United States 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).
The United States and microbiota: the strongest awareness progression globally since 2023 with the skin microbiota as a growing entry point.
Summarizing United States results in the survey
In 2026, the United States records the strongest microbiota awareness progression of any country in the study: +14 points since 2023, reaching 67%, approaching the global average of 72% from a low starting point. The skin microbiota is a particular area of strength: 50% of Americans have heard of it, and 23% know exactly what it is, above the global average of 18%. Probiotic consumption is also above global average. The key challenge remains HCP-transmitted education, which lags behind the country’s growing public engagement.
1. Microbiota awareness is growing the fastest in the US
2 in 3 of American respondents have heard of the microbiota. While this is below the global average of 72%, it represents a remarkable trajectory: awareness has increased by 14 points since 2023, more than in any other country in the study. The United States is catching up rapidly, driven by growing media coverage, health-focused consumer culture, and increasing probiotic product marketing.
of Americans have already heard of the term microbiota
(+14 points vs. 2023)
of them know exactly what microbiota is
(vs. 24% globally)
more than half are aware of the gut microbiota
(vs. 63% globally)
Where US knowledge is strong
American respondents show above-average performance on self-assessed understanding (26% know exactly what the microbiota is, vs. 24% globally) and on several specific knowledge items:
- 63% of respondents know antibiotics have an impact on the microbiota,
- 57% correctly link IBS, obesity, and vaginosis to the microbiota,
- 48% know the gut communicates essential information to the brain.
Learn all about microbiota
Learn moreWhere knowledge gaps remain
Knowledge gaps are significant on the more complex links as in most countries:
- 63% of respondents don't know that the microbiota is not located exclusively in the gut. This is one of the highest rates globally;
- 64% don't know that the microbiota can influence how the body responds to cancer therapies;
- 83% don't know respiratory allergies can be linked to gut microbiota imbalance.
The gap between awareness (67%) and mechanistic understanding is significant in the US. Growing awareness has not yet translated into knowledge of how microbiota is linked to broader health aspects, such as allergies or digestive disorders.
2. Low microbiota-friendly habits and above-average probiotic consumption
Close to half of Americans respondents say they have changed their habits to support a balanced microbiota (49%), slightly below the global average of 53%, but consistent with the pattern of a country where awareness is still rising and behavioral change tends to follow with a lag. Several specific behaviors are notably above global averages.
of them changed behaviors to protect their microbiota
(vs. 53% overall)
claim to have changed their behaviors a lot.
(vs. 13% globally)
more than half believe their microbiota to be well balanced
(vs. 59% overall)
Microbiota-friendly behaviors
Physical activity is a notable strength, consistent with the US health culture:
79% respondents engage in physical activity at least weekly, well above the global average (73%). And 72% of women never practice vaginal douching, which is one of the highest rates globally.
When it comes to supplementation, Americans are above the global averages: 49% consume probiotics and 41% take prebiotics at least monthly.
What is the difference between prebiotics, probiotics and postbiotics?
Learn moreGaps in diet and smoking
- Only 32% eat multiple fruits and vegetables daily (vs. 40% globally);
- 60% consume fermented foods at least weekly (vs. 67% overall);
- 46% have never smoked, slightly below global average (52%).
3. Microbiota education provided by HCPs is a key opportunity
91% of American respondents trust healthcare professionals as one of their primary sources of microbiota information. With awareness rising fast, public interest in the microbiota is growing but the information patients receive from their HCPs does not yet match that interest. On every measure of HCP-transmitted education, the United States falls below the global average.
of Americans trust HCPs as one of their primary sources
(vs. 94% globally)
of them received an explanation of what the microbiota is
(vs. 39% globally)
received all key information from their HCP
(vs. 23% globally)
The antibiotic prescription gap
In the US, as in most countries, not enough HCPs take the opportunity to educate about the microbiota when prescribing antibiotics:
32% of respondents were told by their HCP antibiotics could negatively affect their microbiota balance (vs. 39% globally). Only 1 in 4 were co-prescribed probiotics alongside antibiotics (vs. 38% globally). And just 19% received all key antibiotic-related microbiota information from their HCP (vs. 25% globally).
Antibiotics: what impact on the microbiota and on our health?
Learn moreThe skin microbiota: a concrete entry point for education
The United States stands out for its relatively strong awareness of the skin microbiota. This makes it a particularly relevant entry point for microbiota education in the US context, where beauty, skincare, and wellness industries are closely connected to health messaging.
of Americans have heard of the skin microbiota
(+4 points vs. 2025)
know exactly what the skin microbiota is
(vs. 18% globally)
The skin is visible, monitored, cleaned, and exposed daily, integrated into routines in a way that other microbiotas are not. Yet the microbial ecosystem of the skin remains difficult for people to grasp. Americans act on their skin every day, without always connecting those gestures to the microbiota balance that underpins skin health.
4. First 1,000 days: the strongest awareness in the Western world
One area where the US stands out positively is the first 1,000 days: 58% of American parents and pregnant women have heard of the concept, the highest rate of any country outside Asia, and well above the global average of 43%. 42% of parents received all key information from their pediatrician, also above the global average of 31%.
of American parents and pregnant women have heard of the first 1000 days
(vs. 43% globally)
of them claimed to know exactly what it means
(vs 15% globally)
almost half said to have received information on early microbiota development by an HCP
(vs 31% globally)
Some misconceptions still persist among American parents
- 13% of parents know that the baby's microbiota does not start developing inside the mother's womb, near the global average of 11%;
- 60% don't know that by age 5 the gut microbiota is not yet adult-like;
- 39% 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.
With awareness rising fast and public interest growing especially around the skin microbiota and the first 1,000 days, the US represents a high-potential market for HCP-led microbiota education. The foundation is there; the activation is missing.
Methodology
This fourth edition of the International Microbiota Observatory was conducted by Ipsos among 7,500 individuals in 11 countries (France, Portugal, Poland, Finland, Italy, Germany, USA, Brazil, Mexico, China, Vietnam), between February 3rd and March 13th, 2026. Samples are representative of the population aged 18 and over, via quota sampling (gender, age, region, socio-professional category). Statistical significance is calculated at a 95% confidence level. The survey lasted ten minutes.
The questionnaire covered: microbiota awareness and knowledge; information received from HCPs; behaviors; women's knowledge of the vaginal microbiota; parental knowledge of the first 1,000 days; and health data.
