A Systematic Review on the Health Effects of Fermented Wheat Germ Extract with Emphasis on Cancer

MÜZEYYEN BERKEL KAŞIKÇI¹Aline Issa^2*Nurcan Baglam³Emine Dincer³Amaury Gérard⁴Sumeyye Kabakci⁵Vasfiye Hazal Özyurt⁶Zsolt Zalan⁷Taner Sar⁸Burcu Gündüz Ergün^10,9Christophe Chassard¹¹Smilja Praćer¹²Guy Vergères¹³Mustafa Guzel^14*

• ¹Department of Food Engineering, Manisa Celal Bayar University, Manisa, Türkiye
• ²Department of Nursing and Health Sciences, Notre Dame University– Louaize, Zouk Mosbeh, Zouk Michael, Lebanon
• ³Nutrition and Dietetics Department, Sivas Cumhuriyet University, Sivas, Türkiye
• ⁴Brewing and Food Industry (BrAlim) Research Unit, LABIRIS, Brussels, Belgium
• ⁵National Food Reference Laboratory, Ministry of Agriculture and Forestry, ankara, Türkiye
• ⁶Department of Gastronomy and Culinary Arts, Mugla Sitki Kocman University, Mugla, Türkiye
• ⁷Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences Research, Budapest, Hungary
• ⁸Swedish Centre for Resource Recovery, University of Borås, Boras, Sweden
• ⁹Health Biotechnology Centre of Excellence for Joint Research and Application (SABIOTEK), Yildiz Technical University, Istanbul, Türkiye
• ¹⁰Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Yildiz Technical University, Istanbul, Türkiye
• ¹¹Human Nutrition Unit, INRAE, Université Clermont-Auvergne, Clermont-Ferrand, France
• ¹²Institut za Bioloska Istrazivanja Sinisa Stankovic Odeljenje za geneticka istrazivanja, Belgrade, Serbia
• ¹³Research Division Microbial Food Systems, Agroscope, Berne, Switzerland
• ¹⁴Hittite University, Çorum, Türkiye

ABSTRACT Fermented wheat germ extract (FWGE) is one of the few fermented food products listed in the EFSA novel food Catalogue. It is derived from wheat germ, a by-product of wheat processing, through fermentation with Sacchoromyces cerevisiae. The most widely studied and patented form of FWGE is marketed as Avemar (also referred to as MSC), standardized to contain methoxy-substituted benzoquinones. Given its predominant use in research, this systematic narrative review focused primarily on FWGE use within the medical application. The objective of this review was to systematically evaluate the functionality and potential health benefits of FWGE, following the Study Protocol-S8 developed under COST Action CA20128 – PIMENTO and registered on the Open Science Framework (https://osf.io/fq53j/). A systematic literature search of human studies was conducted through PubMed, Scopus, and Cochrane Library. Studies involving adult participants who received FWGE interventions were included, with primary clinical endpoints selected according to the main indications for FWGE. Additional outcomes were reported when available. Out of the 51 records identified by the literature search, six studies met the inclusion criteria. Data from these studies were extracted and synthesized in summary tables. Supplementary information on the functionality of FWGE was retrieved through a non-systematic search of animal and in vitro studies. Furthermore, this review highlights the potential bioactive constituents of FWGE, particularly benzoquinones, peptides, and phenolic compounds, as mediators of its anticancer and anti-inflammatory properties. Among its proposed mechanisms, FWGE may suppress cancer cell proliferation by disrupting the glucose-related metabolic pathways. While the findings suggest that FWGE may possess therapeutic potential, especially in oncology, the strength of evidence remains limited. Of the six included human studies, only four employed proper control groups and only two demonstrated high methodological quality. As such, the current evidence base is insufficient to draw definitive conclusions, and well-designed clinical trials are needed to strengthen this evidence. Moreover, future research should also explore the development of novel FWGE formulations with enhanced bioactive profiles, optimized by modulating fermentation conditions, including such as microbial strain, pH, temperature, and duration.