Associations of body adiposity index, body mass index, waist circumference, and percentage of body fat in young female Emirati adults

Dalia Haroun; Maryam Darwish; Aseel Ehsanallah

doi:10.1371/journal.pone.0302779

Peer Review History

Original SubmissionNovember 8, 2023
8 Nov 2023 Author Response Attachments Attachment Submitted filename: Response 8.11.23.docx https://doi.org/10.1371/journal.pone.0302779.r001
6 Feb 2024 Decision Letter - Fredirick Lazaro mashili, Editor PONE-D-23-35965Associations of body adiposity index, body mass index, waist circumference, and percentage of body fat in young female Emirati adultsPLOS ONE Dear Dr. Haroun, 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 address all the comments raised by the reviewers This manuscript requires a major revision ============================== Please submit your revised manuscript by Mar 22 2024 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, Fredirick Lazaro mashili, MD, PhD 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. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. Additional Editor Comments: Please address all the concerns raised by both the reviewers [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: I Don't Know 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: While validating the use of BAI in estimating % body fat among Emirati women is novel, given the small sample size and heterogeneity of the population, concluding BMI is superior to BAI in predicting %BF might not be scientifically sound. With this sample size, the population must be tightly homogeneous to draw such conclusion ( eg only obese women, only underweight women etc etc). Since this information is important and could inform future large sample size studies, the following major revisions would improve the quality of the manuscript. 1. The authors should try to make this manuscript more descriptive. Eg portraying histograms or bar charts with proportions of those with high BMI or BAI classifying them to have high body fat, who also have high body fat based on DEXA. Or correlation and regression figures for various BMI categories or any way just to make the manuscript more descriptive. This will help to suggest and not to conclude that BMI is likely superior to BAI pending future research with larger sample sizes or homogeneous populations. Would be good to have a manuscript that has looked at different angles of the 95 participants to convince that even though the sample size is small, it definitely suggest that BMI is more superior than BAI. Reviewer #2: Comments on the paper entitled “Associations of body adiposity index, body mass index, waist circumference, and percentage of body fat in young female Emirati adults” 1.Line 50, I suggest rewriting the sentence to read, Body Mass Index abbreviated as BMI, and not Body Mass Index also known as BMI 2.Line 150, How did you measure weight fluctuations 3.Authors should mention the Names, Brands, Models, and Cities of manufacturers for all types of equipment and tools that were used in measuring all variables 4.It is stated that this study included healthy Emirati women attending “public universities” in the UAE who were chosen via a convenience sampling method (lines 123-124). It is also well explained that” The measurements were taken in the body composition laboratory at Zayed University in Dubai, UAE”. The clarifications are needed to disclose how participants from other universities were conveyed to the measurement center. 5.State if any statistical test for the normality of the data was carried out before running regression and correlation analysis 6.line 292 what is BIA? 7.One of the aims of this study was to determine the relative accuracy of BAI when predicting %BF, However, this objective is not clearly shown through the subsequent sections of the manuscript, in other words the objective should be featured in data collection, analysis, and discussion. ****** 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: Yes: Fredirick Lazaro Mashili Reviewer #2: Yes: Oscar Mbembela ******** [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.0302779.r002
Revision 1
4 Mar 2024 Author Response Editor Comments 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 Response: We have checked that the manuscript meets PLOS one’s style requirements. 2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. Response: informed written consent was collected from all participants included in the study. This has been highlighted in the Material and Methods section. Reviewer Comments Reviewer #1: While validating the use of BAI in estimating % body fat among Emirati women is novel, given the small sample size and heterogeneity of the population, concluding BMI is superior to BAI in predicting %BF might not be scientifically sound. With this sample size, the population must be tightly homogeneous to draw such conclusion ( eg only obese women, only underweight women etc.). Since this information is important and could inform future large sample size studies, the following major revisions would improve the quality of the manuscript. 1. The authors should try to make this manuscript more descriptive. Eg portraying histograms or bar charts with proportions of those with high BMI or BAI classifying them to have high body fat, who also have high body fat based on DEXA. Or correlation and regression figures for various BMI categories or any way just to make the manuscript more descriptive. This will help to suggest and not to conclude that BMI is likely superior to BAI pending future research with larger sample sizes or homogeneous populations. Would be good to have a manuscript that has looked at different angles of the 95 participants to convince that even though the sample size is small, it definitely suggest that BMI is more superior than BAI. Response: We have analysed the data further taking into account the reviewer comments. Our sample was first divided according to % fat levels (by DXA). Then using a using a clustered bar graph, the accuracy classifying adiposity using BMI categories versus BAI were shown. (Fig 1). Furthermore, ROC analysis was used to investigate which measure was better able to detect excess % BF (using a cut-off of 35%) (Fig 4). The results all revealed that BMI was more superior than BAI. Reviewer #2: Comments on the paper entitled “Associations of body adiposity index, body mass index, waist circumference, and percentage of body fat in young female Emirati adults” 1.Line 50, I suggest rewriting the sentence to read, Body Mass Index abbreviated as BMI, and not Body Mass Index also known as BMI Response: This has been revised and reads: “Body Mass Index abbreviated as BMI”. 2.Line 150, How did you measure weight fluctuations Response: Weight fluctuations was gathered by asking participants, "Over the last 3 months, have you experienced any changes in your weight? If so, how many kilograms?". Further clarification has been added to the manuscript under the data collection section. 3.Authors should mention the Names, Brands, Models, and Cities of manufacturers for all types of equipment and tools that were used in measuring all variables Response: This information has been added in the manuscript, material and methods section. 4.It is stated that this study included healthy Emirati women attending “public universities” in the UAE who were chosen via a convenience sampling method (lines 123-124). It is also well explained that” The measurements were taken in the body composition laboratory at Zayed University in Dubai, UAE”. The clarifications are needed to disclose how participants from other universities were conveyed to the measurement center. Response: This was done via snowball sampling. It is now added to the manuscript. 5.State if any statistical test for the normality of the data was carried out before running regression and correlation analysis Response: Normality was assessed using the using the Kolmogorov-Smirnov test- information has been added to the manuscript. % fat was normally distributed; however, WC, BAI and BMI were not. However, the distributions were approximately symmetric with one unusual point. As evidence of robustness, the removal of this point did not change the reported results. Therefore, this should not impact the statistical validity of the correlation and regression analyses. 6.line 292 what is BIA? Response: This was a typing error and should have read BAI. It has been fixed. 7.One of the aims of this study was to determine the relative accuracy of BAI when predicting %BF, However, this objective is not clearly shown through the subsequent sections of the manuscript, in other words the objective should be featured in data collection, analysis, and discussion. Response: Further analyses were carried out to test this aim, and was incorporated into the various sections of the manuscript. These include: (a) Paired sample t-tests for the sample overall as well as across various BMI categories and across different adiposity levels were used to test differences in % BF between DXA and BAI (Table 4), (b) Bland-Altman analysis was used to test individual agreement between BAI and % BF (DXA) (Figure 2) , (c) Linear regression analysis was carried out to test the best predictor of % fat (Table 5) (d) ROC analysis for sensitivity, specificity of BAI in detecting obesity by % BF (assessed by DXA) (Figure 4). Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0302779.r003
3 Apr 2024 Decision Letter - Fredirick Lazaro mashili, Editor PONE-D-23-35965R1Associations of body adiposity index, body mass index, waist circumference, and percentage of body fat in young female Emirati adultsPLOS ONE Dear Dr. Haroun, 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. A minor revision is required for this manuscript Please address all the comments thoroughly and accordingly The suggested minor revision will make the manuscript clearer, well presented and better aligning to journal's style and formatting ============================== Please submit your revised manuscript by May 18 2024 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, Fredirick Lazaro mashili, MD, PhD 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. Additional Editor Comments: Upon further review, minor revisions have been recommended to enhance the manuscript's clarity and presentation. Specifically, it has been suggested that the current repetitive use of tables for presenting results could be diversified to improve readability and simplicity. Implementing these changes will further strengthen your manuscript. [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: 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: Partly 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: While most comments have been addressed, some require further attention. Given the descriptive nature of the manuscript, avoiding the repetitive use of tables for presenting results could enhance clarity and simplicity. Diversifying the methods of data presentation beyond just tables would improve the manuscript. Reviewer #2: I have gone through the author responses to the raised comments, and the comments were satisfactorily responded ****** 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: Fredirick mashili Reviewer #2: Yes: Oscar Mbembela ******** [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.0302779.r004
Revision 2
5 Apr 2024 Author Response Upon further review, minor revisions have been recommended to enhance the manuscript's clarity and presentation. Specifically, it has been suggested that the current repetitive use of tables for presenting results could be diversified to improve readability and simplicity. Implementing these changes will further strengthen your manuscript. Response: We thank the editor and reviewer for their comments, and have revised the presentation of results in two tables in the manuscript (1 table was converted into a figure and the other deleted) to enhance clarity and avoid repetitive use of tables. With these changes implemented, we hope that our paper is accepted for publication. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0302779.r005
12 Apr 2024 Decision Letter - Fredirick Lazaro mashili, Editor Associations of body adiposity index, body mass index, waist circumference, and percentage of body fat in young female Emirati adults PONE-D-23-35965R2 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. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Fredirick Lazaro mashili, MD, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): The reviewer's concern regarding the manuscript presentation has been sufficiently addressed. All other comments raised by the reviewers have also been adequately addressed. Reviewers' comments: https://doi.org/10.1371/journal.pone.0302779.r006

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