Agroscope, Schwarzenburgstrasse 161, 3003 Berne, Switzerland.
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland.
Nutrients. 2018 Apr 4;10(4):448. doi: 10.3390/nu10040448.
Fermented foods represent a significant fraction of human diets. Although their impact on health is positively perceived, an objective evaluation is still missing. We have, therefore, reviewed meta-analyses of randomized controlled trials (RCT) investigating the relationship between fermented foods and non-transmissible chronic diseases. Overall, after summarizing 25 prospective studies on dairy products, the association of fermented dairy with cancer was found to be neutral, whereas it was weakly beneficial, though inconsistent, for specific aspects of cardio-metabolic health, in particular stroke and cheese intake. The strongest evidence for a beneficial effect was for yoghurt on risk factors of type 2 diabetes. Although mechanisms explaining this association have not been validated, an increased bioavailability of insulinotropic amino acids and peptides as well as the bacterial biosynthesis of vitamins, in particular vitamin K2, might contribute to this beneficial effect. However, the heterogeneity in the design of the studies and the investigated foods impedes a definitive assessment of these associations. The literature on fermented plants is characterized by a wealth of in vitro data, whose positive results are not corroborated in humans due to the absence of RCTs. Finally, none of the RCTs were specifically designed to address the impact of food fermentation on health. This question should be addressed in future human studies.
发酵食品在人类饮食中占有重要地位。尽管它们对健康的影响被认为是积极的，但仍缺乏客观的评价。因此，我们回顾了关于发酵食品与非传染性慢性疾病关系的随机对照试验（RCT）的荟萃分析。总体而言，在总结了 25 项关于乳制品的前瞻性研究后，发现发酵乳制品与癌症之间的关联是中性的，而对于心血管代谢健康的特定方面，特别是中风和奶酪摄入，其关联则是微弱有益的，但不一致。对于酸奶预防 2 型糖尿病的风险因素，有最强的有益效果证据。虽然解释这种关联的机制尚未得到验证，但胰岛素增敏性氨基酸和肽的生物利用度增加以及细菌合成维生素，特别是维生素 K2，可能有助于这种有益效果。然而，由于 RCT 的缺乏，研究设计和所研究食品的异质性阻碍了对这些关联的明确评估。发酵植物的文献特点是有大量的体外数据，但由于缺乏 RCT，其阳性结果在人类中并未得到证实。最后，没有一项 RCT 是专门为研究食品发酵对健康的影响而设计的。这个问题应该在未来的人类研究中得到解决。
