Abstract Background Patients recognise the role of diet in IBD and often use social media as a primary source of health-related information1. While prebiotics are proposed to restore the gut microbiota and reduce inflammation in IBD2, little is known about the health claims made about prebiotics on Instagram. This research evaluates the quality, methodological soundness, and credibility of prebiotic anti-inflammatory claims on Instagram. Methods We searched for “#fibra” or “#prebiotico” on Instagram on October 29th, 2025, and took a screenshot of the most popular Spanish-language publication that explicitly addressed “inflammation” among the first 10 “Top posts”, which display popular trending content as determined by Instagram’s algorithm. We then assessed information quality using a modified version of a tool to evaluate the online quality of information on dietary interventions that modulate the microbiome, which includes 14 criteria, including authorship credentials, quantification of benefits, reporting of harms, and inclusion of a link to scientific publications3. The methodological quality and interpretability of the systematic review supporting prebiotic health claims were assessed using a modified version of the Measurement Tool to Assess Systematic Reviews, version 2 (AMSTAR-2), which evaluates 18 critical items, including comprehensiveness of the search, risk of bias assessment, the reporting of absolute effect estimates, and the certainty of evidence4. Results On a scale of 0-14, the information quality score for Instagram content was 7. The publication did not disclose potential conflicts of interest; the title was exaggerated; the language failed to acknowledge the adverse effects of prebiotics and the limitations of research; the effects were not quantified; a disclaimer asking for a healthcare professional was absent; and no references or links to scientific publications were provided. The methodological quality and interpretability of the systematic review supporting Instagram claims about prebiotics for IBD had a moderate confidence level. The report of the systematic review did not contain an explicit statement that the review methods were established prior to the conduct of the review and did not justify any significant deviations from the protocol, the review authors did not report on the sources of funding for the studies, there was no report of absolute effect estimates, and the certainty of the evidence for all outcomes was low to very low. Conclusion Instagram information on prebiotics for IBD does not align with the evidence and is unbalanced. The systematic review supporting social media claims on prebiotics may provide an accurate summary of the available studies. References: 1. Reich, J., Guo, L., Groshek, J., et al. (2019). Social media use and preferences in patients with inflammatory bowel disease. Inflamm Bowel Dis, 25(3), 587-591. doi:10.1093/ibd/izy2802. 2. Limketkai, B. N., Godoy-Brewer, G., Shah, N. D., et al. (2025). Prebiotics for induction and maintenance of remission in inflammatory bowel disease: systematic review and meta-analysis. Inflamm Bowel Dis, 31(5), 1220-1230. doi:10.1093/ibd/izae1153. 3. Prados-Bo, A., Rabassa, M., Bosch, M., et al. (2022). Online information in Spanish on probiotics, yoghurt, kefir, kombucha, fibre and prebiotics: an analysis of the quality of information and the certainty of the evidence supporting health claims. BMJ Open, 12(8), e063316. doi:10.1136/bmjopen-2022-0633164. 4. Esmaeilinezhad, Z., Torbahn, G., Johnston, B. C. (2025). Medical nutrition therapy (MNT) evidence update: comparative effectiveness of dietary programs for reducing mortality and cardiovascular events in adults with increased cardiovascular disease risk. Adv Nutr, 16(4), 100399. doi:10.1016/j.advnut.2025.100399. Conflict of interest: Dr. Prados, Andreu: Andreu Prados-Bo works as a medical writer and scientific consultant for companies commercially involved in the gut microbiome, probiotics, and prebiotics, and also works as a medical writer and operational staff member of Nutritional Therapy for IBD. Bosch, Mireia: Ms. Bosch declares no conflicts of interest. Beall, Kim S.: I am a founder of Nutritional Therapy for IBD, a non-profit focused in evidence-based nutrition for patients with Crohn’s disease and ulcerative colitis. Rabassa, Montserrat: Dr. Rabassa work is supported by the NUTRIFRAIL project (PID2022-141067OA-I00) funded by MICIU/AEI/10.13039/501100011033 and FEDER, EU. Additional support is provided by the Maria de Maeztu Unit of Excellence grant (CEX2021-001234-M), funded by MCIU/AEI/ Co-funded by European Regional Development Fund, ERDF, a way to build Europe. MR work is supported also by Ramon y Cajal grant RYC2021-034349-I funded by MICIU/AEI/10.13039/501100011033 and the European Union NextGenerationEU/PRTR.
Prados et al. (2026) studied this question.