Caregiver Nutritional Health Outcomes of the Simple Suppers Study: Results from a 10 Week, Two-Group Quasi-Experimental Family Meals Intervention

Round 1

Reviewer 1 Report

The article is well written, one aspect is that there are already other publications about this intervention. Even though the authors refer a lot to the available study protocol paper this could be done in a more pleasant way by fist describing the method and then referring to the publication instead of vice versa as is currently the case.

I do have 2 main questions or inputs for the authors after reading. First the Figure with the Flow Diagram is constructed in a similar way as the one for the children. But the numbers do not match. For example in the 10-week lost to follow up we have lost 16 children and only 10 parents. I assume there is a good explanation e.g. families with more than 1 child participating, but it should be mentioned and explained somewhere for completeness.

One of the main limitations is the limited amount of dietary recalls, and among the main outcomes there are several dietary intake measueres. The authors describe a decrease in energy intake but no changes in fruits, vegetables and sweetened beverages. In the discussion they argue that it was without compromising the diet quality. This is likely given the data, but due to the lack of information on for example other food groups and nutrients (e.g. protein, wholegrain, snacks, sweets) we can not confirm this statement. It would be very interesting to know where the energy change came from and maybe the authors could present some more dietary intake data. This would give the paper some more depth and could open up a discussion on the content of the intervention (were the objectives and content matching, which elements in the intervention could have influenced these changes)?

Author Response

Please see attached.

Author Response File: Author Response.docx

Reviewer 2 Report

This manuscript provides great research design, research gaps (limited literatures on caregiver’s direct health outcomes and diet/diet quality among various socioeconomic backgrounds), and excellent outcomes from the 10-week follow-up data. It is hard to recruit low-income households with at least one child (4-10 years old) for nutrition intervention and even harder to collect dietary recalls for long weeks intervention and follow-up. This manuscript reflected the reality of family meal intervention program that improves healthy eating and direct health outcomes, while reducing BMI that might leverage to the long-term health benefits. However, the introduction to support the outcomes is weak. It will be good to explain the current status quo of caregivers’ health (such as non-communicable diseases-diabetes and heart diseases, etc.) and its relationship with children’s health and eating behaviors such as FVs consumptions, drinking sugar sweetened beverages, and negative outcomes of these behaviors that will facilitate future obesity pandemic. I believe the authors can more emphasize the importance of family simple and healthy family meal program as preventive nutritional intervention for public health.  

Also, minor edits are recommended for publication of this manuscript:

1. In abstract, please add the recruitment and selection of control vs. intervention group.
2. In method, Line 106, if possible, please add household size that might represent the picture of households in the neighborhoods.
3. Line 116. The authors mentioned that “all eligible children were invited to participate and complete measures”. However, there is no data related to children of the caregivers who participated in this research. So, please add one short sentence showing that no children data was presented in this paper.
4. Line 185. Please check the BMI equation again. There is a typo.
5. Line 216. Change from n=3 to “three women or three participants”.
6. Figure 1. Fix arrows in figure 1.
7. Table 2. Please make it concise by deleting (Intervention vs……. Participants).

Author Response

Please see attached.

Author Response File: Author Response.docx