Patients find plenty of health information on line, but not all of it is reliable

The Internet has no equal as an information storehouse. The trick is to know how to get right to a source of useful information and not waste time on Web sites that are biased, trying to sell you something or just plain wrong.

Marvin M. Lipman, Consumers Union's chief medical adviser, recalls having a patient who made a Google search and somehow settled on an abdominal aortic aneurysm (a worrisome bulge in the body's main blood vessel) as the logical explanation for his midback pain. No reassuring on Lipman's part eased the patient's apprehension. It took a sonogram to convince him he wasn't at death's door.

Lipman had another patient who was referred to him after her primary-care physician told her she had Graves' disease (an overactive thyroid). She arrived for her appointment armed with computer printouts of useful, accurate information and fully prepared to discuss the pros and cons of treatment options for her problem.

Lipman says that nothing has changed the doctor-patient relationship as radically during his career as the Internet. As recently as 1995, about one in 10 American adults had online access; today, about three of four adults and just shy of 100 percent of teenagers use the Internet to get information and communicate with others, according to the Pew Research Center. The one-way flow of health information from doctor to patient is now a dialogue, or even, at times, a debate.

Caveatemptor.com

Google and Yahoo are among the most-used search engines. But almost anyone can pay these Web sites to display advertisements, or "sponsored links." And anyone with something to sell can set up a Web site with few if any checks and balances on what it says.

While information sites such as AOL sometimes post paid links, many links are nothing more than ads for individual products. By searching Google for "flu symptoms," for example, ads may pop up for Kleenex, Tylenol and the homeopathic preparation called Oscillococcinum.

The top "natural" (i.e., unpaid) search results might also include some sites marketing a specific product. For instance, a recent Google search on "enlarged prostate" yielded information from the Mayo Clinic and the National Institutes of Health but also the Web site for an unproven herbal product.

The other dots

You can also find health information on the generally commercial-free government Web sites (with addresses that end in ".gov") and academic ones (".edu").

Some not-for-profit organizations run Web sites (".org") that are ad-free, including ConsumerReportsHealth.org, which charges for some of its information, and some take advertising. Others are littered with advertising, and some are fronts for industries or manufacturers with a commercial agenda.

Consumers visiting an unfamiliar site should always check the "About Us" section for clues about who is funding the content.

Figuring out the pecking order among Web sites requires narrowing the choices to those that provide up-to-date, reliable and understandable information. Many qualify. No doubt your doctors can recommend personal favorites. This is Lipman's current Top 5 list:

www.cancer.gov for information about cancer.

www.cdc.gov for information about infectious diseases, travel medicine and epidemiology.

www.fda.gov for information about drugs.

www.medlineplus.gov for information about diseases.

www.usp.org for information about medicine and nutritional supplements.

(c) Copyright 2011. Consumers Union of United States Inc.

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Reliable packaging for chemical-free food

It is not obvious when examining a wrapped lettuce or a microwavable bowl of Chinese soup. But plastic food packaging is made of multiple layers designed to act as a barrier for oxygen or bacteria. "Each of these layers is made by a different manufacturer. Still, at the end of the chain, the food manufacturer who sells the packaged product is the sole responsible for food safety," notes Olivier Vitrac, a researcher at the Genial joint research unit of the National Institute of Agricultural Research (INRA-Agroparistech), located in Massy, near Paris. Scientists have been addressing the issue of such potentially harmful molecules diffusing from one layer to the next in food packaging, susceptible to ultimately contaminate the food. This work has been performed under the SafeFoodPackDesign project, coordinated by Vitrac and funded by the French National Research Agency (ANR).

Food packaging is designed to preserve the content as fresh and safe as possible. Its second function is to make the product look attractive to customers, using colourful prints. The problem is that this approach requires the use of potentially harmful molecules such as anti-ultraviolet radiations, anti-oxydisers, glue and pigments from inks. These substances have been suspected—albeit not always proven categorically—of being responsible for triggering cancers. They have also been accused of endocrine disruption because they contain substances like bisphenol A. This hormone-like chemical has recently been banned in France. It has also been the object of the EU funded ENDOCEVAL project, which aims at testing new packaging that are free from bisphenol A.

The SafeFoodPackDesign project goal is to build tools to help packaging manufacturers assess the diffusion risks of potentially harmful molecules, at every stage of the packaging's life; from manufacturing to final use, including transport and storage. As an example, piling up plastic cups designed to hold, for example, Chinese soup, results in putting the inked external layer in contact with the inner layer of the cup immediately underneath. As a result, ink molecules migrate towards the inner layer, which will eventually be in contact with the food. "In this case, the most critical step regarding chemical risk is with no doubt storage," Vitrac explains youris.com.

The first task of the project team has been to build a database of materials used for packaging to document their molecular content. Now, they are measuring the diffusion speed of these molecules, in order to build predictive models. "Building migration models can be challenging in the case of a multi-layer packaging containing several chemicals in contact with non-homogeneous food. Besides, the input data available to feed the model, such as packaging and food composition, is not always accurate," warns Peter Mercea, of FABES, a German company specialised in testing and evaluating migration of substances from packaging into foods.

By December 2014, the project team is expected to have developed an open-source software, based on a method used in aeronautics called Failure Mode Effects and Criticality Analysis, also referred to as FMECA, to detect every critical point on the packaging lifecycle where contamination could occur. A first version is already available.

This new tool could change the way plastic food packaging is designed and handled. At present, the EU Framework Regulation on food contact materials (EC) No 1935/2004 states that packaging must not transfer chemicals to food in quantities that may pose a threat to human health and alter significantly the composition and organoleptic characteristics of the food. "This regulation is already stringent and every new packaging must be proved individually safe before entering the market. But it says nothing about transport and storage and other possible critical points," explains Daniel Ribera, of Bio-tox , a consultancy specialised in sanitary and environmental risk assessment. If, "in addition, SafefoodPackDesign can help assess the related risks, it will provide a real increase in safety for manufacturers and therefore for consumers."

Provided by Youris.com

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