Review for 10.1186/s12876-021-01784-8 (2021)

Reviewer’s report
Title: 
Spinach consumption and nonalcoholic fatty liver disease among adults: a
case-control study
Version: 
1 
Date: 
16 Mar 2021
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses a
testable research question(s) (brief or other article types: is there a clear
objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with technical rigor
to allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work
technically sound? If not, can revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: 
A Food Frequency Questionnaire (FFQ) conducted on an Iranian cohort
comprising of newly diagnosed subjects with NAFLD and controls to determine
the effect of spinach consumption on the presence of NAFLD.
REQUESTED REVISIONS: 
Introduction
1 What were you expecting to find in studying raw vs. boiled spinach? Some
studies have been mentioned on page 10, however it would be helpful to know
your purpose or hypothesis in studying this?
2 Please report any gene studies associated with NAFLD in the same/similar
ethic group if already reported.
Methods
1. Why are the newly diagnosed showing grade II and III NAFLD presence?
Why are these referred for USG in the absence of any other co-morbidities? How
were the controls recruited into the study? What was the method of recruiting
subjects and controls in the study? Is Metabolic Liver Disease Research centre a
tertiary referral centre?
2. Nearly 50% of the female population (patients and controls) have not been
described in terms of pubertal 
status (puberty/menopause),number of
pregnancies, PCOS or other hormonal conditions. More details of the women
population are required.
3. Pg 6, Line 114-115, "Each serving of dietary spinach was computed as 30 and
90 gram raw and boiled spinach consumption", these sentences do not explain
why it was converted as 30-90 raw and boiled. Please elaborate your rationale
behind this sentence.
4. How many (more) questions were specifically asked in terms of spinach
consumption? Please attach a blank copy of your questionnaire with relation to
the same. Please provide a reference for the Iranian FCT and the conversions to
daily intake scale?
Results 
1. Page 8, line 164: Please revise this statement 'more smokers', the NAFLD
patients had more smokers (p value), ate fewer vegetable (p value)…..and you
have already reported their dairy consumption in the next paragraph. However, a
summary statement from Table 1 highlighting their descriptive characteristics
studied as noted above would be a helpful addition.
2. Please report the number of smokers by gender especially if its significantly
different between genders.
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Declaration of competing interests
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes