Fermented achar may help combat malnutrition among women, finds AKU study

Eating small daily portions of traditional fermented pickle can improve gut health and help counter the effects of malnutrition among women in rural Sindh, according to a new study by experts from the Aga Khan University (AKU). 

The community-based trial, conducted in Matiari district, found that women who consumed lemon-chilli and onion achar every day for eight weeks showed marked improvements in gut microbiome diversity and signs of a more balanced immune system.

The study involved 223 women aged 18 to 48, all living in an area with a high prevalence of under-nutrition. Participants consumed about 50 grammes of six types of locally made fermented pickles daily.

The pickles included mango, carrot, radish, onion and lemon-chilli pickles prepared using traditional recipes by a local woman entrepreneur.

Compliance exceeded 70 per cent, demonstrating that such foods can be easily incorporated into the diets of low-income rural families without significant cost or disruption.

Researchers found that women in the lemon-chilli and onion pickle groups experienced significant increases in the diversity of gut bacteria, a key indicator of gut and metabolic health. Blood tests also showed a reduction in white blood cells and platelets, along with an increase in mean corpuscular haemoglobin, suggesting better immune regulation and reduced inflammation.

AKU experts said malnutrition remained a major challenge in Pakistan, where millions of women of reproductive age faced food insecurity and poor diet diversity.

A lack of nutritious options disrupts the gut’s microbial balance, leading to inflammation, poor digestion and reduced nutrient absorption. Fermented foods, rich in beneficial bacteria and bioactive compounds, can help restore gut health, improve digestion and enhance the body’s ability to absorb nutrients more efficiently.

Unlike imported probiotic supplements, traditional South Asian pickles or achar are affordable, widely available and deeply rooted in local culinary culture. The fermentation process naturally boosts the nutritional value of vegetables such as mango, lemon, radish, and onion by generating short-chain fatty acids and peptides that support immune function and lower inflammation.

According to the AKU research team, encouraging the consumption of fermented foods could be a sustainable and low-cost strategy to address malnutrition in women and children across Pakistan. The initiative also supports women’s economic empowerment, as local female entrepreneurs can be trained to produce safe, standardised fermented foods for their communities.

The study was led by Dr Najeeha Talat Iqbal, Dr Junaid Iqbal, Dr Syed Asad Ali, and their colleagues from the AKU departments of paediatrics and child health, biological and biomedical sciences, and community health sciences with collaboration from international partners.

They experts recommended larger-scale studies across the country to further assess the benefits of fermented foods for women’s health, particularly among malnourished and pregnant populations. The researchers suggested that integrating traditional food knowledge with modern nutrition science could provide Pakistan with sustainable home-based solutions to improve maternal and child nutrition.

The study, ‘Fermented pickles improve gut microbiota and immune profile in women in a community trial in rural Pakistan’, was published in Scientific Reports.