Areas Of Diet Research Articles

What's new in the physiopathology of acne?

There are four central factors that contribute to acne physiopathology: the inflammatory response, colonization with Propionibacterium acnes, increased sebum production and hypercornification of the pilosebaceous duct. In addition, research in the areas of diet and nutrition, genetics and oxidative stress is also yielding some interesting insights into the development of acne. In this paper we review some of the most recent research and novel concepts revealed in this work, which has been published by researchers from diverse academic disciplines including dermatology, immunology, microbiology and endocrinology. We discuss the implications of their findings (particularly in terms of opportunities to develop new therapies), highlight interrelationships between these novel factors that could contribute to the pathology of acne, and indicate where gaps in our understanding still exist.

Natural environments, ancestral diets, and microbial ecology: is there a modern "paleo-deficit disorder"? Part II.

Famed microbiologist René J. Dubos (1901–1982) was an early pioneer in the developmental origins of health and disease (DOHaD) construct. In the 1960s, he conducted groundbreaking research concerning the ways in which early-life experience with nutrition, microbiota, stress, and other environmental variables could influence later-life health outcomes. He recognized the co-evolutionary relationship between microbiota and the human host. Almost 2 decades before the hygiene hypothesis, he suggested that children in developed nations were becoming too sanitized (vs. our ancestral past) and that scientists should determine whether the childhood environment should be “dirtied up in a controlled manner.” He also argued that oft-celebrated growth chart increases via changes in the global food supply and dietary patterns should not be equated to quality of life and mental health. Here in the second part of our review, we reflect the words of Dubos off contemporary research findings in the areas of diet, the gut-brain-axis (microbiota and anxiety and depression) and microbial ecology. Finally, we argue, as Dubos did 40 years ago, that researchers should more closely examine the relevancy of silo-sequestered, reductionist findings in the larger picture of human quality of life. In the context of global climate change and the epidemiological transition, an allergy epidemic and psychosocial stress, our review suggests that discussions of natural environments, urbanization, biodiversity, microbiota, nutrition, and mental health, are often one in the same.

Mindfulness Meditation to Promote Wellness and Manage Chronic Disease

Lifestyle medicine is a patient-engaged field that has grown in tandem with our increasing knowledge of the importance of lifestyle factors and modifiable health behaviors for disease prevention, health promotion, and the management of chronic illness. Stress is at the epicenter of many negative behaviors that contribute to unhealthy lives, such as smoking, overeating, and unhealthy diets, and lack of activity. Mindfulness meditation is a stress reduction practice that teaches awareness, appreciation, and nonjudgmental acceptance of one’s present experience, thereby short-circuiting reactive, automatic stress reactions. Our systematic review and meta-analysis focuses on the application of randomized controlled mindfulness intervention studies across a broad range of populations and conditions that are relevant to lifestyle medicine. In addition to organizing and highlighting mindfulness research studies that are relevant to the field of lifestyle medicine, we also empirically examine the impact of study design issues (eg, use of different controls, intervention length and duration, sample size, primary outcomes) on the magnitude of effect of mindfulness interventions in lifestyle medicine. Overall, this systematic review and meta-analysis found partial evidence for mindfulness-based interventions to provide short-term benefits across a wide range of lifestyle medicine–relevant populations and study outcomes, particularly focusing on the areas of diet and weight management and symptom burden. Numerous outcome measures were used; however, the most common were the Perceived Stress Scale and the State Trait Anxiety Inventory. This analysis also provides evidence for mindfulness-based interventions that have fewer than 20 individuals per group, as well as partial support for interventions that are less than the standard 8 weeks in duration.

Lifestyle intervention for improving school achievement in overweight or obese children and adolescents

The prevalence of overweight and obesity in childhood and adolescence is high. Excessive body fat at a young age is likely to persist into adulthood and is associated with physical and psychosocial co-morbidities, as well as lower cognitive, school and later life achievement. Lifestyle changes, including reduced caloric intake, decreased sedentary behaviour and increased physical activity, are recommended for prevention and treatment of child and adolescent obesity. Evidence suggests that lifestyle interventions can benefit cognitive function and school achievement in children of normal weight. Similar beneficial effects may be seen in overweight or obese children and adolescents. To assess whether lifestyle interventions (in the areas of diet, physical activity, sedentary behaviour and behavioural therapy) improve school achievement, cognitive function and future success in overweight or obese children and adolescents compared with standard care, waiting list control, no treatment or attention control. We searched the following databases in May 2013: CENTRAL, MEDLINE, EMBASE, CINAHL Plus, PsycINFO, ERIC, IBSS, Cochrane Database of Systematic Reviews, DARE, ISI Conference Proceedings Citation Index, SPORTDiscus, Database on Obesity and Sedentary Behaviour Studies, Database of Promoting Health Effectiveness Reviews (DoPHER) and Database of Health Promotion Research. In addition, we searched the Network Digital Library of Theses and Dissertations (NDLTD), three trials registries and reference lists. We also contacted researchers in the field. We included (cluster) randomised and controlled clinical trials of lifestyle interventions for weight management in overweight or obese children three to 18 years of age. Studies in children with medical conditions known to affect weight status, school achievement and cognitive function were excluded. Two review authors independently selected studies, extracted data, assessed quality and risk of bias and cross-checked extracts to resolve discrepancies when required. Authors were contacted to obtain further study details and were asked to provide data on the overweight and obese study population when they were not reported separately. Of 529 screened full-text articles, we included in the review six studies (14 articles) of 674 overweight and obese children and adolescents, comprising four studies with multicomponent lifestyle interventions and two studies with physical activity only interventions. We conducted a meta-analysis when possible and a sensitivity analysis to consider the impact of cluster-randomised controlled trials and/or studies at 'high risk' of attrition bias on the intervention effect. We prioritised reporting of the sensitivity analysis when risk of bias and differences in intervention type and duration were suspected to have influenced the findings substantially. Analysis of a single study indicated that school-based healthy lifestyle education combined with nutrition interventions can produce small improvements in overall school achievement (mean difference (MD) 1.78 points on a scale of zero to 100, 95% confidence interval (CI) 0.8 to 2.76; P < 0.001; N = 321; moderate-quality evidence). Single component physical activity interventions produced small improvements in mathematics achievement (MD 3.00 points on a scale of zero to 200, 95% CI 0.78 to 5.22; P value = 0.008; one RCT; N = 96; high-quality evidence), executive function (MD 3.00, scale mean 100, standard deviation (SD) 15, 95% CI 0.09 to 5.91; P value = 0.04; one RCT; N = 116) and working memory (MD 3.00, scale mean 100, SD 15, 95% CI 0.51 to 5.49; P value = 0.02; one RCT; N = 116). No evidence suggested an effect of any lifestyle intervention on reading, vocabulary and language achievements, attention, inhibitory control and simultaneous processing. Pooling of data in meta-analyses was restricted by variations in study design. Heterogeneity was present within some meta-analyses and may have been explained by differences in types of interventions. Risk of bias was low for most assessed items; however in half of the studies, risk of bias was detected for attrition, participant selection and blinding. No study provided evidence of the effect of lifestyle interventions on future success. Whether changes in academic and cognitive abilities were connected to changes in body weight status was unclear because of conflicting findings and variations in study design. Despite the large number of childhood obesity treatment trials, evidence regarding their impact on school achievement and cognitive abilities is lacking. Existing studies have a range of methodological issues affecting the quality of evidence. Multicomponent interventions targeting physical activity and healthy diet could benefit general school achievement, whereas a physical activity intervention delivered for childhood weight management could benefit mathematics achievement, executive function and working memory. Although the effects are small, a very large number of children and adolescents could benefit from these interventions. Therefore health policy makers may wish to consider these potential additional benefits when promoting physical activity and healthy eating in schools. Future obesity treatment trials are needed to examine overweight or obese children and adolescents and to report academic and cognitive as well as physical outcomes.

Nutrition Counseling for Patients With Osteoporosis: A Personal Approach

Patients are often bombarded with information from the internet, family, friends, and television about what is good and bad for their bones—particularly in the area of diet and nutrition. Although some information is valid and evidence based, much is not. Patients often believe that adequate nutrition alone is enough to improve bone density and decrease fragility fracture risk. Although calcium and vitamin D remain the mainstays of medical nutrition therapy, many patients are not receiving adequate counseling on how to get the right amounts of these 2 nutrients and may not understand that calcium and vitamin D are but 2 of many factors in this multifactorial disease. Clinicians must listen carefully to their patients' concerns, beliefs, and questions and help them develop a personalized plan to achieve their daily calcium and vitamin D intakes. Clinicians must stay apprised of the recent research in nutrition and bone health and evaluate the evidence to adequately educate their patients.

Meeting challenges related to the dietary assessment of ethnic minority populations

Migrants from the Indian subcontinent comprise the largest minority group in the UK. With the process of migration come alterations in lifestyle and eating habits. The present study aimed to disseminate the valuable information, experiences and challenges faced by researchers who conduct studies with ethnic minority groups in the area of diet and nutritional surveys, with an emphasis on migrant South Asians. The findings reported are the result of research carried out during 2008-2012, involving 1100 face-to-face dietary recalls conducted in the UK among South Asian children (aged 1.5-11 years; n = 300) and adults (≥30 years; n = 100). Factors to consider when planning and carrying out diet and nutrition survey studies among migrant South Asians were identified and include the employment of culture-specific tools, visual aid reinforcement and the involvement of key community members and translators to facilitate recruitment and data collection. One of the best practices found when working with minority groups was the use of incentives and tangible benefits to reward study participants. It was also found that constant communication and follow-up of the study participants improved the quality of the data and the likelihood of maintaining links with community members for future studies. From the results of in-house studies and a revision of practices reported in earlier literature, two 24-h face-to-face dietary recalls are recommended as the optimal method for the dietary assessment of migrant South Asians. To complement this assessment, ethnic-specific food frequency questionnaires such as that developed and successfully implemented among South Asians in the present study must be employed.

Medical doctors’ attitudes and beliefs about diet and health are more like those of their lay countrymen (France, Germany, Italy, UK and USA) than those of doctors in other countries

The relation between diet and health has become a public health concern in Western/developed countries. Physicians are influenced in their views about health by their medical training and membership in a particular culture/nation to one extent or another. Their medical training is itself influenced by both a common body of accepted formal knowledge and practice and culture- or nation-specific influences on medical education. In this study, we compared physicians from different countries and physicians and lay individuals from the same country with regard to beliefs and attitudes about the relation between diet and health and other health-related issues. Telephone interviews about diet and health conducted with randomly sampled physicians and laypersons in France, Germany, Italy, the United Kingdom, and the USA revealed substantial cultural/national differences and few differences between physicians and laypersons of the same country. Three different measures of similarity converged in supporting the claim that in the areas of diet and health, physicians resemble their countrymen more than they resemble physicians from other Western countries. The degree to which differences in culture- and nation-mediated medical education influence these results is to be determined.

Diet and Physical Activity in Childhood Cancer Survivors: A Review of the Literature

Treatment advances have led to a growing population of childhood cancer survivors. Many are at risk for developing treatment-related late effects. Diet and physical activity may affect levels of health risk. A number of papers have examined these behaviors in childhood cancer survivors. The purpose of this study was to provide a review and summary of the published studies in the areas of diet, physical activity, and related interventions among childhood cancer survivors. A systematic search was conducted for studies published prior to October 2009. Descriptive and intervention studies that included survivors of childhood cancers and a measurement of diet and/or physical activity were reviewed. Twenty-six manuscripts met criteria: ten addressed diet; 20 addressed physical activity, and six included intervention studies. Results suggest that childhood cancer survivors engage in health-promoting activities at rates comparable to the general population. Behavioral interventions have mostly targeted physical activity. Results, overall, are not encouraging, due primarily to difficulties recruiting and retaining participants. Although more rigorous studies are needed, recommendations for health-promoting behaviors should be a regular topic of discussion between health care providers and their childhood cancer survivor patients.

Are prices changes adequate to produce long‐term dietary change: Lessons from Russia's Economic Transition?

Altering of price subsidizes and taxation to promote a healthful diet are major tenets of nutrition‐related food policy. In tobacco, taxation was a main component of smoking reduction campaigns, but public education and norm changing occurred concurrently. In the diet area, tax changes may be opposed by added food marketing. Russia offers an opportunity to test the role of price shifts and subsidy removal unaccompanied by programming. This study evaluates the effect of price change on percent total fat calories consumed and percent total fat from meat, dairy, and fats and determines if effects of price changes differed by income level. Using data from the Russia Longitudinal Monitoring Survey we evaluated dietary changes from 1994–2004 in low, middle, and high income groups. Following economic price shocks and soaring inflation, percent of calories from fat and percent of fat calories consumed from meat, dairy, and fats decreased. Despite continuing increasing costs, percent calories from fat and percent fat from meats and dairy rebounded with income improvements. Cost was inversely associated with percent total fat calories consumed from an item, but over time, had less of an effect on this relation. The rebound was quicker and more apparent in middle and high income groups. The effect of price change is likely short lived if not accompanied by social norm changes and educational programming. Funding T32MH07669403

Establishing a cardiovascular health and wellness program in a community pharmacy: Screening for metabolic syndrome

ObjectivesTo implement a comprehensive service to screen for metabolic syndrome, assess the prevalence of metabolic syndrome, determine the 10-year risk of developing coronary heart disease (CHD), and measure the effectiveness of patient education on lifestyle modifications. DesignCross-sectional study. SettingCommunity pharmacy in Pennsylvania between February 2006 and August 2007. Patients239 patients 18 years of age or older with no history of CHD. InterventionParticipating patients were screened for metabolic syndrome, Framingham risk assessment, and medication use. Test results were discussed and patients were educated on metabolic syndrome and lifestyle recommendations. A follow-up survey was administered. Main outcome measuresPrevalence of metabolic syndrome in the study population, Framingham risk assessment of those with metabolic syndrome, proportion of patients with self-reported lifestyle modifications. ResultsThe prevalence of metabolic syndrome in our study population was 36%. The Framingham risk assessment of patients with metabolic syndrome and no known history of diabetes revealed that 65.3% were at low risk, 26.4% were at moderate risk, and 8.3% were at high risk for CHD. Of the study population with no known history of prediabetes or diabetes, 26% had an abnormal glucose reading. Of those with metabolic syndrome, 87% self-reported a lifestyle modification in the area of diet, exercise, or weight loss in the following 3- to 6-month follow-up period. ConclusionPharmacists have an important role in screening patients for risk factors associated with metabolic syndrome. By providing education on lifestyle modifications, pharmacists can increase the likelihood that patients with metabolic syndrome implement lifestyle changes. A metabolic syndrome screening and education program can be successfully implemented in a community pharmacy setting.

Edible compounds as antitumor agents

The area of diet and cancer prevention research is a dynamic one, producing new theories and findings. The majority of research on diet and cancer suggests that eating fruits, vegetables, whole grains and beans will lower the risk of developing cancer. This review focuses on foods that will help in lowering the risk of cancer. Keywords: Food, phytochemicals, antitumor agents.

Micronutrient effects on blood pressure regulation.

Five micronutrients have been shown to directly influence blood pressure: sodium, calcium, potassium, magnesium, and chloride. The data presented here are based on accumulated findings from epidemiologic, laboratory, and clinical investigations, many of which focused primarily on a single nutrient. However, as also discussed here, nutrients are not consumed in isolation, and their physiologic interactions and combined effects on blood pressure are the subjects of much of the current research in the area of diet and hypertension.

Individual and Neighborhood Differences in Diet Among Low-Income Foreign and U.S.-Born Women

Research on the "immigrant" or "Latino health paradox" has demonstrated that Latinos exhibit better health than U.S.-born whites, for multiple health outcomes, despite adjusting for socioeconomic status. However, little empirical research has focused on women and even less has focused on how the neighborhood residential environment is associated with these health differences, particularly in the area of diet. We analyzed baseline data from 641 low-income women, nested within 184 census tracts, enrolled in a nutrition intervention trial for postpartum women. Individual-level variables, including race/ethnicity, nativity, duration of time in the United States, language acculturation, emotional and instrumental support, and socioeconomic position, were merged with tract-level variables from U.S. Census data (2000) based on residential address. We assessed daily fruit and vegetable servings through a semiquantitative food frequency questionnaire. Using MLWin 2.0 software, we employed a 2-level linear regression model to ascertain associations of neighborhood immigrant, racial, and socioeconomic composition with individual diet, adjusting for individual-level sociodemographic characteristics. In our fully adjusted model, we observed a statistically significant increase of 1/3 of fruit and vegetable daily servings for each 10-percentage point increase in the tract foreign-born population. Each 10-percentage point increase in the tract Black population was associated with a significant 1/5 serving decrease in individual daily fruit and vegetable intake. Among this population of U.S. and foreign-born women, neighborhood composition was associated with individual diet, above and beyond individual-level characteristics, illuminating neighborhood context, immigrant health, and diet.

A Field Test of a Web-Based Workplace Health Promotion Program to Improve Dietary Practices, Reduce Stress, and Increase Physical Activity: Randomized Controlled Trial

Background Most work sites engage in some form of health promotion programming designed to improve worker health and reduce health care costs. Although these programs have typically been delivered through combinations of seminars and print materials, workplace health promotion programs are increasingly being delivered through the Internet.Objective The purpose of this research was to evaluate the effectiveness of a Web-based multimedia health promotion program for the workplace, designed to improve dietary practices, reduce stress, and increase physical activity.Methods Using a randomized controlled trial design with pretest-posttest comparisons within each group, 419 employees of a human resources company were randomly assigned to the Web-based condition or to a condition that provided print materials on the same topics. All subjects were assessed at pretest and posttest through an online questionnaire containing multiple measures of health behavior and attitudes. The test period was 3 months. Questionnaire data were analyzed mainly by analysis of covariance and t tests.Results Retention rates were good for both groups—85% for the Web-based group and 87% for the print group. Subjects using the Web-based program performed significantly better than the print group on Attitudes Toward a Healthful Diet (F1,415 = 7.104, P = .008) and Dietary Stage of Change (F1,408 = 6.487, P = .01), but there were no significant group differences on the five other dietary measures. Both groups also showed improvement from pretest to posttest on most dietary measures, as indicated by significant t tests. Within the Web-based group, dosage analyses showed significant effects of the number of times the subject accessed the program on measures of Dietary Self-Efficacy (F2,203 = 5.270, P = .003), Attitudes Toward a Healthful Diet (F2,204 = 2.585, P = .045), and Dietary Stage of Change (F2,200 = 4.627, P = .005). No significant differences were found between the two groups on measures of stress or physical activity, although t tests of pretest-posttest changes indicated that both groups improved on several of these measures. The Web-based group gave significantly higher ratings to the program materials than the print group on all health topics and in their overall evaluation (F1,410 = 9.808, P = .002).Conclusions The Web-based program was more effective than print materials in producing improvements in the areas of diet and nutrition but was not more effective in reducing stress or increasing physical activity. The higher ratings given to the Web-based program suggest that workers preferred it to the print materials. Both groups showed numerous pretest-posttest improvements in all health topics, although such improvements might be attributable in part to a Hawthorne effect. Results suggest that a multimedia Web-based program can be a promising means of delivering health promotion material to the workforce, particularly in the area of diet and nutrition.

Thematic review series: Patient-Oriented Research. Dietary fat, carbohydrate, and protein: effects on plasma lipoprotein patterns

In general, under isoweight conditions, different types of dietary protein or individual amino acids have little effect on lipoprotein patterns. Dietary carbohydrate tends to increase plasma triglyceride when it displaces fat, accompanied by a decrease in HDL cholesterol concentrations. Potential differential effects of types of carbohydrate are difficult to assess because of differences in rates of absorption and confounding of dietary fiber. Saturated fatty acids increase LDL and HDL cholesterol, whereas trans fatty acids increase LDL but not HDL cholesterol. Unsaturated fatty acids decrease LDL and HDL cholesterol, polyunsaturated more so than monounsaturated. There has been considerable interest in the potential benefit of major shifts in dietary macronutrients on weight loss and lipoprotein patterns. Short-term data favor substituting protein and fat for carbohydrate, whereas long-term data have failed to show a benefit for weight loss. During an active weight loss period low-carbohydrate diets more favorably affect triglyceride and HDL and less favorably affect LDL cholesterol concentrations. Additional efforts need to be focused on gaining a better understanding of the effect of dietary macronutrient profiles on established and emerging cardiovascular disease risk factors, mechanisms for changes observed and contributors to individual variability. Such data are needed to allow reassessment and, if necessary, modification of current recommendations.

Diet and healthy ageing

In the future there will be more people aged 65 years and over ('older adults'). Although the exact mechanisms underlying normal ageing are not fully understood, ageing is generally associated with an increase in chronic diseases, such as cardiovascular disease, diabetes, cancer and osteoporosis. It is becoming clear that it is possible to prevent, slow or reverse the onset of many these by modifying lifestyle factors such as diet. Studies of older adults in a range of countries have highlighted a number of areas in which dietary quality could be improved. It is important to identify dietary patterns in addition to specific dietary components that offer protection against chronic disease. The challenge in the area of diet and healthy ageing is twofold: first, there is a need to improve the diet of older adults; and second, as most chronic diseases begin earlier in life, there is a need to encourage other age groups to adapt their diet so they can enter old age in better health.

Verificação das Boas Práticas de preparação e análise microbiológica de dieta enteral em serviço de nutrição e dietética de hospital privado

nteral formulations are important for the recovery of immunosupressed patients. They are composed by macro and micronutrients, constituting an excellent media for microorganism growth. Such diets’ contamination can occur at different stages of processing. This research aims to verify the microbiological quality of enteral diet in private hospital, the percentage of conformity to the health norms in different areas of diet’s preparation and to isolate the higher risk stage. The methods applied were: microbiological analysis based in RDC Resolution 12\01 and 63\00 for non-industrialized enteral diets and application of a checklist to verify the conformity to Good Preparation Practices. High contamination by total and faecal coliforms and a 61%-index of non-conformities during diet preparation were verified. Also, non-pathogenic microorganisms suggesting inadequate hygiene were found. Faecal coliforms presence can be associated with manipulation or utensils used during processing. Thus, it is necessary to adapt hygiene patterns to enteral diets’ processing

The roles of self-efficacy, outcome expectancies and social support in the self-care behaviours of diabetics

Adult diabetics ( N = 94) completed a questionnaire containing measures of diabetesrelated self-efficacy, outcome expectancies, social support and diabetes self-care. Self-efficacy was consistently associated with self-care in the areas of diet, exercise and blood glucose testing. Outcome expectancies were correlated with exercise and blood glucose testing. The relationship between self-efficacy and blood glucose testing was moderated by outcome expectancies, such that self-efficacy had a greater effect when combined with strong beliefs in outcomes. At low levels of self-efficacy, strong outcome beliefs were associated with poorer self-care. Social support was associated with exercise self-care, and diet-specific positive family interactions were associated with better diet adherence. The relationship between social support and exercise self-care was mediated by self-efficacy. When the effects of self-efficacy were controlled, social support was no longer a significant independent predictor of self-care. The results of this study suggest that programmes designed to increase confidence in self-care abilities are likely to be effective. However, no definitive comment can be made concerning causal order from the present results. It is equally possible that a history of successful diabetes self-care builds patients' confidence in their self-care abilities. The issue of causality is a matter for future research.

Survey of UK dietetic departments: diet in secondary prevention of myocardial infarction.

To collate information on current British dietetic practice in the area of diet in secondary prevention of myocardial infarction, and to compare this with best evidence. A questionnaire was sent to all Chief Dietitians, to be completed by the whole department, asking about current dietary advice and practice, referrals and written dietary information for people following myocardial infarction. Fifty-seven per cent of questionnaires were returned. Dietary fat advice was prioritized by 84% of departments, fruit and vegetables by 49%, oily fish by 45% and fibre by 28%. Most dietitians (81%) felt that this advice would protect from further cardiovascular disease. Percentages of post-myocardial infarction patients given advice by a dietitian varied (median 60%), reasons for non-referral included patients having normal lipids or weight. More were given dietary advice by another health professional (median 90%); however, most dietitians were unsure about the quality of this advice. Diet sheets were felt to reflect advice priorities, but where sheets were sent they were much less likely than departments to prioritize oily fish or fruit and vegetable advice. Dietetic practice for people following myocardial infarction is out of line with current best evidence. Almost half of departments correctly prioritize oily fish advice, but often only see patients with raised lipids or weight. This is not the most effective strategy for preventing deaths.

Children with diabetes website

www.childrenwithdiabetes.com T. Valère phD Created in July 1995 by the father of a child with diabetes, Children with Diabetes aims to help children with diabetes and their families learn about diabetes, meet people with diabetes, and help others with diabetes. The site has received several awards. It was rated among the top 5% of all web sites by Leeks. The home page contains top-level links to each of the major areas of the website. Every page is key word indexed and a User's Guide will help you determine where to start. There are navigation tips, as well as suggested starting points for children, parents and adults. If you have trouble finding something, the Index can help. This alphabetical listing contains links to almost everything within the site. For patients or parents who are new to diabetes or want to learn more, Diabetes Basics is the place to start. Basic facts about diabetes are explained. What is Type 1 diabetes? What is insulin and why is it used? For patients who want to learn more about research into a cure, the information within Diabetes Basics can help. A child's doctor says he or she needs a Hemoglobin A1C test every three months, but the parents are not sure what that means and they forgot to ask the doctor. The Diabetes Dictionary contains definitions for this and hundreds of other terms. Staffed by a group of international multidisciplinary experts, the Diabetes Team answers questions about diabetes. Readers submit dozens of questions each week, and each receives an answer from the Team. Most answers are published. Diabetes at School is designed to help children with diabetes and their parents ensure that they are able to care for their diabetes while at school. Information for Teachers and Child-Care Providers presents a brief overview of Type 1 diabetes and its implications for school. The reviews help children and parents decide which products are best for them. Each product is reviewed with an eye towards usability by children. A special smiley face graphic highlights products that the site highly recommends for children with diabetes. Within the Food and Diet area, readers will find dozens of recipes that will satisfy the taste buds of even the most demanding child. All of the recipes have been taste-tested by at least one child with diabetes. In addition, cookbooks, computerized meal planning products and meal planning aids make it easy to prepare meals that fit diabetic meal plans. Diabetes camp is one of the best places for a child with diabetes to learn self-confidence, to be with other children with diabetes, and simply to have a great time. It's also an excellent opportunity for parents to take a break from diabetes. A listing of camps throughout the world (over a hundred in the USA) is provided. Parents share their experiences in the pages of Parents' Voices. Parents of newly diagnosed children will find support and advice from the more experienced. For children, diabetes can mean feeling alone or feeling different because they don't know any other child who has diabetes. In Kids' Voices, children tell their story, in their own words. Friends is a database of parents, children and teens with diabetes, adults with diabetes, relatives and friends willing to exchange mail or e-mail about diabetes. You can add your name to the thousands of Friends. The Message Board provides a forum for discussion. You may login as a guest and just read messages or create your own user name and password and post messages of your own. The Chat Rooms are among the most visited pages within the site. The site reports on research, daily care, legislative issues, and other news. Each week the What's New page is updated to include a list of the new material that has been added during the past week. A special image highlights new material. You may also sign up to receive the What's New section by e-mail each week. Links to many other online diabetes resources are provided. The list of diabetes organizations in the USA and elsewhere will help people from around the world. Travelers can even learn how to say ‘I have diabetes’ in many different languages. All in all, the site successfully uses web technologies to create a virtual community for diabetic children, their families and professionals dealing with diabetes.