**3. Fermented Foods and Probiotics**

Fermented foods belong to a category of foods called "functional foods that are known to have a positive effect on health" [16]. Probiotics are the bacteria used to ferment traditional foods, and they are the most reported and researched. Thus, fermented foods and probiotics are closely related and co-exist despite the increased commercial interest in probiotics due to the health attributes associated with them [17]. However, the efficacy of probiotics is enhanced when taken in the form of fermented food rather than as probiotics alone [18].

Microbial food cultures have directly or indirectly come under various regulatory frameworks in the course of the last decades. Several of those regulatory frameworks put emphasis on "the history of use", "traditional food", or "general recognition of safety". Traditionally fermented foods are highly beneficial because they supply natural probiotics, now recognized as crucially important for immune health. Fermentation is an inconsistent process—almost more of an art than a science—so commercial food processors developed techniques to help standardize more consistent yields [19].

Fermentation is an anaerobic process converting sugars by bacterial enzymes to alcohol or by yeasts into lactic acid. Fermented foods are described as palatable and wholesome and are generally appreciated for several attributes: their specific unique flavors, aromas, textures, and improved cooking and processing properties. These characteristics of fermented foods are enhanced by virtue of the metabolic activities of the enzymes secreted by microorganisms [20].

Probiotics incorporate mainly fermented dairy foods. While EU permits animal production claims for feed probiotics, the USA and Canada do not. Regulators now accept several modes of action of probiotics, not just gut flora modulation [21], increasingly demanding safe strains [22]. An inventory of microorganisms used in food fermentations covering a wide range of food matrices is also required (dairy, meat, fish, vegetables, legumes, cereals, beverages, and vinegar) [23].

Various indigenous fermented foods containing probiotic bacteria have been part of local diets in Africa due to reported medicinal properties they possess [24]. Consumers must be made aware of the problems concerning raw materials and additives used in food and beverage processing as well as the possible harmful effects of employing genetically modified microorganisms in the fermentation process.

Further development of traditional fermented foods with added probiotic health features would be an important contribution towards reaching the goals of eradication of poverty and hunger, reduction in child mortality rates and improvement of maternal health in Africa [25]. Probiotic consumption may have a positive effect on psychological symptoms of depression, anxiety, and perceived stress in healthy Western human populations [26].

Fermented foods have been inching into the spotlight lately as more and more consumers learn about their inherent probiotic health benefits. The two main health effects from fermented dairy consumption are immune and metabolic positive responses, especially with the addition of probiotic organisms.
