomy — a surgical opening that lets the end of the small intestine drain into a bag, so scientists can sample what leaves the small bowel without a tube down the throat.
Participants swallowed spores of a probiotic B. subtilis strain. Within 3 hours, both spores and freshly germinated active cells were showing up in the ileum fluid. By six to eight hours, spores were present at about 97 million CFU per gram (dry weight) and active cells reached about 73 million CFU per gram at seven hours. In plain terms: the spores survived the stomach, survived bile, and germinated in the small intestine of living people (evidence tier: small randomised crossover human study). That study used a capsule strain, not natto, but the spore biology is the same species and the same mechanism.
The figure shows why natto is different and also where the honest uncertainty sits. The first three steps are solid: the bacteria are there in huge numbers, the spores survive, and they germinate. Step four — what those germinated cells do for the colon, the microbiome and the immune system — is where the human evidence is thin and mixed, as the next section explains. The red branch is the price of carrying live bacteria into a body whose defences are down.
What Human Studies Show
Here is the frustrating part. There are remarkably few randomised trials that feed people natto and measure their gut. Most human evidence comes from B. subtilis probiotic capsules, which contain the same species at a much lower dose. The results below are reported as the trials reported them, including the outcomes that did not move.
Older adults and the immune system (RCT, primary outcome not met)
A French trial randomised 100 healthy adults aged 60–74 to a placebo or 2 billion B. subtilis spores a day, taken in 10-day courses repeated four times over a 4-month winter. The main question was whether the spores cut the number of days with colds, chest infections or stomach bugs. They did not significantly: 5.1 days in the probiotic group versus 6.6 days on placebo, a gap that could easily be chance (P = 0.20). In the subset of 44 people who gave stool and saliva samples, however, the spore group showed significantly higher secretory IgA — the antibody that coats the gut and mouth lining like a first line of defence — and a post-hoc look suggested fewer respiratory infections. Evidence tier: RCT; immune-marker change in a subset, clinical benefit not proven.
Bloating, gas and bowel habits (RCT, primary outcome not met)
A North American trial randomised 100 healthy adults to a placebo or 5 billion CFU of a B. subtilis strain daily for 4 weeks, tracking bloating, abdominal discomfort, gas and bowel habits in daily diaries. Across everyone, there was no significant difference from placebo. Men in the spore group did report fewer days of bloating and gas, but subgroup findings like that are a hypothesis, not a result. The spores were well tolerated, with blood tests staying normal. Evidence tier: RCT; no overall benefit, subgroup signal only.
Natto eaters and butyrate-producing bacteria (cross-sectional)
In a Japanese cohort of 185 people studied for barley intake and gut health, the people who ate a lot of barley and stayed non-obese also ate notably more natto than the others, and their stool carried more Butyricicoccus and Subdoligranulum — bacteria that make butyrate, the short-chain fatty acid that feeds the cells lining the colon. The authors suggest that B. subtilis from natto may help break down fibre so butyrate producers can thrive. That is a reasonable idea, but this was a single snapshot of free-living people: it shows that natto eating travels with a certain gut profile, not that natto caused it. Evidence tier: cross-sectional association.
Fermented foods as a group (RCT)
The strongest whole-food evidence is for fermented foods in general, not natto alone. In a 17-week Stanford trial (18 people per arm), healthy adults who steadily raised their intake of fermented foods saw their gut microbiome diversity rise and many inflammatory markers fall; a high-fibre comparison diet did not produce the same diversity shift over that time. Natto was not the test food, but the trial supports the general principle that eating a variety of live fermented foods changes the gut ecosystem in a measurable, favourable direction. Evidence tier: small RCT.
The fair summary
- Proven in humans: spores survive digestion and germinate in the small intestine.
- Suggestive: higher gut antibodies (IgA) with B. subtilis spores; natto eating linked with butyrate producers; fermented foods as a group raise microbiome diversity.
- Not shown: that natto, or B. subtilis capsules, reliably reduce infections, bloating or bowel complaints in healthy people. Natto-specific gut trials are a genuine research gap.
Animal and test-tube studies make bolder claims, but those findings are a reason to run human trials, not a substitute for them.
Poly-γ-Glutamate and Other Natto Compounds
The live bacteria are only half the story. While they ferment the beans, they also manufacture new substances that stay in the food whether or not the cells survive.
Poly-γ-glutamate: the strings
Those long, sticky threads when you stir natto are mostly poly-γ-glutamate (PGA) — a long chain of glutamic acid units made by the bacterium. PGA grabs calcium and keeps it dissolved, which led researchers to ask whether it helps people absorb calcium.
In a small but well-measured British crossover study, 24 post-menopausal women drank orange juice containing 200 mg of tracer-labelled calcium, once with and once without 60 mg of PGA. Calcium absorption was 39.1% with PGA versus 34.6% without — a modest but statistically significant gain, and largest in the women who absorbed calcium poorly to begin with. Evidence tier: single-dose human crossover trial. It used purified PGA, not natto, and it measured one meal, not bone. It does make a plausible case that the sticky part of natto is doing something useful alongside the vitamin K2 that natto is famous for (see Natto for Bone Density).
Could PGA act like a prebiotic — food for helpful gut bacteria? Animal studies have explored the idea, but we found no human trial testing it directly. Evidence tier: animal only. Treat “natto is a prebiotic” as an open question.
Nattokinase and other products
The bacterium also secretes nattokinase, an enzyme that breaks down fibrin, the protein mesh of blood clots. That is a cardiovascular topic rather than a gut one, and it carries a bleeding caution with blood thinners; see Nattokinase and Fibrinolysis and the Nattokinase page. Fermentation also breaks soy proteins into smaller peptides and free amino acids — part of why natto tastes savoury and is easier to digest than plain boiled soybeans — and produces the ammonia note in its smell.
Vitamin K2: Made by the Microbe
Natto’s best-documented nutritional gift is a direct product of B. subtilis metabolism: menaquinone-7 (MK-7), the long-lasting form of vitamin K2. Soybeans themselves contain almost none; the bacterium makes it during fermentation. Vitamin K2 activates proteins that put calcium into bone and keep it out of artery walls (full detail on Natto for Vitamin K2 (MK-7) and Vitamin K2).
How strong is the effect on the body? A study of post-menopausal women found average blood MK-7 of 5.26 ng/mL in Tokyo, where natto is eaten often, 1.22 ng/mL in Hiroshima, where it is eaten rarely, and 0.37 ng/mL in British women — roughly a fourteen-fold gap between Tokyo and Britain. Eating natto produced a marked, sustained rise in blood MK-7, and across Japanese prefectures more natto eating went with fewer hip fractures in women (evidence tier: cross-sectional and ecological, with a feeding test). A Dutch food-analysis study likewise found that after eating natto, circulating vitamin K2 rose to levels about 10 times higher than the vitamin K1 reached after a meal of spinach (evidence tier: small human feeding study).
This is also where natto differs most sharply from lactic-acid ferments. In that same food database, vitamin K2 was found mainly in meat, liver, butter, egg yolk, cheese, curd cheese and natto. Yogurt, kefir and sauerkraut are not significant K2 sources by comparison — natto stands in a class of its own. The flip side matters: the same vitamin K that helps bone is why people on warfarin must not eat natto casually (see Who Should Be Careful).
Natto vs Sauerkraut, Yogurt and Kefir
“Fermented food” is a category, not a single thing. Natto and the lactic-acid ferments are made by different microbes doing different chemistry, so they bring different things to the table. The matrix below sets them side by side.
What each row means
- Main microbe. Sauerkraut, yogurt and kefir are all driven by lactic acid bacteria — in sauerkraut, species such as Lactobacillus plantarum and Lactobacillus brevis; in yogurt, Streptococcus thermophilus and its partner lactobacillus; in kefir, a mixed community of lactic bacteria plus yeasts. They sour food by making lactic acid. Natto is driven by B. subtilis, which does not sour the beans at all; it breaks protein down, which is why natto smells of ammonia instead of tasting tangy.
- Spore-former. Only natto’s microbe forms spores. Lactic bacteria have no armour and depend on large numbers and the buffering food around them to get some survivors through the stomach.
- Vitamin K2. Natto is in a class of its own, as the Tokyo figure of 5.26 ng/mL in the previous section shows. The lactic ferments are not meaningful K2 sources; aged cheese is the dairy food that carries some.
- Human trial evidence. For sauerkraut, a pilot randomised trial gave 34 people with irritable bowel syndrome either raw or pasteurised sauerkraut daily for 6 weeks: symptoms improved in both groups and gut bacteria shifted, which the authors read as pointing to the cabbage’s fermentation products (prebiotic effects) as much as to live bacteria. For kefir, a 2023 systematic review found 16 randomised trials, with 12 of them at high risk of bias; hints of benefit for dental bacteria, H. pylori treatment and blood lipids, but nothing firm. Yogurt is the most studied of the four. Natto’s own gut trials are sparse, as described above.
The practical message is the one in the figure: these foods are complementary, not interchangeable. See our pages on Sauerkraut, Kefir and Kimchi.
How Much Natto, and Pairing It With Other Ferments
Natto is sold in small single-serving cups, usually 40–50 g each, and that is the amount most Japanese eaters have at a meal — typically at breakfast, over rice. One pack is a sensible daily serving. There is no evidence that eating several packs a day gives more gut benefit, and remember the arithmetic from the first section: a single fresh pack already delivers hundreds of billions of live cells.
Keeping the bacteria alive
- Eat it fresh and cold. Live counts fell about ten-fold over 20 days of storage in the study above, so fresher packs carry more live bacteria.
- Do not cook it hard. Stir natto into hot food at the end, or serve it over warm rice, rather than boiling or frying it. Spores tolerate heat far better than active cells, but nattokinase and much of the fresh character are lost with high heat.
- Frozen natto keeps. Freezing is the usual way natto travels abroad; thaw it in the refrigerator.
Building a fermented-food plate
Because natto and lactic ferments bring different microbes, the best approach is variety. Fermented foods are a priority on this site, and natto fits naturally into a whole-food, fermented-food routine:
- Natto over brown rice with scallions, mustard and a little traditional fermented soy sauce — the classic bowl, with more fibre than white rice to feed gut bacteria.
- Natto with kimchi — the spicy lactic ferment softens natto’s ammonia note and adds a second microbial community.
- Natto with a raw egg yolk, a traditional way to mellow the texture.
- Miso soup on the side — another traditional fermented soy food.
- A spoon of sauerkraut or a glass of full-fat kefir or plain full-fat yogurt later in the day for the lactic-acid side of the picture.
If the taste and texture are a hurdle, the Acquired-Taste Tips page has a step-by-step approach, and How to Make Natto covers making it at home. For the full nutrient breakdown see Natto Nutrients.
Who Should Be Careful
For healthy people, natto has been eaten daily by millions for centuries. But “live bacteria by the hundred billion” cuts both ways, and recent Japanese research has shown that B. subtilis var. natto is not always harmless.
Bloodstream infection in people with weakened defences
- Most B. subtilis found in blood is the natto strain. A Japanese hospital reviewed 7 years of blood cultures: of 4,634 positive cultures, 70 grew B. subtilis, and genetic testing showed 69 of those 70 were the natto variety. Of these, 25 were judged true infections rather than contamination. Those patients were mostly elderly (median age 79), the common sources were abdominal infections, pneumonia and urinary infections, 28% needed urgent surgery or endoscopy, and 16% died within 30 days — though most were already seriously ill. Evidence tier: retrospective case series.
- Children on cancer chemotherapy. In a Tokyo children’s hospital, 23 children who developed B. subtilis bacteremia during chemotherapy were compared with 92 matched children who did not. Natto eaten within the previous week was linked with about 3.3 times the odds of infection, even after accounting for low white-blood-cell counts. Evidence tier: case-control study.
- A breached gut. A case report documented bacteremia after a gastrointestinal perforation in a patient who had eaten natto, with genetic tests showing the blood strain matched the natto the patient ate. Evidence tier: case report.
Who should avoid natto, or ask their care team first: people receiving cancer chemotherapy or with very low white-cell counts; transplant recipients and others on strong immune-suppressing drugs; people with a known bowel perforation, recent bowel surgery or active bowel cancer; and frail older adults in hospital. Spore-based B. subtilis probiotic capsules deserve the same caution, for the same reason.
The other documented cautions
- Warfarin. Natto’s vitamin K2 directly counteracts warfarin, and MK-7 lingers in the blood for days. People on warfarin should avoid natto unless their anticoagulation clinic is managing it. This caution does not apply in the same way to the newer blood thinners that do not act through vitamin K, but see the next point.
- Bleeding risk with nattokinase. Nattokinase breaks down fibrin; combined with any anticoagulant or antiplatelet drug, or before surgery, it may add to bleeding risk.
- Soy allergy. Natto is soybeans; anyone with soy allergy should avoid it.
- Digestive adjustment. Some people notice gas or looser stools when they first add natto; starting with a spoonful and building up is gentler.
The full safety picture is on Natto Safety and Interactions.
Key Research Papers
- Kubo Y, Noguchi T, Kimura K (2021). Storage temperature and quality changes of natto. Food Science and Technology Research. — doi:10.3136/fstr.27.497
- Colom J, Freitas D, Simon A, Brodkorb A, Buckley M, Deaton J, et al. (2021). Presence and Germination of the Probiotic Bacillus subtilis DE111® in the Human Small Intestinal Tract: A Randomized, Crossover, Double-Blind, and Placebo-Controlled Study. Frontiers in Microbiology. — PubMed PMID: 34408741
- Lefevre M, Racedo SM, Ripert G, Housez B, Cazaubiel M, Maudet C, et al. (2015). Probiotic strain Bacillus subtilis CU1 stimulates immune system of elderly during common infectious disease period: a randomized, double-blind placebo-controlled study. Immunity & Ageing. — PubMed PMID: 26640504
- Penet C, Kramer R, Little R, Spears JL, Parker J, Iyer JK, et al. (2021). A Randomized, Double-blind, Placebo-controlled, Parallel Study Evaluating the Efficacy of Bacillus subtilis MB40 to Reduce Abdominal Discomfort, Gas, and Bloating. Alternative Therapies in Health and Medicine. — PubMed PMID: 31719214
- Maruyama S, Matsuoka T, Hosomi K, Park J, Murakami H, Miyachi M, et al. (2024). High barley intake in non-obese individuals is associated with high natto consumption and abundance of butyrate-producing bacteria in the gut: a cross-sectional study. Frontiers in Nutrition. — PubMed PMID: 39545049
- Wastyk HC, Fragiadakis GK, Perelman D, Dahan D, Merrill BD, Yu FB, et al. (2021). Gut-microbiota-targeted diets modulate human immune status. Cell. — PubMed PMID: 34256014
- Tanimoto H, Fox T, Eagles J, Satoh H, Nozawa H, Okiyama A, et al. (2007). Acute effect of poly-gamma-glutamic acid on calcium absorption in post-menopausal women. Journal of the American College of Nutrition. — PubMed PMID: 18187428
- Kaneki M, Hodges SJ, Hosoi T, Fujiwara S, Lyons A, Crean SJ, et al. (2001). Japanese fermented soybean food as the major determinant of the large geographic difference in circulating levels of vitamin K2: possible implications for hip-fracture risk. Nutrition. — PubMed PMID: 11369171
- Schurgers LJ, Vermeer C (2000). Determination of phylloquinone and menaquinones in food. Effect of food matrix on circulating vitamin K concentrations. Haemostasis. — PubMed PMID: 11356998
- Nielsen ES, Garnås E, Jensen KJ, Hansen LH, Olsen PS, Ritz C, et al. (2018). Lacto-fermented sauerkraut improves symptoms in IBS patients independent of product pasteurisation – a pilot study. Food & Function. — PubMed PMID: 30256365
- Kairey L, Leech B, El-Assaad F, Bugarcic A, Dawson D, Lauche R (2023). The effects of kefir consumption on human health: a systematic review of randomized controlled trials. Nutrition Reviews. — PubMed PMID: 35913411
- Sada RM, Yamamoto G, Hamaguchi S, Kuroda E, Okura A, Cai M, et al. (2025). The Majority of Bacillus subtilis Strains Isolated From Blood Cultures Were Derived From Traditional Japanese Fermented Soybeans Natto: A Single-center Retrospective Study. Open Forum Infectious Diseases. — PubMed PMID: 41018695
- Aoyagi R, Okita K, Uda K, Ikegawa K, Yuza Y, Horikoshi Y (2023). Natto intake is a risk factor of Bacillus subtilis bacteremia among children undergoing chemotherapy for childhood cancer: A case-control study. Journal of Infection and Chemotherapy. — PubMed PMID: 36585273
- Hashimoto T, Yahiro T, Khan S, Kimitsuki K, Hiramatsu K, Nishizono A (2023). Bacillus subtilis Bacteremia from Gastrointestinal Perforation after Natto Ingestion, Japan. Emerging Infectious Diseases. — PubMed PMID: 37735785
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