To Örebro University

OBJECTIVE: To examine the associations between parental perception, concern, and dissatisfaction with child weight and their feeding practices among Chinese families. DESIGN: A cross-sectional study.

SETTING: Four public kindergartens in Yangzhou, China. PARTICIPANTS: Chinese parents of preschool children (n = 1,779).

MAIN OUTCOME MEASURES: Three responsive feeding practices (i.e., encouragement of healthy eating, monitoring, and modeling) and 3 nonresponsive feeding practices (i.e., pressure to eat, restriction, and use of food as a reward).

ANALYSIS: Hierarchical multiple regression analysis was performed to examine their associations. The agreement was evaluated with kappa statistics.

RESULTS: Parents who perceived children as overweight or obese reported less pressure to eat (P = 0.04); parents who were concerned about children with underweight reported more pressure to eat (P = 0.01); parents who rated children's body weight size as underweight were less likely to encourage children to eat healthy food (P = 0.04) and restrict food intake (P = 0.02); parents who desired a slimmer child's body size reported less modeling (P < 0.001) and more restriction (P = 0.04). The disagreements between parental self-reported and visual perception of child weight and actual child weight were statistically significant, respectively (P < 0.01).

CONCLUSIONS AND IMPLICATIONS: The results suggested the significant influence of parental perception, concern, and dissatisfaction with child weight on feeding practices. Our findings may inform public health practitioners and primary care providers in designing interventions to enhance parental accurate weight perception and optimize feeding practices.