Gut Health Claims and Monetization Features on TikTok: Cross-Sectional Analysis

BACKGROUND TikTok has emerged as a major source of health information, yet concerns persist regarding content accuracy and monetization features. Gut health content is particularly vulnerable to misinformation. OBJECTIVE This study aimed to examine the relationship between creator profession (“medical” vs “nonmedical”) and the quality of gut health claims and monetization features on TikTok. METHODS We conducted a cross-sectional study screening 412 unique TikTok creator accounts identified using the keywords “guthealth,” “gutcleansing,” and “digestion.” The final sample included 174 publicly accessible individual creators with at least 5000 followers and identifiable, relevant profession information. One video per creator was analyzed. Creator profession was categorized as medical or nonmedical, and health claim quality was coded as high, moderate, or poor. Monetization features (Showcase, Subscription, and external links) were assessed. RESULTS Nonmedical creators were more likely than medical creators to present poor- or moderate-quality health claims (adjusted prevalence ratio 2.33, 95% CI 1.50-3.62). Most creators (160/174, 92%) exhibited at least 1 monetization feature, and Showcase use was greater among nonmedical creators (adjusted prevalence ratio 1.57, 95% CI 1.02-2.42). Videos containing moderate- and poor-quality health claims received 3 times the expected likes as videos containing high-quality claims. CONCLUSIONS Among the sampled creators, nonmedical creators were more likely to present poor- or moderate-quality gut health claims, and lower-quality claims were associated with higher like counts. These findings highlight a misalignment between information quality and like counts on social media.