2026 results: The International Microbiota Observatory 4th edition

1. Knowledge of microbiota is growing at different rates

The 2026 survey results reveal that seven in ten people now know the word "microbiota". That is a real cultural achievement. Four editions in, and what was once a specialist term is entering everyday health vocabulary across countries, across generations, and across languages.

Moreover, the shift goes further than a single word. Awareness is no longer confined to the gut. People are increasingly recognizing that the microbiota are in multiple places of the body, and that each one matters.

Awareness is rising across all microbiota

Awareness has grown for every specific microbiota compared to 2025. The gut leads, but the others are catching up.

Knowledge of microbiota is spreading at different speeds

How much people know about microbiota is growing everywhere, but the pace varies significantly. For instance:

• In Vietnam, 93% have heard of the microbiota, the highest rate globally;
• 2 in 3 respondents from the USA said the have heard of the microbiota. That's a +14 pts increase since 2023, the strongest progression of any country in the study;
• Finland sits at 52%, up +11 pts since 2024, but still the lowest in the study.

2. Microbiota awareness is rising faster than understanding

Here is where the picture changes. Knowing the word "microbiota" is not the same as understanding what the microbiota actually does. When respondents are asked not about recognition, but about mechanisms (how the microbiota functions, what it influences, what it is linked to) the gaps are striking.

Only 24% of respondents know exactly what the microbiota is. But the real measure of that gap is not this single number, it is what people believe, or fail to believe, about specific roles and connections.

Awareness of these topics is relevant to everyday health decisions and to the conversation people should be having with their doctors.

Microbiota understanding remains surface-level

Some core associations are now widely understood, these are the entry points for deeper education. Beyond these general associations, understanding drops sharply. The gut-brain axis, the link with respiratory allergies, the influence on cancer treatments, these remain largely unknown.

The implication is clear: awareness campaigns have done their job on recognition. The next frontier is mechanistic understanding, helping people grasp not just that the microbiota exists, but what it does, how it is disrupted, and why that matters for their health.

3. Knowing about microbiota is not enough to adopt good behaviors for it 

One of the defining findings of this edition is the gap between growing awareness and stagnating, even declining, protective behaviors. The microbiota is better known, but the everyday gestures needed to protect its balance are not yet instinctive. Knowledge is a necessary first step. It is not sufficient.

Do people adopt harmful habits for their microbiota unconsciously?

Over half say they wash their bodies several times a day (53%), which may cause dysbiosis, and 38% of women take vaginal showers, even though this is harmful to their vaginal microbiota.

Who is more likely to act in order to protect their microbiota?

Parents of young children and people with at least one health problem are the most likely to have changed their behaviors (respectively 64% and 57%). Among the general population, the gap between those who know and those who act is still significant.

When it comes to the regions in the survey, Asia leads on action, followed by Latin America and, then, Europe. In Vietnam, 85% report having changed their behaviors. In France, only 38% say the same. The gap is not primarily about knowledge, it is about how health information is translated into daily practice.

4. Healthcare professional remain the cornerstone of microbiota education

Their credibility is unmatched: nearly universal trust, across all countries and all population groups. Yet this edition reveals a troubling paradox: while trust holds, the information patients actually receive from their HCP is declining.

What fundamentals are still not covered in consultations?

The basics are still largely absent from medical conversations:

• 43% were educated on the importance of preserving microbiome balance;
• 43% received guidance on behaviors to adopt;
• Only 39% received an explanation of what the microbiota is, its roles and functions, the most important topic, and the least addressed.

Where do people learn about the microbiota?

Healthcare professionals rank first by a wide margin. Secondary sources vary by country and age group.

5. There are windows of opportunity to educate patients about microbiota

To move from awareness to action, information needs to be delivered at the right moment. The 2026 Observatory identifies three major windows of opportunity where education could have the greatest impact: the antibiotic prescription moment, women's gynecological follow-up, and the first 1,000 days of a child's life.

When prescribing antibiotics

Every antibiotic prescription is a potential microbiota education moment. But in 2026, the information given during this interaction remains insufficient and shows no meaningful improvement.

Almost half of surveyed people being prescribed antibiotics had been told about digestive disorders associated with them. But only 36% received practical advice on limiting the impact antibiotics have on their microbiota.

When women go to gynecological consultations

The vaginal microbiota perfectly illustrates the 2026 paradox: the term is becoming familiar, but real understanding remains limited and the medical dialogue is still incomplete.

Out of all the women in the survey, only 30% claimed to have received all key information about microbiota from their HCP (a drop of -2 points vs. 2025). What's more, just 1 in 4 said all intimate health-related topics were addressed in consultation.

Knowledge gaps remain significant:

• 79% could not correctly answer whether contraceptive pills could protect the vaginal microbiota;
• 55% did not know that the gut microbiota influences the vaginal microbiota;
• 41% found it difficult to talk about sexual discomfort with their healthcare professional.

When a baby's microbiota starts to develop

The first 1,000 days of life (from conception to the child's second birthday) represent a critical window for the development of the infant's microbiota. Yet this concept remains poorly understood, even among parents and pregnant women.

When questioned about the factors influencing their baby's microbiota, parents and pregnant women got less than half of the questions right on average (2.3 out of 6). Meanwhile, 57% of their children had been prescribed probiotics or prebiotics.

These are some key knowledge gaps revealed by the survey:

• 11% of parents knew that the baby's microbiota does not start developing inside the mother's womb;
• 62% of respondents did not link the mode of delivery (vaginal vs. caesarean) to its impact on the newborn's gut microbiota;
• 51% did not know that breastfed babies have a different gut bacteria profile from formula-fed babies.

Explore more results about what parents know (and don’t know) about the microbiota during the first 1,000 days of life below.

Scientific committee

Since 2024, a multidisciplinary international scientific committee oversees the Observatory's editorial process, provides critical analysis of results, and promotes its national deployment.

This scientific committee is made up of:

Methodology

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.

BMI-26.31