## 4 Discussion  
Maintaining cardiovascular and metabolic health is related to many dietary and lifestyle factors, including maintenance of a healthy lipidemic and glycemic profile, as well as oxidative balance [13]. Lifestyle options, such as the inclusion of traditionally fermented soy products, have been suggested as practical tools to address these oxidative and inflammatory issues related to chronic diseases [4]. In this context, miso intake has been inversely associated with cardiovascular risk in women [14], while daily miso consumption for 9 months has been demonstrated to improve the profile of cholesterolemia [11]. Furthermore, implementing sustainable practices to enhance such foods may provide additional health benefits. Fruit byproduct extracts appear to enhance the antioxidant profile of fermented foods, leading to a synergistic activity [15; 16]. Our previous clinical study investigated the acute effect of a miso-type sauce, enhanced with a carotenoid-rich extract from fruit byproducts, on metabolic biomarkers [4]. The findings were highlighted by the postprandial improvement of total plasma antioxidant capacity, serum lipidemic profile (triglycerides, LDL cholesterol), and platelet aggregation in healthy humans after following a high-fat and carbohydrate meal with the novel miso-type sauce [4]. This pilot nutritional intervention-clinical study investigated the effect of the habitual consumption of the innovative biofunctional miso-type sauce, enhanced with bio-carotenoids, on biomarkers of oxidative stress, lipidemia, and glycemia. The nutritional intervention showed that the daily consumption of the biofunctional miso-type sauce for 30 days, in the context of the usual diet, led to increased plasma TAC among healthy participants, compared with the adverse effects observed after the control sauce consumption. This finding is fully consistent with those of the acute dietary intervention lasting 3 h [4]. Although postprandial metabolism appears to be directly affected by the presence of antioxidant components in the context of a high-fat, high-carbohydrate meal, it is probable that this effect is maintained during long-term intake. The role of miso as a free-radical scavenger is mainly related to the improvement of the 1,1-diphenyl-2-picryl-hydrazyl (DPPH) radical scavenging ability, as confirmed by [PERSON] and colleagues [17]. There is evidence that habitual miso soup consumption may reduce Renin-Angiotensin System (RAS) activation and oxidative stress, which are related to the pathogenesis of hypertension [18]. However, there are no clinical studies exploring the exact effect of daily miso intake on parameters of oxidative damage. The demonstrated findings may be attributed to the antioxidant activity of isoflav, presented in the biofunctional fermented sauce. Evidence supports that biofransformation with microorganisms, including _Aspergillus_ sp., may improve \(\beta\)-glucosidase activity, increasing the isoflavone aglycone content [19]. The potent antioxidant activity of isoflav has been noted to be exerted in both lipophilic and aqueous phases. It is noteworthy that the bioavailability of isoflavones in their aglycone form, and, by extension, the extent of ROS reduction, also depends on the bioavailability of phytochemicals [20]. In vitro studies on similar fermented products, such as tempeh, indicate that during the prolonged fermentation process, _Aspergillus oryzae_ may exert proteolytic activity, leading to the production of bioactive peptides and amino acids, which are also bioavailable and may enhance the overall antioxidant activity of the product [21]. Furthermore, there are indications that this bioprocess may release antioxidant compounds derived from fruit byproduct extracts, such as polyphenols and carotenoids, and enhance their biological activity [17]. Numerous observational studies suggest that higher concentrations of circulating carotenoids are inversely associated with markers of oxidative stress.