Table 1_The correlation between nutrition index scores and nutrition status of preschool children in a district of Shanghai.docx

This quasi-experimental pre-post study aimed to evaluate factors influencing children’s nutritional quality using the Nutrition Quotient for Preschoolers (NQ-P) and assess the impact of a targeted family-centered intervention on physical development and dietary behaviors. A total of 1,794 children (mean age: 4.78 ± 0.97 years; 53% boys) were included in the cross-sectional baseline analyses, with a convenience subsample of 163 children participating in a three-month nutritional intervention. Baseline results indicated no significant gender- or age-related differences in NQ-P scores (p > 0.05). However, significant positive correlations were observed between higher NQ-P scores and factors such as parental dietary responsibility, frequent family meals, and outdoor exercise (p < 0.05). Total NQ-P and moderation domain scores were lower in overweight/obese children (BMIZ = 1–3) than in their normal-weight peers (p < 0.05 and p < 0.001, respectively). Post-intervention, significant improvements were noted: the mean BMI decreased from 15.79 ± 3.03 to 15.40 ± 1.90 (p < 0.001), with a notable reduction in overweight/obesity prevalence from 23.9 to 18.4% (p < 0.01). Total NQ-P scores increased from 67.68 ± 8.68 to 68.74 ± 9.02 (p < 0.001), driven by enhancements in the balance and moderation domains across all BMIZ groups (p < 0.05). The intervention stabilized BMI in normal-weight children and improved nutritional outcomes in underweight and overweight subgroups. These findings suggest the potential effectiveness of family-centered dietary management and structured physical activity in enhancing children’s nutritional quality, particularly for those with elevated BMIZ. Tailored interventions based on individual BMIZ classifications are recommended to optimize health outcomes. This study provides evidence-based insights for designing targeted strategies to address childhood malnutrition and obesity.