Fermented foods hold a significant position in global culinary traditions, particularly within ethnic and traditional diets. They are widely consumed for their distinctive flavors, textures, and health-promoting attributes. Although extensive research exists on fermentation processes, comprehensive insights into the nutraceutical potential and mechanistic health benefits of these foods remain limited. This review highlights key fermented products traditionally consumed in the north-eastern region of India including Hawaijar, Soibum, Ngari, alongside global counterparts such as Natto, Chongkukjang, Miso, Kefir, Tempeh, Kimchi, Kombucha, and Sauerkraut. These foods are rich in bioactive compounds (phenolics, peptides, organic acids, and exopolysaccharides), probiotic microorganisms, and essential nutrients that collectively contribute to their antioxidant, anti-inflammatory, antidiabetic, and cardioprotective effects. Recent in vitro and in vivo studies demonstrate that regular consumption of such foods may support the prevention and management of chronic conditions, including diabetes, cardiovascular diseases, obesity, gastrointestinal disorders, and neurodegenerative diseases. However, mechanistic studies remain insufficient to fully elucidate the synergistic interactions between microbial metabolites, host metabolism, and gut microbiota modulation. The review therefore emphasizes the biochemical and therapeutic mechanisms underlying ethnic fermented foods, advocating for advanced metabolomic and molecular approaches to validate their health-promoting efficacy. This review provides a timely and integrative perspective by critically evaluating preclinical and clinical evidence, highlighting mechanistic insights, translational gaps, and future research priorities. These insights will support the development of functional food formulations and reinforce the integration of traditional fermented foods into modern dietary strategies for disease prevention and overall well-being.
Shahni et al. (Fri,) studied this question.