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Who can you trust? A review of free online sources of “trustworthy” information about treatment effects for patients and the public

Andrew d. oxman.

1 Centre for Informed Health Choices, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway

2 University of Oslo, Oslo, Norway

Elizabeth J. Paulsen

Associated data.

All data generated or analysed during this study are included in this published article and the Additional file 1 .

Information about effects of treatments based on unsystematic reviews of research evidence may be misleading. However, finding trustworthy information about the effects of treatments based on systematic reviews, which is accessible to patients and the public can be difficult. The objectives of this study were to identify and evaluate free sources of health information for patients and the public that provide information about effects of treatments based on systematic reviews.

We reviewed websites that we and our colleagues knew of, searched for government sponsored health information websites, and searched for online sources of health information that provide evidence-based information. To be included in our review, a website had to be available in English, freely accessible, and intended for patients and the public. In addition, it had to have a broad scope, not limited to specific conditions or types of treatments. It had to include a description of how the information is prepared and the description had to include a statement about using systematic reviews. We compared the included websites by searching for information about the effects of eight treatments.

Three websites met our inclusion criteria: Cochrane Evidence , Informed Health , and PubMed Health . The first two websites produce content, whereas PubMed Health aggregated content. A fourth website that met our inclusion criteria, CureFacts , was under development. Cochrane Evidence provides plain language summaries of Cochrane Reviews (i.e. summaries that are intended for patients and the public). They are translated to several other languages. No information besides treatment effects is provided. Informed Health provides information about treatment effects together with other information for a wide range of topics. PubMed Health was discontinued in October 2018. It included a large number of systematic reviews of treatment effects with plain language summaries for Cochrane Reviews and some other reviews. None of the three websites included links to ongoing trials, and information about treatment effects was not reported consistently on any of the websites.

It is possible for patients and the public to access trustworthy information about the effects of treatments using the two of the websites included in this review.

Electronic supplementary material

The online version of this article (10.1186/s12911-019-0772-5) contains supplementary material, which is available to authorized users.

Patients and the public must make choices among different treatment options. We define “treatment” broadly, as any preventive, therapeutic, rehabilitative, or palliative action intended to improve the health or wellbeing of individuals or communities [ 1 ]. This includes, for example, drugs, surgery and other types of “modern medicine”; lifestyle changes, such as changes to what you eat or how you exercise; herbal remedies and other types of “traditional” or “alternative medicine”, and public health interventions. Few people would prefer that decisions about what they should and should not do for their health should be uninformed. Yet, if a decision is going to be well informed rather than misinformed, they need information that is relevant, trustworthy, and accessible. They also need to be able to distinguish between claims about the effects of treatments that are trustworthy and those that are not [ 2 ].

Often the problem is too much information rather than too little. For example, a Google search for “back pain” yields over 60 million hits [ 3 ]. PubMed, a free search engine for accessing MEDLINE and other databases maintained by the United States National Library of Medicine, includes over 27 million citations [ 4 ], and this represents only a fraction of the biomedical literature. The Cochrane Central Register of Controlled Trials, a bibliographic database that is restricted to controlled trials of treatments, contains over a million citations [ 5 ]. It is not practical for people making decisions about treatments to use search engines or databases such as these to find relevant information, critically appraise the studies they find, synthesize them, and interpret the results.

Systematic reviews reduce the risk of being misled by bias (systematic errors) and the play of chance (random errors), by using systematic and explicit methods to identify, select, and critically appraise relevant studies, and to collect and analyse data from them [ 6 ]. For information about treatment effects to be trustworthy, it should be based on systematic reviews. For it to be accessible to patients and the public, it should be easy to find and should be clearly communicated in plain language [ 7 ].

Unfortunately, a large amount of information about treatment effects is not based on systematic reviews and is not trustworthy [ 8 – 19 ]. This includes handouts for patients [ 8 , 9 ], internet-based information [ 10 , 11 ], information in social and mass media [ 12 – 18 ], information produced by patient organisations [ 8 , 9 , 12 ]. press releases [ 18 ], and advertisements [ 19 ]. Studies of the trustworthiness of health information have used a variety of criteria, but have consistently found important limitations [ 8 – 19 ]. Although trustworthy information about treatment effects can be found, evidence-based information is frequently written for health professionals or researchers, rather than for patients and the public [ 7 ].

There is an abundance of health information on the internet, which has become an important source of health information over the past two decades [ 10 , 11 , 20 – 24 ], but patients and the public find it difficult to search the internet for trustworthy information [ 21 – 23 ], and are unlikely to critically appraise the information that they do find [ 22 , 23 ].

There are a number of websites that aim to improve access to trustworthy health information for patients and the public. The objectives of this study were to identify free sources of health information for patients and the public which provide information about the effects of treatments based on systematic reviews, and to evaluate those websites.

Our motivation for undertaking this review grew out of a desire to respond to people who were looking for trustworthy information about the effects of specific treatments and landed on Testing Treatments international [ 25 ], a website for promoting critical thinking about treatment claims. Rather than simply noting that the Testing Treatments website does not provide the information they were seeking, we wanted to help them by directing them to sources that do provide this information. Given this motivation, we restricted our review of websites to ones with a broad scope. There were two reasons for this. First, websites with a broad scope can meet the needs of most people seeking trustworthy information about treatment effects. Furthermore, although disease-specific websites can be useful, it would be impractical to assess any more than a small sample of websites for specific conditions or types of treatments. Second, it is easier to become familiar with one or a small number of websites than it is to use multiple websites for questions about different conditions or types of treatments.

We considered any website that defined itself as providing “health information”, which included information about treatments. To be included in this review a website needed to be:

• Available in English
• Freely accessible (i.e. non-commercial with no cost to users or membership fees)
• That described itself as being intended for patients and the public
• Broad in scope (not limited to specific conditions or types of treatments)
• Explicitly based on systematic reviews (i.e. there had to be a description of how the information is prepared and the description had to include a statement about using systematic reviews)

We identified websites that potentially met those criteria by considering websites that we and our colleagues (see Acknowledgements) knew of. The first author (AO) searched for government sponsored websites in English speaking countries (including Australia, Canada, Ireland, New Zealand, the UK, and the USA); searched Google for “health information” and “patient information” to identify websites that are frequently accessed for health information; and checked links to other websites on the websites that were identified. On 29 January 2018, AO conducted a final set of searches using the following terms: “health information”, “patient information”, “evidence-based health information”, and “evidence-based patient information”; and these search engines: Google [ 3 ], Bing [ 26 ], DuckDuckGo [ 27 ], and HONsearch patients [ 28 ]. Google and Bing are the two most popular search engines, DuckDuckGo is not affected by your previous search history, and HONsearch searches “trustworthy” health websites. The first 20 hits for each search were screened, and any websites that looked like they might meet our inclusion criteria were checked.

AO assessed each identified website for inclusion and the second author (EP) checked those judgements using information provided on the websites. In addition, we emailed each excluded website to confirm that our reason for excluding it was correct.

AO collected the following information for each included website:

• The stated purpose
• A statement that information about treatment effects is based on systematic reviews
• Availability of links to the systematic reviews
• Reporting size of effects
• Reporting certainty of the evidence; i.e. a judgement using GRADE (Grading of Recommendations Assessment, Development and Evaluation) [ 29 – 31 ] or another formal approach or an informal judgement about how sure we can be about the reported effects
• Availability of links to ongoing trials
• Information about how up-to-date information about treatment effects is
• What other information is provided
• What tools there are for searching, sorting, and filtering information
• Use of plain language (i.e. summaries written for patients and the public) and the availability of a glossary

EP checked all of the information that was recorded and the judgements that were made. To inform these judgements, both authors independently searched each included website for eight questions about treatments to assess the ease of finding information (AO on 22 December 2017 and EP on 9 January 2018). We selected the eight questions by searching Google for “common health questions” and selecting the first relevant list that we found ( 25 Questions About Your Health Answered - Oprah.com ). Many of the questions in that list were not about treatment effects and we modified some of the questions with the intention of having a variety of questions for different types of conditions and treatments. Table  1 shows the original question from that list, our question, the conditions, the treatments, and the initial search terms that we used to find information about treatment effects on each website.

Questions about treatments used to assess the included websites

We then independently assessed what was reported about treatment effects, the consistency of reporting, and the advantages and disadvantages of each website. Disagreements were resolved by discussion. Based on these assessments and the information we had collected for each website we suggested how the websites could be improved and provided tips for website users.

For each question, we searched for information using plain language terms without Boolean logic (using the first terms shown for each question in the last column of Table ​ Table1). 1 ). We recorded the number of hits for each search and each relevant summary that we found. We assessed the search as easy if we found relevant information using plain language terms without Boolean logic and the relevant information was one of the first few hits. We assessed searches as hard if we had to use technical terms or Boolean logic, or if we could not find relevant information; and as moderate if finding relevant information required some minor fiddling with the search terms or screening more than a few hits.

For each relevant summary that we found, we recorded whether any information was provided about benefits of the treatment and harms of the treatment, whether quantitative information was provided for at least one outcome, and whether a formal or informal assessment of the certainty of the evidence was provided. We then ranked the three websites for each question based on an overall assessment of how hard it was to find relevant information and the completeness of the information about the effects of the treatments.

We considered 35 websites for inclusion. Of these, 26 were excluded because information about treatment effects was not explicitly based on systematic reviews (Table  2 ), five were excluded because they were not intended for patients and the public (Table  3 ), and one was under development (Table  4 ). Three of the 34 websites met our inclusion criteria: Cochrane Evidence , Informed Health , and PubMed Health (Table  5 ). Cochrane Evidence and Informed Health produce content, whereas PubMed Health , which was discontinued in October 2018, aggregated content, including content from the first two websites.

Websites excluded because they are not explicitly based on systematic reviews a

a These websites were excluded because they do not include a description of how information is prepared that includes a statement about using or being based on systematic reviews of research evidence. It is unclear to what extent information about treatment effects on these websites is based on systematic reviews

Websites excluded because they are not intended for patients and the public a

a These websites were excluded because they are not primarily intended for patients and the general public. However, some patients and members of the general public use these databases

Websites under development a

a Last accessed 14 February 2018

Included websites

a The headings used were inconsistent for all three

b We got an error message (“A technical error has occurred. Please try again later.”) when we used AND to limit searches on Informed Health , and no search results when we used quotation marks (e.g. “back pain”). It was possible to use this logic on the other two websites

Cochrane Evidence provides plain language summaries of over 7500 Cochrane Reviews, most of which are systematic reviews of the effects of treatments. The systematic reviews and the plain language summaries are prepared and updated by Cochrane review groups. Cochrane is a global independent network of researchers, professionals, patients, carers, and people interested in health, with over 37,000 contributors from more than 130 countries.

The plain language summaries include links to the full reviews. The full reviews are available in The Cochrane Library, which can be accessed for free in countries that have a national subscription or if the review or an update was published more than one year previously. The headings and content of the plain language summaries are inconsistent. The summaries include some background information, the authors’ conclusions, and links to other summaries that may be of interest. There is variability in the quality of the summaries. Some summaries include pop-up definitions (but not links to longer explanations) for some research and medical terms, and there is a glossary of terms relevant for Cochrane Reviews available on the Cochrane website. The summaries are translated into Chinese, Croatian, Czech, French, German, Japanese, Korean, Malay, Polish, Portuguese, Romanian, Russian, Spanish, Tamil, and Thai. The glossary is only in English.

No other information regarding treatments is provided in Cochrane Evidence , besides the plain language summaries of Cochrane Reviews. Cochrane website, where Cochrane Evidence is found has other information about the Cochrane Colaboration. Navigation tools for Cochrane Evidence are limited to a simple search for the entire Cochrane website. It is possible to sort findings by relevance, alphabetically, or by date of publication; and to filter the summaries by broad health topics and whether the reviews are new or updated.

Informed Health is the English-language version of the German website Gesundheitsinformation.de. The website is prepared by the Institute for Quality and Efficiency in Health Care (IQWiG) in Germany. IQWiG is a professionally-independent, scientific institute established under the Health Care Reform 2004.

The Informed Health website provides information about treatment effects together with other information for a wide range of topics. The website includes “research summaries” for some but not all treatments. “These are objective, brief summaries of the latest findings on a research question described in the title. They usually summarize the results of studies, for instance the results of one or (rarely) several systematic reviews or IQWiG reports. They also describe the study/studies in more detail and explain how the researchers came to their conclusions.” The website states that they “mainly use systematic reviews of studies to answer questions about the benefits and harms of medical interventions.” Links to systematic reviews are provided when these are used, but the reviews may not be freely available.

All of the research summaries that we examined (Additional file  1 ) included quantitative information about the size of the benefits, and they included frequencies for at least one outcome, but most often only for one outcome. The certainty of the evidence is not reported. All of the information is in plain language, written for patients and the public. There are hyperlinks to background information (but not pop-up definitions). There is a glossary of “medical and scientific” terms that includes primarily medical terms and few research terms.

In addition to information about treatments, Informed Health includes information about symptoms, causes, outlook, diagnosis, everyday life, where to learn more, and explanations (“Extras”) of topics such as how the body works, how treatments work, and types of treatments. Navigation tools for Informed Health include browsing by broad topic areas, an index (A to Z list) and a simple search. Search results can be sorted by relevance, the date information on the website was created, or the date it was updated.

PubMed Health specialized in systematic reviews of clinical effectiveness research. It included plain language summaries and abstracts of Cochrane Reviews; abstracts (technical summaries) of systematic reviews in the Database of Abstracts of Reviews of Effects (DARE) up to 31 March 2015; full texts of reviews from public agencies; information developed by public agencies for consumers and clinicians based on systematic reviews; and methods resources about the best research and statistical techniques for systematic reviews and clinical effectiveness research. PubMed Health was a service provided by the National Center for Biotechnology Information at the U.S. National Library of Medicine. It was discontinued October 31, 2018 “in an effort to consolidate similar resources and make information easier to find”. It included information from over 40,000 systematic reviews from a variety of sources, but plain language summaries were not available for most of those reviews. Links to the systematic reviews were provided, but not all of the reviews were freely available.

The reporting was inconsistent. Headings, reporting of effects, and reporting of the certainty of the evidence were inconsistent. PubMed Health had an extensive glossary (Health A – Z) and background information on drugs. Navigation tools included a simple search. Search results could be sorted by date of publication and filtered by Article types (including “Consumer information”); when information was added to PubMed Health , Content providers (including Cochrane and IQWiG); and Reviews with a quality assessment.

None of the three included websites includes links to ongoing trials and adverse effects are not consistently reported on any of the websites. All three include information about how up-to-date the information about treatment effects is.

PubMed Health was the easiest website to search, despite the large number of records that it includes. However, we had difficulties searching all three websites. We found information easily in Cochrane Evidence and Informed Health for one of the eight questions in Table ​ Table1, 1 , and for three of the questions in PubMed Health (Additional file 1 ). Conversely, it was hard to find information (or we did not find any information) for the five questions in Cochrane Evidence , six questions in Informed Health , and three questions in PubMed Health . It was not possible to use Boolean logic when searching Informed Health . This was possible on the other two websites, but none of the three provided any instructions or help for searching.

When we found information, it was consistently available about benefits, but only Informed Health consistently reported this information quantitatively in the plain language summaries. Quantitative information was provided in the linked scientific abstracts. None of the websites consistently reported information about harms or the certainty of the evidence, although Cochrane plain language summaries in Cochrane Evidence and PubMed Health frequently reported the certainty of the evidence. When the certainty of the evidence was reported using GRADE or another systematic approach, there was not a link to an explanation of what the grade means.

Overall we were most satisfied with Cochrane Evidence for 2 questions, with Informed Health for one question, and with PubMed Health for 3 of our questions. We did not find information about treatment effects on any of the three websites for two questions: “Should I stop using phone, tablet, computer, and TV screens before going to bed (for insomnia)?” and “Should I get my osteoarthritic knee replaced?” Informed Health provided advice for the first question (“For instance, it might help to only listen to relaxing music before going to bed and keep from talking on the phone or playing computer or mobile phone games”), but no reference to research evidence for that advice. We easily found relevant systematic reviews for both of these questions in Epistemonikos (Additional file 1 ).

We identified three websites for patients and the public that provide free information about treatment effects based on systematic reviews. A fourth, promising website, CureFacts, was under development (Table ​ (Table4), 4 ), and is still under development as of February 2019. Twenty-two other websites that provide free information for patients and the public claim to provide trustworthy, evidence-based information. However, it is not possible to know the extent to which the information they provide about treatment effects is based on systematic reviews, so is therefore less likely to be trustworthy. We considered four websites that provide access to systematic reviews, but none of these is intended for patients and the public (Table ​ (Table3). 3 ). Nonetheless, some people may find these useful, particularly Epistemonikos . It includes over 100,000 systematic reviews with the abstracts translated to Arabic, Chinese, Dutch, French, German, Italian, Portuguese, and Spanish. It is aimed for health professionals, researchers and policymakers but plain language summaries are not available for most of the reviews. Although it is not intended for patients and the public, it “has been used by well-informed lay people and journalists successfully” (Table ​ (Table3 3 ).

We did not consider databases that are not free, such as Trip Pro, which includes access to over 100,000 systematic reviews; or patient information from web-based medical compendia for clinicians, such as Best Practice , Dynamed , and UptoDate. We also did not consider websites that provide information for patients and the public based on guidelines, such as the UK National Institute for Health and Care Excellence (NICE) guidance for patients; or websites that are limited to specific conditions or types of treatments.

The three websites for patients and the public that explicitly provided information about treatment effects based on systematic reviews were likely to appeal to different people and their appeal may vary depending on the question being asked. We found that we preferred each of the websites for at least one of the eight questions we used as test cases (Table ​ (Table1). 1 ). We found PubMed Health somewhat easier to search, despite the large number of records it includes, and we found both Cochrane plain language summaries and Health Information research summaries when searching PubMed Health . Simple instructions regarding the use of Boolean logic and the use of quotations to limit searches would help improve the ease of use for all three websites. For example, the default for Cochrane Evidence appears to be to insert OR between words, resulting in large numbers of irrelevant hits.

All of the websites could be improved by more consistent use of headings and consistent reporting of both benefits and (especially) harms; inclusion of quantitative information about the size of the effects; and information about the certainty of the evidence based on the use of a consistent set of criteria, such as GRADE [ 29 – 31 ], and links to explanations of what the grades mean. Because many systematic reviews, including Cochrane Reviews, do not consistently provide this information, plain language summaries based on systematic reviews cannot always provide this information. However, they can alert users to the absence of trustworthy information about adverse effects, when this is the case, and it is possible to provide an assessment of the certainty of the evidence even when review authors have not done this [ 32 , 33 ].

All three websites provided plain language summaries of systematic reviews and all three had glossaries. However, none of the websites included both pop-up short definitions (which can be quickly accessed and read as scroll overs without having to go to another webpage) and links to longer explanations (that can be easily accessed when needed).

None of the websites included links to ongoing trials. This is something that, for example, NHS Choices does [ 34 ]. This is important because when there is important uncertainty about the effects of treatments, participating in a randomised trial may be the best option for patients [ 35 , 36 ].

We are not aware of any other studies that have attempted to systematically identify and evaluate websites that provide free access to information about the effects of treatments for patients and the public which is based on systematic reviews. There are thousands of websites that provide health information and we did not systematically screen all of these. Although we believe it is unlikely that there are other websites that meet our inclusion criteria, we did not consider websites for specific conditions or types of interventions, non-English language websites, or websites that were not freely accessible. Others might want to assess these and other sources of information about treatment effects in future studies.

"The evaluation criteria that we used were based on our judgement about what information is important and what is needed to make that information accessible. For example, providing a link to the systematic review enables people to go to the source of information about treatment effects for more information, if they desire. It also makes the basis of the information clear. Information about the size of effects and the certainty of the evidence is essential for making well-informed decisions. Basic search tools are necessary to make it easy to find information on the websites, and summaries that are written in plain language for patients and the public are more likely to be understandable than abstracts written for researchers or health professionals. Consistent headings, content, and use of language make it easier for users to become familiar with the websites and to find and understand information.

Our evaluation was based in part on searching for answers for eight treatment questions (Table ​ (Table1). 1 ). The criteria that we used to assess what we found for each question did not require a great deal of judgement. Consequently, there were only minor disagreements in our assessments (Additional file 1 ), and those were easily resolved. It is uncertain how representative what we found for those questions is for what would be found for other treatment questions, but we believe they provided a fair basis for assessing the websites. Moreover, we sent full drafts of this report to people responsible for each website and their corrections did not substantially alter our assessments or conclusions.

We did not evaluate the readability of the plain language summaries and, although we described other information that each website provides, we did not evaluate whether the websites provided other information that patients and the public want or need to make informed decisions; for example, information about other treatment alternatives, costs, and people’s experiences with the treatment [ 37 , 38 ]. We also did not evaluate how users of the websites experience them [ 39 ]. All of these are potential areas for future research."

Conclusions

It is possible for patients and the public to access trustworthy information about the effects of treatments based on systematic reviews using two of the three websites included in this review. However, all three of these websites could be improved and made more useful and easier to use by consistently reporting information about the size of both the benefits and harms of treatments and the certainty of the evidence, and by making it easier to find relevant information.

Searching the three websites frequently yielded much irrelevant information. Users can limit searches by using Boolean logic - inserting AND between terms (e.g. for the condition and for the treatment) and quotation marks to indicate that words need to be next to each other; e.g. “back pain”. However, this is unlikely to be obvious to novice users. Some users may want to use sources that are not intended for patients and the public, such as Epistemonikos , if they are unable to find information on one of these websites. They also might want to consider searching for ongoing trials, if there is important uncertainty about the effects of relevant treatments.

There are many other websites that claim to provide evidence-based or reliable information about treatments, but it is difficult to assess the reliability of the information about treatment effects provided on those websites since they do not explicitly base that information on systematic reviews.

Additional file

Appendix review of online evidence-based patient info. Assessments of three included websites. Description of data: Search results and assessments of the information found in the three included websites for eight common health questions. (XLSX 29 kb)

Acknowledgements

With support from the James Lind Initiative, Anita Peerson prepared an earlier unpublished version of this review with advice from Iain Chalmers, Douglas Badenoch, Sarah Rosenbaum, and Astrid Austvoll-Dahlgren. We would like to thank the following colleagues for helpful comments on an earlier version of this paper: Astrid Austvoll-Dahlgren, Atle Fretheim, Claire Glenton, Hilda Bastian, Iain Chalmers, Jon Brasey, Karla Soares-Weiser, Marit Johansen, Marita Sporstøl Fønhus, Sarah Rosenbaum, Signe Flottorp.

Not applicable.

Availability of data and materials

Abbreviations, authors’ contributions.

AO made all of the initial assessments and wrote the first draft of this report. EP checked all of the assessments and contributed to revisions of this report. Both authors read and approved the final manuscript.

Ethics approval and consent to participate

Consent for publication, competing interests.

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Andrew D. Oxman, Email: on.enilno@namxo .

Elizabeth J. Paulsen, Email: [email protected] .

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How to Find Reliable Health Information

Finding accurate and reliable information on genetic and rare diseases among the millions of online sources is a difficult task for almost everyone. We hope these tips will help you perform searches more easily.

As Internet users quickly discover, an enormous amount of health information is available online. The material provided is for informational or educational purposes only and is not intended as a substitute for professional medical care, advice, diagnosis, or treatment. This material does not represent an endorsement of any specific tests and products by the National Human Genome Research Institute or the Office of Rare Diseases at the National Institutes of Health. We cannot guarantee the accuracy, completeness, timeliness, or usefulness of the opinions, advice, services, or other information provided. Moreover, we strongly recommend that you seek the advice of your health care provider with any questions regarding your medical care.

Scientific and Medical Literature

Information on just about any disease can be obtained from the published scientific literature. Medical and scientific journals publish articles written for scientists and health professionals. In a process called "peer-review," other professionals review these articles before they are published.

Several types of articles can be found in scientific literature:

• Review articles: These articles present what is known to date about a disease. Such articles may focus on the cause, diagnosis, treatment or other aspects of a disease.
• Basic science or laboratory research: These articles present original "basic science" or "laboratory" research.
• Case reports: These articles describe and discuss the clinical aspects of an individual with a disease. Such articles may also present unusual or unexpected cases.
• Articles discussing treatment: These articles discuss the effects in humans of various treatments that have been tested or used in a specific disease. Articles that discuss treatment may be about many different types of studies that are conducted in humans. Some of the more common studies include clinical trials, case-control studies, cohort studies and case reports.

Treatment articles in published scientific literature report human studies with negative outcomes as well as those with positive outcomes. In other words, some articles report studies where a treatment was deemed to have beneficial effects, while others report studies where a treatment was not deemed to have beneficial effects and/or may have been associated with side effects, some of which could be severe.

Some studies report on the safety of a particular treatment, and do not directly address whether the treatment was actually deemed to have had a beneficial effect. The treatment discussed may be already in use, or it may be experimental and not widely available (or not available at all).

Interpreting the results of studies and weighing the evidence can be a very complex task. Because of this complexity, and because of the technical nature of these articles, we strongly recommend that you discuss with your physician any articles that interest you.

Internet Credibility Help from Genetic Alliance

The Access To Credible Genetics (ATCG) Resource Network has developed the Quality Assessment Toolbox to help create and evaluate educational materials. Families and health professionals can use the tool to judge the quality of currently available educational materials and to assist in the creation of new quality educational materials about genetic conditions.

• www.trustortrash.org For people who want some brief guidance for evaluating health information.
• www.trustortrash.org/developer In-depth information for people developing educational materials.

Additional Websites

Genetics information.

• Genetic Testing Registry www.ncbi.nlm.nih.gov/gtr/ A central location for voluntary submission of genetic test information by health care providers.

MEDLINEplus

• MEDLINEplus www.nlm.nih.gov/medlineplus/ A service of the National Library of Medicine (NLM) and the National Institutes of Health (NIH), MedlinePlus offers high-quality information on more than 600 diseases and conditions. MEDLINEplus describes itself as "a goldmine of good health information from the world's largest medical library."
• Evaluating Health Information www.nlm.nih.gov/medlineplus/evaluatinghealthinformation.html To help people find reliable and scientifically accurate health information, MEDLINEplus has posted a series of documents and links called  Evaluating Health Information , which provides news, information from NIH, information on research and specific conditions and links to organizations and directories.
• MEDLINEplus Guide to Healthy Web Surfing www.nlm.nih.gov/medlineplus/healthywebsurfing.html To help users evaluate the potential quality and accuracy of online health information, MEDLINEplus has developed  Healthy Web Surfing . Addressing issues such as the source and currency of the information can help us make better use of online resources.

Online Medical Dictionaries and Encyclopedias

Complex medical terminology can be difficult to understand. The Web provides some excellent resources to aid in our understanding of these terms and medical jargon.

• NHGRI Talking Glossary of Genetic Terms www.genome.gov/Glossary The NHGRI Talking Glossary of Genetic Terms is meant to help everyone understand the terms and concepts used in genetic research. In addition to definitions, specialists in the field of genetics share their descriptions of terms, and many terms include images, animation and links to related terms.
• MEDLINEplus: Medical Encyclopedia www.nlm.nih.gov/medlineplus/encyclopedia.html The A.D.A.M. (Animated Dissection of Anatomy for Medicine) illustrated health encyclopedia, a part of MEDLINEplus, contains more than 4,000 articles on conditions, treatments, and much more.

NIH Resources

PubMed www.ncbi.nlm.nih.gov/pubmed/ PubMed is NIH's searchable database of published scientific and medical literature. PubMed contains citations from 4,600 journals from the United States and 70 other countries. More than 12 million citations are available in MEDLINE, one component of PubMed.

Information for locating an article, its title, authors and when it was published is listed in PubMed search results. Using the condition name as your search term should locate articles that may be of interest to you. To narrow your search, click on the "Limits" box below the search box and specify the criteria you would like to use to locate articles that may be more relevant to your questions. For example, using the limits of only review articles (on the pull-down menu under "Publication Types"), only items with the condition name in the title, only items with abstracts, only items in English and only human studies, you should locate abstracts of specific interest.

PubMed searches provide citations on journal articles. Citations may include links to article summaries, or links to full articles (through "LinkOut"; see below). For copies of full articles, you can contact a medical/university library, contact your local library for interlibrary loan, or order them online.

• National Network of Libraries of Medicine (NNLM) nnlm.gov/members Designed to help you find health information from libraries in your area.
• LinkOut www.ncbi.nlm.nih.gov/projects/linkout Provides access to full-text articles at journal Web sites and other related Web resources.
• PubMed Tutorial www.nlm.nih.gov/bsd/disted/pubmedtutorial/ How to use PubMed.

ClinicalTrials.gov www.clinicaltrials.gov NIH and the Food and Drug Administration (FDA) developed ClinicalTrials.gov to provide patients, family members and members of the public with current information about clinical research studies and clinical trials that are enrolling individuals.

From the home page, you can enter terms such as condition names, study locations (cities or states), and descriptive terms for patients (such as adult or adolescent). After performing a search, there is a list of search results. Click on a study to review the study's "eligibility" criteria to determine if you or someone else would qualify. To learn more about the study, refer to the study's contact information.

Be sure to check ClinicalTrials.gov often for updates to study information.

• ClinicalTrials.gov Fact Sheet
• Current NHGRI Clinical Studies

Other Publication Search Engine Resources

• BioMedSearch www.BioMedSearch.com BioMedSearch is a free biomedical search site that includes all of the National Institutes of Health (NIH) PubMed documents, plus many more (often in full text). It also has account features such as portfolios to save documents, the ability to share documents (and comment on them) between users and keyword-based alerts.

Other NIH Resources

Both websites also provide general information about clinical trials: Frequently Asked Questions About Clinical Research  (NHGRI) Get Involved in Research  [rarediseases.info.nih.gov]

• NHGRI www.genome.gov  and ORDR rarediseases.info.nih.gov The National Human Genome Research Institute (NHGRI) and the Office of Rare Diseases Research (ORDR) Web sites provide helpful information on genetic and/or rare diseases research, genetic/rare conditions, patient support groups and much more.
• The Genetics Home Reference ghr.nlm.nih.gov Genetics Home Reference is the National Library of Medicine's website for consumer information about genetic conditions and the genes or chromosomes related to those conditions.

Other Sources of Information

Apart from the information listed above, several organizations are dedicated to helping individuals with genetic and rare diseases and provide an array of information.

• The Genetic Alliance www.geneticalliance.org As a broad-based coalition, the Genetic Alliance builds partnerships to promote healthy lives for all those living with genetic conditions. The Genetic Alliance's Web site offers information on genetic conditions and issues related to genetic conditions.
• The National Organization for Rare Disorders (NORD) www.rarediseases.org NORD is a federation of not-for-profit voluntary health organizations serving people with rare disorders. You can search their site or obtain a printed report for a specific disorder by ordering it through NORD's Web site, by calling, or by writing to NORD.
• ORPHANET (English Version) www.orpha.net/consor/cgi-bin/index.php ORPHANET is a French multilingual database dedicated to information on rare diseases and orphan drugs for patients and their families, health professionals and researchers, support groups, and industry.

Last updated: June 24, 2016

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Health Capsule

Finding Reliable Health Information Online

Many people get health information from the internet. But not every online source is reliable. How do you know whether you can trust the health information you find? There are many signs you can look for.

First, it’s important to find out if a website is from a trusted source. Health websites sponsored by the federal government are a good place to start. Their web addresses will be followed by “.gov.” Well-known medical schools and large professional organizations can also be good sources of health information.

For other sites, it’s important to ask a few questions. Who sponsors the website and what are their goals? They may be trying to sell you a product rather than inform you. Find out who wrote and reviewed the information. Are they a medical professional? Be cautious about any website offering a quick fix or “miracle cure” for your health problem.

It’s also important to note when the information was written. Often there will be a date on the bottom of the webpage. You don’t want to make decisions based on out-of-date information.

Social media sites like Facebook and Twitter are another source of health information. But be mindful—just because a post is from a friend or colleague doesn’t mean it’s true or scientifically accurate. Check the original source to decide for yourself.

No information you find online should replace seeing a medical professional. Learn more tips on  finding reliable health information .

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Everyday care, darker skin tones, cosmetic treatments, public health programs, find a dermatologist.

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Both the CDC and the FDA warn against treating this common childhood condition on your own with non-prescription treatments. See what they recommend.

Find answers to questions patients ask about this newer treatment option, including, “What’s involved in switching from a biologic to a biosimilar?”

Everyone's at risk for skin cancer. These dermatologists' tips tell you how to protect your skin.

Find out what may be causing the itch and what can bring relief.

Find out why dark spots appear and what can fade them.

If you have what feels like razor bumps or acne on the back of your neck or scalp, you may have acne keloidalis nuchae. Find out what can help.

You can expect permanent results in all but one area. Do you know which one?

If you want to diminish a noticeable scar, know these 10 things before having laser treatment.

It can smooth out deep wrinkles and lines, but the results aren’t permanent. Here’s how long botox tends to last.

Use these professionally produced online infographics, posters, and videos to help others find and prevent skin cancer.

Free to everyone, these materials teach young people about common skin conditions, which can prevent misunderstanding and bullying.

You can search by location, condition, and procedure to find the dermatologist that’s right for you.

A dermatologist is a medical doctor who specializes in treating the skin, hair, and nails. Dermatologists care for people of all ages.

Where to find accurate online health information

Chatbots, social media, and websites can give you inaccurate information.

Before using any information to change how you care for your skin, hair, or nails, discuss the information with your board-certified dermatologist.

For years, people have been searching for health information online and sharing health advice on social media. Thanks to chatbots like ChatGPT, we can now ask a question and get an instant answer.

Here's what you should know about relying on online medical information:

Chatbots may provide inaccurate information

“Chatbots pull information from many databases, and some of these databases contain inaccurate information,” says board-certified dermatologist Justin Ko, MD, FAAD, who is a member of the American Academy of Dermatology’s Augmented Intelligence Committee.

It's also important to know that chatbots like ChatGPT keep the information that you give them. If you include personal medical information like a diagnosis or treatment plan when you use a chatbot, your medical information becomes data that the chatbot can use and show to others. For this reason, it’s important to not share your medical information with chatbots.

No online information, even if it is accurate and trustworthy, can replace the expertise of your board-certified dermatologist.

Social media offers a wealth of health information, but some of it can be misinformation

As we saw during the COVID-19 pandemic, medical misinformation can spread like wildfire on social media and online forums. People who post responsibly take actions to counteract misinformation and provide their followers with high-quality, science-backed health information.

Here’s what you can do to find responsible, science-backed sources for health information:

Set your preferences so that you follow people and organizations known for providing accurate, trustworthy medical information like board-certified dermatologists, world-renown hospitals and clinics, and organizations like the American Academy of Dermatology.

Understand that well-meaning posts from family, friends, and colleagues can contain health information that isn’t accurate or doesn’t apply to your health.

Many websites provide reliable health information, but some don’t

“Choosing trustworthy websites is an important step in gathering reliable health information,” according to the National Institutes of Aging (NIA). Here are tips that can help you identify reliable websites:

6 ways to identify a reliable website

Make sure the website was created by a trusted organization like a government agency, medical association, hospital, or university.

Disregard a website that promises a single remedy to cure a medical condition.

Ask yourself if the purpose of the site is to inform or to sell. The goal of any trustworthy health information website is to provide accurate, current, and useful information rather than try to sell you something.

Look for one of the following: 1) References on the page, which tell you the sources for the information, or 2) Information that tells you the source is an expert on the subject like a board-certified dermatologist. Trustworthy websites tell you where the information comes from.

Check for contact information that you can use to reach the site owner. Trustworthy sites include this information, which may be an email address, phone number, or mailing address. You’ll often find this information on a page called “About Us” or “Contact Us.”

See if the site has a privacy policy. Trustworthy sites include this information. It may be called “Privacy Policy,” “Legal Notice,” such as the one on this website, or “Our Policies.”

Finding trustworthy online information can help you have more informed talks with your dermatologist. Before using any information to change how you care for your skin, talk with your dermatologist. No one understands your skin better than a board-certified dermatologist.

Image Getty Images

References American Academy of Dermatology. Augmented Intelligence Series:

“Intro to augmented intelligence and where we are now.” Justin Ko, MD, MBA, FAAD and Roxana Daneshjou, MD, PhD, FAAD (interviewed by Jules Lipoff, MD, FAAD). Dialogues in Dermatology . Released 4/6/2023.

“Augmenting our workforce and empowering patients.” Roberto Novoa, MD, FAAD and Jenna Lester, MD, FAAD (interviewed by Adewole Adamson, MD, MPP, FAAD). Dialogues in Dermatology . Released 4/6/2023.

“Toward trustworthy augmented intelligence.” Veronica Rotemberg, MD, FAAD and Ivy Lee, MD, FAAD (interviewed by Jules Lipoff, MD, FAAD). Dialogues in Dermatology . Released 4/6/2023.

Asch DA, “An interview with ChatGPT about health care.” NEJM Catalyst . 4/4/2023.

Lancet Digital Health. “ChatGPT: friend or foe?” Lancet Digit Health. 2023 Mar;5(3):e102.

Lee P, Bubeck S, et al. “Benefits, limits, and risks of GPT-4 as an AI chatbot for medicine. N Engl J Med . 2023 Mar 30;388(13):1233-9.

National Institutes of Aging. “ How to find reliable health information online .” Last updated 1/23/2023. Last accessed 4/27/2023.

Written by: Paula Ludmann, MS

Reviewed by: Hassan I. Galadari, MD, FAAD Mona Gohara, MD, FAAD Roopal Kundu, MD, FAAD Ivy Lee, MD, FAAD Jennifer G. Powers, MD, FAAD Sanna Ronkainen, MD, FAAD

Last updated: 6/22/23

How to Find Cancer Resources You Can Trust

It's important to get information about cancer and other health matters from reliable sources like government websites and professional medical societies.

Cancer and other health information, whether in print or online, should come from a trusted, credible source. Government agencies, hospitals, universities, and medical journals and books that provide evidence-based information are sources you can trust.

Unfortunately, it has become very common for false or misleading information to be found online and in print. If a source makes claims that are too good to be true, remember—they usually are.

There are many resources that provide cancer and other health information to the public, but not all of them are trustworthy. Use the tips below to protect yourself when looking for health information.

How to find trustworthy websites

There are so many websites with cancer information that it can be hard to know which ones to trust. Credible sources of cancer and other health information should make it easy for people to learn who is posting the content. They should make clear the original source of the information, along with the expert credentials of the people who prepare or review the online material.

Ask the following questions to decide if health information online is credible:

• Who manages this information? The person or group that has published health information online should be easy to find somewhere on the page.
• What are the letters at the end of the web address? Government websites end in ".gov" and those ending with ".edu" are run by a university or other educational institution. These are sources that you can usually trust. If you see ".org" or ".com" at the end of a web address, it may also be a trusted site. However, check it closely to make sure.
• Who is paying for the project, and what is their purpose? You should be able to find this information in the “About Us” section. Are they selling something or promoting a "cure"? If so, be very careful! 
• What is the original source of the information that they have posted? If the information was originally published in a research journal or a book, they should say which one(s) so that you can find it.
• How is information reviewed before it gets posted? Most health information publications have someone with medical or research credentials (e.g., someone who has earned an M.D., D.O., or Ph.D.) review the information before it gets posted to make sure it's correct.
• How current is the information? Online health information sources should show you when the information was posted or last reviewed.
• If they are asking for personal information, how will they use that information and how will they protect your privacy? This is very important. Do not share personal information until you understand the policies under which it will be used and you are comfortable with any risk involved in sharing your information online.

How to use social media and email safely

It’s common to go to social media sites to find cancer information. These sites (such as Facebook, Instagram, YouTube, Twitter) can be helpful when they're up-to-date and trustworthy. They also can be good ways for people to connect with others who have similar health issues and questions.

It’s important to only follow social media from reputable sources. Ask the same questions when using social media that you would ask for using a website. Many trusted organizations have social media accounts that link to their websites. For example, the National Cancer Institute has  official Facebook, Instagram, YouTube, and Twitter pages in English and Spanish.

Related, mobile apps are often used to track health activities, such as diet and exercise. Some people use them to record medicine schedules or doctor visits. Using these methods can be very useful. However, not all are reliable or safe. Seek advice from your medical team or others you trust before using them.

Always use caution when using your email or texting. Do not click on a link in a message unless you know or trust the sender. And never open an attachment unless it comes from a trustworthy source. This is true whether you're on your phone or your computer.

Reading other people's stories about their cancer

When it comes to personal social media accounts, it's common for users to post their experiences with cancer. This may include

• how they're feeling physically
• treatments they're going through
• complementary therapies they're using, such as a type of diet or supplements
• what feelings they're having

But remember that everyone is different. Even someone with the exact same kind of cancer has a different body and health history from you. Never take recommendations for treatment or medicines from someone other than your doctor. You don't know where or how the user got their information. You also don't know if the information is current or what the user's knowledge of cancer is.

For more details and information about evaluating online resources, including websites, social media, mobile apps, and fake news sites, see NIH's National Center for Complementary and Integrative Health's webpage, Finding and Evaluating Online Resources .

How to find articles about cancer

If you want to look for articles about cancer that you can trust, search online medical journal databases or ask a librarian for guidance. (Or if you live near a college or university, there may be a medical library you can use.) They can help you look for medical journals, books, and other research in cancer that has been done by experts. Two trusted sites for articles include PubMed and MedlinePlus , both from the National Library of Medicine . 

Articles in popular magazines are usually not written by experts. Rather, the authors speak with experts, gather information, and then write the article. If claims are made in a magazine, remember the below.

• The authors may not have a lot of knowledge in this area.
• They may not say where they found their information.
• The articles most likely have not been reviewed by experts.
• The publisher may have ties to advertisers or other organizations. Therefore, the article may be one-sided in the information or view(s) it presents.

When you read articles about cancer, you can use the same process that the article writer uses:

• speak with experts
• ask lots of questions
• decide if the information applies to you

How to find books about cancer

A number of books have been written about cancer, cancer treatment, and complementary and alternative medicine (CAM) . Some books contain trustworthy content, while others do not.

It's important to know that information is always changing and that new research results are reported every day.   By the time a book is published, the contents may be outdated. Also, be aware that if a book is written by only one person, you may only be getting that one person's view.

If you go to the library, ask the staff for suggestions. Local bookstores may also have people on staff who can help you. If you find a book online, look very carefully at the author’s credentials, background, and expertise. Questions you may want to ask yourself are:

• Is the author an expert on this subject?
• Do you know anyone else who has read the book?
• Has the book been reviewed by other experts?
• Was it published in the past 5 years?
• Does the book offer different points of view, or does it seem to hold one opinion?
• Has the author researched the topic in full?
• Are the references listed in the back?

Anatomy of a Cancer Treatment Scam

The Federal Trade Commission developed this video to help people maintain a healthy level of skepticism when they are searching for information about cancer, so that they don’t become victims of fraud.

Where to get more help

Know the Science: The Facts About Health News Stories An interactive page from the National Center for Complementary and Integrative Health that explains how to interpret complementary health stories published in the media.

Cancer Treatment Scams A page from the Federal Trade Commission (FTC) that advises people to ask their health care provider about products that claim to cure or treat cancer and offers tips for spotting treatment scams.

How to Spot Health Fraud A page from the Food and Drug Administration (FDA) that describes the ins and outs of health fraud with tips on how to avoid it. 

Quick Tips for Buying Medicines over the Internet Also from the FDA, this page explains how to safely buy medicines online, including a link to its source for online pharmacy information, BeSafeRx .

Evaluating Cancer Information on the Internet Developed by the American Society of Clinical Oncology (ASCO), Cancer.Net provides information, including common misconceptions about cancer and tips to evaluate the credibility of online cancer information.

Is This Legit? Accessing Valid and Reliable Health Information A lesson plan created by the National Institute on Drug Abuse (NIDA) designed to help students in grades 9 through 12 learn to access valid and reliable health information.

Here’s how you know

• U.S. Department of Health and Human Services
• National Institutes of Health

Finding and Evaluating Online Resources

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How much do we know about online resources for complementary health approaches.

The number of web and social media sites, along with mobile apps, offering health information about complementary and integrative health approaches (often called complementary and alternative medicine ) grows every day.

What do we know about the accuracy of online health information?

• Some online sources of information on complementary health approaches are useful, but others are inaccurate or misleading.
• Don’t rely on online resources when making decisions about your health. If you’re considering a complementary health approach , discuss it with your health care provider.

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If you’re visiting an online health site for the first time or downloading a new app, ask these five questions:

• Who runs or created the site or app? Can you trust them?
• What is the site or app promising or offering? Do its claims seem too good to be true?
• When was its information written or reviewed? Is it up-to-date?
• Where does the information come from? Is it based on scientific research?
• Why does the site or app exist? Is it selling something?

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• MedlinePlus , sponsored by the National Library of Medicine, which is part of the National Institutes of Health (NIH)
• healthfinder.gov , sponsored by the Office of Disease Prevention and Health Promotion in the U.S. Department of Health and Human Services
• Use the National Center for Complementary and Integrative Health (NCCIH) website as a starting point. NCCIH is the Federal Government’s lead agency for scientific research on complementary and integrative health approaches.
• Follow NCCIH on Facebook , Twitter , Pinterest , and Instagram . These accounts are updated and managed by NCCIH and provide the latest resources on a variety of complementary health approaches.
• For information on dietary supplements, visit the NIH Office of Dietary Supplements website .
• For additional reliable resources from Federal agencies or the World Health Organization on complementary health approaches, visit NCCIH’s Links to Other Organizations page .

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• About one-third of American adults use social networking sites, such as Facebook or Twitter, as a source of health information. If you do:
• Health information on social networking sites is often very brief. For more information, go to the sponsoring organization’s website. On Twitter, look for a link to the website in the header; on Facebook, look in the About section.
• Some social networking sites have a symbol that an account has been verified. For example, Twitter uses a blue badge.
• Use the link from the organization’s official website to go to its social networking sites.

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• There are thousands of mobile apps (a software program you access using your phone or other mobile device) that provide health information you can read on your mobile devices. Almost 20 percent of smartphone owners had at least one health app on their phones in 2012.
• The content of most apps isn’t written or reviewed by medical experts and may be inaccurate and unsafe. In addition, the information you enter when using an app may not be secure.
• There’s little research on the benefits, risks, and impact of health apps, such as the many mindfulness meditation apps that are now available.
• It’s not always easy to know what personal information an app will access or how it will store your data.
• Before you download an app, find out if the store you get the app from says who created it. Don’t trust the app if contact or website information for the creator isn’t available.
• Centers for Disease Control and Prevention
• Protecting Your Privacy Online
• Protegiendo su privacidad en línea

Some of the health information you’ll find online is in the form of news reports. Some of these reports are reliable, but others are confusing, conflicting, or misleading, or they may be missing important information. To find out how to evaluate news stories about complementary health, visit our interactive module Know the Science: The Facts About Health News Stories .

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Your search for online health information may start at a known, trusted site, but after following several links, you may find yourself on an unfamiliar site. Can you trust this site? Here are some key questions you need to ask.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Who runs and pays for the website?

• Any reliable health-related website should make it easy for you to learn who’s responsible for the site. For example, on the NCCIH website, each major page identifies NCCIH and, because NCCIH is part of NIH, provides a link to the NIH home page. You should be able to find out who runs a website and its purpose on the “About Us” page.
• A web address (such as NCCIH’s) that ends in “.gov” means it’s a government-sponsored site; “.edu” indicates an educational institution; “.org” usually means a noncommercial organization and “.com” a commercial organization. Some “.org” sites belong to organizations that promote an agenda; their content may be biased.
• Who pays for the site? Does the site sell advertising? Is it sponsored by a company that sells dietary supplements, drugs, or other products or services? Confirm any information you find on a site that sells products with an independent site that doesn’t sell products.

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• Many health or medical sites post information collected from other websites or sources, which should be identified. For example, the Health Topics A–Z page on the NCCIH site provides links to documents that NCCIH didn’t create—but we name the sources of the documents.

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• The site should describe the evidence (such as articles in medical journals) that the material is based on. Also, opinions or advice should be clearly set apart from information that’s “evidence-based” (based on research results). For example, if a site discusses health benefits you can expect from a treatment, look for references to scientific research that clearly support what’s said.
• Keep in mind that testimonials, anecdotes, unsupported claims, and opinions aren’t the same as objective, evidence-based information.

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• You can be more confident in the quality of medical information on a website if health experts reviewed it. Some websites have an editorial board that reviews content. Others put the names and credentials of reviewers in an Acknowledgments section near the end of the page.

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• Outdated medical information can be misleading or even dangerous. Responsible health websites review and update much of their content on a regular basis, especially fact sheets and lists of frequently asked questions (FAQs). However, content such as news reports or meeting summaries that describe an event usually isn’t updated. To find out whether information is old, look for a date on the page (it’s often near the bottom).

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• Some sites don’t link to any other sites, some link to any site that asks or pays for a link, and others link only to sites that meet certain criteria. You may be able to find information on the site about its linking policy. (For example, NCCIH’s linking policy is available on the NCCIH Website Information and Policies page .)
• Unless the site’s linking policy is strict, don’t assume that the sites that it links to are reliable. You should evaluate the linked sites just as you would any other site that you’re visiting for the first time.

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• Websites track what pages you’re looking at. They may also ask you to “subscribe” or “become a member.” Any credible site collecting this kind of information should tell you exactly what it will and won’t do with it.
• Many commercial sites sell “aggregate” (collected) data about their users to other companies—information such as what percentage of their users are women over 40. In some cases, they may collect and reuse information that’s “personally identifiable,” such as your ZIP code, gender, and birth date.
• Read any privacy policy or similar language on the site, and don’t sign up for anything you don’t fully understand. You can find NCCIH’s privacy policy on the NCCIH website.
• See if the address (URL) for the site starts with “https://” instead of “http://.” Sites that use HTTPS (Secure Hyper Text Transfer Protocol) are encrypted, less likely to be hacked, and more likely to protect your privacy.

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• You should always be able to contact the site owner if you run across problems or have questions or feedback. If the site hosts online discussion forums or message boards, it should explain the terms of use.

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• If the site is linked to social networking sites such as Twitter, Facebook, or YouTube, spend some time reading what has been posted to see whether you feel comfortable with the tone before joining in. You may also be able to review past discussions. Also, look for a comments policy on the website, such as NCCIH’s social media comments policy .

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• Digital Health Literacy (National Network of Libraries of Medicine)
• How To Find Cancer Resources You Can Trust (National Cancer Institute)
• How To Evaluate Health Information on the Internet: Questions and Answers (Office of Dietary Supplements)
• Evaluating Health Information (MedlinePlus)
• En español: Evaluación de información sobre la salud (MedlinePlus)

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Are You Reading News or Advertising?

The Federal Trade Commission (FTC) has warned the public about fake online news sites. The site may look real, but is actually an advertisement. The site may use the logos of legitimate news organizations or similar names and web addresses. To get you to sign up for whatever they’re selling, they may describe an “investigation” into the effectiveness of the product. But everything is fake: there is no reporter, no news organization, and no investigation. Only the links to a sales site are real. Fake news sites have promoted questionable products, including acai berry for weight loss, work-at-home opportunities, and debt reduction plans.

You should suspect that a news site may be fake if it:

• Endorses a product. Real news organizations generally don’t do this.
• Only quotes people who say good things about the product.
• Presents research findings that seem too good to be true. (If something seems too good to be true, it usually is.)
• Contains links to a sales site.
• Includes only positive reader comments, and you can’t add a comment of your own.

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• The Truth Behind Weight Loss Ads (FTC)
• La verdad detrás de los anuncios de pérdida de peso (FTC)

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} How To Protect Yourself From Fake News Sites

If you suspect that a news site is fake, look for a disclaimer somewhere on the page (often in small print) that indicates that the site is an advertisement. Also, don’t rely on internet news reports when making important decisions about your health. If you’re considering a health product described in the news, discuss it with your health care provider.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Read more information about health fraud

• Medication Health Fraud (FDA)
• El Fraude en la Salud (FDA)

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• If you’re thinking about using a dietary supplement, first get information on it from reliable sources. Keep in mind that dietary supplements may interact with medications or other supplements and may contain ingredients not listed on the label. Your health care provider can advise you.
• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.

For More Information

Nccih clearinghouse.

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226

Telecommunications relay service (TRS): 7-1-1

Website: https://www.nccih.nih.gov

Email: [email protected] (link sends email)

Know the Science

NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information.

Explaining How Research Works (NIH)

Know the Science: How To Make Sense of a Scientific Journal Article

Understanding Clinical Studies (NIH)

A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed .

Website: https://pubmed.ncbi.nlm.nih.gov/

National Cancer Institute (NCI)

The National Cancer Institute is the Federal Government's lead agency for cancer research. The National Cancer Institute's Office of Cancer Complementary and Alternative Medicine coordinates and enhances the National Cancer Institute's activities in research on complementary health approaches.

Toll-free in the U.S.: 1-800-4-CANCER (1-800-422-6237)

Website: https://www.cancer.gov/

Email: [email protected] (link sends email)

Office of Dietary Supplements (ODS), National Institutes of Health (NIH)

ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public. Its resources include publications (such as Dietary Supplements: What You Need To Know ) and fact sheets on a variety of specific supplement ingredients and products (such as vitamin D and multivitamin/mineral supplements).

Website: https://ods.od.nih.gov

Email: [email protected] (link sends email)

MedlinePlus

To provide resources that help answer health questions, MedlinePlus (a service of the National Library of Medicine) brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations.

Website: https://www.medlineplus.gov

U.S. Food and Drug Administration (FDA)

The FDA oversees the safety of many products, such as foods, medicines, dietary supplements, medical devices, and cosmetics. See its webpage on Dietary Supplements .

Toll-free in the U.S.: 1-888-463-6332

Website: https://www.fda.gov/

Center for Food Safety and Applied Nutrition (CFSAN)

Part of the FDA, CFSAN oversees the safety and labeling of supplements, foods, and cosmetics. It provides information on dietary supplements. Online resources for consumers include Tips for Dietary Supplement Users: Making Informed Decisions and Evaluating Information.

Toll-free in the U.S.: 1-888-723-3366

Website: https://www.fda.gov/about-fda/fda-organization/center-food-safety-and-applied-nutrition-cfsan

Dietary Supplement Label Database

The Dietary Supplement Label Database—a project of the National Institutes of Health—has all the information found on labels of many brands of dietary supplements marketed in the United States. Users can compare the amount of a nutrient listed on a label with the Government’s recommended amounts.

Website: https://dsld.od.nih.gov

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• Albrecht UV, Von Jan U, Pramann O. Standard reporting for medical apps . Studies in Health Technology and Informatics . 2013;190:201-203.
• Carissoli C, Villani D, Riva G. Does a meditation protocol supported by a mobile application help people reduce stress? Suggestions from a controlled pragmatic trial . Cyberpsychology, Behavior and Social Networking . 2015;18(1):46-53.
• Office of Dietary Supplements. How To Evaluate Health Information on the Internet: Questions and Answers . Office of Dietary Supplements website. Accessed on November 29, 2016.
• Plaza I, Demarzo MM, Herrera-Mercadal P, et al. Mindfulness-based mobile applications: literature review and analysis of current features . JMIR mHealth and uHealth . 2013;1(2):e24.
• Subhi Y, Bube SH, Rolskov Bojsen S, et al. Expert involvement and adherence to medical evidence in medical mobile phone apps: a systematic review . JMIR mHealth and uHealth . 2015;3(3):e79.

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• Boulos MN, Brewer AC, Karimkhani C, et al. Mobile medical and health apps: state of the art, concerns, regulatory control and certification. Online Journal of Public Health Informatics . 2014;5(3):229.
• Buying health products and services online. Federal Trade Commission website. Accessed at www.consumer.ftc.gov/articles/0023-buying-health-products-and-services-online on November 29, 2016.
• Comprar productos y servicios para la salud en internet. Federal Trade Commission website. Accessed at www.consumidor.ftc.gov/articulos/s0023-comprar-productos-y-servicios-para-la-salud-en-internet on November 29, 2016.
• Consumer Reports. Beware of Fake News Online. Consumer Reports website.
• Find quality resources. HealthIT.gov website. Accessed at www.healthit.gov/patients-families/find-quality-resources on November 29, 2016.
• Mani M, Kavanagh DJ, Hides L, et al. Review and evaluation of mindfulness-based iPhone apps. JMIR mHealth and uHealth . 2015;3(3):e82
• Marcano Belisario JS, Huckvale K, Greenfield G, et al. Smartphone and tablet self management apps for asthma. Cochrane Database of Systematic Reviews . 2013;(11):CD010013. Accessed at cochranelibrary.com on November 29, 2016.
• Martínez-Pérez B, de la Torre-Díez I, López-Coronado M. Privacy and security in mobile health apps: a review and recommendations. Journal of Medical Systems . 2015;39(1):181.
• Wallace LS, Dhingra LK. A systematic review of smartphone applications for chronic pain available for download in the United States. Journal of Opioid Management . 2014;10(1):63-68.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

Related Fact Sheets

Be an Informed Consumer

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For students & teachers, how to find credible medical websites for research.

EVERFI Content Team

The Internet is a powerful tool, but it is not without pitfalls. It is no secret that the Internet is the primary form of research for our students — medical information included.

Teaching our students how to use the Internet for medical information comes with a unique set of challenges. Below, we’ll break down how to judge the credibility of online sources.

What Do We Risk?

In a world defined by instant access to communication, we run the risk of our students leaping to incorrect conclusions. For medical information (used to inform medical decisions), this is incredibly dangerous.

Wrong, unsafe, or incorrectly understood medical information can have a very real impact on the lives of our students.

Online Medical Information: How Do We Determine Credibility?

The Who: Always Look to the Source First

The first step in gauging credibility is to analyze the source. Consider publications from the following:

• Mayo Clinic, a nonprofit academic medical center
• National Institutes of Health (NIH), a part of U.S. Department of Health and Human Services
• Johns Hopkins Hospital, one of the world’s premier teaching and biomedical research hospitals

The above institutions are examples of nonprofit, publicly funded, or university-affiliated medical centers. As a general rule of thumb, students can consider information from these sources to be impartial and accurate.

On the other hand, imagine information from the following fictional organizations:

• The Academy of Tobacco Studies, a for-profit research center funded by tobacco companies
• “Aunt Betsy Knows Best”, a blog selling herbal remedies for serious medical conditions

Clearly, these are not credible medical websites for research!

Yes, the examples are extreme. The core approach, however, remains the same — look to the source. If the source has an agenda, the website may lack credibility.

Tip: Websites ending in “.gov” (government) or “.edu” (top level domain for education) tend to be the most credible.

The What: What Information is Offered?

Consider the information offered by the website. For example, this article on the common cold from the Mayo Clinic gives a comprehensive overview of the disease. It offers general treatment tips, of course, but it doesn’t push a product — at best, it briefly mentions a generic medicine brand once or twice.

Tip: If a medical information website is telling the visitor to buy a specific product, it’s likely best to run in the other direction.

The When: Is the Information Current?

Outdated medical information is as potentially hazardous as incorrect content. It’s best to teach students to always check for a publication date.

Tip: The most credible online medical resources probably have the budget for quality web design. If the website looks and feels questionable, it probably is.

The Where: Where Did the Information Come From?

A few minutes spent poking around online can yield “evidence” that the 1969 Moon Landing is a government conspiracy and that smoking is good for your health. It’s vital that students understand where information comes from.

When our students stumble across medical information online, have them consider the following:

• What evidence does it provide?
• Is the evidence from a respectable, peer-reviewed medical publication?
• If the website provides studies as sources, do the studies back up the website author’s claims?

Tip: Medical studies have published abstracts — taking a minute to verify a study supports a website’s information is quick and easy.

The Why: Why Does This Website Exist?

As a pair of general rules:

• Credible online medical resources inform; they do not diagnose.
• Credible sources may recommend treatments; they do not sell medication.

Ask your students to take a minute and consider why a medical website exists. Informative articles from the Mayo Clinic, NIH, or Johns Hopkins exist to provide an objective understanding of a medical issue.

The more we instill a healthy sense of skepticism in our students, the better equipped they will be.

Tip: If a website pushes a treatment or recommends self-diagnosis without a doctor present, run for the hills!

What Are Some Credible Medical Websites For Research?

Our students can develop an appreciation for quality online medical information below:

• Johns Hopkins Medicine : premier teaching and biomedical research center
• Mayo Clinic : Nonprofit medical center
• DailyMed : Government-run drug information website
• MedlinePlus : Government-run health information website
• National Institutes of Health : Government-run health information website

Better Students, Better Research

There’s a lot of medical information on the Internet. Instilling our students with the right mindset for how to find credible medical information online is vital.

If our students can differentiate between credible medical websites and illegitimate ones, we can breathe a sigh of relief.

Real World Learning Matters

EVERFI empowers teachers to bring critical skills education into their classrooms at no cost. Get activated and join 50,000+ educators across North America!

Credible Sources for Students FAQs

Why do students need credible sources in their research papers.

Incorporating credible sources into research papers is a crucial aspect of academic writing. It serves multiple purposes, such as ensuring the accuracy and validity of the information presented, avoiding plagiarism, developing critical thinking skills, and building a strong academic reputation.

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An official website of the United States government

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Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Health Topics
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Evaluating Health Information

Related issues, see, play and learn, videos and tutorials.

• Journal Articles

Find an Expert

Older adults, patient handouts, why do i need to evaluate health information.

Health information is easy to find. But finding reliable health information takes a little effort. Some of the health information you get from newspapers, magazines, books, TV, the Internet, and social media is up to date and trustworthy. But some is not. That's why it's important to evaluate health information for yourself.

But how can you tell the good from the bad? There are two key steps:

• Ask questions before you trust what you read or hear.
• Discuss the information you find with your health care provider before you rely on it. You may have found good information, but your provider can tell you whether it's good for you .

How can I evaluate health information on the Internet?

Asking a few questions will help you decide if you can trust a website. You can usually find most of the answers on the site's "About Us" page. If you can't find information about who runs the website, the site may not be trustworthy, and their health information may be unreliable. Some questions to ask are:

• Federal government agencies.
• Medical schools.
• Large professional or nonprofit organizations. For example, the American College of Cardiology (a professional organization) and the American Heart Association (a nonprofit) and are both reliable sources of information on heart health.
• Inform the public?
• Sell products or services?
• Promote the opinions of a person or group?
• If the site is funded by ads, they should be clearly marked as advertisements. Watch out for ads designed to look like neutral health information.
• If a business pays for the site, the health information may favor that business and its products.
• An editorial board of health experts
• A content review process
• A selection policy for content
• Information about their writers' qualifications, which may be listed at the bottom of the articles
• Where does the information come from? The content pages should have links or references to the sources of the information.
• Is the information up to date? Content pages should include dates when the information was written, reviewed, or updated.
• How does the website use your personal information? Look for a privacy policy section to see how your personal information will be used. Don't share information about yourself unless you're comfortable with any risks involved.

When you find a website that seems to be trustworthy, don't stop there. Look to see if other reliable sites have similar health information.

How can I evaluate health information on social media?

A social media post may come from someone you know, but that doesn't guarantee it's good information. Many of the questions you use to evaluate a website also work for social media too. Ask where the information comes from, why it exists, and if anyone is funding it.

If you're not sure whether the information you see on social media is trustworthy, don"t share it with others.

How can I evaluate health stories in the news?

Some news stories about medical research may not include all the facts you need to know. Ask these questions:

• Does the story say whether the research involved people or animals?
• If it was people, how many people were in the study and who were they?
• How long was the study?
• What type of study was it?
• Who paid for the research?

If you learn a few tips for understanding medical research , you'll be able to decide if a news story may apply to your health. Then you can discuss the information with your provider.

How can I evaluate health information in books?

To evaluate health information in books, ask:

• How old is the book?
• Is the author an expert on the subject?
• Does the book offer different points of view or just those of the author?
• Has the book been reviewed by other experts?
• Does the book list the sources of the content?

After you evaluate health information, talk with your provider before using it to make decisions that may affect your health.

NIH: National Library of Medicine

• Community Toolkit for Addressing Health Misinformation (Surgeon General) - PDF

• Health Information on the Web: Finding Reliable Information (American Academy of Family Physicians) Also in Spanish
• How to Spot Health Fraud (Food and Drug Administration)
• Diet in the News -- What to Believe? (Harvard School of Public Health)
• Finding Cancer Information on the Internet (American Cancer Society)
• Health Misinformation Checklist (Surgeon General) - PDF
• Talk to Your Community about Health Misinformation (Surgeon General) - PDF

Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine)

• Article: Deepfakes, trolls and cybertroopers: how social media could sway elections in...
• Article: Social Media Industry Standards Needed to Protect Adolescent Mental Health, Says...
• Article: Thousands of scientists are cutting back on Twitter, seeding angst and...
• Evaluating Health Information -- see more articles
• Online health information - what can you trust? (Medical Encyclopedia) Also in Spanish

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

• U.S. Department of Health & Human Services HHS
• National Institutes of Health NIH
• Division of Program Coordination, Planning, and Strategic Initiatives DPCPSI

How To Evaluate Health Information on the Internet: Questions and Answers

Cómo evaluar la información de salud de la internet: preguntas y respuestas - Spanish version

• Online resources, such as websites and social media sites, should make it easy for you to learn who is responsible for the site and its information (see Question 1 ).
• If the person or organization in charge of a website did not write the material, the website should clearly identify the original source of the information. For social media sites, it is also important to consider whether the source of the posted content is reliable (see Question 4 ).
• Health-related websites should give information about the medical credentials of the people who have prepared or reviewed the material on the site (see Question 6 ).
• Any site that asks you for personal information should explain exactly what the site will and will not do with that information (see Question 9 ).
• The U.S. Food and Drug Administration and Federal Trade Commission are federal government agencies that help protect consumers from false or misleading health claims on the internet (see Question 12 ).

The internet makes finding health information easy and fast. Much of the information on the internet is valuable; however, the internet also allows rapid and widespread distribution of false and misleading information. You should carefully consider the source of information you find on the internet and discuss that information with your healthcare provider. This fact sheet can help you decide whether the health information you find on the internet or receive by email, text, or social media is likely to be reliable.

Who runs the site?

Online resources such as web and social media sites should make it easy for you to learn who is responsible for the site and its information. On the Office of Dietary Supplements (ODS) website, for example, the ODS is clearly noted on every major page, along with a link to the site's homepage.

Who pays for the site?

It costs money to run web and social media sites. The source of a website's funding should be clearly stated or readily apparent. For example, the U.S. government funds websites with addresses ending in ".gov," educational institutes maintain ".edu" sites, noncommercial organizations' addresses often use ".org," and ".com" denotes a commercial organization. A site's source of funding can affect the content it presents, how it presents that content, and what the owner wants to accomplish on the site.

What is the site's purpose?

The person or organization that runs a website and the site's funding sources determine the site's purpose. Many websites have a link to information about the site, often called "About This Site." This webpage should clearly state the purpose of the site and help you evaluate the trustworthiness of the site's information. Although many legitimate websites sell health and medical products, keep in mind that the website owner's desire to promote a product or service can influence the accuracy of the health information they present. Looking for another source of health information that is independent and unbiased can help you validate the accuracy of the material presented on a site.

What is the original source of the site's information?

Many health and medical websites post information that the owner has collected from other websites or sources. If the person or organization in charge of the site did not write the material, they should clearly identify the original source. For social media sites, it is also important to consider whether the source of the information is reliable, that is, what is the background and expertise of the person posting the content?

How does the site document the evidence supporting its information?

Websites should identify the medical and scientific evidence that supports the material presented on the site. Medical facts and figures should have references (such as citations of articles published in medical journals). Also, opinions or advice should be clearly set apart from information that is "evidence based" (that is, based on research results). Testimonials from people who said they have tried a particular product or service are not evidence based and usually cannot be corroborated.

Who reviewed the information before the owner posted it on the site?

Health-related websites should give information about the medical credentials of the people who prepared or reviewed the material on the website. For example, the ODS website contains fact sheets about vitamins, minerals, and other dietary supplements. These documents undergo extensive scientific review by recognized experts from the academic and research communities.

How current is the information on the site?

Experts should review and update the material on websites on a regular basis. Medical information needs to be current because medical research is constantly coming up with new information about medical conditions and how best to treat or prevent them. Sites should clearly post the most recent update or review date. Even if the information has not changed in a long time, the site owner should indicate that someone has reviewed it recently to ensure that the information is still valid.

How does the site owner choose links to other sites?

Owners of reliable websites usually have a policy governing which links to other sites they post. Some medical websites take a conservative approach and do not provide links to any other sites; some sites provide links to any site that asks or pays for a link; and others provide links only to sites that have met certain criteria. Checking a website's linking policy can help you understand how they choose links to other sites and what they're trying to accomplish by posting those links.

What information about users does the site collect, and why?

Websites routinely track the path users take through their sites to determine what pages people are viewing. However, many health-related websites also ask users to "subscribe" to or "become a member" of the site. Sites sometimes do this to collect a user fee or select relevant information for the user. The subscription or membership might allow the website owner to collect personal information about the user.

Any web or social media site asking you for personal information should explain exactly what the site will and will not do with the information. Many commercial sites sell "aggregate" data—such as what percent of their users take dietary supplements—about their users to other companies. In some cases, sites collect and reuse information that is "personally identifiable," such as your ZIP code, gender, and birth date. Be certain to read and understand any privacy policy or similar language on the site and do not sign up for anything that you do not fully understand.

How does the site manage interactions with users?

Web and social media sites should always offer a way for users to contact the site owner with problems, feedback, and questions. If the site hosts a chat room or some other form of online discussion, it should explain the terms of using the service. For example, the site should explain whether anyone moderates the discussions and, if so, who provides the moderation and what criteria the moderator uses to determine which comments to accept and which to reject. Always read online discussions before participating to make sure that you are comfortable with the discussion and with what participants say to one another.

How can you verify the accuracy of information you receive via email or text?

Carefully evaluate any email or text messages you receive that provide health-related information. Consider the message's origin and purpose. Some companies or organizations use email or text to advertise products or attract people to their websites. A critical eye is warranted if an individual or company is promoting a particular medical product or service in an email or text without providing supporting medical evidence.

How does the U.S. federal government protect consumers from false or misleading health claims posted on the internet?

The Office of Dietary Supplements (ODS) of the National Institutes of Health stimulates and supports research on dietary supplements, distributes the results of research on dietary supplements, and provides educational material on dietary supplements, including fact sheets on dietary supplements and other reliable health information .

The following sources have more information on evaluating health information on the internet:

Finding and Evaluating Online Resources (National Center for Complementary and Integrative Health)

Reviewed: May 4, 2022

The top-rated websites for doctors

Doctors and other healthcare professionals use various health-related websites to gather information for patients, expand medical research, find a supportive community, and seek career guidance. In fact, in a recent Sermo poll of over 2,200 physicians, 33% stated they reference a healthcare website daily, and 48% reference them two-three times a week. 

Top 3 reasons doctors consult medical websites

When Sermo physicians were asked why they consult websites for doctors, and what the biggest benefit of using medical websites are—this is how they responded: 

• 30% Continuing education and refreshing medical school topics
• 28% Staying up to date on global medical news
• 27% Fact-checking, researching and obtaining evidence-based clinical advice and validating your medical decisions

Here’s more of what Sermo physicians have to say about the value of medical websites: 

Continuous updating is essential in our career, I use many means to get articles from the last 5 years at least, and now with Sermo I review interesting cases and share my publications with the intention of obtaining opinions and suggestions that are always welcome. (sic) GP, Turkey

Clinical websites…are essential tools to keep up with latest guidelines, and obtain quick refresh on medical diagnosis and treatment for common illnesses. Family Medicine, U.S.

11 of the best medical websites for doctors

Which types of sites are the best healthcare websites for doctors? Survey responses indicate that 51% visit medical journals, 22% use social media sites, and 12% refer to clinical education resources. An additional 9% visit healthcare organizations. 

The data above highlights the types of websites doctors visit. But, which specific websites do physicians frequent? According to our recent Sermo survey, the top websites for doctors are:

• 21% UptoDate
• 19% MedScape
• 17% World Health Organization (WHO), National Institute of Health (NIH), American Medical Association (AMA)

Medical websites offer good and quick information for practical use; especially medscape, epocrates, and up-to-date. Internal Medicine, U.S.

Here are the top health web sites doctors and medical professionals can use to gather medical information:

PubMed is a database that includes over 33 million citations for biomedical literature for your research needs. It is a part of NIH’s National Library of Medicine within the National Center for Biotechnology Information, and one of the best websites for health information.

PubMed’s website allows you to:

• Filter by year or type of article. 
• Read abstracts or full text. 
• Save citations to a file or email them to yourself. 

2. UptoDate

UptoDate is part of Wolters Kluwer , a provider of information, software, and services for clinicians worldwide since 1836. UptoDate provides health education, news, and decision support for medical organizations and individuals worldwide.

UptoDate features:

• The latest health news (including COVID-19 information).
• Evidence-based medicine. UptoDate’s in-house physician editors oversee the recommendations that both practicing physicians and students need to answer their difficult questions. 
• Health education galore: training webinars, live online learning, Continuing Medical Education, and a Certified Trainer Program. 

3. MedScape 

MedScape is one branch of a family of health websites, including WebMD and MedicineNet. Checking MedScape as part of your routine will keep you up to date with breaking medical news of the day. You can customize your newsfeed to your geographical region and read content in five different languages. Articles on over 7,000 diseases and monographs of over 8,000 drugs, supplements, and herbal remedies are at your fingertips with MedScape.

The MedScape app and website offer membership, education, and helpful resources:  

• The Continuing Medical Education component helps you log your progress, and the Physician Business Academy offers courses for practicing physicians on topics such as insurance, coding, and telemedicine. 
• Membership is free, and you will get access to a community to answer your questions, offer support, and discuss puzzling cases and new treatment options.
• Have a tough question? Type it in Decision Point and get a video answer (with a transcript) for fast answers from a variety of experts.

4. World Health Organization (WHO)

The World Health Organization was founded in 1948 as a part of the United Nations. WHO aims to provide universal health care access to all, regardless of age, economic status, or background. WHO directs the global response to worldwide health emergencies, including natural disasters and international conflicts, and works with world governments to provide medical equipment and professionals where they are needed.

WHO’s website includes world news, travel guidance, and more:

• Find the most up-to-date information about COVID-19 here, including treatments, new variants, and worldwide infection rates. This is your go-to resource for the latest vaccines and research.
• Do you have a trip coming up, or do you have patients asking about travel guidance during the pandemic? Search by country or region to get specific health-related strategies, statistics, and comprehensive, up-to-date travel advice. You can find COVID-19 guidance and other relevant health information tailored to the geographic location of your choosing. 
• Stay abreast of in-person and virtual events , campaigns, and committee meetings.
• Doctors can click on the Newsroom tab to scan the day’s headlines or quickly search for data, resources, and news about any worldwide health topic. 

5. National Institutes of Health (NIH)

The National Institutes of Health is the world’s biggest biomedical research agency. It is part of the United States Department of Health and Human Services. Each of its 27 different Institutes and Centers has a specific research area, such as curing cancer or preventing drug abuse. Over $32 billion in funding goes toward biomedical research through NIH every year.

NIH’s website includes career resources and information crucial for U.S.-based medical professionals:

• Find the latest national health guidance and news, clinical trials, and links to new research programs and agencies. Plus, find jobs at NIH, library and community resources, training opportunities, and links to all its Institutes and Centers.
• Learn how NIH is working to end structural racism within the medical field.
• NIH is one of the go-to websites for doctors to help locate research funding and to learn how to apply for grants .

6. American Medical Association (AMA)

The AMA is the nation’s biggest medical association, connecting almost 200 medical societies and stakeholders. Since its founding in 1847, the American Medical Association has promoted public health, represented physicians in judicial and legislative systems, and trained future health leaders.

AMA’s website provides resources that will help you excel in your medical journey, whether you are a veteran of your field, a resident, or a medical student:

• Becoming a member gives you insurance discounts and access to the JAMA Network (an online audio subscription and print journal).
• Keep up to date with virtual and in-person events . 
• AMA is an accredited provider of continuing medical education.
• Information available for members and non-members includes COVID-19 updates, health care advocacy resources, tips for residents and students, and resources for managing your practice and delivering the best possible care. 

7. ClinicalKey

ClinicalKey is run by Elsevier, a global health research and online analytics hub. ClinicalKey is an online database you can use to search journals, drugs, treatments, and more. Use information on ClinicalKey to help your patients in a timely manner.

ClinicalKey’s content can help validate your medical choices or help you reach a diagnosis: 

• Have a complex question and not a lot of time? Find answers quickly in the form of video or written word explanations.
• News within your speciality and the medical field as a whole, including COVID-19 updates.
• Resources are helpful for medical librarians, clinicians looking to help patients or student research. 
• ClinicalKey offers institution-based subscriptions tailored to students, nurses, and pharmacology professionals. Individual subscriptions can be tailored to a variety of specialties, from dermatology to pediatrics . 

8. Epocrates

Since 1998, Epocrates has provided up-to-date information to clinicians. Over a million users benefit from the pill identification feature, pediatric dosing information, and COVID-19 updates. 

Their medical information team compiles the information for you to sift through easily and get the diagnostic information you need. 

Epocrates allows for quick, trusted, easily accessible information:

• Save time by downloading the free Epocrates app to have all this information in the palm of your hand. 
• Epocrates also allows physicians to check if medicines are compatible with each other simultaneously in the body and confirm which insurance plans cover which drugs by state. 
• A premium content subscription at $16.99 per month includes infection disease treatments, alternative medicines, and more. 

Perhaps the most widely known medical website among the public, WebMD is part of the MedScape network. It can be useful for practicing physicians to supplement their knowledge or to better understand how patients think. Before consulting with their doctors, many patients tend to check their symptoms on WebMD and even self-diagnose. Knowing what patients might be reading before they come in to see you will help you anticipate their questions and concerns. 

WebMD includes:

• COVID-19 info, news stories, and blogs on trending topics. Reading the patient-authored blogs will help doctors better understand patients’ experiences and concerns with various conditions. 
• A free app for on-the-go medical information. 
• Award-winning health journalism, plus community resources, support, and even events. 

10. MedicineNet 

Also part of the WebMD and MedScape family, MedicineNet provides information about health and wellness, medication, and medical conditions for the public. Founded in 1996, this website aims to educate the public on maintaining health and to empower healthy choices. 

MedicineNet primarily educates patients, but doctors will benefit from knowing what kind of medical information patients may be accessing:

• Content is written by practicing physicians. MedicineNet has a peer-reviewed editorial policy. 
• Patients have likely done some research on their own about their ailment. Like WebMD, physicians may find this website useful to understand the patient’s mindset. 
• MedicineNet was created to address questions that develop after a physician consultation concludes or if a physician is not immediately available to answer a patient’s question. 
• Health quizzes and a medical terms dictionary encourage education among patients.

Looking for more support and real-world experience directly from your medical peers? At Sermo, you’ll experience a community-based knowledge exchange that connects over 1 million physicians from 150+ countries. 

Sermo is more than a website for medical professionals: it is a portal for accessing a global community of physicians who can help you answer tough challenges you’re facing, a place to build your professional reputation, and a collection of opportunities for doctors to earn extra income . It is a shared space to support and to be supported. After all, “sermo” means “talk” in Latin! 

Sermo is the number one social network for doctors —and it provides many benefits to members:

• Improve your practice by getting advice from your peers.
• Stay up-to-date on the latest medical news and information.
• Share your questions, experiences, and observations with the 24/7 worldwide community of medical professionals.
• Learn about any drug from peer ratings. Sermo has the world’s biggest database for physician drug ratings —featuring over one million reviews, and counting. Each drug is rated for efficacy, safety, tolerability, accessibility and adherence.
• Take continuing medical education courses.
• Earn money for participating in medical research studies and contributing to the community. 
• Connect with other doctors in a stress-free, patient-free environment. Our free app on iOS or Android promotes learning and discussion.

I have been a member of SERMO for a few long years – during this time, I made more friends, I learned a lot from clinical cases, I got up to date with new medical information, and of course, I made money doing surveys …….a lot. Nephrology, Spain

These websites for healthcare professionals will help you access the ever-changing medical landscape, as well as the peer-to-peer connections you seek. 

If you’re looking for a social outlet with clinicians who understand your position and a platform to discuss the latest news and get second opinions on diagnoses and treatments—visit Sermo today.

It is your job to support the patient. Let Sermo support you. Sign up to create your account for free and join the future of medical networking .

More physician resources

A complete guide to paid physician surveys

What is Continuing Medical Education (CME)?

Maximizing your survey earnings: Tips for physician survey participants

• COVID-19 and your mental health

Worries and anxiety about COVID-19 can be overwhelming. Learn ways to cope as COVID-19 spreads.

At the start of the COVID-19 pandemic, life for many people changed very quickly. Worry and concern were natural partners of all that change — getting used to new routines, loneliness and financial pressure, among other issues. Information overload, rumor and misinformation didn't help.

Worldwide surveys done in 2020 and 2021 found higher than typical levels of stress, insomnia, anxiety and depression. By 2022, levels had lowered but were still higher than before 2020.

Though feelings of distress about COVID-19 may come and go, they are still an issue for many people. You aren't alone if you feel distress due to COVID-19. And you're not alone if you've coped with the stress in less than healthy ways, such as substance use.

But healthier self-care choices can help you cope with COVID-19 or any other challenge you may face.

And knowing when to get help can be the most essential self-care action of all.

Recognize what's typical and what's not

Stress and worry are common during a crisis. But something like the COVID-19 pandemic can push people beyond their ability to cope.

In surveys, the most common symptoms reported were trouble sleeping and feeling anxiety or nervous. The number of people noting those symptoms went up and down in surveys given over time. Depression and loneliness were less common than nervousness or sleep problems, but more consistent across surveys given over time. Among adults, use of drugs, alcohol and other intoxicating substances has increased over time as well.

The first step is to notice how often you feel helpless, sad, angry, irritable, hopeless, anxious or afraid. Some people may feel numb.

Keep track of how often you have trouble focusing on daily tasks or doing routine chores. Are there things that you used to enjoy doing that you stopped doing because of how you feel? Note any big changes in appetite, any substance use, body aches and pains, and problems with sleep.

These feelings may come and go over time. But if these feelings don't go away or make it hard to do your daily tasks, it's time to ask for help.

Get help when you need it

If you're feeling suicidal or thinking of hurting yourself, seek help.

• Contact your healthcare professional or a mental health professional.
• Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline , available 24 hours a day, seven days a week. Or use the Lifeline Chat . Services are free and confidential.

If you are worried about yourself or someone else, contact your healthcare professional or mental health professional. Some may be able to see you in person or talk over the phone or online.

You also can reach out to a friend or loved one. Someone in your faith community also could help.

And you may be able to get counseling or a mental health appointment through an employer's employee assistance program.

Another option is information and treatment options from groups such as:

• National Alliance on Mental Illness (NAMI).
• Substance Abuse and Mental Health Services Administration (SAMHSA).
• Anxiety and Depression Association of America.

Self-care tips

Some people may use unhealthy ways to cope with anxiety around COVID-19. These unhealthy choices may include things such as misuse of medicines or legal drugs and use of illegal drugs. Unhealthy coping choices also can be things such as sleeping too much or too little, or overeating. It also can include avoiding other people and focusing on only one soothing thing, such as work, television or gaming.

Unhealthy coping methods can worsen mental and physical health. And that is particularly true if you're trying to manage or recover from COVID-19.

Self-care actions can help you restore a healthy balance in your life. They can lessen everyday stress or significant anxiety linked to events such as the COVID-19 pandemic. Self-care actions give your body and mind a chance to heal from the problems long-term stress can cause.

Take care of your body

Healthy self-care tips start with the basics. Give your body what it needs and avoid what it doesn't need. Some tips are:

• Get the right amount of sleep for you. A regular sleep schedule, when you go to bed and get up at similar times each day, can help avoid sleep problems.
• Move your body. Regular physical activity and exercise can help reduce anxiety and improve mood. Any activity you can do regularly is a good choice. That may be a scheduled workout, a walk or even dancing to your favorite music.
• Choose healthy food and drinks. Foods that are high in nutrients, such as protein, vitamins and minerals are healthy choices. Avoid food or drink with added sugar, fat or salt.
• Avoid tobacco, alcohol and drugs. If you smoke tobacco or if you vape, you're already at higher risk of lung disease. Because COVID-19 affects the lungs, your risk increases even more. Using alcohol to manage how you feel can make matters worse and reduce your coping skills. Avoid taking illegal drugs or misusing prescriptions to manage your feelings.

Take care of your mind

Healthy coping actions for your brain start with deciding how much news and social media is right for you. Staying informed, especially during a pandemic, helps you make the best choices but do it carefully.

Set aside a specific amount of time to find information in the news or on social media, stay limited to that time, and choose reliable sources. For example, give yourself up to 20 or 30 minutes a day of news and social media. That amount keeps people informed but not overwhelmed.

For COVID-19, consider reliable health sources. Examples are the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).

Other healthy self-care tips are:

• Relax and recharge. Many people benefit from relaxation exercises such as mindfulness, deep breathing, meditation and yoga. Find an activity that helps you relax and try to do it every day at least for a short time. Fitting time in for hobbies or activities you enjoy can help manage feelings of stress too.
• Stick to your health routine. If you see a healthcare professional for mental health services, keep up with your appointments. And stay up to date with all your wellness tests and screenings.
• Stay in touch and connect with others. Family, friends and your community are part of a healthy mental outlook. Together, you form a healthy support network for concerns or challenges. Social interactions, over time, are linked to a healthier and longer life.

Avoid stigma and discrimination

Stigma can make people feel isolated and even abandoned. They may feel sad, hurt and angry when people in their community avoid them for fear of getting COVID-19. People who have experienced stigma related to COVID-19 include people of Asian descent, health care workers and people with COVID-19.

Treating people differently because of their medical condition, called medical discrimination, isn't new to the COVID-19 pandemic. Stigma has long been a problem for people with various conditions such as Hansen's disease (leprosy), HIV, diabetes and many mental illnesses.

People who experience stigma may be left out or shunned, treated differently, or denied job and school options. They also may be targets of verbal, emotional and physical abuse.

Communication can help end stigma or discrimination. You can address stigma when you:

• Get to know people as more than just an illness. Using respectful language can go a long way toward making people comfortable talking about a health issue.
• Get the facts about COVID-19 or other medical issues from reputable sources such as the CDC and WHO.
• Speak up if you hear or see myths about an illness or people with an illness.

COVID-19 and health

The virus that causes COVID-19 is still a concern for many people. By recognizing when to get help and taking time for your health, life challenges such as COVID-19 can be managed.

• Mental health during the COVID-19 pandemic. National Institutes of Health. https://covid19.nih.gov/covid-19-topics/mental-health. Accessed March 12, 2024.
• Mental Health and COVID-19: Early evidence of the pandemic's impact: Scientific brief, 2 March 2022. World Health Organization. https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1. Accessed March 12, 2024.
• Mental health and the pandemic: What U.S. surveys have found. Pew Research Center. https://www.pewresearch.org/short-reads/2023/03/02/mental-health-and-the-pandemic-what-u-s-surveys-have-found/. Accessed March 12, 2024.
• Taking care of your emotional health. Centers for Disease Control and Prevention. https://emergency.cdc.gov/coping/selfcare.asp. Accessed March 12, 2024.
• #HealthyAtHome—Mental health. World Health Organization. www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome---mental-health. Accessed March 12, 2024.
• Coping with stress. Centers for Disease Control and Prevention. www.cdc.gov/mentalhealth/stress-coping/cope-with-stress/. Accessed March 12, 2024.
• Manage stress. U.S. Department of Health and Human Services. https://health.gov/myhealthfinder/topics/health-conditions/heart-health/manage-stress. Accessed March 20, 2020.
• COVID-19 and substance abuse. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/covid-19-substance-use#health-outcomes. Accessed March 12, 2024.
• COVID-19 resource and information guide. National Alliance on Mental Illness. https://www.nami.org/Support-Education/NAMI-HelpLine/COVID-19-Information-and-Resources/COVID-19-Resource-and-Information-Guide. Accessed March 15, 2024.
• Negative coping and PTSD. U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/gethelp/negative_coping.asp. Accessed March 15, 2024.
• Health effects of cigarette smoking. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm#respiratory. Accessed March 15, 2024.
• People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed March 15, 2024.
• Your healthiest self: Emotional wellness toolkit. National Institutes of Health. https://www.nih.gov/health-information/emotional-wellness-toolkit. Accessed March 15, 2024.
• World leprosy day: Bust the myths, learn the facts. Centers for Disease Control and Prevention. https://www.cdc.gov/leprosy/world-leprosy-day/. Accessed March 15, 2024.
• HIV stigma and discrimination. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/hiv-stigma/. Accessed March 15, 2024.
• Diabetes stigma: Learn about it, recognize it, reduce it. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/diabetes_stigma.html. Accessed March 15, 2024.
• Phelan SM, et al. Patient and health care professional perspectives on stigma in integrated behavioral health: Barriers and recommendations. Annals of Family Medicine. 2023; doi:10.1370/afm.2924.
• Stigma reduction. Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/od2a/case-studies/stigma-reduction.html. Accessed March 15, 2024.
• Nyblade L, et al. Stigma in health facilities: Why it matters and how we can change it. BMC Medicine. 2019; doi:10.1186/s12916-019-1256-2.
• Combating bias and stigma related to COVID-19. American Psychological Association. https://www.apa.org/topics/covid-19-bias. Accessed March 15, 2024.
• Yashadhana A, et al. Pandemic-related racial discrimination and its health impact among non-Indigenous racially minoritized peoples in high-income contexts: A systematic review. Health Promotion International. 2021; doi:10.1093/heapro/daab144.
• Sawchuk CN (expert opinion). Mayo Clinic. March 25, 2024.

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Healthy Living with Diabetes

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On this page:

How can I plan what to eat or drink when I have diabetes?

How can physical activity help manage my diabetes, what can i do to reach or maintain a healthy weight, should i quit smoking, how can i take care of my mental health, clinical trials for healthy living with diabetes.

Healthy living is a way to manage diabetes . To have a healthy lifestyle, take steps now to plan healthy meals and snacks, do physical activities, get enough sleep, and quit smoking or using tobacco products.

Healthy living may help keep your body’s blood pressure , cholesterol , and blood glucose level, also called blood sugar level, in the range your primary health care professional recommends. Your primary health care professional may be a doctor, a physician assistant, or a nurse practitioner. Healthy living may also help prevent or delay health problems  from diabetes that can affect your heart, kidneys, eyes, brain, and other parts of your body.

Making lifestyle changes can be hard, but starting with small changes and building from there may benefit your health. You may want to get help from family, loved ones, friends, and other trusted people in your community. You can also get information from your health care professionals.

What you choose to eat, how much you eat, and when you eat are parts of a meal plan. Having healthy foods and drinks can help keep your blood glucose, blood pressure, and cholesterol levels in the ranges your health care professional recommends. If you have overweight or obesity, a healthy meal plan—along with regular physical activity, getting enough sleep, and other healthy behaviors—may help you reach and maintain a healthy weight. In some cases, health care professionals may also recommend diabetes medicines that may help you lose weight, or weight-loss surgery, also called metabolic and bariatric surgery.

Choose healthy foods and drinks

There is no right or wrong way to choose healthy foods and drinks that may help manage your diabetes. Healthy meal plans for people who have diabetes may include

• dairy or plant-based dairy products
• nonstarchy vegetables
• protein foods
• whole grains

Try to choose foods that include nutrients such as vitamins, calcium , fiber , and healthy fats . Also try to choose drinks with little or no added sugar , such as tap or bottled water, low-fat or non-fat milk, and unsweetened tea, coffee, or sparkling water.

Try to plan meals and snacks that have fewer

• foods high in saturated fat
• foods high in sodium, a mineral found in salt
• sugary foods , such as cookies and cakes, and sweet drinks, such as soda, juice, flavored coffee, and sports drinks

Your body turns carbohydrates , or carbs, from food into glucose, which can raise your blood glucose level. Some fruits, beans, and starchy vegetables—such as potatoes and corn—have more carbs than other foods. Keep carbs in mind when planning your meals.

You should also limit how much alcohol you drink. If you take insulin  or certain diabetes medicines , drinking alcohol can make your blood glucose level drop too low, which is called hypoglycemia . If you do drink alcohol, be sure to eat food when you drink and remember to check your blood glucose level after drinking. Talk with your health care team about your alcohol-drinking habits.

Find the best times to eat or drink

Talk with your health care professional or health care team about when you should eat or drink. The best time to have meals and snacks may depend on

• what medicines you take for diabetes
• what your level of physical activity or your work schedule is
• whether you have other health conditions or diseases

Ask your health care team if you should eat before, during, or after physical activity. Some diabetes medicines, such as sulfonylureas  or insulin, may make your blood glucose level drop too low during exercise or if you skip or delay a meal.

Plan how much to eat or drink

You may worry that having diabetes means giving up foods and drinks you enjoy. The good news is you can still have your favorite foods and drinks, but you might need to have them in smaller portions  or enjoy them less often.

For people who have diabetes, carb counting and the plate method are two common ways to plan how much to eat or drink. Talk with your health care professional or health care team to find a method that works for you.

Carb counting

Carbohydrate counting , or carb counting, means planning and keeping track of the amount of carbs you eat and drink in each meal or snack. Not all people with diabetes need to count carbs. However, if you take insulin, counting carbs can help you know how much insulin to take.

Plate method

The plate method helps you control portion sizes  without counting and measuring. This method divides a 9-inch plate into the following three sections to help you choose the types and amounts of foods to eat for each meal.

• Nonstarchy vegetables—such as leafy greens, peppers, carrots, or green beans—should make up half of your plate.
• Carb foods that are high in fiber—such as brown rice, whole grains, beans, or fruits—should make up one-quarter of your plate.
• Protein foods—such as lean meats, fish, dairy, or tofu or other soy products—should make up one quarter of your plate.

If you are not taking insulin, you may not need to count carbs when using the plate method.

Work with your health care team to create a meal plan that works for you. You may want to have a diabetes educator  or a registered dietitian  on your team. A registered dietitian can provide medical nutrition therapy , which includes counseling to help you create and follow a meal plan. Your health care team may be able to recommend other resources, such as a healthy lifestyle coach, to help you with making changes. Ask your health care team or your insurance company if your benefits include medical nutrition therapy or other diabetes care resources.

Talk with your health care professional before taking dietary supplements

There is no clear proof that specific foods, herbs, spices, or dietary supplements —such as vitamins or minerals—can help manage diabetes. Your health care professional may ask you to take vitamins or minerals if you can’t get enough from foods. Talk with your health care professional before you take any supplements, because some may cause side effects or affect how well your diabetes medicines work.

Research shows that regular physical activity helps people manage their diabetes and stay healthy. Benefits of physical activity may include

• lower blood glucose, blood pressure, and cholesterol levels
• better heart health
• healthier weight
• better mood and sleep
• better balance and memory

Talk with your health care professional before starting a new physical activity or changing how much physical activity you do. They may suggest types of activities based on your ability, schedule, meal plan, interests, and diabetes medicines. Your health care professional may also tell you the best times of day to be active or what to do if your blood glucose level goes out of the range recommended for you.

Do different types of physical activity

People with diabetes can be active, even if they take insulin or use technology such as insulin pumps .

Try to do different kinds of activities . While being more active may have more health benefits, any physical activity is better than none. Start slowly with activities you enjoy. You may be able to change your level of effort and try other activities over time. Having a friend or family member join you may help you stick to your routine.

The physical activities you do may need to be different if you are age 65 or older , are pregnant , or have a disability or health condition . Physical activities may also need to be different for children and teens . Ask your health care professional or health care team about activities that are safe for you.

Aerobic activities

Aerobic activities make you breathe harder and make your heart beat faster. You can try walking, dancing, wheelchair rolling, or swimming. Most adults should try to get at least 150 minutes of moderate-intensity physical activity each week. Aim to do 30 minutes a day on most days of the week. You don’t have to do all 30 minutes at one time. You can break up physical activity into small amounts during your day and still get the benefit. 1

Strength training or resistance training

Strength training or resistance training may make your muscles and bones stronger. You can try lifting weights or doing other exercises such as wall pushups or arm raises. Try to do this kind of training two times a week. 1

Balance and stretching activities

Balance and stretching activities may help you move better and have stronger muscles and bones. You may want to try standing on one leg or stretching your legs when sitting on the floor. Try to do these kinds of activities two or three times a week. 1

Some activities that need balance may be unsafe for people with nerve damage or vision problems caused by diabetes. Ask your health care professional or health care team about activities that are safe for you.

Stay safe during physical activity

Staying safe during physical activity is important. Here are some tips to keep in mind.

Drink liquids

Drinking liquids helps prevent dehydration , or the loss of too much water in your body. Drinking water is a way to stay hydrated. Sports drinks often have a lot of sugar and calories , and you don’t need them for most moderate physical activities.

Avoid low blood glucose

Check your blood glucose level before, during, and right after physical activity. Physical activity often lowers the level of glucose in your blood. Low blood glucose levels may last for hours or days after physical activity. You are most likely to have low blood glucose if you take insulin or some other diabetes medicines, such as sulfonylureas.

Ask your health care professional if you should take less insulin or eat carbs before, during, or after physical activity. Low blood glucose can be a serious medical emergency that must be treated right away. Take steps to protect yourself. You can learn how to treat low blood glucose , let other people know what to do if you need help, and use a medical alert bracelet.

Avoid high blood glucose and ketoacidosis

Taking less insulin before physical activity may help prevent low blood glucose, but it may also make you more likely to have high blood glucose. If your body does not have enough insulin, it can’t use glucose as a source of energy and will use fat instead. When your body uses fat for energy, your body makes chemicals called ketones .

High levels of ketones in your blood can lead to a condition called diabetic ketoacidosis (DKA) . DKA is a medical emergency that should be treated right away. DKA is most common in people with type 1 diabetes . Occasionally, DKA may affect people with type 2 diabetes  who have lost their ability to produce insulin. Ask your health care professional how much insulin you should take before physical activity, whether you need to test your urine for ketones, and what level of ketones is dangerous for you.

Take care of your feet

People with diabetes may have problems with their feet because high blood glucose levels can damage blood vessels and nerves. To help prevent foot problems, wear comfortable and supportive shoes and take care of your feet  before, during, and after physical activity.

If you have diabetes, managing your weight  may bring you several health benefits. Ask your health care professional or health care team if you are at a healthy weight  or if you should try to lose weight.

If you are an adult with overweight or obesity, work with your health care team to create a weight-loss plan. Losing 5% to 7% of your current weight may help you prevent or improve some health problems  and manage your blood glucose, cholesterol, and blood pressure levels. 2 If you are worried about your child’s weight  and they have diabetes, talk with their health care professional before your child starts a new weight-loss plan.

You may be able to reach and maintain a healthy weight by

• following a healthy meal plan
• consuming fewer calories
• being physically active
• getting 7 to 8 hours of sleep each night 3

If you have type 2 diabetes, your health care professional may recommend diabetes medicines that may help you lose weight.

Online tools such as the Body Weight Planner  may help you create eating and physical activity plans. You may want to talk with your health care professional about other options for managing your weight, including joining a weight-loss program  that can provide helpful information, support, and behavioral or lifestyle counseling. These options may have a cost, so make sure to check the details of the programs.

Your health care professional may recommend weight-loss surgery  if you aren’t able to reach a healthy weight with meal planning, physical activity, and taking diabetes medicines that help with weight loss.

If you are pregnant , trying to lose weight may not be healthy. However, you should ask your health care professional whether it makes sense to monitor or limit your weight gain during pregnancy.

Both diabetes and smoking —including using tobacco products and e-cigarettes—cause your blood vessels to narrow. Both diabetes and smoking increase your risk of having a heart attack or stroke , nerve damage , kidney disease , eye disease , or amputation . Secondhand smoke can also affect the health of your family or others who live with you.

If you smoke or use other tobacco products, stop. Ask for help . You don’t have to do it alone.

Feeling stressed, sad, or angry can be common for people with diabetes. Managing diabetes or learning to cope with new information about your health can be hard. People with chronic illnesses such as diabetes may develop anxiety or other mental health conditions .

Learn healthy ways to lower your stress , and ask for help from your health care team or a mental health professional. While it may be uncomfortable to talk about your feelings, finding a health care professional whom you trust and want to talk with may help you

• lower your feelings of stress, depression, or anxiety
• manage problems sleeping or remembering things
• see how diabetes affects your family, school, work, or financial situation

Ask your health care team for mental health resources for people with diabetes.

Sleeping too much or too little may raise your blood glucose levels. Your sleep habits may also affect your mental health and vice versa. People with diabetes and overweight or obesity can also have other health conditions that affect sleep, such as sleep apnea , which can raise your blood pressure and risk of heart disease.

NIDDK conducts and supports clinical trials in many diseases and conditions, including diabetes. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.

What are clinical trials for healthy living with diabetes?

Clinical trials—and other types of clinical studies —are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help health care professionals and researchers learn more about disease and improve health care for people in the future.

Researchers are studying many aspects of healthy living for people with diabetes, such as

• how changing when you eat may affect body weight and metabolism
• how less access to healthy foods may affect diabetes management, other health problems, and risk of dying
• whether low-carbohydrate meal plans can help lower blood glucose levels
• which diabetes medicines are more likely to help people lose weight

Find out if clinical trials are right for you .

Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.

What clinical trials for healthy living with diabetes are looking for participants?

You can view a filtered list of clinical studies on healthy living with diabetes that are federally funded, open, and recruiting at www.ClinicalTrials.gov . You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe for you. Always talk with your primary health care professional before you participate in a clinical study.

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.

NIDDK would like to thank: Elizabeth M. Venditti, Ph.D., University of Pittsburgh School of Medicine.

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• BOOK REVIEW
• 29 March 2024

The great rewiring: is social media really behind an epidemic of teenage mental illness?

• Candice L. Odgers 0

Candice L. Odgers is the associate dean for research and a professor of psychological science and informatics at the University of California, Irvine. She also co-leads international networks on child development for both the Canadian Institute for Advanced Research in Toronto and the Jacobs Foundation based in Zurich, Switzerland.

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Social-media platforms aren’t always social. Credit: Getty

The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness Jonathan Haidt Allen Lane (2024)

Two things need to be said after reading The Anxious Generation . First, this book is going to sell a lot of copies, because Jonathan Haidt is telling a scary story about children’s development that many parents are primed to believe. Second, the book’s repeated suggestion that digital technologies are rewiring our children’s brains and causing an epidemic of mental illness is not supported by science. Worse, the bold proposal that social media is to blame might distract us from effectively responding to the real causes of the current mental-health crisis in young people.

Haidt asserts that the great rewiring of children’s brains has taken place by “designing a firehose of addictive content that entered through kids’ eyes and ears”. And that “by displacing physical play and in-person socializing, these companies have rewired childhood and changed human development on an almost unimaginable scale”. Such serious claims require serious evidence.

Collection: Promoting youth mental health

Haidt supplies graphs throughout the book showing that digital-technology use and adolescent mental-health problems are rising together. On the first day of the graduate statistics class I teach, I draw similar lines on a board that seem to connect two disparate phenomena, and ask the students what they think is happening. Within minutes, the students usually begin telling elaborate stories about how the two phenomena are related, even describing how one could cause the other. The plots presented throughout this book will be useful in teaching my students the fundamentals of causal inference, and how to avoid making up stories by simply looking at trend lines.

Hundreds of researchers, myself included, have searched for the kind of large effects suggested by Haidt. Our efforts have produced a mix of no, small and mixed associations. Most data are correlative. When associations over time are found, they suggest not that social-media use predicts or causes depression, but that young people who already have mental-health problems use such platforms more often or in different ways from their healthy peers 1 .

These are not just our data or my opinion. Several meta-analyses and systematic reviews converge on the same message 2 – 5 . An analysis done in 72 countries shows no consistent or measurable associations between well-being and the roll-out of social media globally 6 . Moreover, findings from the Adolescent Brain Cognitive Development study, the largest long-term study of adolescent brain development in the United States, has found no evidence of drastic changes associated with digital-technology use 7 . Haidt, a social psychologist at New York University, is a gifted storyteller, but his tale is currently one searching for evidence.

Of course, our current understanding is incomplete, and more research is always needed. As a psychologist who has studied children’s and adolescents’ mental health for the past 20 years and tracked their well-being and digital-technology use, I appreciate the frustration and desire for simple answers. As a parent of adolescents, I would also like to identify a simple source for the sadness and pain that this generation is reporting.

A complex problem

There are, unfortunately, no simple answers. The onset and development of mental disorders, such as anxiety and depression, are driven by a complex set of genetic and environmental factors. Suicide rates among people in most age groups have been increasing steadily for the past 20 years in the United States. Researchers cite access to guns, exposure to violence, structural discrimination and racism, sexism and sexual abuse, the opioid epidemic, economic hardship and social isolation as leading contributors 8 .

How social media affects teen mental health: a missing link

The current generation of adolescents was raised in the aftermath of the great recession of 2008. Haidt suggests that the resulting deprivation cannot be a factor, because unemployment has gone down. But analyses of the differential impacts of economic shocks have shown that families in the bottom 20% of the income distribution continue to experience harm 9 . In the United States, close to one in six children live below the poverty line while also growing up at the time of an opioid crisis, school shootings and increasing unrest because of racial and sexual discrimination and violence.

The good news is that more young people are talking openly about their symptoms and mental-health struggles than ever before. The bad news is that insufficient services are available to address their needs. In the United States, there is, on average, one school psychologist for every 1,119 students 10 .

Haidt’s work on emotion, culture and morality has been influential; and, in fairness, he admits that he is no specialist in clinical psychology, child development or media studies. In previous books, he has used the analogy of an elephant and its rider to argue how our gut reactions (the elephant) can drag along our rational minds (the rider). Subsequent research has shown how easy it is to pick out evidence to support our initial gut reactions to an issue. That we should question assumptions that we think are true carefully is a lesson from Haidt’s own work. Everyone used to ‘know’ that the world was flat. The falsification of previous assumptions by testing them against data can prevent us from being the rider dragged along by the elephant.

A generation in crisis

Two things can be independently true about social media. First, that there is no evidence that using these platforms is rewiring children’s brains or driving an epidemic of mental illness. Second, that considerable reforms to these platforms are required, given how much time young people spend on them. Many of Haidt’s solutions for parents, adolescents, educators and big technology firms are reasonable, including stricter content-moderation policies and requiring companies to take user age into account when designing platforms and algorithms. Others, such as age-based restrictions and bans on mobile devices, are unlikely to be effective in practice — or worse, could backfire given what we know about adolescent behaviour.

A third truth is that we have a generation in crisis and in desperate need of the best of what science and evidence-based solutions can offer. Unfortunately, our time is being spent telling stories that are unsupported by research and that do little to support young people who need, and deserve, more.

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UC to open national trial to study self-testing for HPV, cervical cancer

New method could improve access, early detection and treatment to underserved populations.

Cervical cancer is preventable through vaccination for human papillomavirus (HPV) and treatable through early detection. But the National Cancer Institute (NCI) reports more than half of all cervical cancer cases diagnosed in the United States occur in patients who have never been screened or are infrequently screened. 

Barriers to screening include socioeconomic factors, a lack of awareness and a lack of access, whether patients are physically far from a clinic or do not seek care due to being uninsured or underinsured. 

To help close the gap in access to screening, the NCI has launched the Cervical Cancer ‘Last Mile’ Initiative , a public-private partnership working to provide evidence on the effectiveness and accuracy of self-testing for HPV. 

Part of this initiative is the SHIP trial (Self-collection for HPV testing to Improve Cervical Cancer Prevention). The University of Cincinnati Cancer Center is one of 25 SHIP trial sites across the country testing whether samples self-collected by patients for HPV testing are as accurate and effective as clinic-collected samples. 

Leeya Pinder, MD. Photo/University of Cincinnati.

Leeya Pinder, MD, local principal investigator of the trial, said there are several ways to screen for cervical cancer. But primary HPV testing, rather than other methods including Pap and HPV cotesting, shows the most promise for being an effective self-testing method. 

“It really gives people the opportunity to just do a vaginal swab or a cervico-vaginal swab so that they can get tested for high-risk HPV, which is usually the driver of cervical precancer and cervical cancer,” said Pinder, a Cancer Center member and associate professor in the UC College of Medicine Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. “What we’ve been trying to do over the last several years is prove that women can actually do HPV testing on their own.” 

While other countries have approved self-collection HPV testing, the method is not currently approved by the U.S. Food and Drug Administration. Pinder said previous studies have shown self-testing methods are effective, especially for certain underscreened populations. 

“Those populations include those who sometimes struggle with substance abuse, sometimes have a history of trauma or other kinds of abuse, those that are concerned about their immigration status or actually, many things,” she said. “These are reaching the people who for whatever reason do not have great access to a health care provider to get their cervical cancer screening.” 

In the SHIP trial, patients who already have a scheduled appointment for a colposcopy, an examination of the cervix, vagina and vulva, will self-test in the clinic before providers collect samples for HPV testing and continue with their routine scheduled procedure as they normally would.  

“These patients are getting two swabs, so the goal is to provide additional data that this works so that the FDA has more evidence by which to approve self-testing as a means by which we could actually target populations with limited access,” Pinder said. 

In addition to self-testing potentially increasing access to cervical cancer screening, prevention and early detection and treatment, Pinder said she is excited at the potential to personalize outreach and education to individual communities’ unique population and needs.

Pinder said health care providers could streamline care and offer connections to services, including HPV vaccinations, if self-testing is approved. Photo/iStock/anilakkus.

“I think that it will provide us an opportunity to reach people by partnering with other outreach organizations such as the 513 Relief Bus , mobile mammography vans , church events,” Pinder said. “I really think it will provide us an opportunity to reach the masses.” 

If self-testing is approved, Pinder noted health care providers will need to streamline communications procedures and link patients to care. This could look like follow-ups with clear next steps for those found to be HPV positive and/or at higher risk for cervical cancer and offering easy-to-access HPV vaccinations for those whose self-tests are negative. 

“I think that it opens a lot of doors for us in terms of education, getting people screened and then figuring out how to link people to efficient care and provide opportunities,” she said. 

Since the SHIP trial will enroll patients already scheduled to come into the clinic, community members cannot enroll themselves. However, Pinder said the Cancer Center is working to launch additional research studying HPV self-testing. This may include an early intervention program at the emergency department and comparing mail-in testing versus office testing, that will provide community members an opportunity to participate in the research. 

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The Importance of Lived Experience Perspectives – Insights From the IACC

Joshua A. Gordon, M.D., Ph.D., and Susan Daniels, Ph.D., HHS National Autism Coordinator and Director of the NIMH Office of National Autism Coordination

April 4, 2024

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During National Autism Acceptance Month, NIMH and the NIMH Office of National Autism Coordination  celebrate the important contributions of autistic people in our families and our society, and we reaffirm our support for their acceptance, inclusion, and full participation in all aspects of community life. This April, we would like to highlight NIMH’s unique role in federal autism coordination efforts and reflect on how the lived experiences of autistic people and their families have shaped federal autism research, services, and policy.

We have the privilege of serving as the Chair and Executive Secretary of the Interagency Autism Coordinating Committee (IACC)  . The IACC is a federal advisory committee established by Congress and currently authorized under the Autism CARES Act of 2019. The committee includes federal officials from agencies that support autism research and vital services for people with disabilities, as well as public members, including autistic adults, family members, advocates, researchers, and service providers from diverse communities around the country.

The IACC serves as a forum for community engagement and provides an important point of convergence and collaboration. Federal agency members and public members work together to develop and provide advice that informs the Secretary of the Department of Health and Human Services, federal agencies, Congress, and the President. This advice guides the activities of federal agencies and helps ensure that federal programs are responsive to the needs of the autism community.

Reflecting community needs

In working with the IACC, we have seen how community voices, reflecting the lived experiences of autistic people and their families, can contribute to important advances in federal autism activities. Public input on the co-occurring mental and physical health conditions often experienced by autistic individuals is one such example. These conditions can include seizure disorders, gastrointestinal problems, and disruptions in sleep. They can also include mental disorders and mental health conditions such as anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), self-injury, and suicidal ideation. Many autistic individuals also have learning disabilities or additional developmental conditions and disabilities.

For many people with autism, co-occurring conditions can contribute to lost opportunities and decreased productivity, poor health outcomes, and, in some cases, premature death. Discussions initiated by public members of the IACC, along with public comments received at IACC meetings and at an IACC-sponsored town hall  , helped to shape the research objectives on co-occurring conditions in the inaugural 2009 IACC Strategic Plan   .

The topic of co-occurring conditions remains an IACC priority today. The 2021-2023 IACC Strategic Plan   includes comprehensive recommendations for research investigating the biology underlying co-occurring conditions and autism, as well as interventions and services to address these conditions across the lifespan. Just last year, the IACC issued a Request for Information  seeking additional community input on the topic and received responses from more than 1,200 people. Themes and priorities from these responses will be included in the forthcoming IACC Strategic Plan Update , which will focus on the impact of co-occurring conditions on the physical and mental health of people on the autism spectrum. The update aims to further identify opportunities for research and services to improve well-being for autistic people.

Representing diverse experiences

Hearing from people with lived experience has shed light on additional issues important to the autism community, including wandering and elopement, the needs of transition-age youth and adults, and autism in girls and women. Autistic people and family members have also emphasized the breadth of experiences and challenges across the spectrum of ability and disability and the need for a range of personalized tools, interventions, services, and supports rather than a one-size-fits-all approach.

Based on input from autistic people and families from diverse and underserved communities, the IACC has prioritized the need to increase equity and reduce disparities experienced by autistic individuals across race, ethnicity, culture, sex and gender, socioeconomic status, and geographic location, including rural and urban communities. This also includes the need for more researchers and service providers who come from diverse communities and have lived experience with autism and disability.

The 2021-2023 IACC Strategic Plan includes two cross-cutting recommendations – one on equity and disparities and one on sex and gender – to intensify focus on addressing gaps in these areas and increase equity for all autistic people. The committee also continues to support priorities to ensure that autism research and services meet the needs of individuals across the whole spectrum, including those with the highest support needs, and across the full lifespan into older adulthood. Importantly, the strategic plan emphasizes inclusion and acceptance of all autistic people and reducing barriers to their participation in every aspect of community life.

Prioritizing collaboration and inclusion

In all of this work, consideration of diverse viewpoints and experiences from across the autism community and a spirit of cooperation, collaboration, and civility have been crucial. As the autism landscape continues to evolve, collaboration between federal agencies and community members will remain a cornerstone of progress in improving the health and well-being of autistic people and their families.

Community engagement plays an important role across the broad portfolio of federal research, services, and policy activities related to disabilities, mental health, and physical health. Federal agencies gather public input through federal advisory committees; solicit public comments through formal requests for information; and engage individuals with lived experience in grant review panels, community engagement programs, and community-based participatory research. Lived experience perspectives strengthen federal programs and help ensure federal research and services address the issues most important to those whom they serve.

During Autism Acceptance Month, let us honor the contributions of autistic individuals and others with lived experience; strive to ensure that their voices, perspectives, and priorities are heard and represented in federal activities for research, services, and policy; and work toward a more inclusive society for all.

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Is Apple Cider Vinegar Really a Cure-All?

It has been said to help with weight loss, blood sugar control, acne and more. But experts say the science is more nuanced.

By Alice Callahan

On TikTok , a man swirls a tablespoon of apple cider vinegar into a cup of water, drinks it and eats two slices of pizza. Then, he tests his blood sugar. “These are the best results of all,” he says, showing a much lower spike on a blood sugar graph than when he ate the pizza without the vinegar.

In other posts, TikTok users rave about apple cider vinegar’s remarkable ability to help them lose weight , settle their stomachs and — when applied to their skin — clear their acne and eczema .

Apple cider vinegar has been used as a home remedy for healing wounds, quelling coughs and soothing stomachaches for thousands of years, said Carol Johnston, a professor of nutrition at Arizona State University.

But while some of apple cider vinegar’s health claims have a little science behind them, Dr. Johnston said, many claims haven’t been studied at all. Here’s what we know about apple cider vinegar — and some important cautions to keep in mind if you try it.

How might apple cider vinegar benefit health?

Apple cider vinegar is made via fermentation, in which yeast and bacteria convert carbohydrates first into alcohol and then into acetic acid, which gives vinegar its pungent taste and odor and potentially, research suggests, its health benefits, Dr. Johnston said.

Social media proponents often recommend using unpasteurized and unfiltered versions, which contain a haze of bacteria and undigested carbohydrates called “the mother,” said Dr. Chris Damman, an associate professor of gastroenterology at the University of Washington School of Medicine. But there’s no evidence that these “raw” apple cider vinegars are healthier than regular ones, he said.

Vinegars made from apples and other fruits also contain compounds called polyphenols, which have antioxidant and anti-inflammatory properties and might contribute to their potential health benefits, he said.

What does the research suggest?

Blood sugar control.

In the early 2000s, Dr. Johnston, who had been studying how certain diets could help manage Type 2 diabetes, came across a study from 1988 showing that acetic acid could lower blood sugar spikes in rats after they were given a starch solution.

She was intrigued and decided to test the idea in people with Type 2 diabetes and insulin resistance .

Since then, Dr. Johnston and other researchers have found in small limited studies that drinking one to two tablespoons of apple cider or other types of vinegar mixed with water just before high-carbohydrate meals resulted in less drastic blood sugar spikes than meals without vinegar did.

Some studies suggest that vinegar may slow the movement of food through the digestive tract and interfere with certain enzymes that break carbohydrates down into simple sugars, resulting in lower blood sugar spikes.

But more research is needed to show that apple cider vinegar is safe and beneficial for long-term use, said Paul Gill, a researcher at Monash University in Australia.

Weight loss

Several small, short-term studies in adults who were classified as overweight or obese have found associations between apple cider vinegar and weight loss.

In a 2009 study of 155 adults in Japan, for instance, researchers found that those who drank two tablespoons of apple cider vinegar in water every day for three months lost about four pounds. And in one 2024 trial of 120 people aged 12 to 25 in Lebanon, researchers reported that those who took one tablespoon of apple cider vinegar with water each morning for three months lost an average of 15 pounds.

But the one study that tracked participants after they stopped taking apple cider vinegar found that, on average, they regained most of the weight within a month. And just as many studies on similar groups of people have found no links to weight loss.

Given the lack of robust data and the short time frames of the studies, Beth Czerwony, a dietitian at the Cleveland Clinic, said that she did not recommend that her patients use apple cider vinegar for weight loss.

If vinegar does indeed help people lose weight, it may do so by slowing digestion, which can make you feel fuller for longer, she said.

Animal research has also shown that acetic acid can reduce the accumulation of fat in certain tissues and may help increase the secretion of hormones that signal fullness. So while the evidence in humans is mixed, it’s plausible that vinegar could help with weight loss, Dr. Damman said.

Tamara Duker Freuman, a dietitian in New York City who specializes in digestive conditions, said that many of her patients remark that drinking apple cider vinegar before or after meals reduces their symptoms of acid reflux .

“I believe them,” she said. But, she noted, “hundreds of other patients with horrible reflux” have said that vinegar worsened their symptoms.

Unfortunately, there’s no good research on vinegar and digestive health, said Dr. Nitin K. Ahuja, a gastroenterologist at Penn Medicine.

People who use vinegar to treat reflux, which is commonly caused by stomach acid escaping into the esophagus, say that the acid from the vinegar prompts the stomach to produce less acid, Dr. Ahuja said. But, he added, there’s no supportive data, and “mechanistically, it doesn’t make sense” that adding acid to the stomach will somehow help to control it.

Studies performed in petri dishes suggest that apple cider vinegar can kill certain microbes , which could potentially create gut microbiome changes that might reduce bloating, Dr. Ahuja said. But again, he added, this has not been studied in humans.

If you have frequent or severe reflux symptoms, get treatment from a doctor, he said.

Skin conditions

Applying dilute apple cider vinegar to the skin has long been used as a home remedy for eczema, Dr. Lydia Luu, a dermatologist at the University of Virginia School of Medicine, said. And after several patients asked about such a treatment, she and her colleagues decided to test it.

In their 2019 study , the researchers asked 22 participants, half of whom had eczema, to soak one arm in tap water and one arm in dilute apple cider vinegar for 10 minutes per day for two weeks. Afterward, there were no differences between the participants’ skin in terms of its pH, microbes or its ability to retain moisture — all of which are typically altered in eczema. Sixteen of the study participants reported symptoms like mild burning or itching, mostly on the arm treated with vinegar; one developed severe itching, moderate burning and a small sore; and another developed a raised rash.

Apple cider vinegar “is not very helpful for eczema, unfortunately,” Dr. Luu said — and could make your symptoms worse.

Some of Dr. Luu’s patients “swear by” apple cider vinegar for wart removal, and TikTok is teeming with videos suggesting such a treatment for acne or dark spots or to remove skin tags . But there aren’t good studies about these uses, Dr. Luu said, and apple cider vinegar can cause chemical burns and skin scarring .

Is it safe to try?

Consuming apple cider vinegar, even when diluted, can interact with certain medications, including some drugs for diabetes and the heart, as well as diuretics. Apple cider vinegar may also lower blood potassium, which can be a problem for those who already have low levels, Ms. Czerwony said. So check with your doctor before trying it, she said.

The same advice goes for using apple cider vinegar on your skin, Dr. Luu said. A primary care doctor or dermatologist can likely recommend safer, more effective treatments.

If you want to use vinegar to control your blood sugar, Dr. Johnston suggested diluting one or two tablespoons of any type of vinegar into water and drinking, but don’t exceed two to four tablespoons in a day. Even when diluted, vinegar can erode tooth enamel , so she recommended drinking the vinegar with a straw.

If you drink it undiluted, you run the risk of corroding your esophagus lining too, Dr. Ahuja said.

“Don’t just shoot it,” Dr. Johnston added.

A safer and tastier approach, Dr. Damman suggested, is to use apple cider vinegar in your cooking. Mix it into a vinaigrette or sushi rice , pair with olive oil as a dip for bread, or incorporate it into a refreshing fizzy drink . If there are any health benefits to be reaped, he said, you’ll likely get them this way, too.

Alice Callahan is a Times reporter covering nutrition and health. She has a Ph.D. in nutrition from the University of California, Davis. More about Alice Callahan

A Guide to Better Nutrition

A viral TikTok trend touts “Oatzempic,” a half cup of rolled oats with a cup of water and the juice of half a lime, as a weight-loss hack. We asked the experts if there’s anything to it .

How much salt is too much? Should I cut back? We asked experts these and other questions about sodium .

Patients were told for years that cutting calories would ease the symptoms of polycystic ovary syndrome. But research suggests dieting may not help at all .

We asked a nutrition expert how she keeps up healthy habits without stressing about food. Here are seven tips  she shared for maintaining that balance.

There are many people who want to lose a few pounds for whom weight loss drugs are not the right choice. Is old-fashioned dieting a good option ?

Read these books to shift into a healthier way of thinking about food .

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How to build a flywheel of scientific validation for digital health startups.

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CEO of Posit Science, developers of the BrainHQ brain training program. Focused on digital health and bringing science to the people.

Digital health startups have a unique challenge compared to other software startups. They have to show that their service actually works—not just that it "works" like any software works (the app opens, the data is saved, there aren’t any show-stopping bugs), but that it actually works .

For example, a weight loss app should have data showing users lose weight, or a mental health app should have data showing that it helps with a user’s mental health. At our company, BrainHQ, we make a brain training app, and it’s essential to have gold-standard scientific evidence that it improves brain health and performance.

The difference between a digital health app with evidence and without evidence is enormous. Scientific evidence lets an app make strong evidence-based marketing claims that matter to users and drive growth—" 54% reduction in time to fall asleep " (from sleep-training app Sleep.io) or " think faster, focus better, and remember more " (from BrainHQ). An app without scientific evidence must fall back on generalized, often weak claims.

Evidence-based claims can make the difference between being a flash in the pan and driving sustained commercial success across consumers, healthcare provider networks and insurance payors.

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How can a new digital health startup get this kind of scientific evidence? As randomized controlled trials take money and time, building a flywheel of scientific validation—an engine that started slowly, then spun up to the point where dozens of papers are published annually—can be a successful strategy. Here’s how this can be accomplished.

1. Start the flywheel by making friends.

The first step is to form a scientific advisory board (SAB) composed of academic scientists who are thought leaders in your field of digital health and who are excited about bridging the industry/academic divide. Perhaps you know a few already through the work you’ve done developing your digital health program, or perhaps you can get a friendly introduction to a few.

If it comes down to it, you can cold-email researchers with a brief note (remember, these are busy people) describing your science and asking if they would be interested in learning more and considering joining your SAB.

2. Push the flywheel by making your research program their research program.

Scientific studies (especially for innovative commercial programs) need academic partners, often for access to patients and always for credibility.

One approach I recommend avoiding is approaching academic scientists with your digital health app and asking them to run a study for you. Regardless of how cool or "guaranteed to work" the app is, academic scientists have their own research priorities. Their time is typically already 100% spoken for by existing research programs.

To become a part of that 100%, consider collaborating on a grant. The National Institutes of Health (and virtually every other large federal agency) is mandated by Congress to offer Small Business Innovation Research (SBIR) grants . These grants can only go to qualified small businesses, which means that, while they aren’t easy to get, they also are not as brutally competitive as the research grants that academic scientists are fighting for.

SBIRs (and their cousins, Small Business Technology Transfer grants) allow you to fund research activities by your academic partner at their university using your digital health program. This is a win for your company and a win for your academic partner.

3. Accelerate the flywheel by making their research program your research program.

After you have a few high-quality scientific publications, you may find that researchers begin to reach out to you to ask if they can use your digital health program in their grant-funded studies. This is an incredible opportunity to advance the science of your field while making friends and advocates.

At BrainHQ, for example, we responded to a growing interest by developing an investigator-initiated research program. In a case such as this, a key goal for success is to provide great scientific support to academic partners and provide your app to virtually any qualified investigator.

It’s important to distinguish between company-sponsored research (where you should maintain very tight control over the protocol to answer specific research questions important to advancing your business) and investigator-initiated research (where you won’t get to influence the protocol in any way beyond ensuring that good science is being done).

4. Keep the flywheel spinning by becoming the partner of choice.

As your scientific credibility and published research grow, you may find that academic scientists, who have invented something new in your field, approach you to become their commercialization partner. As you know better than anyone, it’s not easy to start a company. You should view academic innovations not as competitors but as part of your product roadmap.

Academic scientists want their innovations to make a difference in the world and to be brought to market by people who understand the importance of good science. Being that partner can accelerate your own pace of innovation.

Summing It All Up

Science matters in digital health. It’s a new field, and its development must go forward on solid, evidence-based ground. Building out your science in the right way can help ensure that your innovations can take their rightful place in healthcare alongside pharmaceuticals and medical devices.

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