INTRODUCTION:

Therapeutic drinks are consumed significantly through diet, where their significance for health has gained a lot of attention over the last few years.

By 2024, the beverage market is projected to bring in US$164.10 billion (about $500 per person in the US) in sales. The market is anticipated to surpass an anticipated worth of US$259.80 billion (about $800 per person in the US) by 2029, with revenue expected to grow at a forecast 9.62% per year (CAGR 2024–2029). By 2029, it is projected that the beverage sector will be serving 1.1 billion customers.

User penetration is expected to increase from 12.0% in 2024 to 14.7% by 2029. The mean income per user is predicted to reach $218.70 USD¹.

Probiotics are the living microorganisms which are administered or taken with an objective to promote health. They are present in supplements for nutrition, yogurt and other fermented meals, and pharmaceuticals. Probiotics have been linked to some cases of serious or deadly infections in preterm infants; healthcare providers have been alerted to this risk by the Food and Drug Administration of the US (FDA)².

A prebiotic is defined as "a non-digestible food component that selectively stimulates the growth and/or activity of beneficial bacteria in the colon, thereby promoting host health and producing positive effects for the host." Only a few carbohydrate group molecules, such as lactulose, GOS, and both short- as well as long-chain β-fructans [FOS and inulin], have been categorized as prebiotics³. Probably most common prebiotics found in drinks are FOS, GOS, and inulin; which include tea, coffee, soda, powdered drinks, and alcohol⁴. Due to its tastelessness, FOS and inulin are often used as substitutes for fiber in a variety of liquids, especially tea, coffee, juices, sports drinks, energy drinks, and carbonated and noncarbonated beverages⁵.

Probiotics and prebiotics work together to prevent the growth of pathogenic bacteria and encourage the creation of healthy organisms, which is how synbiotics are made⁶. Since more people are aware of the advantages of eating a balanced diet for their health and to improve stomach function, synbiotics meet consumer needs⁷.

These days there is a lot of attention being paid to producing nutritious food, in particular food that contains probiotics, prebiotics, and synbiotics, which can help enhance the condition of the gastrointestinal tract. A substantial number of functional foods are dairy-based and have acquired broad acceptance around the globe⁸.

Fermented foods should be a part of a balanced diet to temporarily improve the live microorganisms in our guts. As a result, fermented food has become increasingly popular, and people are now requesting this kind of cuisine. Dairy products are indigestible for some populations, including those who are committed vegetarians, sensitive to lactose, or allergic to milk proteins. Thus, there is a need to investigate novel non-dairy matrices as probiotic carriers to provide customers a dairy product substitute that isn't fermented. The benefits of a variety of fermented non-dairy beverages (fruit, vegetable, cereal, legume, and pseudocereal) as potential carriers of probiotic bacteria, prebiotics, and bioactive compounds (produced throughout the fermentation process) that provide protection to guarantee that the viability of the bacteria is between 10⁶ and 10⁷CFU/mL at the point of intake, allowing the gut to absorb the bacteria in sufficient amounts to enhance human health by changing the gut flora⁹. Different classes of functional beverages were listed under figure 1.

Figure 1. Various classes of functional beverages

Health benefits:

Yogurt and fruit on their own have been found to be markers of a healthy diet. Fruits are reliable with a good number of polyphenols, prebiotic fibers, and antioxidants that all promote gut wellness. They also have a comparatively low energy density. Conversely, yogurt is a high-nutrient food that contains a variety of essential fatty acids, dairy protein, minerals like magnesium and calcium, vitamin B-12, and conjugated linoleic acid. It may also be a source of probiotics because it has helpful bacterial cultures in it. The distinct fermented food matrix found in yogurt improves digestion and nutrient absorption, adding to its already beneficial health effects. Consuming yogurt and fruit together may provide a range of vitamins and minerals, vital fatty acids, probiotics, prebiotics, and high-quality protein, all of which may have a positive synergistic impact on health. Fruits have been demonstrated to lower the possibility of cardiovascular disease, whereas yogurt has been associated with a lower risk of being overweight and type 2 diabetes. Fruits and yogurt when consumed together may have synergistic health advantages due to possible probiotic and prebiotic interactions. Moreover, the intake of less nutritious snacks when replaced with fruit and yogurt help cut down on the consumption of items high in calories that promote obesity. The favorable effects of both fruit and yogurt on the cardiometabolic system and their correlation with a balanced diet, there is enough data to support additional research into the possible synergistic health advantages of consuming both fruits and yogurt together^10,11.

Resistance to insulin, intestinal dysbiosis, and hyperglycemia are linked to type 2 diabetes (T2DM). Probiotics and prebiotics can reduce oxidative stress and decrease pro-inflammatory markers, among other different mechanisms of action that can help manage type 2 diabetes. Numerous in vitro and in vivo studies have demonstrated that the intake of dairy products, such as yogurt, as well as milk that is fermented, and cheese, enriched by potentially beneficial probiotic types, prebiotic supplements ingredients, and synbiotics, reduces insulin resistance, obesity, depressive behaviors, hyperglycemia, and oxidative stress in diabetic patients¹².

Tea, chocolate, fruits, and vegetables all contain polyphenols, which may be good for human health. For example, cocoa flavan-3-ols have been linked to a lower risk of diabetes, stroke, and myocardial infarction. Dietary polyphenols also aid in lowering blood pressure, lipid profiles, insulin resistance, and systemic inflammation. The flavonoid quercetin and the stilbene resveratrol have been related to better cardiovascular health. Dietary polyphenols' ability to have therapeutic benefits may be partly explained by their reciprocal relationship with the gut microbiota. This is due to the fact that polyphenols have been shown to have positive effects on human health via changing the composition of the gut microbiota. To be more precise, polyphenols are transformed into medicinally beneficial bioactive chemicals by the gut flora¹³.

Taking an excessive amount of alcohol generates problems with the intestinal absorption of minerals, including a few vitamins. Alcohol's ability to hinder the body's ability to absorb water and sodium is one of the factors that contribute to the likelihood of diarrhea in alcoholics. Overindulgence in alcohol (even in a single episode) can cause bleeding, erosions of the duodenum, and damage to the upper jejunum's mucosa. In addition to non-specific abdominal problems in alcoholics, a higher frequency of bacterial overgrowth in the small intestine may be a factor in the functional and/or morphological abnormalities of this area of the gut. Alcohol-induced mucosal injury makes the gut more permeable to large scale molecules. This facilitates the transfer of endotoxin along with additional bacterial toxins from the gut lumen to the portal circulation, increasing the risk of liver injury by exposing the liver to more toxins¹⁴.

Frequent intake of sugar-sweetened beverages (SSB) raises the risk of dental cavities, obesity, diabetes (type-2), and heart conditions. Use of environmental interventions, or actions that modify the social or physical context in which people choose their beverages, has been recommended as a strategy to lower sugar-sweetened beverages intake¹⁵.

Indeed, there is a correlation between the rise in adolescent obesity and the increased intake of sugar-sweetened beverages (SSBs). Sugar-sweetened drinks are beverages that contain added sugars, such as sodas, fruit drinks, energy drinks, and sweetened teas and coffees. SSBs are categorized as high-GI beverages because they lower insulin sensitivity and raise postprandial blood glucose levels. High-GI beverages also contribute to a lower sense of satiety and consequent overindulgence in food. Low-GI drinks cause hunger to reappear later, which allows you more flexibility in serving sizes and frequency. In this demographic, reducing SSB consumption, eliminating it altogether, or significantly reducing it can all help to lower calorie intake, improve satiety, lessen insulin resistance tendencies, and make weight management easier¹⁶.

Types of functional beverages:

1. Dairy based beverages:

Probiotics have been used more widely as functional components in food, animal feed, and medicinal goods throughout the last 20 years. The dairy business is the major food industry in which probiotics are used in various dairy products such as ice cream, yogurt, cheese, sour/fermented milk, and newborn formula. These probiotics are added to dairy products after fermentation, where their presence adds numerous health-promoting qualities as well as functional qualities like enhanced flavor, aroma, and texture. Alternatively, they are used as starter culture alone or in conjunction with conventional starters. Still, there are a lot of issues with the probiotics' efficacy and stability in dairy products¹⁷. Many studies have been conducted on a wide range of topics, including composition, safety and quality of yogurt and its manufacturing processes, addition of flavorings, the viscosity measurements, mixing, package, chemical-based components, physical as well as sensory characteristics, microscopic structure, specialized products, starter cultures and probiotics, and their use in sour cream. Probiotics are used for cultured buttermilk, flavor issues have emerged with time, and alternate manufacturing techniques have been developed. Yogurt and other fermented dairy items are healthy. The broader applications of cultured dairy products and novel techniques for processing them to improve shelf life and safety are the results of a century of research and development¹⁸.

2. Fruit beverages:

Fruit matrices are a technological stand-in that can be employed as an autochthonous or allochthonous LAB fermenter as well as probiotic carriers. Microbial enzymes interact with a variety of fruit phytochemicals during fermentation to produce novel molecules that affect the fermented drinks' functioning and aroma. Additionally, fermentation lowers the sugar level of fruit-based beverages, enhancing their nutritional value and prolonging their shelf life. The development of novel probiotic drinks to cater to lactose intolerant consumers or those who only take vegeterian food holds enormous potential for the global functional food industry¹⁹.Fruit drinks high in anthocyanins are particularly interesting as functional products because of their antibacterial qualities against infections, antioxidant activity, and-more recently-prebiotic potential. The strong phenolic component content and high acidity of anthocyanin-rich fruits restrict the creation of these beverages. However, the survivability of the probiotic strains in the beverages may be increased with careful strain selection and media adaptation techniques. Probiotic cultures are more viable during fermentation, which also enhances the product's stability and safety and may boost its antioxidant potential. Furthermore, probiotic health effects may be enhanced synergistically by fermentation metabolites. Conversely, probiotic inoculation without fermentation enables the production of synbiotic beverages with softer physicochemical and sensory alterations²⁰.

3. Sports beverages:

Functional beverages are a tasty and practical way to replace electrolytes, carbohydrates, and various other elements lost or consumed during physical training and competitions. An athlete's level of body hydration amid physical activity is one of the best indicators of their health and can potentially negatively affect their performance. Athletic performance is severely hampered by dehydration until it becomes hazardous. The demands of athletes are said to be supported by the remaining nutrients during and/or after physical activity²¹. Beetroot juice increases nitric oxide (NO), which has a number of advantages including better blood flow, gas exchange, biogenesis of mitochondria and efficiency, and increased contraction of muscles. Juice from beetroot intake may have ergogenic benefits on endurance of the heart and lungs, which could improve sports performance, based on these changes in biomarkers. By increasing efficiency, which improves performance through a range of distances, lengthens the time to exhaustion at submaximal intensities, and may improve the greatest absorption of oxygen and cardiorespiratory performance at anaerobic threshold intensities (VO2max), the consumption of beetroot juice supplements can help athletes achieve greater cardiorespiratory endurance. Supplementing with beetroot juice may mitigate the ergolytic effects of hypoxia on the cardiorespiratory endurance of athletes. Supplementing with beetroot juice may not have a decisive effect on cardiorespiratory endurance, pairings with other Supplements like caffeine may outweigh the benefits of beetroot juice consumption²².

4. Energy beverages:

Energy drinks (EBs) with compounds and stimulants are becoming more common in grocery stores and gyms, and they are being consumed more often by "weekend warriors" and athletes looking for an advantage in endurance competitions. The cardiovascular system may change significantly after prolonged exposure to the different energy beverage components, and the safety of energy beverages is still being investigated.²² Various functional beverages properties and uses are described^{23- 25}in Table 1.

Fermented milk and dairy products have been integral to human diets since ancient times. Various strains are employed in fermenting these products, with lactic acid bacteria being the most common agents. These bacteria, abundant in nature and present on mucosal surfaces of the human body, are deemed safe (GRAS) due to their widespread use in fermented foods. Key genera within the lactic acid bacteria group include Lactobacillus, Leuconostoc, Lactococcus, Pediococcus, and Streptococcus. They ferment milk carbohydrates, primarily lactose, into lactic acid and other byproducts. The resulting acidity precipitates milk proteins, contributing to the thicker consistency of fermented products. This high acidity and low pH inhibit the growth of undesirable bacteria, including pathogens. Some lactic acid bacteria also produce antimicrobial agents. Given milk's rich nutrient profile, including protein, calcium, phosphorus, and B vitamins, dairy products are highly nutritious. Table 2, describes the source of microorganisms and their therapeutic uses of dairy and non-dairy beverages^26-28.

CONCLUSION:

Consumer attention is shifting towards advertisements promoting functional beverages, including stimulant drinks, sports beverages, and other fortified drinks that promise to enhance performance, mental alertness, and physical refreshment. Additionally, there is a growing willingness among consumers to invest in products that promote intestinal health, making it a sought-after functional attribute. Consequently, companies have an opportunity to expand their customer base and product offerings. Given the competitiveness of the functional beverage market, producers must respond to evolving consumer demands and drive innovation by incorporating scientifically validated benefits of potent active ingredients to differentiate their products. The primary market driver is the increasing demand for probiotic beverages, driven by health-conscious consumers. The rising popularity of veganism is also driving demand for plant-based alternatives to functional dairy milk. While plant-based milk analogs may not offer all the nutritional benefits of dairy, producers are addressing this by fortifying their products with micronutrients such as calcium and vitamins D and B₁₂ to enhance their nutritional value.

ACKNOWLEDGEMENT:

We express our sincere thanks to Dr. L. Rathaiah, Chairman, Vignan Group of Institutions for providing necessary facilities to carry out the above review.

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Received on 04.05.2024 Revised on 07.11.2024

Accepted on 03.03.2025 Published on 02.08.2025

Available online from August 08, 2025

Research J. Pharmacy and Technology. 2025;18(8):3969-3973.

DOI: 10.52711/0974-360X.2025.00570

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Type of beverage	Source	Property	Use
Orange juice	Vit-C	Anti-oxidant	It helps in reducing-Age-related macular degeneration and cataract, cancer, cardiovascular disease.
Cranberry juice	Vit-C,E,K	Anti-oxidant	It helps in maintaining-Blood pressure, inflammatory conditions, stress-related oxidative damage, cholesterol, and metabolism of glucose prevent urinary tract infections.
Prune juice	B-Complex C,E,K vitamins	Anti-oxidant including phenolic compounds	Used in the treatment of constipation. Maintain the health of skin eyes and nervous system and help in the production of red blood cells.
Pomegranate juice	Good source of Vit-K	High in anti-oxidants	It improves memory and heart health.
Tomato juice	Vit-C	Good source of lycopene and anti-oxidants	Maintain skin health and potassium present in it decreases blood pressure.
Isotonic sports drinks		Contains similar amount of carbohydrates and electrolytes as that of human body	Restoring water, carbohydrates, and salts lost during exercise is the urpose of isotonic sports drinks. The drink's electrolyte and carbohydrate content keep the body's glycogen levels stable.
Hypotonic sports drinks		Presence of less percentage of carbohydrates	Primarily consumed by athletes who need less carbohydrates and more water.
Hypertonic sports drinks		Presence of highest percentage of carbohydrates	The rate of water passage in the human gut is increased when hypertonic sports drinks are consumed.

Beverage	Product	Microorganism	Activity	Effect of micro organism
Dairy	Kefir	Lactobacillu skefiri	Anti-microbial activity	Resistant to bile
	Yogurt	Lactobacillus barbarum	Anti-oxidant activity	Naturally sweeten yogurt and increase yogurt aroma
Non-diary	Apple juice		Anti-oxidant activity	The DPPH assay's examination of antioxidant characteristics in connection to FRAP and radical scavenging activities