United States: knowledge and behaviors about microbiota 2023 results

The Biocodex Microbiota Institute commissioned Ipsos to carry out a major international survey of 6,500 individuals across seven countries (France, Spain, Portugal, the USA, Brazil, Mexico, and China): the International Microbiota Observatory.

Microbiota are essential to our health, but remain poorly understood worldwide. Americans are among the least inclined to change their behavior to protect their microbiota and receive relatively little information on the subject from their healthcare professionals.

1. Americans show less awareness than citizens of other countries about their microbiota, but not about probiotics...

For example, they are the least familiar with the terms “microbiota” (only 53% vs. 64% overall), “gut microbiota” (42% vs. 53% overall), and “dysbiosis” (only 20% vs. 28% overall). On the other hand, while their awareness about probiotics is not high, it is better than in many countries: they beat the average when it comes to knowing the precise meaning of terms like “probiotic” (53% vs. 43% overall) and “prebiotic” (36% vs. 27% overall).


of Americans are familiar with the term “gut microbiota”.


of Americans know the precise meaning of the term “probiotic”.


of Americans know the precise meaning of the term “prebiotic”.

2. They have a very low awareness of the various behaviors that should be adopted...

but are more likely than citizens of other countries to know that probiotics (65% vs. 62% overall) and prebiotics (56% vs. 51% overall) can have beneficial effects on the microbiota.


What exactly are probiotics?

Find out more...

3. However, Americans are also the least likely to have adopted specific behaviors to preserve the balance of their microbiota...

with only 47% having done so (10 points below the overall figure and the lowest level along with the French) and only 16% claiming to do so “a lot” (1 point above the overall figure).

4. Moreover, Americans are among the least likely to discuss the matter with their doctor...

Only 37% declare they have ever been prescribed probiotics or prebiotics (versus 46% overall). However, this is more than in France, Spain, or Portugal. They are also the least likely, along with the French, to say that their doctor has explained the behaviors needed to preserve their microbiota (31% vs. 44% overall). Lastly, only 1 in 4 Americans has ever had the role of their microbiota explained to them (28% vs. 37% overall). Only 1 in 5 report that their doctor suggested them to have their microbiota tested (21% vs. 30% overall).


Only 1 in 4 Americans has ever had the role of their microbiota explained to them.


Only 1 in 5 report that their doctor suggested them to have their microbiota tested.

In the US, patient education is now key to explaining both the role of the microbiota and the behaviors needed to best preserve them. This vital education should be provided by healthcare professionals. 

Photo Observatoire: Le microbiote à chaque étape de la vie : des parents sensibilisés, des seniors peu informés
Download the infographic of the overall results


The Ipsos Panel conducted a major online international survey involving 6,500 individuals, surveyed between March 21 and April 7, 2023 in 7 countries: the United States, Brazil, Mexico, France, Portugal, Spain and China.

Data was collected using the quota method, which is the most commonly used sampling plan for obtaining a representative sample of a study population. The quota variables for each country were:

  • gender
  • age
  • region
  • socio-professional category

The survey population included 48% men and 52% women. The average age was 46.9 years. The sample of 6,500 individuals allowed a detailed analysis by age group: 18-24, 25-34, 35-44, 45-59, 60 and over.

The 26-question included:

  • socio-demographic data
  • assessment of knowledge of the microbiota
  • the level of and desire for information from healthcare professionals
  • identification and adoption of behaviors aimed at combating microbiota imbalance
  • women’s level of knowledge, information and behavior with regard to the vulvovaginal microbiota
  • health data