Soft Drink Addiction Scale: Reliability and Validity Analysis in Young Mexican People

Round 1

Reviewer 1 Report

This manuscript describes development and validation of a soft drink addiction scale for young adults in Mexico. Having shown good reliability and validity, this scale has potential value as a research and assessment tool. Overall, the study was conducted very well. The manuscript is clearly written and organized, results are clearly described and thoroughly discussed.

Lines 210-211: A sentence or two interpreting the results shown in Table 4 would be helpful.

Line 267:  Is “Who” referring to the World Health Organization? If so, it should be all caps. If not, it seems a reference is needed?

Table 5.  Indicate in the table title or as a footnote that these are Pearson correlation coefficients.

Overall, the quality of the language and writing is good. However, there are some sentences with awkward sentence structure and use of words. 

Author Response

We appreciate your valuable time dedicated to reviewing the manuscript and the corrections that were pointed out to us, below we respond to each of them and indicate the lines that had changes in the manuscript.

Lines 210-211: A sentence or two interpreting the results shown in Table 4 would be helpful.

Reply: The structure of the discussion section was modified to add this interpretation

Lines: 261-275

Line 267:  Is “Who” referring to the World Health Organization? If so, it should be all caps. If not, it seems a reference is needed?

Reply: The correction was made

Line: 267

Table 5.  Indicate in the table title or as a footnote that these are Pearson correlation coefficients

Reply: Suggested description added

Line: 234

In addition to the changes made, a review of the manuscript was carried out by a colleague fluent in English writing

All Changes to the manuscript were highlighted

Kind regards,

Dr. Cesar Campos-Ramirez, Dr. Nicolas Camacho-Calderon, Dr. Maria Elena Villagran-Herrera, Dr. Adriana Aguilar-Galarza, Dr. Miriam Aracely Anaya-Loyola and Dr. Jorge Palacios-Delgado

Reviewer 2 Report

The work mainly presents a description of the results of statistical analyses conducted (reliability and validity) regarding the soft drink addiction scale in a group of young people from Mexico.

The introduction lacks information about what cultural (or other) factors influence the increased consumption of soft drinks in the case of a group of adults from Mexico.

Is there any other socio-economic data available about the study group, e.g. place of residence, number of people in the family, parents' education, etc.?

The characteristics of the study group did not include results regarding the interpretation of BMI and/or TBF% taking into account gender?

The amount of fluids consumed is usually given daily?

The description of the validity factors of the scale should be included in the work methodology and not in the discussion.

The discussion does not refer to the results of studies determining the consumption of soft drinks conducted in other studies (ex. Liq.In7 study).

Author Response

We appreciate your valuable time dedicated to reviewing the manuscript and the corrections that were pointed out to us, below we respond to each of them and indicate the lines that had changes in the manuscript.

The introduction lacks information about what cultural (or other) factors influence the increased consumption of soft drinks in the case of a group of adults from Mexico.

Reply: Suggested information was added

Lines 55-68 and 90-93

Is there any other socio-economic data available about the study group, e.g. place of residence, number of people in the family, parents' education, etc.?

Reply:  The available information regarding your suggestion has been added

Lines 98-102 and 104-109

The characteristics of the study group did not include results regarding the interpretation of BMI and/or TBF% taking into account gender?

Reply: The studies that use instruments to measure food addiction ref (8,10,16 and 19) and instruments to measure related factors (22, 26 and 27) did not carry out criterion validity using anthropometric indicators, this is the first study to do so, thus being a strength of the present study. Because it is only a validation and not properly a diagnosis to estimate the nutritional status, it was decided to use this variable as continuous without differentiating the gender and not categorical since it better fits the model used in the statistical analysis.

The amount of fluids consumed is usually given daily?

Reply: The consumption frequency questionnaire used gives daily, weekly, monthly and annual response options in order to cover patterns of high consumption and low consumption. It was decided to report the data weekly since surveys generally report it this way in Mexico.

Lines 121-128

The description of the validity factors of the scale should be included in the work methodology and not in the discussion.

Reply: In the methodology section the description of the analyzes carried out to obtain these factors was added according to your suggestion. According to the recommendation of the journal editor, it would not be appropriate to add the discussion of the factors in the methodology since these factors are part of the results obtained.

Lines 163-175

The discussion does not refer to the results of studies determining the consumption of soft drinks conducted in other studies (ex. Liq.In7 study).

Reply: Different studies that evaluate the soft drink consumption determinants were added to the discussion section (refs 3, 17, 19, 23 and 40). The study that you mentioned was considered, however, since the author´s affiliation is with the private industry, particularly the beverage production industry, it could be biased and it was decided not to include it.

Lines 234

In addition to the changes made, a review of the manuscript was carried out by a colleague fluent in English writing

All Changes to the manuscript were highlighted

Kind regards,

Dr. Cesar Campos-Ramirez, Dr. Nicolas Camacho-Calderon, Dr. Maria Elena Villagran-Herrera, Dr. Adriana Aguilar-Galarza, Dr. Miriam Aracely Anaya-Loyola and Dr. Jorge Palacios-Delgado

Reviewer 3 Report

Abstract:

·         The abstract could be more concise and focus on the research's core aspects. It should briefly state the research problem, methods, key findings, and conclusions without going into excessive detail.

·         While it is mentioned that a questionnaire was used, the abstract could benefit from briefly mentioning the key components of the methodology, such as the sampling technique and data analysis methods, to give readers a clearer understanding of the research approach.

·         The abstract should highlight the most significant findings more distinctly. It should also emphasize the implications of these findings in the context of public health or behavioral science.

1. Introduction

·         The introduction effectively identifies the issue of obesity and soft drink consumption but could benefit from a more direct link between these topics and the paper's focus on Mexican youth.

·         While the paper touches on the concept of "food addiction," it may benefit from a more comprehensive review of existing literature, including varying perspectives and potential criticisms of this concept.

·         The emphasis on the cultural adaptation of the Yale Food Addiction Scale is commendable. However, further elaboration on the specific cultural factors in Mexico that influence soft drink consumption could strengthen the argument.

·         The manuscript identifies a research gap but could more explicitly justify the need for a new scale specifically for Mexican youth. Clarification on how existing scales fall short in this context would be beneficial.

·         The objective of developing a new scale is clear, but the introduction could be enhanced by explicitly stating the study's hypothesis or expected outcomes.

·         The introduction is generally well-structured but could be more cohesive in linking the various elements of the obesity issue, the concept of food addiction, and the Mexican cultural context.

2. Materials and Method

·         The description of the study population is clear, but it may benefit from additional demographic details to better understand the sample's representativeness.

·         The methods are well explained, yet there is a lack of detail on how the data was anonymized or kept confidential, which is crucial for ethical considerations.

·         The scales used are identified, but the manuscript could elaborate on why these particular scales were chosen over others.

·         The process is described, but the manuscript could benefit from more specifics on the standardization of these measurements, especially if there were multiple data collectors.

·         The statistical analysis is adequately explained. However, it might be helpful to justify the choice of statistical tests used concerning the study’s specific aims.

·         The approach for instrument validation is mentioned, but further explanation on the validation process would enhance the reader's understanding.

·         The recruitment process is outlined, but the manuscript could include more details on participants' inclusion and exclusion criteria.

·         The procedures are generally well described. However, additional information on the data collection timeframe and follow-up periods would benefit.

3. Results

·         The factor analysis and high-reliability score are strengths. However, the manuscript could benefit from a more detailed explanation of how these factors were derived and validated.

·         The manuscript effectively demonstrates correlations with related behavioral factors, enhancing the scale's credibility. Nonetheless, the implications of these correlations for broader contexts or potential interventions remain unexplored.

· Multiple regression analysis is appropriate, but the manuscript could provide more insight into the selection of variables included in the model.

4. Discussion

·         While the study establishes a correlation between the scale and soft drink consumption, it could benefit from exploring connections with broader dietary patterns or lifestyle factors.

·         A comparison with existing scales measuring addiction to other substances or behaviors would strengthen the argument for the scale's specificity and utility.

·         While the manuscript acknowledges the need for scale refinement, a more detailed discussion on how future research might address these limitations would be beneficial.

·         The potential application of the scale in designing intervention strategies for reducing soft drink consumption is mentioned, but this could be expanded to include specific examples or proposed methods.

·         A deeper discussion on how the scale's effectiveness might vary across different cultural or demographic groups would add depth to the study's implications.

·         The manuscript could propose specific future research directions, such as longitudinal studies or experimental interventions, to further validate and utilize the scale.

The manuscript is well-written, with clear and coherent sentences. The grammar and syntax are mostly correct, and the technical vocabulary is used appropriately. There are minor instances where the language could be polished for clarity and fluency, but these do not impede understanding. 

Author Response

We appreciate your valuable time dedicated to reviewing the manuscript and the corrections that were pointed out to us, below we respond to each of them and indicate the lines that had changes in the manuscript.

Abstract:

• The abstract could be more concise and focus on the research's core aspects. It should briefly state the research problem, methods, key findings, and conclusions without going into excessive detail.

Reply: The abstract was summarized to include only the aspects that you recommends to us.

Línes: 18-32

• While it is mentioned that a questionnaire was used, the abstract could benefit from briefly mentioning the key components of the methodology, such as the sampling technique and data analysis methods, to give readers a clearer understanding of the research approach.

Reply: The method to obtain the sample and the data analysis such as reliability, criterion validity, construct validity and predictive value were included.

Lines 22-30

• The abstract should highlight the most significant findings more distinctly. It should also emphasize the implications of these findings in the context of public health or behavioral science.

Reply: The abstract was modified according to your suggestions

Lines 29-33

1. Introduction

• The introduction effectively identifies the issue of obesity and soft drink consumption but could benefit from a more direct link between these topics and the paper's focus on Mexican youth.

Reply: The modification was made according to your suggestion,

Lines 40-45

• While the paper touches on the concept of "food addiction," it may benefit from a more comprehensive review of existing literature, including varying perspectives and potential criticisms of this concept.

Reply: The introduction was modified to include neurobiological perspectives that are similar to the consumption of substances of abuse, and possible criticisms of this theory were added.

Lines 46-68

• The emphasis on the cultural adaptation of the Yale Food Addiction Scale is commendable. However, further elaboration on the specific cultural factors in Mexico that influence soft drink consumption could strengthen the argument.

Reply: The recommendations for the cultural adaptation for Mexico were added, as well as the factors that influence the consumption of these drinks.

Lines 90-93 and 128-131

• The manuscript identifies a research gap but could more explicitly justify the need for a new scale specifically for Mexican youth. Clarification on how existing scales fall short in this context would be beneficial.

Reply:  The explanation was added in the introduction, in fact there is only one scale that evaluates food addiction, this scale is American, and there is none for the Mexican population.

Lines 84-109 and 135-142.

• The objective of developing a new scale is clear, but the introduction could be enhanced by explicitly stating the study's hypothesis or expected outcomes.

Reply: It has now been added in the introduction section.

Lines 69-79

• The introduction is generally well-structured but could be more cohesive in linking the various elements of the obesity issue, the concept of food addiction, and the Mexican cultural context.

Reply: Modifications were made throughout the introduction according to your suggestion

Lines 37-95

2. Materials and Method

• The description of the study population is clear, but it may benefit from additional demographic details to better understand the sample's representativeness.

Reply: Description of the demographic characteristics of the participants was added according to your suggestion

Lines 98,99 and 104-106

• The methods are well explained, yet there is a lack of detail on how the data was anonymized or kept confidential, which is crucial for ethical considerations.

Reply: Was added according to your suggestion

Lines: 110-114

• The scales used are identified, but the manuscript could elaborate on why these particular scales were chosen over others.

Reply: What was requested was added

Lines: 77-79, 84-89 and 144-147

• The process is described, but the manuscript could benefit from more specifics on the standardization of these measurements, especially if there were multiple data collectors.

Reply: The procedure for taking measurements was added and it was specified that they were only taken by a standardized nutritionist

Lines 149-157

• The statistical analysis is adequately explained. However, it might be helpful to justify the choice of statistical tests used concerning the study’s specific aims.

Reply: The reason why these statistical analyzes were chosen was added.

Lines 159-163 and 169-170

• The approach for instrument validation is mentioned, but further explanation on the validation process would enhance the reader's understanding.

Reply: The description of the process of the different statistical analyzes was added to complete the validation

Lines 159-163 and 169-170

• The recruitment process is outlined, but the manuscript could include more details on participants' inclusion and exclusion criteria.

Reply: Inclusion and exclusion criteria was added

Lines 106-109

• The procedures are generally well described. However, additional information on the data collection timeframe and follow-up periods would benefit.

Reply: The data collection period was added, due to was a cross-sectional study, there was no follow-up of the participants over time.

Lines 113-114

3. Results

• The factor analysis and high-reliability score are strengths. However, the manuscript could benefit from a more detailed explanation of how these factors were derived and validated.

Reply: The sections 2.4. Statistical Analyses and 3.2. Reliability of the soft drink addiction scale to detail how these factors were derived and validated.

Lines 162-175 and 199-212

• The manuscript effectively demonstrates correlations with related behavioral factors, enhancing the scale's credibility. Nonetheless, the implications of these correlations for broader contexts or potential interventions remain unexplored.

Reply: Possible fields or contexts where the knowledge generated in this research could be applied were added.

Lines 260-264, 271- 278, 289-300 and 309-315

• Multiple regression analysis is appropriate, but the manuscript could provide more insight into the selection of variables included in the model.

Reply: The syntax and wording of this section was modified according to your suggestion.

Lines 235-247

4. Discussion

• While the study establishes a correlation between the scale and soft drink consumption, it could benefit from exploring connections with broader dietary patterns or lifestyle factors.

Reply: Possible connections were added according to your suggestion

Lines 279-289 and 290-295

• A comparison with existing scales measuring addiction to other substances or behaviors would strengthen the argument for the scale's specificity and utility.

Reply: The comparison was carried out according to the suggestion and the support at the neurophysiological level of this phenomenon was also added.

Lines 261-271 and 274-279

• While the manuscript acknowledges the need for scale refinement, a more detailed discussion on how future research might address these limitations would be beneficial.

Reply: The proposal for possible future research was added, but due to the rules of the journal we cannot add a detailed discussion of this issue, since the discussion section has to focus on the obtained results.

Lines 304- 317

• The potential application of the scale in designing intervention strategies for reducing soft drink consumption is mentioned, but this could be expanded to include specific examples or proposed methods.

Reply: Added what was requested

Lines 308- 317

• A deeper discussion on how the scale's effectiveness might vary across different cultural or demographic groups would add depth to the study's implications.

Reply: The request was added, but due to journal standards we cannot add a detailed discussion of the effectiveness variation in different cultures, since the discussion section has to focus on the obtained results.

Lines 294-307

• The manuscript could propose specific future research directions, such as longitudinal studies or experimental interventions, to further validate and utilize the scale.

Reply: Added future research directions

Lines 308-317

In addition to the changes made, a review of the manuscript was carried out by a colleague fluent in English writing

All Changes to the manuscript were highlighted

Kind regards,

Dr. Cesar Campos-Ramirez, Dr. Nicolas Camacho-Calderon, Dr. Maria Elena Villagran-Herrera, Dr. Adriana Aguilar-Galarza, Dr. Miriam Aracely Anaya-Loyola and Dr. Jorge Palacios-Delgado

Round 2

Reviewer 2 Report

Thank you, the work has been corrected, but it is worth supplementing.

The title of the paper and the abstract should include a reference to the research group (from Mexico?).

In the discussion Line 287 288 there is information "in this study, a correlation was found with the scale of addiction to soft drinks and TBF%", but in the results or group description, I do not find any information regarding TBF% in the research group.

The discussion should include some results from the work of Martinez, H. et al. (2018). “Fluid intake among Latin American adults: results from four national cross-sectional studies Liq.In7 2016.” Eur J Nutr 57(3): 65–75.

Author Response

We appreciate your valuable time dedicated to reviewing the manuscript and the corrections that were pointed out to us, below we respond to each of them and indicate the lines that had changes in the manuscript.

The title of the paper and the abstract should include a reference to the research group (from Mexico?).

Reply: The change was made

Lines: 3, 22

In the discussion Line 287 288 there is information "in this study, a correlation was found with the scale of addiction to soft drinks and TBF%", but in the results or group description, I do not find any information regarding TBF% in the research group.

Reply: The correlation is reported in the Table 5. Criterion validity between the soft drink addiction scale factors, independent constructs and TBF %.

Lines: 226-233

The discussion should include some results from the work of Martinez, H. et al. (2018). “Fluid intake among Latin American adults: results from four national cross-sectional studies Liq.In7 2016.” Eur J Nutr 57(3): 65–75.

Reply: Results of the recommended study were included in the discussion section.

Lines: 298-304

In addition to the changes made, a review of the manuscript was carried out by a colleague fluent in English writing

All Changes to the manuscript were highlighted

Kind regards,

Dr. Cesar Campos-Ramirez, Dr. Nicolas Camacho-Calderon, Dr. Maria Elena Villagran-Herrera, Dr. Adriana Aguilar-Galarza, Dr. Miriam Aracely Anaya-Loyola and Dr. Jorge Palacios-Delgado