Objective  To explore the relationship between nutritional status and guardian-evaluated body shape and the effect of eating behaviors on the relationship among preschool children.

  Methods  We conducted a cross-sectional study among 2 395 children aged 2 – 6 years recruited in 6 kindergartens in Huangshan city of Anhui province between May and June 2017. The study included a self-administered questionnaire survey completed by main guardians of the children to collect information on the children′s demographics, eating behaviors, and body shape and an examination on physical development by child health practitioners to assess the children′s nutritional status. The Children′s Eating Behavior Questionnaire (CEBQ) was adopted in the survey.

  Results  The low body weight children were assessed with the highest CEBQ domain scores of satiety responsiveness (SR, 7.63 ± 2.91), slowness in eating (SE, 7.16 ± 3.00), and emotional under eating (EU, 5.45 ± 2.84) and the lowest scores of food responsiveness (FR, 4.83 ± 3.26) and enjoyment of food (EF, 6.73 ± 3.52); while the overweight and obesity children were evaluated with lower SR, SE, and EU scores but higher FR and EF scores, with significant differences (P < 0.05 for all). The consistency rate between guardian-evaluated body shape and the actual nutritional status was 58.7 % for the children, indicating a poor consistency (Kappa = 0.198, P < 0.001). Among all the children assessed with normal nutritional status, the guardian-evaluated thin children had higher SR (8.16 ± 3.01), SE (7.18 ± 2.87), and EU (5.83 ± 2.98) score; the guardian-evaluated slightly fat children had higher FR (7.79 ± 4.05) and EF (8.60 ± 4.45) score; and the children with guardian-evaluated normal body shape had higher food fussiness (FF, 8.84 ± 3.20) and desire to drink (DD, 3.65 ± 3.0) score; there were significant differences in the domain scores among the three groups (P < 0.05 for all).

  Conclusion  Among preschool children, eating behavior is closely correlated with nutritional status and could affect the guardians’ evaluation on their body shape. The study results also indicated that the consistency between guardian-evaluated body shape and actual nutritional status of the children is poor.