The survey was filled by a total of 309 people, out of which 203 were college students of Delhi University, India. The other proportion of people who answered the questionnaire included 26 engineers, 23 teachers, 22 self-employed persons and others (Fig. 1). As the majority of survey respondents were students, further analysis was done amongst student’s data only.

With the increase in advertising and marketing of probiotic products in the 21^st century, and more people becoming aware of gut health, the demand for probiotics is growing more and more. As a consequence, a whopping 91.6% people had heard about probiotics. Most of the students (39.41%) had become aware of existence of probiotics through the ever-ongoing advertisements on the television or newspaper. 22.66% people had heard about it on social media, through online forums and internet advertisements (Fig. 2).

Although, a major chunk of survey-takers had heard about probiotics through diverse platforms, some of them did not know what they actually meant. As discussed previously, probiotics are healthy bacteria that benefit the gastrointestinal tract and immune system. 88.70% of participants had the knowledge of what essentially constitutes a probiotic, but 3.49% thought it was a drug and a small fraction thought it to be a vitamin.

Upon being asked the benefits of these drinks, 10.34% thought it helped in building immunity, 28.08% people felt they improved the digestive system, which is generally what probiotics are tend to be associated with in TV commercials, while a good 49.75% respondents agreed with both the statements. The rest did not seem to have any idea about its advantages (Fig. 3).

Nowadays, doctors in most countries prescribe probiotics along with antibiotics. An antibiotic dosage not only kills the harmful pathogenic bacteria, it also tends to destroy the good bacteria in the gut creating an imbalance. This is often termed as ‘dysbiosis’ and it may lead to various gastrointestinal problems like diarrhoea. Probiotics generally help to restore that healthy balance. But only 19.21% people knew about any probiotics that their doctor prescribed. A total of 28.57% people claimed their doctors did not provide them with any probiotic supplements with antibiotics, while a major portion of participants i.e. 52.22% did not have any idea if their doctor prescribed probiotics or not, and whether any of the pills prescribed were probiotic in nature that they did not know of.

Probiotic supplements are available in most drug stores and supermarkets in numerous forms. They come as capsules or tablets to swallow, loose powder to sprinkle on food, or as drinks or in fermented and non-fermented dairy products¹⁴. Since a number of probiotics available in the market are in the form of drinks, they have higher popularity as the mode of consumption in the masses. People who regularly consumed probiotics, also felt that the liquid form was much easier to consume, as confirmed by 62.07% respondents. On the other hand, 31.53% found capsules to be much better, while the rest preferred sachet as a means of intake (Fig. 4).

Probiotics can be found in not only supplements, but also naturally in a variety of food products like yoghurt, kefir, tempeh, sauerkraut, miso, some varieties of cheese, kombucha, buttermilk etc. Upon analyzing the survey, it was found that majority of students were aware that probiotics can be consumed through food also in addition to external supplements.

According to an article by Hrefna Palsdottir, yoghurt is one of the best sources of probiotics, since it is made from milk that has been fermented by friendly bacteria, mainly lactic acid bacteria and Bifidobacteria¹⁵. In children, yoghurt may help reduce the diarrhoea caused by antibiotics. It can even help relieve the symptoms of irritable bowel syndrome (IBS). When asked if the survey audience ingested yoghurt because of the presence of probiotics, a big portion of 60.10% people answered with a yes, showing that they are well informed with the natural sources of probiotics.

It was further observed that although students were well acquainted with the basic knowledge about probiotics, the technical know how about the same was lacking. Majority of them (74.38%) were unaware about the tradenames of probiotic supplements available in the market. Another major group of around 72% did not know about unit of measurement and the recommended  count of probiotic bacteria on the commercial labels (Fig. 5 a&b). A dosage of 10⁸ CFU/day is recommended for ingestion, although there isn’t a specified level of probiotic bacteria in foods that would guarantee the biological activity. According to an article by Healthline, supplements that have live cultures, (i.e. consumption before expiration), multiple bacteria strains(a combination of probiotics is usually more effective than a single one) and appropriate quantities of bacteria to form colonies (measured in colony-forming units called CFUs) are the most effective¹⁶.

This extended knowledge about the details of probiotic supplements should also be disseminated as benefits of probiotic bacteria vary from strain to strain and for maximal health benefits, they should be consumed in the recommended doses.

In addition to this, the concept of prebiotics was majorly lacking amongst the students with only 32.5% of them knowing that prebiotics serve as food for optimal growth of probiotic bacteria (Fig. 6). It is suggested that the information regarding prebiotics should also be emphasized upon in the masses as prebiotics are fibres and natural sugars that stimulate the growth of good gut bacteria. They are included in various foods such as almonds, onion, garlic, certain fruits, cereal grains etc. These if included in day to day diet will help maintain a healthy gut environment for commensal gut flora as well as probiotic bacteria to grow. Additionally, prebiotic substances like indigestible carbohydrates, such as fructooligosaccharides and inulin have also been incorporated in a number of products like cheese and yoghurt, to maintain and enhance probiotic viability¹⁷. Thus, knowledge about prebiotics should not be neglected.

The expansion in the probiotic market indicates the rising interest of the public in gut health and their preference of natural remedies over allopathic medicine. According to our research, the general population of students seem to have good awareness and knowledge of probiotics albeit obtained from different sources.In accordance with a 2018 research survey done by Kolady et al. the respondents of the current study exhibited a high level of familiarityamong the students about probiotics¹⁸. Additionally, a greater level of knowledge was observed in the current study compared to a previous similar study conducted on college students in Phillippines by Meijia et al.where they had a good level of knowledge about probiotics and its consumption¹⁹.

Upon comparing it with a study performed on healthcare professionals in Nigeria, it was found 72.14% had heard of the term²⁰. This was a drastic decline to the present 91.4% statistical data. This may have been due to higher exposure of the students to the concept of probiotics as a part of their educational curriculum or general classroom discussions. A similar trend was observed in a survey done on medical students, performed by Payahoo et al. wherein only 50.7% people had high knowledge²¹.

The survey-takers had a superficial knowledge of what probiotics essentially meant, referring to the good bacteria present in it and their contribution to health, but lacked critical information with respect to dosage and brand names. Most of them could associate with Yakult within the category, but failed to recognise other trade names.The basic technical knowledge prerequisite for proper consumption was missing,like the CFU count, prescription with antibiotics and the concept of prebiotics. In addition to this,they could identify that food and supplements both could contain probiotic gut bacteria, especially yoghurt, which was the reason for consumption for many respondents.

In a study by Stanczak and Heuberger published in 2009, participants when asked about the reason for consuming probiotics chose the option ‘increase immune function²², while in another study by Reshma et al.in 2017, 83.5% of the respondents selected the option which related to improvement of the gastrointestinal condition²³. However, in the current study, although some people selected gastrointestinal or immune health as a benefit, a larger percentage (49.75%) picked both the options, inferring to a rise in knowledge of the advantages of probiotics among the people in the recent decade.

One more survey done on general dental practitioners exposed that around 22% of the respondents did not know about probiotics²⁴. This came in accordance with another study by Betz et al, who found that younger survey-takerswho had higher education level were more likely to be familiar with the concept than with less education²⁵. But on the other hand, in contrast to this was the study conducted in Jordan that revealed that college students lacked the important information about probiotics²⁶. Merely 11.7% of students had a little level of knowledge about probiotics and unfortunately only a minute fraction-7.0% were capable to recognize probiotics.