1

Exploring The Diversity of Fermented Plant Based Beverage with an

Emphasis on Therapeutic Role of Probiotics: A review

Paulami Ghosh1, Shuchi Upadhyay*1, Suvendu Manna2

1 Department of Allied Health Sciences, School of Health Sciences and Technology, University of
Petroleum and Energy Studies (UPES) Dehradun, Uttarakhand, India 248007
2 Department of Health Safety and Engineering University of Petroleum and Energy Studies, Dehradun,
Uttarakhand, 248007, India.

Abstract
The gastrointestinal disorders are on the rise each day, showing a study increase in incidence
rates over time. The worldwide research target is to expose the major food constituents in
drinks and beverages to provide health benefits to people. The awareness and market demand
for probiotic enriched plant-based beverages are increasing due to the increase in the number
of people with dairy product allergies, lactose intolerance, and gut discomfort. The existence
of various plant based probiotic beverages soymilk, rice milk, and coconut milk—are the
most crucial carrier matrices used in probiotic beverage formulation and have lots of health
benefits. The probiotic products are safe and beneficial as a preventive approach for the
treatment of several diseases, particularly atopic illnesses such as irritable bowel syndrome
(IBS), acute infectious diarrhoea, and antibiotic-induced disorders, and are suitable carriers
for delivering good bacteria in storage due to their ability to carry sufficient probiotic yield.
Therefore, this review focuses on the recent development of probiotic beverages, role of
probiotics as an efficient functional component of plant based fermented beverages.

Keywords: Fermented beverage, Non-dairy; dairy; phytochemicals; Probiotic microbiome.

Probiotics
2

Plant based fermented

drink

Plant based food matrices Health benefits of fermented

drink

Figure: graphical abstract

1. Introduction

Probiotics are defined as microorganisms that have a beneficial effect on the host
intestinal microbial balance. Lactic acid bacteria and bifid bacteria are the most
common type of bacteria used as probiotics. The Latin word ‘pro’ means ‘’for’’ and
the Greek word ‘bios’ means “life”. In ancient time, people consume probiotics as
fermented milk. Probiotics were used for so many decades connect with good taste
and control various diseases such as intestinal disorders, obesity, diabetes,
hypertension, diarrhoea [1]. The use of probiotic fortified foods and drinks have
gained attention globally because of its numerous health benefits. The most
commonly used genera as probiotic Bifidobacterium and Lactobacillus which are
considered as GRAS (generally- recognized-as-safe) indicates less hazardous for
human health[2]. It has been observed that probiotic supplementation helps to
promote the maintenance and improvement of a healthy gut microbiota[3]. Probiotic
enhance to treat and prevent such health conditions such as lactose intolerance, high
blood pressure and serum cholesterol, irritable bowel syndrome, Crohn's disease,
antibiotic-associated diarrhoea, and numerous gastrointestinal disorders etc. In
3

addition, probiotic has anti-carcinogenic properties and boost the immune system[4].
Probiotics are added to fruit juices or various drink for goodness of nutrition and extra
health benefits. There are many ways to measure probiotic safety. Probiotic have an
ergogenic effect on sportsperson and persons who are related to heavy exercise o gym.
Sportspersons suffer from gastrointestinal distress (such as vomiting, nausea,
diarrhoea etc.) may reduce with ingestion probiotics. As US National Library of
medicine reported that 65% of world population now has to reduce ability of lactose
present in cow’s milk[5].Subsequently taking certain probiotic strain, sportsperson
may amplify energy bring in; this leads to performance and make energize. There is
administered of strong dose of probiotic strain Lactobacillus plantarum rise blood
glucose concentration during high-speed treadmill running. The present review
focused on encouraging researchers and the food industry to explore the potential of
non-dairy fermented beverages as a source of microorganisms with probiotic
potential. In addition, the positive impact of consuming probiotic beverages on human
health is briefly shown. In order to improve culture viability during drying, storage,
and/or gastric transit, thermos protectants such as trehalose, non-fat milk solids,
and/or adonitol, growth-promoting agents such as various probiotic/prebiotic
combinations, and granular starch have been used [6]. This review primarily
investigated to know about clinical evaluation of various probiotic strains and their
health benefits, along with pant-based matrices as a best carrier of probiotics in human
body. In India plant-based gluten-free beverage has not yet gained that much
popularity and awareness. Plant-based health drinks or beverages are the most
beneficial substitute for those who have different dietary restrictions or allergies[7].
4

Figure 1: Authors working in the area

Figure 2: Keywords associated with the paper

1.1. Effects of probiotic beverages on human health

Probiotics regulate bacteria within the host environment, so contributing to the

environment's health. Additionally, they aid in the fight against overweight and
obesity [8]. Despite the tremendous potential of probiotics in nutritional and
therapeutic applications, their integration into human health, nutrition, and the
management of many disorders still requires more investigation. The purpose of this
review is to showcase the potential positive effects of probiotics on human health,
dietary optimization, and the regulation of prevalent metabolic illnesses or
anomalies[9].

1.1.1 probiotic on controlling food allergy

Probiotics have antiallergic properties on various food allergens such as milk
allergen, peanuts, soy-allergen etc. Probiotic bacteria such as L. plantarumL67 have
been manifested to fighting allergy related disorder (Table 1/ Fig 3) with synthesis
of interleukin 12 and interferon-gamma in their host[10]. Health benefit of
probiotics mainly granted due to instigation of immune or modulation of immune
system since oral doses of probiotics react with gastrointestinal mucosal area
associated with lymphoid tissues where 70% of immune cells are constrained.
5

Probiotics helps to control food allergy by reducing inflammation, strengthening gut

lining [11].

1.1.1 probiotic for obesity control

obesity is the root cause of several degenerative diseases. Non-alcoholic fatty liver
disease and steatohepatitis, liver abnormalities etc. may happen due to obesity. Fatty

acids, cholesterol, and lipid metabolites are significantly elevated in the liver as a
result of lip toxicity-induced fat storage. The expression of lipogenic genes, such as
fatty acid synthase (FAS), peroxisome proliferator-activated receptor gamma (PPAR),
and transcription factor CCAAT/enhancer-binding protein (C/EBP α), regulates these
processes[12]. Metabolic disorders induced in the liver are significantly influenced by
these lipogenic genes. Numerous investigations have demonstrated that liver weight,
triglycerides, and lipogenic gene expression are associated to obesity, although the
synthesis and storage of fat are reduced by the administration of probiotics, especially
LABs. Few researchers have observed that administration of Lactobacillus can
decrease the LPS binding protein levels that can resist insulin which may control
diabetes mellitus by decreasing the metabolic profiles such as - total cholesterol and
triglyceride levels, C -reactive protein (CRP), HbA1c, blood glucose, and insulin
level, as well as systolic and diastolic blood pressure. Therefore, it can be claimed that
Lactobacillus as mentioned as (Table 1/ Fig 3) is an alternate therapy option for
diabetes mellitus as well as obesity. Reduced tight junction protein expression leads to
increased intestinal permeability, which eventually favours the translocation of
bacterial lipopolysaccharide which can cause metabolic endotoxemia and insulin
resistance [13].
 6

Fig 3:- Health benefits of probiotics adopted and modified from [14] [15].

1.1.3 Probiotic on irritable bowel disease

Irritable bowel syndrome/ disease is distinguished by persistent inflammation in the

GI tract, probiotic strain responsible to reduce IBS as mentioned in Fig 3. Enteric
bacteria may modify proinflammatory and anti-inflammatory cytokine levels in the
colon and making intestinal disorder more prevalent. Th1 cells generate pro-
inflammatory cytokines and Th2 cells release anti-inflammatory cytokines that
maintain immune system in intestinal barrier[16].
Lactobacillus, Bifidobacterium and Streptococcus are predominantly used probiotic
genera in food matrices and dairy products. It also has been investigated that plant-
based beverages have great possible carrier for probiotic. Fruits, nuts, cereals,
legumes can be used as novel functional probiotic beverage as an alternative of dairy
based fermented beverages, while plant based fermented beverages meet the demand
of consumers for lactose intolerance, allergenic for fat from dairy products as
mentioned in detailed in Table 1 [17].

Table1: Common probiotic strains used in fermented beverages and their

therapeutic role

Category of Name of Role of probiotics Strain References

beverages probiotic
beverages
Kombuga Helps to increase amount of Gluconoacetobactor [14]
vitamin B, folic acid Lactobacillus
Borde Helps to reduce cancer Lactobacillus [18]
Cereal Yeast
based Ogi Reduce abdominal Lactobacillus [19]
probiotic discomfort & diarrhoea plantarum
beverage Streptococcus lactis
Kunun zaki Helps to prevent high blood Lactobacillus [20]
pressure, blood clotting & fermentum
lower blood glucose level. Lactobacillus coccusla
 7

Mandarin Rich in vitC & vitA , helps Lactobacillussalivariu [14]

juice to improve immunity s

Hardaliye Reduce risk of heart disease, Lactobacillus sp. [21]

improve nervous system
Mehevu Strengthen bone health Lactobacillus [22]
Rich in antioxidant bulgericus
Lactobacillus brevis
Togwa Provide energy for physical Lactobacillus [23]
activity Streptococcus
Boza Fight against varicella Lactobacillus sp [24]
zoster infection
Atole Increase immunity and Lactobacillus ssp [25]
helps to retain moisture

Whey Act as an emulsifier Bifidobacterium sp [26]

cheese [27]

Kefir Reduce cholesterol level Leuconostoc. [28]

Lactobacillus
Whey Rich in nutritional Lactobacillus casei, [29]
sorghum properties L.rahmnosus ,
probiotic acidophilus
beverage
Grape helps to reduce blood sugar Lactobacillus casei [30]
flavoured & rich in antioxidant
whey drink
Bifidus Basically, help for treatment Lactobacillus bifid [31]
milk of liver problems bacterium
Whey based Acidophilus Reduce chances of lactose Acidophilus; L. ssp [32]
probiotic milk intolerance, reduce gastric
beverage inflammation
Shubat Provides supplementation Streptococcus [29]
for basic nutrition thermophiles
8

Lactobacillus casei
Grape fruit Reduce blood glucose level Lactobacillus casei [30]
whey drink
Koumiss Helps to treatment for Lactobacillus [33]
kumiss tuberculosis, lung disorder bulgericus
lactobacillus
acidophilus

1.1.4 Antimicrobial properties of Probiotic

Probiotic microorganism generates such compounds with low molecular weight and
they compete with illnesses and release antimicrobial agents (such lactic acid,
bacteriocin, and hydrogen peroxide) that boost the host's antimicrobial response
mentioned in Table1. The Bacteroidetes phyla, which is primarily made up of Gram
negative - bacteria, and the Firmicutes phyla, which is primarily made up of Gram-
positive bacteria, account for about 90% of all bacterial species. Transepithelial
resistance to invading microorganisms is enhanced and cytokine production is
increased with TLR2 activation. The TLR2 receptors recognise the peptidoglycan
presents in gram positive bacteria such as Lactobacillus sp. Lactobacillus strains
demonstrated that L. casei CRL431 communicated with and interacted with epithelial
cells via TLR2 receptors; L. casei was found to have a modest effect on IL-12
production. Additionally, they postulated that the intact peptidoglycan of Lactobacilli
impeded the synthesis of IL-12 via TLR2 signalling. Pepto glycan reduces IL-12
production by 12-48 percent in TLR2-imperfect macrophages, indicating that the
TLR2-self-supporting mechanism is in operation, despite the requirement for TLR2
recognition shown in Fig 4 [34].
9

Figure 4 : Antimicrobial activity of probiotic in intestinal adopted and modified from [35].

Probiotics although have substantial potential in nutritional and therapeutic applications

significant investigations are required for further.

2. Probiotics and Plant based beverage

Dairy based probiotic beverages have higher sugar content and cholesterol. Plant based
beverages are different from dairy based drink include more phytochemicals, dietary
fibre, antioxidant (such as – isoflavonoids, tocopherol). It contains antinutrients too
which been removed by mechanical and thermal processing of raw materials such as
roasting , drying , soaking, germinating etc.[36]. Peoples have concerned towards non-
dairy protein-based drinks which remains from cereals, different seeds, pulses, legumes,
fruits, vegetables, nuts etc. to avoid animal-based drinks. It has recently paid a lot of
attention because of their viable health benefits including reduction in blood sugar levels,
improving gut mobility and enrich in micronutrient etc. The increased global interest in
plant-based beverages containing components that can provide favourable health impacts
is driving up consumer demand. Now a days in vegan food industry is plant based milk
as an alternative of animal milk as these are necessary component of many vegan food
like plant based ice crem, yogurt, butter, cheese etc.[37] [38]. Beverage can deliver
probiotic, prebiotic, amino acids, essential fatty acids, vitamins, minerals, etc.[39]. There
are different ranges of beverage that can be useful to support heart disease, diabetes type
2, improve gut health, and helps in weight management too[40]. Over the past decade
Obesity, become a major concern in many countries. Although the prevalence of obesity
may vary in different ways such as the interplay of genetic factors, lifestyle,
environmental factors, and social factors. [41]. This type of enrichment can be used in a
variety of products, not just milk substitutes[42][43] . Some other kind of beverage is a
10

functional beverage that is useful to improve gut health, weight management, and delay
the aging process. Young and old both consumers have health benefits of plant-based
milk substitute. A functional beverage is further classified as animal-based (including
probiotics& minerals) & plant-based beverage (depending upon the source of raw
materials), sports drink, etc. In the Present decades, plant-based foods become
encouraged by the whole world because of affordability; due to the huge consumption of
animal foods, biodiversity is going to destroy gradually[44]. plant-based beverages are
accessible in market basically derived from seeds, cereals, legumes or as mixed of
various food items. Protein source of beverages are divided into 4 section such as:
Cereals (rice, oats, millets, barley) [45] Legumes (chickpea, peas, soy), Seeds (sesame
seeds, pumpkin seed, sunflower seed, hemp, basil seeds, watermelon seed), Nuts
(almond, peanuts, walnut).

2.1 Phytochemicals present in plant-based fermented beverages

Phytochemicals are present in fruits, vegetables and grains are secondary metabolites
of plants though they are not pronounced as essential nutrients. However, these
compounds have ability to decrease the damage from oxidative stress which produced
free radicals by metabolism. The phytochemicals might be categorised as
polyphenols, Beta-Glucan, alpha tocopherol isoflavones, carotenoids, betalains,
glucosinolates etc. (Table 2) there is a constraint factor of bioavailability of these
phytochemicals due to interaction with other foods. Some research has been showed
that phytochemicals act as bioactive compound only after extracting from their natural
source. In compared researchers have fascinated to develop dietary plant-based
supplements from extract [46].

Table 2: Phytochemicals present in plant-based fermented beverage

Types of plant Functional Health benefits References

beverage compounds present
Plant based Beta-Glucan They have protective characteristics [47]
alpha tocopherol of heart disease, lowering blood
isoflavones, Phyto glucose level, cholesterol level,
sterols, Oryzanol, osteoporosis.
phytosterol, Phenolic
compounds
11

Caffeinated Catechins, flavonoids, Helps to control metabolism, obesity, [48]

beverages caffeine, helps to prevent neurological
polysaccharide, disorder, urinary stone.
trigonelline,
chlorogenic acid
Fruits and Lycopene, beta- These are high in antioxidants, [49]
vegetables- carotene, allcin, prevent some cancers, helps to
based beverage sulforaphane, cynarine improve digestive system, anti-
inflammatory properties.
Cereal based Dietary fibre, phenolic These are anticarcinogenic, [50]
contents, phytic acid, antiapoptotic, antiaging. helps to
oryzanol, maintain good bacteria level in
human gut.
Dairy based Prebiotic, mono Dairy based beverage helps to [51]
beverage unsaturated fatty provide good amount of micro
acids, poly minerals like calcium, Potassium,
unsaturated fatty acid Phosphorus etc., improve immunity,
(MUFA, PUFA), bone strength, prevent bone related
proteins, minerals, diseases and maintain good amount
vitamins. of gut microflora. Milk also has
bioactive compounds.

2.2 Characteristics (pros and cons) of based fermented beverages

Plant based probiotic fermented beverages employed for various clinical importance
is interesting area of research. The subsequent area provide overview of several
contributes of fermented beverages such as anti-inflammatory, anti-diabetic, anti-
cancer, anti-allergic, beneficial for central nervous system, angiogenic properties etc.
are discussed in Table 3:

Table3: characteristics plant based fermented beverage

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Type of Target nutrient major characteristics References

beverage
Whey based Probiotic Good for gut microbiota
probiotic Not suitable for lactose [52]
beverage intolerance patient
Fermented food γ-Aminobutyric acid Act like antidepressant,
beverage sedative, antihypertensive, [53]
antidiabetic
Not suitable for lactose
intolerance patient
water kefir Antioxidant Good in phenolic compound. [54]
beverages plant based beverage
Low in protein

Carbohydrate Carbohydrate to reduce the stress of the work [55]

drink and analgesic affects. High in
sugar

Multigrain Dietary fiber and low Rich in antioxidant & low in [56]
beverage glycemic index glycemic index, develop
obesity & lifestyle disorder

Fermented soy- Probiotics and soy stimulate gastro intestinal [57]

based beverage protein, health
isoflavonoids, May arise food allergy from
soy protein
Conventional oats milk, multi grain Reduce chances of lactose [36]
milk beverage milk, soy milk intolerance & food allergy

Probiotic rich in soluble improves antioxidant activity

Legumes based proteins, peptides and and calcium solubility, [58]
beverages amino acids plant-based proteins may have
13

poor digestibility

Sugar sweetened Milk protein, fat energy & calorie dense to do [59]
beverage daily physical activity

Fruit based Polyphenols Rich in vitamins & minerals; [60]

beverage (bioactive fight against non-
components) communicable disease
Chances of contamination
from pathogens
Fermented millet Iron, calcium, rich in minerals & antioxidant. [61]
beverage vitamin B. Phenolic compound &
alkaloids.

Beverage from Protein from plant Anticancer, anti-inflammation,

peas, cottonseed, source anti-anemic antithrombotic, [45]
lentils, sunflower anti-obesity.
seeds, beans, Present anti-nutritional factors
peanuts etc. & limiting amino acid
Plant based milk Vitamins & minerals Good for teeth health Less [62]
amount of iodine & calcium

Plant based Vitamin D, Vitamin Reduce bone demineralization [8]

beverage B12 & reduce the chances of
fortified with prostate cancer. Lactose free,
vitD, vit B12 &
calcium
Kefir fermented exopolysaccharide Lactose free, [63]
14

beverage

Oat bran Rich in soluble β Anticancer & hypo [64]

probiotic Glucan, protein, cholestrolemia.
beverages dietary fiber Acidity of beverage may
increase.

Fermented Rich in soluble β Inhibit tumor growth, decrease [65]

probiotic Glucan, protein, ageing process, and resist
beverage from dietary fiber fatigue.
jujube extract

Beverage from Rich in essential Reduce lactose sensitivity [66]

chickpeas & amino acid Due to presence of anti-
[67]
lupine nutritional factors have adverse
effect on metabolism.

Almond milk Rich in mono and Constipation relief, good for [68]
beverage with poly unsaturated fatty heart health
goodness of acids
inulin

2.3 Pathophysiology of plant based fermented probiotic beverages

Probiotics are considered as food supplement, the probiotic makes any specific health
claims, which means that the importance of safety will be overlooked. Whereas
world-wide probiotic drink extending position due to higher intake[69]. Probiotics
may be implicated in the formation of metabolites having hazardous potential. The
synthesis of d-lactate, a chemical accountable for growth of d-lactic acidosis, is one of
the possible safety concerns. Moreover the association between probiotics, d-lactic
acidosis (metabolic acidosis), small intestine bacterial overgrowth, and symptoms
15

including abdominal bloating, distention, and gas has not been proven in reported
cases of cognitive impairment[70]. However, one study found that when probiotics
were stopped and patients were given antibiotics, the symptoms of brain fogginess
improved[71]. Lactobacillus-containing probiotics have been related to bacteraemia
and endocarditis in immunocompromised patients and those with heart
abnormalities[72]. It has been documented mortality from Lactobacillus and linked
endocarditis is 23 percent, and because infections correlated with Lactobacilli are
highly rare, a popular past record of probiotic intake is necessary to rule out probiotics
as a cause of endocarditis. The proposed probiotic mechanisms of action, including
whether or not gut colonization is required; interactions of probiotic strains with the
gut microbiota; well-being; and potentiality in future. [73][74].

Fig 5: Pathophysiology of probiotic beverage in human intestine adopted and modified from [9].
16

2.4 Bioavailability of plant based fermented beverage

Probiotics are added to fruit juices or various drink for goodness of nutrition and extra
health benefits. There are many ways to measure probiotic safety. However there is a
controversy for probiotic safety ; there is such clinical trial , methodology and data for
probiotic safety –some researchers stated that probiotic has multiple health benefits
but how much it is safe and how much dose is safe for patients and consumers[75].
The Food and Agriculture Organization (FAO) & World Health Organisation (WHO)
provide some guidelines for probiotic safety. Probiotic strains should be characterised
by a series of inspections, which will determine any potential health hazards.

Efficacy of administration of probiotic doses for patients who have severe illness is
concern for population; bioavailability and bio accessibility of probiotic beverages is a
question for researchers. Because chances of toxicity from probiotic drink may arise
in view of the fact sometimes-excess administration unaccompanied by healthcare
professionals, excess intake of water or table salt (NaOH) also sometimes can arise
health hazards. Measurement of safety there are some assessment methods has been
taken [76] [77].

Figure 6: diagrammatic view of bioavailability of plant based fermented beverage

3. Conclusions
17

In conclusion this review focused on analytical literature of numerous health benefits of

probiotic beverages, stability, bioavailability of phytochemicals presents in plant-based
formulation along with mechanism of action in intestinal epithelial mucosa, antimicrobial
substance production. There is limited study on effectiveness of probiotic fermented
beverages. Non-dairy beverages with goodness of probiotics become more demanding
globally for their countless health benefits. It is important to acknowledge the challenges
associated with conducting and replicating research on fermented foods, primarily due to
the considerable diversity of ingredients and cultures that exist even within food
categories. This minor variation may contribute to the presence of inconsistent results.

4. Future scope and Global trend for plant based probiotic beverage
Probiotic products make up the majority of the total functional food market, accounti
ng for 60–70% of sales[78]. Many researchers have successfully investigated the
possibilities of non-dairy probiotic beverages. However, for the creation of non-
dairy beverage-based ready-to-reconstitute powders, the concept of drying such
beverages is evolving. Such products have the ability to provide consumers with
longer shelf lives, preserved nutrients, health benefits, and convenience, allowing for
commercial application. Nonetheless, commercial production of non-dairy probiotic
alternatives in the form of beverages and instant powders faces numerous challenges
in the future, including techniques to overcome low pH, the presence of
antimicrobial substances and organic acids, and other factors that affect probiotic
survivability during transportation and storage[79][80]. The most pertinent at the
ready product on the market is any kind of beverages. In the future, human studies in
the field of probiotics are needed to determine which probiotic strain has the most
efficacy and for which ailment.
[81].In the future, human studies in the field of probiotics are needed to determine w
hich probiotic strain has the most efficacy and for which ailment. Amid probiotics
50 to 60 percent are sold as food items, 30 to 40 percent are sold as beverage or
supplements and 10 percent sold as pharmaceutical products. Nevertheless, despite
being a recent entry, the market for non- roughly 26 billion United states dollar by
2025 [82].
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In early development of civilization plant based probiotic beverage was less

available. Medical complicacies like lactose intolerance, allergens, negative
association of bovine milk fat with cardiovascular disease compared to traditional
milk and concerned lifestyle like high protein requirement, balanced amino acid
profile, probiotic beverages have made vegan diets more appealing to consumers
than traditional mammalian milk[79]. By 2024, the global non-dairy plant milk-
based market is prognoses to generate earnings of more than 38 billion dollars, with
a compound annual growth rate of more than 14 percent between year of 2018 and
2024.

AUTHOR CONTRIBUTIONS: Paulami Ghosh: Writing original draft, Data

curation Methodology, Formal analysis. Shuchi Upadhyay: conceptualization,
Supervision and Review of work. Suvendu manna: Review and editing, validation
and supervision of work. Surajit Mondal: Review and Visualization.

CONFLICT OF INTEREST STATEMENT

The authors ready to declare no conflicts of interest in this work.
Acknowledgement: Authors would like to express sincere thanks to R&D UPES and
SoHST UPES for support.
ETHICS STATEMENT: The author declares no ethical requirement for this work

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