When weight is an encumbrance; avoidance of stairs by different demographic groups

Frank F. Eves

doi:10.1371/journal.pone.0228044

Peer Review History

Original SubmissionOctober 2, 2019
20 Nov 2019 Decision Letter - Lee Smith, Editor PONE-D-19-27601 When weight is an encumbrance; avoidance of stairs by different demographic groups. PLOS ONE Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== This is a fine paper, however, one reviewer has requested minor revisions we would like you to address before acceptance. ============================== We would appreciate receiving your revised manuscript by Dec 26 2019 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This paper reports a literature review, and three new empirical studies, that together demonstrate that those for whom stair use is most physiologically costly are most likely to avoid using the stairs. The paper is well-written and the studies use a rigorous methodology, including direct observation of thousands of participants in real-world settings. The paper furthers understanding of reasons for stair use, or rather avoidance thereof, and has important implications for public health policy and practice. I have only very minor suggestions for improvement. Abstract: Please state explicitly the number of studies presented in the manuscript. Abstract, Discussion subsection: ‘minimization of physiological costs of transport-related walking biases behaviour towards avoidance of stairs when an alternative is available’. This statement seems an over-generalisation; presumably it is not just any ‘alternative’ that must be available, but rather a lower-cost alternative. Abstract and throughout paper: I found the term ‘lifestyle physical activity’ to describe stair use slightly awkward. While an accurate depiction, applying the term ‘lifestyle’ to the mundane act of climbing stairs has the effect (to me, at least) of inflating its importance and meaning to individuals. Might this be changed to ‘incidental physical activity’ or ‘instrumental physical activity’ instead? Abstract, Discussion subsection: Both here, and in the Conclusion, the author argues that observed striving to minimize costs ‘runs counter to public health initiatives’. Which initiatives, and how does cost minimisation conflict with such initiatives? This point could be expanded on in the General Discussion. Introduction, p4: The sentence beginning ‘For body weight, all physical activity contributes…’ is difficult to comprehend. Please simplify. Introduction, p4: What is meant by the term ‘in the field’ in the first paragraph? Can this be deleted? Preliminary study: This study summarises a ‘preliminary literature review’, but the methods used to conduct the review are not reported. Assuming this review was carried out for the purpose of this paper, the sources within the literature review should be explicitly stated, together with an indication of the process of identifying these sources. Preliminary study, p6: The author reports here that while ‘nine studies reported that females avoided stairs more than males, five reported the opposite disparity’. Why should the opposite disparity have been found? This seems at odds with the arguments forwarded in the Introduction regarding groups most likely to avoid stair use, so should be considered in more depth. Study 1, p11: Replace the term ‘no significant effect’ with ‘no effect’. Reviewer #2: Excellent paper, very minor comments included. Abstract: "This minimization of costs runs counter to public health initiatives that targets weight gain." Please specify what "this minimization of costs" strands for. Gender and sex: throughout the paper, please check for consistency and use sex (male/female) or gender (men and women) or clearly define the different use of each. Currently sex and gender seem to be used interchangeably. Method: pleaae define "large bags" ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. 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Revision 1
5 Dec 2019 Author Response I thank the reviewers, and the editor, for their generally positive comments. I have responded to each of query below. Reviewer #1: This paper reports a literature review, and three new empirical studies, that together demonstrate that those for whom stair use is most physiologically costly are most likely to avoid using the stairs. The paper is well-written and the studies use a rigorous methodology, including direct observation of thousands of participants in real-world settings. The paper furthers understanding of reasons for stair use, or rather avoidance thereof, and has important implications for public health policy and practice. I have only very minor suggestions for improvement. I thank the reviewer for their kind comments. Abstract: Please state explicitly the number of studies presented in the manuscript. Now included in the abstract as requested. Abstract, Discussion subsection: ‘minimization of physiological costs of transport-related walking biases behaviour towards avoidance of stairs when an alternative is available’. This statement seems an over-generalisation; presumably it is not just any ‘alternative’ that must be available, but rather a lower-cost alternative. I can understand why the reviewer queries this statement. While the first two studies entail minimization of the energetic costs of active transport, choosing a ramp to ascend increases both energetic and temporal costs at both locations in the final study. In this case, it is likely that rate of expenditure is the key variable as I explain in the associated discussion section. Abstract and throughout paper: I found the term ‘lifestyle physical activity’ to describe stair use slightly awkward. While an accurate depiction, applying the term ‘lifestyle’ to the mundane act of climbing stairs has the effect (to me, at least) of inflating its importance and meaning to individuals. Might this be changed to ‘incidental physical activity’ or ‘instrumental physical activity’ instead? I understand the reviewer’s concern here and have changed the usage to either ‘the lifestyle physical activity of active transport’ or ‘incidental physical activity of stair climbing/usage as part of daily life’. The paper reports a bias to avoid stairs as a result of extra weight carried. This is true for both climbing and the less intense activity of stair descent. Such a bias is also seen for the only experimental data for walking on the level (Levine et al., 2008) and the epidemiological studies of Metcalf et al., (2011) and Ekelund et al., (2008) that demonstrate that extra weight reduces what are termed ‘objective measures’ of physical activity. Observational studies of stair use allow a test of the biasing effects of extra weight carried because of the ability to clearly identify the behavioural choice made. I think that these effects generalise and have made this point explicitly in the discussion section (page 22, line 289–292, page 23 line 295-298). I thank the reviewer for the greater clarity about my underlying assumptions and the implications of the data resulting from this requested clarification. Abstract, Discussion subsection: Both here, and in the Conclusion, the author argues that observed striving to minimize costs ‘runs counter to public health initiatives’. Which initiatives, and how does cost minimisation conflict with such initiatives? This point could be expanded on in the General Discussion. I apologise for the oversight. I now make explicit in the general discussion that increased physical activity is a current target of public health in the developed world and provide appropriate references (page 23, line 311-314). Introduction, p4: The sentence beginning ‘For body weight, all physical activity contributes…’ is difficult to comprehend. Please simplify. I have reworded the sentence to read ‘For body weight, all physical activity requires energy expenditure that counters intake that can lead to weight gain.’ I hope this is now clearer. Introduction, p4: What is meant by the term ‘in the field’ in the first paragraph? Can this be deleted? I have removed the phrase and replaced it with ‘outside the laboratory’ to make explicit that this was not a laboratory study but rather one that used an 11-story building. Preliminary study: This study summarises a ‘preliminary literature review’, but the methods used to conduct the review are not reported. Assuming this review was carried out for the purpose of this paper, the sources within the literature review should be explicitly stated, together with an indication of the process of identifying these sources. The information about the process and sources for the preliminary literature review are presented in the supplementary file S1. Preliminary study, p6: The author reports here that while ‘nine studies reported that females avoided stairs more than males, five reported the opposite disparity’. Why should the opposite disparity have been found? This seems at odds with the arguments forwarded in the Introduction regarding groups most likely to avoid stair use, so should be considered in more depth. I agree with the reviewer that greater avoidance in men is puzzling. I have no clear explanation but have inserted the sentence. ‘The anomalies of greater avoidance in men might reflect differing locations by gender of meaningful journey ends within the building.’ (page 6, line 137ff). Study 1, p11: Replace the term ‘no significant effect’ with ‘no effect’. I have resisted this suggestion. The OR of 1.14, (95% CI = 0.99, 1.32, p=0.08) is close to significance and I feel that the unqualified ‘no effect’ would be misleading. Reviewer #2: Excellent paper, very minor comments included. I thank the reviewer for their kind comment. Abstract: "This minimization of costs runs counter to public health initiatives that targets weight gain." Please specify what "this minimization of costs" strands for. The sentence has been altered to now read ‘This minimisation of physical activity costs runs counter to public health initiatives to increase activity to improve population health.’ Gender and sex: throughout the paper, please check for consistency and use sex (male/female) or gender (men and women) or clearly define the different use of each. Currently sex and gender seem to be used interchangeably. I thank the reviewer for their vigilance. I have amended the manuscript to make explicit that I am referring to sex. Method: pleaae define "large bags" I now make explicit that ‘large bags were sizes greater than a briefcase or small rucksack.’ Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0228044.r002
7 Jan 2020 Decision Letter - Lee Smith, Editor When weight is an encumbrance; avoidance of stairs by different demographic groups. We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements. Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication. Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. With kind regards, Lee Smith Academic Editor PLOS ONE Additional Editor Comments (optional): Thank you for adequately responding to the reviewer comments. I have now recommended that this paper is accepted. Reviewers' comments: https://doi.org/10.1371/journal.pone.0228044.r003
Formally Accepted
8 Jan 2020 Acceptance Letter - Lee Smith, Editor PONE-D-19-27601R1 When weight is an encumbrance; avoidance of stairs by different demographic groups. Dear Dr. Eves: I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. For any other questions or concerns, please email plosone@plos.org. Thank you for submitting your work to PLOS ONE. With kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Lee Smith Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0228044.r004

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