Exploring the health benefits, mechanisms of action, and emerging safety concerns of fermented foods with emphasis on African foods

Fermented foods are consumed worldwide for their enhanced sensory, nutritional, and functional properties. The fermentation process, primarily mediated by lactic acid bacteria, yeasts, and molds, generates bioactive compounds including short-chain fatty acids, vitamins, and peptides that support gut health, immune modulation, and nutrient bioavailability. This review examines the microbiology and biochemistry of fermentation, emphasizing how microbial communities influence the nutritional and therapeutic potential of fermented foods. Particular attention is given to traditional African fermented products, including fermented dairy-based foods, vegetables, beverages, cereals and legumes, such as ogi, nono, maziwa lala, kunu-zaki, dawadawa, ugba, iru and injera which hold significant cultural, dietary, and economic value. Differences between traditional spontaneous fermentation and controlled industrial processes are highlighted, demonstrating how standardization affects safety and product consistency. Emerging safety concerns, including biogenic amines, mycotoxins, and antibiotic resistance genes, are discussed, underscoring the need for stringent quality control, regulatory oversight, and targeted research. The review concludes with recommendations for harmonized regulations and further studies on the health implications of both traditional and modern fermented foods, with an emphasis on African dietary practices. • Fermentation enhances nutrition and safety via beneficial microbial activity. • LAB, yeasts, and molds drive bioactive compound formation in fermented foods. • Traditional African fermentations face quality and safety standard challenges. • Regulatory frameworks ensure microbial safety and probiotic strain assessment. • Harmonizing global and local guidelines can promote safer fermented foods