PONE-D-22-18808Comparison of low-salt preference trends and regional variations between patients with major non-communicable diseases and the general populationPLOS ONE

Dear Dr. Ock,

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Two reviewers well assessed this manuscript.However, there are still corrections existed in the present form of the manuscript.

Read the suggestions carefully and respond them appropriately.

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PLOS ONE

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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

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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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

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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

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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: Dear Authors,

The article provides a good insight into the trends in low-salt preference and regional differences in Korea among patients with the main non-communicable diseases.

For a better understanding of the work, I have some suggestions:

Line 118.

Can the authors explain the background or give a reference why the 13 NCD listed are the main ones?

Line 208:

To the reader who does not know Korea well, the names of the regions do not give useful information.

Would it make sense to describe each region (in few words) background that could influence salt consumption?

For example,

-a coastal region, traditionally lot of fish are consumed,…

-an inland region, …

-rural region,... intensive urban region,..

-a region where traditionally few meat is consumed...

Lines 234 235:

The low-salt preference rates of patients with different major NCDs and the general population was gradually decreasing after peaking mainly in 2013

The trend is evident from figures 2,3,4,5, can you comment the reasons for the trend?

Line 305:

In the title of the article you "regional variations" are "highlighted

Can you briefly comment the reasons for the differences in patient behavior between regions?

Best regards.

Reviewer #2: This study deals with an important issue within Korea as well as worldwide. The study uses the results of a large survey to analyze trends over time in the differences in low salt preference between major NCD patients and the general population, and offers suggestions for future environmental improvement and education. However, there are some concerns in this paper.

1. Abstract: Result: The authors specifically describe the low salt preference rate. Since the survey years for this study are 2008-2019, Please indicate the year of the survey.

2. Introduction: 87: The survey years are 2008-2017, but is it 2008-2019?

3. Materials and methods: What is the size of The Korea Community Health Survey? Please provide sample size information for each survey year.

4.Materials and methods: Participants: The authors do not include cancer as Major NCD Patients, although they mention it in the study limitations. Why not include cancer in this analysis?

In addition, since the results and discussion focus on hypertension, diabetes, and dyslipidemia, it would be better to exclude other diseases. I think it would be better to have the data of Fig2-Fug5 to grasp the overall trend of NCD, but I feel it is difficult to confirm the data.

5.Results:178-179:　“In the general population, it peaked in 2013 at 74.4% (APC: -11.788, p-value: <0.001)”. Isn't the APC value 11.788?

6.Results:184-185：Other NCD results are not mentioned in the results that follow. If the relevant data set is not always available, then it may be possible to remove it.

7. Results:194：Please list the ACP values for 2013.

8. Results:201：Please correct the p-value.

9. Discussion: The low salt preference rate and the adherence rate of not adding salt or soy sauce at the table have changed since 2013, but the reasons for this have not been mentioned. Is there any possible reason for this change, such as a change in the survey methodology, the selection method of the target population, or a change in government policy policy regarding salt reduction?

10. Discussion：260-261：“the reaction to a salty taste is influenced by the sodium concentration in the food”. It would be helpful to the reader's understanding if you could describe the specific impacts while presenting the reports of the cited references.

11. Discussion：260-261：Please describe in detail the contents of your education to cooks and foodservice professionals.

12. Disccussion：287-288：Please cite any reports showing that low-salt preference is related to temperature.

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Reviewer #1: No

Reviewer #2: No

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Comparison of low-salt preference trends and regional variations between patients with major non-communicable diseases and the general population

PONE-D-22-18808R1

Dear Dr. Ock,

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.

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Kind regards,

Masaki Mogi

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

The authors well responded to the Reviewers' comments. 

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

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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

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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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: Yes

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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

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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: Dear Authors,

Thanks for the comments and inclusion of reccomendations.

I wish you successful further research work.

Best regards

Reviewer #2: (No Response)

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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

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