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Bessa MK, Bessa GR, Bonamigo RR. Kefir as a therapeutic agent in clinical research: a scoping review. Nutr Res Rev 2024; 37:79-95. [PMID: 36994828 DOI: 10.1017/s0954422423000070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Increasing research has been conducted on the role of probiotics in disease treatment. Kefir, a safe, low-cost probiotic fermented milk drink, has been investigated in many in vitro and animal studies, although parameters for human therapeutic dose or treatment time have not yet been determined. Here we perform a scoping review of clinical studies that have used kefir as a therapeutic agent, compiling the results for perspectives to support and direct further research. This review was based on Joanna Briggs Institute guidelines, including studies on the effects of kefir-fermented milk in humans. Using the term KEFIR, the main international databases were searched for studies published in English, Spanish or Portuguese until 9 March 2022. A total of 5835 articles were identified in the four databases, with forty-four eligible for analysis. The research areas were classified as metabolic syndrome and type 2 diabetes, gastrointestinal health/disorders, maternal/child health and paediatrics, dentistry, oncology, women's and geriatric health, and dermatology. The many study limitations hampered generalisation of the results. The small sample sizes, methodological variation and differences in kefir types, dosage and treatment duration prevented clear conclusions about its benefits for specific diseases. We suggest using a standard therapeutic dose of traditionally prepared kefir in millilitres according to body weight, making routine consumption more feasible. The studies showed that kefir is safe for people without serious illnesses.
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Affiliation(s)
- Milena Klippel Bessa
- Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil
| | | | - Renan Rangel Bonamigo
- Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil
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2
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Alves E, Gregório J, Rijo P, Rosado C, Monteiro Rodrigues L. Kefir and the Gut-Skin Axis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113791. [PMID: 36360671 PMCID: PMC9653948 DOI: 10.3390/ijerph192113791] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 05/31/2023]
Abstract
The human gastrointestinal (GI) tract is a dynamic system influenced by various environmental factors, including diet and exposure to ingested probiotics, and prone to various functional impairments. These impairments are mostly related to any combination of motility alterations, visceral hypersensitivity, and changes in the mucosa, immune function, and intestinal microbiota. Intestinal microbial imbalance and immunological dysfunction have been linked to several chronic inflammatory disease states, including atopic dermatitis (AD). Disruption of the intestinal microbial balance, known as gut dysbiosis, has been demonstrated to negatively impact skin function by increasing the intestinal permeability. Consequently, the gut-skin axis may be receptive to modulation via dietary modification, namely, via ingestion of probiotics, thus representing interesting potential as an AD therapy. Kefir is an ancient probiotic food that has been demonstrated to positively impact the general condition of the digestive system, including the intestinal microbiota. However, the literature is still scarce on the impact on the gut-skin relationship of a diet containing kefir. This study, continuing research in our group, aimed to evaluate the impact of kefir intake on GI symptoms in healthy and AD skin subjects. Results showed a significant improvement in GI status, namely, in functional constipation, abdominal pain intensity, and abdominal distension, thus supporting the hypothesis that kefir intake is positively associated with improvement in GI status. The existence of a relationship between the improvement in skin parameters and the improvement in GI status after kefir consumption was established, thus reinforcing the role of homemade kefir as a potential modulator of the gut-skin axis in both healthy and atopic individuals.
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Affiliation(s)
- Emília Alves
- CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, Portugal
- Health Sciences Ph.D. Program, University of Alcalá, Carretera Madrid-Barcelona, Km 33.100, 28805 Alcalá de Henares, Spain
| | - João Gregório
- CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Patrícia Rijo
- CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, Portugal
- Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisboa, Portugal
| | - Catarina Rosado
- CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Luis Monteiro Rodrigues
- CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, Portugal
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Wagenaar MC, van der Putten AAJ, Douma JG, van der Schans CP, Waninge A. Definitions, signs, and symptoms of constipation in people with severe or profound intellectual disabilities: A systematic review. Heliyon 2022; 8:e09479. [PMID: 35663754 PMCID: PMC9156888 DOI: 10.1016/j.heliyon.2022.e09479] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/06/2022] [Accepted: 05/13/2022] [Indexed: 10/25/2022] Open
Abstract
Background It is difficult to diagnose constipation for people with severe or profound intellectual disabilities. Definitions for this are ambiguous, and the symptoms and signs are often unnoticed. The aim of this study is to identify clear definitions of constipation for people with different levels of intellectual disabilities and to identify signs and symptoms. Method Guided by the PRISMA statement, a systematic review of the literature was conducted within electronic databases MEDLINE, Embase, CINAHL, Cochrane, and PsycINFO. Definitions, signs, and symptoms were extracted and the quality of definitions was assessed. Results In total, 24 studies were included. Quality of definitions ranged from poor to good quality. Standard and referenced definitions were used in ten studies, a self-composed definition was employed in eleven studies; and three studies did not refer to a source of the definition. The self-composed definitions had not been evaluated after being used for the target group, and no scientific substantiation was available. A broad range of signs and symptoms were described. Conclusions No substantiated definition has been ascertained for constipation for people with severe or profound intellectual disabilities. Further research will be necessary to identify which signs and symptoms are important for defining constipation in this target group.
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Affiliation(s)
- Marjolijn C Wagenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | - Annette A J van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, the Netherlands
| | - Johanna G Douma
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, the Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands.,Department Health Psychology, University Medical Centre Groningen, Groningen, the Netherlands.,Department Rehabilitation Medicine, University Medical Centre Groningen, Groningen, the Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands.,Department Health Psychology, University Medical Centre Groningen, Groningen, the Netherlands
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Naz SS, Malik T. Summary of Probiotic Potential of the Kefir for the Prevention and Alleviation of Functional GI Diseases. CURRENT NUTRITION & FOOD SCIENCE 2022. [DOI: 10.2174/1573401318666220321140726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Functional Gastrointestinal (GI) disease is a term that refers to a range
of disease conditions involving chronic diarrhea, irritable bowel syndrome, constipation,
inflammatory bowel disease (IBD), and lactose intolerance. Statistical reports have documented
>40% of the world's population is being afflicted by functional GI disorders. Consequences of
frequent intake of antibiotics include mortality of gut microflora, antibiotic-associated diarrhea,
the establishment of antibiotic resistance, and inference with healthy bodily functions. To
overcome the harms of antibiotics, studies are being conducted to determine the potential of
probiotics as alternatives to antibiotics.
Aim of Study:
The purpose of constructing this literature review is to outline the potential
attributes of Kefir and to assess the solitary efficiency of this beverage in the amelioration of GI
disease conditions.
Methodology:
Extraction of data entailed digging of literature hubs including PubMed, PubMed
Central, Research Gate, Science Direct, and Google Scholar, employing a different combination
of keywords to retrieve substantial details. Selection criteria of the articles involved the
published reports of preceding 10 years (2012-2021) that exhibited relevancy with the topic
Conclusion:
Kefir grains having different origins provide a distinct array of antimicrobial
spectrums and are found to be effective against different pathogens. IBDs, diarrheal sicknesses,
and constipation can be alleviated by the consumption of this beverage. Moreover, the probioticantibiotic combination is also essential for the mitigation of several diseases. The synergistic
impact of several microbial strains is vital for the treatment of celiac disease. Lactose maldigestion can be relieved by the consumption of kefir having β-galactosidase enzyme activity.
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Affiliation(s)
- Sheikh Saba Naz
- Microbiology, Science, Jinnah University for Women, Karachi, Pakistan
| | - Taqdees Malik
- Microbiology, Science, Jinnah University for Women, Karachi, Pakistan
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Fermented foods: an update on evidence-based health benefits and future perspectives. Food Res Int 2022; 156:111133. [DOI: 10.1016/j.foodres.2022.111133] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/15/2022]
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Effects of Malted Rice Amazake on Constipation Symptoms and Gut Microbiota in Children and Adults with Severe Motor and Intellectual Disabilities: A Pilot Study. Nutrients 2021; 13:nu13124466. [PMID: 34960021 PMCID: PMC8705246 DOI: 10.3390/nu13124466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 01/08/2023] Open
Abstract
Constipation is a frequent complication in patients with severe motor and intellectual disabilities (SMID). The aim of this study was to investigate changes in constipation symptoms and gut microbiota associated with the intake of malted rice amazake, a fermented food in Japan, in patients with SMID. Ten patients consumed the test food for six weeks, and their physical condition, dietary and medication status, and constipation assessment scale (CAS) were investigated. Comprehensive fecal microbiome analysis using the 16S rRNA sequence method was performed. The results showed a significant decrease in CAS, and a significant increase in Lactobacillales and decrease in Escherichia-Shigella after consuming malted rice amazake. To investigate the difference in the effects of malted rice amazake consumption, based on the characteristics of the original gut microbiota, the patients were grouped according to the similarity of their gut microbiota before the intervention; Firmicutes-rich Group 1 (n = 5), Actinobacteria-rich Group 2 (n = 4), and Proteobacteria-rich Group 3 (n = 1). The CAS decreased in Groups 1 and 2. The relative abundance of Bifidobacterium showed an increasing tendency both overall and in Group 1, but it was originally higher in Group 2. Our results suggest that malted rice amazake consumption reduces constipation symptoms and simultaneously changes the gut microbiota, but the changes may vary depending on the original composition of the gut microbiota.
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Chronic Constipation: Is a Nutritional Approach Reasonable? Nutrients 2021; 13:nu13103386. [PMID: 34684388 PMCID: PMC8538724 DOI: 10.3390/nu13103386] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/12/2021] [Accepted: 09/20/2021] [Indexed: 12/13/2022] Open
Abstract
Chronic constipation (CC) is one of the most common gastroenterological diagnoses in clinical practice. Treatment includes several steps, depending on the severity of symptoms. Lifestyle modifications and increased intake of fiber and water are suggested by most health professionals. Unfortunately, the recommendations in this regard are the most varied, often conflicting with each other and not always based on solid scientific arguments. This paper aims to clarify this topic by providing practical indications for the management of these patients in every day clinical practice. The literature available on this topic is scarce, and dietary studies have important methodological biases. However, fiber, mainly by binding water and acting as bulking agents and/or as prebiotics for the intestinal microbiota, and mineral water, especially if rich in magnesium and/or bicarbonate, are useful tools. An adequate, well-designed diet should be a cornerstone of any effective treatment for chronic constipation. High-quality studies on larger samples are mandatory to give scientific validity to the role of the food in CC therapy and to enable professionals to choose the best approach for their patients, combining nutritional and pharmacological agents.
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Wang J, Bai X, Peng C, Yu Z, Li B, Zhang W, Sun Z, Zhang H. Fermented milk containing Lactobacillus casei Zhang and Bifidobacterium animalis ssp. lactis V9 alleviated constipation symptoms through regulation of intestinal microbiota, inflammation, and metabolic pathways. J Dairy Sci 2020; 103:11025-11038. [PMID: 33222846 DOI: 10.3168/jds.2020-18639] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022]
Abstract
Studies suggest that probiotics and fermented milk can improve defecation in constipated patients. However, the mechanism of fermented milk containing probiotics on constipation remains poorly understood. Volunteers with chronic constipation symptoms were recruited and given 200 g/d of fermented milk containing Lactobacillus casei Zhang and Bifidobacterium animalis ssp. lactis V9 (PFM) for 4 wk. Clinical symptoms, cytokines, metagenomics, and metabolomics were evaluated in constipated participants before and after PFM intervention. After PFM intervention, we observed significant improvement of constipation symptoms. In the serum samples, the anti-inflammatory cytokine IL-10 increased and the proinflammatory cytokine C-reactive protein and lipopolysaccharides decreased. Metagenomics results showed that the increase of B. animalis was correlated with an increase in defecation frequency. Fatty acid biosynthesis and bile acid biosynthesis in stool samples as well as carnitine shuttle, vitamin E metabolism, and ascorbate and aldarate metabolism were identified as significantly altered metabolic pathways. Acylcarnitine, located on the carnitine shuttle pathway, had a significantly positive correlation with defecation frequency. It was speculated that PFM may contribute to alleviating constipation symptoms through 3 potential mechanisms: fine-tuning gastrointestinal microbiota, fighting inflammation, and regulating metabolic pathways.
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Affiliation(s)
- Jicheng Wang
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Key Laboratory of Dairy Products Processing, Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Xiaoye Bai
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Key Laboratory of Dairy Products Processing, Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Chuantao Peng
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Key Laboratory of Dairy Products Processing, Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Zhongjie Yu
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Key Laboratory of Dairy Products Processing, Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Bohai Li
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Key Laboratory of Dairy Products Processing, Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Wenyi Zhang
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Key Laboratory of Dairy Products Processing, Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Zhihong Sun
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Key Laboratory of Dairy Products Processing, Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Heping Zhang
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Key Laboratory of Dairy Products Processing, Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China.
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Navabzadeh M, Hashem-Dabaghian F, Kazemi T, Shojaii A, Nakhaei I, Hadinia J, Ghods R. Effect of a Persian medicine preparation, Ma'aljobon, on constipation in patients with hypertension. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:100. [PMID: 31850089 PMCID: PMC6906916 DOI: 10.4103/jrms.jrms_66_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/05/2019] [Accepted: 09/12/2019] [Indexed: 11/26/2022]
Abstract
Background: Constipation is a common and prevalent digestive problem. Forcing and straining due to constipation may have a negative effect on some parts of the body, including the heart. The aim of the study was to evaluate the effect of Ma'aljobon (a kind of whey) on functional constipation in hypertensive patients. Materials and Methods: The present double-blind, placebo-controlled randomized clinical trial was a part of the study about the effect of Ma'aljobon on stage 1 hypertension, performed in 2017–2018. Hypertensive patients accompanying constipation were included in the study. Patients were randomly divided into two groups: Group A (n = 19) received 25 g of Ma'aljobon powder and Group B (n = 22) received 25 g of maltodextrin powder, twice a day for 6 weeks. The number and quality of defecation during a day were evaluated at baseline and at the end of the study within and between groups. Data were analyzed by SPSS software (version: 17) using Chi-square or Fisher's exact test. P <0.05 was considered as significant level. Results: Forty-one patients had inclusion criteria, of whom 34 patients completed the study (19 in Group A and 15 in Group B). The mean ± standard deviation age of patients was 53.86 ± 8.92 years (range: 34–80 years). Before intervention, there was no significant difference between the two groups with respect to constipation; however, after 6 weeks' treatment, the frequency of constipation was significantly different between groups (P < 0.001). At the end of 6th week, constipation in the Group A was improved completely in terms of the number of defecation and stool consistency; but, in the Group B, eight (53.33%) patients still suffered from constipation (P < 0.001). No specific complications were reported in both groups. Conclusion: Ma'aljobon can improve constipation in hypertensive patients without any adverse effect.
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Affiliation(s)
- Maryam Navabzadeh
- Department of Persian Medicine, Birjand University of Medical Sciences, Birjand, Iran.,Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fataneh Hashem-Dabaghian
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran.,School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Toba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Asie Shojaii
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran.,School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Iman Nakhaei
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Roshanak Ghods
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran.,School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
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Dimidi E, Cox SR, Rossi M, Whelan K. Fermented Foods: Definitions and Characteristics, Impact on the Gut Microbiota and Effects on Gastrointestinal Health and Disease. Nutrients 2019; 11:nu11081806. [PMID: 31387262 PMCID: PMC6723656 DOI: 10.3390/nu11081806] [Citation(s) in RCA: 267] [Impact Index Per Article: 53.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 12/16/2022] Open
Abstract
Fermented foods are defined as foods or beverages produced through controlled microbial growth, and the conversion of food components through enzymatic action. In recent years, fermented foods have undergone a surge in popularity, mainly due to their proposed health benefits. The aim of this review is to define and characterise common fermented foods (kefir, kombucha, sauerkraut, tempeh, natto, miso, kimchi, sourdough bread), their mechanisms of action (including impact on the microbiota), and the evidence for effects on gastrointestinal health and disease in humans. Putative mechanisms for the impact of fermented foods on health include the potential probiotic effect of their constituent microorganisms, the fermentation-derived production of bioactive peptides, biogenic amines, and conversion of phenolic compounds to biologically active compounds, as well as the reduction of anti-nutrients. Fermented foods that have been tested in at least one randomised controlled trial (RCT) for their gastrointestinal effects were kefir, sauerkraut, natto, and sourdough bread. Despite extensive in vitro studies, there are no RCTs investigating the impact of kombucha, miso, kimchi or tempeh in gastrointestinal health. The most widely investigated fermented food is kefir, with evidence from at least one RCT suggesting beneficial effects in both lactose malabsorption and Helicobacter pylori eradication. In summary, there is very limited clinical evidence for the effectiveness of most fermented foods in gastrointestinal health and disease. Given the convincing in vitro findings, clinical high-quality trials investigating the health benefits of fermented foods are warranted.
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Affiliation(s)
- Eirini Dimidi
- King's College London, Department of Nutritional Sciences, London SE1 9NH, UK
| | - Selina Rose Cox
- King's College London, Department of Nutritional Sciences, London SE1 9NH, UK
| | - Megan Rossi
- King's College London, Department of Nutritional Sciences, London SE1 9NH, UK
| | - Kevin Whelan
- King's College London, Department of Nutritional Sciences, London SE1 9NH, UK.
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