PONE-D-24-16170Exploring the Textural Characteristics of Foods Preferred by Chinese Elderly Individuals Based on IDDSI LevelsPLOS ONE

Dear Dr. Chen,

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We look forward to receiving your revised manuscript.

Kind regards,

Chung-Ta Chang

Academic Editor

PLOS ONE

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2023YFF1104405 Creation and industrialization demonstration of nutritious and healthy food for the elderly

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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

Reviewer #3: Partly

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

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: 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

Reviewer #3: 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

Reviewer #3: 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 Only Correction would be to do a ANOVA Or its Nonparametric Counterpart as multiple groups are thre based on data normality. Not much changes only the article will have more value and will be less of type 1 errors.

Reviewer #2: I would like congratulate the authors for producing good quality manuscript, but I have some queries and suggestions to increase the quality of the manuscript:

1. Kindly mention the study design of this manuscript.

2. Paired t was used in the study. It is a parametric test, was the normality of the data checked before applying this test. If so kindly mention.

3. Kindly upload high resolution images for figures.

4. Abstract is supposed to provide the gist of the manuscript. Kindly reduce the word count of your abstract.

5. Discussion should be less quantitative, kindly reduce the use of data in the discussions section and compare it with recent literature.

6. Discussion section can be elaborated after a thorough literature review.

7. Kindly provide the strengths and limitations of this study.

8. Kindly mention the future recommendations for this study

Reviewer #3: 1. Introduction

• The introduction clearly outlines the study's objective to explore the relationship between food texture characteristics and IDDSI levels among elderly Chinese individuals.

• The relevance of the study is well-established, highlighting the growing elderly population and the importance of addressing dysphagia through appropriate food textures.

• The introduction could benefit from a more thorough review of existing literature to contextualize the study within the broader field of dysphagia research.

• Explicitly stating the research questions or hypotheses could help to focus the study and guide the reader through the subsequent sections.

2. Methods

• The methods section provides detailed descriptions of how food hardness, cohesiveness, and adhesiveness were measured, ensuring reproducibility.

• The use of the IDDSI framework is appropriate and aligns the study with international standards for dysphagia diets.

• The sample size and selection criteria for the elderly participants should be explicitly stated. Details on the demographic characteristics of the participants (e.g., age range, gender distribution, health status) would enhance the study's generalizability.

• A more detailed explanation of the statistical methods used, including any assumptions made and how they were tested, would strengthen the rigor of the analysis.

3. Results

• The results are clearly presented with appropriate use of tables and figures to illustrate key findings.

• The results include statistical significance levels, providing a clear indication of which findings are most robust.

• Some sections of the results could benefit from more detailed descriptions. For instance, explaining why certain food categories showed significant changes in texture characteristics at specific IDDSI levels.

• Brief comparisons with existing studies in the results section could provide additional context and highlight the study's contributions to the field.

4. Discussion

• The discussion provides a thoughtful interpretation of the findings, linking changes in hardness, cohesiveness, and adhesiveness to the IDDSI levels and their implications for dysphagia management.

• The discussion effectively highlights the practical implications for food preparation and selection for elderly individuals with dysphagia.

• Providing specific practical guidelines or recommendations for food preparation based on the study's findings would be valuable for practitioners.

• A more detailed discussion of the study's limitations, including potential sources of bias and the generalizability of the findings, would provide a more balanced view.

5. Conclusion

• The conclusion succinctly summarizes the key findings and their implications for the preparation of dysphagia diets.

• The call for future research is well-articulated, emphasizing the need for further exploration of food texture characteristics and processing techniques.

• More specific recommendations for future research directions would be helpful. For example, suggesting specific food components or processing techniques to investigate.

• Discussing strategies for implementing the study's findings in real-world settings, such as in healthcare facilities or home care environments, would enhance the practical relevance of the research.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes: Shivashankar Keingadarane

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Attachments

Attachment

Submitted filename: Reviewer Comments.docx

PONE-D-24-16170R1Exploring the Textural Characteristics of Foods Preferred by Chinese Elderly Individuals Based on IDDSI LevelsPLOS ONE

Dear Dr. Chen,

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 Jan 29 2025 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,

Chung-Ta Chang

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.

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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 #4: All comments have been addressed

Reviewer #5: (No Response)

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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 #4: Yes

Reviewer #5: Yes

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

Reviewer #4: Yes

Reviewer #5: I Don't Know

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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 #4: Yes

Reviewer #5: 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 #4: Yes

Reviewer #5: 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 #4: It seems to me that the revised version of the article has changed much and previous deficiencies do not remain. For these reasons, I can consider it for publication.

Reviewer #5: 2.5 Texture measurement methods- the machine used for testing needs to recognized by make and model.

2.3 Food processing continually repeating eg. "means egg-to-water ratio is 1:2. 2.3 first paragraph implies this clearly, thus does not need continual restatement.

Pg 56 A research supports - change to Previous research/#2.4 correct units is mL not ml.

Table 6 - requires unit for cohesion gf,

The predictive equation should be complimented with description from where the values were derived rather than relying on the reader recalling their existence in the text. e.g. values derived from the intercept values of the multiple linear regressions in Table 6 - values from adhesion, cohesion etc.

Figures lack explanation - the reader needs to be provided with some explanation such as ig. 1 the scope of hardness for seven food types displaying peaks for - colours make it difficult to distinguish in the document - please address.

Fig.2 Cohesiveness of seven food groups indicates extensive overlaps within th IDDSI levels,

Fig 3. Adhesiveness demonstrates distinct peaks for .....

Etc for other figures

Note some of the colours were difficult to distinguish in the manuscript and need serious review.

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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 #4: No

Reviewer #5: Yes: Dr Graham Ellender

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[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.

Exploring the Textural Characteristics of Foods Preferred by Chinese Elderly Individuals Based on IDDSI Levels

PONE-D-24-16170R2

Dear Dr. Chen,

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,

Chung-Ta Chang

Academic Editor

PLOS ONE

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Reviewers' comments: