Mapping the Gut-Brain Connection: Exploring Knowledge, Attitudes, and Practices in Diverse Age Groups and Geographic Contexts

doi:10.21203/rs.3.rs-4291880/v1

This research aimed to discern the correlation between knowledge, attitude, and practices concerning gut health across various age groups and geographical settings. Drawing from a diverse demographic, the study exhibited an equal distribution between two main age brackets and cities, with a noticeable tilt towards female participants across various occupations. Misconceptions about the gut's anatomy and function were prominent, with a sizeable fraction equating the gut solely to the stomach. Moreover, the prevalent belief that passing 1-2 bowels daily indicates superior gut health signals a potential oversimplification of health markers. Despite growing scientific evidence emphasizing the gut's inter-connection with other systems, the surveyed population displayed limited awareness of these relationships. However, in exploring perceptions about functional foods, the study found a dichotomous opinion on their therapeutic role. Statistical analyses, including regression and correlation, revealed no significant age-dependent tendencies in the willingness to adopt dietary supplements, while only a weak correlation was detected between gender and two gut-related variables. The findings offer valuable insights for health educators, medical practitioners, and policymakers, highlighting the necessity for comprehensive educational campaigns tailored to address these misconceptions and reinforce a scientifically grounded understanding of gut health.

Gut health

Gut

Functional foods

Dietary supplements

Health misconceptions

The gut has a digestive system in addition to being the body's major nervous, immune, and endocrine organs. known as the enteric nervous system. Gut is called as second brain of the human body as it acts as a Trojan Horse. Gut is 90m long, starts from mouth to ends to anus. Gut Associated Lymphoid Tissue (GALT), which makes up 70% of the immune system, is located in the Gastrointestinal tract (GIT). Gut is the considered as the most powerful, sensitive and complex organ which is directly related to the inflammatory diseases like obesity, Inflammatory bowel diseases (IBD), celliac diseases, depression, intestinal or colon cancer.

The gut contains 10 times more bacteria than the whole body, as the majority (90–95%) of the cells in the digestive tract are made up of microbes, making it a microbial organ. There are up to 10⁴ microbe cells may be found in the human GIT, which serves as a representative of all microbes that reside on or in the human body⁽¹⁾. The gut and the microbata has a symbiotic relationship, The gut gives microorganisms a home and food source, whereas the microbata has an impact on the gut's growth and functionality. The gut and its microbial inhabitants synergically performs the tasks of digestion, immune and endocrine functions and neurotransmission^(2,3,4,5).The gut microbiota is a significant source of metabolites, hormones, and neuro-mediators that impact both directly and indirectly on the organs and gut, like the microbiota directly regulated the gut activities whereas the function of extra-intestinal organs including the liver, brain, and kidney is indirectly influenced by the gut microbiota⁽⁶⁾.

There are 100 trillions of microbes residing in the gut⁽⁷⁾ from which large intestine contains highest amount of microbes, 9 million genes approx and 150 species of microbes. Intestine is called as a reservior of microorganisms. The instenial flora is crucial for maintaining the human cytology and contributes a vital role in the pathophysiology of both internal and external chronic diseases interrelated with gut. The gut microbial make-up varies with lifestyle, diet, age, gender, environment and somewhere also depends on the genes of the individual. The ratio of good versus bad bacteria in the gut is 85:15 and if there is any imbalance or off in configuration of gut microbiota then dysbiosis occurs. Additionally, a range of factors, such as energy intake, choline, short chain fatty acids (SCFAs), the gut-organ axis, and bile acids will all be affected by the host's gut microbiota imbalance.

The most dominant microbes in gut are Firmicutes and Bacteriocidetes and the ratio of the Firmicutes and Bacteriocidetes change with change in the environmnet of gut. These bacteria helps to increase host immunity and also responsible for immune tolerance of food in human like intolerance of gluten or gluten insenstivity that leads to celliac disease, IBD, Inflammatory bowel syndrome (IBS), diarrhoea, constipation, gastroesophegal reflux disease (GERD), intestinal cancer. Bacterial fermentation is occur in the colon that produce SCFA and the byproducts of bacterial fermentation can provide up to 10% of an individual's daily energy demands. The right colon has a low pH (5-6) which makes the environment valid for a rapid bacterial growth and SCFA production as a result of carbohydrate fermentation whereas the left side of the colon has less carbohydrate fermentation because of its basic pH nature. So, in left colon Proteolysis occur, which has been connected to the generation of toxic nitrogenous products such ammonia, amines, and phenolic compounds. Some gut microbiota members also create vitamins such as folate, biotin, and vitamin K-2.

The microbiota in the gut influence nutrient metabolism and also responds to the circadian rhythm of the human. For all living forms circadian rhythms have been found to be a crucial component of their ability to perform metabiological functions. This mechanism enables biological clocks to be adjusted to a 24-hour cycle of storing vs burning energy depending, in part, on environmental signals, such as light-dark cycles, sleeping versus waking, and fasting versus refeeding, which in turn supports metabolic equilibrium^(8,9). Shift in behavioral rythms, includes changes in food habits, irregular shift-work timings and jet lag all affect the makeup of the gut microbiota and indicate the emergence of obesity and other co-morbidities^(10,11). Most recent studies show that, Microbes in the gut have a principal role in modulating the amplitude and rhytmicity of key circadin clock genes.The gut microbiota are strongly linked with many pain related disorders like Admonial pain, migrane, chronic back pain and tune a pain perception by influencing the visceral and peripheral pain response⁽¹²⁾. Mood and emotions of the person is highly effected by the colonization of the intestinal microbiota. Chances of infection increases if there is decrease in the good microbiota because of decrease in immune system which induce fatigue, decrease appetite and increase anxiety like behaviour or decrease in consciousness⁽¹²⁾, for example high in unconsciousness is concerned with an increase in density of certain ubiquitous butyrate- producing bacteria such as Lachnospiraceae⁽¹³⁾.

The commensal microbiome has a substantial relationship with social interaction and reproductive behaviours. Social behaviours, social anxiety and social manners, reproductive behaviour is effected with the healthy or abnormal gut microbiota⁽¹²⁾.

Gut bacteria affects dietary behaviour. Mammalian dietary preferences have a strong connection with the digestive tract microbiota, which differ widely amongst species depending on their nutritional profile. The gut microbiota is likely responsible for regulating human hunger; the reason why some foods taste good might be that the gut’s fauna needs certain foods to support its growth.⁽¹⁴⁾. The gut microbiota also responsible for getting some eating disorders like anorexia nervosa, binge eating.

Therefore, GIT microbiota has a significant role in the human body. Dysbiosis of the gut microbiota is very sensitive condition and almost all the organs like brain, liver, kidney, heart, skin, lungs and more, somewhere are related with the gut. Whereas, the mechanism of gut microbiota is not researched much but the regulation of gut microflora, microbial metabolic mechanism and its derivatives necessitates the normal human health and with that abnormal microbial metabolism involved in development of diseases like Diabetes, Obesity, Non-alcholic fatty liver, Metabolic syndrome, Depression, Anxiety, Parkinson’s disease.

The purpose of this study report is to look at the effects of gut dysbiosis impact on other organs. Participants will be conveniently surveyed by dividing into two age groups and of different areas. Knowledge about gut health will be examined, allowing a comparison between the different age group and areas. This research study is based on qualitative and quantitative data which is analytical study. This study was conducted in two geographical locations of India, one group is from north that is Chandigarh and other group is from west that is Mumbai. As this was based on convenient sampling. There were equal participants from Chandigarh as well as Mumbai. Subjects from Chandigarh were mostly young college going students (18–30 years), were as subjects from Mumbai were adults (middle age, 31–55 years). This research study, data collection is conducted by using the Likert scale. Survey is the next and most important stage of the study to analyze the data for the final result. Before starting the actual study, a pilot study was conducted between 10 subjects. 5 were youngsters and 5 middle age people. After conducting pilot study there were few changes in questionnaire like few scientific terms changed into simple terms. After pilot study the main study questionnaire was made keeping in mind all points about gut and gut health. The questionnaire was about 20 questions which include questions related to gut health knowledge, awareness and practices people do to make there gut healthy and also there demographic data like Name, Age, Occupation and City. This whole study and questionnaire was based on convenient non- random sampling. The Sample size was 110, which included 55 youngsters and 55 middle age population. The population of our sample was equally distributed in Chandigarh and Mumbai. The subjects are divided on the basis of some parameters like age (The age was selected was 18–30 for youngsters and 30–55 for middle age), city (Chandigarh and Mumbai) and occupation (non- nutritionist background). The approach chosen will allow an analysis of young people's or adults' knowledge or awareness of gut health. The study seeks to add to the understanding of people's awareness, knowledge, and practices for making their guts healthy by utilizing a Likert scale, survey technique, and proper statistical analysis.

The report is considered as a major part of any study. The result section states the finding of the research arranged in a logical sequence without bias and interpretation. This chapter presents the finding of the study, wherein the raw data collected was utilized to find out significant and understandable results.

Variables		Frequency (Total- 110)	%
Age	18 – 30 years	55	50
Age	31 – 55 years	55	50
Gender	Female	69	62
Gender	Male	41	37
Occupation	Business	16	14
	Jobs	41	37
	Students	34	30
	Other	19	17
City	Mumbai	55	50
City	Chandigarh	55	50

Table no.1- Demographic data

The provided table no. 1 offers valuable insights into the demographic composition of the surveyed group. When considering age, the participants are evenly split into two groups: those aged 18 to 30 years and those aged 31 to 55 years, with each group accounting for 50% of the total sample size of 110. Moving on to gender, the data indicates that females are more prominently represented, constituting 63 % (69 out of 110) of the respondents, while males account for the remaining 38 % (41 out of 110).

Occupation-wise, the respondents cover a range of roles. The largest group appears to be those employed in jobs, comprising 37 % of the participants, followed by students at 30.91%. Business professionals make up 14% of the sample, and individuals categorized as "others" represent 17%. These occupation proportions shed light on the diversity of the participants' professional backgrounds.

Considering the geographic distribution, the survey encompassed participants from two main cities: Mumbai and Chandigarh. Remarkably, each city contributes an equal share of 50% to the overall sample, with 55 respondents hailing from each location. This geographical balance underscores the comprehensive nature of the survey, capturing perspectives from different urban settings.

The analysis of this demographic data illustrates a well-rounded representation across various aspects. This includes an equal distribution in age groups, a higher presence of females among the respondents, diverse occupational backgrounds, and an even distribution of participants from two distinct cities. These findings collectively provide a nuanced understanding of the characteristics and perspectives of the surveyed population.

KNOWLEDGE AND AWARNESS REGARDING GUT AMONG RESPONDENTS

To determine if there's a significant difference in the awareness of the importance of gut health between females and males, we examined the proportion of individuals from each gender who answered 'yes' to questions, which relate to the awareness of gut health.

Gut is the biggest organ of the human body
Scale	Frequency	%
1 (Strongly Agree)	20	18
2 (Agree)	33	30
3(Neutral)	20	18
4 (Disagree)	27	25
5(Strongly Disagree)	10	9

Table no. 2- Reaction to Gut is the biggest organ of the body

The table no. 2 showcases respondents' reactions to the statement "The gut is the biggest organ of the human body," rated on a scale of 1 to 5. At the scale's lowest point (1), 20 respondents (18% of the total 110 participants) expressed strong disagreement or reservations about the statement. Scale 2 had the highest frequency, with 33 respondents, accounting for 30% of the total, further indicating disagreement or uncertainty regarding the claim. The mid-point, Scale 3, saw 20 participants, or 18.18% of the respondents, giving a neutral response or perhaps being unsure about their stance on the subject. Moving up the scale, Scale 4 had 27 respondents (25%) who seemed to lean towards agreement with the assertion. Lastly, Scale 5, which could denote strong agreement, had the least frequency. Only 10 respondents, or 9.09% of the sample, rated the statement at this highest level. The majority of the respondents (48%, combining Scales 1 and 2) seem to have reservations or disagree with the idea that the gut is the largest organ of the human body. Meanwhile, a significant portion (33%, combining Scales 4 and 5) appear to be in agreement. The rest (18% at Scale 3) remain neutral or undecided. This distribution suggests a diverse range of opinions and perhaps a lack of common consensus on the subject among the respondents.

Gut is only stomach
Scale	Frequency	%
1 (Strongly Agree)	12	11
2 (Agree)	18	16
3(Neutral)	13	18
4 (Disagree)	45	41
5(Strongly Disagree)	22	20

Table no. 3- Response to question gut is only stomach

The table no. 3 provides responses to the statement "The gut is only the stomach," rated on a scale of 1 to 5. Beginning with the strongest disagreement, Scale 1 saw only 12 respondents, which makes up 11% of the total 110 participants. Scale 2, indicating a level of disagreement, had a higher frequency, with 18 respondents. This accounts for 16% of the sample, suggesting a portion of participants who either disagreed or had reservations about the statement. The midpoint, Scale 3, represents those potentially unsure or neutral about the claim. Here, 13 participants, or 18% of the respondents, fell into this category. Scale 4, moving towards agreement, had a significant representation. 45 respondents, or 41% of the total, seemed to lean towards the assertion that the gut is synonymous with the stomach. Lastly, Scale 5, indicating the strongest agreement, saw 22 participants. This is 20% of the sample, suggesting that a notable subset of the respondents firmly believes in the claim presented. A majority of the respondents (54%, combining Scales 4 and 5) appear to agree to some extent with the idea that the gut is only the stomach. However, 28% (combining Scales 1 and 2) either disagreed or were skeptical. The remaining 14 % (Scale 3) were neutral or undecided on the matter. This distribution highlights that while a significant portion believes that the gut is only the stomach, there remains a considerable number of participants who either don't share this belief or are undecided.

If you pass 1-2 bowels per day, your gut health is excellent
Scale	Frequency	%
1 (Strongly Agree)	25	23
2 (Agree)	60	55
3(Neutral)	19	17
4 (Disagree)	5	5
5(Strongly Disagree)	1	1

Table no. 4- Reaction to question, If you pass 1-2 bowels per day, your gut health is excellent

The table no. 4- reflects responses to the statement "If you pass 1-2 bowels per day, your gut health is excellent," gauged on a scale of 1 to 5. At Scale 1, indicating the strongest disagreement, a sizable 25 respondents expressed their reservations. This comprises 23% of the total 110 participants, signifying a significant portion of the sample refuting the statement outright. Moving to Scale 2, there's an even more pronounced disagreement. 60 respondents, or 55% of the sample, rated here, suggesting substantial skepticism or disagreement with the notion that passing 1-2 bowels a day equates to excellent gut health. At the neutral point, Scale 3, 19 respondents, accounting for 17% of the sample, expressed an undecided stance or perhaps saw some validity in the statement but weren't fully convinced. Scale 4, indicating a leaning towards agreement, had a low representation with only 5 respondents, making up 5% of the total. This suggests that very few participants in the sample began to align with the claim. Finally, at Scale 5, symbolizing the strongest agreement, there was minimal agreement with the statement. Only 1 respondent, or 1% of the sample, completely agreed with the presented claim. An overwhelming majority of the respondents (79%, combining Scales 1 and 2) either disagreed or strongly disagreed with the idea that passing 1-2 bowels per day signifies excellent gut health. A smaller segment (17% at Scale 3) maintained a neutral stance. Only a minor portion of the participants (5%, combining Scales 4 and 5) expressed any level of agreement. This feedback suggests that the common perception among these respondents challenges the belief that 1-2 bowel movements daily are a definitive indicator of excellent gut health.

Gut has relation with other organs
Scale	Frequency	%
1 (Strongly Agree)	37	38
2 (Agree)	53	48
3(Neutral)	13	12
4 (Disagree)	6	5
5(Strongly Disagree)	1	2

Table no. 5- Reaction to question gut has a relation with other organs

The table no. 5 captures responses to the assertion "Gut has a relation with other organs," using a scale from 1 to 5. Starting with Scale 1, which indicates strong disagreement, there were 37 respondents who refuted the statement, representing 38% of the total 110 participants. This indicates that a significant portion of the sample does not believe in a direct connection between the gut and other organs. At Scale 2, suggestive of some disagreement or reservations, there is an even larger representation. 53 respondents, or 48% of the sample, rated here. This further amplifies the skepticism or lack of awareness among participants about the gut's relationship with other organs. The mid-point, Scale 3, which might indicate a neutral stance or mild agreement, witnessed 13 participants or 12% of the respondents. These individuals might be unsure or partially acknowledge the relation but need more evidence or information. Scale 4, leaning towards agreement, had only 6 respondents, accounting for 5% of the total. This suggests that a minimal portion of the sample somewhat agrees with the statement but perhaps not fully. Lastly, at Scale 5, representing complete agreement, only 1 respondent (1% of the sample) fully endorsed the idea that the gut has a relationship with other organs. A vast majority of the respondents (81%, combining Scales 1 and 2) either disagreed or expressed doubts about the interrelation between the gut and other organs. A smaller segment, 12% at Scale 3, took a neutral position. Only a marginal 6% of the participants (combining Scales 4 and 5) indicated any level of agreement. This distribution suggests that the prevailing perception among the surveyed individuals either refutes or is unaware of the intricate connections the gut shares with other organs in the body.

Functional foods are foods that helps to manage the diseases like diabetes.
Scale	Frequency	%
1 (Strongly Agree)	19	17
2 (Agree)	53	48
3(Neutral)	27	25
4 (Disagree)	10	9
5(Strongly Disagree)	1	1

Table no. 6- Responses to the statement Functional foods are foods that help manage diseases like diabetes

The table no. 6 showcases responses to the statement "Functional foods are foods that help manage diseases like diabetes," rated on a scale of 1 to 5. Starting at Scale 1, symbolizing strong disagreement, there were 19 respondents who expressed their skepticism. This accounts for 17% of the total 110 participants, suggesting that a significant portion of the sample does not recognize functional foods as having a role in managing conditions like diabetes. Moving to Scale 2, indicating a level of disagreement or reservations, there's a pronounced representation. With 53 respondents, which constitutes 48% of the sample, it appears that almost half of the participants have some doubts or do not fully subscribe to the idea posited by the statement. Scale 3, which could be viewed as a neutral response or slight inclination either way, recorded 27 participants, or 25% of the respondents. These individuals might be undecided, partially acknowledging the role of functional foods but perhaps seeking more evidence or clarity. Scale 4, leaning towards agreement, saw a smaller group. Only 10 respondents, or 9% of the total, seemed to recognize or believe that functional foods have a role in disease management. Finally, at Scale 5, signifying the strongest agreement, a mere 1 respondent, which is 1% of the sample, completely agreed with the statement. The majority of the respondents (65%, combining Scales 1 and 2) either disagreed or expressed reservations about the role of functional foods in managing diseases like diabetes. 25% took a middle ground, potentially reflecting uncertainty or a balanced view. Only a small 10% (combining Scales 4 and 5) showed any significant agreement with the assertion. The data suggests that the understanding or belief in the role of functional foods in disease management is not widely held among the surveyed group.

The bowel movement is affected by excessive tension, and constipation may result.
Scale	Frequency	%
1 (Strongly Agree)	30	27
2 (Agree)	53	48
3(Neutral)	21	19
4 (Disagree)	4	4
5(Strongly Disagree)	2	2

Table no. 7- Responses to the assertion, The bowel movement is affected by excessive tension, and constipation may result

The table no. 7 provides responses to the assertion "The bowel movement is affected by excessive tension, and constipation may result," measured on a scale of 1 to 5. At Scale 1, indicating strong disagreement, 30 respondents expressed skepticism or outright refutation of the statement, making up 27% of the total 110 participants. This suggests that over a quarter of the sample doesn't recognize a direct connection between tension and its potential effects on bowel movement. At Scale 2, hinting at disagreement or reservations, a significant portion of the participants weighed in. With 53 respondents, this group represents 48% of the sample, suggesting that many have some doubts or don't entirely agree with the assertion made in the statement. Scale 3, which can be viewed as a neutral stance or mild inclination, registered 21 participants, accounting for 19% of the respondents. These individuals might acknowledge some link between tension and bowel movement but may require more evidence or information to fully commit to the idea. Scale 4, leaning towards agreement, had a much smaller group with only 4 respondents, or 4% of the total, suggesting that very few participants in the sample begin to see the relationship between tension and its potential bowel-related consequences. Lastly, at Scale 5, representing strong agreement, a meager 2 respondents (2% of the sample) wholeheartedly concurred with the idea that excessive tension could result in constipation. The vast majority of the respondents (75%, combining Scales 1 and 2) either disagreed or held reservations about the correlation between excessive tension and its potential to lead to constipation. A smaller group, 19% at Scale 3, held a neutral position. Only a minute 5% of the participants (combining Scales 4 and 5) expressed any level of strong agreement. This distribution reveals that while some awareness exists regarding the link between tension and bowel movement, there's still a prevalent skepticism or lack of knowledge among the surveyed individuals.

Diet therapies helps to maintain gut health.
Scale	Frequency	%
1 (Strongly Agree)	37	34
2 (Agree)	52	47
3(Neutral)	14	13
4 (Disagree)	6	5
5(Strongly Disagree)	1	1

Table no. 8- Responses to the assertion "The bowel movement is affected by excessive tension, and constipation may result

The table 8 elucidates responses to the statement "Diet therapies help to maintain gut health," rated on a scale from 1 to 5. Commencing with Scale 1, denoting strong disagreement, 37 respondents rejected or displayed reservations about the assertion. This constitutes 34% of the total 110 participants, indicating that over a third of the sample does not believe in the efficacy of diet therapies in maintaining gut health. Shifting to Scale 2, indicating a degree of disagreement or uncertainty, there's a prominent segment. With 52 respondents, this group accounts for 47% of the sample, demonstrating that a significant chunk of participants either have reservations or are not entirely convinced of the role of diet therapies for gut health. At the mid-point, Scale 3, likely symbolizing neutrality or slight inclination either way, 14 participants, or 13% of the respondents, rated. These individuals might be on the fence or might somewhat recognize the potential of diet therapies but require more substantial evidence or clarity. Scale 4, which leans towards agreement, witnessed a small fraction. Only 6 respondents, equating to 5% of the total, seem to acknowledge or are inclined to believe that diet therapies are beneficial for gut health. Lastly, at Scale 5, standing for complete agreement, a solitary respondent (1% of the sample) expressed unwavering belief in the role of diet therapies for gut health. A substantial majority of respondents (81%, combining Scales 1 and 2) either disagreed or held some doubts about the effectiveness of diet therapies in maintaining gut health. A smaller fraction, 13% at Scale 3, remained neutral or moderately inclined. A mere 6% (combining Scales 4 and 5) showcased any considerable agreement. The data paints a picture of prevalent skepticism or lack of awareness regarding the potential benefits of diet therapies for gut health among the surveyed individuals.

Based on the survey results as in graph- 1, when asked if the gut is the biggest organ of the human body, 20% of the participants from the first group agreed, followed by 29% from the second group, 20% each from the third and fourth groups, and 10.9% from the fifth group.

From the individuals surveyed about the statement 'Gut is only the stomach', graph 2 depicts the data, 5% strongly agreed (group 1), 25% agreed (group 2), 15% were neutral (group 3), 36% disagreed (group 4), and 18% strongly disagreed (group 5). For clarification, the "gut" typically refers to the entire digestive tract, which includes not only the stomach but also the esophagus, small intestine, and large intestine, among other components.

A significant majority of participants (a total of 65% from groups 1 and 2) either strongly agreed or agreed with the statement as evidence in the graph 3. This suggests a general understanding or belief that functional foods can indeed play a role in managing diseases like diabetes. A sizable percentage (29%) remained neutral. This group might be uncertain about the exact role of functional foods, or they may not have enough information to form a decisive opinion. Only a small portion (5%) disagreed with the notion, indicating that a few respondents may be skeptical or may believe other methods are more effective for disease management.

Regarding the belief that passing 1-2 bowels per day indicates excellent gut health, graph 4 portray that 18.1% of respondents strongly agreed (group 1), 60% agreed (group 2), 18% were neutral (group 3), 4% disagreed (group 4), and no respondents strongly disagreed (group 5).

Survey results, graph 5 indicate that when asked about the interrelation of the gut with other organs, 35% of participants strongly agreed (group 1), 44% agreed (group 2), 20% were neutral (group 3), none of the respondents disagreed (group 4), and 2% strongly disagreed (group 5).

The majority of the participants either strongly agreed or agreed (summing up to 71%) with the statement in the graph 6, suggesting a prevalent belief or understanding that stress or excessive tension can influence bowel movements, potentially leading to constipation. A quarter of the participants remained neutral, perhaps being uncertain or unaware of the connection. A very small percentage (4%) disagreed, indicating they might not believe there's a strong connection between tension and bowel movement disruptions. No participants strongly refuted the idea.

A substantial majority of the participants (totaling 76% from groups 1 and 2) either strongly agreed or agreed with the statement represents the graph 7. This reflects a prevalent belief or understanding that dietary interventions can be beneficial for gut health. Meanwhile, 16% of respondents remained neutral, possibly due to a lack of knowledge or uncertainty about the direct impact of diet therapies on gut health. A smaller percentage (totaling 7% from groups 4 and 5) either disagreed or strongly disagreed with the statement. This suggests that a minority of respondents may be skeptical about the role of diet therapies in maintaining gut health or believe other factors are more influential.

ASSOCIATION BETWEEN AGE AND WILLINGNESS TO TAKE DIETARY SUPPLEMETNS FOR IMPROVING GUT HEALTH

ANOVA
	df	SS	MS	F	Significance F
Regression	1	0.193827	0.193827	0.8123	0.369441
Residual	108	25.76981	0.238609	2
Total	109	25.96364

Table no. 9- F-statistics

The F-statistic in table no. 9 is used to determine if there is a significant relationship between the dependent variable (willingness to take dietary supplements) and the independent variable (age). In this case, the F-value is 0.81. The p-value (Significance F) associated with the F-statistic is 0.36. Typically, a p-value of less than 0.05 is considered significant, suggesting that there is a less than 5% chance that the observed association is due to random variation alone. Given the p-value of 0.36, which is greater than 0.05, we fail to reject the null hypothesis. This means that, based on the data provided, there is no statistically significant association between age and the willingness to take dietary supplements for improving gut health. In simpler terms, age does not seem to significantly influence an individual's willingness to take dietary supplements for gut health, at least according to this data set.

	Coefficients	Standard Error	T Stat	P-value	Lower 95%	Upper 95%	Lower 95.0%	Upper 95.0%
Intercept	1.526316	0.112064	13.62001	3.43E-25	1.304185	1.748446	1.304185	1.748446
X Variable 1	0.055523	0.061605	0.901288	0.369441	-0.06659	0.177634	0.06659	0.177634

Table no. 10- Variable Statistics

The intercept is significantly different from zero. When the age is 0 (or at the reference level), the expected willingness score (or whatever measure is being used) is approximately 1.526316 as represent in table no. 10. The coefficient for the X Variable (presumably Age) is 0.055523. However, with a p-value of 0.36, this association is not statistically significant at the typical 0.05 level. The 95% confidence interval for this coefficient includes zero (-0.06 to 0.17) as shown in table 4.9, further indicating that the effect is not statistically significant. In conclusion, age does not significantly influence the willingness to take dietary supplements for improving gut health. The regression results are consistent with the ANOVA results you provided earlier.

CORRELATION TABLE

Variable 1	Variable 2	Correlation value
Gender	Q1	0.08312
Gender	Q2	0.179692

Table no. 11- Correlation of different questions between the genders

The correlation between Gender and Q1 is 0.08312, which represents a very weak positive correlation. In practical terms, this suggests that there is a slight association where as one variable increases, the other does too, but the strength of this relationship is minimal. Given the closeness of this value to 0, it indicates little to no significant linear relationship between Gender and Q1. The correlation between Gender and Q2 is 0.179692 as shown is table no. 11. This indicates a weak positive correlation. As one variable increases, the other tends to increase as well, but the relationship isn't strong. Despite being weak, the correlation between Gender and Q2 is stronger than the correlation between Gender and Q1. The correlation between Gender and Q1 is very weak, suggesting a minimal relationship between the two. Meanwhile, the correlation between Gender and Q2 is slightly stronger but still weak, indicating a modest positive relationship. Neither correlation suggests a robust or highly significant relationship between Gender and the two variables, Q1 and Q2.

The findings presented in this report provide a multifaceted understanding of the surveyed population's awareness and beliefs concerning various aspects of gut health. The demographic analysis revealed a balanced representation of age and city distribution, with a predominance of female participants and a diverse range of occupations. This provides a comprehensive insight into various perspectives across different demographic sectors. Regarding awareness on gut health, there were noticeable misconceptions. For instance, a significant proportion of respondents believed that the gut is synonymous with the stomach. This underlines the need for educational initiatives that better explain the gut's complexity, encompassing the entire digestive tract rather than just one organ. Similarly, the widespread belief that passing 1–2 bowels per day indicates excellent gut health shows the prevalence of simplified health markers, which might not capture the nuances of individual health scenarios. Interestingly, the relationship between the gut and other organs seems to be under-acknowledged among the respondents. This lack of awareness is striking given the rising scientific evidence pointing towards the gut's integral role in overall health, influencing various systems like the immune, endocrine, and nervous systems. The responses to the statement on functional foods suggest that while many respondents see their potential benefits in disease management, a considerable portion remains skeptical or uncertain. This finding emphasizes the need for more widespread dissemination of knowledge regarding functional foods and their role in health. The regression and ANOVA analyses concerning the association between age and willingness to take dietary supplements for improving gut health indicated no significant relationship. This implies that willingness to consider dietary supplements is not age-dependent in the surveyed population. The correlation between gender and both Q1 and Q2 suggests that gender has a weak relationship with these variables. Although the correlation between gender and Q2 is slightly stronger than with Q1, both values indicate weak relationships. Such findings caution against making strong gender-based assumptions about awareness or beliefs concerning gut health. The balanced representation across age groups and cities, coupled with a higher female participation and varied occupational backgrounds, affirms that the study tapped into a rich tapestry of perspectives. This ensures that the insights gleaned can be seen as illustrative of broader public perceptions, providing invaluable guidance for future educational campaigns and public health interventions. A significant takeaway is the extent of misconceptions surrounding gut health. The tendency to equate the gut with the stomach highlights an oversimplified understanding of the digestive system among the populace. Such misconceptions, if left unaddressed, can have implications on how individuals approach their digestive health, potentially leading to suboptimal health decisions. The limited recognition of the gut's role in influencing other body systems is particularly concerning. Given the robust scientific evidence underscoring the gut's interrelation with organs like the brain, lungs, and liver, this gap in knowledge suggests that the broader medical community and public health practitioners might need to ramp up efforts to disseminate this crucial information. The varied perceptions about functional foods, particularly their role in disease management, suggest both an opportunity and a challenge. On one hand, there's a foundation of belief in the efficacy of functional foods, but on the other, there's discernible skepticism. Moreover, the lack of a statistically significant association between age and the inclination to take dietary supplements for gut health indicates that age might not be the primary driver in this health decision, pointing towards other potential influences or barriers that need exploration. While gender showcased a weak correlation with the two variables Q1 and Q2, the data suggests that gender may not be a predominant factor in shaping beliefs or awareness about gut health. However, as with all such findings, this serves as a starting point for further nuanced investigations into gender-based health perceptions. The secondary data, emphasizing the relationship between the gut and various diseases, underscores the gut's pivotal role in overall health. The results underscore the importance of health education in dispelling myths and establishing a more informed understanding of gut health and related areas. The presence of misconceptions and lack of awareness, even in an urban setting with diverse occupational backgrounds, is a testament to the need for targeted health communication strategies. Future studies might delve deeper into understanding the roots of these misconceptions, enabling more effective educational interventions.

The findings reiterate the importance of an integrative approach to health, viewing the body as a complex, interconnected system rather than isolated compartments. This study illuminates both the strengths and gaps in public awareness about gut health. While some foundational knowledge exists, there's a clear need for deeper, more nuanced educational initiatives. Addressing these misconceptions and knowledge gaps is not just a matter of academic accuracy; it's a pivotal step towards fostering a more health-literate populace that can make informed decisions about their well-being. Given the gut's centrality to overall health, such endeavors are not just advisable; they are imperative.

Acknowledgments: We would like to express my sincere gratitude and appreciation to Symbiosis Skills and Professional University for their invaluable support and resources that made this research paper possible. The unwavering commitment to academic excellence and the conducive environment for research at the university played a significant role in shaping the outcomes of this study.

Conflict of interest: None. This study doesn’t contain any interest, financial relationship, personal relationship, religious or political beliefs that might influence the objectivity of the author can be considered as a potential source of conflict of interest. All manuscripts submitted to the journal must include a conflict of the interest disclosure statement or a declaration by the authors that they do not have any conflicts of interest to declare.

Financial support: Not applicable

Ethics statement: The study has the approval from institutional ethics committee (BHR II) of Symbiosis International university, Pune. Wherever, this Study do not involve any trials of humans and animals body or tissue sample. We confirmed that a survey conducted on a human participant was in accordance with relevant guidelines and regulations/ institute, Symbiosis skills and Professional university and Ethic committee BHR II SIU.

Informed Consent: Informed consent for participation was taken from all human participants before starting the survey and confirmed it from the institute department, Beauty & wellness of Symbiosis skills and professional university, Pune. This journal has a Conflict of Interest policy in place and complies with institutional standards on research involving Human Participants and Informed Consent.

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Graph 1 to 7 are available in the Supplementary Files section.

No competing interests reported.

Mapping the Gut-Brain Connection: Exploring Knowledge, Attitudes, and Practices in Diverse Age Groups and Geographic Contexts

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Abstract

Introduction

Materials and Methods

Results and Discussion

Discussion

Conclusion

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References

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Additional Declarations

Supplementary Files

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