For 15 years, pickle makers from across the East Coast have gathered to celebrate brined vegetables at New York City’s Lower East Side Pickle Day. Last year, thirty thousand people squeezed in lines beside white tents that stretched over a quarter mile. A word appeared on some of the sauerkraut tents: “probiotic.” Several of the pickle makers were bragging about the bacteria in their salt-soaked spears. As it turns out, hundreds of web pages tout the benefits of pickles as a source of probiotics. How did the ancient pickle somehow get tied to an emerging health food trend?

Since fermented foods are a source of the same bacteria that naturally live in our guts, some customers buy pickles with health benefits in mind. But scientists have not determined whether eating probiotic foods regularly actually has tangible benefits.

The term “probiotic” has existed since the 1960s as the opposite of “antibiotic,” although the World Health Organization first recognized them with a formal definition in 2001. The following year the WHO released a preliminary report on how companies should go about evaluating what constitutes a “probiotic,” and in 2010 a group of scientists released a report on how to design benefit-determining probiotic studies. But without the backing of a clinical trial, a slew of companies have begun selling capsules packed with bacteria claiming to aid with digestion.

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Pickles have been an important food source regardless of their bacterial content for thousands of years—they date back to 2000 BC in Mesopotamia. Prior to the modernization of refrigeration in the 19th century, many vegetables were only available during their specific growing season. Fermenting the food via pickling helped change that. “Fermentation is one of the oldest ways of preserving food that we have,” said Elizabeth Sullivan, Process Authority at Cornell University’s Northeast Center for Food Entrepreneurship. Vegetables left in a salty brine turn sour-tasting over time, but stay edible. “It’s not a method of keeping food fresh. It’s a method of keeping it from making you sick,” Sullivan clarified. “You can harvest it in August and eat it the following April without getting food poisoning.”

Jewish immigrants brought pickles to New York’s Lower East Side late in the late 19th century. Stephen Leibowitz, age 71, is the Chief Pickle Maven at the oldest continuously-operating pickle company in New York, United Pickle Company. His grandfather, Max Leibowitz started the first pickle stand on the Lower East Side’s Essex Street in 1897. Said the living Leibowitz in his thick New York accent, “They had no refrigeration, no televisions, just big European families with lots of kids.” His grandfather copied the recipe from the grocery store where he worked and tweaked it with garlic and spices. Soon, locals lined up around the block. Competitor Isidor Guss founded the famed Guss’ Pickles in 1920, according to Leibowitz, and by the 1960s, there were several hundred pickle companies in New York and the Lower East Side streets were lined with pickle stands.

Changing times have all but stripped the Lower East Side of its pickles. Companies went out of business as their owners aged, while other businesses consolidated. Gentrification brought skyrocketing rents to the neighborhood. United Pickle Company acquired the Guss name and only a handful of the original companies from that heyday have stuck around. But there has been a resurgence of interest in pickling in New York, mirroring the rise of a trendy new health claim: that pickles are probiotic foods.

At least two of the Lower East Side Pickle Day picklers—Crooked Carrot Farm & Kitchen and MacDonald Farms from Ithaca, NY—advertise their pickles with the probiotic labels. Customers respond well to these labels, said Silas Conroy, who is in charge of product development at Crooked Carrot. “I hear it a lot more now from farmer’s market customers I interact with … they’ll ask me whether these are probiotic or not,” he said. “I feel like that didn’t happen as much at first.”

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Plenty of other food companies tout the probiotic benefits of their products. Most notably, Dannon Activia yogurt features the advantages of good bacteria prominently on labels, though the company settled a lawsuit in 2010 regarding the veracity of the health claims on their products. The labels initially stated that Dannon yogurt was “scientifically proven” to aid in digestion—the lawsuit required Dannon changing the wording to “clinical studies show” to better reflect the evidence. The benefit would only come “when eaten regularly as part of a balanced diet and healthy lifestyle,” according to an ABC News story.

So what does pickling actually do, and how do the bacteria get in there? The pickling process is really just a method humans have developed to battle the most harmful single-celled organisms. The goal of pickling is to produce an acidic environment in which bacteria like the Clostridium botulinum that causes botulism can’t survive.

Achieving a safe level of acidity via pickling happens in one of two ways, explained Sullivan. Picklers can put their vegetables into already-acidic vinegar, after which they become the sweet bread-and-butter pickles or the cheap pickles that come on hamburgers. Fermented pickles take much longer, on the other hand, since they rely on the behavior of lactic acid bacteria, which includes hundreds of bacterial species that lacto-ferment by turning the vegetables’ natural sugars into lactic acid. Picklers begin the fermentation process by putting fresh veggies in a brine that’s at least 2.25 percent salt by weight, which ensures that only the lactic acid bacteria survive. It takes the bacteria a few weeks to leave behind enough lactic acid to stop the harmful bacteria, and three months to make enough lactic acid for a full-sour flavor, said Bruno Xavier, Extension Associate at the Cornell University’s Northeast Center for Food Entrepreneurship.

Lactic acid bacteria also live inside us. The premise behind probiotic claims is the true statement that the types of good bacteria that comprise our microbiomes—the zoo of microorganisms living inside our body—play an important role in maintaining our digestive systems. And microbiome issues underlie plenty of health disorders like colitis and Clostridium difficile infections. But some nutritionists hypothesize that eating fermented foods or taking a probiotic can potentially increase the diversity and hardiness of the microbiome and thus promote good digestion. “The microbiome reflects whatever we eat,” said Alessio Fasano, Chair of Pediatric Gastroenterology and Nutrition at Massachusetts General Hospital. “One thing we know is that we have something between 500 and 1000 species of microorganisms in our gut. When we decrease the diversity, say from 500 to 50, that’s bad news … fermented food is a way you to keep your microbiome diversified so there can be more species that can survive.” Maintaining a diverse microbiome might keep the gut running more smoothly, which he compared to using premium gasoline in a car engine.

But Fasano stopped short of suggesting that there are any tangible benefits to frequently eating lots of fermented food. He suggested adding a serving or so every once in a while and instead focusing on maintaining a balanced diet. “I’m always concerned when people say ‘this is good for you,’ and then they go all in,” he said. “But common sense is balance.”

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Today, the only pickler left on the Lower East Side is ex-Guss employee Alan Kaufman, who runs The Pickle Guys on Essex Street. He has found the health fads helpful for his business. “Pickles have become very trendy for the past eight years or so with the probiotics,” said Kaufman. And it’s good for business. “It just helps. People come in and ask for probiotic items, lactate-fermented. Whatever works, you know what I mean?”

The trendiness has heralded a new crop of pickle companies like McClure’s, Rick’s Picks and Brooklyn Brine. Shamus Jones founded Brooklyn Brine eight years ago and considers himself part of a new guard of picklers. He has built an operation in Brooklyn’s Industry City that exports pickles around the United States and as far as Australia. When I visited the the New York-born vegetarian he had a shaved head, and is heavily tattooed with two holes on his lips that once contained snakebite piercings. He spoke early in our conversation about filling out stacks of paperwork to ensure he could brand his pickles as kosher and non-GMO: not containing any genetically modified ingredients. But when I asked if he ever thought about advertising the probiotic nature of pickles, his response was more measured.

“It’s a hard question to answer,” he said. It was obvious that pickle sales generally benefit from folks buying pickles for probiotic claims. Currently his lineup does not include a fermented pickle, but he’s made them in the past and plans to make them in the future. “Food trends are great in some ways, but it’s terrifying how irresponsible people can be with it.” The question made him squirm at his desk, 30 feet from the picklers pouring brine over sliced cucumbers in his enormous pickle monastery. “People are trying to jam probiotics down your throat … [there are] probiotic beverages like kombucha that they convince you you need to have, morning, noon and night.” He loves his pickles, his company, and the other passionate artisan picklers — he tries his hardest not to talk smack about his competitors. But he does not want people to think they should be eating fermented pickles with that sort of daily frequency others encourage for other probiotic products like kombucha. “Depending on what type of pickle you eat, you can be blowing out your sodium intake or eroding the enamel on your teeth, depending on where you get the pickle from.”

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Like Conroy, Kaufman and Leibowitz, Jones was a craft pickler first, and focused only on continuing and improving upon vegetable preservation. While the probiotic link may have brought business to craft picklers, few picklers seem to advertise their products as such. It seems that the Pickle Day probiotic talk was, more than anything, an advertising tactic to draw the eyes of health-conscious New Yorkers. Online and at the markets you’ll undoubtedly find health-conscious foodies extolling the single-celled critters souring up their fermented pickles. But until scientists actually test the effects of lactobacillales in clinical trials, it’s best not to eat them for supposed health benefits alone.