Nutritional Knowledge of the Mediterranean Diet Is Associated with Positive Attitudes and Adherence in a Non-Mediterranean Multi-Ethnic Society
Round 1
Reviewer 1 Report
It is undoubtedly an interesting and well-conducted study, which analyzes the relationship between the knowledge and the daily practice of the principles of the Mediterranean Diet in an Australian population. However, the main limitation remains the small number of participants. The authors rightly cited the PREDIMED study, which considered 7447 subjects, compared to the 373 participants in the study under review. In summary, it is an interesting study, if we consider it as a pilot study to be continued by increasing the number of subjects involved.
Author Response
We would first like to thank the reviewer for their valuable comments and kind words. We appreciate the fact that they found the study interesting and well-conducted. We do agree that the sample size is much smaller than the PREDIMED study; this is due to budget and time constraints and the fact that this study was conducted in one city in Queensland, Brisbane. Our main goal is to conduct this study on a large national scale Australia wide. This limitation has now been added to the limitations section.
Author Response File: 
Author Response.docx
Reviewer 2 Report
This manuscript deals with the understanding how the public in a non- Mediterranean multi-ethnic society perceived the Mediterranean dietary pattern (MDP) and its general health benefits. The MDP has been linked to decreased risks of various common non-communicable diseases (NCDs) such as cardiovascular diseases, obesity, hypertension, diabetes, cancer and cognitive decline. The paper provides new insights about the association between nutritional knowledge and adherence to the MDP in a multi-ethnic non-Mediterranean setting. And it is the first Australian study to correlate the relationships between knowledge, attitudes and practices towards the MDP. In addition there are also highlighted some future intervention strategies such as, increasing awareness to the MDP, and provide individuals the right tools to aid adherence to this dietary pattern.
It is a well-written article with elements of originality.
Nonetheless:
In the literature, however, there is a work that refer to the anti-inflammatory action of Mediterranean Diet in relation to the potent inflammatory mediator Platelet Activating Factor (PAF) and the existence of anti-inflammatory micronutrients (PAF-inhibitors) in the foods of Mediterranean Diet as well as the relation of the Mediterranean Diet with various common non-communicable diseases (NCDs). Indicatively, I mention
-Mediterranean diet and platelet-activating factor; a systematic review.
Clinical Biochemistry, 60, Pages 1-10, 2018,
Nomikos, T., Fragopoulou, E., Antonopoulou, S., Panagiotakos, D.B
which it should be at least also mentioned together with the reference 8.
Author Response
We highly appreciate the reviewer’s positive feedback about the paper and believing that it is well written and original. Thank you for the interesting paper recommendation, we believe it will be an added value to our paper. This reference is now added as reference 9.
Author Response File: Author Response.docx
Reviewer 3 Report
The authors should use the provided template for the journal.
Introduction:
Row 77 - revise: only a sample of Australia populations was studies.
Participants and Recruitment:
When did data collection occurred?
What was the inclusion and/ exclusion criteria for the study?
Instruments:
In which section/part of the questionnaire the authors requested the demographics?
Row 131 - Please orientate the reader by including a phrase: e.g. For the second part of the questionnaire...
Row 162 - See previous comment.
Results:
Row 198 - Revise: There are three "variables" for the dietary knowledge scores, excluding the total score.
Row 206 - change 0-30 to 0-31 points
Row 207 - change 17.5+4.5 points - values differ in table 2.
Row 209 - A total score is provided for the knowledge scores, what about a total score for attitudes (Table 3)?
Table 1 - Reference is made to Graduate degree - do you mean Post-graduate degree?
Table 2 - Include a note on participants received on point for each correct answer.
Table 4 - Remove question mark.
Tables do not adhere to the journal's prescriptions.
Discussion:
Row 294 - 295 - Revise sentence: people's knowledge; ...sample of Australians living....
Author Response
The authors should use the provided template for the journal.
Noted, thank you
Introduction:
Row 77 - revise: only a sample of Australia populations was studies.
Kindly note that this has now been amended
Participants and Recruitment:
When did data collection occurred?
Thank you for this comment. This has now been added
What was the inclusion and/ exclusion criteria for the study?
Kindly note that the inclusion/exclusion criteria has now been added into the Participants and Recruitment section.
Instruments:
In which section/part of the questionnaire the authors requested the demographics?
Thank you for pointing this. The demographics section was the first part of the questionnaire. This has now been added at the beginning of the Instruments section
Row 131 - Please orientate the reader by including a phrase: e.g. For the second part of the questionnaire...
This phrase has now been added
Row 162 - See previous comment.
Added
Results:
Row 198 - Revise: There are three "variables" for the dietary knowledge scores, excluding the total score.
This has now been amended accordingly
Row 206 - change 0-30 to 0-31 points
Amended. Thank you for noting this
Row 207 - change 17.5+4.5 points - values differ in table 2.
Amended. The correct values were the ones reported in the text
Row 209 - A total score is provided for the knowledge scores, what about a total score for attitudes (Table 3)?
Unfortunately, there is no total attitudes scores. Unlike the knowledge scores (That all assess knowledge), the attitudes scores are very diverse hence no total score can be calculated; however, for future studies, it would be a great idea to work on a universal total attitudes score
Table 1 - Reference is made to Graduate degree - do you mean Post-graduate degree?
Yes exactly
Table 2 - Include a note on participants received on point for each correct answer.
Added to table 2
Table 4 - Remove question mark.
Done
Tables do not adhere to the journal's prescriptions.
This has now been amended
Discussion:
Row 294 - 295 - Revise sentence: people's knowledge; ...sample of Australians living..
Thank you for noting this, it has now been amended
Author Response File: Author Response.docx
