Food consumption and adherence to dietary guidelines among Jordanian children and adolescents

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Al-Shami" }, { "@type": "Person", "name": "Ayoub Al-Jawaldeh" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Early-life food consumption patterns may affect children’s health by increasing susceptibility to developing non-communicable chronic diseases (NCDs) in adulthood. Aims To evaluate Jordanian children and adolescents’ energy and macronutrient intake and how closely they adhere to dietary recommendations. Methods This cross-sectional study used data from Jordan’s Population-based Food Consumption Survey, a household population-based study conducted in Jordan between 2021 and 2022 (561 children and adolescents 8-19 years). Dietary intake was assessed using the two non-consecutive 24-hour dietary recall methods (24-h DR). The estimated food group and nutrient intakes were compared to nutritional recommendations, including MyPlate dietary guidelines. Results The prevalence of overweight/obese individuals based on body mass index (BMI) was 44%, and the average waist-to-height ratio (WHtR) was 24.7%. Compared to MyPlate dietary guidelines, children and adolescents had a higher added sugar intake (57g/day). Also, consuming vegetables, fruits, and dairy fell short of MyPlate dietary guidelines. The total discretionary calorie intake in children and adolescents was approximately one-third of the total energy intake. Conclusion The food consumption of Jordanian children and adolescents includes high intakes of discretionary calories, with a low intake of fruits, vegetables, and dairy products. The prevalence of overweight/obesity was elevated compared to international norms. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/12-1094", "name": "Food consumption and adherence to dietary guidelines among Jordanian..." } } ] } Home Browse Food consumption and adherence to dietary guidelines among Jordanian... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Alkhatib B, Al Hourani H, Al-Shami IK and Al-Jawaldeh A. Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.12688/f1000research.138866.4 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] Buthaina Alkhatib https://orcid.org/0000-0002-6105-0680 1 , Huda Al Hourani https://orcid.org/0000-0001-7017-6499 1 , Islam K. Al-Shami https://orcid.org/0000-0001-7149-0885 1 , Ayoub Al-Jawaldeh https://orcid.org/0000-0001-7387-8277 2 Buthaina Alkhatib https://orcid.org/0000-0002-6105-0680 1 , Huda Al Hourani https://orcid.org/0000-0001-7017-6499 1 , Islam K. Al-Shami https://orcid.org/0000-0001-7149-0885 1 , Ayoub Al-Jawaldeh https://orcid.org/0000-0001-7387-8277 2 PUBLISHED 04 Feb 2025 Author details Author details 1 Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan 2 Regional Office for the Eastern Mediterranean, Committee for World Health Organization, Cairo, Egypt Buthaina Alkhatib Roles: Conceptualization, Investigation, Methodology, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Huda Al Hourani Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation Islam K. Al-Shami Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Ayoub Al-Jawaldeh Roles: Data Curation, Funding Acquisition, Resources, Supervision, Visualization OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Agriculture, Food and Nutrition gateway. Abstract Background Early-life food consumption patterns may affect children’s health by increasing susceptibility to developing non-communicable chronic diseases (NCDs) in adulthood. Aims To evaluate Jordanian children and adolescents’ energy and macronutrient intake and how closely they adhere to dietary recommendations. Methods This cross-sectional study used data from Jordan’s Population-based Food Consumption Survey, a household population-based study conducted in Jordan between 2021 and 2022 (561 children and adolescents 8-19 years). Dietary intake was assessed using the two non-consecutive 24-hour dietary recall methods (24-h DR). The estimated food group and nutrient intakes were compared to nutritional recommendations, including MyPlate dietary guidelines. Results The prevalence of overweight/obese individuals based on body mass index (BMI) was 44%, and the average waist-to-height ratio (WHtR) was 24.7%. Compared to MyPlate dietary guidelines, children and adolescents had a higher added sugar intake (57g/day). Also, consuming vegetables, fruits, and dairy fell short of MyPlate dietary guidelines. The total discretionary calorie intake in children and adolescents was approximately one-third of the total energy intake. Conclusion The food consumption of Jordanian children and adolescents includes high intakes of discretionary calories, with a low intake of fruits, vegetables, and dairy products. The prevalence of overweight/obesity was elevated compared to international norms. READ ALL READ LESS Keywords Food consumption, discretionary calories, energy intake, MyPlate dietary guidelines, added sugars, saturated fats Corresponding Author(s) Buthaina Alkhatib ( [email protected] ) Close Corresponding author: Buthaina Alkhatib Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Alkhatib B et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Alkhatib B, Al Hourani H, Al-Shami IK and Al-Jawaldeh A. Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.12688/f1000research.138866.4 ) First published: 01 Sep 2023, 12 :1094 ( https://doi.org/10.12688/f1000research.138866.1 ) Latest published: 04 Feb 2025, 12 :1094 ( https://doi.org/10.12688/f1000research.138866.4 ) Revised Amendments from Version 3 The updates in v4 were based on the reviewer's four corrections. Table 1 has been added to the methodology section; however, some paragraphs have been rewritten. A paragraph about COVID-19 in the discussion has been removed—no added references. Also, some paragraphs have been merged, and some sentences in the discussion have been rewritten. And a limitation has been added. The updates in v4 were based on the reviewer's four corrections. Table 1 has been added to the methodology section; however, some paragraphs have been rewritten. A paragraph about COVID-19 in the discussion has been removed—no added references. Also, some paragraphs have been merged, and some sentences in the discussion have been rewritten. And a limitation has been added. See the authors' detailed response to the review by Sarah Ibrahim See the authors' detailed response to the review by MoezAlIslam E. Faris READ REVIEWER RESPONSES Introduction Food habits formed early in childhood are likely to follow and form the foundation of adult eating patterns. Early-life food consumption patterns may affect children’s health by increasing susceptibility to developing non-communicable chronic diseases (NCDs) in adulthood. 1 , 2 Many NCDs risk factors among children and adolescents, such as obesity, are caused by unhealthy eating behaviors and a lack of physical activity. 3 – 5 It is important to notice that obesity prevalence has been elevated dramatically among Jordanians; a recent report approved that approximately 75% of Jordanians of both sexes are overweight or obese. 6 Changes in food consumption patterns in children and adolescents can be attributed to a variety of factors, including but not limited to being at school and interacting with peers during school days, the widespread availability of processed foods, availability of inexpensive food portions with family-size, eating out of home, and the ease of food delivery applications. 7 – 9 Numerous studies have examined how children and adolescents worldwide are adopting unhealthy eating habits, such as skipping meals like breakfast, 10 , 11 unhealthy snacking which is composed of energy-dense foods, 12 – 14 drinking sweetened beverages, 15 , 16 eating fast foods, 15 , 17 and consuming little fruits and vegetables. 15 , 16 , 18 These unhealthy habits can lead to excessive or insufficient nutrient intake, defined as ‘Nutritional status deterioration,’ and have serious health consequences. 19 Increased risk of overweight and obesity among children and adolescents is one of these severe health problems. Childhood dietary intake plays a significant role in preventing and treating childhood overweight and obesity as it is a crucial factor in growth and development. 20 Obesogenic eating patterns have been extensively investigated and linked to an increased risk of becoming overweight or obese. 21 Among these eating patterns was the consumption of identified obesogenic foods (such as sweetened beverages, fast food, and snacks). 22 An investigation in Greece found that children who consume obesogenic foods are more likely to be obese. 23 In China, the modern dietary pattern was positively associated with future obesity in children and adolescents. 24 Moreover, a nutritious diet can help prevent cardio-metabolic multi-morbidities frequently observed in adult patients with neuropsychiatric problems. 25 To maintain a regular immune response and lower the risk of adverse mental health disorders and associated co- and multi-morbid conditions later in life and maintain a regular immune response, dietary changes made as early as childhood and adolescence represent a promising preventive strategy. 26 Over the past 40 years, the consumption of discretionary or luxury snack foods has increased globally, 27 and it has been linked to overweight and obesity prevalence and increasing chronic disease risk as a consequence. 28 Discretionary foods are food and beverages that contain added fat and sugar that are not considered necessary for a healthy diet, contribute to excessive energy intake, and displace core foods and essential nutrients. 29 , 30 Although some recommendations have been made, most dietary guidelines around the world discourage the consumption of these foods. For American children and adolescents, the discretionary calorie allowance ranges between 8% and 20% for all sex-age groups. 31 The recommended maximum discretionary foods and beverages for Australian children and inactive adolescents are 0-1/2 servings/day, which equals 143 kcal. 32 There has been little research on Jordanian children’s and adolescents’ dietary habits, and there is only sporadic data to suggest that certain food groups or individual items are consumed insufficiently or excessively. 33 This study aimed to 1) characterize the food consumption of Jordanian children and adolescents and 2) assess their adherence to dietary guidelines, especially MyPlate (It is the last suggested dietary guideline used globally). The present study’s findings will help future interventions or policies or at least describe how this study would contribute to solving the problem of obesity or informing public health interventions. Methods Ethical statement Institutional Research Ethics Board approval was obtained from the Hashemite University (No.7/13/2020/2021). Following the head of the household’s oral permission, one of the participant’s parents signed an informed consent form for children and adolescents under 16. A written consent form was signed by adolescents over 16 years, and data collection began during the first visit in the presence of one of the parents. Design and sample selection The current study is based on Jordan’s Population-based Food Consumption Survey (JPFCS), conducted between October 2021 and March 2022. The JPFCS was created to collect dietary habits, eating patterns, and nutritional status among children, adolescents, adults, and the elderly, as well as Jordanian individuals aged eight years and older. A representative sample of 701 households was invited to participate. The number of agreed-upon households to participate was 632, with a 90.2% response rate drawn from simple random sampling from Jordan’s three major regions (Central, Northern, and Southern). Two thousand seven hundred twenty-one household members were approached, and 2,145 participants agreed to participate. The total number of children and adolescents who took part was 617 (28.8%). Children and adolescents with chronic diseases, physical disabilities, food allergies and intolerance, or cognitive impairment were excluded from the study to neutralize the effect of the disease on food intake and to reduce the impact of the medications taken on the dietary pattern and food consumption. A study protocol has been described in detail by Al-Shami et al. (2023). 34 The current study included JPFCS children and adolescents divided into two age groups: children (8-12 years) and adolescents (13-19 years). Obtaining food intake for children under eight during the past 24 hours is challenging, especially while they are away from home (food eaten in kindergarten or daycare centers). 34 As a result, data reliability is higher for children aged eight and above. As a result, from 617 JPFCS participants, the final net sample size for the current analysis was 561 eligible participants (the calculated minimum sample size was 425). Survey tool The Hashemite University’s website stated that nutritionists were required to assist with data collection. Based on their experience, they were chosen through in-person interviews and then trained. The above-mentioned trained nutritionists conducted a face-to-face interview with the head of the household to obtain dietary and anthropometric measurements, particularly for children (see extended data 35 ). Dietary data were collected from the children (<12 years) with parents’ help, while older participants were those who answered their dietary questions. The data above was gathered via a structured questionnaire completed during the interview. Anthropometric measurements An experienced nutritionist used established methods to measure anthropometric measurements of children and adolescents, including height (cm) using Seca portable stadiometer), without shoes, weight (kg) (using Tanita digital weighing scale), and waist circumference (WC) (cm) (using Seca measuring tape). Participants’ body weight and height were recorded to the nearest 0.1kg and 0.1cm. A flexible anthropometric tape measured the participant’s WC while standing. Body mass index (BMI) was calculated ’as weight (kg) divided by the square of the height (m 2 ). 36 Moreover, the BMI-for-Age Z-Score (BAZ) was calculated. For the association of BMI-for-age with overweight and obesity, values > +1 SD represent overweight, and values > +2 SD represent obesity according to WHO reference curves. Values between +1 SD and -2 SD were considered ‘normal’. In comparison, values > -2 SD were considered ‘thin’. 36 The waist-to-height ratio (WHtR) was calculated by dividing the participant’s waist circumference by height. A WHtR cutoff of ≥ 0.5 is generally accepted as a universal cutoff for obesity in children. 37 Dietary assessment Two non-consecutive 24-hour dietary recalls (24-h DR) were obtained to assess food intake on one weekday and one weekend. Furthermore, the child’s parents were asked to be present during the collection of the 24-hour DR. The first 24-hour DR was collected during the interview, while the second recall was obtained via phone. Participants were asked to recall and list all foods and beverages they consumed from midnight to midnight the previous day, along with their quantity, preparation method, and most popular food brand names. A photographic food atlas was also created to simplify the estimation of consumed food portion size; this tool contains over 150 foods and composite recipes consisting of high-definition-colored photos of various foods and meals commonly consumed in Jordanian diets. The survey was introduced in Arabic and translated into English before the analysis. 35 Three food composition databases were used to estimate nutrient intake in children and adolescents. The consumed foods collected by 24-DR were entered into a Computerized Nutrient Analysis Program: ESHA’s Food Processor ® , Nutrition Analysis Software (version 11:0; ESHA Research), Composition of Local Jordanian Food Dishes, 38 and Lebanon Food Composition Data: Traditional Dishes, Arabic Sweets, and Market Foods. 39 Furthermore, based on MyPlate dietary guidelines, consumed foods were classified into five food groups (grains, vegetables, fruits, protein, and dairy), with a specified number of consumed servings of each food group. The Essential Guide to Nutrient Requirements, published by the Institute of Medicine in 2019, was approved and recommended by the USDA as part of the Dietary Guidelines for Americans, 2020-2025. This guide reflects the Acceptable Macronutrient Distribution Ranges (AMDR). 40 The mean recommended energy intake for children and adolescents based on the MyPlate Dietary Guidelines, and AMDR were 1800 and 2200 ( Table 1 ), regardless of sex. 5 The recommended daily intake of fruits and vegetables based on the Joint FAO/WHO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases is a minimum of 400 g of fruits and vegetables/day, an equivalent of ≥5 servings/d. 41 Table 1. Daily recommendations of the food groups according to MyPlate dietary guidelines within calorie allowance. 5 Foods Included in the Analyses Serving Size Recommended Daily intake Children Adolescents Food Group Grains Thin white or whole wheat Kmaj bread, thick Kmaj white or whole wheat bread, burger bun, Sammon (Sammoli or Hamam, a pan white French-like bread), shrak bread (non-pocket, one-layered flatbread). Rice and rice in dishes, macaroni, cornflakes One ounce of bread (any type), ½ cup of cooked rice or macaroni, ½ cup of cornflakes 6 oz 7 oz Vegetables Cooked vegetables such as green beans, okra, and spinach. Raw vegetables such as tomatoes, cucumber, lettuce, and cabbage ½ cup cooked vegetables or 1 cup raw vegetables. 2.5 Cups 3 Cups Fruits Fresh fruits such as apples, bananas, and oranges. 100% fruit juices, dried and canned fruits One small fresh fruit, ½ cup 100% fruit juice, two tablespoons dried fruits, ½ cup canned fruits. 1.5 Cups 2 Cups Dairy Milk, yogurt, white cheese in brine, spreadable processed cheese, cheddar-flavored processed cheese, and labneh (condensed salted yogurt) One cup of milk yogurt, 45 gm cheese, and two tablespoons of labaneh. 3 Cups 3 Cups Protein Lamb and veal meat, chicken, fish, tuna and sardine, sausages, boiled and fried eggs, and any cooked vital organs of chicken, lamb, and veal (liver, heart, kidneys, tongue, …) 2-3 oz of cooked lamb, veal, chicken, or fish, one small can of tuna or sardine, two eggs. 5 oz 6 oz Foods to limit Added sugars Beverages like: Carbonated beverages, canned juices (fruit drinks), any sweetened ready-to-use hot drink, and sweetened tea and coffee; Sweets and desserts: Sugar, jam and honey, ice cream, Jell-O, pudding, custard, chocolate, cake, Arabic sweets (baklava, harissa) One teaspoon of sugar, 1 Tablespoon jam or honey, ½ cup of ice cream, ½ cup of Jell-O or pudding or custard, 1 ounce of chocolate, 2-ounce cake, 1 ounce of Arabic sweets <45 g <50 g Saturated fat Found naturally in meat and its substitute, in any animal organ, as well as in whole and reduced fat milk, in whole fat dairy products, in eggs, and many restaurant-type foods, in butter, ghee, lard, in any animal extracted fat One teaspoon of butter, ghee, lard <20 g <22 g Statistical analysis Analysis was conducted using SPSS software (IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp) ( https://www.ibm.com/products/spss-statistics ). PSPP ( https://www.gnu.org/software/pspp/ ), a freely accessible software, can run the same analysis used in this study. All analyses were stratified based on sex and age group. Anthropometric characteristics were described using frequencies and percentages for categorical variables. Dietary intakes were normally distributed, also outlier values for participants’ energy intake were calculated by excluding any value that increased or decreased by 2.5 standard deviations of the group mean, as outliers can significantly impact statistical analyses and skew the results of any hypothesis test if they are inaccurate. The energy and macronutrient intake distribution were reported as means and standard deviation (Mean ± SD). An independent sample t-test was used to compare differences between boys and girls within each age group. The normality of the distributions was assessed through the Kolmogorov-Smirnov test and Kurtosis and Skewness values. Differences were considered significant at p < 0.05. Results Baseline characteristics of the participants A total of 561 Jordanian children and adolescents participated in this study: 217 (38.7%) children and 344 (61.3%) adolescents. 70 The general characteristics of the study population are presented in Table 1 . Based on the household analysis, there were 4.5 people per family on average. Additionally, nearly 50% of the sample under study (JPFCS original sample) stated that their household’s overall income is less than 500 JD. Although boys and girls accounted for almost equal proportions within the children group, adolescent girls accounted for the disproportionation compared to boys within the same age group (57% vs. 43%, respectively). For the overall children group, participants who consumed dietary supplementations accounted for only 6%, with no significant difference between boys and girls. A higher proportion of adolescents were using dietary supplements (any vitamins or minerals or herbs consumed as capsules, tablets, or drinks instead of the diet) (12.5%), with a significant difference between sexes. Adolescent girls were found to be the most frequent group to use nutritional supplements (16.3%) when compared to boys (7.4%) from the same group ( p = 0.014). When compared to other regions in Jordan that were distributed according to their geographic distribution, the central areas had higher proportions of either children or adolescents of both sexes (children: 61.8% of boys and 53.3% of girls; adolescents: 56.1% of boys and 62.2% of girls). Findings related to the participant’s anthropometric characteristics stratified by age and sex are presented in Table 2 . About two-thirds of adolescents were classified as normal weight (64.5%), and about half of the children were also within the normal weight category (52.3%). Without significant differences between both sexes in each age group, children’s boys had the highest overweight and obesity prevalence (46.3%), followed by girls in the same age group (41.5%), adolescent boys (33.8%), and the lowest prevalence was for adolescent girls (30.6%). About a quarter of the children’s boys had abnormal WHtR (≥0.5) (25.5%), and 23.8% of the same group of girls too; however, 30.4% and 21.4% of adolescent boys and girls, respectively, were also classified as having abnormal WHtR (≥0.5), with no significant differences. Table 2. Sociodemographic and anthropometric characteristics of the study population ( n = 561). Variable All (8-12 y) Children 217 (38.7%) All (13-19 y) Adolescents 344 (61.3%) Boys 110 (50.7%) Girls 107 (49.3%) p -value Boys 148 (43%) Girls 196 (57%) p -value Geographical distribution of participants among regions Center 125(57.6) 68 (61.8) 57 (53.3) 0.29 205 (59.6) 83 (56.1) 122 (62.2) 0.48 North 80 (36.9) 35 (31.8) 45 (42.1) 116 (33.7) 55 (37.2) 61 (31.1) South 12 (5.5) 7 (6.4) 5 (4.7) 23 (6.7) 10 (6.8) 13 (6.6) Using nutritional supplements Yes 13 (6.0) 4 (3.6) 9 (8.4) 0.14 43 (12.5) 11 (7.4) 32 (16.3) 0.01 No 204 (94) 106 (96.4) 98 (91.6) 301 (87.5) 137 (92.6) 164 (83.7) BMI-for-age † Thinness 8 (3.7) 6 (5.5) 2 (1.9) 0.24 12 (3.5) 5 (3.4) 7 (3.6) 0.82 Normal 113 (52.3) 53 (48.2) 60 (56.6) 222 (64.5 93 (62.8) 129 (65.8) Overweight/Obese 95 (44.0) 51 (46) 44 (41.5) 110 (32.0) 50 (33.8) 60 (30.6) WHtR †† <0.5 162 (75.3) 82 (74.5) 80 (76.2) 0.78 257 (74.7) 103 (70) 154 (78.6) 0.06 ≥0.5 53 (24.7) 28 (25.5) 25 (23.8) 87 (25.3) 45 (30) 42 (21.4) Whole sample analysis (n = 632 households) Family size (mean± SD) 4.5±1.6 Household monthly income (JD) 1000 (good) 79 (12.8) * Bold p -value: +1 SD represent overweight, values > +2 SD represent obesity, values between +1 SD and -2 SD were considered “normal,” while values > -2 SD were considered “thinness.” †† WHtR ≥ 0.5 is generally accepted as a universal cutoff for obesity in children and adolescents. Graphic representation of adherence to MyPlate dietary guidelines Table 1 categorizes the most common food items consumed by Jordanian children and adolescents into five food groups and the recommended number of servings for each food group for both age groups, based on 1800 kcal/day for children and 2200 kcal/day needs for adolescents. The reference MyPlate dietary guidelines image was presented for children in Figure 1 and adolescents in Figure 2 . Figure 1. Compliance of the mean habitual food consumption with the MyPlate dietary guidelines in children. Figure 2. Compliance of the mean habitual food consumption with the MyPlate dietary guidelines in adolescents. In children, the entire group consumes less than the recommended number of servings from all food groups. On the other hand, boys came close to meeting the recommended servings for grains, achieving 30.6% of the standard plate recommendation of 30%, while all other food groups were lower than the recommended number of servings, as shown in Figure 1 . Mismatching between real and recommended intake based on the standard plate has been indicated. As shown in Figure 1 , a higher gap has been found among children girls’ intake of dairy, protein, and fruits (11%, 9.6%, and 6.8%, respectively) when compared to boys from the same age group (13%, 12.4%, and 8.7%; respectively) ( Figure 1 ). Furthermore, Jordanian adolescents, overall or according to sex differences, consumed less than the recommended serving number of each food group ( Figure 2 ), based on 2200 kcal/day as the average total energy requirement ( Table 1 ). In girls, the actual intake of grains, fruits, vegetables, and proteins was 22%, 7.3%, 7.8%, and 11%, respectively, which did not meet the recommended reference plate. This discrepancy was also observed in boys’ consumption of fruit and vegetables (6.1% and 9.1%, respectively). However, there appears to be less mismatch in grain and protein intake (28.8% and 15.1%, respectively) ( Figure 2 ). Interestingly, both age groups showed the same outcome regarding sex differences because there was a significant difference in their intake of grains and proteins ( p -value < 0.05) among all the food groups. Energy and macronutrient intakes among the study population The mean daily energy and macronutrient intake of the study population, stratified by age and sex, is shown in Table 3 . In the children’s group, the mean total energy intake was 1796.4 ± 557.1 kcal/day, with a significant difference between boys and girls; the mean total energy intake for boys was 1950 kcal/day compared to 1638 kcal/day for girls ( p < 0.001). Similar results were shown in the adolescent group, with a significantly higher mean energy intake in boys compared to girls (2116.3 kcal/day vs. 1688.5 kcal/day) ( p < 0.001), while the average total intake of the group was 1872. 6 ± 579.1 kcal/day. Table 3. Mean daily intakes of energy (kilocalories) and macronutrients stratified by age group and sex. Total (8-12 y) Children Total (13-19 y) Adolescents Boys Girls p- value Boys Girls p -value Energy and macronutrients Total energy intake (EI) (kcal) 1796.4 ± 557.09 1950.01 ± 602.39 1638 ± 457.83 <0.001 1872.57 ± 579.06 2116.34 ± 600.39 1688.5 ± 488.8 <0.001 Total carbohydrates (g) 230.82 ± 73.95 247.83 ± 81.84 213.33 ± 60.38 0.001 234.47 ± 75.26 260.96 ± 76.41 214.47 ± 68.02 <0.001 % From the total EI 51.75 ± 6.61 51.11 ± 7.11 52.4 ± 6.02 0.154 50.37 ± 7.34 49.72 ± 6.91 50.86 ± 7.63 0.153 Total protein (g) 59.19 ± 20.82 65.43 ± 23.61 52.77 ± 15.11 <0.001 67.72 ± 25.92 78.99 ± 28.54 59.21 ± 19.96 <0.001 % From the total EI 13.24 ± 2.45 13.046 ± 2.53 13.01 ± 2.34 0.184 14.58 ± 3.69 15.01 ± 3.69 14.24 ± 3.66 0.056 Total fat (g) 73.32 ± 27.85 80.17 ± 29.29 66.27 ± 24.49 <0.001 75.79 ± 29.45 86.01 ± 32.02 68.08 ± 24.77 <0.001 % From the total EI 36.33 ± 6.05 36.73 ± 6.23 35.93 ± 5.85 0.333 36.05 ± 6.6 36.1 ± 6.44 36.02 ± 6.73 0.915 Type of fat Polyunsaturated fats (g) 10.91 ± 7.25 12.24 ± 8.09 9.54 ± 6.01 0.006 10.86 ± 7.05 12.69 ± 8.07 9.47 ± 5.81 <0.001 % From the total EI 5.26 ± 2.58 5.42 ± 2.73 5.09 ± 2.43 0.354 5.11 ± 2.54 5.25 ± 2.54 5 ± 2.55 0.354 Monounsaturated fats (g) 19.29 ± 10.28 21.32 ± 11.02 17.21 ± 9.04 0.003 19.79 ± 11.36 23.24 ± 12.59 17.17 ± 9.57 <0.001 % From the total EI 9.55 ± 3.98 9.76 ± 4.21 9.33 ± 3.74 0.434 9.4 ± 4.17 9.83 ± 4.37 9.09 ± 3.99 0.105 Saturated fats (g) 16.35 ± 7.47 18.33 ± 7.46 14.31 ± 6.93 <0.001 16.32 ± 8.15 18.69 ± 9.09 14.53 ± 6.85 <0.001 % From the total EI 8.16 ± 2.66 8.52 ± 2.64 7.8 ± 2.64 0.047 7.78 ± 2.78 7.87 ± 2.7 7.7 ± 2.85 0.603 Trans fat (g) 0.5 ± 0.8 0.52 ± 0.81 0.47 ± 0.8 0.64 0.6 ± 1.2 0.81 ± 1.51 0.45 ± 0.88 0.006 % From the total EI 0.25 ± 0.43 0.25 ± 0.42 0.26 ± 0.43 0.863 0.27 ± 0.48 0.3 ± 0.52 0.24 ± 0.46 0.254 Omega-3 Fatty acids (g) 0.57 ± 0.5 0.64 ± 0.53 0.48 ± 0.45 0.018 0.63 ± 0.5 0.73 ± 0.58 0.56 ± 0.49 0.004 Omega-6 Fatty acids (g) 5.96 ± 5.24 6.86 ± 5.7 5.03 ± 4.57 0.01 6.12 ± 5.12 6.89 ± 5.73 5.53 ± 4.53 0.015 Cholesterol (mg) 133.22 ± 93.74 147.76 ± 100.9 118.28 ± 83.61 0.02 168.07 ± 150.1 218.51 ± 192.64 129.8 ± 90.47 <0.001 * p -value < 0.05 is considered statistically significant (2-tailed). Table 3 further examines the various types of fat consumed; the mean saturated fat (SFA) intake was nearly equal for both age groups and rounded to 16 g/day ( Table 3 ), which was within an acceptable amount when compared to the MyPlate dietary guidelines allowed amounts of 20 g/day and 22 g/day for children and adolescents, respectively ( Table 2 , Figure 1 , and Figure 2 ). Boys of both ages consumed significantly more saturated fats than girls of the same age (children: 18.3 g/day vs. 14.3 g/day, and adolescents: 18.7 g/day vs. 14.5 g/day, for boys and girls, respectively) ( p < 0.001) ( Table 4 ). Table 4. Mean and Standard deviation of discretionary calorie intake among the study population. Total (8-12 y) Children Total (13-19 y) Adolescents Boys Girls p- value Boys Girls p -value Discretionary calories Added sugars (g) 56.5 ± 31.7 59.68 ± 36.39 53.22 ± 25.76 0.133 56.55 ± 28.58 60.87 ± 28.88 53.28 ± 27.97 0.015 % From the total EI 12.95 ± 6.06 12.52 ± 6.01 13.39 ± 6.1 0.286 12.31 ± 5.58 11.83 ± 5.38 12.68 ± 5.72 0.166 Added fats (g) 36.06 ± 18.21 39.33 ± 18.87 32.7 ± 16.95 0.007 34.66 ± 20.15 38.92 ± 22.3 31.42 ± 17.73 0.001 % From the total EI 17.7 ± 6.26 17.89 ± 6.09 17.51 ± 6.45 0.654 16.31 ± 7.3 16.08 ± 7.12 16.49 ± 7.44 0.612 Total Discretionary calorie intake % From the total EI 30.65 ± 7.99 30.41 ± 7.99 30.9 ± 8.04 0.648 28.63 ± 9.01 27.92 ± 8.86 29.16 ± 9.1 0.205 * p -value < 0.05 is considered statistically significant (2-tailed). EI: energy intake. Moving in sequence, the mean intake of polyunsaturated (PUFA) and monounsaturated fats (MUFA) was nearly equal in both age groups; however, boys in both age groups consumed significantly more than girls ( p < 0.05) ( Table 3 ). Trans fat (TFA) intake was considerably higher in adolescent boys than in girls (0.81 g/day vs. 0.45 g/day) ( p = 0.006). Irrespective of sex-specific differences, the mean cholesterol intake of the adolescents was higher than that of the children’s group (168.1 ± 150.1 mg/day vs. 133.2 ± 93.7 mg/day, respectively). Also, mean cholesterol intake was significantly higher in boys than in girls in the child group (148 mg/day vs. 118 mg/day ( p = 0.02) and in adolescents (219 mg/day for boys vs. 130 mg/day for girls) ( p < 0.001). In addition, omega-3 and omega-6 fatty acid intake was significantly higher in boys than in girls in both age groups ( Table 3 ). Consumption of discretionary calories According to the MyPlate dietary guidelines, which aim to make every bite count and choose options full of nutrients, some foods and beverages were recommended to be explicitly limited: added sugars and saturated fats. Foods that were analyzed as added sugars and saturated fats were listed in Table 2 , as well as their typical serving sizes. The maximum allowed amount to consume for each age group was presented in the same table. Age differences in mean intake from added sugar were almost equal to 57 g/day, and this means higher than MyPlate dietary guidelines allowed amounts, which were <45 g/day and <50 g/day for children and adolescents, respectively ( Table 4 , Figure 1 , and Figure 2 ). Although no significant difference between boys and girls was found within the children group, adolescent boys significantly consumed higher amounts of added sugars when compared to girls from the same group (60.87 g/day vs. 53.28 g/day, respectively) ( p = 0.015). Moreover, children and adolescent boys consumed significantly higher amounts of total added fats than girls (39.33 g/day, 38.92 g/day vs. 32.7 g/day, and 31.42 g/day ( p = 0.007; 0.001; respectively) ( Table 4 ). For children and adolescents, total discretionary calorie intake (added sugar and fat) accounted for approximately 30.7% and 28.6% of total energy intake, respectively, which is considered higher than the recommendations (<10% of total energy intake). Discussion The food consumption of Jordanian children and adolescents has never been studied before. Furthermore, the COVID-19 pandemic significantly contributes to the shift in dietary intake globally toward obesogenic food choices, besides decreased physical activity and increased screen time, leading to weight gain. 42 , 43 The present study characterizing dietary patterns and adherence to guidelines) and explicitly linking the results to these objectives. The present study showed that the overall prevalence of generalized overweight and obesity among the studied sample was 36.6%. The prevalence of overweight and obesity was higher in children than in adolescents (44.3% vs. 32%). About 1/5 to 1/4 of participants from all age groups were classified as overweight. Hamad and colleagues (2016) found that the overall average prevalence of overweight and obesity among school-age adolescents was 36.2% and 9.9 %, respectively. 44 Globally, overweight and obesity have increased dramatically among children and adolescents aged five to 19, from 4% in 1975 to just over 18% in 2016. 45 In Jordan, the image was not dissimilar to other countries worldwide. Zayed et al. (2016) reported that analysis by sex showed that obesity was more prevalent among Jordanian males, with 18.9% obese compared to 11.2% of females. 46 Jordanian obesity prevalence and its related sex patterns appear consistent with what has been reported in the literature. Another obesity index, WHtR, revealed that nearly a quarter of the children’s boys (25.5%) and 23.8% of the same group of girls had abnormal WHtR; however, 30.4% and 21.4% of adolescent boys and girls, respectively, were also classified as having abnormal WHtR. WHtR was not used to assess abdominal obesity in Jordanian children and adolescents earlier. A few studies on WHtR as an indicator of obesity in the Eastern Mediterranean region reported similar results; in the United Arab Emirates (UAE), 27.2% of subjects had abnormal WHtR, 47 and in Lebanon, 38.3% had abnormal WHtR. 48 Obesity as a result of diet has been extensively studied. Fast food and sugar-sweetened beverages are directly linked to the childhood obesity epidemic. The initial findings on the prevalence of obesity were primarily related to food intake. This study found that adolescents engaged in eating behaviors are associated with an increased risk of being overweight and obese. The MyPlate dietary guidelines were created in 2011, indicating how much of the plate should be allocated to protein foods, grains, fruits, and vegetables. The current study’s findings revealed that children’s girls consumed fewer than the recommended servings from all MyPlate dietary guidelines groups. On the other hand, children’s boys nearly consumed the recommended amount of grains (30.6% vs. 30% of the plate), while all different food groups consumed less than the recommended number of servings. However, adolescents’ intake was off-balance in all recommended servings of MyPlate dietary guidelines, regardless of sex. Compared with studies in the Eastern Mediterranean countries, 28% of Emirati adolescents met the recommended daily fruit and vegetable intake, with significantly more males than females. 49 A multinational comparison study of eleven Eastern Mediterranean countries revealed that 19.4% of adolescents reported consuming fruits and vegetables ≥5 times/day. 50 In Iran, a study found that only 30.3% and 34.6% of adolescents consumed the recommended amount of fruit and vegetables, respectively. 51 In Egypt, 45.9% of children and adolescents have fruits and vegetables 1-6 times daily. 52 In the UAE, around 50% of school-age adolescents had less than five servings of fruits and vegetables. 47 Similar findings were reported among Saudi children, with 69% and 71% of the samples not consuming fruits and vegetables daily. 53 Furthermore, a review of the dietary patterns and nutrient intakes of children (5-10 years) and adolescents (10-19 years) in the Eastern Mediterranean Regions revealed that their diet was poor, with fruits, vegetables, and dairy products. 54 According to current study findings and studies from Eastern Mediterranean countries, Western countries did not achieve better results in this area. In Belgium, adolescents were less likely to follow food-based dietary recommendations than the youngest children and adults. 37 A study in 33 countries in Europe and North America reported that many adolescents do not eat fruit and vegetables daily. 55 Although most studies reported low fruit and vegetable consumption among children and adolescents worldwide, it is essential to note that the methods used to assess their intake vary; some studies rely on self-reporting food frequency, while others rely on face-to-face 24-DR. Although the current study’s findings showed a low consumption of fruits, vegetables, and dairy groups, the mean energy intake was within the normal range of requirements for age and sex. The mean total energy intake among the children was 1796.4 ± 557.09 kcal/day, with a significant difference between boys and girls. Similar findings were shown among the adolescent group: a significantly higher mean energy intake among boys compared to girls (2116.34 kcal/day vs. 1688.5 kcal/day; respectively) ( p < 0.001), while the average overall group intake was 1872.57± 579.06 kcal/day. The present findings indicated that means of macronutrient percentages were found to comply with the AMDRs for both carbohydrates and protein. Fat was high among Jordanian children and adolescents (36.33±6.05% and 36.05±6.6%; AMDRs for both groups: 25-35%). Similar results were observed in a previous study conducted among Jordanian adolescents aged 14-18 with a fat intake of around 37% of EI. 56 Such findings are comparable to those reported in other countries in the region, including Lebanon (39.2% of EI for 4-13 years), 57 and Palestine (39.8% of EI for boys 11-16 years). 58 The picture appears similar to what has been reported in Western countries, including Spain, where about 43.4% of boys and 46.9% of girls between 4 and 17 years exceeded the AMDR in total fat intake, 59 while the mean contribution of fats to EI was 36.9% and 37.2% in Italian boys and girls; respectively (teenagers: 10-17.9 years). 60 Remarkably, the results of our study were consistent with those of other studies, showing that the pattern of energy and macronutrient intake has become a popular choice for trendy styles among children and adolescents worldwide. Discretionary calories, including added fat and sugar, are unnecessary for health. These foods contribute excess energy to the diet by displacing nutritious foods and should be consumed in moderation. The total intake of discretionary calories in the current study exceeded the recommendations for both age groups by three times (30.7% and 28.6% of total EI for children and adolescents, respectively), considering that the advice is <10% of the total EI. 61 These results are comparable to those of other countries worldwide. Discretionary foods and beverages accounted for more than a third of the daily energy intake of Australian children aged 2 to 18. 32 The same findings were found in Pakistan, where adolescents consumed 31.3% of their energy from discretionary foods. 62 On average, about 14% of total EI in American children and adolescents was from added sugars. 63 Despite adequate carbohydrate intake, the average intake of added sugars was nearly 57 g/day (about 13% and 12% of total EI for children and adolescents, respectively), and these averages were higher than the levels allowed by the MyPlate dietary guidelines and WHO guidelines. These findings might be related to the frequent consumption of sweet snacks, including cakes, pastries, and sweets/chocolates. Adolescents in some Middle Eastern countries, such as Sudan and Kuwait, have increased their daily consumption of sweets and desserts. 54 , 64 Consistently, the German Child and Adolescent Study results were no better than the present results, reporting that 50% of carbohydrate intake came from added sugars (23.5%) and total sugars (28.1%). 65 In addition, the percentage of energy contribution from added sugars in US children and adolescents was 14.3% at 2-8 years and 16.2% at 9-18 years, while the primary sources are sweetened beverages, candy, and sweet baked goods. 66 The primary sources of added sugars in the present study were sweetened beverages such as carbonated beverages, canned juices (fruit beverages), many types of sweetened ready-to-drink beverages, and sweetened tea; chocolate, cakes, as well as various kinds of Arabic sweets such as baklava, as well as Western desserts. Contrary to previously published studies, the present findings’ mean intake of saturated fats was almost equal for both age groups and rounded at 16 g/day; it was within an acceptable amount compared to the MyPlate dietary guidelines’ allowed amounts. Notably, boys from both age groups consumed significantly higher amounts of cholesterol, saturated, polyunsaturated, and monounsaturated fatty acids than girls from the same age group. Many Middle Eastern countries, including Lebanon, 57 Iran, 51 Palestine, 58 and Saudi Arabia, 67 had average saturated fat intakes (10.7%,10.3%, 10.3%, and 11.3%, respectively) that exceeded the recommendations (AMDR upper limit for saturated fat is 10% of total EI). A similar pattern of results was obtained in Western countries such as Italy (11.5%), the UK (13.2%), France (15%), and Spain (12.3%). 59 , 60 , 68 , 69 Strengths and limitations The large representative sample from a population-based study, the careful data quality control methods by reducing dietary intake misreporting, evaluating overweight and obesity by using WHtR (indicating central obesity) rather than BMI (indicating overall obesity), and the repaint of the specific MyPlate dietary guidelines for all age groups were significant strengths of our study. One of the current study’s limitations was that it was cross-sectional, which hindered the observation of causal effects. Furthermore, there is a lack of evaluation of physical activity, nutrition-related blood tests, and blood pressure. Moreover, potential biases include recall bias from 24-hour dietary recalls or potential underrepresentation of dietary intakes. Implications for research and practice It appears that fat and added sugar consumption must be controlled, while the amount of grains that should be consumed by “boys,” youngsters, children, and adolescents did not follow all of the MyPlate dietary recommendations. Children and adolescents consumed a slightly larger proportion of fat than the AMDRs, even though the mean energy intake was within the calculated requirements; policymakers and health professionals must take appropriate steps to address this issue. It is recommended that families, children, and adolescents receive nutrition education about the components of MyPlate dietary guidelines and the adverse health effects of obesogenic diets. Implementing community education programs about healthy eating habits requires cooperation between governmental and non-governmental organizations. Conclusions In conclusion, the prevalence of overweight and obesity approached about half of children, and a third of adolescents were classified as overweight and obese. On the other hand, about a quarter of the children and adolescents had abnormal WHtR. Notably, children and adolescents mismatched the intake of all recommended servings of MyPlate dietary guidelines (except grain intake in ’boys’ children). Despite the mean energy intake being within the estimated recommendations, children and adolescents consumed a slightly higher fat proportion than the AMDRs. Noticeably, the mean intake of added sugar was higher than the MyPlate dietary guidelines allowed amounts, while the mean intake of saturated fats was within an acceptable MyPlate dietary guidelines amount for both groups. Moreover, about 1/3 of energy consumed was from discretionary calories. Remarkably, boys consumed higher amounts of cholesterol, saturated, polyunsaturated, and monounsaturated fats than girls. Data availability Underlying data Zenodo: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents. https://doi.org/10.5281/zenodo.8159227 . 70 The project contains the following underlying data: • SPSS JPFCS children and Teenagers 2023. sav. (Anonymised participants’ data was used in this study). Extended data Zenodo: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents. https://doi.org/10.5281/zenodo.8240928 . 35 This project contains the following extended data: • A study of the food consumption rate using 24-hour memory for a sample of Jordanian society.docx (English version of data collection survey including two sheets for 24-hour recall). • دراسة معدل استهلاك الطعام باستخدام التذكر ل 24 ساعة لعينة من المجتمع الأردني النسخة العربية .docx. (Arabic version of data collection survey including two sheets for 24-hour recall). 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Publisher Full Text Comments on this article Comments (0) Version 4 VERSION 4 PUBLISHED 01 Sep 2023 ADD YOUR COMMENT Comment Author details Author details 1 Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan 2 Regional Office for the Eastern Mediterranean, Committee for World Health Organization, Cairo, Egypt Buthaina Alkhatib Roles: Conceptualization, Investigation, Methodology, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Huda Al Hourani Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation Islam K. Al-Shami Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Ayoub Al-Jawaldeh Roles: Data Curation, Funding Acquisition, Resources, Supervision, Visualization Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (4) version 4 Revised Published: 04 Feb 2025, 12:1094 https://doi.org/10.12688/f1000research.138866.4 version 3 Revised Published: 30 Sep 2024, 12:1094 https://doi.org/10.12688/f1000research.138866.3 version 2 Revised Published: 05 Dec 2023, 12:1094 https://doi.org/10.12688/f1000research.138866.2 version 1 Published: 01 Sep 2023, 12:1094 https://doi.org/10.12688/f1000research.138866.1 Copyright © 2025 Alkhatib B et al . 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COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 4 VERSION 4 PUBLISHED 04 Feb 2025 Revised Views 0 Cite How to cite this report: Ibrahim S. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.176995.r364514 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v4#referee-response-364514 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 19 Feb 2025 Sarah Ibrahim , Human Anatomy and Embryology Department, Tanta University, Tanta, Gharbia Governorate, Egypt Approved VIEWS 0 https://doi.org/10.5256/f1000research.176995.r364514 Upon reviewing the manuscript, I have no ... Continue reading READ ALL Upon reviewing the manuscript, I have no further edits/feedback. The comments have been addressed. Competing Interests: No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Ibrahim S. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.176995.r364514 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v4#referee-response-364514 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 3 VERSION 3 PUBLISHED 30 Sep 2024 Revised Views 0 Cite How to cite this report: Chokor FAZ. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.171932.r338455 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v3#referee-response-338455 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 03 Dec 2024 Fatima Al Zahraa Chokor , Qatar University, Doha, Doha, Qatar Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.171932.r338455 The article investigates the dietary habits and nutritional status of Jordanian children and adolescents in relation to MyPlate dietary guidelines. The study employs data from the Jordan Population-based Food Consumption Survey (JPFCS) and analyzes dietary intake, anthropometric measurements, and adherence ... Continue reading READ ALL The article investigates the dietary habits and nutritional status of Jordanian children and adolescents in relation to MyPlate dietary guidelines. The study employs data from the Jordan Population-based Food Consumption Survey (JPFCS) and analyzes dietary intake, anthropometric measurements, and adherence to dietary guidelines. The findings reveal significant deviations from recommended dietary patterns, particularly concerning low intake of fruits, vegetables, and dairy, excessive fat and added sugar consumption, and a high prevalence of overweight and obesity. The study underscores the necessity for nutrition education and policy interventions to promote healthier eating habits among Jordanian youth. Introduction: The introduction generally flows well, moving from the broader context of childhood eating habits to the specific problem of obesity and dietary patterns in Jordan. However, the transition between general global concerns and Jordan-specific issues could be smoother. For example, the mention of Jordanian obesity prevalence as a separate paragraph of one sentence in lines 5-6 is abrupt and could benefit from a brief segue that connects global trends to the local context. It would be also good to discuss the long-term societal and economic implications of the increasing trends of obesity in Jordan and thus highlighting the benefits of early intervention, especially in this age group to frame the study’s relevance. Very little in the literature was cited from Jordan, this warrants discussion of studies from Jordan or at least from the region (regional perspective) which would provide a stronger foundation for the study. Where does Jordan stand with the nutrition transition occurring in the EMR? Little is mentioned on micronutrient deficiencies which is one of the objectives It is good to provide a brief rationale for using the MyPlate guidelines and their relevance to Jordanian dietary habits You have presented and evaluated dietary intakes in the study but this has not been mentioned as part of the objectives It would be better to reframe the objectives in a way where they can inform future interventions or policies or at least describe how this study would contribute to solving the problem of obesity or informing public health interventions Methods: Rewrite: elderly, Jordanian individuals Rewrite: with a 90.2% response rate drawn simple random sampling from Jordan’s three major regions (Central, Northern, and Southern). Provide a more detailed explanation of how dietary data were standardized and verified for accuracy. Were dietary intakes normally distributed? If yes, report that in statistical analysis. If not, medians have to be reported and non-parametric tests have to be used. Outlier values for participants’ energy intake… has to be written under statistical analysis section This sentence is written under ‘Design and sample selection’ and it is already mentioned in ‘Ethical statement’: Following the head of the household’s oral permission, one of the participant’s parents signed an informed consent form for children and adolescents under 16. A written consent form was signed by adolescents over 16 years, and data collection began during the first visit in the presence of one of the parents. Sample size calculations not presented Instead of having a section for Survey Tool and another section for Dietary assessment, better to have the write-up divided into ‘anthropometric assessment’ and ‘Dietary intake assessment’ Has there been missing data? Reference needed for WHO reference curves for BMI-for-age categorization How were households selected? The sampling strategy lacks sufficient detail. What is the eligibility criteria? It has not been mentioned how sample characteristics were collected? Income, family size, etc… Has there been data collected on parents’ education and employment? How was height collected? With or without shoes? How many times were anthropometric measurements done? What about foods consumed at school? How was this data collected? How were composite and mixed recipes (mixed dishes) categorized under MyPlate food groups? Has the average of dietary intake been calculated or the usual intake? This is not clear: According to the Essential Guide to Nutrient Requirements, published by the Institute of Medicine in the National Academies Press in 2019, it also was approved and recommended by the USDA Dietary Guidelines for Americans, 2020-2025, which reflects the Acceptable Macronutrients Distribution Ranges (AMDR). How were food groups intakes compared to dietary recommendations? Elaboration needed in the methods section Cite table 2 in the methods How were the differences in the proportions of Sociodemographic and anthropometric characteristics compared between the two sexed in each age group? Mention the test name in statistical analysis Results Rewrite in a clearer manner: When compared to other regions in Jordan that were distributed according to their geographic distribution, the central areas had higher proportions of either children or adolescents of both sexes (children: 61.8% of boys and 53.3% of girls; adolescents: 56.1% of boys and 62.2% of girls). Table 1: correct percent of overweight/obesity for children boys Include as a footnote how was p-value obtained in Table 1, 3, and 4 Since there is no consensus on the appropriate cut points of WHtR in pediatric populations, better to replace normal/abnormal in table 1 with <0.5 versus ≥0.5. Same applies for in-text interpretation. Add reference for recommendations presented in Table 2 There are minor formatting inconsistencies, such as the use of parentheses for p-values and multiple numerical data points in a single sentence. Results need to better written for clarity: example: In children, the entire group consumes less than the recommended number of servings from all food groups and girls of the same age group. What do you mean by and girls of the same age group? Not an appropriate term to use: children’s boys almost finished the recommended … replace by: Boys came close to meeting the recommended servings for grains, achieving 30.6% of the standard plate recommendation of 30%. When stating: higher gap has been found among children girls’ intake of dairy, protein, and fruits (11%, 9.6%, and 6.8%, respectively) when compared to boys from the same age group (13%, 12.4%, and 8.7%; respectively), differences in compliance shall be tested for statistical significance. Replace: which did not agree with did not meet. Overall, the results section could be significantly improved by utilizing more precise and professional language to enhance clarity and readability. Discussion : The discussion can benefit from starting by summarizing the study’s objectives (e.g., characterizing dietary patterns and adherence to guidelines) and explicitly linking the results to these objectives. The discussion includes a detailed elaboration on the impact of COVID-19 on dietary patterns and physical activity, but this is not mentioned at all in the introduction, nor is there any indication that data on post-pandemic changes in dietary patterns were collected. This inconsistency is problematic as it introduces a topic in the discussion that was neither contextualized nor justified earlier in the article. Additionally, without specific data related to the pandemic's effects, the inclusion of COVID-19 as a contributing factor appears speculative and unsupported by the study's findings. The discussion restates many results without fully interpreting their significance or exploring potential underlying causes. Example when comparing prevalence of high WHtR, prevalence of overweight and obesity, compliance to food groups recommendations. This section lacks discussion of implications and a forward-looking perspective on how the study could inform policy or future research. What is meant by generalized overweight and obesity? There is little exploration of sociocultural or regional factors specific to Jordan. The discussion does not provide enough context for why certain dietary patterns (e.g., high fat and sugar consumption) might prevail in Jordan, especially when exploring sex differences. Discuss the health implications of high fat and sugar consumption in detail, citing evidence from clinical or epidemiological studies. Highlight how Jordan is experiencing a nutritional transition and how this is reflected in the study’s findings. ‘Careful data quality control methods by reducing dietary intake misreporting’ was mentioned in the strengths section but not elaborated in methods section. How can you explain the representativeness of the dietary intakes at the individual levels based on 24hdr? The limitations section does not address other potential biases, such as recall bias from 24-hour dietary recalls or potential underrepresentation of dietary intakes. You have collected data on supplement use (yes/no), but the macronutrients intake assessment was based on foods and beverages consumed only without taking into consideration supplement use. The language is sometimes repetitive (e.g., repeated mentions of dietary guidelines and excess fat/sugar consumption). The structure could be improved by grouping related ideas more cohesively. Ideas presented in a somewhat scattered manner, making it harder to identify key points. While some recommendations are provided (e.g., controlling fat and sugar intake), they are vague and not strongly linked to the study’s findings. Conclusions: The conclusion is overly focused on descriptive statistics and does not highlight the broader implications of these findings for public health or long-term health outcomes. It does not also include any recommendations for interventions, policy changes, or future research. Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: epidmeiology, biostatistics, maternal and child health, dietaty intakes I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Chokor FAZ. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.171932.r338455 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v3#referee-response-338455 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 2 VERSION 2 PUBLISHED 05 Dec 2023 Revised Views 0 Cite How to cite this report: Faris ME. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.159480.r274011 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v2#referee-response-274011 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 13 Sep 2024 MoezAlIslam E. Faris , University of Sharjah, Sharjah, Sharjah, United Arab Emirates Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.159480.r274011 I was invited to review the manuscript titled: "Food consumption and adherence to dietary guidelines among Jordanian children and adolescents". The manuscript is important, tackles an interesting and timely issue in relation to the pandemic of obesity, especially . among ... Continue reading READ ALL I was invited to review the manuscript titled: "Food consumption and adherence to dietary guidelines among Jordanian children and adolescents". The manuscript is important, tackles an interesting and timely issue in relation to the pandemic of obesity, especially . among children and adolescents. The manuscript is well-written, and relies on national validated data source. However, minor issues need to be adequately addressed to make this work more legible for publication. Forty (40) comments, edits, and suggestions need to be addressed, and are found in the attached PDF file. Pease find attached through the link: https://f1000research.s3.amazonaws.com/linked/675431.138866.pdf Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Nutrition, obesity, and inflammation I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Faris ME. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.159480.r274011 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v2#referee-response-274011 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 30 Sep 2024 Buthaina Alkhatib , Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan 30 Sep 2024 Author Response Greetings Thank you for the valuable notes and suggestions . All comments have been revised, and responses have been added to the comment boxes in the manuscript. Competing Interests: No competing interests were disclosed. Greetings Thank you for the valuable notes and suggestions . All comments have been revised, and responses have been added to the comment boxes in the manuscript. Greetings Thank you for the valuable notes and suggestions . All comments have been revised, and responses have been added to the comment boxes in the manuscript. Competing Interests: No competing interests were disclosed. Close Report a concern Author Response 30 Sep 2024 Buthaina Alkhatib , Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan 30 Sep 2024 Author Response response to reviewer point by point: https://doi.org/10.5281/zenodo.13810327 Competing Interests: No competing interests were disclosed. response to reviewer point by point: https://doi.org/10.5281/zenodo.13810327 response to reviewer point by point: https://doi.org/10.5281/zenodo.13810327 Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 30 Sep 2024 Buthaina Alkhatib , Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan 30 Sep 2024 Author Response Greetings Thank you for the valuable notes and suggestions . All comments have been revised, and responses have been added to the comment boxes in the manuscript. Competing Interests: No competing interests were disclosed. Greetings Thank you for the valuable notes and suggestions . All comments have been revised, and responses have been added to the comment boxes in the manuscript. Greetings Thank you for the valuable notes and suggestions . All comments have been revised, and responses have been added to the comment boxes in the manuscript. Competing Interests: No competing interests were disclosed. Close Report a concern Author Response 30 Sep 2024 Buthaina Alkhatib , Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan 30 Sep 2024 Author Response response to reviewer point by point: https://doi.org/10.5281/zenodo.13810327 Competing Interests: No competing interests were disclosed. response to reviewer point by point: https://doi.org/10.5281/zenodo.13810327 response to reviewer point by point: https://doi.org/10.5281/zenodo.13810327 Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Agraib L. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.159480.r227951 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v2#referee-response-227951 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 15 Dec 2023 Lana Agraib , Department of Food and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jerash Governorate, Jordan Approved VIEWS 0 https://doi.org/10.5256/f1000research.159480.r227951 No ... Continue reading READ ALL No new comment Competing Interests: No competing interests were disclosed. Reviewer Expertise: My areas of research are obesity, chronic disease, and dietary patterns I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Agraib L. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.159480.r227951 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v2#referee-response-227951 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 01 Sep 2023 Views 0 Cite How to cite this report: Ibrahim S. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.152097.r223002 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v1#referee-response-223002 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 27 Nov 2023 Sarah Ibrahim , Human Anatomy and Embryology Department, Tanta University, Tanta, Gharbia Governorate, Egypt Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.152097.r223002 Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Please find my feedback for some revisions below: Abstract The background is an ... Continue reading READ ALL Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Please find my feedback for some revisions below: Abstract The background is an articulation of the study purpose. Would be helpful to include some background information to substantiate the purpose of conducting this study- situate the problem first and then proceed to indicate the purpose of the study. Background Perhaps including a little bit of information on the current overweight and/or obesity-related challenges in Jordan, that would have also sparked the interest to conduct this study. Methods Reword: This study received ethical approval from the Institutional Board Review (IRB) committee, reviewed and approved the survey protocol at The Hashemite University (No.7/13/2020/2021). To: Institutional Research Ethics Board approval was obtained from the Hashemite University (No.7/13/2020/2021). Further clarification on where was data collected conducted? What type of sampling method was used? Further elaboration warranted. Rationale for excluding children with chronic disease warranted. Survey Tool The following statement is unclear in this subsection: It was announced on the university’s website about the need for nutritionists to work in data collection, and they were selected after personal interviews and based on their experience, and they were subsequently trained. Recommend re-writing this section; as it stands, it is not entirely clear (semi-structured interviews, face-to-face interviews, various tools used)- particularly the first few sentences. Was the nutritionist present during the recall? Data Analysis Should be written as stratified based on sex (and not gender). Discussion Recommend condensing the discussion further (a number of studies are summarized here), and very little information provided on the implications section, which is important. Recommend highlighting key research articles in the discussion to substantiate your findings etc. and flush out the implications section further. A section on the limitations is warranted. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Ibrahim S. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.152097.r223002 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v1#referee-response-223002 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 18 Sep 2024 Buthaina Alkhatib , Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan 18 Sep 2024 Author Response Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Response: Many thnaks Please find my feedback for some revisions below: ... Continue reading Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Response: Many thnaks Please find my feedback for some revisions below: Abstract The background is an articulation of the study purpose. Would be helpful to include some background information to substantiate the purpose of conducting this study- situate the problem first and then proceed to indicate the purpose of the study. Response: (It has been modified) Background Perhaps including a little bit of information on the current overweight and/or obesity-related challenges in Jordan, that would have also sparked the interest to conduct this study. Response: (It has been modified) Methods Reword: This study received ethical approval from the Institutional Board Review (IRB) committee, reviewed and approved the survey protocol at The Hashemite University (No.7/13/2020/2021). To: Institutional Research Ethics Board approval was obtained from the Hashemite University (No.7/13/2020/2021). Response: it has been modified . Further clarification on where was data collected conducted? Response: it has been written in details in the section” study design and sample selection’, also the details were published in the protocol manuscript Al-Shami et al. (34) What type of sampling method was used? Further elaboration is warranted. Response: simple random sampling for households. ( it has been provided ) The rationale for excluding children with chronic disease warranted. Response: the study aimed to investigate the children and adolescents in the whole apparently healthy population, the exclusion of those with chronic diseases was to neutralize the effect of the disease on food intake and to reduce the effect of the medications taken on the dietary pattern and food consumption. Survey Tool The following statement is unclear in this subsection: It was announced on the university’s website about the need for nutritionists to work in data collection, and they were selected after personal interviews and based on their experience, and they were subsequently trained. Recommend re-writing this section; as it stands, it is not entirely clear (semi-structured interviews, face-to-face interviews, various tools used)- particularly the first few sentences. Response: “The university's website stated that nutritionists were required to assist with data collection. Based on their experience, they were chosen through in-person interviews, and they were then trained.” Was the nutritionist present during the recall? Response: YES, for the first 24-hour recall, then the other recall was obtained by phone call. It has been clarified in the first 4 lines on the “dietary assessment” section Data Analysis Should be written as stratified based on sex (and not gender). Response : (It has been modified) Discussion Recommend condensing the discussion further (a number of studies are summarized here), and very little information is provided on the implications section, which is important. Recommend highlighting key research articles in the discussion to substantiate your findings etc. and flush out the implications section further. Response: it has been modified and highlighted with red color. A section on the limitations is warranted. Response: it is available in the paragraph before the implications, and it has been separated into a single paragraph. Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Response: Many thnaks Please find my feedback for some revisions below: Abstract The background is an articulation of the study purpose. Would be helpful to include some background information to substantiate the purpose of conducting this study- situate the problem first and then proceed to indicate the purpose of the study. Response: (It has been modified) Background Perhaps including a little bit of information on the current overweight and/or obesity-related challenges in Jordan, that would have also sparked the interest to conduct this study. Response: (It has been modified) Methods Reword: This study received ethical approval from the Institutional Board Review (IRB) committee, reviewed and approved the survey protocol at The Hashemite University (No.7/13/2020/2021). To: Institutional Research Ethics Board approval was obtained from the Hashemite University (No.7/13/2020/2021). Response: it has been modified . Further clarification on where was data collected conducted? Response: it has been written in details in the section” study design and sample selection’, also the details were published in the protocol manuscript Al-Shami et al. (34) What type of sampling method was used? Further elaboration is warranted. Response: simple random sampling for households. ( it has been provided ) The rationale for excluding children with chronic disease warranted. Response: the study aimed to investigate the children and adolescents in the whole apparently healthy population, the exclusion of those with chronic diseases was to neutralize the effect of the disease on food intake and to reduce the effect of the medications taken on the dietary pattern and food consumption. Survey Tool The following statement is unclear in this subsection: It was announced on the university’s website about the need for nutritionists to work in data collection, and they were selected after personal interviews and based on their experience, and they were subsequently trained. Recommend re-writing this section; as it stands, it is not entirely clear (semi-structured interviews, face-to-face interviews, various tools used)- particularly the first few sentences. Response: “The university's website stated that nutritionists were required to assist with data collection. Based on their experience, they were chosen through in-person interviews, and they were then trained.” Was the nutritionist present during the recall? Response: YES, for the first 24-hour recall, then the other recall was obtained by phone call. It has been clarified in the first 4 lines on the “dietary assessment” section Data Analysis Should be written as stratified based on sex (and not gender). Response : (It has been modified) Discussion Recommend condensing the discussion further (a number of studies are summarized here), and very little information is provided on the implications section, which is important. Recommend highlighting key research articles in the discussion to substantiate your findings etc. and flush out the implications section further. Response: it has been modified and highlighted with red color. A section on the limitations is warranted. Response: it is available in the paragraph before the implications, and it has been separated into a single paragraph. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 18 Sep 2024 Buthaina Alkhatib , Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan 18 Sep 2024 Author Response Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Response: Many thnaks Please find my feedback for some revisions below: ... Continue reading Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Response: Many thnaks Please find my feedback for some revisions below: Abstract The background is an articulation of the study purpose. Would be helpful to include some background information to substantiate the purpose of conducting this study- situate the problem first and then proceed to indicate the purpose of the study. Response: (It has been modified) Background Perhaps including a little bit of information on the current overweight and/or obesity-related challenges in Jordan, that would have also sparked the interest to conduct this study. Response: (It has been modified) Methods Reword: This study received ethical approval from the Institutional Board Review (IRB) committee, reviewed and approved the survey protocol at The Hashemite University (No.7/13/2020/2021). To: Institutional Research Ethics Board approval was obtained from the Hashemite University (No.7/13/2020/2021). Response: it has been modified . Further clarification on where was data collected conducted? Response: it has been written in details in the section” study design and sample selection’, also the details were published in the protocol manuscript Al-Shami et al. (34) What type of sampling method was used? Further elaboration is warranted. Response: simple random sampling for households. ( it has been provided ) The rationale for excluding children with chronic disease warranted. Response: the study aimed to investigate the children and adolescents in the whole apparently healthy population, the exclusion of those with chronic diseases was to neutralize the effect of the disease on food intake and to reduce the effect of the medications taken on the dietary pattern and food consumption. Survey Tool The following statement is unclear in this subsection: It was announced on the university’s website about the need for nutritionists to work in data collection, and they were selected after personal interviews and based on their experience, and they were subsequently trained. Recommend re-writing this section; as it stands, it is not entirely clear (semi-structured interviews, face-to-face interviews, various tools used)- particularly the first few sentences. Response: “The university's website stated that nutritionists were required to assist with data collection. Based on their experience, they were chosen through in-person interviews, and they were then trained.” Was the nutritionist present during the recall? Response: YES, for the first 24-hour recall, then the other recall was obtained by phone call. It has been clarified in the first 4 lines on the “dietary assessment” section Data Analysis Should be written as stratified based on sex (and not gender). Response : (It has been modified) Discussion Recommend condensing the discussion further (a number of studies are summarized here), and very little information is provided on the implications section, which is important. Recommend highlighting key research articles in the discussion to substantiate your findings etc. and flush out the implications section further. Response: it has been modified and highlighted with red color. A section on the limitations is warranted. Response: it is available in the paragraph before the implications, and it has been separated into a single paragraph. Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Response: Many thnaks Please find my feedback for some revisions below: Abstract The background is an articulation of the study purpose. Would be helpful to include some background information to substantiate the purpose of conducting this study- situate the problem first and then proceed to indicate the purpose of the study. Response: (It has been modified) Background Perhaps including a little bit of information on the current overweight and/or obesity-related challenges in Jordan, that would have also sparked the interest to conduct this study. Response: (It has been modified) Methods Reword: This study received ethical approval from the Institutional Board Review (IRB) committee, reviewed and approved the survey protocol at The Hashemite University (No.7/13/2020/2021). To: Institutional Research Ethics Board approval was obtained from the Hashemite University (No.7/13/2020/2021). Response: it has been modified . Further clarification on where was data collected conducted? Response: it has been written in details in the section” study design and sample selection’, also the details were published in the protocol manuscript Al-Shami et al. (34) What type of sampling method was used? Further elaboration is warranted. Response: simple random sampling for households. ( it has been provided ) The rationale for excluding children with chronic disease warranted. Response: the study aimed to investigate the children and adolescents in the whole apparently healthy population, the exclusion of those with chronic diseases was to neutralize the effect of the disease on food intake and to reduce the effect of the medications taken on the dietary pattern and food consumption. Survey Tool The following statement is unclear in this subsection: It was announced on the university’s website about the need for nutritionists to work in data collection, and they were selected after personal interviews and based on their experience, and they were subsequently trained. Recommend re-writing this section; as it stands, it is not entirely clear (semi-structured interviews, face-to-face interviews, various tools used)- particularly the first few sentences. Response: “The university's website stated that nutritionists were required to assist with data collection. Based on their experience, they were chosen through in-person interviews, and they were then trained.” Was the nutritionist present during the recall? Response: YES, for the first 24-hour recall, then the other recall was obtained by phone call. It has been clarified in the first 4 lines on the “dietary assessment” section Data Analysis Should be written as stratified based on sex (and not gender). Response : (It has been modified) Discussion Recommend condensing the discussion further (a number of studies are summarized here), and very little information is provided on the implications section, which is important. Recommend highlighting key research articles in the discussion to substantiate your findings etc. and flush out the implications section further. Response: it has been modified and highlighted with red color. A section on the limitations is warranted. Response: it is available in the paragraph before the implications, and it has been separated into a single paragraph. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Agraib L. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.152097.r204311 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v1#referee-response-204311 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 12 Sep 2023 Lana Agraib , Department of Food and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jerash Governorate, Jordan Approved VIEWS 0 https://doi.org/10.5256/f1000research.152097.r204311 Thanks to the authors, this article is well-written and the figure and table are well-drawn and easier to read and understand helping in getting the idea more easily. The article addresses the food consumption pattern among Jordanian children and adolescents. It ... Continue reading READ ALL Thanks to the authors, this article is well-written and the figure and table are well-drawn and easier to read and understand helping in getting the idea more easily. The article addresses the food consumption pattern among Jordanian children and adolescents. It addresses an important topic in Jordan, especially indicating the consumed food group that may affect children and adolescents’ health, as the prevalence of obesity among this age group is rising dramatically. In more detail, Alkhatib and colleagues highlighted that the intakes of fruits, vegetables, and dairy products were low among the study group, while the consumption of additives specifically sugar and fat which was defined using the term "discretionary calorie" was high, and this may explain the increasing in obesity rate. It should make an important contribution to children and adolescent health programs which in consequence reduce obesity and the associated adulthood diseases that increase the burden in the health sector. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: My areas of research are obesity, chronic disease, and dietary patterns I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Agraib L. Reviewer Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.152097.r204311 ) The direct URL for this report is: https://f1000research.com/articles/12-1094/v1#referee-response-204311 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 4 VERSION 4 PUBLISHED 01 Sep 2023 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 4 (revision) 04 Feb 25 read Version 3 (revision) 30 Sep 24 read Version 2 (revision) 05 Dec 23 read read Version 1 01 Sep 23 read read Lana Agraib , Jerash University, Jerash, Jordan Sarah Ibrahim , Tanta University, Tanta, Egypt MoezAlIslam E. Faris , University of Sharjah, Sharjah, United Arab Emirates Fatima Al Zahraa Chokor , Qatar University, Doha, Qatar Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Ibrahim S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 19 Feb 2025 | for Version 4 Sarah Ibrahim , Human Anatomy and Embryology Department, Tanta University, Tanta, Gharbia Governorate, Egypt 0 Views copyright © 2025 Ibrahim S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Upon reviewing the manuscript, I have no further edits/feedback. The comments have been addressed. Competing Interests No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Ibrahim S. Peer Review Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.176995.r364514) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1094/v4#referee-response-364514 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Chokor F. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 03 Dec 2024 | for Version 3 Fatima Al Zahraa Chokor , Qatar University, Doha, Doha, Qatar 0 Views copyright © 2024 Chokor F. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The article investigates the dietary habits and nutritional status of Jordanian children and adolescents in relation to MyPlate dietary guidelines. The study employs data from the Jordan Population-based Food Consumption Survey (JPFCS) and analyzes dietary intake, anthropometric measurements, and adherence to dietary guidelines. The findings reveal significant deviations from recommended dietary patterns, particularly concerning low intake of fruits, vegetables, and dairy, excessive fat and added sugar consumption, and a high prevalence of overweight and obesity. The study underscores the necessity for nutrition education and policy interventions to promote healthier eating habits among Jordanian youth. Introduction: The introduction generally flows well, moving from the broader context of childhood eating habits to the specific problem of obesity and dietary patterns in Jordan. However, the transition between general global concerns and Jordan-specific issues could be smoother. For example, the mention of Jordanian obesity prevalence as a separate paragraph of one sentence in lines 5-6 is abrupt and could benefit from a brief segue that connects global trends to the local context. It would be also good to discuss the long-term societal and economic implications of the increasing trends of obesity in Jordan and thus highlighting the benefits of early intervention, especially in this age group to frame the study’s relevance. Very little in the literature was cited from Jordan, this warrants discussion of studies from Jordan or at least from the region (regional perspective) which would provide a stronger foundation for the study. Where does Jordan stand with the nutrition transition occurring in the EMR? Little is mentioned on micronutrient deficiencies which is one of the objectives It is good to provide a brief rationale for using the MyPlate guidelines and their relevance to Jordanian dietary habits You have presented and evaluated dietary intakes in the study but this has not been mentioned as part of the objectives It would be better to reframe the objectives in a way where they can inform future interventions or policies or at least describe how this study would contribute to solving the problem of obesity or informing public health interventions Methods: Rewrite: elderly, Jordanian individuals Rewrite: with a 90.2% response rate drawn simple random sampling from Jordan’s three major regions (Central, Northern, and Southern). Provide a more detailed explanation of how dietary data were standardized and verified for accuracy. Were dietary intakes normally distributed? If yes, report that in statistical analysis. If not, medians have to be reported and non-parametric tests have to be used. Outlier values for participants’ energy intake… has to be written under statistical analysis section This sentence is written under ‘Design and sample selection’ and it is already mentioned in ‘Ethical statement’: Following the head of the household’s oral permission, one of the participant’s parents signed an informed consent form for children and adolescents under 16. A written consent form was signed by adolescents over 16 years, and data collection began during the first visit in the presence of one of the parents. Sample size calculations not presented Instead of having a section for Survey Tool and another section for Dietary assessment, better to have the write-up divided into ‘anthropometric assessment’ and ‘Dietary intake assessment’ Has there been missing data? Reference needed for WHO reference curves for BMI-for-age categorization How were households selected? The sampling strategy lacks sufficient detail. What is the eligibility criteria? It has not been mentioned how sample characteristics were collected? Income, family size, etc… Has there been data collected on parents’ education and employment? How was height collected? With or without shoes? How many times were anthropometric measurements done? What about foods consumed at school? How was this data collected? How were composite and mixed recipes (mixed dishes) categorized under MyPlate food groups? Has the average of dietary intake been calculated or the usual intake? This is not clear: According to the Essential Guide to Nutrient Requirements, published by the Institute of Medicine in the National Academies Press in 2019, it also was approved and recommended by the USDA Dietary Guidelines for Americans, 2020-2025, which reflects the Acceptable Macronutrients Distribution Ranges (AMDR). How were food groups intakes compared to dietary recommendations? Elaboration needed in the methods section Cite table 2 in the methods How were the differences in the proportions of Sociodemographic and anthropometric characteristics compared between the two sexed in each age group? Mention the test name in statistical analysis Results Rewrite in a clearer manner: When compared to other regions in Jordan that were distributed according to their geographic distribution, the central areas had higher proportions of either children or adolescents of both sexes (children: 61.8% of boys and 53.3% of girls; adolescents: 56.1% of boys and 62.2% of girls). Table 1: correct percent of overweight/obesity for children boys Include as a footnote how was p-value obtained in Table 1, 3, and 4 Since there is no consensus on the appropriate cut points of WHtR in pediatric populations, better to replace normal/abnormal in table 1 with <0.5 versus ≥0.5. Same applies for in-text interpretation. Add reference for recommendations presented in Table 2 There are minor formatting inconsistencies, such as the use of parentheses for p-values and multiple numerical data points in a single sentence. Results need to better written for clarity: example: In children, the entire group consumes less than the recommended number of servings from all food groups and girls of the same age group. What do you mean by and girls of the same age group? Not an appropriate term to use: children’s boys almost finished the recommended … replace by: Boys came close to meeting the recommended servings for grains, achieving 30.6% of the standard plate recommendation of 30%. When stating: higher gap has been found among children girls’ intake of dairy, protein, and fruits (11%, 9.6%, and 6.8%, respectively) when compared to boys from the same age group (13%, 12.4%, and 8.7%; respectively), differences in compliance shall be tested for statistical significance. Replace: which did not agree with did not meet. Overall, the results section could be significantly improved by utilizing more precise and professional language to enhance clarity and readability. Discussion : The discussion can benefit from starting by summarizing the study’s objectives (e.g., characterizing dietary patterns and adherence to guidelines) and explicitly linking the results to these objectives. The discussion includes a detailed elaboration on the impact of COVID-19 on dietary patterns and physical activity, but this is not mentioned at all in the introduction, nor is there any indication that data on post-pandemic changes in dietary patterns were collected. This inconsistency is problematic as it introduces a topic in the discussion that was neither contextualized nor justified earlier in the article. Additionally, without specific data related to the pandemic's effects, the inclusion of COVID-19 as a contributing factor appears speculative and unsupported by the study's findings. The discussion restates many results without fully interpreting their significance or exploring potential underlying causes. Example when comparing prevalence of high WHtR, prevalence of overweight and obesity, compliance to food groups recommendations. This section lacks discussion of implications and a forward-looking perspective on how the study could inform policy or future research. What is meant by generalized overweight and obesity? There is little exploration of sociocultural or regional factors specific to Jordan. The discussion does not provide enough context for why certain dietary patterns (e.g., high fat and sugar consumption) might prevail in Jordan, especially when exploring sex differences. Discuss the health implications of high fat and sugar consumption in detail, citing evidence from clinical or epidemiological studies. Highlight how Jordan is experiencing a nutritional transition and how this is reflected in the study’s findings. ‘Careful data quality control methods by reducing dietary intake misreporting’ was mentioned in the strengths section but not elaborated in methods section. How can you explain the representativeness of the dietary intakes at the individual levels based on 24hdr? The limitations section does not address other potential biases, such as recall bias from 24-hour dietary recalls or potential underrepresentation of dietary intakes. You have collected data on supplement use (yes/no), but the macronutrients intake assessment was based on foods and beverages consumed only without taking into consideration supplement use. The language is sometimes repetitive (e.g., repeated mentions of dietary guidelines and excess fat/sugar consumption). The structure could be improved by grouping related ideas more cohesively. Ideas presented in a somewhat scattered manner, making it harder to identify key points. While some recommendations are provided (e.g., controlling fat and sugar intake), they are vague and not strongly linked to the study’s findings. Conclusions: The conclusion is overly focused on descriptive statistics and does not highlight the broader implications of these findings for public health or long-term health outcomes. It does not also include any recommendations for interventions, policy changes, or future research. Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise epidmeiology, biostatistics, maternal and child health, dietaty intakes I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Chokor FAZ. Peer Review Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.171932.r338455) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1094/v3#referee-response-338455 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Faris M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 13 Sep 2024 | for Version 2 MoezAlIslam E. Faris , University of Sharjah, Sharjah, Sharjah, United Arab Emirates 0 Views copyright © 2024 Faris M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (2) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I was invited to review the manuscript titled: "Food consumption and adherence to dietary guidelines among Jordanian children and adolescents". The manuscript is important, tackles an interesting and timely issue in relation to the pandemic of obesity, especially . among children and adolescents. The manuscript is well-written, and relies on national validated data source. However, minor issues need to be adequately addressed to make this work more legible for publication. Forty (40) comments, edits, and suggestions need to be addressed, and are found in the attached PDF file. Pease find attached through the link: https://f1000research.s3.amazonaws.com/linked/675431.138866.pdf Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Nutrition, obesity, and inflammation I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (2) Author Response 30 Sep 2024 Buthaina Alkhatib, Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan Greetings Thank you for the valuable notes and suggestions . All comments have been revised, and responses have been added to the comment boxes in the manuscript. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Author Response 30 Sep 2024 Buthaina Alkhatib, Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan response to reviewer point by point: https://doi.org/10.5281/zenodo.13810327 View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Faris ME. Peer Review Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.159480.r274011) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1094/v2#referee-response-274011 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Agraib L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 15 Dec 2023 | for Version 2 Lana Agraib , Department of Food and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jerash Governorate, Jordan 0 Views copyright © 2023 Agraib L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions No new comment Competing Interests No competing interests were disclosed. Reviewer Expertise My areas of research are obesity, chronic disease, and dietary patterns I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Agraib L. Peer Review Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.159480.r227951) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1094/v2#referee-response-227951 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Ibrahim S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 27 Nov 2023 | for Version 1 Sarah Ibrahim , Human Anatomy and Embryology Department, Tanta University, Tanta, Gharbia Governorate, Egypt 0 Views copyright © 2023 Ibrahim S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Please find my feedback for some revisions below: Abstract The background is an articulation of the study purpose. Would be helpful to include some background information to substantiate the purpose of conducting this study- situate the problem first and then proceed to indicate the purpose of the study. Background Perhaps including a little bit of information on the current overweight and/or obesity-related challenges in Jordan, that would have also sparked the interest to conduct this study. Methods Reword: This study received ethical approval from the Institutional Board Review (IRB) committee, reviewed and approved the survey protocol at The Hashemite University (No.7/13/2020/2021). To: Institutional Research Ethics Board approval was obtained from the Hashemite University (No.7/13/2020/2021). Further clarification on where was data collected conducted? What type of sampling method was used? Further elaboration warranted. Rationale for excluding children with chronic disease warranted. Survey Tool The following statement is unclear in this subsection: It was announced on the university’s website about the need for nutritionists to work in data collection, and they were selected after personal interviews and based on their experience, and they were subsequently trained. Recommend re-writing this section; as it stands, it is not entirely clear (semi-structured interviews, face-to-face interviews, various tools used)- particularly the first few sentences. Was the nutritionist present during the recall? Data Analysis Should be written as stratified based on sex (and not gender). Discussion Recommend condensing the discussion further (a number of studies are summarized here), and very little information provided on the implications section, which is important. Recommend highlighting key research articles in the discussion to substantiate your findings etc. and flush out the implications section further. A section on the limitations is warranted. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 18 Sep 2024 Buthaina Alkhatib, Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan Thank you for submitting this paper. An interesting and important study appreciating the impact nutrition has on NCDs. Response: Many thnaks Please find my feedback for some revisions below: Abstract The background is an articulation of the study purpose. Would be helpful to include some background information to substantiate the purpose of conducting this study- situate the problem first and then proceed to indicate the purpose of the study. Response: (It has been modified) Background Perhaps including a little bit of information on the current overweight and/or obesity-related challenges in Jordan, that would have also sparked the interest to conduct this study. Response: (It has been modified) Methods Reword: This study received ethical approval from the Institutional Board Review (IRB) committee, reviewed and approved the survey protocol at The Hashemite University (No.7/13/2020/2021). To: Institutional Research Ethics Board approval was obtained from the Hashemite University (No.7/13/2020/2021). Response: it has been modified . Further clarification on where was data collected conducted? Response: it has been written in details in the section” study design and sample selection’, also the details were published in the protocol manuscript Al-Shami et al. (34) What type of sampling method was used? Further elaboration is warranted. Response: simple random sampling for households. ( it has been provided ) The rationale for excluding children with chronic disease warranted. Response: the study aimed to investigate the children and adolescents in the whole apparently healthy population, the exclusion of those with chronic diseases was to neutralize the effect of the disease on food intake and to reduce the effect of the medications taken on the dietary pattern and food consumption. Survey Tool The following statement is unclear in this subsection: It was announced on the university’s website about the need for nutritionists to work in data collection, and they were selected after personal interviews and based on their experience, and they were subsequently trained. Recommend re-writing this section; as it stands, it is not entirely clear (semi-structured interviews, face-to-face interviews, various tools used)- particularly the first few sentences. Response: “The university's website stated that nutritionists were required to assist with data collection. Based on their experience, they were chosen through in-person interviews, and they were then trained.” Was the nutritionist present during the recall? Response: YES, for the first 24-hour recall, then the other recall was obtained by phone call. It has been clarified in the first 4 lines on the “dietary assessment” section Data Analysis Should be written as stratified based on sex (and not gender). Response : (It has been modified) Discussion Recommend condensing the discussion further (a number of studies are summarized here), and very little information is provided on the implications section, which is important. Recommend highlighting key research articles in the discussion to substantiate your findings etc. and flush out the implications section further. Response: it has been modified and highlighted with red color. A section on the limitations is warranted. Response: it is available in the paragraph before the implications, and it has been separated into a single paragraph. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Ibrahim S. Peer Review Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.152097.r223002) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1094/v1#referee-response-223002 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Agraib L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Sep 2023 | for Version 1 Lana Agraib , Department of Food and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jerash Governorate, Jordan 0 Views copyright © 2023 Agraib L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thanks to the authors, this article is well-written and the figure and table are well-drawn and easier to read and understand helping in getting the idea more easily. The article addresses the food consumption pattern among Jordanian children and adolescents. It addresses an important topic in Jordan, especially indicating the consumed food group that may affect children and adolescents’ health, as the prevalence of obesity among this age group is rising dramatically. In more detail, Alkhatib and colleagues highlighted that the intakes of fruits, vegetables, and dairy products were low among the study group, while the consumption of additives specifically sugar and fat which was defined using the term "discretionary calorie" was high, and this may explain the increasing in obesity rate. It should make an important contribution to children and adolescent health programs which in consequence reduce obesity and the associated adulthood diseases that increase the burden in the health sector. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise My areas of research are obesity, chronic disease, and dietary patterns I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Agraib L. Peer Review Report For: Food consumption and adherence to dietary guidelines among Jordanian children and adolescents [version 4; peer review: 2 approved, 2 approved with reservations] . F1000Research 2025, 12 :1094 ( https://doi.org/10.5256/f1000research.152097.r204311) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1094/v1#referee-response-204311 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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