Fermented food and nutritional guidelines

A tipping point is the “point at which a series of small changes or incidents becomes significant enough to cause a larger, more important change.” I think this term applies to the idea that consuming live microbes through fermented foods should be recommended by official governmental channels.

Although I – either along with or parallel to several colleagues – have been interested in this topic for several years (see here, here, here, here, here), some recent developments have made me realize that this idea is maturing. Today I saw an article by Bell et al. (2017) titled Nutritional Guidelines and Fermented Food Frameworks. In their abstract they state:  “Fermented foods and beverages have long been a part of the human diet, and with further supplementation of probiotic microbes, in some cases, they offer nutritional and health attributes worthy of recommendation of regular consumption.”  This is a simple and notable statement. Yesterday, I saw an article headlined “Scientist wants fifth food group added to Canada’s Food Guide”, which describes Prof. Gregor Reid’s advocacy for fermented foods.

At the 2017 ISAPP meeting in Chicago, one group of assembled academic and industry scientists recommended that a systematic review should be conducted to determine the strength of evidence that consumption of live microbes in foods can improve to health.

In June, Medscape published an article, “The 6 Dietary Tips Patients Need to Hear From Their Clinicians.” Number six was “Consume fermented foods/probiotics and fiber for gastrointestinal and overall health.”

In 2015, ISAPP filed comments with the U.S. Dietary Guidelines Advisory Committee asking them to (1) acknowledge that microbial communities are important to health maintenance and are influenced by diet, and (2) recommend that foods containing live and active cultures, probiotics and prebiotics be consumed as part of a healthy diet to promote the health and diversity of the host microbiota.

In 2015, human microbiome researchers, Drs. Justin and Erica Sonnenburg, published a book, The Good Gut. In it they conclude that “…fermented foods, which contain a diverse collection of microorganisms, offer the best chance of encountering a microbe that will have a positive effect.”

In 2013, Prof. Colin Hill and I co-authored a paper on rethinking the probiotic concept. It contained the following statement: “It may well be that the best advice to healthy consumers interested in probiotics is to consume a bolus of safe microbes, and many different microbes may serve this purpose equally well.”

There is a need for the research community to unite on this issue and determine an effective way to present this concept to those developing dietary recommendations. For this to move forward, a foundational concept is that benefits can be realized by generally healthy people, a notion that has been challenged by many recent headlines (see here, here, here, here and the CSPI Nutrition Action Healthletter, June/July 2017). There are likely gaps in the science that may preclude convincing conclusions about magnitude and extent of benefits. But we need to try.


See here for additional information by ISAPP on fermented foods.