Sorting through the noise: How microbiome science launched health influencer culture and how 20-year-olds can make sense of it all

Diet photo.

This article was originally published in the December 6 Print Edition.

Ella Caggiano, an Instagram fitness influencer with over 150,000 thousand followers, refuses to post a “what I eat in a day” video.

“I’ve never posted one before. I never will,” she said. “Eat like me, you’re not going to look like me.”

Even if a follower were to copy Caggiano’s exact meal plan and workout routine, they would inevitably, always look different.

“Everyone has different lifestyle factors that go into achieving the results that you want,” Caggiano, the recent University of Miami exercise physiology graduate, said.

“There’s a million ways to achieve results, a million ways to be fit, a million things that you could do to be successful in your fitness journey. But at the end of the day, one thing might work for you and something else might work better for someone else.”

This is not a revelation Caggiano came to on her own. The idea is backed by several decades of research in what may be the most-exciting new wave of science – microbiology.

Over 50% of you, is not really you.

Microbiology is the study of the thousands of microbes, commonly known as bacteria, that make up more than half of cells in the human body.

“Every single nook and cranny of your body – inside and out – is inhabited by microbes, but their densest of all in the gut. Here they produce vitamins our body cannot synthesize, aid in digestion, fortify the immune system and even play a critical role in modulating our moods,” Kathleen McAuliffe, an adjunct professor in the Ecosystem Science and Policy Program and a book author who writes on biomedical topics, said.

It was not until two decades ago though that the human microbiome began to be recognized as a critical component of well-being, as scientists demonstrated the prominent connection between gut health and mental health. Most of this occurs through the “gut-brain axis”, a system composed of the vagus nerve, circulatory system and enteric nervous system that help the brain communicate with the microbes in the gut.

Between 2007 and 2012 alone, the number of journal articles published on the microbiome increased by almost 250%.

“There is no question that microbiome science is of fundamental importance when it comes to understanding how diet affects health,” McAuliffe said.

Since their discovery, microbes have been linked to a variety of diseases including Parkinsons, Irritable Bowel Disease and obesity. The field shows promise for potentially treating these chronic conditions, but medical research is a slow process. In the meantime, the limited information has been adopted by a far faster moving field: the online wellness industry.

Probiotic Promises

Alongside microbiome discoveries came a wave of interest in probiotics, supplements that introduce “good” bacteria into the gut microbiome to enhance health. Studies revealed probiotics could do everything from prevent osteoporosis to lower levels of depression.

Companies like Dannon ran with this data and probiotics quickly became the marketable product of the microbiome and solution to gut health. The probiotic industry is now forecasted to exceed $70 billion in market size before 2030.

However, Dannon was also accused of overstating the benefits of probiotics in its yogurt in a 2009 lawsuit, later settled for $35 million. These heavily-marketed false promises are used throughout the probiotic industry that remains unregulated by the FDA.

“When it comes to the entire probiotic industry, I think that it’s a classic case of the industry taking advantage of the ignorance of consumers to sell useless products,” McAuliffe said.

For every study suggesting the positive results of probiotics, another claims its uselessness, predominantly because of colonization resistance that prevents the probiotic bacteria from taking hold in a gut already dominated by microbes. A tremendous amount of funding has been invested into research looking to generalize and improve the strains of bacteria that can be used in probiotics, with only a handful of large-scale success stories.

Not a solution to be written off, the “Wild West” of unregulated probiotic shelves, is also not one to be promoted, McAuliffe noted.

Still, probiotics have infiltrated the recommendations of many influencers including Caggiano. She suggests specific supplements or probiotics to aid in digestion, but only after natural remedies have been pursued.

“I am a very big proponent of making sure that your nutritional needs are being met through food before you go to supplementation because a lot of people rely on supplements in order to fix problems that could be fixed with their nutritional protocols,” Caggiano said.

Probiotics are only at the surface of this new health obsession. Since the start of 2019, the term “gut health” has tripled in Google search popularity and related products have become a leading trend for consumers.

Poppi, an alternative soda company, has branded themselves as a gut-friendly soda packed with prebiotic agave inulin and under 25 calories a can. The company received a $25 million investment in December 2022 after a revenue growth of nearly 150% in one year, most of which was led by a massive social media campaign.

When new science meets social media

The influx of microbiome studies and probiotics on the market hit consumers in the late 2000s. At the same time social media, especially with the 2010 launch of Instagram, was on the rise.

This overlap allowed influencers, most untrained in fitness and nutrition, to take control of the microbiome narrative, leaving not only probiotics unregulated, but also the people endorsing them.

Soon emerged 5-minute workouts that could take 3 inches off your waist in days, supplement obsessions and new forms of miracle diets that could transform the body overnight.

“​​Most of what you’re hearing on social media is one size fits all, and everything we’re learning about the microbiome is telling us exactly the opposite,” McAuliffe said.

A 2023 investigation into leading social media “dieticians,” found at least 35 posts that were paid for by American Beverage, a lobbying group that represents popular soda brands Coca-Cola and PepsiCo. The influencers, including Steph Grasso with over 2.2 million Tik Tok followers, posted that the World Health Organization’s artificial sweetener warnings were clickbait and promoted soda as a healthy drink option to curb further sugar cravings.

This is part of a wave of influencers that have taken advantage of their registered dietician status to suggest supplements, probiotics and specific diets to their followers with the promise of achieving a better figure.

“These “influencers” most certainly take away from those of us who are trying to properly educate, even myself have been accused of being ‘fake’ and ‘a liar’ on many, many occasions,” said Celeste Fisher.

Fisher is a National Council on Strength & Fitness (NCSF) certified personal trainer, with an Instagram following just short of 100,000 and University of Miami student. She tries to educate her audience of the basics of nutrition, as opposed to highlighting one specific method to be healthy.

“Overall, influencers get a horrible reputation, but rightfully so. There’s not many of us out there that stay science based, are certified by a reputable source, and stay true to ourselves and our audience.”

Sophomore psychology major, Austin Schulman, is training to compete in a body builder competition next summer. He follows an extensive regime, but not the one most influencers tell him to.

“There’s a lot of people who are like researchers first fitness influencers second, but, if you go to the people who are fitness influencers first, they’re just trying to make money, They’re just trying to convince you, not tell you the truth,” he said.

Instead he uses his background as an exercise physiology minor, shadowing in PT clinics and specific trainers to guide him.

For example, Schulman avoids pre-workout, a supplement blend typically high in caffeine meant to boost energy before the gym. Pre-workout, traditionally mixed with water, grew in popularity after a TikTok trend in 2021 that promoted dry-scooping, taking the supplement, without a liquid, with the promise of a better workout.

While pre-workouts can enhance performance, “dry-scooping” quickly jolts the body with caffeine as opposed to the gradual effect of drinking it. Pre-workout has been linked to heart attacks and even death, when 29-year-old personal trainer Thomas Mansfield overdosed on caffeine.

“The harm with social media is taking everything at face value. I don’t think you can, because people don’t see nuance with social media. It’s like a straight fix thing. You want to create content that’s fast that people can digest easily,” Schulman said.

Not all users are able to spot the differences between these quick-fixes and the genuine science-backed advice however. But a general rule of thumb Fisher said, is that if it looks too good to be true, it probably is.

“Take information with a grain of salt”

Diet and fitness trends show no signs of stopping, nor does the research on the capabilities of harnessing one’s microbiome to achieve perfect health. For college students, trying to stay in shape while being full-time students, the most important part of fitness is focusing on yourself, and what works for you, Caggiano said.

Caggiano tried several diets and workout routines before figuring out her approach to fitness, it’s something she’s very candid with on her account, posting videos making fun of the “insane weight loss trends” she tried in middle school.

“You have the power to achieve all the goals that you want, but you need to be able to be a smart consumer. Take information with a grain of salt, realize that nobody’s perfect and no one diet is going to bring you the happiness that you want for yourself,” she said.