Assessment of Eating Habits and Perceived Benefits of Physical Activity and Body Attractiveness among Adolescents from Northeastern Romania
, Ioan Gotcă 2,*, Veronica Mocanu 2,*, Veronica Popescu 3, Maria-Liliana Iliescu 4, Egidia-Gabriela Miftode 5 and Vasile-Lucian Boiculese 4Round 1
Reviewer 1 Report
The paper consists of an observational study conducted on 1320 adolescents from 4 high schools in Iaşi, Romania, aimed at evaluating their eating habits, physical activity, and body image perceptions.
This is a basic investigation, where some criticisms can be highlighted.
MAJOR POINTS:
- Although underlined by the authors in the “Strengths and limitations of the study” Section, any information on the socio-economic status is lacking. However, this is an important issue to be addressed, because of the impact that social, cultural, and economic aspects have on eating habits.
- No information is available concerning questions present in the food questionnaire. Some food categories are lacking. What about fish? What about legumes? And, more importantly, what about red processed meat?
- Another major concern is about body image perception. Since a significant percentage of the sample were not in the normal BMI range (26.87% girls were underweight and 11.11% boys were overweight), it would have been interesting to investigate if the condition of underweight/overweight/obesity (assessed through the BMI) matched or not with the perception of adolescent real situation (in practice if there was or not a distortion of his/her image).
MINOR POINTS:
It would be better to show (in Text and Tables) the BMI range defining the condition of normal weight, under-/over-weight, and obesity.
Author Response
We thank the Referees for their interest in our work and for helpful comments that will greatly improve the manuscript.
- We added information:
The selected schools included students from similar socioeconomic groups.
- We added information:
”The short diet quality screener (sDQS) was used to estimate overall diet quality [6]. In this study, participants were asked to report their habitual intake of (i) cereals; (ii) vegetables; (iii) fruit; (iv) dairy products; (v) red meat, poultry, and fish; (vi) meat substitutes; (vii) sweetened foods; (viii) alcoholic beverages; (ix) drinks with caffeine and (x) fast food. Standardized portion sizes were used to quantify the frequency of food intake. Food frequency consumption was arranged in three frequency response categories: (i) ‘recommended daily consumption’, ‘more than recommended daily consumption’ and ‘less than recommended daily consumption’ according to Romanian nutrition guidelines [7].”
- We added information:
”In our study, we established the upper percentile for the subscale body attractiveness of the physical self-perception scale (score>21) to indicate adolescents who perceive that they have an attractive body. According to BMI, 84.8% of the underweight group, 86.7% of the normal weight group, 73.5% of the overweight group and 56.7% of the obesity group considered their body to be attractive.”
MINOR POINTS:
We made the changes.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
In the manuscript „Assessment of eating habits, physical activity, and body image perceptions among adolescents from North-Eastern Romania” the Authors tried to determine the association between eating habits, physical activity, and body image perceptions among adolescents from high schools in Romania. The advantage of the study is a large group of adolescents and an important topic.
However, I have a lot of remarks.
The first general concern is that we need to use consistent phrases. The Authors used eating habits, eating behavior, food intake or diet. Thus, the Authors should improve that to avoid unnecessary confusion.
In keywords, the Authors wrote „eating behavior”, but in the title is „eating habits”. It is not proper.
Introduction;
I do not understand why the Authors described goals of nutritional education. The Authors did not study level of nutritional education and its effect on eating habits, physical activity, and body image perceptions. The Authors even did not describe some characteristics in the Introduction. The review of literature is not enough. Thus, the introduction needs to be re-written with that in mind.
Materials and Methods;
What was the draw type?
What were the questionnaire? Were the tools validated? I do not know anything about tools.
What categories of consumption frequency?
How last the study?
What were the inclusion and exclusion criteria?
I could not do again your study. The Methods must be described, that I may do the same.
Results;
Why the Authors did not put Chi2 and p-value results in tables? I would like to see it. The Results can be shorter. The Authors should focus on the most important things.
Discussion;
Actually, the discussion starts in 201 line. All before are results. In discussion, we compare our results with results of previous study at the same topic. We lead research discussion, not repeat results.
References;
The Authors found only 13 positions. Really, was not more?
Author Response
We thank the Referees for their interest in our work and for helpful comments that will greatly improve the manuscript.
- 1. We correct the key words:
”eating habits”
- We added information in Introduction section.
- We added information in Materials and Methods
”This was a cross-sectional study, and it was performed with the participation of adolescents enrolled in four high schools located in Iasi city, Northeastern region of Romania. The schools were selected randomly. The studysample included 1320 adolescents 14-18 years old and written assent from adolescents and written informed consent from legal guardians was obtained. Data collection was done via a face-to-face interview based on a structured, pre-tested questionnaire between January 2016 and December 2018. The participants completed anonymously the questionnaire in their classrooms at school under the guidance of the interviewers and the teachers. The information was obtained via a questionnaire that was administered and which was divided into three sections as follows: (1) Food frequency questionnaire-The short diet quality screener; (2) Revised Profile of Physical Self-perception; (3) Physical activity.
The short diet quality screener (sDQS) was used to estimate overall diet quality [6]. In this study, participants were asked to report their habitual intake of (i) cereals; (ii) vegetables; (iii) fruit; (iv) dairy products; (v) red meat, poultry, and fish; (vi) meat substitutes; (vii) sweetened foods; (viii) alcoholic beverages; (ix) drinks with caffeine and (x) fast food. Standardized portion sizes were used to quantify the frequency of food intake. Food frequency consumption was arranged in three frequency response categories: (i) ‘recommended daily consumption’, ‘more than recommended daily consumption’ and ‘less than recommended daily consumption’ according to Romanian nutrition guidelines [7].
Revised Physical Self-Perception Profile (PSPP-R) the six-item subscale of the body (perceived bodily attractiveness), was used to measure physical self-esteem [8]. Perceived benefits of physical activity were assessed using a scale consisting of 10 statements relating to its effects on health. The subjects’ task was to assess their accuracy on a scale of 1 (definitely false) to 4 (definitely true).”
4. We added Pearson's chi-squared test in the table for the significant differences
5. We added more information to the Discussions and References.
Author Response File: Author Response.pdf
Reviewer 3 Report
The Authors should provide more information in Materials and Methods about what answers the students may have chosen in the questionnaire. What kind of scale did the authors use to evaluate the frequency of the consumption. What kind of questions was in section Profile of Physical Self-perception - drawing or descriptive? What kind of questionnaire was used to describe the physical activity level?
It should be better to give the information about p-value in all tables in section Results.
In my opinion, the work is well composed, but it does not bring much new to the world of science because the problem occurs in most countries, and perhaps in all of them, has been described for many years, and the results are similar. In connection with the above, I believe that the amount of literature in this manuscript should be much more numerous, so the authors should edit the Discussion.
Author Response
We thank the Referees for their interest in our work and for helpful comments that will greatly improve the manuscript.
- We added information in Materials and Methods
”This was a cross-sectional study, and it was performed with the participation of adolescents enrolled in four high schools located in Iasi city, Northeastern region of Romania. The schools were selected randomly. The studysample included 1320 adolescents 14-18 years old and written assent from adolescents and written informed consent from legal guardians was obtained. Data collection was done via a face-to-face interview based on a structured, pre-tested questionnaire between January 2016 and December 2018. The participants completed anonymously the questionnaire in their classrooms at school under the guidance of the interviewers and the teachers. The information was obtained via a questionnaire that was administered and which was divided into three sections as follows: (1) Food frequency questionnaire-The short diet quality screener; (2) Revised Profile of Physical Self-perception; (3) Physical activity.
The short diet quality screener (sDQS) was used to estimate overall diet quality [6]. In this study, participants were asked to report their habitual intake of (i) cereals; (ii) vegetables; (iii) fruit; (iv) dairy products; (v) red meat, poultry, and fish; (vi) meat substitutes; (vii) sweetened foods; (viii) alcoholic beverages; (ix) drinks with caffeine and (x) fast food. Standardized portion sizes were used to quantify the frequency of food intake. Food frequency consumption was arranged in three frequency response categories: (i) ‘recommended daily consumption’, ‘more than recommended daily consumption’ and ‘less than recommended daily consumption’ according to Romanian nutrition guidelines [7].
Revised Physical Self-Perception Profile (PSPP-R) the six-item subscale of the body (perceived bodily attractiveness), was used to measure physical self-esteem [8]. Perceived benefits of physical activity were assessed using a scale consisting of 10 statements relating to its effects on health. The subjects’ task was to assess their accuracy on a scale of 1 (definitely false) to 4 (definitely true).”
2. We added Pearson's chi-squared test in the table for the significant differences
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
The authors replied to all points.
Now the manuscript can be accepted.
Reviewer 2 Report
The Authors answered to all remarks. Thank you for your work.
Reviewer 3 Report
The Authors corrected the suggestions. However, in my opinion, the originality of the manuscript is still low.
