Fermented dairy products are formed during the acidification of milk through fermentation by suitable microorganisms; it contains different microorganisms in sufficient numbers and in an active state. A wide range of fermented milk products are produced and consumed around the world, including yogurt, kefir, koumiss, and yogurt beverages. There are various health benefits associated with the consumption of fermented dairy. Many studies reported that some fermented milk products have antimicrobial, antimutagenic, anticarcinogenic, and antihypertensive properties as well as provide benefits on mineral metabolism, reduce lactose intolerance symptoms and cholesterol levels. In addition to these effects, it has many other beneficial effects such as positive effects on type 2 diabetes and hypertension, antimutagen and antioxidant effects, and reduction of allergic symptoms. Dairy products including fermented milk are known to be the main carrier of probiotic microorganisms, and many clinical studies show the effects of probiotic strains on health. In this study, the effects of fermented milks on human nutrition and health are mentioned.

(1) Background: The human microbiota is essential for maintaining a healthy body. The gut microbiota plays a protective role against pathogenic bacteria. Probiotics are live microorganisms capable of preventing and controlling gastrointestinal and balancing the immune system. They also aid in better nutrients and vitamins absorption. Examples of natural probiotic cultures are kefir and kombucha. (2) Methods: Therefore, the aim of this review was to address the beneficial properties of probiotic kefir and kombucha using a Boxplot analysis to search for scientific data in the online literature up to January 2024: (Latin American and Caribbean Health Sciences (LILACS), PubMed, Medical Literature Analysis (MED-LINE), Science Direct, Google Scholar/Google Academic, Bioline Inter-national and Springer Link). Boxplots showed the summary of a set of data \"Index Terms-Keywords\" on kefir and kombucha in three languages (English, Portuguese and Spanish). (3) Results: Google Scholar was the database with the highest number of articles found, when the search for the keywords used in the study (containing ~4 × 106-~4 million articles available). This was Followed by the Science Direct database, containing ~3 × 106-~3 million articles available, and the BVS databases-Biblioteca Virtual de Saúde (Virtual Health Library) e Lilacs, both containing a value of ~2 × 106-~2 million articles available. The databases containing the smallest number of articles found were Nutrients and Medline, both containing a value of ≤0.1 × 106-≤100 thousand articles. (4) Conclusions: Scientific studies indicate that kefir and kombucha certainly contain various functional properties, such as antimicrobial, antitumor, anticarcinogenic and immunomodulatory activity, in addition to having a microbiological composition of probiotic bacteria and yeasts. Kefir and kombucha represent key opportunities in the food and clinic/medical fields.

Although milk kefir and water kefir have different physical, chemical and microbiological characteristics, several microbial species that make up kefir stand out with probiotic functions. Furthermore, because it is suitable for a variety of substrates, kefir and the species of probiotic microorganisms that make it up are seen as a promising alternative in the development of probiotic and health-promoting foods. The aim of this study was to carry out a bibliometric analysis of water kefir and milk kefir in probiotic foods and to critically analyze recent applications and prospects. Using the Scopus database, 202 documents published between 2013 and 2022 were identified and submitted to bibliometric analysis using the VOSviewer software. Regarding recent applications, 107 documents published between 2021 and June 2023 were identified. It was observed that, in the literature consulted, no study used bibliometric analysis to evaluate the use of water kefir and milk kefir in probiotic foods. Due to the presence of probiotic species, kefir has been listed as an alternative for the production of new probiotic food matrices that are beneficial to health. Recent applications show kefir\'s potential in the development of probiotic products based on fruit and fruit juice, whey beverages, fermented milks and derivatives, and alcoholic beverages such as beers.

Beverage fermentation is an ancient ritual that has been practised for millennia. It was slowly disappearing from households and communities due to the advancement of manufacturing technology and the marketing of soft drinks until the recent revival of the beverage fermentation culture due to an increase in the demand for health drinks amid the COVID-19 pandemic. Kombucha and kefir are two well-known fermented beverages that are renowned for their myriad of health benefits. The starter materials for making these beverages contain micro-organisms that act like microscopic factories producing beneficial nutrients that have antimicrobial and anticancer effects. The materials modulate the gut microbiota and promote positive effects on the gastrointestinal tract. Due to wide variations in the substrates and types of micro-organisms involved in the production of both kombucha and kefir, this paper compiles a compendium of the micro-organisms present and highlights their nutritional roles.

BACKGROUND: Kefir consumption has been associated with immune response modulation, antioxidant, and anti-inflammatory effects.
OBJECTIVE: The objective of this systematic review was to investigate the role of kefir against inflammation and the main response mechanisms involved in this process in a murine model.
METHODS: The searches were searched in the PubMed, Science Direct, and LILACS databases. Only murine model studies, according to PRISMA guidelines, published in the past 10 years were included.
METHODS: Only articles about original and placebo-controlled experiments in murine models used to investigate the anti-inflammatory mechanisms of kefir were considered. Of the articles found, 349 were excluded according to the following criteria: duplicate articles (n = 99), off-topic title and abstract (n = 157), reviews (n = 47), studies in vitro (n = 29), and studies with humans (n = 17). In total, 23 studies were included in this review.
METHODS: Two independently working authors assessed the risk of bias and extracted data from the included studies.
RESULTS: Kefir consumption had positive effects on inflammation modulation. The main mechanisms involved were the reduction of pro-inflammatory and molecular markers; reduction in inflammatory infiltrate in tissues, serum biomarkers, risk factors for chronic diseases, and parasitic infection; composition and metabolic activity change of intestinal microbiota and mycobiota; activation of humoral and cellular immunity; and modulation of oxidative stress.
CONCLUSIONS: Kefir modulates the immune system in different experimental models, among other secondary outcomes, to improve overall health. The beverage reduces inflammation through the alternation between innate, Th1, and Th2 responses, reducing levels of pro-inflammatory cytokines while increasing those of anti-inflammatory ones. In addition, it also mediates immunomodulatory and protective effects through the numerous molecular biomarkers and organic acids produced and secreted by kefir in the intestinal microbiota. The health-promoting effects attributed to kefir may help in the different treatments of inflammatory, chronic, and infectious diseases in the population.

Fermentation of lactose in milk by bacteria and yeasts naturally present in kefir grains produces a beverage that has been suggested to have cardiovascular benefits. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of this kefir beverage on cardiometabolic risk factors.
Literature search utilised PubMed, Scopus, ISI Web of Science, and Google Scholar for articles published from inception until June 2021. Cardiometabolic risk indices extracted included insulin and insulin resistance (HOMA_IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), haemoglobin A1c (HbA1c) and body weight (BW). In total, six RCTs (314 subjects) were selected for the meta-analysis. Inverse-variance weighted mean difference (WMD) with a 95% confidence interval (CI) was calculated for the mean changes in TC, TG, HDL-C, LDL-C, FBS, HbA1c and BW compared to baseline. A random effects model was used to estimate the pooled WMD.
Kefir intake significantly reduced fasting insulin (WMD: -3.69 micro-IU/mL,95% CI: -6.30 to -1.07, p = 0.006, I2 = 0.0%) and HOMA-IR (WMD: -2.56, 95% CI: -3.82 to -1.30, p<0.001, I2 = 19.4%). No effect on TC (p = 0.088), TG (p = 0.824), HDL-C (p = 0.491), LDL-C (p = 0.910), FBS (p = 0.267), HbA1c (p = 0.339) or body weight (p = 0.439) were found for kefir treatment.
Kefir has a beneficial effect in decreasing insulin resistance; however, no effect was seen on BW, FBS, HbA1C, and lipid profile.

Increasing research has been conducted on the role of probiotics in disease treatment. Kefir, a safe, low-cost probiotic fermented milk drink, has been investigated in many in vitro and animal studies, although parameters for human therapeutic dose or treatment time have not yet been determined. Here we perform a scoping review of clinical studies that have used kefir as a therapeutic agent, compiling the results for perspectives to support and direct further research. This review was based on Joanna Briggs Institute guidelines, including studies on the effects of kefir-fermented milk in humans. Using the term KEFIR, the main international databases were searched for studies published in English, Spanish or Portuguese until 9 March 2022. A total of 5835 articles were identified in the four databases, with forty-four eligible for analysis. The research areas were classified as metabolic syndrome and type 2 diabetes, gastrointestinal health/disorders, maternal/child health and paediatrics, dentistry, oncology, women\'s and geriatric health, and dermatology. The many study limitations hampered generalisation of the results. The small sample sizes, methodological variation and differences in kefir types, dosage and treatment duration prevented clear conclusions about its benefits for specific diseases. We suggest using a standard therapeutic dose of traditionally prepared kefir in millilitres according to body weight, making routine consumption more feasible. The studies showed that kefir is safe for people without serious illnesses.

Kefir, a fermented beverage made from kefir grains, has gained immense popularity around the world due to its potential health-promoting properties. Kefir beverages are both marketed commercially and brewed privately by individuals. Both milk and sugar solutions can be used as substrates with various additives included based on consumer preference. Fermentation occurs via microorganisms including lactic acid bacteria, acetic acid bacteria, and yeasts, which are naturally present in kefir grains. Health-promoting effects of kefir are thought to occur through immune, gastrointestinal, and metabolic regulation. Both clinical trials and mechanistic studies in cell culture and animal models have explored these effects. Studies in vitro and in animals have shown the ability of kefir and kefir components to antagonize pathogens, reduce proinflammatory cytokine production, contribute to cytotoxicity of tumor cell lines and reduce tumor burden, and improve serum glycemic and lipid profiles. However, some data from clinical trials are conflicting, and the precise mechanisms by which kefir promotes well-being are not completely defined. This review summarizes the current body of evidence in both cell culture and animal models that provide insight into the mechanisms by which kefir beverages may protect consumers from enteric infections and improve immune and metabolic health. We believe that readers will gain knowledge helpful for both developing more targeted mechanistic studies and selecting informative outcomes when designing clinical studies.

Kefir, a traditional, fermented-milk beverage, has increasingly been promoted for various health benefits. The evidence from systematic reviews, however, is limited.
Evidence from randomized controlled trials testing oral consumption of fermented-milk kefir on any outcome of human health or disease.
A systematic search of 4 electronic databases (PubMed, Scopus, Allied and Complementary Medicine Database, and Cochrane Trials) from inception to July 31, 2021, was conducted.
Data extraction and risk-of-bias assessments were conducted by 2 reviewers independently.
A total of 18 publications reporting the results of 16 studies were included. Per the narrative analysis, fermented-milk kefir may have potential as a complementary therapy in reducing oral Streptococcus mutans, thereby reducing dental caries risk, and in Helicobacter pylori eradication therapy. Kefir may further aid treatment of adult dyslipidemia and hypertension, although evidence was very limited. Safety was only assessed in 5 of the 18 included publications, and 12 of the studies had an overall high risk for bias.
Kefir is a dairy product with a unique microbiological profile that appears to be a safe for generally healthy populations to consume. However, efficacy and safety data from high-quality human trials are essential before any recommendations may be made for conditions of the oral and gastric microbiota and metabolic health.
PROSPERO registration no. CRD42020211494.

Fermented foods are among the traditional foods consumed for centuries. In recent years, awareness of fermented foods has been increasing due to their positive health benefits. Fermented foods contain beneficial microorganisms. Fermented foods, such as kefir, kimchi, sauerkraut, and yoghurt, contain Lactic acid bacteria (LAB), such as Lactobacilli, Bifidobacteria, and their primary metabolites (lactic acid). Although studies on the effect of consumption of fermented foods on diabetes, cardiovascular, obesity, gastrointestinal diseases on chronic diseases have been conducted, more studies are needed regarding the relationship between neurological diseases and microbiota. There are still unexplored mechanisms in the relationship between the brain and intestine. In this review, we answer how the consumption of fermented foods affects the brain and behavior of Alzheimer\'s disease, Parkinson\'s disease, multiple sclerosis disease, stroke, and gut microbiota.