Title: Magnitude of sugar-sweetened beverage consumption and associated factors among
women aged 15-49 years old in two Sub-Saharan African Countries
Version: 1 Date: 11 Aug 2023
Reviewer:  Monica Ewomazino Akokuwebe
Reviewer's report:
Sugar-Sweetened Beverage Consumption and associated factors among women aged 10-49
years old in two Sub-Saharan African Countries
Peer Reviewer 1 – Comments
Dear Author(s),
This paper has potential merits, as it discusses topical concerns regarding women. However,
there are a few comments that require clarification, and they need to be addressed. However,
my comments raised in this manuscript is to ensure this helps the manuscript better and comes
out in publication in BMC Women's Health. Hence, my comments are as follows:
1. Check the sentence, and rewrite the sentence [Line 35-36]
2. In the Abstract, are there studies showing that women consumed more SSB beverages, so
they are more prone to the burden of obesity and other NCDs? Please, clarify that in the abstract
[Line 38-40]
3. Check the sentence. It is incorrect [Line 46-47]
4. Rewrite and clarify whether SSB may cause those diseases you mentioned because other risk
factors can make one prone to such diseases [Line 50-60]
5. Kindly specify the broad objective of this study, then state the specific objectives of this study,
as this will assist and guide the methods and patterns the message you are passing will flow
through via the findings, discussion and conclusion. [Line 68-70].
6. Check Line 75
7. Separate Study design and setting from data source. The data source should have its separate
subsection under Methods [73-83]
8. Discuss in detail the study settings – the two countries you are working on and how they have
affected SSB among women of reproductive Age [73-85]
9. Give us a detailed description of the data source(s) for both countries since they are from the
same source [73-85]
10. The section under population and sampling procedures should be done for each country,
separated by paragraphs so that your reader can understand the geographical dimensions of both
countries in the aspects of enumeration areas and sampling processes. [Line 86-98]
11.  Describe how the data was collected for each of the countries; even though they are from
secondary sources, there is always a methodological report attached to the secondary sources of
data to show all the procedures and processes involved in the methodology [Line 99-103]
12.  Under study variables, I think the right name for the section is 'Variable Measurements',
and under this section, you have to discuss the following with better clarifications:
(1) the Outcome Variable or Dependent variable to illustrate what questions from the secondary
data sources were used as the dependent variable and how it was measured to ascertain the type
of statistical analysis that will be utilized. For instance, a question that says in the last three
months till date, have you been taking excessive SSB? If the response says Yes = 1 (coded as 1),
otherwise No = 2 (coded as 0). This already showed that my analysis would be binary logistic
regression analysis, as the outcome variable is a binary: Yes or No. [Line 105-109]
(2) The Explanatory variables (factors) of the Independent variables will be mentioned here
and explained in detail their measurement. For instance, the explanatory factors include Age
(15-19, 20-24, 25-29, 30-34, 35+), Education (No education, Primary, Secondary, Higher) etc
[Line 111-140]
13. How was Minimum Dietary Diversity (MDD) measured? Did you look at previous studies
and see how it was coded or recorded? Or did you adopt the measurement just the way it is from
the secondary sources [Line 132-135]
14. Put all the variables together as I suggested above. The way you put them makes them scatter
all over and without no meaning, hanging all by themselves alone [Line 117-140]
15. Under data management and analysis, I suggest you discuss what type of statistical
software was used and how your data was weighted (justify such actions). Then, describe
your research in line with the specific objectives of this study. For instance, descriptive
analysis was utilized to show the respondents' prevalence (Bar graphs) and socio-demographic
characteristics (frequency and percentages – Table 1). Bivariate was used to indicate the possible
associations between the dependent and independent variables (Table 2). Multivariate analysis
(binary logistic regression) was employed to draw the predictors of the relationship between the
dependent and independent variables by showing the Unadjusted Odds Ratio (UOR) and the
Adjusted Odds Ratio(AOR). The statistical analysis was done at a 5% or 1% significance level.
So, as mentioned above, my illustrations will guide you in the effect of these corrections I just
raised above. [Line 142-154]
16. Under ethical consideration, kindly rewrite this. Follow this template: (The 2018 Nigeria
Demographic Health Surveys can be downloaded from the website and are free to use by
researchers for further analysis. To access the data from the Demographic Health Survey (DHS)
MEASURE, a written request was submitted to the DHS MACRO. Electronic permission was
granted to use the dataset for this study; this was received from the ICF in May 2021. The DHS
ensured international ethical standards of confidentiality, anonymity and informed consent, and
availability of de-identified DHS datasets.) [Line 156-161]
17. This sentence is unclear: The women's median Age (iqr) was 24 (15,33) years old. What is
iqr stands for? [Line 171-172]
18. In Table 1, why do you include CI? What does CI represent, and what does it stand for? I think
Table one should be in frequency and percentages to show the socio-demographic characteristics
of the respondents of this study. Remove the CI and make the table frequency and percentages.
[Line 176-178]
19. Instead of magnitude, why not use 'Distribution of Women's Consumption of SSBs by
Food Security and Wealth Index? This title is more appropriate than what you put down in the
manuscript. [179-183]
20. This should be the bivariate analysis of the factors associated with women's consumption of
SSB by socio-demographic characteristics. [Line 189-212]
21. In Table 2, the bivariate analysis should be removed from the multivariate analysis. The
multivariate analysis should be in Table 3. [Line 213-215]
22. In Table 2, why is COR = # < 0.25, why not COR = # < 0.05 just as the AOR = # < 0.05.
What is COR stands for? Is this COR stand for Canonical correlation analysis? In multivariate
analysis, a common way to inspect the relationship between two sets of variables based on their
correlation is the Canonical Correlation Analysis (COR). It determines linear combinations of
all variables of each type with the maximal correlation between the two linear combinations.
This is also known as 'Parametric bivariate' analysis. Kindly Remove all the bivariate analyses
from the multivariate analyses. This is very important. [Line 215]
See Reference: Zhuang, X., Yang, Z., & Cordes, D. (2020). A technical review of canonical
correlation analysis for neuroscience applications. Human brain mapping, 41(13), 3807–3833.
https://doi.org/10.1002/hbm.25090.
23. Let the Discussion section be inferred from the results of this study. So you will have
to completely rewrite this section and let each paragraph represent each specific objective
according to the analyses carried out in this study. [Line 219- 263]
24. Make a separate section for Study strengths and limitations. First, show the study's strengths
before proceeding to the data's limitations. Let this section reflect the accurate 'picture' or 'reality'
of the literature review, methods and findings. [Line 256-263]
25. This statement is confusing. What do you mean by hierarchical structure? Is it the model
or the strength of this study that includes using the appropriate statistical model for data with a
hierarchical structure? Remember, it was binary Logistic Regression analysis that you utilized.
[Line 256-257]
26. Discuss the conclusion in a better form; this section needs to be rewritten in a better and more
focused way. Let your discussion under the 'conclusion section' be inferred from this study's
major and essential/significant outcomes/findings. [Line 265-270]
27. Add recommendation(s) at the end of the conclusion. [Line 270]
28. The font name you used in the main manuscript differs from the References. Kindly address
this. [Line 18-298] and [Line 302-420]
29. The paper needs a Professional English Editor to edit the entire article. There are many
vocabulary errors, blunders, and incorrect sentences. You must send this manuscript to an
outstanding Professional English language Editor for thorough editing. [Line 1-420]