> Statements of significance

> Scientific studies have already highlighted that sourdough fermentation can improve nutrient bioaccessibility or reduce the GI of bread; however, it remains unclear whether the effect of sourdough fermentation on cereals translates to beneficial effects in a clinical setting. Our systematic review reveals the difficulty in establishing a clear consensus with regards to the beneficial effects of sourdough per se on health and suggests that sourdough has great potential to produce a variety of functional foods; however, its complex and dynamic ecosystem requires further standardization to conclude its clinical health benefits.