Traditional fermented foods and beverages have played a vital role in the diet, culture, and economy of Eastern African countries for centuries, contributing significantly to food security, poverty alleviation, and sustainable development. Despite their importance, comprehensive documentation of their production methods, nutritional benefits, and safety challenges remains limited. This review critically examines the most widely consumed fermented foods and beverages in the region, derived from both plant and dairy sources, with a focus on their processing technologies, microbial dynamics, nutritional profiles, and food safety issues.
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