Effect of lactic acid fermented foods on glycemic control in diabetic adults: a systemic review and meta-analysis of randomized controlled trials

Abstract

Lactic acid bacteria (LAB) fermented foods are reported to have potential in managing glycemic control. This systematic review aimed to evaluate the effectiveness of LAB-fermented foods on improving glycemic control in adults with prediabetics or type 2 diabetes mellitus (T2DM). Randomized controlled trials (RCTs) on LAB fermentation-related foods were searched on PubMed, Cochrane, Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Sixteen RCTs were included, and the results concluded LAB-fermented food had significant effects in HbA1c (Z = 6.24, MD = −0.05, CI: −0.07 to −0.04, p ≤ 0.00001), fasting plasma glucose (Z = 2.50, MD = −0.16, CI: −0.29 to −0.04, p = 0.01) and fasting serum insulin (Z = 2.51, MD = −0.20, CI: −0.35 to −0.04, p = 0.01). There were significant effects on lipid profile, inflammatory markers, and body mass index in secondary analyses. Subgroup analysis suggests LAB-fermented consumption with a longer duration, younger age group and adults with T2DM, had a larger effect size. Clinicians could offer LAB-fermented food as dietary recommendations for prediabetic and diabetic adults. Larger trials are warranted to verify LAB-fermented food benefits on glycemic control. Systematic Review Registration: PROSPERO Registration No. CRD42022295220

Keywords:

• Fermentation
• glycemic control
• lactic acid bacteria
• prediabetes
• type 2 diabetes mellitus

Acknowledgements

We would are thankful for generous support from Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.

Authors’ contributions

Wei Zhou TEO was involved in study conception, design, search strategy development, database searching, study selection, data extraction, collection, analysis, and writing of the manuscript. Jie Yang SEE was involved in the independent review of articles during the study selection and data extraction process and quality appraisal. Dr. Sheena RAMAZANU and Dr. James CHAN Chun Yip were engaged in the study design and critical content review of the manuscript. Dr. Xi Vivien WU was involved in study conception, design, data analysis, and the overall critical review of the manuscript.

Disclosure statement

The authors declare no conflicts of interest. The submitted article represents the original work of the authors. The article is not currently under consideration elsewhere, nor has it been previously published in the same or substantially similar form. No copyright to any other work was breached in the manuscript’s creation.

Funding

The author(s) reported there is no funding associated with the work featured in this article.