Title: Associations of the Healthy Beverage Index (HBI) and the risk of Breast Cancer (BrCa):
A Case–Control Study
Version: 1 Date: 14 Aug 2023
Reviewer's report:
The article has many major problems in the results and discussion sections. The main problem
is the deviation from the objectives of the study in the above two sections. Comments were
included in the text of the article. Some are as follows:
-In the aim of the study, it was not mentioned that Dietary intakes is also examined in relation
to breast cancer; While half of the analysis results were related to it.
-The significance level of the variables should be mentioned.
-Regarding Table 1, please answer the following:
1. “Anti-inflammatory drugs” was used instead of Painkiller variable. Use similar words. These
two names are not used interchangeably, although one of the uses of anti-inflammatory drugs
is pain relief.
2. Of course, anti-inflammatory drugs were mentioned in Table 1. Does it mean non-steroidal
anti-inflammatory drugs (NSAIDs)? If yes, correct it. If not, do you mean steroid type like corton
drugs?
3. Another question is, what is the purpose of the question "taking anti-inflammatory drugs" and
comparing it in two groups? Why should a person chronically use these drugs considering their
side effects? To conclude later that because of the use of this drug, the level of cancer incidence
in users was lower?.
- The use of anti-inflammatory drugs is completely temporary and everyone may often use them
as painkillers at some point in their life. This means that the short-term use of these drugs (also
randomly) can significantly reduce the incidence of cancer?.
-Energy, carbohydrates and fats are not micronutrients. Carbohydrates, protein and fat are
macronutrients. And micronutrients include vitamins and minerals. This is one of the very basic
principles of nutrition science
-Table 2 shows that hormone replacement therapy reduces the risk of breast cancer. This is
contrary to the existing literature. Also, the authors did not discuss this finding.
-The results of comparing the food intake of the two case and control groups seem very optimistic
and ideal. This is a bit strange
- In Table 3, using Tukey's test, it should be mentioned that the difference observed in the
ANOVA test was significant between which two variables?
-In Table 3, the values of HBA quartiles should be mentioned.
-hat happened in table 4 comparing the two control and case groups? Instead, the variable
before and after menopause was examined. My understanding of Table 4 is to compare the total
population, then women before menopause and then after menopause in three models. And it is
not indicative of the comparison between control and control groups.
-This conclusion does not follow from table 4, according to the explanation of table 4 in the
results section. First, the description of Table 4 needs to be revised.
-There was no discussion about the relationship between the variables in Tables 2 and 3. If it
is not related to the subject of the study, it should be removed from the tables. If it is related,
it should be discussed
-Please compare this conclusion with the purpose of the study. You find that they are not aligned.
-Findings regarding the relationship between food intake were not mentioned as part of the
objectives of the study, but they were mentioned in the results, and there was no mention of
these relationships in the discussion; While it appeared again only in the conclusion.
-The limitations and strengths of the study should be mentioned.
- Suggestions for further research