Narrative review integrates clinical and epidemiological evidence on fermented foods' effects on health outcomes, suggesting implications for dietary guidance.
Fermented foods represent a diverse category of products shaped by microbial metabolism, offering distinctive sensory qualities and potential health benefits. Although prior reviews have explored the nutritional and microbial aspects of fermented foods or focused on specific health outcomes and mechanisms of action, few recent narrative reviews have integrated clinical and epidemiological evidence across diverse health domains. This review addresses that gap by critically evaluating observational and interventional studies linking fermented food consumption with metabolic, cardiovascular, oncologic, and neuropsychological outcomes, while summarizing associated biomarkers that may underpin these effects. Emphasis is placed on clinical studies of fermented foods containing live microbes. Through mapping current evidence to non-communicable disease outcomes, the review identifies consistent protective associations, methodological limitations, and key knowledge gaps, and outlines priorities to advance the field and its translation into dietary guidance. It further underscores the need for standardized product characterization and well-powered clinical trials to establish causality. Overall, this work provides the most current and integrative assessment of fermented foods and human health, highlighting their potential as a valuable yet underutilized component of strategies for chronic disease prevention and public health policy.
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Sampsell et al. (2025) studied this question.
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