Preschool children’s eating behaviors and caregivers’ feeding practices in relation to children’s weight in China: a network analysis

This study aimed to characterize the interactions between preschool children’s eating behaviors and their caregivers’ feeding practices, and to compare these patterns across underweight, normal weight, and overweight/obesity groups using a network model. A cross-sectional survey (January–July 2021) included 3–6-year-old preschool children and their primary caregivers from seven cities in Shaanxi Province, China. Children’s eating behaviors and caregivers’ feeding practices were measured using the Chinese Preschoolers’ Eating Behavior Scale and the Chinese Preschoolers’ Caregivers’ Feeding Behavior Scale. Network centrality indices identified core and bridge behaviors, with stability assessed via case-dropping bootstrapping. The network had 14 nodes, 82 non-zero edges (90.11% of all possible edges), and all networks showed good stability (correlation stability coefficient > 0.5). Among subgroups, the overweight/obese group had the highest mean edge weight (0.048), while the underweight group had the lowest non-zero edge proportion (45.05%). Across all samples, the strongest edge was between Feeding Responsibility and Content-Restricted Feeding (0.47), and the strongest cross-domain link was Emotional Eating-Weight Concerns (0.22), both stably confirmed by bootstrap. Feeding Responsibility had the highest strength (1.74) across groups, and Weight Concerns had the highest overall bridge strength (0.58), identifying it as a key connector. Edge weight distribution differed significantly between normal-weight and overweight/obese groups (p = 0.02). Network analysis identified Feeding Responsibility as core behavior and Weight Concerns as a critical cross-domain bridge, highlighting caregivers’ central role. These findings inform targeted interventions and nutritional strategies. Network analysis reveals that caregivers’ Feeding Responsibility (as core behavior) and Weight Concerns (as cross-domain bridge) are key in preschoolers’ feeding–eating network, emphasizing caregivers’ central role.Weight-specific differences in the feeding–eating network structure indicate that tailored interventions are necessary for preschoolers with different weight statuses.The study’s findings provide guidance for developing targeted nutritional strategies, with caregivers’ Feeding Responsibility and Weight Concern identified as priority intervention targets. Network analysis reveals that caregivers’ Feeding Responsibility (as core behavior) and Weight Concerns (as cross-domain bridge) are key in preschoolers’ feeding–eating network, emphasizing caregivers’ central role. Weight-specific differences in the feeding–eating network structure indicate that tailored interventions are necessary for preschoolers with different weight statuses. The study’s findings provide guidance for developing targeted nutritional strategies, with caregivers’ Feeding Responsibility and Weight Concern identified as priority intervention targets.