Associations of alcohol consumption and physical activity with lean type 2 diabetes mellitus among Korean adults: A prospective cohort study

Inkyung Baik; Sang Ick Park

doi:10.1371/journal.pone.0238641

Peer Review History

Original SubmissionFebruary 2, 2020
29 May 2020 Decision Letter - Petri Böckerman, Editor PONE-D-20-03085 Associations of alcohol consumption and physical activity with lean type 2 diabetes mellitus among Korean adults: A prospective cohort study PLOS ONE Dear Dr. Baik, 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. The revised version should address all comments in the reports. Please submit your revised manuscript by Jul 13 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're 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. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Petri Böckerman Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Thank you for including your ethics statement: "Human Subjects Review Committee of Kookmin University (KMU-201512-HR-094)". a. Please amend your current ethics statement to confirm that your named institutional review board or ethics committee specifically approved this study. b. Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”). For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research. 3. In your Abstract and discussion sections, please ensure to revise statements of causation (such as "To prevent lean T2DM, abstaining from alcohol and physical activity should be encouraged"), as they are not supported by the observational nature of the present study. 4. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. Moreover, please include more details on how the questionnaire was pre-tested, and whether it was validated. [Note: HTML markup is below. 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: Partly 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: Referee report on "Associations of alcohol consumption and physical activity with lean type 2 diabetes mellitus among Korean adults: A prospective cohort study" (PONE-D-20-03085) In this paper, the authors examined associations between alcohol consumption and the risk of type 2 diabetes mellitus (T2DM) among lean Korean adults. Based on the results, alcohol drinkers who consumed alcohol at least 16g/day were more likely to develop T2DM over a 10 -year period than life-time abstainers. Physical activity decreased the risk of T2DM. Obesity is one of the leading risk factors of T2DM but risk factors among lean individuals have received less attention. The article is very clear and pleasant to read. However, I wish there was a bit more elaboration on the context. I am also somewhat concerned about the number of observations which seems to be low in some regressions. Below are my comments on this paper. 1. In the introduction, it should be explicitly stated, why it is important to investigate the incidence of T2DM among lean individuals. 2. Why alcohol consumption may affect the incidence of T2DM? On pages 19-20 the authors provide one potential explanation but I suppose there are also other explanations? I would like to see discussion of why alcohol consumption may affect the incidence of T2DM already in the introduction. 3. Not only the volume but also patterns of drinking may have implications on the association between alcohol consumption and health. For example, the type of alcohol (e.g. wine vs. spirits) and the way alcohol is consumed (e.g. with meals vs. binge drinking) may have implications on the association between alcohol consumption and T2DM. The authors have access to detailed information on alcohol consumption. They could utilize their data to explore whether different patterns of drinking have implications on their results or at least discuss the potential role of different drinking patterns. 4. It looks like the number of individuals (number of cases) does not sum up to n = 2338 in table 2 and the same problem applies also to Table 3. Also, if I read the tables correctly, the number of observations in some groups seems to be very low (< 20 in Table 2 and < 10 in Table 3) which makes it very challenging to detect reasonable-size effects with reasonable power. 5. The authors note that including both lifetime abstainers and former drinkers to the reference group would lead to biased conclusions. This finding has been reported also elsewhere (see e.g. Baliunas et al. 2009) and the authors could refer to these studies as well. 6. Data description: Page 4, line 69: “A population-based prospective study included male and female Koreans aged 40 to 69 years”. Please clarify, was this the age at the baseline (if not, when)? Also, please clarify whether information on BMI (and T2DM) were based on self-reported information or medical examinations. References Baliunas, D. O., Taylor, B. J., Irving, H., Roerecke, M., Patra, J., Mohapatra, S., & Rehm, J. (2009). Alcohol as a risk factor for type 2 diabetes: a systematic review and meta-analysis. Diabetes care, 32(11), 2123-2132. Reviewer #2: Comments 1. The exact contribution to the (international) literature should be stated in the revised introduction. 2. What is the motivation for the focus on Korea? 3. The paper uses information on health surveys. Was non-response to the surveys random or not? This information would be useful in order to better understand the estimation results. If those with least physical activity are less likely to respond to the health surveys, the estimates that are obtained may be biased, at least to some degree. This issue should be noted in the paper. 4. Do the data contain (survey) weights or not? Why they have not been used in the estimations? 5. Do the models contain the relevant controls? Physical activity is linked to education (https://doi.org/10.1111/sms.13653). This issue should be noted in the revised version. 6. The paper does not consider the potential heterogeneity in the estimated effects. The relationships can differ significantly e.g. by gender. 7. The concluding section of the paper should discuss more about the practical policy lessons that can be drawn from the estimation results. ****** 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. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0238641.r001
Revision 1
2 Jul 2020 Author Response Re: PONE-D-20-03085 Associations of alcohol consumption and physical activity with lean type 2 diabetes mellitus among Korean adults: A prospective cohort study Here are our responses to the comments for the above-referenced manuscript. Response to the Reviewer #1’s comments: 1. In the introduction, it should be explicitly stated, why it is important to investigate the incidence of T2DM among lean individuals. Response: Thank you for your valuable comments. We revised the Introduction part according to the comment (lines 60-68, revised). 2. Why alcohol consumption may affect the incidence of T2DM? On pages 19-20 the authors provide one potential explanation but I suppose there are also other explanations? I would like to see discussion of why alcohol consumption may affect the incidence of T2DM already in the introduction. Response: We agree on this opinion. We revised the Introduction part according to the comment (lines 60-68, revised). 3. Not only the volume but also patterns of drinking may have implications on the association between alcohol consumption and health. For example, the type of alcohol (e.g. wine vs. spirits) and the way alcohol is consumed (e.g. with meals vs. binge drinking) may have implications on the association between alcohol consumption and T2DM. The authors have access to detailed information on alcohol consumption. They could utilize their data to explore whether different patterns of drinking have implications on their results or at least discuss the potential role of different drinking patterns. Response: In terms of alcoholic beverages, almost all alcohol drinkers consumed ‘soju’, which is a major type of alcoholic beverage in Korea and similar to ‘sake’. So, we were unable to conduct separate analyses according to the types of alcoholic beverage. The information on the consumption of meals or specific foods in the occasion of alcohol drinking was unavailable. Among alcohol drinkers who consumed 30g/day or greater, about 20% were binge drinkers. We found no significant association between binge drinking and T2DM partly due to a small number of binge drinkers. We now added information on the types of alcoholic beverage (lines 166-168, revised). 4. It looks like the number of individuals (number of cases) does not sum up to n = 2338 in table 2 and the same problem applies also to Table 3. Also, if I read the tables correctly, the number of observations in some groups seems to be very low (< 20 in Table 2 and < 10 in Table 3) which makes it very challenging to detect reasonable-size effects with reasonable power. Response: We have now corrected the number of participants (Tables 2 and 3, revised). 5. The authors note that including both lifetime abstainers and former drinkers to the reference group would lead to biased conclusions. This finding has been reported also elsewhere (see e.g. Baliunas et al. 2009) and the authors could refer to these studies as well. Response: Thank you for this comment. The original list of references included the study of Baliunas et al. (2009). We added the reference number of this article in the Discussion part (line 260, revised). 6. Data description: Page 4, line 69: “A population-based prospective study included male and female Koreans aged 40 to 69 years”. Please clarify, was this the age at the baseline (if not, when)? Also, please clarify whether information on BMI (and T2DM) were based on self-reported information or medical examinations. Response: We have now clarified the description regarding age, BMI, and T2DM according to the comment (lines 110-111 and 137-138, revised). Response to the Reviewer #2’s comments: 1. The exact contribution to the (international) literature should be stated in the revised introduction. Response: Thank you for your valuable comments. We re-checked out all references quoted in the Introduction part. The reference 7 was added (line 58) because we estimated the prevalence of lean T2DM in a Korean population using the Korean NHANES data. There was no previous literature regarding such an estimate. 2. What is the motivation for the focus on Korea? Response: We added the text regarding the motivation (lines 64-68, revised). 3. The paper uses information on health surveys. Was non-response to the surveys random or not? This information would be useful in order to better understand the estimation results. If those with least physical activity are less likely to respond to the health surveys, the estimates that are obtained may be biased, at least to some degree. This issue should be noted in the paper. Response: Because the health surveys were administered by trained researchers, the number of non-responders to the surveys including specific questions on physical activity was trivial. Thus, we think that the effects of non-responders on the study findings were insignificant. We have now noted this aspect in the manuscript (lines 294-295, revised). 4. Do the data contain (survey) weights or not? Why they have not been used in the estimations? Response: The present study used data from a whole cohort and applied the inclusion and exclusion criteria. If the study used data from a sample which was selected from an original cohort, survey weights might have been considered in the analysis. 5. Do the models contain the relevant controls? Physical activity is linked to education (https://doi.org/10.1111/sms.13653). This issue should be noted in the revised version. Response: The models included educational level with other potential confounding factors. This issue has been noted in the line 290. 6. The paper does not consider the potential heterogeneity in the estimated effects. The relationships can differ significantly e.g. by gender. Response: We agree on this comment. Because we also thought that the associations can differ by gender, we presented data stratified by gender in Table 3. 7. The concluding section of the paper should discuss more about the practical policy lessons that can be drawn from the estimation results. Response: We have now added a text according to the comment (lines 282-283, revised). Response to the editor’s comments: 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. Response: We checked it out. 2. Please amend your current ethics statement to confirm that your named institutional review board or ethics committee specifically approved this study. Response: We have now revised the ethics statement (lines 97-105, revised). 3. In your Abstract and discussion sections, please ensure to revise statements of causation (such as "To prevent lean T2DM, abstaining from alcohol and physical activity should be encouraged"), as they are not supported by the observational nature of the present study. Response: We have now revised it (lines 35-36, revised). 4. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. Moreover, please include more details on how the questionnaire was pre-tested, and whether it was validated. Response: Because of the copyright that The Korea Centers for Disease Control & Prevention owns, we are unable to provide a questionnaire copy. In terms of the validity of alcohol consumption, additional information has been now added (lines 124-127, revised). Attachments Attachment Submitted filename: Responses to Reviewers.docx https://doi.org/10.1371/journal.pone.0238641.r002
20 Jul 2020 Decision Letter - Petri Böckerman, Editor PONE-D-20-03085R1 Associations of alcohol consumption and physical activity with lean type 2 diabetes mellitus among Korean adults: A prospective cohort study PLOS ONE Dear Dr. Baik, 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. The revised version should address the remaining comments. Please submit your revised manuscript by Sep 03 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're 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. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Petri Böckerman Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: (No Response) Reviewer #2: All comments have been addressed ******** 2. 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 4. 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: No ****** 5. 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 ****** 6. 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: I think the paper has improved. However, there are still two issues the authors should consider. 1. I asked the authors to explain in the introduction, why it is important to investigate the incidence of T2DM among lean individuals. The only explanation they give is that there is not much previous evidence on this topic. However, I think just the fact that there is not much evidence does not justify the topic. So, why is it important to investigate the incidence of T2DM among lean individuals? 2. Reviewer 2 brought up an excellent point about non-response. In the revised version, the authors state that “Because the health surveys were administrated by trained researchers, the number of non-responders was trivial”. As long as a survey is voluntary, there is a significant risk that non-random non-response occurs. The authors should provide exact information concerning non-response. Reviewer #2: I am happy with the revised version of the paper. I like the research question, the structure of the paper, the quality of writing, and the way the authors describe their empirical proceeding and results. Most importantly, the authors have addressed all the issues stated in my referee report for the first version appropriately. ****** 7. 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. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0238641.r003
Revision 2
5 Aug 2020 Author Response Re: PONE-D-20-03085 Associations of alcohol consumption and physical activity with lean type 2 diabetes mellitus among Korean adults: A prospective cohort study Here are our responses to the comments for the above-referenced manuscript. Response to the Reviewer #1’s comments: Reviewer #1: 1. I asked the authors to explain in the introduction, why it is important to investigate the incidence of T2DM among lean individuals. The only explanation they give is that there is not much previous evidence on this topic. However, I think just the fact that there is not much evidence does not justify the topic. So, why is it important to investigate the incidence of T2DM among lean individuals? Response: Thank you for further comments. We have now added contents related to the importance of research for lean T2DM (lines 58-60 and 70-72, revised). 2. Reviewer 2 brought up an excellent point about non-response. In the revised version, the authors state that “Because the health surveys were administrated by trained researchers, the number of non-responders was trivial”. As long as a survey is voluntary, there is a significant risk that non-random non-response occurs. The authors should provide exact information concerning non-response. Response: We have now added the exact proportion of non-responders (1.2%) (line 299, revised). Reviewer #2: I am happy with the revised version of the paper. I like the research question, the structure of the paper, the quality of writing, and the way the authors describe their empirical proceeding and results. Most importantly, the authors have addressed all the issues stated in my referee report for the first version appropriately. Response: Thank you very much for your valuable comments. Attachments Attachment Submitted filename: Responses to Reviewers_2v.docx https://doi.org/10.1371/journal.pone.0238641.r004
21 Aug 2020 Decision Letter - Petri Böckerman, Editor Associations of alcohol consumption and physical activity with lean type 2 diabetes mellitus among Korean adults: A prospective cohort study PONE-D-20-03085R2 Dear Dr. Baik, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. 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 help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- 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. Kind regards, Petri Böckerman Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ******** 2. 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 4. 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: No ****** 5. 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 ****** 6. 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: (No Response) Reviewer #2: I am happy with the revised version of the paper. I like the research question, the structure of the paper, the quality of writing, and the way the authors describe their empirical proceeding and results. Most importantly, the authors have addressed all the issues stated in my referee report for the first version appropriately. ****** 7. 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. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No https://doi.org/10.1371/journal.pone.0238641.r005
Formally Accepted
26 Aug 2020 Acceptance Letter - Petri Böckerman, Editor PONE-D-20-03085R2 Associations of alcohol consumption and physical activity with lean type 2 diabetes mellitus among Korean adults: A prospective cohort study Dear Dr. Baik: I'm 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 let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, 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. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Petri Böckerman Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0238641.r006

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