Prevalence of fast food consumption and associated factors among secondary school adolescents in Jigjiga Town Somali Region Eastern Ethiopia

Ahmed Mohammed Ibrahim; Nasra Ali Hussein; Mohyadin Abdullahi Ahmed; Girma Tadesse Wadajo; Mohamed Omar Osman; Ramadan Budul Yusuf; Abdilahi Ibrahim Muse; Seid Muhumed Abdilaahi; Raymond Place; Jakob Zinsstag

doi:10.1371/journal.pone.0327787

Peer Review History

Original SubmissionMarch 5, 2025
Decision Letter - Omnia El Seifi, Editor PONE-D-25-10434PREVALENCE OF FAST FOOD CONSUMPTION AND ASSOCIATED FACTORS AMONG SECONDARY SCHOOL ADOLESCENTS IN JIGJIGA TOWN SOMALI REGION EASTERN ETHIOPIAPLOS ONE Dear Dr. Ibrahim, 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: - strong justification should be provided in the introduction- In depth practical implication of the research should be added ============================== Please submit your revised manuscript by May 31 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 . 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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: Partly Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes 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: No 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: Dear Editor in Chief Plos ONE The paper: Prevalence of fast food consumption and associated factors amont seconday school adolescents in Jigjiga town Somali region eastern Ethiopis is a good study and a worthy research topic. It is quite relevant to Plos One topic. However, the article cannot be considered for publication in Plos One as it is. It needs a strong strong revision, as there are serious readability problems and methodological issues that the author(s) must manage effectively. All Parts of manuscript need revision. Actually, I suggest the authors study more articles in order to know the method of article writing. For example, it is about strength of statistical analysis in abstract that is unusual. The aim of introduction is not complete. There are lots of sentences that are vague and incomplete. Therefore, it is important to review the article’ writing. There are some typos throughout the text. The reference part is not regarding with Guideline of journal. The quality of figures is so weak and the data is presented in content of manuscript. The format of section Conclusion is like a report not article. Reviewer #2: Dear Authors, The manuscript entitles "Prevalence of Fast Food Consumption and Associated Factors among Secondary School Adolescents in Jigjiga Town, Somali Region, Eastern Ethiopia" addresses an important and increasingly relevant topic—fast food consumption and its associated factors among adolescents in a low-income setting. The study is well-timed and contributes useful data from a relatively underrepresented region. The authors are commended for their effort in collecting primary data from a representative adolescent population and for their attempt to explore behavioral, economic, and demographic correlates of fast-food consumption. The manuscript has the potential for publication but requires significant revision in language, statistical interpretation, and contextual discussion. 1. The topic is highly pertinent given the global nutrition transition and the rise of non-communicable diseases. The focus on a specific and under-researched Ethiopian region enhances the value and uniqueness of the findings. The study has a clearly stated objective and aligns well with the background literature presented. 2. The manuscript requires substantial English language editing. Numerous grammatical issues, redundancy, and awkward phrasing (e.g., "the prevalence fast-food consumption") hinder clarity and readability. 3. There is repetition of content in the Abstract, Results, and Discussion sections. The abstract should concisely summarize key findings without reproducing exact statistical outputs in multiple locations. 4. Terms like "fast food consumption," “availability,” and “influencing factors” should be clearly defined and used consistently throughout. The operational definitions are useful, but some are buried deep in the text and would benefit from clearer integration into the methods. 5. While the authors conduct multivariable analysis, important potential confounders such as physical activity level, dietary diversity, parental knowledge, and school-based dietary environments are not considered, limiting causal inference. 6. The rationale for using a cut-off of p < 0.25 for variable selection in multivariable models should be justified with appropriate citation. 7. Model diagnostics (e.g., Hosmer-Lemeshow test) were mentioned, but additional information such as ROC curve or pseudo-R² values would strengthen the analytical rigor. 8. The discussion could benefit from a more critical analysis of the results, especially the contradictions (e.g., the higher prevalence among males vs. other LMIC studies showing the opposite). Cultural explanations and regional dietary patterns should be elaborated to contextualize the findings. 9. Although some limitations are implicitly noted, a clearly demarcated section discussing the study’s limitations—especially the cross-sectional design and potential recall or social desirability bias—is necessary. 10. There are inconsistencies and apparent errors in reference formatting (e.g., missing journal names, vague URLs, or unclear citations). The reference list should be carefully revised to comply with PLOS ONE guidelines. 11. The term "knowledge on fast food" might be better phrased as "awareness of health risks associated with fast food consumption." 12. Figure captions and numbering could be more descriptive. 13. Tables should indicate p-values for multivariable regression clearly and consistently. ****** 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: Yes: Dr Manne Munikumar ******** [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.0327787.r001
Revision 1
17 May 2025 Author Response PONE-D-25-10434 PLOS ONE PREVALENCE OF FAST FOOD CONSUMPTION AND ASSOCIATED FACTORS AMONG SECONDARY SCHOOL ADOLESCENTS IN JIGJIGA TOWN SOMALI REGION EASTERN ETHIOPIA Acknowledgment to the editor and reviewers We sincerely appreciate the editor and reviewers' for their insightful and constructive comments, which has enhanced the caliber and readability of our work. Every comment has been thoroughly examined, and the manuscript has been updated as a result. We address each comments in detail below, along with the revisions that were done. ACADEMIC EDITOR COMMENT: 1. Strong justification should be provided in the introduction Response to the editor: The Introduction section has been substantially revised to provide a clearer and stronger rationale for the study. We have emphasized the rising trend of fast food consumption among adolescents, the associated health risks, and the specific data gap in Jigjiga and similar LMIC contexts. ACADEMIC EDITOR COMMENT: 2. In depth practical implication of the research should be added Response to the editor: We agree and have added a detailed discussion of the study’s practical implications in both the Conclusion and Discussion sections, with emphasis on policy, health education, and school-based interventions. ACADEMIC EDITOR COMMENT: 3. The IRB document you have supplied (JJURERB/039/2024) does not match the approval number stated in your manuscript (JJURERC039/2024). Please could you address this and provide the correct No (JJURERB/039/2024) in the Manuscript. Response to the editor: We have corrected the IRB number in the manuscript to JJURERB/039/2024 to match the ethical approval letter. ACADEMIC EDITOR COMMENT: 4. Please provide a complete Data Availability Statement in the submission form, ensuring you include all necessary access information or a reason for why you are unable to make your data freely accessible. If your research concerns only data provided within your submission, please write "All data are in the manuscript and/or supporting information files" as your Data Availability Statement. Response to the editor: The following statement has been added as per the journal’s guidance: “All data are in the manuscript and/or supporting information files. ACADEMIC EDITOR COMMENT: 5. Please include a separate caption for each figure in your manuscript. Response to the editor: Separate, descriptive captions have been added for all figures. ACADEMIC EDITOR COMMENT: 6. Please ensure that you refer to Figure 1 in your text as, if accepted, production will need this reference to link the reader to the figure. Response to the editor: Figure 1 is now clearly referenced in the Results section where we discuss the prevalence of fast food consumption. Reviewer Comment: The paper: Prevalence of fast food consumption and associated factors amount secondary school adolescents in Jigjiga town Somali region eastern Ethiopia is a good study and a worthy research topic. It is quite relevant to Plos One topic. However, the article cannot be considered for publication in Plos One as it is. It needs a strong revision, as there are serious readability problems and methodological issues that the author(s) must manage effectively. All Parts of manuscript need revision. Actually, I suggest the authors study more articles in order to know the method of article writing. For example, it is about strength of statistical analysis in abstract that is unusual. The aim of introduction is not complete. There are lots of sentences that are vague and incomplete. Therefore, it is important to review the article’ writing. There are some typos throughout the text. Response to the reviewers: We are grateful to your positive evaluation and valuable suggestions. The manuscript has been revised accordingly, as detailed below: We have conducted a full language and style revision throughout the manuscript to improve clarity, grammar, and flow. Methodological aspects have been clarified in the Methods section. The Introduction has been rewritten to clearly justify the study, define key concepts, and highlight the public health significance and regional gap. All sections have been revised and proofread to eliminate typographical and grammatical issues. Redundancies have been removed, and unclear phrasing has been clarified. Reviewers Comment: The reference part is not regarding with Guideline of journal. The quality of figures is so weak and the data is presented in content of manuscript. Response to the reviewers: All figures have been improved for clarity and consistency. Figure captions have been added separately as required. The format of section Conclusion is like a report not article. Consumption and its associated factors among adolescents in a low-income setting. The study is well-timed and contributes useful data from a relatively underrepresented region. The authors are commended for their effort in collecting primary data from a representative adolescent population and for their attempt to explore behavioral, economic, and demographic correlates of fast-food consumption. The manuscript has the potential for publication but requires significant revision in language, statistical interpretation, and contextual discussion. Response to the reviewers: The Conclusion has been rewritten in a scholarly tone, summarizing key findings and highlighting implications for future research and policy. Reviewers Comment: 1. The topic is highly pertinent given the global nutrition transition and the rise of non-communicable diseases. The focus on a specific and under-researched Ethiopian region enhances the value and uniqueness of the findings. The study has a clearly stated objective and aligns well with the background literature presented. Response to the reviewer: Thank you for your encouraging comment. We have strengthened the framing of our study within the context of global nutrition transition and regional data gaps. Reviewers Comment: 2. The manuscript requires substantial English language editing. Numerous grammatical issues, redundancy, and awkward phrasing (e.g., "the prevalence fast-food consumption") hinder clarity and readability. Response to the reviewer: The manuscript has undergone thorough language editing to improve readability and eliminate awkward phrasing and redundancy Reviewers Comment: 3. There is repetition of content in the Abstract, Results, and Discussion sections. The abstract should concisely summarize key findings without reproducing exact statistical outputs in multiple locations. Response to the reviewer: Redundant content has been removed from the Abstract and Discussion to streamline the presentation of results. Reviewers Comment: 4. Terms like "fast food consumption," “availability,” and “influencing factors” should be clearly defined and used consistently throughout. The operational definitions are useful, but some are buried deep in the text and would benefit from clearer integration into the methods. Response to the reviewer: Operational definitions for 'fast food consumption,' 'availability,' and 'influencing factors' have been revised and moved to the Methods > Operational Definitions section. These terms are now used consistently throughout the manuscript. Reviewers Comment: 5. While the authors conduct multivariable analysis, important potential confounders such as physical activity level, dietary diversity, parental knowledge, and school-based dietary environments are not considered, limiting causal inference. Response to the reviewers: We acknowledge this limitation and have added a clear Limitations section discussing the absence of these variables and the implications for causal inference. Reviewers Comment: 6. The rationale for using a cut-off of p < 0.25 for variable selection in multivariable models should be justified with appropriate citation. Response to the reviewer: We have included a justification in the Methods section with the appropriate citation. Reviewers Comment: 7. Model diagnostics (e.g., Hosmer-Lemeshow test) were mentioned, but additional information such as ROC curve or pseudo-R² values would strengthen the analytical rigor. Response to the reviewer: We have added the ROC curve (AUC = 0.74) and Nagelkerke pseudo R² (0.31) to the model diagnostics, now detailed in the Methods section. Reviewers Comment: 8. The discussion could benefit from a more critical analysis of the results, especially the contradictions (e.g., the higher prevalence among males vs. other LMIC studies showing the opposite). Cultural explanations and regional dietary patterns should be elaborated to contextualize the findings. Response to the reviewer: The Discussion section now includes a more nuanced interpretation of sex-based differences and cultural dietary patterns in the Somali Region. Reviewers Comment: 9. Although some limitations are implicitly noted, a clearly demarcated section discussing the study’s limitations—especially the cross-sectional design and potential recall or social desirability bias—is necessary. Response to the reviewer: A new Limitations subsection has been added at the end of the Discussion. Reviewers Comment: 10. There are inconsistencies and apparent errors in reference formatting (e.g., missing journal names, vague URLs, or unclear citations). The reference list should be carefully revised to comply with PLOS ONE guidelines. Response to the reviewer: The reference list has been revised to comply with PLOS ONE guidelines, including correct journal names, formats, and citation styles. Reviewers Comment: 11. The term "knowledge on fast food" might be better phrased as "awareness of health risks associated with fast food consumption." Response to the reviewer: This has been reworded as awareness of health risks associated with fast food consumption. Reviewers Comment: 12. Figure captions and numbering could be more descriptive. Response to the reviewer: Figure captions have been rewritten for clarity, and p-values in tables have been standardized and clearly indicated. Reviewers Comment: 13. Tables should indicate p-values for multivariable regression clearly and consistently. Response to the reviewer: p-values for multivariable regression we incorporation in the revision Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0327787.r002
Decision Letter - Omnia El Seifi, Editor <div>PONE-D-25-10434R1PREVALENCE OF FAST FOOD CONSUMPTION AND ASSOCIATED FACTORS AMONG SECONDARY SCHOOL ADOLESCENTS IN JIGJIGA TOWN SOMALI REGION EASTERN ETHIOPIAPLOS ONE Dear Dr. Ibrahim, 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 : - The manuscript still requires language and gramatical revision.- The rationale for selecting in the multivariate model (p < 0.25) needs to be justified with proper references. - Enhancing the cultural context in your discussion—especially regarding gender differences and socioeconomic influences—would strengthen the interpretive depth of the findings.============================== Please submit your revised manuscript by Jul 28 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, Omnia Samir El Seifi, M.D., 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.] 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: 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: NONE, it can be accepted. All the comments replied and included in the text. It was my previous comments to author Dear Editor in Chief Plos ONE The paper: Prevalence of fast food consumption and associated factors amont seconday school adolescents in Jigjiga town Somali region eastern Ethiopis is a good study and a worthy research topic. It is quite relevant to Plos One topic. However, the article cannot be considered for publication in Plos One as it is. It needs a strong strong revision, as there are serious readability problems and methodological issues that the author(s) must manage effectively. All Parts of manuscript need revision. Actually, I suggest the authors study more articles in order to know the method of article writing. For example, it is about strength of statistical analysis in abstract that is unusual. The aim of introduction is not complete. There are lots of sentences that are vague and incomplete. Therefore, it is important to review the article’ writing. There are some typos throughout the text. The reference part is not regarding with Guideline of journal. The quality of figures is so weak and the data is presented in content of manuscript. The format of section Conclusion is like a report not article. Reviewer #2: Dear Authors, This study presents valuable insights into the prevalence and determinants of fast food consumption among adolescents in Jigjiga, an under-researched region in Eastern Ethiopia. The topic is both timely and relevant to global public health discourse, particularly in low- and middle-income contexts. Your revisions demonstrate responsiveness to earlier feedback, especially with the expanded rationale, improved methodology, and inclusion of ethical and statistical clarifications. However, the manuscript still requires significant refinement in scientific language and consistency. Several sections, particularly the Abstract, Discussion, and Conclusion, contain grammatical errors, redundant phrasing, and lack the academic tone expected in peer-reviewed journals. Furthermore, operational definitions should be presented clearly and consistently, and the rationale for variable inclusion in the multivariate model (p < 0.25) needs to be justified with proper references. Enhancing the cultural context in your discussion—especially regarding gender differences and socioeconomic influences—would strengthen the interpretive depth of the findings. ****** 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 ******** [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.0327787.r003
Revision 2
19 Jun 2025 Author Response Response to the Reviewers PONE-D-25-10434R1 PREVALENCE OF FAST FOOD CONSUMPTION AND ASSOCIATED FACTORS AMONG SECONDARY SCHOOL ADOLESCENTS IN JIGJIGA TOWN SOMALI REGION EASTERN ETHIOPIA ACADEMIC EDITOR Comments: - The manuscript still requires language and grammatical revision. - The rationale for selecting in the multivariate model (p < 0.25) needs to be justified with proper references. - Enhancing the cultural context in your discussion—especially regarding gender differences and socioeconomic influences—would strengthen the interpretive depth of the findings. Response to Academic Editor: Dear Editor, Thank you for your valuable comments and thoughtful suggestions. We would like to indicate that all the comments have been carefully corrected and addressed as follows: • The manuscript has undergone thorough language and grammatical revision to enhance clarity and readability. • The rationale for selecting variables with a p-value < 0.25 in the multivariate model has been clearly justified and supported with proper reference in the revised manuscript. • The discussion section has been expanded to better reflect the cultural context, particularly in relation to gender differences and socio-economic influences on fast food consumption, to provide deeper interpretive insight in to the findings. Reviewers' comments: Reviewer #1: NONE, it can be accepted. All the comments replied and included in the text. It was my previous comments to author. It needs a strong revision, as there are serious readability problems and methodological issues that the author(s) must manage effectively. All Parts of manuscript need revision. Actually, I suggest the authors study more articles in order to know the method of article writing. For example, it is about strength of statistical analysis in abstract that is unusual. The aim of introduction is not complete. There are lots of sentences that are vague and incomplete. Therefore, it is important to review the article’ writing. There are some typos throughout the text. The reference part is not regarding with Guideline of journal. The quality of figures is so weak and the data is presented in content of manuscript. The format of section Conclusion is like a report not article. Response to Reviewer #1: Dear Reviewer, We would like to express our sincere appreciation for the focused and constructive comments provided on our manuscript. We would like to note that most of the issues raised were addressed in the previous revision, as acknowledged in the reviewer’s initial statement: "NONE, it can be accepted. All the comments replied and included in the text. It was my previous comments to author." However, in light of the additional comments provided, we have carefully reviewed the manuscript once again and have made further revisions to ensure the quality and clarity of the work. Specifically: • Readability and Structure: The manuscript has undergone a comprehensive language and grammar review to enhance clarity, coherence, and flow throughout all sections. • Conclusion Section: The conclusion has been rewritten to better reflect an academic tone, focusing on summarizing key findings and implications, rather than reporting. Reviewer #2: Dear Authors, This study presents valuable insights into the prevalence and determinants of fast food consumption among adolescents in Jigjiga, an under-researched region in Eastern Ethiopia. The topic is both timely and relevant to global public health discourse, particularly in low- and middle-income contexts. Your revisions demonstrate responsiveness to earlier feedback, especially with the expanded rationale, improved methodology, and inclusion of ethical and statistical clarifications. However, the manuscript still requires significant refinement in scientific language and consistency. Several sections, particularly the Abstract, Discussion, and Conclusion, contain grammatical errors, redundant phrasing, and lack the academic tone expected in peer-reviewed journals. Furthermore, operational definitions should be presented clearly and consistently, and the rationale for variable inclusion in the multivariate model (p < 0.25) needs to be justified with proper references. Enhancing the cultural context in your discussion—especially regarding gender differences and socioeconomic influences—would strengthen the interpretive depth of the findings. Response to Reviewer #2: Dear Reviewer, Thank you very much for your thoughtful and constructive comments and suggestions, as well as for acknowledging the relevance and improvements made in our manuscript. We greatly appreciate your insights, which have helped us further improve the quality of this manuscript. In response to your valuable comments and suggestions, we have made the following revisions: • The Abstract, Discussion, and Conclusion was edited to enhance scientific language, remove redundancies, and ensure a consistent academic tone. • We revised the operational definitions for clarity and consistency. • We incorporated a justification with appropriate references for including variables with p < 0.25 in the multivariate model. • The discussion is strengthened with the cultural context in the discussion, particularly regarding gender differences and socioeconomic influences. Attachments Attachment Submitted filename: Response_to_Reviewers_auresp_2.docx https://doi.org/10.1371/journal.pone.0327787.r004
Decision Letter - Omnia El Seifi, Editor <p>PREVALENCE OF FAST FOOD CONSUMPTION AND ASSOCIATED FACTORS AMONG SECONDARY SCHOOL ADOLESCENTS IN JIGJIGA TOWN SOMALI REGION EASTERN ETHIOPIA PONE-D-25-10434R2 Dear Dr. Ibrahim, 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, Omnia Samir El Seifi, M.D., Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0327787.r005
Formally Accepted
Acceptance Letter - Omnia El Seifi, Editor PONE-D-25-10434R2 PLOS ONE Dear Dr. Ibrahim, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. 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. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Omnia Samir El Seifi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0327787.r006

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