PONE-D-23-17357FACTORS ASSOCIATED WITH FOOD CONSUMPTION AND DIETARY DIVERSITY AMONG INFANTS AGED 6-18 MONTHS IN ASHANTI REGION GHANAPLOS ONE

Dear Dr. Opoku Agyemang,

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.

Please submit your revised manuscript by Aug 09 2023 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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Pradip Chouhan

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 stating the following financial disclosure: 

"NO"

At this time, please address the following queries:

a) Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution. 

b) State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

c) If any authors received a salary from any of your funders, please state which authors and which funders.

d) If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.”

Please include your amended statements within your cover letter; we will change the online submission form on your behalf.

3. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability.

"Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized.

Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access.

We will update your Data Availability statement to reflect the information you provide in your cover letter.

4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 

[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: Yes

Reviewer #2: Yes

Reviewer #3: No

**********

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

**********

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

Reviewer #3: 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: No

Reviewer #2: Yes

Reviewer #3: No

**********

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: Title: Factors Associated with Food Consumption and Dietary Diversity Among Infants Aged 6-18 Months in Ashanti Region Ghana

Authors have highlighted an interesting and significant issues through this manuscript.

1) Abstract:

Well Written. Need to rewrite the background part of the abstract. Try to address objective of the study in abstract part.

2) Introduction: Need to improve.

a) The research gap is unclear. Overall, the introduction is unclear as to what the authors want to say. It is better to rewrite based on i) what the issue is, ii) why it is important, iii) what the literature says, iv) what the research gap and question in this study are, and v) how this study could contribute to the literature.

b) The concept, methods and results are cohesive and scientifically sound. If I would nit-pick, there are some issues with grammar. However, the manuscript can be understood regardless.

c) Yet, to be of interest for readers outside Ghana, too, the paper should also refer to some studies in the international literature (studies done on the children of others countries) on child feeding practice, to highlight the gaps and unanswered questions, the methodologies used etc. Authors may cite following literature on breastfeeding practice in India

Ghosh, P., Rohatgi, P., Bose, K. (2022). Determinants of Time-Trends in Exclusivity and Continuation of Breastfeeding in India: An Investigation from the National Family Health Survey. Social Science and Medicine, 292, 1-10. https://doi.org/10.1016/j.socscimed.2021.114604

3) Methodology: Well written

4) Results: Well Written

5) Discussion: Need to improve

a) The Discussion section tells a coherent story of what was discovered and the implications for Ghana. I suggest the authors to shed light on those results that may be generalizable (outside the Ghana context). This section should also reflect the contribution of the study to the international literature in the study area.

b) In this section authors have already summarized the process, the results, and the overall purpose of this study.

c) One paragraph/part should answer questions about the limitations and potential flaws or shortcomings of this study. One paragraph should focus on the successes of the study.

d) Authors can also compare the results of different methods and assess which was more fruitful and why. Discuss the implications of this research and compare it to the results of other studies. Authors can cite related studies to show how your study compares (in addition to the introduction).

6) Conclusion: The conclusion offers you a chance to briefly present how your work advances the field from the present state of knowledge. Make a proper justification for your work here and indicate extensions and wider implications of the study.

Reviewer #2: The paper titled "FACTORS ASSOCIATED WITH FOOD CONSUMPTION AND DIETARY DIVERSITY AMONG INFANTS AGED 6-18 MONTHS IN THE ASHANTI REGION, GHANA" presents an intriguing study. With the revisions suggested below, I am confident that this paper can be strengthened and transformed into a captivating published article.

1. The rationale behind selecting the Ashanti Region in Ghana as the study area needs to be explained and justified by the author.

2. The research paper lacks novelty, and it is necessary to incorporate this in the end of the introduction section of the manuscript.

3. Check spelling/writing whole manuscript. Several errors are available in the manuscript (IN ASHANTI REGION GHANA…. (77.4%)… (35%)

4. Please rewrite the whole “materials and methods” section. I am unable to understand how many independent and dependent variables there are. Do not make it complicated. Try to simplify.

5. The author refers to the prevalence of child dietary diversity, but unfortunately, I couldn't locate the specific table for this.

6. Figure 1 is not clearly visible.

7. How did you select the sample for your study? Could you please provide details about the procedure used for sample selection?

8. Please include detailed analytical techniques (formulas, descriptions etc.) for "Dominance analysis of relative contribution" and "Binary logistic regression" in the appendix for the reader.

9. I couldn't find any information regarding existing policies or policy enhancement strategies in the discussion section of this study related to food consumption and dietary diversity among infants aged 6-18 months in Ghana.

10. Other necessary factors that impact food consumption and dietary diversity among infants aged 6-18 months should be considered. These factors include maternal and family support, parental feeding practices (such as pressure to eat), food availability and accessibility, and cultural and ethnic factors. Please add.

11. What are the strength and limitations of the study? Please mention.

12. In the discussion section, it is unnecessary to restate the result of the study. “(unadjusted OR=2.3, p. Please remove.

13. What interventions and strategies can be implemented to enhance food consumption and dietary diversity among infants aged 6-18 months in Ghana? Please recommend this in the conclusion section of the manuscript.

Reviewer #3: 1. In introduction part, dietary diversity and it's relation with impaired growth need to be clearly mentioned. Dietary diversity and balanced meal are same?

2. In methodology section

1. Why the study participants taken between 6-18 months and not 6 to 23 months which is standard.

2. 24 hours recall method is not a proper estimation of dietary diversity specially here 9 food groups were taken as to maintain minimum dietary diversity which may not reflect the true diet habit for the participant.

3. In result section,

1. table 1: The dietary diversity presence calculated by scoring 18 food groups intake, also test of significance applied taking these food groups as independent variables. Multicollinearity will be present for statistical test, thus can not be applied.

2. None of the table mentioned the total number of sample size (n) in title.

3. the knowledge of mother regarding diet were shown in open ended but options given as dichotomous. The statements need to be modified.

4. The title and description didn't match in table 5. In title it is mentioned as dietary diversity. also in methodology as presence of dietary diversity. But in binary regression the impression was made as presence of lower dietary diversity which should be mentioned in data analysis section and also the title needed to be changed.

5. In supplementary table 2, how the test of significance was applied is not clear as the table had 3 variables.

**********

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

Reviewer #3: 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.

PONE-D-23-17357R1FACTORS ASSOCIATED WITH FOOD CONSUMPTION AND DIETARY DIVERSITY AMONG INFANTS AGED 6-18 MONTHS IN ASHANTI REGION, GHANAPLOS ONE

Dear Dr. Godwin Opoku Agyemang,

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.

Please submit your revised manuscript by Nov 03 2023 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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Pradip Chouhan

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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: Yes

********** 

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: Authors address the issues that I have suggested previously. The author has revised all areas that is possible for this study.

Reviewer #2: 1. In the Materials and Methods section of the manuscript, keep only "Dependent variable:" and "Independent variable:" labeled as point. and remove the word "Data collection." Remove "socio-demographic," "complementary feeding knowledge," "complementary feeding practices," "child morbidity," and "dietary diversity" after "Dependent variable:" and "Independent variable:

2. In the "Strengths and Limitations of the study" section, remove the phrases "a very large sample size and" and "with a relatively smaller sample size" from the first sentence.

3. Check and very ole literatures should be replaced by the updated ones.

4. Include DOI or link to each reference.

********** 

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: Yes: Dr. Pritam Ghosh

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.

Attachments

Attachment

Submitted filename: Comments to authors_2.docx

PONE-D-23-17357R2FACTORS ASSOCIATED WITH FOOD CONSUMPTION AND DIETARY DIVERSITY AMONG INFANTS AGED 6-18 MONTHS IN ASHANTI REGION, GHANAPLOS ONE

Dear Dr. Opoku Agyemang,

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.

==============================

ACADEMIC EDITOR: Please insert comments here and delete this placeholder text when finished. Be sure to:

In the conclusion of the abstract , kindly add the implications of your study and/or recommendations. 

Insert line numbers in the document. ​

I have included additional documents in the attached file. 

Please submit your revised manuscript by Nov 24 2023 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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Sandra Boatemaa Kushitor, Ph.D.

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

[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.

Attachments

Attachment

Submitted filename: PONE-D-23-17357_R2.pdf

FACTORS ASSOCIATED WITH FOOD CONSUMPTION AND DIETARY DIVERSITY AMONG INFANTS AGED 6-18 MONTHS IN ASHANTI REGION, GHANA

PONE-D-23-17357R3

Dear Dr. Agyemang, 

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,

Sandra Boatemaa Kushitor, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: