Date of Award

3-2025

Degree Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Advisor

Dr. Jacob Shabani

Second Advisor

Dr. Rosebella Iseme-Ondiek

Third Advisor

Dr. Logan J. Rabuogi

Department

Family Medicine (East Africa)

Abstract

Introduction 

Type 2 diabetes mellitus (T2DM) remains a major global health challenge, particularly in resource limited countries where conventional treatments are often inaccessible or unaffordable. While lifestyle interventions can reduce diabetes risk, their efficacy is moderate, highlighting the need for alternative strategies. Fermented foods (FFs), which are widely available and affordable, have been shown to improve glucose metabolism and may offer a promising adjunct in the prevention and management of T2DM and prediabetes.

Methods 

A systematic review and meta-analysis were conducted to assess the effects of fermented food consumption on glycemic control and cardiometabolic risk markers in adults with prediabetes or T2DM. Four databases (COCHRANE, PUBMED, GOOGLE SCHOLAR and SCOPUS) were searched for randomized controlled trials (RCTs) published up to September 2024. Studies were screened and selected based on predefined eligibility criteria, with data extraction performed using Covidence software. Study quality was assessed using the Cochrane Risk of Bias Tool, and results were synthesized according to PRISMA guidelines. Meta-analyses were performed using a random-effects model.

Results & Analysis 

Out of 4,930 articles identified, 24 studies were included in the systematic review and meta-analysis (1,261 participants). Interventions included milk-based, non-soy plant-based, and soy-based fermented foods, administered over 4 to 16 weeks. All fermented food consumption led to significant reductions in fasting blood glucose (MD = -10.97 mg/dL, p < 0.0001) and HbA1c (MD = -3.18 mmol/mol, p = 0.006). Improvements were also observed in total cholesterol, LDL cholesterol, triglycerides, and HDL cholesterol. No significant changes were found in BMI or inflammatory markers. Subgroup analyses indicated greater glycemic improvements in prediabetic populations and with soy-based interventions. The majority of studies scored low risk of bias in most of the assessed domains. vii

Conclusion 

This review demonstrates that fermented foods significantly improve glycemic control and lipid profiles in adults with prediabetes and T2DM. These findings support the potential role of fermented foods as accessible, adjunct dietary interventions for managing diabetes and reducing cardiometabolic risk, especially in resource-limited settings. Further research is needed to determine optimal intervention types and durations.

First Page

1

Last Page

88

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