Title: The Impact of Carbohydrate Quality Index on Menopausal Symptoms and Quality of Life
in Postmenopausal Women
Version: 3 Date: 25 Apr 2025
Reviewer's report:
Thank you to the authors for revising the manuscript and addressing many of the
previous comments and suggestions. The current version of the article demonstrates notable
improvements in several areas. However, it is important to note that certain aspects of scientific
writing and academic structure still require further attention. Below, I outline some remaining
issues that need to be addressed to enhance the clarity, coherence, and academic rigor of the
manuscript.
In the results section of the abstract, only the p-values are reported, with no mention of
effect sizes. This omission is also present in the main text, where the type of effect size and
corresponding numerical values are not clearly reported. Given the importance of effect sizes
in interpreting the magnitude and practical significance of findings—beyond mere statistical
significance—it is essential that the authors specify and report appropriate effect size metrics
(e.g., Mean±SD, odds ratio), along with their corresponding values.
At the beginning of the discussion section, the authors restate the study’s objectives and
briefly reiterate elements of the methodology. However, according to standard academic writing
conventions, the discussion should begin by highlighting and interpreting the key findings of the
study. The current structure weakens the analytical depth of the discussion. It is recommended
that the authors revise the opening of the discussion to focus on the main results and their
implications, rather than repeating previously stated objectives or methods.The discussion
section should begin with a direct response to the research question, rather than general remarks
or repetitive statements.
At the end of the manuscript, the authors have provided a ClinicalTrials.gov registration ID
(NCT06666244-10/29/2024). This raises the question of whether the present study is part of a
larger clinical trial, as the current design appears to be a cross-sectional study. Typically, trial
registration is required for interventional studies, particularly randomized controlled trials, and
not for purely observational or cross-sectional research. The authors are kindly requested to
clarify this point and explain the rationale for including a trial registration number for this study.
The background section of the abstract could be improved in terms of clarity and depth. It
is recommended that the authors more explicitly highlight the role of nutrition—particularly
dietary patterns relevant to menopausal women—in the management of menopausal symptoms.
Given that carbohydrates constitute a major portion of dietary intake in many Asian countries,
the quality of carbohydrate consumption may play a significant role in modulating menopausal
health outcomes and related chronic conditions. Integrating this perspective into the background
would strengthen the rationale for the study and improve its contextual relevance.
In the literature review section, the discussion is overly limited, relying almost exclusively
on reference 18. To enhance the depth and scientific grounding of this section, it is strongly
recommended that the authors expand their review to include additional studies examining the
role of glycemic index and carbohydrate quality in the development and management of various
health conditions during menopause. Incorporating a broader range of relevant literature would
provide stronger justification for the current study