Title: Association between depressive symptoms of mothers and eating behaviors of school-
going children in Urban Bangladesh: A Cross-sectional Study
Version: 1 Date: 25 Jan 2023
Reviewer:  Shabnam Naher
Reviewer's report:
Interesting research was done on the topic of "Depressive Symptoms among Mothers are
associated with Eating Behaviors of School-going Children in Urban Bangladesh: A Cross-
sectional Study." For further quality improvement, it would be much appreciated if the authors
addressed the following concerns in their paper.
Abstract
- The study recommendation about “mothers should be concerned about their children’s eating
behaviors from a very early life” is a generic statement. It should be specified.
Keywords
- “Mother” can be added.
Introduction
- Need further citation on “Globally, depression is identified as a common mental illness and
one of the leading causes of disability”.
- More updated data should be provided when saying that “In 2016, the age-standardized …was
3.9% and 4.4%, respectively”.
- Relevant data on whether father’s depressive symptoms are less affecting to children’s eating
habit can be added instead of the comparison of depressive symptoms of men and women.
- There must be a connection between first and second paragraph. It would be better if the authors
can add some connecting reference between last sentences of first paragraph and first sentences
of the second paragraph.
Materials and Methods
- Why the authors selected mothers of children (class V- VIII)? It would be great to rationalize it.
- Was there any specific reason of unavailability of one-eighth of the students on the sampling
frame during the data collection period? If yes, please mention it on the method section.
- How many relevant experts reviewed the questionnaire? It would be better if the qualifications
of those experts mention in brief so that the potential bias can be minimized.
- Who actually ensured the quality of the back-translation process? If it is the experts, then please
mention it on that specific sentence.
- Is there any justification of choosing six non-sampling study areas for pretesting of the
questionnaire?
- When authors are saying that “In terms of the completeness and accuracy of the data, we
checked thoroughly on a daily basis”, how did they check that? Did they maintain a logbook
or something else?
- Need to mention the abbreviation of Statistical Package for the Social Sciences.
Results
- “Mothers (54.30%) were #40” does it implies age? Please specify.
- Instead of a manual entry, the tables can be directed from SPSS file.
- Please clarify the sentence for readers “Interestingly we found that ….higher chance of being
depressed both in unadjusted”.
- Tables comes up with the p value can have the detail underneath the table as footnotes for
further clarification (e.g., *<0.001, **p<0.05).
Discussion
- The first sentence does not convey the study objective. It should address the eating behaviors
of children as well. Please rewrite the sentence for clarification.
- Depressive symptoms in mothers after births are not conveying the study relevance. Please
rationalize relevant reference.
- The way authors claim the association between soft drinks and mother’s depressive symptoms
in their discussion is contradictory with their findings. Please rewrite with proper wordings.
- Need citation for this “Fast foods are widely…desire to eat and without thinking the
consequences mothers are fulfill their children’s desire.”
- The study is addressing mother’s depression. Please rewrite the argument where mentioned
about parental depression on children’s fast-food intake.
- Why the authors think about the necessity of diversified questionnaires for the study context?
Is it only the issue with the diversified questionnaires?
- When the authors mentioning about the association between soft drink/fast food consumption
with mother’s depressive status, did they find any potential reason behind that? If yes, it would
be appreciated to justify those in discussion section.
- The last paragraph of the discussion section needs to be revised as it discussed more generic
comments without proper referencing. Also, these discussions should be relevant to the study
objective.
Conclusions and recommendations
- The recommendations implying school children’s execution of lunch program whereas the
study is about the depressive symptoms of mothers with their children’s eating behavior. The
study subject is missing in recommendations.
- Overall, the study recommendation is not addressing the study objective. It would be
appreciated to revise it.
Limitations
- The authors should acknowledge the absence of inter-rater reliability in their limitation section.
Other comments
- There are couple of spelling mistakes and writing error (e.g., line start with “then It was further”
on page 6; line start with “since there was just one interviewer (the PI) inter-rater reliability…..”;
324 (n) on page 6). It would be highly encouraged to check the paper with an English language
expert.
- Some corrections are needed on the referencing section. Please recheck them.
Overall, the writing is good. I would really appreciate if the authors addressed the above-
mentioned concerns for further improvement. Good luck.