Germany 2026: knowledge and behaviors about microbiota
The survey was conducted by Ipsos among 7,500 people in 11 countries (France, Portugal, Poland, Finland, Italy, Germany, United States, Mexico, Brazil China, and Vietnam).
Germany and microbiota:
awareness is growing but HCP education and behavioral change remain the lowest in Europe.
Summarizing Germany's results in the survey
In 2026, Germany presents one of the most challenging profiles in the study. Awareness has grown to 68%, and the country shows solid general health behaviors. But on the indicators that matter most for microbiota health (HCP education, probiotic prescriptions, antibiotic counselling, first 1000 days, and behavioral change), Germany consistently ranks at or near the bottom across Europe. The gap between the trust patients place in their doctors and the microbiota information they actually receive is particularly pronounced here.
1. Germans display growing microbiota awareness but limited understanding
68% of German respondents have heard of the microbiota. While this is below the global average of 72%, it represents meaningful progress from previous years. But awareness does not translate into depth: only 19% know exactly what the microbiota is, and knowledge of specific mechanisms remains largely surface-level.
of Germans have already heard of the term microbiota
(vs. 72% globally)
1 in 5 of them know exactly what the microbiota is
(vs. 24% globally)
over half are aware of the gut microbiota
(vs. 63% globally)
Low awareness across all microbiota types
Germany’s awareness profile is consistently below global averages across all seven microbiota types measured, though the gut microbiota remains the most recognized:
- 54% of respondents are know the gut microbiota (vs. 63% globally);
- 46% are aware of the skin microbiota (vs. 50% globally);
- 41% are aware of the vaginal microbiota (vs. 51% globally);
- 38% know the oral microbiota (vs. 52% globally).
Learn all about microbiota
Learn moreWhere knowledge is solid and where it falls short
German respondents show strong understanding of diet and its microbiota consequences, and of antibiotic impact:
- 78% know diet has significant consequences on microbiota balance;
- 71% know antibiotics have an impact on the microbiota;
- 65% correctly identify that IBS, obesity, and vaginosis can be linked to the microbiota;
- 60% know the gut communicates essential information to the brain.
But gaps appear when knowledge moves beyond general associations to specific disease links:
2. Europe lowest behavioral change, with few microbiota-specific habits
37% of German respondents have changed their behaviors to protect their microbiota: the lowest rate in Europe alongside France, and 16 points below the global average. This does not reflect a generally unhealthy population: German respondents show strong results on several traditional health indicators. The gap is specific to microbiota-oriented habits, which suggests the deficit is primarily one of awareness and motivation, not capacity.
of Germans have changed behaviors to protect their microbiota
(vs. 53% globally)
more than half consider their gut microbiota well balance
(vs. 59% globally)
of them consume fermented foods at least weekly
(vs. 67% overall)
Strong traditional health habits, weaker microbiota-specific ones
German respondents perform above average on certain traditional health behaviors:
68% engage in physical activity at least weekly (vs. 73% globally), and 70% consume fermented foods at least weekly, above the global average of 67%.
56% never self-medicate for intimate irritation (vs. 42% globally), the highest rate in Europe. 69% of female respondents never practice vaginal douching, above global average (56%).
But microbiota-specific supplementation habits are among the lowest globally:
- Only 19% of them consume probiotics at least monthly (vs. 42% globally);
- Only 16% consume prebiotics at least monthly (vs. 38% globally).
What is the difference between prebiotics, probiotics and postbiotics?
Find out more
3. German HCPs among the least active educators on microbiota
94% of German respondents trust healthcare professionals as one of their primary sources of microbiota information. This near-universal trust is a significant asset, yet the information German HCPs actually transmit to their patients is among the lowest recorded across all 11 countries. The gap between trust and delivery is particularly stark in Germany.
of Germans trust HCPs as one of their primary sources on microbiota information
(vs. 94% globally)
of them received an explanation of what the microbiota is
(vs. 39% globally)
received all key microbiota information from their HCP
(vs. 23% globally)
A consistently low educational impact
On every indicator of HCP-transmitted microbiota education, Germany ranks at or near the bottom:
27% of respondents were educated on the importance of preserving microbiota balance (vs. 43% globally). 25% received guidance from their HCPs on behaviors to adopt (vs. 43% globally). Only 24% were prescribed probiotics or prebiotics by their HCPs, the lowest rate in the study (vs. 51% globally).
Antibiotics: the most pronounced education gap
In Germany, not enough HCPs take the opportunity to educate about the microbiota when prescribing antibiotics. Only 14% of German patients received all key antibiotics-related information when antibiotics were prescribed, the lowest rate in the study alongside France:
- 24% were told by their HCPs antibiotics could negatively affect their microbiota balance (vs. 39% globally);
- 30% were told about digestive disorders associated with antibiotics (vs. 45% globally);
- 20% received advice from their HCPs on limiting the negative consequences of antibiotics on the microbiota;
- Only 14% were co-prescribed probiotics alongside antibiotics, the lowest rate in the study (vs. 38% globally).
Antibiotics: what impact on the microbiota and on our health?
Learn more
4. The first 1,000 days: a concept still largely unknown among German parents
In 2026, about 18% of German parents and pregnant women have heard of the concept (below the global average of 43%), but 20% of parents received all key information from their pediatrician (vs. 39% globally).
of German parents/pregnant women are aware of the first 1,000 days concept
(vs. 43% globally)
of them claimed to know exactly what it means
(vs. 15% globally)
received information on early microbiota development from their HCP
(vs. 39% globally)
Significant misconceptions among German parents
- 4% of parents know that the baby's microbiota does not start developing inside the mother's womb, below the global average of 11%;
- 88% don't know that by age 5 the gut microbiota is not yet adult-like;
- 36% don't know the impact of early antibiotic use on infant gut microbiota development, slightly higher than the global average of 35%;
- Only 1 in 3 know that pet exposure during early life influences the gut microbiota.
In Germany, the high trust in healthcare professionals is not being transformed into microbiota education. This is reflected in below average knowledge by Germans of the microbiota. HCPs could be more active in teaching patients about microbiota, especially when it comes to explaining about the first 1000 days concept.
Methodology
This fourth edition of the International Microbiota Observatory was conducted by Ipsos on 7,500 individuals across 11 countries (France, Portugal, Poland, Finland, Italy, Germany, the USA, Brazil, Mexico, China, and Vietnam). The countries surveyed are the same as in the previous wave.
The survey was conducted over the Internet between February 3 and Mars 13, 2026. For each country, the sample is representative of the population aged 18 and over in terms of :
- gender
- age
- profession
- region
Representativeness was ensured via quota sampling, the most commonly used sampling method for obtaining a representative sample of the population studied. The quota variables for each country were gender, age, region, and socio-professional category. The data were adjusted:
- within each country, again to ensure that each population is representative
- globally, so that each country has the same weight. Statistical analyses were carried out using Cosi software (M.L.I., France, 1994), with a significance level of 95%
The survey population was 48% male and 52% female. The sample of 7,500 individuals made it possible to carry out a detailed analysis by age group:
- 18-24
- 25-34
- 35-44
- 45-59
- 60 and over
The changes shown are year-over-year, that is, compared to the 3rd edition of the Observatory conducted in 2025. Changes relative to previous editions—the first and second editions—are shown on a constant scope basis, meaning they were calculated by considering only those countries included in all waves of the survey (namely the United States, Brazil, Mexico, France, Portugal, and China). Other countries, which were included in the Observatory’s second or third editions, are not included in the results presented on a constant scope basis.
The questionnaire includes 24 questions on:
- socio-demographic data
- the level of knowledge about microbiomes
- the level of and desire for information from healthcare professionals
- the level of knowledge and information among parents and pregnant women regarding a child’s microbiome
- the identification and adoption of behaviors designed to combat microbiome imbalances
- the level of knowledge, information, and behaviors of women about the vulvo-vaginal microbiome
- health data
The questionnaire lasted ten minutes and the 7,500 individuals had to complete the entire questionnaire in order to be included in the survey. The terms used in the questionnaire to talk about the microbiome have been translated and adapted to the terms used in each country.
