Reviewer's report
Title:The effect of physical activity and body mass index on menopausal
symptoms: a cross-sectional study in primary care
Version: 3Date:26 August 2013
Reviewer: PASCAL IZZICUPO
Reviewer's report:
Major Compulsory Revisions
The study investigates the relationship between menopausal symptoms and both
physical activity and BMI, in peri-menopausal and post-menopausal Turkish
women. Physically active women show fewer bothersome symptoms than
women with low levels of physical activity, whereas BMI seems to have not
relationship with menopausal symptoms. Positive effects of lifestyle changes are
promising because might reduce the use of pharmacological agents.
The study is well written with proper statistical analysis but I have some concern
about the interest for publishing:
My major concern is about the contribution of this study to improve on
knowledge. In background section, you cite studies that relate menopausal
symptoms with physical activity leading to contrasting results. However the
present study does not provide new results respect to some cited studies, with
few little exceptions (e. g. smoking status). Furthermore, the relationship between
the scores of MRS and IPAQ were previously reported by Canario AC et al. in a
similar way to your study (Canário AC et al. The impact of physical activity on
menopausal symptoms in middle-aged women. Int J Gynaecol Obstet. 2012
Jul;118(1):34-6 and da Silveira Gonçalves AK et al. [Impact of physical activity on
quality of life in middle-aged women: a population based study]. Rev Bras
Ginecol Obstet. 2011 Dec;33(12):408-13.). These studies were conducted on
Brazilian population and ethnical and cultural differences could play an important
role in menopausal symptoms, legitimizing the investigation on Turkish
population. However, I suggest at least citing these studies and justifying the
need of a similar study in Turkish population. Because IPAQ provides data about
sitting time, can you provide results about this item? I suggest including this point
in your analysis because, in my knowledge, it has not been related to
menopausal symptoms, previously. Because HRT may influences body
composition, I suggest to take it into account when you analyze the effect of BMI.
Are there differences between inactive and active women respect to confounding
factors such us, educational level, employment status, etc...? I recommend you
to adjust your analysis for these variables.
Minor essential revisions
Methods, instrumental and data collection
-How were weight and height measured? Please, insert name and company of
instruments or, indicate if they were simply asked to participants. If the latter is
the case, this might explain the lack of relationships between BMI and
menopausal symptoms and should be mentioned in discussion.
Results, second sentence
- ‘The MRS total score were also high in non-smoking…’. Change high with
higher.
Discretionary revisions
Background, second sentence
-Provide reference for: ‘while 75-80% of women…’.
-the use of semicolon make the sentence a bit confusing: can you rephrase?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests