Fermented milk

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

Actimel®, arerra (Ethiopia), augat (Ethiopia), ayib, ayran, bifidobacteria, bifidobacteria-fermented milk (BFM), Bifidobacterium, buttermilk, casein phosphopeptides, Causido®, cultured dairy foods, cultured dairy products, cultured milk products, dadhi, dahi (India), Enterococcus, ergo (Ethiopia), fermented dairy product, Gaio®, ititu (Ethiopia), kibe (Ethiopia), koumus, Lacto™, Lactobacillus, Lactobacillus
acidophilus, Lactobacillus
bulgaricus, Lactobacillus
casei, Lactobacillus
helveticus, Lactobacillus
johnsonii, Lactobacillus
paracasei, Lactococcus
lactis, Lactococcus
lactis
cremoris, Leuconostoc lactotripeptides, Leuconostoc
mesenteroides
cremoris, matzoon, mazoni, probiotic, ropy milk, Streptococcus
bulgaricus, traditional butter, traditional fermented curd, verum, yoghurt, yogurt.
Note: Kefir, a specific type of fermented milk, is not covered in this monograph. Yogurt is not covered in detail in this monograph.

Background

Fermented milk is made when bacteria change lactose (the sugar in milk) into lactic acid, which causes the tangy taste.
Fermented milk has calcium, protein, phosphorus, and riboflavin (or vitamin B2) and may improve nutritional status in children.
Bacteria present in fermented milk increase and balance the flora in the gut. These bacteria may decrease stomach problems, improve immunity, and shorten infections.
Fermented dairy foods have less lactose than milk and therefore are commonly used by lactose-intolerant people.
Fermented milk has been studied for allergies, diarrhea, infections in the gut, and improving immune function.

Scientific Evidence

Uses These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
B	Allergy According to limited research, drinking fermented milk may help with allergies. Further research is needed in this area.
B	Diarrhea Specific types of fermented milk have helped to prevent antibiotic-caused diarrhea. Fermented milk has been given to children recovering from acute diarrhea and to children that lacked proper nourishment and had diarrhea. Further studies are needed in this topic.
B	Helicobacter pylori infection (in the stomach) Ferment milk may have activity against Helicobacter pylori, which is a bacterium that may cause stomach ulcers. Drinking fermented milk regularly may decrease inflammation in the stomach caused by Helicobacter pylori. Further research is necessary to determine a conclusion.
B	Immune function Certain types of fermented milk may improve the immune system’s ability to respond quickly. In poorly nourished people, the elderly, and children, fermented milk may help improve immune system function. Further research is needed in all age groups.
B	Lactose intolerance Fermented dairy foods are commonly used by lactose-intolerant individuals. In fermented milk, lactose is broken down to glucose and galactose by bacteria. Further studies are needed to confirm this.
C	Antibacterial Fermented milk may stop the growth of bacteria that causes stomach disease. Antibacterial effects of fermented milk become stronger when combined with gastric juice. Limited research has shown that regular use of fermented milk may decrease bacteria in the nose and throat but not in the genital area. Further research in this area is required.
C	Breast cancer prevention Limited research has shown that women taking fermented milk have a reduced risk of breast cancer in women. Further research is needed to arrive at a conclusion.
C	Heart disease prevention Regular intake of a specific type of fermented milk may decrease the risk of heart disease. More evidence is needed to arrive at a firm conclusion.
C	Constipation Some research suggests that fermented milk may help alleviate long-term constipation. More studies are needed to determine whether fermented milk helps with constipation.
C	High cholesterol There is conflicting evidence on whether fermented milk helps reduce total and LDL cholesterol levels. Higher-quality research is needed before any conclusion may be reached.
C	High blood pressure Limited research has shown that fermented milk products may lower blood pressure, while other research had conflicting results. Further research is necessary for a conclusion to be reached.
C	Irritable bowel syndrome (IBS) Fermented milk may help alleviate certain symptoms of IBS (a disorder of the stomach). More research in this area is needed.
C	Nerve disorders Limited research showed that fermented milk was beneficial for human T cell lymphotropic virus type-1 (HTLV-1) myelopathy/tropical spastic paraparesis (HAM/TSP), which is a rare disease involving inflammation of nerves. Further research is required.
C	Nutritional deficiencies (in children) Limited research showed that children were better nourished after consuming fermented milk. Further research is needed.
C	Peptic ulcer (damage of the stomach lining) Limited research has shown that intake of large amounts of fermented milk decreased ulcer (stomach lining damage) risk, while intake of large amounts of regular milk increased this risk. Further studies are needed before a conclusion can be made.
C	Pouchitis (intestinal pouch inflammation) Early research suggests that fermented milk may reduce the risk of pouchitis. Pouchitis is an inflammation of the intestinal pouch made after colon removal in ulcerative colitis (UC) patients. Further research is necessary before conclusions can be made.
C	Premature labor prevention Early research suggests that drinking fermented milk during pregnancy may prevent vaginal infections and therefore prevent infection-caused preterm labor. Further research is needed before a conclusion can be reached.
C	Reducing side effects of chemotherapy or radiotherapy Fermented milk may prevent radiotherapy-associated diarrhea. Further research is needed.
C	Sleep quality Certain fermented milk may improve quality of sleep in elderly people. Further research in this area is required.
C	Ulcerative colitis (inflammation of the large intestine) Early research suggests that fermented milk may treat and reduce flares of ulcerative colitis (inflammation of the large intestine). Further research in this area is necessary.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

Anemia, arthritis, athletic performance enhancement, appetite suppressant, attention-deficit hyperactivity disorder (ADHD), autoimmune diseases, biliary/gall bladder disease, bladder cancer prevention, colon cancer prevention, Crohn’s disease (inflammation of the digestive tract), dental caries, deficiency (lactase), depression, diabetes, digestion, gastric cancer, hyperglycemia (high blood sugar levels), iron absorption enhancement, obesity (related metabolic disorders), pancreatic disorders (children), post-menopausal bone loss, respiratory tract infections, skin care, tuberculosis, urinary tract infection, urogenitary disorders (problems with the urinary system and the genitals).

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

To treat allergies, 100 milliliters of heat-treated fermented milk has been used by mouth daily for eight weeks. Also, 200-400 milliliters of fermented milk taken by mouth once daily for 30 days.
For heart disease prevention, 450 milliliters of Gaio® was taken by mouth daily for eight weeks.
To treat constipation, 100 grams of fermented milk was taken daily for two weeks
To treat diarrhea, 250 milliliters of fermented milk was taken by mouth daily for two weeks.
To treat Helicobacter pylori infection, 100 milliliters of fermented milk was taken by mouth once daily for 14 days. Another fermented milk preparation (125 grams) was taken by mouth twice daily for three weeks and then once daily for 13 weeks.
To treat high cholesterol, 200 grams of fermented milk product (Gaio®) was taken by mouth daily for six months.
For high blood pressure, six test tablets (12 grams) containing powdered fermented milk were taken by mouth daily for four weeks. Also, 150 milliliters of fermented milk was taken by mouth daily for 21 weeks.
For immune function, 90 grams of fermented milk was given through a feeding tube for 12 weeks. Also, 200 milliliters of fermented milk (Actimel®) was taken by mouth daily.
To treat irritable bowel syndrome, fermented milk was taken by mouth for four weeks.
To treat lactose intolerance, 480 milliliters of fermented milk was given by mouth once.
To treat postmenopausal bone loss, fermented milk was given by mouth daily for one week. Also, 220 milliliters of fermented milk was given by mouth for two days.
To reduce chemotherapy side effects, 150 milliliters of a fermented milk product was given by mouth daily.
To improve sleep quality in the elderly, 100 grams of fermented milk was taken by mouth daily for three weeks.
To treat ulcerative colitis (UC), 100 milliliters of fermented milk was taken by mouth daily for 12 weeks, in addition to UC medications.

Children (under 18 years old)

For allergies, 100 milliliters of fermented milk was taken by mouth daily for one year.
To treat diarrhea, fermented milk was taken by mouth for 90 days. Also, 125 grams or 250 grams of fermented milk was taken daily by mouth for one month.
To improve immune function, fermented milk was taken for six weeks. Also, two daily units of Actimel® were taken by for 20 weeks.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in people with known allergy or sensitivity to dairy products.

Side Effects and Warnings

Fermented milk appears to be safe in adults and children in amounts normally taken in food.
Fermented milk should be used with caution in people using drugs that cause low blood sugar, as fermented milk may lower blood sugar levels.
Fermented milk may cause stomach problems such as cramping, diarrhea, bloating, vomiting, flatulence, nausea, and constipation. Use with caution in people with stomach problems.
Caution is advised when fermented milk is used large amounts in pregnant and lactating women, and children.
Caution is advised when using fermented milk with antiallergy, antibacterial, antidiarrheal, antihypertensive, antilipidemic, antineoplastic, and gastrointestinal agents.
Use caution when fermented milk is taken with a low-fat or low-cholesterol diet, as it may further lower cholesterol levels.
Avoid fermented milk in people with a known allergy or sensitivity to dairy products.

Pregnancy and Breastfeeding

Fermented milk is likely safe for nonallergic pregnant women in amounts generally found in foods.
Fermented milk when taken during pregnancy may restore normal vaginal flora and reduce vaginal infections, which in turn may reduce premature labor.
Caution is advised when fermented milk is used large amounts in pregnant and lactating women.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Since fermented milk may alleviate allergies, it may increase the effect of other antiallergy agents.
Since fermented milk has antibiotic properties, it may increase the effect of other antibiotic drugs.
Since fermented milk fermented may reduce antibiotic-associated diarrhea, it may increase the effect of other antidiarrheal drugs.
Fermented milk may lower blood pressure and may increase the effects of other agents that lower blood pressure.
Fermented milk may lower cholesterol levels and may increase the effects of other cholesterol-lowering agents.
Fermented milk may have effects against cancer (especially breast and colon cancer), and therefore may increase the effect of certain anticancer agents.
Fermented milk contains calcium and may increase serum calcium levels. Caution is advised if also taking other calcium supplements.
Fermented milk may slow gastric emptying. Caution is advised if taking other agents that slow gastric emptying.
Fermented milk may irritate the stomach and therefore may increase the irritation caused by drugs that irritate the stomach.
Fermented milk may increase function of the immune system and therefore may interact with drugs that alter the function of the immune system.
Fermented milk may improve sleep, and this may help increase the effects of other agents that improve sleep.

Interactions with Herbs and Dietary Supplements

Since fermented milk may alleviate allergies, it may increase the effect of other antiallergy herbs and supplements.
Since fermented milk has antibiotic properties, it may increase the effect of other antibiotic herbs and supplements.
Since fermented milk fermented may reduce antibiotic-associated diarrhea, it may increase the effect of other antidiarrheal herbs and supplements.
Fermented milk may lower blood pressure and therefore increase the effects of other agents that lower blood pressure.
Fermented milk may lower cholesterol levels and therefore increase the effects of other cholesterol-lowering herbs and supplements.
Fermented milk may have anticancer activity (especially for breast and colon cancer) and therefore may increase the effect of certain anticancer agents.
Fermented milk contains calcium and may increase serum calcium levels. Caution is advised if also taken with other calcium supplements.
Fermented milk may slow gastric emptying. Caution is advised if taking other herbs and supplements that slow gastric emptying.
Fermented milk may irritate the stomach and therefore may increase the irritation caused by herbs and supplements that irritate the stomach.
Fermented milk may increase function of the immune system and therefore may interact with herbs and supplements that alter the function of the immune system.
Fermented milk may improve sleep and therefore may increase the effects of herbs and supplements that improve sleep.
Fermented milk may have antioxidant properties and therefore may increase the effects of other antioxidant herbs and supplements.
Fermented milk may have additive skin-improving effects when taken with vitamin E and borage seed oil.
Fermented milk may increase the absorption of iron.

Author Information

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Anukam KC, Osazuwa EO, Osadolor HB, et al. Yogurt containing probiotic Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 helps resolve moderate diarrhea and increases CD4 count in HIV/AIDS patients. J Clin.Gastroenterol. 2008;42(3):239-243. View Abstract
Ataie-Jafari A, Larijani B, Alavi, et al. Cholesterol-lowering effect of probiotic yogurt in comparison with ordinary yogurt in mildly to moderately hypercholesterolemic subjects. Ann.Nutr.Metab 2009;54(1):22-27. View Abstract
Charlton KE, Steyn K, Levitt NS, et al. A food-based dietary strategy lowers blood pressure in a low socio-economic setting: a randomised study in South Africa. Public Health Nutr. 2008;11(12):1397-1406. View Abstract
Ebringer L, Ferencik M, and Krajcovic J. Beneficial health effects of milk and fermented dairy products–review. Folia Microbiol.(Praha) 2008;53(5):378-394. View Abstract
Giovannini M, Agostoni C, Riva E, et al. A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis. Pediatr Res 2007;62(2):215-220. View Abstract
Nichols AW. Probiotics and athletic performance: a systematic review. Curr.Sports Med Rep. 2007;6(4):269-273. View Abstract
Othman M, Neilson JP, and Alfirevic Z. Probiotics for preventing preterm labour. Cochrane Database.Syst.Rev. 2007;(1):CD005941. View Abstract
Plana N, Nicolle C, Ferre R, et al. Plant sterol-enriched fermented milk enhances the attainment of LDL-cholesterol goal in hypercholesterolemic subjects. Eur.J Nutr. 2008;47(1):32-39. View Abstract
Puch F, Samson-Villeger S, Guyonnet D, et al. Consumption of functional fermented milk containing borage oil, green tea and vitamin E enhances skin barrier function. Exp.Dermatol 2008;17(8):668-674. View Abstract
Silva MR, Dias G, Ferreira CL, et al. Growth of preschool children was improved when fed an iron-fortified fermented milk beverage supplemented with Lactobacillus acidophilus. Nutr.Res 2008;28(4):226-232. View Abstract
Takeda K and Okumura K. Effects of a fermented milk drink containing Lactobacillus casei strain Shirota on the human NK-cell activity. J Nutr. 2007;137(3 Suppl 2):791S-793S. View Abstract
Wenus C, Goll R, Loken EB, et al. Prevention of antibiotic-associated diarrhoea by a fermented probiotic milk drink. Eur.J Clin.Nutr. 2008;62(2):299-301. View Abstract
Yamamura S, Morishima H, Kumano-go T, et al. The effect of Lactobacillus helveticus fermented milk on sleep and health perception in elderly subjects. Eur.J Clin.Nutr. 2009;63(1):100-105. View Abstract
Yang YX, He M, Hu G, et al. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women. World J Gastroenterol. 10-28-2008;14(40):6237-6243. View Abstract
Zeng J, Li YQ, Zuo XL, et al. Clinical trial: effect of active lactic acid bacteria on mucosal barrier function in patients with diarrhoea-predominant irritable bowel syndrome. Aliment.Pharmacol.Ther 10-15-2008;28(8):994-1002. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Fermentedmilk