Mediterranean Diet and Sarcopenia Features in Apparently Healthy Adults over 65 Years: A Systematic Review

Round 1

Reviewer 1 Report

Thank you for the opportunity to review the manuscript ‘Mediterranean Diet and Sarcopenia features in apparently healthy adults over 65 y: A systematic Review’

Below is the feedback for authors as per PRISMA guidelines:

Title

Please use years instead of Y (should be 65 years and above)

Abstract

Please include one sentence on objectives (just before methods, line 23).

Introduction

Overall, the introduction is well written and presents both the rational and objective

There are minor suggestions:

Line 41 – include % with 31

Line 50 – expand ESPEN

Line 69 – may replace very important with vital

Methods

Overall, methods section needs improvement.

Line 107-108: needs correction (sentence formation)

Table 2 – under population it should be >= 65 years

Line 123 – before quality assessment, please include a sub-section on study selection (item #8) and explain the process of screening

Line 128 – here authors have used the term cohort, however, later both prospective studies and cohort studies is used, would suggest using common term throughout

Line 128 – needs correction (sentence formation)

Line 132 – following

Line 137 – please include new sub-sections on effect measures (item #12) and synthesis (item #13)

Results

The results section can be improved as below.

Line 139 – needs correction (sentence formation)

Line 142 – PRISMA flow diagram, the numbers do not match. Please double check the numbers in the narrative and the flow diagram.

Line 148-149 – 4 cross-sectional and 6 prospective studies. This information is already presented in Line 139-140 and hence can be deleted from here.

Line 166 – it should be four studies

Line 178-179 – needs correction, instead of ref 59, I think the authors should include ref 48 (accordingly the results would change).   

Table 3 – column Age (y) (mean +-SD) needs correction – in each row, need not mention years

Table 3 – column Follow-up (months) needs correction – in each row, mention in moth or change the column heading unit

Discussion

The discussion is well presented, except minor errors.

Line 228-229 – there was no evidence of positive effect on sarcopenia

Line 256-257 – this is already mentioned in the introduction, can be deleted from here

Conclusion

Line 318-319 – needs correction (no positive effect on muscle strength and sarcopenia).   

Author Response

Thank you for your valuable comments, which helped us improve our manuscript significantly.
We took them into consideration and made all the changes you suggested.

Author Response File: Author Response.docx

Reviewer 2 Report

Thank you for asking me to review the study entitled “Mediterranean Diet and Sarcopenia Features in Apparently Healthy Adults Over 65 Y: A Systematic Review”

The study aimed to systematically review evidence of the role of Mediterranean diet in sarcopenia prevention and/or improvement, including recent data, in healthy elders.

The fact that the population of interest is individuals with sarcopenia is a particular aspect of interest in this study since few systematic reviews focus on this population. Other strengths of this study are the use of the PRISMA guidelines. However, the lack of a record in a database for systematic reviews is necessary (Prospero, etc.)

What is the time window for the search?

The following parameters were searched for review:

Eligibility criteria, search strategy, study selection process as well as quality appraisal procedure were properly applied.

The authors should deepen the discussion because it appears sterile. What are the characteristic foods of the Mediterranean diet

It is also important to consider weight or muscle mass loss. What are the effects of the Mediterranean diet on weight or muscle mass loss in sarcopenia?

Limitations included the risk of bias assessment found in most of the papers included in the analyses.

In sum, the paper is well-written and well-conducted adding more knowledge to the considered topic.

Author Response

Thank you for your valuable comments, which helped us improve our manuscript significantly.
We took them into consideration and made all the changes you suggested.

Author Response File: Author Response.docx