PONE-D-23-35645Validity of self-reported weight and height among female young adults in the United Arab EmiratesPLOS ONE

Dear Dr. Haroun,

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Preeti Kanawjia, MD

Academic Editor

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: Partly

Reviewer #2: Yes

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

Reviewer #1: I Don't Know

Reviewer #2: Yes

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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: The authors present an interesting study entitled "Validity of self-reported weight and height among female young adults in the United Arab Emirates". The study presents the findings on the validity of self-reported height and weight measures in a small group of female students within a defined age range. In its current form, the manuscript provides insufficient information for additional replication, and may be of limited utility given its small sample size.

Major issues:

1. Kindly provide the formula and/or calculation justifying why the sample size of 131 is sufficient for a study of this nature.

2. Kindly provide more details on the scale used for height measurements - specifying the make and model of the scale, and describe how it was set up to assure accuracy.

3. Line 158 states that Bland-Altman plots were performed to assess the agreement between self-reported and directly measured weight and height. Figure 1 only shows 1 Bland-Altman plot, comparing measured to self-reported weight. Please provide both the weight and height BA plots.

4. The conclusions of the study are incongruous with the reported results. The authors conclude that "The findings of this study propose that self-reported values should not be taken into account when determining the prevalence of unhealthy body weight for targeting weight loss or gain interventions. In general, female university students in the UAE struggled to provide accurate self-reports of their weight and height, leading to inaccurate BMI scores." In fact, the results show strong ICC values where calculated, and that the mean discrepancies between self-reported and measured height and weight were low (Table 4). For instance, a discrepancy of 0.5 - 1 kg in body weight is not out of the ordinary, given fluctuations in body weight throughout the day and during the menstrual cycle - particularly pertinent in this group of participants who were all female. Furthermore, discrepancies of less than 1 cm in height is negligible, and fall within the margin of error for height measurements. The discrepancies in the BA plot appear to be driven entirely by a small number of individuals, for whom there may be other factors leading to them providing inaccurate self-reported weight values. Kindly justify the conclusions made.

5. There appears to be substantial similarities between the text in this article and similar published articles. Please run this text through a plagiarism detection software and correct wherever appropriate.

6. There were no pre-defined range of acceptable limits of height and weight measure discrepancies, which should be defined a priori. Please refer to the following: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470095/

7. Kindly justify the statement "However, if these values were to be used to determine the prevalence

368 of underweight or overweight, or target students for nutritional interventions programs, then

369 approximately one fifth of those who were underweight or overweight would be misclassified as

370 normal weight." 5 participants self-reported as normal but were underweight, whereas 7 overweight individuals self-reported as normal. 12 of 131 participants to not make up one fifth. Additionally, these findings should include the caveat that these findings were based on a very small number of individuals.

Minor issues:

1. SD was not fully defined at first mention.

2. Spelling error on line 158: testes in place of tests.

Reviewer #2: I would like to applaud the efforts of the authors for conducting a study to validate the self-reported measures of height and weight. Please see my comments below to improve the content and validity of the manuscript.

•Line 147 Add the hypothesis of the study

•Line 131-133 Is it a post-hoc analysis, then add it under the discussion section while discussing methodological considerations and limitations of the study

•Line 135 Any other contraindication for bioelectrical impedance analysis?

•Line 140 Explain more about “trained researchers” – their qualifications, specialization, and relevant experience

•Line 144 Add the scale/portable stadiometer details used for measuring the height of participants

•Line 147 Add the reliability and validity of the portable Tanita Body Composition Analyser (BC-420MA)

•Were the participants assessed at a fasting state in the morning using the portable Tanita Body Composition Analyser (BC-420MA)?

•Remove zero (dotted) line for the Bland-Altman plots

•Add a brief explanation of the absences of heteroscedasticity in the plots

•Add a linear regression analysis to explain the absence of a proportional bias in the plots

•Future recommendations should include similar studies on male participants

Thank you for the opportunity to review the manuscript

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Reviewer #1: No

Reviewer #2: No

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Validity of self-reported weight and height among female young adults in the United Arab Emirates

PONE-D-23-35645R1

Dear Dr. Haroun,

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,

Preeti Kanawjia, MD

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

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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: I Don't Know

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

**********

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: The authors present an interesting study entitled "Validity of self-reported weight and height among female young adults in the United Arab Emirates". The study presents the findings on the validity of self-reported height and weight measures in a small group of female students within a defined age range. The authors have addressed my previous comments or acknowledged the limitations of their study in the text.

There remains several serious issues with the submission:

Major issues:

1. The resolution of the BA plots are of far too low resolution in the given file to be assessed. Only one file is provided to authors, in which the figures are embedded. Please ensure the figures provided to the journal are of high quality.

2. Limitations that should be stated and discussed are that the sample size was small, and that the observed group was of a limited demographic.

Minor errors:

1. Line 224: 0.976 was missing a decimal point.

2. Line 156: Are these undergraduate studies or do they already hold a Bachelor's degree in Public Health and Nutrition?

3. Figure 1 is not cross-referenced in the text.

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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