Sex-stratified results should be evaluated alongside sex-adjusted results for further discussion of significant associations with sex

Dear Editor:

Additional data presentation would enhance the understanding of the conclusions reported by Kurasawa, et al. (Volume 1, Issue 2)¹⁾. In their study, they used multiple logistic regression analysis to calculate odds ratios (ORs) adjusted for sex and age. While they reported a significant association with sex in the adjusted ORs, their findings focused on associations between obesity and factors such as “eating dinner alone,” “small family size,” and “eating very fast,” as well as a negative association with “daily alcohol consumption,” based solely on adjusted ORs. Evaluating sex-stratified associations could provide a more nuanced understanding of these relationships.

A similar report by Kurasawa, et al. (Volume 1, Issue 1)²⁾ demonstrated that overweight was associated with “being unable to manage stress,” using both crude and adjusted ORs. However, this report did not address whether overweight was associated with sex. Given the likelihood of a significant relationship between overweight and sex, additional sex-stratified analysis could lead to a more comprehensive discussion and potentially a different conclusion. The sample size in their study appears sufficient to perform sex-stratified analyses.

Alternatively, multiple logistic regression analysis could include multiple covariates, such as sex. However, if the OR for sex in relation to obesity is substantially larger than those for other covariates, sex-stratified analysis would be more appropriate for exploring sex-related disparities.

References

• 1.   Kurasawa  R,  Takeuchi  A,  Watanabe  K, et al. Association between obesity and eating dinner alone in the working age population in Yugawara town, Japan: a cross-sectional study. Prevent Med Res 1; 26–33: 2023. DOI: 10.60219/pmr.1.2_26.
• 2.   Kurasawa  R,  Watanabe  K,  Watanabe  Y, et al. Relationship between weight gain and stress factors among working-age people in Yugawara Town, Kanagawa Prefecture, Japan: a cross-sectional study. Prevent Med Res 1; 10–21: 2023. DOI: 10.60219/pmr.1.1_10.