A survey of consumer ’ opinion about consumption and health benefits of fermented plant beverages in Thailand

Fermented plant beverages (FPBs) are non-alcoholic FPBs due to the Lactic acid bacteria (LAB) mediated fermentation. The LAB fermented beverages are produced from a wide variety of plant based ingredients like cereals, fruits, and vegetables. The LAB fermented beverages are widely prepared and consumed throughout the world particularly in Thailand. Many people in Thailand believe that consumption of FPBs can prevent and cure sickness, and have anti-aging property (Peerajan et al., 2016). FPBs were initially produced for household use by the local people, and later they were commercialized due to the health benefits of FPBs. About > 3,500 different fermented products are available in the market and being consumed by the people over the world, and most of the FPBs and fermented dairy products are produced in Asian, African, and Eastern countries (Kabak & Dobson, 2011). Many countries have unique FPBs regarding preparation, raw materials usage, and starter culture. The cereals based indigenous FPBs were reviewed and listed by Waters et al. (2015).


Introduction
Fermented plant beverages (FPBs) are non-alcoholic FPBs due to the Lactic acid bacteria (LAB) mediated fermentation.The LAB fermented beverages are produced from a wide variety of plant based ingredients like cereals, fruits, and vegetables.The LAB fermented beverages are widely prepared and consumed throughout the world particularly in Thailand.Many people in Thailand believe that consumption of FPBs can prevent and cure sickness, and have anti-aging property (Peerajan et al., 2016).FPBs were initially produced for household use by the local people, and later they were commercialized due to the health benefits of FPBs.About > 3,500 different fermented products are available in the market and being consumed by the people over the world, and most of the FPBs and fermented dairy products are produced in Asian, African, and Eastern countries (Kabak & Dobson, 2011).Many countries have unique FPBs regarding preparation, raw materials usage, and starter culture.The cereals based indigenous FPBs were reviewed and listed by Waters et al. (2015).
The main purpose of fermenting the food and consuming the fermented products are the preservation of food from spoilage for quite a long period, and enhancement of the nutritional value of food, respectively.The process of making FPBs detoxify the adverse compounds of plant raw materials like phytates, tannins, and polyphenols (Gadaga et al., 1999).The consumers of FPBs are trusting that FPBs can prevent obesity, diabetics, diseases related to gastro intestinal tract, and even cancer.Some studies reported that the raw materials and compounds of traditional FPBs have anti-lung cancer, anti-colon cancer, and anti-breast cancer properties (McGovern et al., 2010;Takagi et al., 2015).
Furthermore, the lifestyle of the consumer, an increase in food allergies, food intolerance, malabsorption, and diet-related diseases like cardiovascular disease, hyper blood pressure affected the fermented food market during the last decade, especially dairy products.FPBs are good enough to supplement the dietary antioxidants, dietary fiber, minerals, vitamins, and other micronutrients to needy people (Waters et al., 2015).
Thai FPBs are commonly manufactured as per the ancient formulation with industrialized procedures for commercial marketing throughout the country.Thai Community Product Standards (TCPS) (No. 481/2004) regulates the quality of the local products, especially fermented beverages.As per the regulation of TCPS, the quality criteria for Thai FPBs are with the limitations of ethanol content (≤ 3% v/v), methanol content (≤ 3% v/v), pH (≤ 4.3), and no viable cells of Salmonella spp., Staphylococcus aureus, and Clostridium perfringens in 50 g, 1 ml, and 0.1 g of sample, respectively.Moreover, the presence of Escherichia coli should be < 2.2 MPN index per 100 ml of sample, and Yeast and mold count should be ≤ 100 colonies per 1 g of sample, respectively.Recently, we have examined and reported the physical and chemical safety of commonly used FPBs of Thailand and most of the FPBs are safe to consume except some Morinda based drinks, and the study also recommends the benign serving size of FPBs (Chaiyasut et al., 2017).
On Thailand, public media like newspapers, organic and agriculture society, and community education centers are promoting the production and use of ethnic FPBs.Thus far, as per our knowledge, there was no detailed report on opinion and consumers' preference for the FPBs in Thailand.Accordingly, the current study was conducted to know the real status, satisfaction of consumers, and the impact of FPB consumption by surveying the representatives from all the parts of Thailand.

Methodology
About two hundred and thirty-five (∼235) consumers were randomly selected to represent all the part of Thailand.Every person was individually interviewed by one of our field researchers, and the information was collected for the prescribed questions (Appendix 1).The questions were about consumption methods, effects of FPBs, consumers' satisfaction, and benefits of FPBs along with their identity.The representative consumers were asked to write the answers to the questionnaire by themselves, or an interrogator filled the form as per the oral response of consumers.All the collected information were cumulated and verified twice with an independent researcher to avoid the human error.The data is represented in percentage for every executed parameter, and these are presented in tables and figures.
The majority of the people (69 out of 235; 29.4%) reported that they consume 2 servings per day, regularly.Subsequently, 44 (18.7%), 30 (12.8%), 28 (11.9%), and 25 (10.6%)consumers stated that they consume once a day, 1-2 servings per week, almost every day, and 3 servings per day, respectively (Figure 1b).There was no consistency in the serving size (volume of the consumption) among the consumers of FPBs, and it depended on the economic issues and availability of the product at the time of acquisition.
The continuation of FPBs consumption was influenced by the beneficial and adverse effects being gained by the consumers because of the FPBs.About 23.4% of people terminated the Worldwide, fermented foods and beverages occupy about one-third of the human diet (Borresen et al., 2012).A consumer' sensory survey regarding selection of Gochujang (Korean soybean and grain-based fermented food with red pepper) as one of the food in their diet revealed that the modification of flavor like reduced hotness, promote the selection of the food by UK consumers (Burgess, 2014), which indicated that the selection of fermented food attributed to many characteristic features of the food.
The consumption of FPBs increased the severity of some of the illness, such as drowsiness, arthralgia, opportunistic infection in HOV patients, kidney disease, asthma/allergy, hypertension, and other conditions (frequent urination, and edema), but the worsening of health condition was recorded in ∼ 0.4-2.1% of consumers (Figure 2a).
FPBs drinking habits for multiple reasons, among them, 3.8% of the consumers stopped the consumption of FPBs due to some adverse effects.About 70.6% of consumers continued the consumption of FPBs among which 18.8% people faced some of the adverse effects (Figure 1c).The detailed scientific report on adverse effect of FPBs is not available.The probiotic strains isolated form the FPBs of Thailand was not harmful to experimental animals (Duangjitcharoen et al., 2009).
Vietnamese traditional fermented foods are reported as rich sources of probiotic and beneficial microbes.The short term and long term fermented foods are used.Dua chua (short term fermented fruit or vegetable), and Tuong (long-term fermented Soybean sauce paste) were the major fermented plant based food of Vietnam.The health promoting properties such as anticancer, antimicrobial activities are attributed to the residing natural microbes especially lactic acid bacteria (Anh, 2015).A detailed study on consumption of Kimchi, (famous Korean salt-fermented food and a good source of minerals, vitamins, fibers, and other trace nutrients) suggested that the intake of kimchi containing a large volume of salt was not associated with hypertension, indeed, high consumption of kimchi helps to neutralize the salt imbalance (Song & Lee, 2014).
The people in the Eastern Himalayas region prepare and use traditional soybean based fermented foods namely Kinema, hawaijar, tungrymbai, bekang, and peruyaan.Even though it is prepared by the natural fermentation process, Bacillus subtilis is the major microbe involved in the process, because the usage of starter enhances the process and achieve the product earlier.
The sticky fermented soybean provides the nutrient-rich, low-fat content diet with the antioxidant property that nourishes the consumer' health (Tamang, 2015).
The influence of fermented food on the mental health of the human has already been reviewed (Selhub et al., 2014).Ot is known that the changes in the microbiome of the human cause psychological changes, and the diet play the major role in gut microbiome fluctuations (Dash et al., 2015;Kennedy et al., 2016).The foodborne bacterial infection like Cronobacter sakazakii infection was also reported showing impact on the cognitive behavior of the experimental animal (Sivamaruthi et al., 2015).The preparation of FPBs in hygienic condition might provide the health benefits to the consumers.Ultimately, the survey results suggested that the consumption of FPBs improved the mental health of the consumers by regulating the microbiome.The variations in the opinion were due to the consumption of different FPB products with different composition and microbial load.

Commonly available FPBs in Thailand, storage, and economic feasibility
We surveyed most common and popular FPBs of Thailand.A sum of 226 products was identified as popular fermented drinks in Thailand, among which Morinda (128), and black galingale (38) based products occupied the major FPB market in Thailand.About 95 (42.0%), and 96 (42.5%) products were in the form of a concentrate and were sour, and sweet taste, respectively.A sum of 35 (15.5%)FPBs was under the ready to drink categories (Table 3).
The storage temperature of FPBs plays the critical role in preserving the beneficial effects of the raw materials.Most of the surveyed consumers reported that they stored the FPBs (both concentrated (57.9%) and ready to drink products (18.7%)) at room temperature, and about 28.1% and 18.3% of people stored the concentrated and ready to drink FPB products at refrigerator (∼ 4 °C) temperature, respectively.Some of the consumers did not disclose the proper storage conditions of their FPB products (Figure 3a).The storage condition of the product varies on the availability of refrigerator and basic knowledge of the preservation method of FPBs.The majority of the surveyed consumers conveyed that the consumption of FPBs did not affect their economic status, and it was effective (88.1%), but 6.4% of the people reported that the FPBs was not economically feasible (Figure 3b).

Overall consumer' satisfaction about FPBs
The overall consumer' satisfaction about FPBs was collected with six different scales (from 5 star (excellent) to 1 star (poor), and unknown) and three different categories (about benefits, physical and economical properties, and the status of the consumer after consumption of FPBs).
A sum of 94, 73, and 40 consumers reported that the benefits of FPBs are very good, excellent, and good, respectively.
The general acceptability of FPB consumption by the surveyed consumers was "very good" (Table 4).The results suggested that the majority of consumers of FPBs are, in general, were satisfied with the current quality of FPBs.

Conclusion
Even though, several studies detailed about the beneficial effects of fermented fruits, vegetables, and Lactic acid bacteria (Di Cagno et al., 2013;Swain et al., 2014).The opinion of FPB consumers may vary on the type and composition of product, and frequency of usage.The current survey results suggested that the fermented plant beverages of Thailand are in continuous use by the Thai people which was not entirely influenced by the adverse side effects of FPBs.Moreover, many surveyed consumers said that they recovered from several illnesses, for which they started consuming the FPBs.People's opinion on FPBs may change on the introduction of new products, advertisements, and other marketing artifices, but the popularity of the traditional Thai fermented beverages remains unchanged.
Appendix 1. Questioner form for the survey of fermented plant beverages (FPBs) consumers in Thailand.

Figure 1 .
Figure 1.The rationale of FPBs consumption among the surveyed Thai consumers (a), the consumption regularity (b), the continuity of FPBs consumption (c).Percentage value represents the number of consumers.

Figure 2 .
Figure 2. Harmful (a), and beneficial effects (improvement in health conditions) (b) to the consumers during FPBs consumption, and changes in the psychological status of the consumers (c).Percentage value represents the number of consumers.

Figure 3 .
Figure 3.The storage pattern of FPBs in Thailand (a), and the impact of FPBs consumption on the economic status of the surveyed consumers (b).Percentage value represents the number of consumers.

Table 1 .
Basic information about the surveyed consumers of FPB in Thailand.

Table 2 .
The effects of FBPs consumption.

Table 3 .
The popularity of FPBs in Thailand.

Formula Nature of the products *Concentrate Ready to drink Sour Sweet
The consumers have to prepare the drink from the fermented plant concentrates.The values are represented in numbers and in percentage. *
*1-5 represent the satisfaction levels.5 indicates consumers were extremely satisfied with FPBs, and 1 indicates the satisfaction level is very poor.

Information about the consumption of FPBs 2
.1 What FPBs did you consume, and where you find it (On decreasing order of the preference) When you started consuming FPBs, Did you have any adverse reactions in the first week of consumption?(you can choose more than one) □Normal/did not have any adverse effects □ Dry mouth or throat □Drowsiness □ Fever □ Diarrhea June 2018 308 308/309 Consumer opinion about fermented plant beverages 3.6 Which conditions or diseases got better after consuming FPBs? (you can choose more than one) Dpportunistic infection in people with HOV (specify) …………………….……….. Did you have any adverse reactions after consuming for more than a week?(You can choose more than one choice) Of you consumed concentrated FPBs, when did you completely consume each bottle?

satisfaction of FPBs benefits Check
√ in the table which depend on your opinion or write your suggestion in the space below Did you think that consuming FPBs can help to improve your qualities of life?