Wondering about the side effects of that new drug your doctor prescribed? Want advice on how to cope with a new diagnosis? Should you believe reports that calcium can prevent colon cancer?
If you're like tens of millions of Americans, you're more likely to look for answers on the Internet than to call the doctor. And you're likely to start at a search engine. But type "preventing osteoporosis" into www.google.com, for example, and up pop links to more than 100,000 pages of information. That's just too much to sort through.
What's more, search engines dredge up commercial and non-commercial sites in no apparent order. And it's not always easy to tell the difference (unless you hit a page with a hard sales pitch).
To save you the aggravation, we searched the Web for reliable, consumer-friendly health and nutrition sites. We found some first-class places to start your searches from, and some sites that aren't as helpful as you might think (see boxes). We also found a handful of other sites that are worth bookmarking:
* To see what's in any food. For the calories, calcium, folate, saturated fat, or just about any other nutrient in any of 10,000 (mostly non-brand-name) foods, go to www.nal.usda.gov/fnic/foodcomp. The U.S. Department of Agriculture has been collecting data on what's in food for more than 100 years. You'll probably make the most use of the nutrient breakdowns under "Search the Nutrient Database," but the site also contains separate listings of vitamin K, carotenoids, trans fats, and much more.
* To calculate your body mass index (BMI). To see if you're underweight, overweight, or just right, go to www.nhlbisupport.com/bmi. The site, which is part of the National Institutes of Health, also explains how your BMI affects your risk of heart attack and stroke.
* To look up scientific studies. The world's largest database of published medical research is at www.ncbi.nlm.nih.gov/entrez/query.fcgi. You can search through more than nine million scientific articles (most have just abstracts; a few have the full text).
* To participate in a study. At www.clinicaltrials.gov you'll find which government-sponsored studies are recruiting (in the U.S. and Canada) and what the requirements are. In early 2003, for example, 162 clinical trials on prostate cancer and six on osteoarthritis were looking for volunteers.
At WebMD (www.webmd.com) we were able to quickly locate top-notch information. A good place to start: the "Newly Diagnosed," "Stay Healthy," or "Living with Illness" buttons on the WebMD Health page. Each opens up a world of resources.
The site is loaded with feature articles, news items, advice columns, recipes, charts and guides, and links to support groups. Some of the material is written by WebMD, and some comes from experts in the field. (For example, a recent visit turned up a Q&A with weight-loss researcher Kelly Brownell and a guide to prostate cancer by The Cleveland Clinic.)
Advertisements and material from the site's sponsors (who are identified on the Home page) are clearly marked.
* www.nutrition.gov. It's touted as "easy access to all online federal government information on nutrition." While some of its material is useful, much isn't. When we searched for the "Atkins diet," for example, the first document to pop up was an unedited transcript of a three-year-old debate in which Robert Atkins was one of seven participants. The second was a list of 13 links to "Fraud and Nutrition Misinformation," only one of which was about the Atkins diet (and it was one-sided and outdated). And the third was a 1981 U.S. Postal Service complaint against a company for selling an anti-wrinkle supplement (Atkins was an expert witness).
* www.nal.usda.gov/fnic. It may be the place to go to find out what's in just about any food, but for other information, the U.S. Department of Agriculture's Food and Nutrition Information Center isn't what you'd call user-friendly. When we searched for "trans fat," for example, up came a technical scientific paper about food analysis that only laboratory wonks would find useful. The next document was a USDA timeline from 1892 to 2002 showing that the agency released its first analysis of foods for trans fats in 1995. While that may not tell you much, at least the information isn't biased.
* www.eatright.org. "Should you be concerned about trans fatty acids?" asks an article in the "Healthy Lifestyle" section of the American Dietetic Association's Web site. The answer: "At this point, it's not clear." H-e-l-l-o? The National Academy of Sciences has told the public to eat as little trans fat as possible because there is no safe level. That's why the Food and Drug Administration (FDA) has announced that it will require that labels list the amount of trans fat in foods. What's not clear about that? (What is clear is that some of the ADA's funding comes from food manufacturers that use trans fats in their products.) Note: After publication of this article, the ADA removed this reference to trans fat. However, it is preserved in Google's cache here.
* www.navigator.tufts.edu. This industry-funded site rates hundreds of nutrition Web sites for accuracy, depth, timeliness, and usability. While the Tufts University dietitians who do the reviews identify some worthwhile sites, they persistently favor mainstream government, academic, and industry Web sites that support the status quo and avoid controversy.
For example, Navigator gives one of its highest ratings to www.ific.org, the Web site of the industry-funded International Food Information Council (IFIC). Guess they didn't look at IFIC's "Questions and Answers about Mercury in the Environment and Food," which ignores major research showing that mercury in seafood may harm children. And they must have missed the "Questions and Answers About Trans Fat," which stubbornly refuses to admit that trans increases the risk of heart disease.
Also receiving a "Better than Most" rating: the pork industry's site (www.porkandhealth.org), which implies that pork is nutritionally comparable to "white meats" like chicken and turkey and ignores the controversy over the environmental damage caused by the factory farming of pigs.
* Phony "Public-Service" Sites. They're designed to look like public-service sites, and they provide some information about health. But they're really reaching for your wallet. And, in most cases, it's impossible to figure out who's behind them.
Take www.bones-and-osteoporosis.com. The slickly designed site, which appears near the top of Google searches for "preventing osteoporosis," offers "straight" talk about the disease. But the talk is window-dressing to lure visitors into buying expensive dietary supplements or participating in drug trials run by major pharmaceutical companies. (Recruiting volunteers is a lucrative business.) The only clue that the site may not be public-spirited: At the bottom of the Home Page, in tiny print, are the words "Copyright W3Commerce, Inc." (W3Commerce of San Diego, California, manages Web sites for drug and food companies.)
Some other sites registered to W3Commerce: www.diabetes-and-diet.com, www.about-hypertension.com, www.depression-and-anxiety.com, www.about-migraine-treatments.com, and www.preventing-obesity.com. (Whenever you see .com at the end of a Web address, remember that somebody may be trying to sell you something.)
These two sites are stronger on diseases than on foods and nutrition. If you want quicker results on nutrition, start at WebMD.
www.medlineplus.gov is maintained by the National Institutes of Health (NIH), the world's largest medical research institution. The site has links to reliable information on more than 500 health topics, plus access to medical dictionaries, a medical encyclopedia, facts about thousands of drugs, information on alternative therapies like Tai Chi and acupuncture, and directories of hospitals, specialists, government sites, and health organizations like the American Cancer Society.
www.healthfinder.gov is the federal government's gateway to health information on hundreds of topics. Go to the "Just for You" directory and click on "men" and then "prostate cancer," for example, and you'll be linked to 20 articles on prevention, screening, and treatment from the National Cancer Institute, the National Institute on Aging, the American Academy of Family Physicians, the Centers for Disease Control and Prevention (CDC), the American Foundation for Urologic Disease, and major medical school sites.
At www.cspinet.org you'll find articles from the current and back issues of Nutrition Action Healthletter; quizzes to help rate your diet and see how much you know about vitamins, fat, and harmful bacteria; information on which food additives are safe or not; guides to help you shed unwanted pounds, lower your blood pressure, and reduce your cholesterol; and a link to www.smartmouth.org, our Web site for kids.
* To see what's in any food. For the calories, calcium, folate, saturated fat, or just about any other nutrient in any of 10,000 (mostly non-brand-name) foods, go to www.nal.usda.gov/fnic/foodcomp. The U.S. Department of Agriculture has been collecting data on what's in food for more than 100 years. (The U.S. database is far more comprehensive than anything available in Canada. In fact, much of the information in Health Canada's Canadian Nutrient File - www.hc-sc.gc.ca/food-aliment/ns-sc/nr-rn/surveillance /cnf-fcen/e_index.html - comes from the U.S. database.) You'll probably make the most use of the nutrient breakdowns under "Search the Nutrient Database," but the USDA site also contains separate listings of vitamin K, carotenoids, trans fats, and much more.
* To calculate your body mass index (BMI). To see if you're underweight, overweight, or just right, go to www.healthyontario.com, click on "Health Tools," then on "Body Mass Index Calculator." You can also find out whether your BMI puts you at increased risk of heart disease and stroke.
* If you have allergies. The Canadian Food Inspection Agency lists food recalls and allergy alerts at www.inspection.gc.ca/english/corpaffr/recarapp/ recaltoce.shtml. You can even sign up to have them automatically e-mailed to you.
* www.nin.ca. The Canadian National Institute of Nutrition's Web site has links to dozens of articles on subjects like food allergies, osteoporosis, and vitamins. But most are at least four or five years old. Its two reviews of antioxidants, for example, were written in 1996. When you're talking health and nutrition, seven years ago is ancient history.
* www.chp-pcs.gc.ca/CHP/index_e.jsp. The Canada Health Portal (CHP) was set up by the Federal, Provincial, and Territorial Governments" to help you access authoritative and trusted health information quickly and easily." Substitute "bureaucratic" for "authoritative and trusted" and you'll have a good idea of what the site is like. When we searched for "trans fat," for example, we got 26 documents, none of them explaining why trans fat is bad for your heart or listing which foods it's found in. (The article rated most relevant by the site: "Label Inspection Guide for Fish and Fish Products." There is no trans fat in fish.)
www.healthyontario.com was set up in 2002 by the Ontario Ministry of Health and Long-Term Care as a way to provide Ontarians with a world-class Web site for health information. Even if you don't live in Ontario, this site is a must-visit if you want reliable, useful articles on just about any health condition, from "abnormal heart rhythms" to "zits." Have a question about a drug you're taking? You can see how hundreds of prescription medications work, when to take (and not take) them, what their side effects are, and which other drugs you shouldn't mix them with. There are also a half dozen interactive tools that help you assess your ideal weight; the calories you burn every day; the fat, sodium, and other nutrients in the foods you eat; and even your prospects for a long life.
Is it safe to drink unpasteurized apple cider? What are the symptoms of an E. coli O157:H7 infection? The University of Guelph's Food Safety Network (www.foodsafetynetwork.ca) will tell you that... and a whole lot more. Start by clicking on "Eat Well, Eat Safe." Minimum cooking temperatures, bacteria profiles, food handling and storage tips, information on food recalls. If it has to do with food safety, odds are it (or a link to it) is there. You can print out factsheets on everything from acrylamide to mad cow disease to how to safely stuff a turkey. The Network also maintains a national toll-free food safety telephone line (1-866-503-7638).
At www.cspinet.org/canada you'll find articles from the current and back issues of Nutrition Action Healthletter; quizzes to help rate your diet and see how much you know about vitamins, fat, and harmful bacteria; information on which food additives are safe or not; guides to help you shed unwanted pounds, lower your blood pressure, and reduce your cholesterol; and a link to www.smartmouth.org, our Web site for kids.