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Ju S, Kwon Y, Yeum KJ. Persistent Calcium Inadequacy in Korean Adults over 20 Years: Analysis of the 1998-2018 Korea National Health and Nutrition Examination Survey. Foods 2024; 13:3568. [PMID: 39593984 PMCID: PMC11593063 DOI: 10.3390/foods13223568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Revised: 11/01/2024] [Accepted: 11/05/2024] [Indexed: 11/28/2024] Open
Abstract
Calcium inadequacy in Asian populations has been well documented, but whether it has improved over time remains uncertain. We analyzed dietary calcium intake and its association with osteoporosis prevalence over a 20-year period in 48,653 adults (21,932 men and 26,721 women, aged 19 years and older) in Korea, using data from the first to the seventh Korea National Health and Nutrition Examination Survey (1998-2018). Over the past 20 years, Korean adults consistently fell short of the recommended dietary calcium intake, with women and older adults particularly affected, typically consuming only 40-80% of the recommended levels. The 30-49 age group had the highest calcium intake (497-568 mg/day), while those aged 75+ had the lowest (319-457 mg/day). A significant inverse relationship was found between calcium intake and osteoporosis risk, with lower calcium intake associated with higher odds of developing osteoporosis, as determined by both physician diagnoses and bone mineral density measurements (p < 0.001). Notably, over the past 20 years, 68-70% of dietary calcium consistently came from plant-based foods. This study strongly emphasizes the urgent need to enhance calcium-rich food availability and implement targeted interventions to increase calcium intake among those most affected by inadequacy, particularly the elderly and women. Further research with recent data would be valuable for understanding current intake levels and evolving nutritional needs.
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Affiliation(s)
- Seyoung Ju
- Department of Food and Nutrition, College of Biomedical and Health Science, Konkuk University, Chungju-si 27478, Chungchungbuk-do, Republic of Korea;
| | - Yongseok Kwon
- National Institute of Agricultural Sciences, 166 Nongsaengmyeong-ro, Jeonju 55365, Jeonbuk-do, Republic of Korea;
| | - Kyung-Jin Yeum
- Department of Food and Nutrition, College of Biomedical and Health Science, Konkuk University, Chungju-si 27478, Chungchungbuk-do, Republic of Korea;
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Tasnim T, Sadiq MZA, Karim KMR. Depression level, nutritional status, and dietary nutrient intake of the older adult at the community level in a selected area of Bangladesh. Heliyon 2023; 9:e18199. [PMID: 37501974 PMCID: PMC10368819 DOI: 10.1016/j.heliyon.2023.e18199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023] Open
Abstract
Malnutrition is associated with higher rates of morbidity and death in the older population. Depression or mental health is a major component of older adult malnutrition. The aim of the study was to measure the level of malnutrition and depression in older adults, as well as their correlated factors, such as dietary energy and nutrient consumption. A cross-sectional study was conducted among 108 older individuals living in two areas of Faridpur, Bangladesh. The Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression (GD) Scale, and 24-h dietary recall were used to measure the nutritional status, depression level, and dietary nutrients, respectively. A total of 20.4% and 55.6% were malnourished or at risk of malnutrition, respectively. Around 81.5% of the study subjects exhibited a different degree of depression and 9.3% were identified as having severe depression. There was a significant inverse association between the MNA-SF score and the GD score (r = -0.684, p=<0.001). The average energy and protein consumption was 1387 kcal and 45.52 g, respectively; and energy and protein intake were significantly lower in the depressed group (1353 Kcal, 43.8 g) than in the non-depressed group (1530 Kcal, 52.4 g). An extremely low energy consumption (<20 kcal/kg body weight/day) was noted in 27.1% of the older adults. None of the participants in this study were able to meet the requirements for dietary fiber, calcium, vitamin B6, folate, vitamin D, and vitamin E. Specific nutrition-related intervention programs as well as social and familial support are recommended to improve the nutritional status of older adults.
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Affiliation(s)
- Tasmia Tasnim
- Department of Nutrition and Food Engineering, Daffodil International University, Daffodil Smart City, Birulia, 1216, Savar, Dhaka, Bangladesh
| | - Md Zafar As Sadiq
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh
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Locks LM, Shah M, Bhaise S, Hibberd PL, Patel A. Assessing the Diets of Young Children and Adolescents in India: Challenges and Opportunities. Front Pediatr 2022; 10:725812. [PMID: 35656376 PMCID: PMC9152162 DOI: 10.3389/fped.2022.725812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Sustainably addressing the crisis of undernutrition for children and adolescents in underserved and resource-limited communities will require, among other investments, interventions aimed at optimizing the diets of these vulnerable populations. However, to date, there are substantial global gaps in the collection of dietary data in children and adolescents. This review article summarizes the challenges and opportunities in assessing diet among children and adolescents in India. National surveys in India identify the scale of the triple burden of malnutrition (undernutrition, micronutrient deficiencies and overnutrition) in children and adolescents and assess key nutrition and food security indicators for making informed policy decisions. However, national surveys do not collect data on diet, instead relying on anthropometry, biomarkers of micronutrient deficiencies, and summary measures of diet, such as the WHO infant and young child feeding summary indicators. Sub-national surveys and the scientific literature thus fill important gaps in describing the nutrient intakes of children and adolescents in India; however large gaps remain. Future research can be improved by investments in infrastructure to streamline the assessment of diet in India. The current challenges confronting the collection and analysis of high-quality dietary data occur in both the data collection and data analysis phases. Common methods for assessing diets in low-resource settings-such as 24 h recalls and food frequency questionnaires are particularly challenging to implement well in young children and adolescents due to motivation and memory issues in young respondents. Additionally, there are challenges with parental recall including children having multiple caretakers and meals outside the home. Furthermore, analysis of dietary data is hindered by the lack of affordable, accessible software for dietary data analysis relevant to the diversity in Indian diets. New technologies can address some of the challenges in dietary data collection and analysis, but to date, there are no platforms designed for population-level dietary assessment in India. Public and private sector investment in dietary assessment, as well as collaboration of researchers and the creation of open-source platforms for the sharing of data inputs (local food lists, recipe databases, etc.) will be essential to build infrastructure to better understand the diets of children and adolescents in India and improve dietary interventions in these target groups.
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Affiliation(s)
- Lindsey M. Locks
- Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
- Department of Global Health, School of Public Health, Boston University, Boston, MA, United States
| | - Miloni Shah
- Department of Global Health, School of Public Health, Boston University, Boston, MA, United States
| | | | - Patricia L. Hibberd
- Department of Global Health, School of Public Health, Boston University, Boston, MA, United States
- Department of Infectious Diseases, School of Medicine, Boston University, Boston, MA, United States
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur, India
- Datta Meghe Institute of Medical Sciences, Sawangi, India
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Citu IM, Citu C, Margan MM, Craina M, Neamtu R, Gorun OM, Burlea B, Bratosin F, Rosca O, Grigoras ML, Motoc A, Malita D, Neagoe O, Gorun F. Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection. Nutrients 2022; 14:nu14071445. [PMID: 35406057 PMCID: PMC9003126 DOI: 10.3390/nu14071445] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
Magnesium may contribute to the immune response during and after SARS-CoV-2 infection by acting as a cofactor for immunoglobulin production and other processes required for T and B cell activity. Considering magnesium as a recommended dietary supplement during pregnancy and the possible role of magnesium deficiency in COVID-19 and its complications, the current study sought to determine the effect of magnesium and magnesium-containing nutritional supplements on the immune response following SARS-CoV-2 infection in pregnant women, as well as to observe differences in pregnancy outcomes based on the supplements taken during pregnancy. The study followed a cross-sectional design, where patients with a history of SARS-CoV-2 infection during their pregnancy were surveyed for their preferences in nutritional supplementation and their profile compared with existing records from the institutional database. A cohort of 448 pregnant women with COVID-19 during 22 months of the pandemic was assembled, out of which 13.6% took a magnesium-only supplement, and 16.5% supplemented their diet with a combination of calcium, magnesium, and zinc. Around 60% of patients in the no-supplementation group had the SARS-CoV-2 anti-RBD lower than 500 U/mL, compared with 50% in those who took magnesium-based supplements. A quantity of magnesium >450 mg in the taken supplements determined higher levels of antibody titers after COVID-19. Low magnesium dosage (<450 mg) was an independent risk factor for a weak immune response (OR-1.25, p-value = 0.003). The observed findings suggest supplementing the nutritional intake of pregnant women with magnesium-based supplements to determine higher levels of SARS-CoV-2 anti-RBD antibodies, although causality remains unclear.
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Affiliation(s)
- Ioana Mihaela Citu
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
- Correspondence: ; Tel.: +40-(722)-322-877
| | - Madalin-Marius Margan
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Oana Maria Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Bogdan Burlea
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Ovidiu Rosca
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Mirela Loredana Grigoras
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.L.G.); (A.M.)
| | - Andrei Motoc
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.L.G.); (A.M.)
| | - Daniel Malita
- Department of Radiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Octavian Neagoe
- First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Florin Gorun
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
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Cervera‐Mata A, Sahu PK, Chakradhari S, Sahu YK, Patel KS, Singh S, Towett EK, Martín‐Ramos P, Quesada‐Granados JJ, Rufián‐Henares JA. Plant seeds as source of nutrients and phytochemicals for the Indian population. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.15414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Ana Cervera‐Mata
- Departamento de Edafología y Química Agrícola Facultad de Farmacia Universidad de Granada Granada Spain
| | - Pravin Kumar Sahu
- School of Studies in Environmental Science Ravishankar Shukla University Raipur India
| | - Suryakant Chakradhari
- School of Studies in Environmental Science Ravishankar Shukla University Raipur India
| | - Yaman Kumar Sahu
- School of Studies in Chemistry Ravishankar Shukla University Raipur India
| | | | - Samarendra Singh
- Department of Higher Education Government of Chhattisgarh New Raipur India
| | | | - Pablo Martín‐Ramos
- Department of Agricultural and Environmental Sciences Instituto de Investigación en Ciencias Ambientales de Aragón University of Zaragoza Huesca Spain
| | - José Javier Quesada‐Granados
- Departamento de Nutrición y Bromatología Centro de Investigación Biomédica Instituto de Nutrición y Tecnología de los Alimentos Universidad de Granada Granada Spain
| | - José A. Rufián‐Henares
- Departamento de Nutrición y Bromatología Centro de Investigación Biomédica Instituto de Nutrición y Tecnología de los Alimentos Universidad de Granada Granada Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA Universidad de Granada Granada Spain
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Zhao F, He L, Zhao L, Guo Q, Yu D, Ju L, Fang H. The Status of Dietary Energy and Nutrients Intakes among Chinese Elderly Aged 80 and Above: Data from the CACDNS 2015. Nutrients 2021; 13:1622. [PMID: 34066082 PMCID: PMC8150709 DOI: 10.3390/nu13051622] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/01/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
This study analyzed the status of dietary energy and nutrients intakes among the oldest-old in China. Data was obtained from the China Adult Chronic Disease and Nutrition Surveillance in 2015 (CACDNS 2015). We enrolled 1929 Chinese elderly people aged 80 and above who participated in both 3-day 24-h dietary recalls and household condiments weighing. The dietary intakes were calculated based on Chinese Food Composition Tables and assessed using Chinese Dietary Reference Intakes (DRIs). The dietary intakes of energy and most nutrients were all below the EAR or AI, except for fat, vitamin E, niacin, iron and sodium. As a result, daily dietary intakes of energy and most nutrients were inadequate in the oldest-old in China, especially vitamin A, vitamin B1, vitamin B2, folate and calcium, with the prevalence of deficiency more than 90%. Furthermore, the prevalence of inadequacy of vitamin C, zinc, selenium and magnesium was also high with the proportion below the EAR more than 60%. Approximately 30% of the subjects with dietary vitamin E intake did not reach AI, and more than 90% of subjects have reached AI in the intake of sodium, while more than 90% did not reach AI in potassium. The mean intakes of niacin and iron have reached EAR, but around 15% were still faced with the risk of deficiency. In addition, although the dietary energy intake was below EER, the energy contribution from fat in total population and all subgroups (region, age, gender, education level, material status, household income level groups) all exceeded the recommended proportion of 30% from the DRIs and close to or over 35%, is a significant concern. For the majority of nutrients, higher daily dietary intakes and lower prevalence of deficiencies were found in the oldest-old living in urban areas, aged 80-84 years, with high school and above education level, living with spouse and from high household income family. These findings indicates that the dietary intakes of energy and nutrients were inadequate, while the energy contribution from fat and dietary sodium intake were too high among the oldest-old in China. Most oldest-old were at high risk of nutritional deficiency, particularly for those who living in rural areas, with lower education level and from low household income.
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Affiliation(s)
| | | | | | | | | | | | - Hongyun Fang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (F.Z.); (L.H.); (L.Z.); (Q.G.); (D.Y.); (L.J.)
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Gupta A, Ramakrishnan L, Pandey RM, Sati HC, Khandelwal R, Khenduja P, Kapil U. Risk factors of anemia amongst elderly population living at high-altitude region of India. J Family Med Prim Care 2020; 9:673-682. [PMID: 32318402 PMCID: PMC7113975 DOI: 10.4103/jfmpc.jfmpc_468_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/01/2020] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Anemia is a major public health problem amongst elderly population in India. Anemia in old age further worsens the age-related decline in functional ability, mobility, fatigue, bone density, and skeletal muscle mass. There is lack of evidence on the prevalence and risk factors of anemia among elderly population. Hence, this study was undertaken. Methodology: A community-based cross-sectional study was conducted during the year 2015–2016 in District Nainital, Uttarakhand state, India. A total of 958 subjects were selected from 30 clusters (villages) identified using population proportional to size methodology. Information on sociodemographic profile, nutritional status, body mass index, and dietary intake was obtained. Blood sample was collected from each subject on the filter paper for estimation of hemoglobin (Hb) level using cyanmethemoglobin method. Results: We found that 92.1% of the elderly subjects were anemic. Moderate and severe anemia was found to be significantly higher among female subjects, unemployed, illiterates, subjects using smoke-producing fuel, subjects belonging to lower socioeconomic status, malnourished and underweight subjects, subjects with self-reported hyperacidity, and subjects who had not utilized health facility and had lower iron and vitamin C intake when compared with subjects with mild anemia and normal hemoglobin levels. Conclusion: High prevalence of anemia exists amongst elderly subjects living at high-altitude region of rural Uttarakhand State, India. There is a need to educate the elderly population about the importance of adequate intake of foods rich in iron and vitamin C to reduce the prevalence of anemia among them.
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Affiliation(s)
- Aakriti Gupta
- Department of Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Lakshmy Ramakrishnan
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Hem Chandra Sati
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ritika Khandelwal
- Department of Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Preetika Khenduja
- Department of Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Umesh Kapil
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
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Eating Habits in Older Adults: Compliance with the Recommended Daily Intakes and Its Relationship with Sociodemographic Characteristics, Clinical Conditions, and Lifestyles. Nutrients 2020; 12:nu12020446. [PMID: 32053923 PMCID: PMC7071317 DOI: 10.3390/nu12020446] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 01/25/2023] Open
Abstract
Background: Older people have different nutritional requirements from those of the general population; in particular, they need a lower energy intake, higher protein content to preserve muscle mass, and a greater supply of vitamins and minerals to maintain good bone health. The objective of this study is to evaluate the degree of compliance with nutritional recommendations, and its relationship with sociodemographic characteristics, clinical conditions, and lifestyles in older people residing in the Spanish Mediterranean. METHODS Cross-sectional study with 341 people over 60 years old. Participants were selected using a snowball strategy. A validated food intake frequency questionnaire for older populations was used to determine the daily food intake. This evaluation was carried out at two time points from which the average nutrient intake was obtained. Sociodemographic, clinical, and lifestyle variables were obtained from an ad hoc elaborated questionnaire. RESULTS Compliance with dietary intakes was low, by deficiency, such as in vitamin D, where none of the participating subjects met the requirements, and iodine, where the compliance rate did not exceed 20%, or by excess, such as with monounsaturated fatty acids, fiber, iron, B vitamins, vitamin E, and vitamin C. People with better blood pressure, cholesterol, and glucose levels observed a higher degree of compliance with the recommended intakes. Living in rural areas, being divorced, or being illiterate negatively influence meeting the recommended intakes of certain nutrients. Increased physical activity was associated with an increased compliance with Kcal recommendations, cholesterol, and vitamin B2 intake. CONCLUSION this study highlights the importance of accurately knowing the dietary intakes in the older population, and what factors, such as lifestyles or sociodemographic characteristics, may predispose to better or worse compliance with the recommendations.
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Candía S, Candia P, Mena RP, Durán Agüero S. [Food quality in the elderly population in Santiago of Chile]. Rev Esp Geriatr Gerontol 2019; 54:147-150. [PMID: 30770216 DOI: 10.1016/j.regg.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 12/27/2018] [Accepted: 01/07/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION With the increase in the elderly population of Chile, it is very important to evaluate the quality of food of this age group using simple and quick tools. OBJECTIVE To compare the food quality of the elderly, according to gender and age. MATERIAL AND METHODS A cross sectional study was conducted on 458 elderly subjects ≥60 years-old of Santiago de Chile. Each one of them were interviewed in their home using the Food Quality Survey for Elderly (FQSE). The objective of this survey is to measure the quality of the food and preparations considered healthy and/or unhealthy for elderly. Weight and height, was obtained from the control document of the elderly. RESULTS Men consume a higher number of unhealthy foods compared to women (P=.01). On comparing ages, those over 80 years-old consumed less unhealthy foods (P=.01). The elderly obese showed a lower score in unhealthy eating habits and total intake score. CONCLUSION Women eat healthier compared to men, and better eating habits are observed at an older age, especially in men. Finally, on comparing nutritional status, the elderly obese are those who eat in the most inadequate form.
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Affiliation(s)
- Sebastian Candía
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago, Chile
| | - Priscila Candia
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago, Chile
| | - Rafael Pizarro Mena
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Santiago, Chile
| | - Samuel Durán Agüero
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago, Chile.
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