Authors:
T. Biczók Doctoral School of Pathological Sciences, Semmelweis University, Budapest, Hungary

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Sz. Kassai Institute of Psychology, Eötvös Lóránd University, Budapest, Hungary

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V. A. Gyarmathy Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

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Abstract

Purpose

There has been a recent increase in interest in chia seeds as a growing number of people try to observe a healthy lifestyle, particularly healthy eating habits. Given the increasing popularity of chia seeds in Hungary as well, we performed a study to examine what information on chia seeds is available on Hungarian websites.

Materials and Methods

We conducted a systematic, qualitative content analysis to examine the first 200 Hungarian results of a Google search on “chia seeds”.

Results

We identified five main topics: 1. general information, 2. effects/side-effects, 3. modes of preparation, 4. target audience, and 5. tone of the article. Sometimes information (especially on the effects) was presented in a sensationalist manner, and some claims were not scientifically well-founded, but rather based on subjective opinion.

Conclusions

In the online media, chia seed consumption was mainly recommended for those who are trying to lose weight and for diabetics, even though there is currently no proof that it can improve the condition of such people. Further studies are needed to demonstrate and confirm claims related to the beneficial effects of the chia seed. Until this has been done, readers of Google-search results – especially those who have a health condition – should be cautious about certain statements published on non-scientific websites.

Abstract

Purpose

There has been a recent increase in interest in chia seeds as a growing number of people try to observe a healthy lifestyle, particularly healthy eating habits. Given the increasing popularity of chia seeds in Hungary as well, we performed a study to examine what information on chia seeds is available on Hungarian websites.

Materials and Methods

We conducted a systematic, qualitative content analysis to examine the first 200 Hungarian results of a Google search on “chia seeds”.

Results

We identified five main topics: 1. general information, 2. effects/side-effects, 3. modes of preparation, 4. target audience, and 5. tone of the article. Sometimes information (especially on the effects) was presented in a sensationalist manner, and some claims were not scientifically well-founded, but rather based on subjective opinion.

Conclusions

In the online media, chia seed consumption was mainly recommended for those who are trying to lose weight and for diabetics, even though there is currently no proof that it can improve the condition of such people. Further studies are needed to demonstrate and confirm claims related to the beneficial effects of the chia seed. Until this has been done, readers of Google-search results – especially those who have a health condition – should be cautious about certain statements published on non-scientific websites.

Introduction

In recent years, a growing number of people try to observe a healthy lifestyle, particularly healthy eating habits. Chia seeds offer a promising opportunity in the context of a healthier diet [1, 2]. The flowery chia plant (Salvia hispanica L. – also referred to as Aztec sage or Spanish sage) originates from Middle and South America and belongs to the Lamiacea family. Its height can reach up to 1 m. The leaves of the chia plant grow opposite of each other, and the tiny flowers (3–4 mm) can bloom in numerous shades of colour from white to purple. Chia seeds are oval and about 1–2 mm in size, and may be white, black, or grey, or have mottled tones [1, 3].

Chia seeds were already being used for nutritional purposes 3,500 years ago, and they were an especially important in Middle-Mexico [1]. Aztecs and Mayans made medications, foods, and inks out of them. Before Columbus, chia seeds were one of the three main food items, besides corn and beans. People ate chia seeds whole or ground, and also extracted the oil, which was the main ingredient for body and face inks. Chia seeds had an important role in Aztec society: the subjugated peoples of the monarch paid taxes with chia seeds, and they were offered to the gods in religious rituals [1].

The chia seed is about 15–25% protein, 30–33% fat and 26–41% carbohydrates. It has a fibre content of 18–30% and is also rich in minerals, vitamins, and dry matter (90–93%). As an oily seed, it contains a significant amount of omega-3 and omega-6 fatty acids, and its antioxidant properties are also outstanding. Analytical studies have revealed that its heavy-metal content is under the safety limit, and it is free of mycotoxin and gluten [3, 4]. Although there are many claims about the chia seed's health benefits, only a few have been scientifically proven [1]. Still, due to its chemical composition and nutritive value, the chia seed represents a huge potential in several regions around the globe, in the areas of human nutrition, animal feed, medicine, cosmetics, and pharmaceutics [1, 4]. Since Internet research is an important complementary method to traditional research [5], and given the increasing popularity of the chia seed in Hungary, we conducted research to determine what information on chia seeds is available on Hungarian websites.

Materials and methods

We used systematic qualitative content analysis to review the first 200 Hungarian results of a Google (www.google.hu) search on “chia mag”. In order to simulate the average web user as accurately as possible, we did not apply filters that would have modified the list of results. To exclude potential biases that might have resulted from Google's personalized operations, we conducted searches on 6 different computers and compared the results. The systematic qualitative content analysis is used to identify themes and patterns of data. It is often used in psychology because it is flexible enough to reach both the semantic and latent content of uncountable data [6], while it can also be used to explore research areas for which there is no preliminary information [7]. In the current study, we applied this method to assess information about chia seeds delivered by Hungarian websites, in order to better understand user interest in and general knowledge about chia seeds, and chia seed consumption patterns. The systematic, qualitative content analysis treats the emerging data sensitively, through five steps of analysis: 1. Familiarisation with the data 2. Generation of initial codes 3. Searching for themes 4. Reviewing themes, and 5. Defining and naming themes [6]. Accordingly, we read the resulting articles carefully and looked for main topics and formulae. During the analysis, we created primary codes, which give the same importance to every element of the text [6]. We then manually organized the primary codes into secondary categories. The primary codes and secondary categories were first created subjectively by the individual researchers, then, as a team, we discussed and aggregated and incorporated any divergent codes and categories. The final validation was performed by the team based on team discussion. We reread the articles to check the validity of the codes and topics and created new codes and topics where necessary. Then we selected quotes from the websites which we thought represented the identified topics [6, 7].

Results

The following five main topics were identified in the qualitative content analysis: 1. general information, 2. effects/side-effects, 3. modes of preparation, 4. target audience, and 5. tone of the article.

  1. General information

Most sites on the chia seed conveyed general information. These websites frequently talked about the plant's (1) history, (2) general description, and (3) nutrient content:

“Aztec and Mayan records show that the chia seed was used as food already in 3500 BC. It was also called runners' food, mainly because it was a good nutrition source for long hunting days. It was used as a grain, or oil was pressed out of it. People paid with it as tax for the emperors. On religious rituals it was offered to the gods and was also used as face and body paint.”

“The Salvia Hispanica (Aztec sage) comes from Middle and South America and belongs to the mints' family. This flowery plant has a short stem and oblong, oval shaped leaves. Its violet-blue flowers bloom from July to September, and the tiny black seeds ripen from August to September.”

The majority of the sites we examined referred to the nutrient composition of chia seeds, but quantifiable data referring to 100 g of the seed was indicated on only about one in ten web pages. Even though many web pages indicated a specific number, the recommended consumption was specified mostly in teaspoons as measurement units:

“Six teaspoons of chia seeds contain 138 calories, 4.6 grams of protein, and 8.7 grams of carbohydrates and 9.8 grams of fibre."

The recommended serving amounts also varied from 2 coffee spoons to 6 teaspoons.

Since chia is primarily advertised as a weight-loss panacea, claims on calorie content appear in almost every description, including data on calories, carbohydrates, fat, and fibre amounts. We found an extreme claim, which declared that there were virtually no calories in it:

“When chia seeds are in water, they become jellified, they swell, and the weight increases. The gel is made up of water, has no calories in it, and a message is sent to the body that you ate enough – and all without increasing calorie intake!”

In some other articles, we found energy values between 400 and 486 kcal per 100 g of chia seeds. On a few websites, the carbohydrate amount of chia seeds was shown to range from 2.0 g to 42.2 g per 100 g. The most frequent data for protein and fat content were 21.1 g and 31.4 g, respectively, and for fibre, it varied between 31.4 g and 38.0 g per 100 g.

  1. 2.Effects/Side-effects

The nutritional benefits were detailed in most articles, but without referring to scientific resources or research. One often emphasized effect was the prevention of cardiovascular and heart diseases through cholesterol regulation. A blood-sugar-regulation effect for diabetics was also often mentioned. Others effect described were improved digestion through the elimination of constipation, cleaner bowels (due to the chia seed's high fibre content), a slowing of the ageing process, and the prevention of tumours (due to the seed's antioxidant content).

“It is advisable to increase the dose gradually, because consuming large amounts may have – even if rarely – certain side-effects and may alter the effect of certain drugs (such as diabetic, anti-hypertensive, and anticoagulant medications).”

  1. 3.Modes of preparation

A considerable proportion of the analysed articles provided recommendations on chia seed recipes and modes of preparation. Chia seeds can be used as a basic ingredient in pudding or jelly, or to enrich foods with fibres, vitamins, and minerals. They can also be added as a thickening or gelling agent to yoghurts, cereals, soups, and shakes, and they can also be used for making salad dressings, sauces, or even cakes.

  1. 4.Target audience

The analysed sites almost always included target groups for whom the consumption of the chia seed was particularly recommended. Most sites generally recommended it for everyone, but particularly for athletes, those who want to lose weight, and patients with diabetes, gluten sensitivity, or cardiovascular diseases. Most of the information, however, consisted of subjective opinions and personal accounts, and no scientific sources or references were given.

  1. 5.The tone of the articles

Most articles had chia seed advertisements, so their tone was often sensationalist. The articles seemed to have the intention to reach everyone and to offer solutions for many types of problems, symptoms, and diseases. Those sites that claimed the chia seed was a “superfood” were usually web shops where products – including chia seeds – could be ordered.

Discussion

Systematic qualitative content analysis revealed the following five main topics: general information, interaction/side effects, and modes of preparation, target audience, and tone of the article.

The web sites we assessed mentioned a wide range of nutrient content. Muñoz et al. [1] conducted a literature review of the chia seed's nutrient content, which showed that the energy content is 486 kcal per 100 g [1]. Several of the sites that we assessed mentioned values considerably lower than that, especially the one that told readers that the chia seed was calorie-free. Muñoz et al. [1] stated the carbohydrate content was 42.2 g per 100 g – but the sites we assessed described it to be between 2.0 and 42.2 g. This unreliable information about the carbohydrate content may be particularly dangerous since many sites recommend this “superfood” mostly to diabetics [1]. In addition, the web sites mentioned higher values for protein (21.2 g vs. 16.5 g) and fat (31.4 g vs. 20.7 g) and a comparable range for fibre content (31.4 g–38 g vs. 34 g).

According to Nieman et al. [8], the chia seed is the richest plant source of alpha-linolenic acid (a type of omega-3 fatty acid), which improves blood cholesterol level. Their study describes an experiment in which laboratory rats were divided into two groups: one group was fed with corn oil and the other with chia seed oil. At the end of the study period, the researchers tested the animals' total, high density (HDL), and low density (LDL) cholesterol levels. The results showed that the animals that were fed the chia seeds had significantly higher levels of HDL (“good cholesterol”) and total cholesterol than those rats that were given corn oil.

Two randomized controlled trials have also been conducted to assess the assumed weight-loss effects of chia seeds, but neither was able to confirm this assumption. Nieman et al. [8] enrolled 76 overweight and obese men and women aged between 20 and 70 in an experiment and divided them randomly into two groups. The first group received 25 g of chia seeds soaked in 250 ml of water twice a day, before their first and the last meal of the day, while the other group received a placebo. After 12 weeks the researchers did not find any significant difference between the body weights of the two groups. Another study [9] not only was unable to confirm the weight loss effect of the chia seed but also failed to demonstrate other claimed health benefits, such as an improved cardiovascular system. The authors concluded that chia seeds can be a healthy addition to the diet, but that selling the seed as a nutritional supplement is not yet scientifically well-founded, and further research is needed to explore its beneficial properties.

Limitations

The current study has several limitations. First, we analysed only the first 200 Google results, and therefore we may have missed other relevant pages with different information content, thereby biasing our study results. However, research shows that 90% of people read only the organic listings on the first page of the Google results and that very few advance to further pages [10]. Given how page placement varies over time, especially with a relatively new search term, and the need to get a large enough sample, analysing the first 200 results appears to be a good approach. Although it is unlikely that the average user will find a website in the results shown in the first 200 results on one computer that is not included in the first 200 results on another computer, we cannot guarantee this without a doubt. Another limitation is that we did not eliminate those results that give less well-founded information. Those results are also part of the sample, but the aim of the study was to assess what information can be found on the Internet. An additional limitation is that the results are in Hungarian because the members of the research group are Hungarians. Therefore, different online information may be available in other languages, so our results are not necessarily representative of the content of websites in other languages.

Conclusions

In the current study, we assessed what information is available on Hungarian websites about chia seeds. We found that sometimes information was presented in a sensationalist tone and that some claims were not scientifically well-founded, but rather based on opinion. In the online media, chia seed consumption was mainly recommended for those who are trying to lose weight and for diabetics, even though it has not been proven to have a beneficial effect for such people. Further studies are needed to demonstrate and confirm claims related to the beneficial effects of the chia seed. Until these are conducted, readers – especially those who have a health condition – should be cautious about certain statements published on non-scientific web pages.

Authors' contribution

TB collected and summarized the data, wrote and translated the sections of the manuscript. SzK summarized the scientific background of the research and contributed to the writing of the manuscript. VAGy supervised the study, reviewed and finalized the manuscript.

Conflicts of interest/Funding

The authors declare no conflict of interest. No financial support was received for this study.

Acknowledgements

We are grateful for the help and contribution of Erika Alföldi, Fanni Romhányi and Blanka Vékony during this study.

Oral presentation at the 13th Conference of the Hungarian Medical Association of America – Hungary Chapter (HMAA-HC) at 30–31 August 2019, in Balatonfüred, Hungary.

Conflicts of interest. The authors declare no conflict of interest.

Funding. No financial support was received for this study.

Authors' contribution. TB collected and summarized the data, wrote and translated the sections of the manuscript. SzK summarized the scientific background of the research and contributed to the writing of the manuscript. VAGy supervised the study, reviewed and finalized the manuscript.

References

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    Felisberto MHF, Wahanik AL, Gomes-Ruffi CR, Clerici MTPS, Chang YK, Steel CJ. Use of chia (Salvia hispanica L.) mucilage gel to reduce fat in pound cakes. Food Sci Tech 2015;63(2):104955. https://doi.org/10.1016/j.lwt.2015.03.114.

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    Pelbát G, Gyarmathy VA, Bacsó Á, Bartos E, Bihari A, Rácz J. Portrayal of new psychoactive substances in the hungarian online media. Int J Ment Health Ad 2017;15:1107. https://doi.org/10.1007/s11469-015-9629-z.

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  • 8.

    Nieman DC, Cayea EJ, Austin MD, Henson DA, McAnulty SR, Jin F. Chia seed does not promote weight loss or alter disease risk factors in overweight adults. Nutr Res 2009;29(6):4148. https://doi.org/10.1016/j.nutres.2009.05.011.

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  • 9.

    Ulbricht C, Chao W, Nummy K, Rusie E, Tanguay-Colucci S, Iannuzzi CM, et al. Chia (Salvia hispanica): a systematic review by the natural standard research collaboration. Rev Recent Clin Trials 2009;4(3):16874.

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  • 10.

    Sharp E. The First Page of Google, by the Numbers [Internet]. Orlando: ProtoFuse, B2B Marketing Agency for Technology Companies; 2014 April [cited 2019 September 26]. Available from: https://www.protofuse.com/blog/first-page-of-google-by-the-numbers.

    • Search Google Scholar
    • Export Citation
  • 1.

    Muñoz LA, Cobos A, Diaz O, Aguilera JM. Chia seed (Salvia hispanica): an ancient grain and a new functional food. Food Rev Int 2013;29(4):394408. https://doi.org/10.1080/87559129.2013.818014.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Pintado T, Herrero AM, Jiménez-Colmenero F, Ruiz-Capillas C. Strategies for incorporation of chia (Salvia hispanica L.) in frankfurters as a health-promoting ingredient. Meat Sci 2016;114:7584. https://doi.org/10.1016/j.meatsci.2015.12.009.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Mohd Ali N, Yeap SK, Ho WY, Beh BK, Tan SW, Tan SG. The promising future of chia, Salvia hispanica L. J Biomed Biotechnol 2012:171956. https://doi.org/10.1155/2012/171956.

    • Search Google Scholar
    • Export Citation
  • 4.

    Felisberto MHF, Wahanik AL, Gomes-Ruffi CR, Clerici MTPS, Chang YK, Steel CJ. Use of chia (Salvia hispanica L.) mucilage gel to reduce fat in pound cakes. Food Sci Tech 2015;63(2):104955. https://doi.org/10.1016/j.lwt.2015.03.114.

    • Search Google Scholar
    • Export Citation
  • 5.

    Pelbát G, Gyarmathy VA, Bacsó Á, Bartos E, Bihari A, Rácz J. Portrayal of new psychoactive substances in the hungarian online media. Int J Ment Health Ad 2017;15:1107. https://doi.org/10.1007/s11469-015-9629-z.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3(2):77101. https://doi.org/10.1191/1478088706qp063oa.

  • 7.

    Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24(2):10512.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Nieman DC, Cayea EJ, Austin MD, Henson DA, McAnulty SR, Jin F. Chia seed does not promote weight loss or alter disease risk factors in overweight adults. Nutr Res 2009;29(6):4148. https://doi.org/10.1016/j.nutres.2009.05.011.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Ulbricht C, Chao W, Nummy K, Rusie E, Tanguay-Colucci S, Iannuzzi CM, et al. Chia (Salvia hispanica): a systematic review by the natural standard research collaboration. Rev Recent Clin Trials 2009;4(3):16874.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Sharp E. The First Page of Google, by the Numbers [Internet]. Orlando: ProtoFuse, B2B Marketing Agency for Technology Companies; 2014 April [cited 2019 September 26]. Available from: https://www.protofuse.com/blog/first-page-of-google-by-the-numbers.

    • Search Google Scholar
    • Export Citation
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Senior Editors

Editor-in-Chief: Zoltán Zsolt NAGY
Vice Editors-in-Chief: Gabriella Bednárikné DÖRNYEI, Ákos KOLLER
Managing Editor: Johanna TAKÁCS
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Editorial Board

  • Zoltán BALOGH (Department of Nursing, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Klára GADÓ (Department of Clinical Studies, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • István VINGENDER (Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Attila DOROS (Department of Imaging and Medical Instrumentation, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Judit Helga FEITH (Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Mónika HORVÁTH (Department of Physiotherapy, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Illés KOVÁCS (Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Ildikó NAGYNÉ BAJI (Department of Applied Psychology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Tamás PÁNDICS (Department for Epidemiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • József RÁCZ (Department of Addictology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Lajos A. RÉTHY (Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • János RIGÓ (Department of Clinical Studies in Obstetrics and Gynaecology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Andrea SZÉKELY (Department of Oxyology and Emergency Care, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Márta VERESNÉ BÁLINT (Department of Dietetics and Nutritional Sicences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Gyula DOMJÁN (Department of Clinical Studies, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Péter KRAJCSI (Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • György LÉVAY (Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Csaba NYAKAS (Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Vera POLGÁR (Department of Morphology and Physiology, InFaculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • László SZABÓ (Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Katalin TÁTRAI-NÉMETH (Department of Dietetics and Nutrition Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Katalin KOVÁCS ZÖLDI (Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • Gizella ÁNCSÁN (Library, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary)
  • András FALUS (Department of Genetics, Cell- and Immunbiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary)
  • Zoltán UNGVÁRI (Department of Public Health, Faculty of medicine, Semmelweis University, Budapest, Hungary)
  • Romána ZELKÓ (Faculty of Pharmacy, Semmelweis University, Budapest, Hungary)
  • Mária BARNAI (Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary)
  • László Péter KANIZSAI (Department of Emergency Medicine, Medical School, University of Pécs, Pécs, Hungary)
  • Bettina FŰZNÉ PIKÓ (Department of Behavioral Sciences, Faculty of Medicine, University of Szeged, Szeged, Hungary)
  • Imre SEMSEI (Faculty of Health, University of Debrecen, Debrecen, Hungary)
  • Teija-Kaisa AHOLAAKKO (Laurea Universities of Applied Sciences, Vantaa, Finland)
  • Ornella CORAZZA (University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom)
  • Oliver FINDL (Department of Ophthalmology, Hanusch Hospital, Vienna, Austria)
  • Tamás HACKI (University Hospital Regensburg, Phoniatrics and Pediatric Audiology, Regensburg, Germany)
  • Xu JIANGUANG (Shanghai University of Traditional Chinese Medicine, Shanghai, China)
  • Paul GM LUITEN (Department of Molecular Neurobiology, University of Groningen, Groningen, Netherlands)
  • Marie O'TOOLE (Rutgers School of Nursing, Camden, United States)
  • Evridiki PAPASTAVROU (School of Health Sciences, Cyprus University of Technology, Lemesos, Cyprus)
  • Pedro PARREIRA (The Nursing School of Coimbra, Coimbra, Portugal)
  • Jennifer LEWIS SMITH (Collage of Health and Social Care, University of Derby, Cohehre President, United Kingdom)
  • Yao SUYUAN (Heilongjiang University of Traditional Chinese Medicine, Heilongjiang, China)
  • Valérie TÓTHOVÁ (Faculty of Health and Social Sciences, University of South Bohemia, České Budějovice, Czech Republic)
  • Tibor VALYI-NAGY (Department of Pathology, University of Illonois of Chicago, Chicago, IL, United States)
  • Chen ZHEN (Central European TCM Association, European Chamber of Commerce for Traditional Chinese Medicine)
  • László FÖLDVÁRI-NAGY (Department of Morphology and Physiology, Semmelweis University, Budapest, Hungary)

Developments in Health Sciences
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Developments in Health Sciences
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