Impact of fermented foods consumption on gastrointestinal wellbeing in healthy adults: a systematic review and meta-analysis
Journal
Frontiers in Nutrition
Date Issued
2025-10-10
Author(s)
Arghya Mukherjee
Dominic N. Farsi
Ljupco Angelovski
Guy Vergères
DOI
doi: 10.3389/fnut.2025.1668889
Abstract
Objective: In recent years, the consumption of fermented foods (FFs) has been
linked with gastrointestinal health and wellbeing. Here, we systematically review
and meta-analyse the currently available evidence relating to this as part of
the COST Action PIMENTO and guided by the European Food Safety Authority
(EFSA) health claim dossiers.
Methods: MEDLINE, Scopus and Cochrane CENTRAL bibliographic libraries
were searched for relevant literature up to 31st January 2025. All eligible
studies were included for narrative review as per EFSA guidelines, but only
randomised controlled trials (RCTs) were considered for meta-analyses. Risk of
bias, mechanisms of action, bioactive compounds and safety were additionally discussed. Data was pooled using mean difference (MD)/standardized MD
for continuous data and relative risk (RR) for dichotomous data. Certainty of
evidence was evaluated through GRADE assessment.
Results: A total of 25 studies (19 RCTs included in meta-analysis) with 4,328
participants were included in the systematic review. Meta-analysis demonstrated
the beneficial impact of FF consumption on frequency of bowel movements
(MD 0.60, CI 0.04, 1.16, p = 0.04, I2 = 74%), stool consistency (Bristol Stool Form
Scale) (MD 0.25, CI 0.03, 0.47, p = 0.03, I2 = 72%), gastrointestinal symptoms
(SMD −0.60, CI −1.05, −0.15, p = 0.009, I2 = 90%) and intestinal transit time
(−13.65 CI −21.88, −5.43, p = 0.001, I2 = 95%), among others. Certainty of
evidence was highly variable and mostly low.
Conclusion: Our analysis suggests that FF consumption beneficially impacts the
frequency of bowel movements, stool consistency, incidence of hard stools,
intestinal transit time, abdominal symptoms, bloating, borborygmi, flatulence
and degree of constipation.
Systematic review registration: This study was registered at the Open Science
Framework (osf.io, registration number: q8yzd)
linked with gastrointestinal health and wellbeing. Here, we systematically review
and meta-analyse the currently available evidence relating to this as part of
the COST Action PIMENTO and guided by the European Food Safety Authority
(EFSA) health claim dossiers.
Methods: MEDLINE, Scopus and Cochrane CENTRAL bibliographic libraries
were searched for relevant literature up to 31st January 2025. All eligible
studies were included for narrative review as per EFSA guidelines, but only
randomised controlled trials (RCTs) were considered for meta-analyses. Risk of
bias, mechanisms of action, bioactive compounds and safety were additionally discussed. Data was pooled using mean difference (MD)/standardized MD
for continuous data and relative risk (RR) for dichotomous data. Certainty of
evidence was evaluated through GRADE assessment.
Results: A total of 25 studies (19 RCTs included in meta-analysis) with 4,328
participants were included in the systematic review. Meta-analysis demonstrated
the beneficial impact of FF consumption on frequency of bowel movements
(MD 0.60, CI 0.04, 1.16, p = 0.04, I2 = 74%), stool consistency (Bristol Stool Form
Scale) (MD 0.25, CI 0.03, 0.47, p = 0.03, I2 = 72%), gastrointestinal symptoms
(SMD −0.60, CI −1.05, −0.15, p = 0.009, I2 = 90%) and intestinal transit time
(−13.65 CI −21.88, −5.43, p = 0.001, I2 = 95%), among others. Certainty of
evidence was highly variable and mostly low.
Conclusion: Our analysis suggests that FF consumption beneficially impacts the
frequency of bowel movements, stool consistency, incidence of hard stools,
intestinal transit time, abdominal symptoms, bloating, borborygmi, flatulence
and degree of constipation.
Systematic review registration: This study was registered at the Open Science
Framework (osf.io, registration number: q8yzd)
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