Reviewer ’s report  
 
Title: The Effects of concurrent training (aerobic -resistance) and milk consumption on some 
markers of bone mineral density in women with osteoporosis  
 
Version: 0 Date: 10 Jul 2018  
 
Revie wer: Reviewer 2  
 
Reviewer's report:  
 
"PEER REVIEWER COMMENTS: To view the full report from the academic peer reviewer, 
please see the attached file.  
 
REVIEWER COMMENTS FROM REPORT: This report aimed to investigate the effect of 
concurrent exercise and mild supplement on young female osteoporosis. The outcome 
measurements included bone marker, and BMD on hip and spine.  
My major concern is the source of patients. Where are these patients included? General clinic? 
Specialty clinic? Healthy volunteer? The source of patient will determine the generalization of 
study results, and also cause selection bias. Osteoporosis younger than 40 may have secondary 
cause s, such as early menopause, steroid user, or other endocrine diseases. These secondary 
etiology should be pursued in young osteoporotic patients. Besides, the asymmetry of BMD 
between right and left hip is very unusual. Why these patients had right hip BMD  at around   -
1.0, and right hip BMD at around -2.5? It is very strange.  
The other major concern is small sample size. As small as 10 subjects in each group may cause 
statistical error. The author should list the normality test result, since non -parametri c test should 
be employed if normality is not met. Paired t test is not appropriate under this condition.  
 
REQUESTED REVISIONS:  
Major revision is needed. Please see Point 5  
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
Minor issues:  
1. The manuscript needs to be English -edited.  
 
2. P3L12: sport is different from exercise. Please clarify this paragraph.  
 
3. P3L53(Method): What is the diagnostic criteria for osteoporosis? Caucasian BMD data was 
employed as norms, or race -specific data as norms?  
 
4. P3L56: what is use of certain drug? Please specify. Do they have medication for 
osteoporosis?  
 
5. P3L59: The author mentioned "received little sunlight", how do you quantify sunlight 
exposure?  
 
6. The Introduction is too lengthy.  
 
7. Since there ar e some baseline difference between the 4 groups pre -intervention, adjustment 
or stratification is needed. " 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comment s to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical rev iew?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indi cate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past fiv e years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that ma y in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, f unding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilize d for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honorar ia for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
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on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
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