Peanut allergy: microbiota makes a difference

The severity of a peanut food allergy does not depend solely on the level of specific IgE antibodies. A study shows that oral and gut bacteria, such as Rothia, break down the allergen and modulate anaphylaxis severity. Microbiota may therefore help explain why the same allergy causes reactions of very different intensity from one patient to another.

The gut microbiota
 Peanut allergy: microbiota makes a difference

Bacteria capable of disarming allergens

In mice, researchers1 observed that the presence of gut bacteria changes how the body responds to peanuts. The group of mice with rich and diverse gut microbiota broke down the two proteins responsible for most allergic reactions, Ara h 1 and Ara h 2, far more effectively than mice raised with little or no gut microbiota. As a result, fewer intact allergens entered the bloodstream and the allergic reaction triggered after exposure was significantly less intense. Conversely, a second group with limited microbial diversity showed more markers of a severe reaction. 

Ara h 1 and Ara h 2

The two peanut allergen proteins most often recognized by the immune system of people with allergies.

Immune system

All the cells and molecules that protect the body against infections, abnormal cells and foreign substances. In an allergy, IgE and mast cells are involved in recognizing the allergen and triggering the reaction. 

Severe allergic reaction (IgE-mediated anaphylaxis)

Acute, generalized reaction that can be fatal within minutes, triggered when an allergen binds to IgE attached to mast cells, causing the rapid release of inflammatory mediators. 

The bacterial genus Rothia stood out in this research. It is naturally present in the human mouth and small intestine. In the laboratory, it breaks down the two main peanut allergens at specific sites, preventing IgE antibodies from recognizing them. Less recognition means less activation of mast cells, the immune cells responsible for allergy symptoms.

IgE (Immunoglobulin E)

Antibody responsible for immediate allergic reactions, produced by the immune system when it comes into contact with an allergen.

Mast cells

Immune cells that release inflammatory substances during an allergic reaction.

Microbiotal bacteria (enzymatic breakdown of food proteins)

Microorganisms in the oral cavity and intestine that use proteolytic enzymes to break down food proteins resistant to human digestion, including peanut allergens. 

Some Staphylococcus strains have a similar effect, but not all of them. The study shows that two strains of the same species can behave in opposite ways, with one efficiently breaking down the allergen and the other not at all. 

Preventing peanut allergy thanks to the microbiota?

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A finding confirmed in patients with allergies

The researchers then analyzed saliva samples from 19 patients with peanut allergy. These children, ages 1 to 14, were studied before starting oral immunotherapy treatment. The group of patients that tolerated the highest allergen doses during controlled tests harbored more bacteria capable of breaking down peanuts, including bacteria from the Rothia genus, regardless of their blood levels of Ara h 2-specific IgE. They therefore showed greater allergy tolerance. This observation was then identified in 120 children monitored in an independent study, further strengthening its credibility.

These findings could eventually help better estimate the reactivity threshold and personalize treatment, but they cannot predict the severity of a child’s allergic reaction.

More than 70% of peanut allergies persist over time. This makes the search for new ways to limit the severity of accidental allergic reactions particularly valuable. For affected children and their families, the goal would be to reduce the risk associated with unintentional exposure.These findings still need confirmation through larger studies before any clinical application, but they open up a serious avenue: a microbiota that protects or, conversely, increases exposure depending on the microorganisms it contains. A promising discovery for potential future treatments.

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A world tour of fermented foods

Fermentation is a simple and natural way to preserve food. All it takes is the action of microorganisms such as yeasts and bacteria. No wonder this method has spread throughout the world, from preserving herring in Sweden to fermenting butter in the Tuareg desert. But the benefits of fermentation can go far beyond that: in many cases, it can also make foods easier to digest.

The gut microbiota
A world tour of fermented foods

United States, India…
Pickles: the ancient art of fermented vegetables

For many people, the word “pickles” conjures up images of tangy, vinegar-soaked cucumbers that are a staple of American hamburgers. The exact origin of pickles remains unclear, but as early as 2030 B.C., cucumbers from the Indian subcontinent were reportedly being preserved through fermentation.1 And the tradition is still very much alive. In India, pickled vegetables and fruits—such as mangoes, lemons, and chili peppers—known as achar, play an important role in Indian cuisine.1 But be aware: not all pickles are created equal. Traditional pickles are left to ferment for several months in a very salty brine—a low-oxygen environment conducive to fermentation by lactic acid bacteria—while other, speedier recipes combine fermentation with vinegar. “Refrigerated” pickles, on the other hand, ferment for only a few days and must be kept cold.2
Long-fermented varieties have greater nutritional benefits as they contain more live microorganisms, some of which may contribute to the balance of the gut microbiota, digestion, and even immunity, although these health effects have yet to be confirmed.3–5

Sweden
Surströmming: canned fermented herring

This Swedish specialty is made from fresh herring that is salted and then submerged in brine where fermentation continues inside the can.6 As the process unfolds, the can naturally begins to bulge. The health benefits of this surprising dish—which has a very sour and slightly fizzy taste—6 are thought to come primarily from the fish itself, which is rich in protein and omega-3 fatty acids.7 Fermented fish in general has also been associated with possible antioxidant and antihypertensive effects, as well as potential protection against certain cancers and beneficial changes to the gut microbiota (increase in Bacteroidetes, decrease in Firmicutes).8 
But, these benefits should be taken with a grain of salt, as there is far from a consensus on them: in one human trial, volunteers consuming surströmming for a week experienced no significant changes to their gut microbiota.9 

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Inforgraph A world tour of fermented foods

Morocco, Algeria
Smen: a long-lasting butter

Smen is a fermented, clarified(1) butter traditionally made in North Africa. It is prepared from camel milk: after the milk undergoes spontaneous fermentation, the butter is separated by churning, then fermented, salted, and stored in hermetically sealed earthenware jars, where it can age for several years.12 Over time, smen develops an intensely rich flavor and powerful aromas. As with all fermented dairy products, fermentation is thought to produce small bioactive molecules that have beneficial effects on health. However, many of the health benefits traditionally attributed to smen—from treating hemorrhoids and rheumatism to soothing colds and burns—belong more to cultural tradition than to firmly established science.13 Nevertheless, antibacterial properties against Staphylococcus aureus and Escherichia coli have been demonstrated in vitro, and accelerated wound healing has been observed in animals (but not—yet?—in humans).14

(1) Clarification involves removing water and milk proteins (particularly casein), leaving almost nothing but fat and giving it a much longer shelf life.12

Bulgaria
Yogurt: for better milk digestion

Yogurt is a fermented dairy product made using two specific bacteria: Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus.10 These bacteria convert the lactose—the natural sugar in milk—into lactic acid. This process gives yogurt its characteristic taste and texture, while also making the milk easier to digest. Other bacteria can ferment milk too, but the resulting product is then referred to as “fermented milk” rather than “yogurt”. One direct result of this lactic fermentation process is that it can make dairy easier to digest for people with lactose intolerance.10 The consumption of yogurt and other fermented dairy products has also been associated with a reduced risk of breast and colorectal cancer and type 2 diabetes mellitus, better weight management, and improved cardiovascular, bone, and digestive health.10,11 
But here again, a little caution is needed: while the associations are promising, science is still far from proving a direct cause-and-effect relationship.

Ethiopia
Injera: a gluten-free flatbread 

Injera is a traditional fermented flatbread from Ethiopia, made from teff flour,15 an ancient gluten-free grain. A staple of Ethiopian cuisine, it is particularly rich in carbohydrates, while also providing protein, fiber, and a range of minerals. Its fermentation is powered by yeasts—notably the well-known brewer’s yeast Saccharomyces cerevisiae—and lactic acid bacteria.16–19 Their action appears to improve protein digestibility, increase the activity of beneficial compounds such as phenols, and enhance antioxidant activity.15,20
It can also reduce compounds (known as antinutritional factors) naturally present in grains, which limit the absorption of certain nutrients.21

Nigeria
Gari: an affordable cassava-based food

Gari is a grainy, creamy flour made by roasting fermented cassava paste.22 This staple food is part of the daily diet of millions of Nigerians thanks to its availability and affordability. The traditional production process involves several sequential steps: grating the cassava, optionally adding red palm oil, fermenting, draining (dehydration), sifting, roasting on a heated griddle to gelatinize the starch, and then cooling.22 All these steps help reduce certain undesirable compounds such as cyanide, but also destroy vitamins. Gari is rich in carbohydrates and fiber but low in protein. It may also contain phenols with antioxidant properties, although this depends on how the gari is made and the type of cassava used.23

What foods promote a balanced microbiota?

Learn more

Indonesia
Tempeh: taking the nutritional benefits of soy to the next level

Originating on the island of Java, tempeh is an Indonesian staple that has become a favorite among vegetarians around the world. This fermented soy product, far less bland than its cousin tofu, adds nutty and mushroom-like flavors to many Indonesian dishes. It is made by fermenting soybeans with the fungus Rhizopus oligosporus, a technique said to have been inspired by traditional Chinese methods of making soy sauce.24 This fermentation process improves the absorption of soy’s proteins, minerals, vitamins, and isoflavones, while reducing antinutritional factors. The result is a product of high nutritional quality that can contribute to preventing malnutrition.24,25 Some authors have also reported potential benefits ranging from lower LDL cholesterol and blood pressure26 to antioxidant, digestive, and cognitive effects—24 and even improved athletic performance.27 However, most of these findings are still very much preliminary. 

Philippines
Bagoong: a condiment rich in protein… but also in salt and histamines

Bagoong is a traditional Filipino condiment made from fish or small shrimp that are ground and fermented with salt. Although rich in protein, the nutritional composition of this paste varies depending on the recipe.28,29 For example, shrimp-based bagoong (also known by the generic names Terasi in Asia, Belacan in Malaysia, and Kapi in Thailand…) tends to be slightly higher in fat and lower in minerals. As for its potential health benefits (antioxidant? cholesterol-lowering?),30 they have rarely been studied, and often only in test tubes rather than in humans, which makes the results highly uncertain. Keep in mind that bagoong is high in both histamines (with a risk of poisoning sometimes called non-allergic food hypersensitivity) and in salt (an ingredient best consumed in moderation).28,29,31 

Miracle foods do not exist, but a balanced diet does.

Check out our series of articles on microbiota and fermented foods:

The many health benefits of fermented foods

Learn more

Kefir: a natural ally for your gut microbiota?

Learn more

Yogurts, the great allies of your gut microbiome

Learn more

Kombucha: marketing hype or scientific claims?

Learn more

Kimchi: a blend of fiber and beneficial bacteria

Learn more

The beneficial—and sometimes paradoxical—effects of miso

Learn more
Sources

1. Chakraborty R, Roy S. Exploration of the diversity and associated health benefits of traditional pickles from the Himalayan and adjacent hilly regions of Indian subcontinent. J Food Sci Technol. 2018;55(5):1599-1613. 

2. Stankus T. Pickled Vegetable Condiments: A Global Industry and Its Literature. J Agric Food Inf. 2014;15(1):3-18. 

3. Tan X, Cui F, Wang D, Lv X, Li X, Li J. Fermented Vegetables: Health Benefits, Defects, and Current Technological Solutions. Foods. 2024;13(1):38. 

4. Ahmada Kh A, A.A Abdo A, Khan S, Aleryani H, Mi S, Wang X. Advancing Pickling Techniques to Enhance Bioactive Compounds and Probiotic Content in Pickled Vegetables. Food Rev Int. 2026;42(1):31-57.

5. Hafeez SH, Khalid A, Ahmed S, et al. Fermented pickles improve gut microbiota and immune profile in women in a community trial in rural Pakistan. Sci Rep. 2025;15(1):34522. 

6. Chan SXY, Fitri N, Mio Asni NS, et al. A Comprehensive Review with Future Insights on the Processing and Safety of Fermented Fish and the Associated Changes. Foods. 2023;12(3):558. 

7. Cha YJ, Yu D. Health benefits and functions of salt-fermented fish. J Ethn Foods. 2024;11(1):34. 

8. Khongthaw B, Dladla M, Chauhan PK, et al. Fermented Fish Products: A Comprehensive Overview of Traditional Processing Techniques, Varieties, and Their Health Benefits. Compr Rev Food Sci Food Saf. 2026;25(3):e70457. 

9. Kallner A, Debelius J, Schuppe-Koistinen I, Pereira M, Engstrand L. Effects of Consuming Fermented Fish (Surströmming) on the Fecal Microflora in Healthy Individuals. J Med Food. 2023;26(3):185-192. 

10. Savaiano DA, Hutkins RW. Yogurt, cultured fermented milk, and health: a systematic review. Nutr Rev. 2020;79(5):599-614.

11. Tremblay A, Drouin-Chartier JP, Marette A, Drapeau V. Yogurt and health: a focus on its matrix. Crit Rev Food Sci Nutr. 2026;66(2):342-351. 

12. Mosbah S, Annou G, Bouricha M, Mekkaoui S, Boudjenah-Haroun S. Physicochemical and microbiological study of fresh cream and fermented butter (Smen) made from camel milk. Int J Biosci IJB. Published online March 1, 2022:52-59. 

13. El Lamti F, Mennane Z, Elmtili N, Mrani Alaoui M. Ethnomedicinal Knowledge and Traditional Methodology for the Preparation of Fermented Butter “ Smen ” Among the Rural People of Northern Morocco: A Field Study. J Med Food. 2024;27(11):1133-1139. 

14. El Lamti F, Zarouki MA, Mennane Z, et al. Old fermented butter, Smen, as a potential product for wound healing in a mouse incisional wound model: Antibacterial and histological studies. Biocatal Agric Biotechnol. 2026;73:103959.

15. Legesse Bedada T, Martínez-Villaluenga C, Amare E, et al. Unveiling the nutritional composition and bioactivity of Ethiopian native fermented foods: Kocho and Injera. Food Chem. 2025;474:143158.

16. Neela S, Fanta SW. Injera (An Ethnic, Traditional Staple Food of Ethiopia): A review on Traditional Practice to Scientific Developments. J Ethn Foods. 2020;7(1):32.

17. Muche N, Geremew T, Jiru TM. Isolation and characterization of potential probiotic yeasts from Ethiopian injera sourdough. 3 Biotech. 2023;13(9):300.

18. Worku H, Tadesse BT, Jiru TM, et al. Metagenomic analysis of dominant lactic acid bacteria and yeast and starter culture formulation for injera sourdough fermentation. Appl Food Res. 2026;6(1):101781.

19. Desiye A, Abegaz K. Isolation, characterization and identification of lactic acid bacteria and yeast involved in fermentation of Teff (EragrostisTef) Batter. In: 2013. Accessed July 6, 2026. https://www.semanticscholar.org/paper/Isolation%2C-characterization-and-identification-of-Desiye-Abegaz/3373ba786cbed5f07d2c6330a5362ea56198adc2

20. Shumoy H, Gabaza M, Vandevelde J, Raes K. Soluble and bound phenolic contents and antioxidant capacity of tef injera as affected by traditional fermentation. J Food Compos Anal. 2017;58:52-59. 

21. Mengesha Y, Tebeje A, Tilahun B. A Review on Factors Influencing the Fermentation Process of Teff (Eragrostis teff) and Other Cereal-Based Ethiopian Injera. Int J Food Sci. 2022;2022(1):4419955.

22. Akpoghelie PO, Owheruo JO, Edo GI, et al. The benefits and processing technologies of gari, a famous indigenous food of Nigeria. Discov Food. 2025;5(1):91. 

23. Laya A. Physicochemical Composition and Antioxidant Activity of Five Gari Processed from Cassava Roots (Manihot esculenta Crantz) Harvested at Two Different Maturity Stages and Two Seasons. BioMed Res Int. 2023;2023(1):4779424.

24. Ratnaningsih R, Kusumawaty N, Herawati ACI Ervika RN, et al. History, manufacture, nutritional content, bioactive compounds, and health benefits of tempeh and tofu as alternative protein in Indonesia: a review. Aust J Crop Sci. 2025;19(07):839-852. 

25. Nafisah N, Anjani G, Afifah DN. A REVIEW OF NON-SOY TEMPEH AND POTENTIAL BENEFITS IN METABOLIC SYNDROME. J Aisyah J Ilmu Kesehat. 2024;9(2). 

26. Ahnan‐Winarno AD, Cordeiro L, Winarno FG, Gibbons J, Xiao H. Tempeh: A semicentennial review on its health benefits, fermentation, safety, processing, sustainability, and affordability. Compr Rev Food Sci Food Saf. 2021;20(2):1717-1767. 

27. Subali D, Christos RE, Givianty VT, et al. Soy-Based Tempeh Rich in Paraprobiotics Properties as Functional Sports Food: More Than a Protein Source. Nutrients. 2023;15(11):2599. 

28. Julmohammad N, Atun M, Roslan J, et al. Compositional analysis and nutritional profiling of southeast Asian fermented fish products: insights into macronutrients, micronutrients, and bioactive compounds. Discov Food. 2025;5(1):75.

29. Damsud T, Chumsri A, Chinnanon M, Ongmanee C. Changes in the chemical composition, antioxidant and α-glucosidase inhibitory activities of shrimp paste (Ka-pi) following in vitro simulated gastrointestinal digestion. J Agric Food Res. 2025;22:102066. 

30. Herlina VT, Setiarto RHB. Terasi, exploring the Indonesian ethnic fermented shrimp paste. J Ethn Foods. 2024;11(1):7. 

31. Khudair AJD, Mohd Zaini NS, Jaafar AH, Meor Hussin AS, Wan-Mohtar WAAQI, Abd Rahim MH. Production, Organoleptic, and Biological Activities of Belacan (Shrimp Paste) and Pekasam (Fermented Freshwater Fish), the Ethnic Food from the Malay Archipelago. Sains Malays. 2023;52(4):1217-1230.

 

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The beneficial—and sometimes paradoxical—effects of miso

Perhaps Japan’s greatest culinary ambassador is miso soup, which helped introduce the West to a fifth taste: umami. Now enjoyed around the world, this culinary icon is said to nurture our gut microbiota thanks to the fermented soybean paste it contains. Let’s take a closer look at the reasons behind its benefits, which can sometimes seem paradoxical.

The gut microbiota
The beneficial—and sometimes paradoxical—effects of miso

Miso is a traditional Japanese condiment and one of the hallmarks of umami,1 the fifth basic taste alongside sweet, salty, sour, and bitter. In the Land of the Rising Sun, it is best known as the star ingredient of the famous soup that bears its name.1 Since the 1970s, it has steadily made its way into Western kitchens, where it is used as a versatile condiment.2 

Miso production

The production of 700,000 metric tons in 1980 to fall 40% to 426,000 by 2013. A possible reversal of such a trend is beginning, with an annual production of 482,000 metric tons in 2019.
Source: Allwood, 2021.2 

What is miso?

Miso is a fermented soybean paste produced in two stages:1,2 

  • koji preparation: an initial substrate (usually rice, barley, or soybeans) is inoculated with a microscopic filamentous fungus—most commonly Aspergillus oryzae. This produces what is known as ‘koji’.
  • final fermentation: the koji is then mixed with a puree of cooked soybeans and salt. This mixture undergoes a second fermentation, this time involving yeasts and bacteria (including lactic acid bacteria). This stage can last anywhere from a few weeks to three years.

There are four main categories of miso based on its ingredients: rice miso (which accounts for around 80% of production in Japan), barley miso, soybean miso, and blended miso.1,2 Its flavor (ranging from sweet to salty) and color (white, red, or black) depend on the ingredients used, the proportion of koji, and how long it is left to ferment.1,2 

Health benefits of soy

Miso, whose main ingredient is soy, retains many of soy’s nutritional benefits. Soy is rich in high-quality protein (twice as much as most other legumes) because it contains all nine essential amino acids.3,4 Soy is also rich in fiber, which helps feed our gut bacteria, and in minerals. Miso also contains isoflavones, plant compounds that can bind to human estrogen receptors. These are sometimes referred to as phytoestrogens. 

This has raised concerns:5 could these compounds affect hormone-dependent cancers, fertility, or hormonal development? While these concerns were once legitimate, current evidence is entirely reassuring: research has found no increased risk and even suggests that soy consumption may have a potential protective effect against cancer,6particularly in women.7,8

One final point to keep in mind: miso, like any soy-based food, contains several allergenic proteins.9 Although fermentation can significantly reduce their allergenic potential by breaking down complex proteins, the risk remains for people with a high sensitivity to soy.9 

Miracle foods do not exist, but a balanced diet does.

Fermentation that boosts health benefits

Miso’s double-fermentation process transforms soybeans into a food that is not only easier to digest but also richer in bioactive compounds.3,9,10 For example, fermentation improves the digestibility of soy proteins by breaking them down into smaller molecules that are easier to absorb.3 It also increases the bioactivity of the well-known isoflavones, transforming them into a form of phytoestrogens that is more bioavailable and active in the body, with potential health benefits, including :

  • protection against certain cancers,
  • improved lipid profile,
  • and beneficial effects on cardiovascular health—although the evidence remains inconclusive.3,10–12 

It should be noted, however, that because these compounds have estrogen-like activity, consuming them in excessively high amounts could potentially pose toxic risks to the reproductive system, particularly in pregnant women, women of childbearing age, and prepubescent children (ANSES, French National Agency for Food, Environmental and Occupational Health & Safety).13
Miso is naturally rich in diverse and varied microorganisms, including the trio Aspergillus oryzae derived from koji), the yeast Zygosaccharomyces rouxii and the bacterium Tetragenococcus halophilus.1,2,14 This microbial community enriches the gut microbiota,15 promoting its diversity and stability, boosting certain beneficial bacteria while reducing less favorable ones. This rebalancing of the microbiota is intriguing enough that some researchers have suggested a potential protective effect against diabetes mellitus—10,15 but for now, that hypothesis still needs to be substantiated. 

The many health benefits of fermented foods

Learn more

Finally, an improved gut flora means an increased production of key compounds, particularly (sidenote: Short chain fatty acids (SCFA) Short chain fatty acids (SCFA) are a source of energy (fuel) for an individual’s cells. They interact with the immune system and are involved in communication between the intestine and the brain. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020;11:25. )  (SCFAs).15
These small molecules work in our favor: they nourish the cells of our colon, help strengthen our intestinal barrier, support immune function, and may help reduce inflammation.4,9,15  

The salt paradox

The WHO and public health campaigns regularly remind us: we should cut back on salt. Yet miso is one of the main sources of salt in the Japanese diet. And here comes the paradox: despite its high salt content, this Japanese specialty does not seem to have the same harmful effects as plain old salt: consuming it may have no effect on blood pressure.2,16,17 It may even lower heart rate16and increase salt excretion through urine!18 
How can this surprising result be explained? One possibility is potassium. Soybeans and the other ingredients commonly found in miso soup (vegetables, fish...) are rich in potassium, which may help counteract some of salt’s blood-pressure-raising effects.1 According to some experts, the key may therefore be not just how much sodium we consume, but the balance between sodium and potassium.1,2,19

1– 2 g of salt

One serving traditional (common) miso soup usually contains 1– 2 g of salt.
Source: Kondo, 2019.16 


Thus, thanks to its double fermentation process, miso becomes easier to digest and richer in potentially beneficial compounds. When consumed in moderation—high daily intake of 1 to 5 bowls per day appears to be associated with an increased risk of stomach cancer in men–7 it may offer a range of health benefits, despite its high salt content.

Check out our series of articles on microbiota and fermented foods:

Kefir: a natural ally for our gut microbiota?

Learn more

Yogurts, the great allies of your gut microbiome

Learn more

Kombucha: marketing hype or scientific claims?

Learn more

Kimchi: a blend of fiber and beneficial bacteria

Learn more

A world tour of fermented foods

Learn more
Sources

1. Kusumoto KI, Yamagata Y, Tazawa R, et al. Japanese Traditional Miso and Koji Making. J Fungi. 2021;7(7):579. 

2. Allwood JG, Wakeling LT, Bean DC. Fermentation and the microbial community of Japanese koji and miso: A review. J Food Sci. 2021;86(6):2194-2207. 

3. do Prado FG, Pagnoncelli MGB, de Melo Pereira GV, Karp SG, Soccol CR. Fermented Soy Products and Their Potential Health Benefits: A Review. Microorganisms. 2022;10(8):1606. 

4. Belobrajdic DP, James-Martin G, Jones D, Tran CD. Soy and Gastrointestinal Health: A Review. Nutrients. 2023;15(8):1959. 

5. Messina M, Barnes S, Setchell KD. Perspective: Isoflavones—Intriguing Molecules but Much Remains to Be Learned about These Soybean Constituents. Adv Nutr. 2025;16(5):100418. 

6. Wang C, Ding K, Xie X, et al. Soy Product Consumption and the Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2024;16(7):986. 

7. Li N, Wu X, Zhuang W, et al. Soy and Isoflavone Consumption and Multiple Health Outcomes: Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies and Randomized Trials in Humans. Mol Nutr Food Res. 2020;64(4):1900751.

8. Yamamoto S, Sobue T, Kobayashi M, Sasaki S, Tsugane S, For the Japan Public Health Center-Based Prospective Study on Cancer Cardiovascular Diseases (JPHC Study) Group. Soy, Isoflavones, and Breast Cancer Risk in Japan. JNCI J Natl Cancer Inst. 2003;95(12):906-913.

9. Harahap IA, Suliburska J, Karaca AC, Capanoglu E, Esatbeyoglu T. Fermented soy products: A review of bioactives for health from fermentation to functionality. Compr Rev Food Sci Food Saf. 2025;24(1):e70080.

10. Jayachandran M, Xu B. An insight into the health benefits of fermented soy products. Food Chem. 2019;271:362-371. 

11. Papagianni O, Delli E, Vasila ME, et al. The Acute Effect of a Novel Miso-Type Sauce, Enhanced with a Carotenoid-Rich Extract from Fruit By-Products, on Postprandial Biomarkers of Oxidative Stress and Inflammation. Nutrients. 2022;14(6):1316. 

12. Papagianni OI, Dimou C, Koutelidakis AE. Biofunctional Miso-Type Sauce Enhanced with Biocarotenoids: How Does Its Habitual Consumption Affect Lipidemic, Glycemic, and Oxidative Stress Markers? A Pilot Cross-Over Clinical Study. Appl Sci. 2025;15(11):5962. 

13. AVIS de l’Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail relatif à l’élaboration de VTR long terme par voie orale pour les isoflavones, ANSES, 2025. 

14. Dimidi E, Cox SR, Rossi M, Whelan K. Fermented Foods: Definitions and Characteristics, Impact on the Gut Microbiota and Effects on Gastrointestinal Health and Disease. Nutrients. 2019;11(8):1806. 

15. Hashimoto Y, Hamaguchi M, Fukui M. Fermented soybean foods and diabetes. J Diabetes Investig. 2023;14(12):1329-1340. 

16. Ito K, Miyata K, Mohri M, Origuchi H, Yamamoto H. The Effects of the Habitual Consumption of Miso Soup on the Blood Pressure and Heart Rate of Japanese Adults: A Cross-sectional Study of a Health Examination. Intern Med. 2017;56(1):23-29. 

17. Kondo H, Sakuyama Tomari H, Yamakawa S, et al. Long-term intake of miso soup decreases nighttime blood pressure in subjects with high-normal blood pressure or stage I hypertension. Hypertens Res. 2019;42(11):1757-1767.

18. Takahashi F, Hashimoto Y, Kaji A, et al. Association of Estimated Salt and Miso Intake with the Prevalence of Obesity in People with Type 2 Diabetes: A Cross-Sectional Study. Nutrients. 2021;13(9):3014.  

19. Watanabe H. Beneficial Biological Effects of Miso with Reference to Radiation Injury, Cancer and Hypertension. J Toxicol Pathol. 2013;26(2):91-103. 

 

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Kimchi: a blend of fiber and beneficial bacteria

Just like K-Pop, kimchi is impossible to avoid on a trip to Korea—and honestly, you wouldn’t want to. This iconic fermented cabbage turns up at almost every single meal, acting as the undisputed backbone of the Korean dining table. But it's not just a cultural staple anymore; scientists are now giving it serious side-eye and extensive research, thanks to its superpower ability to keep your gut microbiome happy and your overall health in check. 

The gut microbiota
Kimchi: a blend of fiber and beneficial bacteria

Kimchi is a traditional Korean side dish, typically made from cabbage or radishes depending on the recipe.1–3 
Historically, it was prepared in winter using lacto-fermentation—a clever way to preserve vegetables for long periods.4 The cabbage is soaked in brine (a mixture of water and salt) for several weeks, allowing lactic acid bacteria to multiply. By producing lactic acid, these bacteria give kimchi its tangy flavor while naturally preserving it.5 
It shares a resemblance with European sauerkraut—salted, fermented cabbage—though the type of cabbage and spices used are quite different.6 Kimchi is so deeply woven into Korean culture that Kimjang—the communal tradition of preparing vast quantities of kimchi for the winter—was inscribed on UNESCO’s List of Intangible Cultural Heritage of Humanity in 2013. 

Everything You Need to Know About Kimchi

The word ‘kimchi’ originated from ‘chimchae’, the Chinese character, meaning salted vegetables.
Source : Park, 2014.2

42% 
In 2019, 42% of Korean households still produced their own kimchi.
Source : Cha, 2024.4

1,78 MT 
Koreans consumed a total of 1.78 million tons of kimchi in 2020.
Source : Cha, 2024.4

22 
November 22 is designated “Kimchi Day” and was established in 2020 to promote the growth of the kimchi industry, preserve and advance kimchi culture, and raise awareness of kimchi’s nutritional value and importance.
Source : Kim, 2023.7

1500 
According to Samguk sagi, the chronicle of the three kingdoms of Korea, people already consumed kimchi around 1,500 years ago.
Source : Cha, 2024.4

N°1 
Cabbage kimchi was ranked as the most frequently consumed food by Koreans in 2020, with a 55% portion in the Korean diet, indicating that kimchi is consumed more frequently than rice, which is the staple food for Koreans.
Source : Cha, 2024.4

Cabbage + fermentation = a plateful of health benefits

Since it’s made from cabbage, kimchi is low in calories (18 kcal/100g) and rich in beneficial fiber. It also contains a range of compounds characteristic of the Brassicaceae family (the large family that includes cabbage, turnips, radishes, and mustard), whose health benefits may be almost as impressive as their tongue-twisting1(1) names.2,4
Kimchi also provides several vitamins—notably A, C, B1, and B2— as well as minerals—calcium, potassium, iron, and phosphorus.2,4
The health benefits of this Korean dish do not come from cabbage alone, they may also be attributed to the fermentation of the cabbage6 : compared to fresh cabbage, kimchi (fermented cabbage) has been associated with reductions in blood pressure, body fat, fasting blood sugar and total cholesterol… although these findings should be taken with a pinch of salt: the study involved only 22 people.8 
Fermentation also enriches kimchi with live lactic acid bacteria, notably the genera Lactobacillus, Leuconostoc and Weissella , along with the valuable metabolites they produce.2,4,5,7
For example, eating kimchi appears to be associated with an increase in gut bacteria known for producing (sidenote: Short chain fatty acids (SCFA) Short chain fatty acids (SCFA) are a source of energy (fuel) for an individual’s cells. They interact with the immune system and are involved in communication between the intestine and the brain. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020;11:25. ) —molecules recognized for their beneficial effects on gut health and metabolism—and with a reduction in far less desirable bacteria, such as Clostridium and Escherichia coli.9 
More beneficial bacteria, fewer potentially harmful bacteria: kimchi may just be a tasty ally of your gut microbiota . 

Fermented vegetables: good reasons to include them in your diet

Learn more

Caution: effects… and dosage matter!

Given this promising nutritional profile, some researchers have explored the potential links between kimchi consumption and a surprisingly wide range of health outcomes, from obesity, cancer, atopic dermatitis, irritable bowel syndrome, and even cardiovascular health and skin health … 3,6,7,10–14
A few studies have been conducted, but they remain scarce and are often limited to Asian populations. In short, a little caution is warranted when interpreting the results, which remain inconclusive, and even when an effect is observed, it tends to be fairly modest.

Miracle foods do not exist, but a balanced diet does.

For example, with regard to obesity, some studies suggest that kimchi consumption may be associated with a potential beneficial effect. One large study that followed 115,726 Koreans found that moderate kimchi consumption—1 to 3 servings per day (perfectly common in Korea, perhaps a little ambitious for the average Westerner)—was associated with a lower prevalence of obesity, particularly among men. But caution: this does not mean there is a cause-and-effect relationship. Kimchi lovers may simply be Koreans who tend to lead healthier lifestyles overall.1
Nevertheless, another study—this time involving 3 grams of powdered kimchi daily (versus a placebo)—seems to support a potential role for kimchi in weight management.15 Let’s also put this “discovery” into perspective: eating more vegetables has been linked to better weight management for quite some time… 
Of course, as with most things in nutrition, more is not necessarily better: beyond a certain level of consumption, any potential benefits may diminish, because kimchi, due to its recipe, contains a lot of salt, which can contribute to high blood pressure and is a risk factor for stomach cancer.1,2,16 

The daily sodium intake from kimchi consumption in adults aged over 19 years is 500.1 mg/day (15.1% of the total daily sodium intake).
Source : Jung, 2024.1

Check out our series of articles on microbiota and fermented foods:

The many health benefits of fermented foods

Learn more

Kefir: a natural ally for our gut microbiota?

Learn more

Yogurts, the great allies of your gut microbiome

Learn more

Kombucha: marketing hype or scientific claims?

Learn more

The beneficial—and sometimes paradoxical—effects of miso

Learn more

A world tour of fermented foods

Learn more
Sources

1. Jung H, Yun YR, Hong SW, Shin S. Association between kimchi consumption and obesity based on BMI and abdominal obesity in Korean adults: a cross-sectional analysis of the Health Examinees study. BMJ Open. 2024;14(2):e076650. 

2. Park KY, Jeong JK, Lee YE, DailyIII JW. Health Benefits of Kimchi (Korean Fermented Vegetables) as a Probiotic Food. Journal of Medicinal Food. 2014;17(1):6-20. 

3. Song E, Ang L, Lee HW, et al. Effects of kimchi on human health: a scoping review of randomized controlled trials. J Ethn Food. 2023;10(1):7. 

4. Cha J, Kim YB, Park SE, et al. Does kimchi deserve the status of a probiotic food? Critical Reviews in Food Science and Nutrition. 2024;64(19):6512-6525.

5. Bemis DH, Camphausen CE, Liu E, et al. Nutrient Availability and Pathogen Clearance Impact Microbiome Composition in a Gnotobiotic Kimchi Model. Foods. 2025;14(11):1948.

6. Fijan S, Fijan P, Wei L, Marco ML. Health Benefits of Kimchi, Sauerkraut, and Other Fermented Foods of the Genus Brassica. Applied Microbiology. 2024;4(3):1165-1176.

7. Kim HJ, Kwon MS, Hwang H, et al. A Review of the Health Benefits of Kimchi Functional Compounds and Metabolites. Microbiol Biotechnol Lett. 2023;51(4):353-373. 

8. Kim EK, An SY, Lee MS, et al. Fermented kimchi reduces body weight and improves metabolic parameters in overweight and obese patients. Nutrition Research. 2011;31(6):436-443.

9. Kim HY, Park KY. Clinical trials of kimchi intakes on the regulation of metabolic parameters and colon health in healthy Korean young adults. Journal of Functional Foods. 2018;47:325-333.

10. Ahn S, Darooghegi Mofrad M, Nosal BM, Chun OK, Joung H. Effects of Fermented Kimchi Consumption on Anthropometric and Blood Cardiometabolic Indicators: A Systematic Review and Meta-Analysis of Intervention Studies and Prospective Cohort Studies. Nutr Rev. 2025;83(7):e1441-e1457. 

11. Kim HY, Park ES, Choi YS, et al. Kimchi improves irritable bowel syndrome: results of a randomized, double-blind placebo-controlled study. Food & Nutrition Research. Published online May 23, 2022.

12. Cha J, Ko SH, Shin D. Causal effect of kimchi intake on HDL-cholesterol levels in middle aged Korean men: a two-sample Mendelian randomization analysis. Genes Nutr. 2025;20:23.

13. Choi IH, Noh JS, Han JS, Kim HJ, Han ES, Song YO. Kimchi, a Fermented Vegetable, Improves Serum Lipid Profiles in Healthy Young Adults: Randomized Clinical Trial. Journal of Medicinal Food. 2013;16(3):223-229. 

14. Erdoğan F, Toprak K. Kimchi: a traditional fermented food with emerging health implications: Kimchi: ortaya çikan sağlik etkileriyle geleneksel bir fermente gida. Journal of Advanced Studies in Health Science and Obesity. 2026;2(2):1-18. 

15. Lee W, Kwon MS, Yun YR, et al. Effects of kimchi consumption on body fat and intestinal microbiota in overweight participants: A randomized, double-blind, placebo-controlled, single-center clinical trial. Journal of Functional Foods. 2024;121:106401.

16. Yang JY, Kim KE, Cho SJ, Hur C. Kimchi friend or foe: preserving cultural foods developed pre-refrigeration. Preventive Medicine Reports. 2026;61:103357. 

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Kombucha: marketing hype or scientific claims?

Madonna, Kourtney Kardashian, Halle Berry... All Hollywood swears by it. Kombucha is the wonder beverage of the moment, and its fame is spreading across the globe. Time to take a closer look at the fermented tea said to have (too?) many health benefits. 

The gut microbiota
Kombucha: marketing hype or scientific claims?

Kombucha is a non-alcoholic or low alcohol fermented tea-based beverage said to have originated in China around 220 B.C 1. It is prepared using a mixture of bacteria and yeast, which form a “mother” (similar to the process used to make vinegar) that is added to a sugary tea-based solution . In recent years, the drink has been embraced by celebrities, influencers, and marketing gurus, making it popular in Western countries, where it is credited with a wide range of health benefits 1,2.
But what does the science actually say? What health effects have been definitively proven? Should the influencers’ claims or the health promises on certain labels be taken at face value? 

$5 billion

The global kombucha market was valued at approximately $5 billion in 2025, and it continues to grow. 
Source : Andrade et al.1

Why all the hype? 

Science has shown that diet strongly influences the composition and function of our gut microbiota, with potential knock-on effects on the body’s functioning and health 2. There is therefore growing interest in fermented foods in general due to their bioactive compounds and potential benefits. Kombucha is no exception. With its variety of surprisingly tangy flavors, the drink’s reputation is boosted by folklore describing it as the “tea of immortality” 1. However, there remains concern that the influencers and marketers may have jumped the gun a bit, since the results of studies are far from conclusive. 

The kombucha recipe: yeast and bacteria working as a team

Kombucha production begins with the preparation of a sweetened tea: an infusion of black, green, or oolong tea is mixed with table sugar (sucrose). Once this infusion has cooled, a mixture of bacteria and yeast, called a SCOBY* or kombucha “mother,” is added to it.
This thick, gelatinous disc floating on the surface of the tea is like a miniature “biofactory” in which the yeast and bacteria work as a team: 

  • the yeast breaks down the sucrose in the mixture into simple sugars (fructose and glucose), some of which are converted into alcohol and carbon dioxide (which gives the drink its tiny bubbles) ;
  • the bacteria then convert the glucose and alcohol produced by the yeast into various organic acids (lactic, gluconic, and acetic acids), which lower the pH and give the drink its tangy flavor. 

To add variety, fruits, herbs, or spices can be added. 
Source : Andrade et al.1
*SCOBY = Symbiotic Culture Of Bacteria and Yeast . 

Results in humans remain inconclusive 

Some studies conducted on animal models do suggest that consuming the fermented tea may confer health benefits 2: these include antihyperglycemic effects (which limit harmful spikes in blood sugar levels), antioxidant effects (which protect cells from oxidation), and anti-inflammatory effects, as well as changes in the gut microbiota (increased lactobacilli) associated with improved metabolic health. But these results were obtained in animals, not in humans. 

So, what about humans? Intervention studies involving kombucha are few, small in scale, and therefore not very robust. A small number of trials suggest: 

  • a beneficial effect on blood glucose levels: a smaller rise in blood glucose levels after a meal in healthy subjects 3, and a decrease in blood glucose levels in people with diabetes 4. However, another trial found no changes in these parameters, nor in inflammatory markers 2; 
  • a beneficial effect on the gut microbiota of people of normal weight 2,5 and obese individuals 5, with more pronounced effects in the latter group 5 ;
  • an improvement in gastrointestinal symptoms in overweight individuals (green tea kombucha consumed as part of a healthy, low-calorie diet) 6, and in constipation in people with irritable bowel syndrome (beverage rich in fiber and vitamins) 7. 

Irritable Bowel Syndrome and microbiota: is there a link?

Learn more

So, what does this tell us? In 2025, a team set out to compile all the results published to date, a total of 8 clinical trials 8. The verdict? Kombucha may have modest beneficial effects on digestive health and the gut microbiota in some people, as well as on certain biological markers. However, the results are highly inconsistent, and the sample sizes are small, which does not allow for robust conclusions about clinical benefits. Caution is therefore advised... 

Miracle foods do not exist, but a balanced diet does. 

What mechanisms are involved? 

If the health effects are confirmed, what mechanisms could be involved? On the one hand, tea infusions provide potentially beneficial molecules, depending on the type consumed. For example, green tea is rich in catechins 8, molecules which reduce oxidative stress. At the same time, kombucha’s preparation method makes it a source of bacteria (particularly acetic and lactic acid bacteria) and yeasts 2,8. These microorganisms are capable of producing a wide variety of metabolites with potential health benefits 2,8 including:

  • phenolic compounds,
  • organic acids, 
  • vitamins, and more.  

But that’s not all. Consuming the fermented tea may be associated with an increase in our gut microbiota of bacteria that produce  (sidenote: Short chain fatty acids (SCFA) Short chain fatty acids (SCFA) are a source of energy (fuel) for an individual’s cells. They interact with the immune system and are involved in communication between the intestine and the brain. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020;11:25. )  (SCFAs) such as butyrate, acetate, and propionate 2,8. These small fatty acids can enter our bloodstream and are considered particularly beneficial for our gut barrier, ​​​​metabolism and immune system 8. 
Among the species that produce SCFAs, one appears to be specifically associated with kombucha: Weizmannia coagulans (formerly known as Bacillus coagulans), which is thought to colonize, at least temporarily, the gut of those who consume it 2. Bacteria involved in the metabolism of polyphenols, such as Ellagibacter isourolithinifaciens,  are also thought to have a stronger presence​​​​​​​ 2. 
​​​​​​​Again, though, these tentative findings are based on very preliminary research.  

Finally, a few notes of caution 

Kombucha is generally considered safe to drink. However, variability in the microbial composition of “homemade” versions, hygiene practices, and the associated contamination risks are key concerns that require close attention. A few isolated case studies have reported adverse events following prolonged daily consumption, such as nausea, vomiting, or headache 9. Furthermore, ethanol production during fermentation is not negligible. Therefore, caution is advised for pregnant women, young children, immunocompromised individuals, or those with renal failure 9. 

Check out our series of articles on microbiota and fermented foods:

The many health benefits of fermented foods

Learn More

Kefir: a natural ally for our gut microbiota?

Learn more

Yogurts, the great allies of your gut microbiome

Learn more

Kimchi: a blend of fiber and beneficial bacteria

Learn more

The beneficial—and sometimes paradoxical—effects of miso

Learn more

A world tour of fermented foods

Learn more
Sources

1. Andrade DKA, Wang B, Lima EMF, et al. Kombucha: An Old Tradition into a New Concept of a Beneficial, Health-Promoting Beverage. Foods. 2025;14(9):1547. 

2. Ecklu-Mensah G, Miller R, Maseng MG, et al. Modulating the human gut microbiome and health markers through kombucha consumption: a controlled clinical study. Sci Rep. 2024;14(1):31647. 

3. Atkinson FS, Cohen M, Lau K, Brand-Miller JC. Glycemic index and insulin index after a standard carbohydrate meal consumed with live kombucha: A randomised, placebo-controlled, crossover trial. Front Nutr. 2023;10. 

4. Mendelson C, Sparkes S, Merenstein DJ, et al. Kombucha tea as an anti-hyperglycemic agent in humans with diabetes – a randomized controlled pilot investigation. Front Nutr. 2023;10. 

5. Costa MA de C, da Silva Duarte V, Fraiz GM, et al. Regular Consumption of Black Tea Kombucha Modulates the Gut Microbiota in Individuals with and without Obesity. J Nutr. 2025;155(5):1331-1349. 

6. Fraiz GM, Bonifácio DB, Lacerda UV, et al. The Impact of Green Tea Kombucha on the Intestinal Health, Gut Microbiota, and Serum Metabolome of Individuals with Excess Body Weight in a Weight Loss Intervention: A Randomized Controlled Trial. Foods. 2024;13(22):3635. 

7. Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Pilipenko VI, Isakov VA, et al. Efficacy of newly developed kombucha-based specialized food product for treatment of constipation-predominant irritable bowel syndrome. Probl Nutr. 2022;91(5):95-104. 

8. Fraiz GM, Bonifácio DB, de Paulo RS, et al. Benefits of Kombucha Consumption: A Systematic Review of Clinical Trials Focused on Microbiota and Metabolic Health. Fermentation. 2025;11(6):353. 

9. Anantachoke N, Duangrat R, Sutthiphatkul T, Ochaikul D, Mangmool S. Kombucha Beverages Produced from Fruits, Vegetables, and Plants: A Review on Their Pharmacological Activities and Health Benefits. Foods. 2023;12(9):1818. 

 

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Kefir: a natural ally for your gut microbiota?

Slightly fizzy, tangy, and naturally rich in live microorganisms, kefir is becoming a favorite among fermented food enthusiasts. Behind its distinctive flavor is a centuries-old fermented beverage that is now being studied for its potential effects on the gut microbiota. Digestion, immunity, athletic performance, oral health… what does the science really say?

The gut microbiota
Kefir: a natural ally for our gut microbiota?

Kefir is a fermented beverage native to the Caucasus, Eastern Europe, and the Balkans, where people have been drinking it for centuries. Today, kefir is making a worldwide comeback. Made with either water or milk, it is prepared using kefir “grains”: small white or translucent clusters containing a mixture of lactic acid bacteria, acetic acid bacteria, and yeast within a matrix of polysaccharides and proteins.
This microscopic ecosystem transforms milk or sugar water into a tangy, slightly sparkling beverage rich in fermentation-derived compounds that contribute to the drink’s nutritional value.

There are two main types:

  • milk kefir, which has been studied most extensively,
  • and water kefir, typically prepared with sugar water, and sometimes with nuts, dried fruit or lemon.

The composition of kefir varies greatly depending on the grains used, the type of milk or sugar, the temperature, the fermentation time, and storage conditions. This microbial diversity is precisely what makes kefir so beneficial: it may influence our gut microbiota and, through it, a range of key bodily functions—from digestion to immunity—much like other fermented foods such as kombucha 1,2,3,4.

Kefir: is it good for gut health?

Learn more

Does kefir really “feed” our gut microbiota?

Kefir is often described as a “functional food”—one that may provide health benefits beyond its basic nutritional value. Human studies suggest that kefir may have promising effects on the gut microbiota, digestion, certain markers of inflammation, metabolism, and immunity. Its primary site of action appears to be the gut microbiota. By delivering live microorganisms with a probiotic effect, along with compounds produced during fermentation, kefir may help promote a more diverse and active gut microbiota. In particular, some studies have shown an increase in bacteria involved in the production of (sidenote: Short chain fatty acids (SCFA) Short chain fatty acids (SCFA) are a source of energy (fuel) for an individual’s cells. They interact with the immune system and are involved in communication between the intestine and the brain. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020;11:25. ) —molecules that are essential for the intestinal barrier and for communication between the gut microbiota, the immune system, and metabolism 1,2,5. 

That said, caution is still advised: not all kefirs are the same, and studies use very different doses, durations, and recipes. Therefore, kefir shows considerable promise, but we should not yet attribute universal health powers to it, nor should we assume that all products offer the same benefits.

Did you know? Kefir grains are not grains of cereal!

Despite their name, kefir “grains” are small clusters of living microorganisms held together by a natural matrix called kefiran 6. Each grain forms a miniature ecosystem, containing dozens of species of bacteria and yeasts that work together throughout the fermentation process 7. This diversity explains why two differently prepared kefirs never have exactly the same composition. 

Could kefir benefit our oral microbiota? 

Our mouth also has its own microbiota. When this microbiota is out of balance, certain bacteria can contribute to cavities, enamel erosion, and gum disease. Preliminary research suggests that kefir may help promote a more balanced oral environment, particularly by limiting certain bacteria involved in cavity formation, such as Streptococcus mutans. Obviously, kefir is no substitute for brushing, fluoride use, or regular dental checkups. Its potential benefit lies more in its role as a fermented food that can complement good oral hygiene. This is provided that you choose a low-sugar kefir, especially when it is made with sugar water and fruit 8,9.

Does kefir affect the gut-brain axis? 

Like other fermented foods, kefir has attracted scientific interest for its potential effects on the gut-brain axis—the constant communication between our microbiota, our immune system, and our brain. By altering certain gut bacteria and promoting the production of metabolites such as short-chain fatty acids, kefir could help create a less inflammatory environment, that may be conducive to healthy cognitive function.

Researchers are investigating its potential benefits for Alzheimer's disease, with encouraging results regarding inflammation, oxidative stress, and certain mechanisms linked to the toxic accumulation of proteins in the brain. However, this research is still in its very early stages, often conducted on animal or experimental models, and does not yet allow us to conclude that there are direct benefits for humans.

Milk kefir also provides nutrients that contribute to the normal functioning of the nervous system, such as certain B vitamins, choline, and folic acid. However, this research is still in its early stages, and while this fermented beverage remains a valuable part of a balanced diet, further research will be needed before kefir can be considered as a complementary treatment for Alzheimer’s and Parkinson’s diseases 10,11,12,13 . 

Is kefir a real “coach” for athletes? 

Kefir may also have a role to play in sports nutrition. Whether made from cow’s, buffalo’s, donkey’s, or sheep’s milk, fermentation can alter the milk’s protein content, enrich it with bioactive peptides, and enhance certain antioxidant properties. Early findings in athletes are encouraging.
A study conducted among professional female soccer players suggests that daily consumption of kefir (200 mL per day) could modulate the gut microbiota—by increasing the levels of
Akkermansia muciniphila and Faecalibacterium prausnitzii, which are bacteria often linked to short-chain fatty acid production and anti-inflammatory activity—and improve indicators of athletic performance. Studies in mice have also shown a potential effect on post-exercise fatigue.
While the evidence is still limited, kefir can be a good addition to a balanced diet that includes other fermented foods, fruits, and vegetables, as well as unsweetened beverages 
14,15,16.

Could one gut bacterium replace a gym membership?

Learn more

Kefir checks a lot of boxes: a long history, a rich microbial diversity, compounds derived from fermentation, and a potential effect on the gut and oral microbiota. It shows promising results on certain metabolic, immune, cognitive, and athletic markers, but many of these findings need to be confirmed in humans. The right tactic? Enjoy it as a healthy fermented food that isn't too sweet, in reasonable amounts—for example, 100 to 200 mL a day to start.

To put it simply, kefir is not a miracle elixir. But when incorporated into a varied diet, along with sleep, physical activity, and a healthy lifestyle, it can become a simple and natural ally for your gut microbiota!

Miracle foods do not exist, but a balanced diet does. 

Check out our series of articles on microbiota and fermented foods:

The many health benefits of fermented foods

Learn more

Yogurts, the great allies of your gut microbiome

Learn more

Kombucha: marketing hype or scientific claims?

Learn more

Kimchi: a blend of fiber and beneficial bacteria

Learn more

The beneficial—and sometimes paradoxical—effects of miso

Learn more

A world tour of fermented foods

Learn more
Sources

1. Sabina Fijan, Petra Povalej Bržan, Maja Šikić Pogačar, Petra Klanjšek. Kefir Consumption and Health Effects Based on Human Clinical Trials: An Overview of Literature. Healthcare (Basel). 2026 Mar 4;14(5):652.

2. Yejin Choi, Gi Beom Keum, Juyoun Kang, Hyunok Doo, Jinok Kwak, Haram Kim, Yeongjae Chae, Suyoung Lee, Hyunjin Yang, Sheena Kim, Xingmin Sun, Hyeun Bum Kim, Soo Jin Yoo. Evaluation of kefir consumption on gut microbial diversity in a healthy young population using full-length 16S rRNA sequencing. Front Microbiol. 2025 May 21;16:1587831. 

3. Marta Calatayud, Rosa Aragao Börner, Jonas Ghyselinck, Lynn Verstrepen, Jelle De Medts, Pieter Van den Abbeele, Claire L Boulangé, Sarah Priour, Massimo Marzorati, Sami Damak. Water Kefir and Derived Pasteurized Beverages Modulate Gut Microbiota, Intestinal Permeability and Cytokine Production In Vitro. Nutrients. 2021 Oct 29;13(11):3897. 

4. Nor Farahin Azizi, Muganti Rajah Kumar, Swee Keong Yeap, Janna Ong Abdullah, Melati Khalid, Abdul Rahman Omar, Mohd Azuraidi Osman, Sharifah Alawieyah Syed Mortadza, Noorjahan Banu Alitheen. Kefir and Its Biological Activities. Foods. 2021 May 27;10(6):1210. 

5. Mel R, Al Khafaji AH, Muthusamy S, et al. Changes in gut microbiota composition following water kefir consumption in healthy adults. Sci Rep 2026;16:16006. 

6. Azizi, N. F., Kumar, M. R., Yeap, S. K., Abdullah, J. O., Khalid, M., Omar, A. R., Osman, M. A., Mortadza, S. A. S., & Alitheen, N. B. Kefir and Its Biological Activities. Foods, (2021) 10(6), 1210. 

7. Bourrie BCT, Willing BP and Cotter PD. The Microbiota and Health Promoting Characteristics of the Fermented Beverage Kefir. Front. Microbiol. (2016) 7:647. doi: 10.3389/fmicb.2016.00647

8. Anna González-Rascón, Elda Georgina Chávez-Cortéz, Angélica Hurtado-Camarena, Nicolás Serafín-Higuera, Sandra Castillo-Uribe, Víctor Manuel Martínez-Aguilar, Bertha Arelly Carrillo-Ávila, Viviana Pitones-Rubio. Evaluating the Impact of Kefir Consumption on Dental Caries and Periodontal Disease: A Narrative Review. Dent J (Basel). 2025 Feb 18;13(2):86. 

9. Eleni Grace Black, Andrea Bugarcic, Romy Lauche, Emad El-Omar, Fatima El-Assaad. The Effects of Kefir on the Human Oral and Gut Microbiome. Nutrients. 2025 Dec 11;17(24):3861. 

10. Yuri Castelo Branco Tanure, Ana Clara Morais Mafra, Bruna Luiza Motta Guimarães, Rafael Coelho Magalhãe, Catherine Fagundez, Israel Júnior Borges do Nascimento, Julio Cesar Moreira Brito. Potential benefits of kefir and its compounds on Alzheimer's disease: A systematic review. Brain Behav Immun Integr . 2025 Apr:10:100115.

11. Matheus H Silva, Letícia L Batista, Serena M Malta, Ana C C Santos, Ana P Mendes-Silva, Ana M Bonetti, Carlos Ueira-Vieira, Anderson R dos Santos. Unveiling the Brazilian kefir microbiome: discovery of a novel Lactobacillus kefiranofaciens (LkefirU) genome and in silico prospection of bioactive peptides with potential anti-Alzheimer properties. BMC Genomics. 2024 Sep 20;25:884. 

12. Ellen J Gates, Anna K Bernath, Andis Klegeris. Modifying the diet and gut microbiota to prevent and manage neurodegenerative diseases. Rev Neurosci. 2022 Mar 21;33(7):767-787. Print 2022 Oct 26.

13. Letícia Leandro Batista, Serena Mares Malta, Heitor Cappato Guerra Silva, Luiza Diniz Ferreira Borges, Lays Oliveira Rocha, Jéssica Regina da Silva, Tamiris Sabrina Rodrigues, Gabriela Venturini, Kallyandra Padilha, Alexandre da Costa Pereira, Foued Salmen Espindola, Carlos Ueira-Vieira. Kefir metabolites in a fly model for Alzheimer’s disease. Sci Rep. 2021 May 27;11:11262. 

14. Ece Öneş, Mutlucan Zavotçu, Nida Nisan, Murat Baş, Duygu Sağlam. Effects of Kefir Consumption on Gut Microbiota and Athletic Performance in Professional Female Soccer Players: A Randomized Controlled Trial. Nutrients. 2025 Jan 30;17(3):512. 

15. Chiara La Torre, Paolino Caputo, Erika Cione, Alessia Fazio. Comparing Nutritional Values and Bioactivity of Kefir from Different Types of Animal Milk. Molecules. 2024 Jun 6;29(11):2710. 

16. Yi-Ju Hsu, Wen-Ching Huang, Jin-Seng Lin, Yi-Ming Chen, Shang-Tse Ho, Chi-Chang Huang, Yu-Tang Tung. Kefir Supplementation Modifies Gut Microbiota Composition, Reduces Physical Fatigue, and Improves Exercise Performance in Mice ; Nutrients . 2018 Jul 4;10(7):862. 

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The hidden connection: how your microbiome impacts fertility

The communities of bacteria that inhabit the vagina, uterus, gut, and semen play an important role in fertility. Could targeting microbiota with therapies such as probiotics improve the chances of success of assisted reproductive technologies (ART)?

The vaginal microbiota The gut microbiota
The Hidden Connection: How Your Microbiome Impacts Fertility

Infertility affects approximately 1 in 10 couples. But a new discovery 1 could bring them hope: the tiny bacteria that live in our bodies may play a key role in our ability to conceive. These communities interact with our immune system, our hormones, and our metabolism.

12 Infertility is generally defined as the failure of a couple of reproductive age to achieve pregnancy after 12 months of regular unprotected intercourse ¹.

8-12% Infertility affects an estimated 8–12% of couples worldwide, making it a major reproductive health issue ¹.

For women and men: a matter of balance

In women, a healthy vaginal microbiota is dominated by beneficial bacteria called Lactobacillus, particularly the species L. crispatus. These bacteria are allies of our intimate health by maintaining an acidic environment, limiting inflammation, and promoting the uterus’s receptivity to pregnancy. When this balance is disrupted (vaginal dysbiosis), other bacteria associated with an imbalance become more abundant: the vaginal pH rises, inflammation increases, potentially impairing sperm motility, embryo implantation and immune tolerance between the mother and the fetus.

The uterus is also believed to have its own microbiota. The presence of beneficial bacteria in the endometrium is thought to improve pregnancy rates, while certain pathogens are thought to reduce them. However, these findings remain controversial, because the samples are difficult to analyze and are highly susceptible to contamination.

In men, semen also contains its own microbiota. When beneficial bacteria dominate, they produce fewer inflammatory compounds and protect spermatic DNA. Conversely, certain pathogenic bacteria may increase inflammation and slow sperm motility. However, studies linking seminal microbiota to male fertility are still limited and require further research.

The gut: the hidden conductor?

The gut microbiota may also influence fertility through the immune system, hormones, and metabolism. In women with polyendocrine ovarian metabolic syndrome (formerly polycystic ovary syndrome), an imbalance in the gut microbiota seems to promote inflammation, insulin resistance, and hormonal disruptions. Another example is endometriosis, a condition associated with gut dysbiosis that may also alter estrogen metabolism, enhance inflammation, and contribute to the growth of lesions which could potentially affect the embryo’s ability to implant in the uterus.

Polyendocrine ovarian metabolic syndrome (formerly polycystic ovary syndrome)

Polycystic ovary syndrome was renamed polyendocrine ovarian metabolic syndrome (POMS) in May 2026. It is a condition associated with hormonal and metabolic imbalances that affects 1 in 8 women.
Most symptoms of POMS appear early, often during puberty, they include:

  • excessive testosterone production, which manifests notably as excessive hair growth in 70% of affected women ; 
  • acne, and hair loss ;
  • ovulatory disorders ;
  • and polycystic ovaries.

 The persistent hormonal imbalance leads to the development of multiple small follicles as well as irregular menstrual cycles, which can ultimately lead to infertility in women 2.

How can balance be restored?

As a preventive measure, it is important to avoid any practices that may disrupt your vaginal or seminal microbiota and your gut microbiota. In the event of a confirmed bacterial infection (vaginosis), your doctor may prescribe appropriate treatment.
Approaches aimed at modulating microbiota to restore balance – such as probiotics – are also being investigated, but their impact on pregnancy outcomes remain uncertain. As for microbiota transplantations, they are still limited to clinical research. In the future, microbiota profiling could help better personalize care for couples undergoing assisted reproductive technology (ART) cycles. However, this approach remains under evaluation and requires more robust scientific evidence before it can be incorporated into standard clinical practice.

Practices that put your vaginal microbiota at risk

Learn more
Sources

1.Du B, Yang Y, He L, Tang Y. Microbiota and infertility: a translational review of mechanisms and clinical applications in assisted reproduction. Eur J Obstet Gynecol Reprod Biol. 2026 Feb 20;318:114941. doi: 10.1016/j.ejogrb.2026.114941.

2.Teede HJ, Khomami MB, Morman R et al. Global Name Change Consortium. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026 Jun 6;407(10545):2329-2339. doi: 10.1016/S0140-6736(26)00717-8. 

 

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Yogurts, the great allies of your gut microbiome

Are you a regular yogurt, Greek yogurt, or skyr fan? These dairy specialties have one thing in common: they help support a healthy gut microbiota. Produced on a large scale for nearly a century, dairy products have become a staple of everyday diets and help keep us healthy by supporting our microbiota and digestion.

The gut microbiota

Although fermented milk products have existed for millennia—as evidenced by traces of lactic fermentation found in pottery dating back to 8000-7000 BC—it wasn’t until the early 20th century that Stamen Grigorov and Elie Metchnikoff identified a bacterium essential to yogurt production 1.

Today, in most parts of the world, the term yogurt refers to a fermented milk product made through the combined action of two bacteria:

  • Streptococcus thermophilus
  • Lactobacillus bulgaricus.

These lactic acid bacteria work in symbiosis and are essential to yogurt production through the process of milk fermentation. It can be made from cow’s or sheep’s milk, plain or flavored, stirred or enriched with cream…
While recipes, spellings, textures, and pronunciations may differ, they all trace back to the Turkish root yoğurt, found in the verb “yoğurmak” meaning “to thicken”. Only skyr follows a slightly different tradition: originating in Norway and Iceland, it is a strained yogurt made from skim milk, with a denser texture. Very low in fat and particularly high in protein—about twice as much as regular yogurt—it has a particularly appealing nutritional profile 2.

Beyond their differences, all of these yogurts share nutritional benefits worth exploring in more detail to better understand their effects on health, digestion, and microbiota.

What foods promote a balanced microbiota?

Learn more

They help make our gut a more hospitable place

The first benefit of yogurt is that it reshapes the population of microorganisms in our gut. This is because Streptococcus thermophilus and Lactobacillus bulgaricus are probiotics that help maintain the balance and diversity of the gut microbiota 3,4.This diversity goes hand in hand with a healthy and well-functioning microbiota, which ensures good digestion and a stronger immune system.

Not all fermented foods are probiotics…

To be considered probiotics, fermented foods must contain live microorganisms that are precisely identified (down to the exact strain!) and present in sufficient quantities. And above all, the health benefits of these microorganisms must be scientifically proven through clinical studies… However, some products may be labeled “contains probiotics”, as is the case with yogurt thanks to its two key bacteria! 

The safety and purity of the strains are guaranteed in this type of industrially produced food, as is the viability of the strains throughout the yogurt’s shelf life.

They help protect us from minor colds

Thanks to the probiotics they contain, yogurts could help support the gut’s immune defenses. Their bacteria help maintain a balanced gut microbiota, limit the growth of certain unwanted microorganisms, and strengthen the intestinal lining. Some studies also suggest improved regulation of the immune response and a reduction in certain digestive infections, but these effects vary depending on the product consumed, the strains it contains, and the individual 5,6.
As a result, regular yogurt consumption could help lower the risk of gastrointestinal infections… and even common colds in older adults! One study has found that consuming 90 g of yogurt daily boosts the immune system and protects against infections 7!

They help fight diabetes

For several years now, scientists have observed that regular consumption of dairy products—particularly plain yogurt (mainly made from cow’s milk, typically 80 to 125 g per day)—is associated with a lower risk of developing type 2 diabetes. According to the International Diabetes Federation, type 2 diabetes mellitus currently affects around 11% of the world's population. This protective effect may occur through the gut microbiota, regardless of whether the yogurt is high-fat or low-fat 8,9.


They help shed excess weight

Regular yogurt consumption has also been associated with less long-term weight gain compared with people who never eat yogurt 10. This may be partly explained by yogurt’s high protein content, which promotes satiety and helps better regulate appetite 11.
Yogurt is also a good source of calcium—from milk—, which may play a role in metabolism. Some data suggest that calcium helps modulate the gut microbiota and strengthen the intestinal barrier, thereby limiting the inflammatory processes involved in obesity 12.
Finally, results from the PREDIMED study indicate that daily yogurt consumption is also associated with lower abdominal obesity, further supporting the idea of a beneficial effect on body composition 13.

They help combat lactose intolerance

Yogurt is also a must-have for anyone dealing with lactose intolerance caused by cow’s milk. With fermentation, the bacterium Lactobacillus bulgaricus converts lactose into lactic acid, making it much easier to digest. This process helps restore the gut’s pH balance and reduces symptoms of digestive disorders such as constipation, bloating, and diarrhea, which can often cause abdominal pain 14,15. Eat as much as you like—your digestive system will thank you!


They help keep our hearts healthy

Yogurt has another ace up its sleeve: it protects our cardiovascular system over the long term. Scientists have found that eating one to two yogurts a day reduces the risk of developing high blood pressure by 10% to 20% 16. They have reached similar conclusions regarding heart attacks and stroke-related mortality, specifically with whole-milk yogurt 17,18.
 

The Mediterranean diet: good for the body, good for the heart

Learn more

They help us strengthen our bones

Daily yogurt consumption is associated with stronger bones, thanks to an increased bone density (+3 to 4%) and a reduced risk of osteoporosis (up to -39% in women and -52% in men) 19. These benefits seem to be linked to yogurt’s high calcium and protein content, and potentially its positive impact on the gut microbiota 20,21.


Do they bring us closer to immortality?

Could yogurt actually extend our life expectancy? A study of a woman who lived to be 117 years old revealed a surprisingly “young” gut microbiota, associated with good overall health. Her regular consumption of yogurt may have contributed to the presence of beneficial bacteria such as Bifidobacterium 22.

More broadly, research shows that the microbiota plays a crucial role in aging by influencing immunity, inflammation, and overall health 23. While these results are still preliminary and do not prove a direct link between yogurt and longevity… they’re still a good excuse to have another one, just in case science has a few more surprises in store for us!

Miracle foods do not exist, but a balanced diet does. 

Check out our series of articles on microbiota and fermented foods:

The many health benefits of fermented foods

Learn more

Kefir: a natural ally for our gut microbiota?

Learn more

Kombucha: marketing hype or scientific claims?

Learn more

Kimchi: a blend of fiber and beneficial bacteria

Learn more

The beneficial—and sometimes paradoxical—effects of miso

Learn more

A world tour of fermented foods

Learn more
Sources

1. Hiol, Anne, and Patrick Veiga. “From the Laboratory to the Plate: How Gut Microbiome Science Is Reshaping Our Diet.” The Journal of Nutrition, vol. 155, no. 11, Nov. 2025, pp. 3595–3605. 

2. Ajmera, Rachael. “Why Skyr Is Nutritious and Super Healthy.” Healthline, 11 Mar. 2017.

3. Le Roy, Caroline Ivanne, et al. “Correction to: Yoghurt Consumption Is Associated with Changes in the Composition of the Human Gut Microbiome and Metabolome.” BMC Microbiology, vol. 22, no. 1, 2022, p. 66.

4. Ma, Guangyu, et al. “Effect of Probiotic Administration during Pregnancy on the Functional Diversity of the Gut Microbiota in Healthy Pregnant Women.” Microbiology Spectrum, vol. 12, no. 6, 2024, e00413-24. 

5. Leeuwendaal, Noortje K., et al. “Fermented Foods, Health and the Gut Microbiome.” Nutrients, vol. 14, no. 7, 2022, p. 1527.

6. Marco, Maria L., et al. “Health Benefits of Fermented Foods: Microbiota and Beyond.” Current Opinion in Biotechnology, vol. 44, 2017, pp. 94–102.

7. Makino, Seiya, et al. “Reducing the Risk of Infection in the Elderly by Dietary Intake of Yoghurt Fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1.” British Journal of Nutrition, vol. 104, no. 7, 2010, pp. 998–1006.

8. Chen, Mu, et al. “Dairy Consumption and Risk of Type 2 Diabetes: 3 Cohorts of US Adults and an Updated Meta-Analysis.” BMC Medicine, vol. 12, no. 1, 2014, p. 215. 

9. Aune, Dagfinn, et al. “Dairy Products and the Risk of Type 2 Diabetes: A Systematic Review and Dose-Response Meta-Analysis of Cohort Studies.” The American Journal of Clinical Nutrition, vol. 98, no. 4, 2013, pp. 1066–1083. 

10. Sayon-Orea, Carmen, et al. “Associations between Yogurt Consumption and Weight Gain and Risk of Obesity and Metabolic Syndrome: A Systematic Review.” *Advances in Nutrition*, vol. 8, no. 1, 2017, pp. 146S–154S.

11. Tremblay, Angelo, and Shirin Panahi. “Yogurt Consumption as a Signature of a Healthy Diet and Lifestyle.” The Journal of Nutrition, vol. 147, no. 7, 2017, pp. 1476S–1480S. 

12. Gomes, J. M. G., et al. “Could the Beneficial Effects of Dietary Calcium on Obesity and Diabetes Control Be Mediated by Changes in Intestinal Microbiota and Integrity?” British Journal of Nutrition, vol. 114, no. 11, 2015, pp. 1756–1765. 

13. Santiago, S., et al. “Yogurt Consumption and Abdominal Obesity Reversion in the PREDIMED Study.” Nutrition, Metabolism and Cardiovascular Diseases, vol. 26, no. 6, 2016, pp. 468–475. 

14. Ibrahim, Salam A., et al. “Fermented Foods and Probiotics: An Approach to Lactose Intolerance.” Journal of Dairy Research, vol. 88, no. 3, 2021, pp. 357–365.

15. Savaiano, Dennis A. “Lactose Digestion from Yogurt: Mechanism and Relevance.” The American Journal of Clinical Nutrition, vol. 99, no. 5, 2014, pp. 1251S–1255S.

16. Buendia, Justin R., et al. “Long-Term Yogurt Consumption and Risk of Incident Hypertension in Adults.” Journal of Hypertension, vol. 36, no. 8, 2018, pp. 1671–1679. 

17. Warensjö, Eva, et al. “Biomarkers of Milk Fat and the Risk of Myocardial Infarction in Men and Women: A Prospective, Matched Case-Control Study.” The American Journal of Clinical Nutrition, vol. 92, no. 1, 2010, pp. 194–202. 

18. Goldbohm, R. Alexandra, et al. “Dairy Consumption and 10-Year Total and Cardiovascular Mortality: A Prospective Cohort Study in the Netherlands.” The American Journal of Clinical Nutrition, vol. 93, no. 3, 2011, pp. 615–627. 

19. Laird, E., et al. “Greater Yogurt Consumption Is Associated with Increased Bone Mineral Density and Physical Function in Older Adults.” Osteoporosis International, vol. 28, no. 8, 2017, pp. 2409–2419. 

20. Orwoll, Eric S., et al. “Analysis of the Associations between the Human Fecal Microbiome and Bone Density, Structure and Strength: The MrOS Cohort.” Journal of Bone and Mineral Research, vol. 37, no. 4, 2022, pp. 597–607.

21. Wang, Jihan, et al. “Diversity Analysis of Gut Microbiota in Osteoporosis and Osteopenia Patients.” PeerJ, vol. 5, 2017, e3450. 

22. Santos-Pujol, E., et al. “The Multiomics Blueprint of the Individual with the Most Extreme Lifespan.” Cell Reports Medicine, vol. 6, no. 10, 2025, 102368. 

23. Kadyan, S., et al. “Microbiome-Based Therapeutics towards Healthier Aging and Longevity.” Genome Medicine, vol. 17, no. 1, 2025, p. 75.
 

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Impact of microbiota on reproductive health

The composition of the vaginal, gut, and seminal microbiota may play a key role in the success of assisted reproductive technology (ART) treatments. These microbial ecosystems have emerged as a promising avenue for improving the likelihood of treatment success.

Impact of microbiota on reproductive health

Infertility, whether affecting males or females, is a major global health concern, with an estimated prevalence of 8 to 12% of the population. Research 1 on microbiota has provided new insights into reproductive health by identifying microbial communities that interact with the host at the metabolic, immune, and endocrine levels.

8-12% Infertility affects an estimated 8–12% of couples worldwide, making it a major reproductive health issue ¹.

12 Infertility is generally defined as the failure of a couple of reproductive age to achieve pregnancy after 12 months of regular unprotected intercourse ¹.

Key role of microbiota in the reproductive systems

In women, a vaginal microbiota dominated by Lactobacillus (particularly L. crispatus) is associated with an acidic pH, reduced inflammation, and an endometrium conducive to embryo implantation. Conversely, vaginal dysbiosis is associated with an elevated pH, increased production of pro-inflammatory metabolites, and impaired sperm motility, embryo implantation, and maternal-fetal immune tolerance. The endometrium is also thought to host a low-biomass microbiota. The presence of Lactobacillus is associated with improved reproductive outcomes (conception, implantation, clinical pregnancy, or live births), whereas Atopobium or Gardnerella are more frequently associated with failure.

In men, the seminal microbiota influences sperm quality: Lactobacillus is associated with lower production of oxidative compounds and better sperm DNA integrity, whereas Prevotella and Streptococcus are associated with inflammation and impaired sperm motility. However, evidence linking the seminal microbiota to male infertility is still emerging, as findings are often limited by small sample sizes and substantial inter-individual variability.

The gut microbiota is also involved

The gut microbiota may also influence fertility through immune, endocrine, and metabolic pathways. For example, in polyendocrine ovarian metabolic syndrome (formerly polycystic ovary syndrome), gut dysbiosis (characterized by reduced microbial diversity, increased Escherichia, decreased Lactobacillus) appears to promote inflammation, insulin resistance, and hormonal imbalances through the translocation of lipopolysaccharides (LPS) across the intestinal barrier and the disruption of intestinal enzymes. 

Polyendocrine ovarian metabolic syndrome (formerly polycystic ovary syndrome)

Polycystic ovary syndrome (PCOS), which affects one in eight women, was renamed polyendocrine metabolic ovarian syndrome (PMOS) in May 2026. The new name better reflects the endocrine, metabolic, and ovarian nature of this multisystemic disease by removing a misleading reference to “polycystic ovaries,” which has led to delayed diagnoses and stigmatization 2.

What mechanisms and interventions are involved?

The vaginal, uterine, intestinal, and seminal microbiota are thought to influence fertility through immuno-inflammatory and endocrine-metabolic mechanisms, as well as by maintaining a protective barrier effect.
Several approaches are being investigated to optimize microbiota prior to assisted reproductive technology (ART) treatments:

  • antibiotics are effective for treating confirmed infections (chronic endometritis, vaginosis); some studies have reported improved clinical pregnancy rates following antibiotic treatment – sometimes doubling pregnancy rates in IVF – but antibiotic therapy also depletes beneficial Lactobacillus ;
  • probiotics (oral or intravaginal) can partially restore microbial balance, although their effects on pregnancy outcomes remain inconsistent ;
  • emerging therapies (fecal or vaginal transplantation) are promising but remain experimental and require well-controlled clinical trials.

Microbiota profiling could therefore become a valuable component of ART protocols by refining patient stratification and guiding targeted adjuvant therapies. However, before implementation, stronger causal evidence, validated biomarkers, and standardized methodological frameworks are required.

Sources

1.Du B, Yang Y, He L, Tang Y. Microbiota and infertility: a translational review of mechanisms and clinical applications in assisted reproduction. Eur J Obstet Gynecol Reprod Biol. 2026 Feb 20;318:114941. doi: 10.1016/j.ejogrb.2026.114941.

2.Teede HJ, Khomami MB, Morman R et al. Global Name Change Consortium. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026 Jun 6;407(10545):2329-2339. doi: 10.1016/S0140-6736(26)00717-8.

 

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Colorectal cancer: could bacteria within tumors predict disease progression?

Bacteria found directly within colorectal tumors may help predict how the disease will progress. This is the conclusion of a large international study published in late 2025, focused on a cancer that affects nearly 48,000 people in France each year.

The gut microbiota
Colorectal cancer: could bacteria within tumors predict  disease progression?

A common cancer among people over 50

Colorectal cancer affects the colon or rectum and is the second leading cause of cancer-related death worldwide, according to the WHO 1.

47 582 In France, 47,582 new cases were diagnosed in 2023 – 95% of which occurred in people over the age of 50, with men accounting for 55% of cases and women 45% ².

This disease results from an abnormal transformation of colorectal cells that multiply uncontrollably.
Known risk factors include:

  • age,
  • family history,
  • and certain inflammatory bowel diseases.

But researchers have begun to investigate another potential factor: bacteria present directly within tumor tissues. 

Subtypes of colorectal cancer

Colorectal cancer is not a homogeneous group. Scientists have established a classification into four molecular subtypes (CMS1 through CMS4), based on:

  • biological characteristics,
  • behavior,
  • and response to treatments 4.

This classification helps physicians better tailor treatment to each patient. 

CMS1
  • Highly mutated tumors
  • with strong immune response,
  • typically located in the right side of the colon.

In the study, CMS1 tumors showed an enrichment of several Fusobacterium subspecies and bacteria of oral origin compared to the other subtypes.

CMS2

The most common subtype.
In this subtype, the presence of the
pks genetic module and the abundance of Enterobacteriaceae are associated with a poorer prognosis.

CMS3

Tumors with specific metabolic abnormalities.

CMS4

A subtype associated with a poorer overall prognosis and a higher risk of metastases. In the study, the presence of specific Fusobacterium subspecies was associated with worse clinical outcomes for this subtype.

Bacteria at the heart of the tumor

It has long been established that the human gut is home to billions of microorganisms – the gut microbiota – which play a key role in immune system and overall health.

Gut microbiota: our immune system’s best friend

Learn more

A study 3 published in Nature Communications in December 2025, involving 937 Swedish patients, found that bacteria are also present directly within tumor tissues, alongside colorectal cancer cells. 

Using an advanced sequencing technique, researchers identified 361 bacterial species in the tumors and adjacent tissues, including:

  • several genera from the Enterobacteriaceae family (notably E. coli),
  • several genera within the Firmicutes phylum,
  • as well as the genera Fusobacterium, Akkermansia and Treponema.

The findings suggest that specific microbial profiles are associated with poorer clinical outcomes: for example, pks+ strains of E. coli were found in 17.4% of the tumors analyzed. These bacteria carry a genetic module –pks – which enables the production of colibactin, a toxin which directly attacks the DNA of colon cells.

The colon: a key organ

The colon is the final section of the intestine. It is approximately 5 feet long and is divided into several sections:

  • the ascending colon,
  • the descending colon,
  • and the rectum. 

Colorectal cancer develops in the lining of the colon or rectum where the gut microbiota – composed of billions of bacteria that play a vital role in human health – also resides. 

The researchers also observed that some bacteria present inside tumors appear to interact with the local immune system by activating inflammatory pathways, a mechanism known to promote tumor progression.
These associations were consistently observed across multiple patient cohorts, which reinforces the reliability of the findings.

Promising results

Based on these observations, the researchers developed a risk score based on the bacterial composition of colorectal tumors.
This score can help predict how the disease is likely to progress in a patient, complementing existing diagnostic tools – regardless of
 :

  • age,
  • cancer stage,
  • or the tumor’s genetic characteristics.

Ultimately, the bacterial profile of colorectal tumors could become a valuable tool to aid in prognosis and patient monitoring, and pave the way for new therapeutic strategies targeting the immune system and microbiota.
However, these results remain correlational and further studies are needed to confirm the underlying mechanisms. 

Sources

1. PAHO-Bilan mondial du cancer.
2. Ameli-Cancer colorectal.
3. Shi Z. et al. Tissue-resident microbiota impacts colorectal cancer progression and prognosis. Nature Communications, 2026, 17:346. https://doi.org/10.1038/s41467-025-67047-2.
4. Guinney J. et al. The consensus molecular subtypes of colorectal cancer. Nature Medicine, 2015, 21(11), 1350–1356. https://doi.org/10.1038/nm.3967.

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