The nutritional value of fermented foods has long been recognized, even though the scientific bases for many of the nutritional claims have only recently been studied. Strong evidence that fermentation enhances nutritional value now exists for several fermented products, especially yogurt and wine. Fluid milk is not regularly consumed in most of the world because most people are unable to produce the enzyme p-galactosidase, which is necessary for digestion of lactose, the sugar found naturally in milk. Individuals deficient in p-galactosidase production are said to be lactose intolerant, and when they consume milk, mild-to-severe intestinal distress may occur. This condition is most common among Asian and African populations, although many adult Caucasians may also be lactose intolerant.
Many studies have revealed, however, that lactose-intolerant subjects can consume yogurt without any untoward symptoms and can therefore obtain the nutritional benefits (e.g., calcium, high quality protein, and B vitamins) contained in milk. In addition, it has been suggested that there may be health benefits of yogurt consumption that extend beyond these macronutrients. Specifically, the microorganisms that perform the actual yogurt fermentation, or that are added as dietary adjuncts, are now thought to contribute to gastrointestinal health, and perhaps even broader overall well-being (Chapter 4).
Similarly, there is now compelling evidence that wine also contains components that contribute to enhanced health (Chapter 10). Specific chemicals, including several different types of phenolic compounds, have been identified and shown to have anti-oxidant activities that may reduce the risk of heart disease and cancer.That wine (and other fermented foods) are widely consumed in Mediterranean countries where mortality rates are low has led to the suggestion that a "Mediterranean diet" may be good for human health.
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