Mapping Fermented Food Prevalence and Intake Across European Regions: Results from the PIMENTO Study

Background/Objectives: Fermented foods are integral to European diets, yet compre-hensive data on their consumption patterns remain scarce. This study aimed to char-acterise fermented food intake across four European regions and examine demographic influences on consumption behaviour. Methods: Cross-sectional data were collected from 12,646 adults in 53 countries (2023–2024) using the validated Fermented Food Frequency Questionnaire (3FQ) under the PIMENTO COST Action (CA 20128). Weighted analyses accounted for regional popu-lation distributions, sex, and age. Intake was assessed across 15 fermented food cate-gories, with prevalence and quantity estimates derived from frequency and portion-size data. Results: Among all fermented food groups, fermented dairy products were consumed almost universally (94.1–95.6%) with median daily intakes of 66.7–80.1 g/day. Coffee and fermented cereals were also highly prevalent (78.4–84.1% and 89.9–95.9%, respectively), with median intakes of 60.0–73.1 g/day for coffee and 44.0–77.1 g/day for cereals. Choc-olate showed a weekly intake (76.0–138.8 g/week) with prevalence exceeding 90% in all regions. In contrast, fermented vegetables and legumes had low intakes (4.4–8.4 g/day and 4.5–9.0 g/week, respectively), and plant-based alternatives were consumed by up to 72.8% in Western Europe, but with a negligible intake (median 25.5 g/week). Alcoholic beverages varied regionally: wine ranged from 12.5 to 25.0 g/day, and beer/cider from 25.0 to 50.0 g/day. Fermented non-alcoholic beverages had low prevalence (18.3–49.3%) but relatively higher weekly intake among consumers (18.7–49.8 g/week). Across cate-gories, a clear discordance emerged between high prevalence and modest intake. Conclusions: This Europe-wide mapping of fermented food consumption revealed substantial regional heterogeneity and modest overall intake. These findings help es-tablish baseline data for nutritional epidemiology research and evidence-based dietary guidelines, although they also support that region-specific rather than pan-European dietary guidelines may be required. Future research should integrate microbiome and other approaches to elucidate their combined health implications comprehensively.