Supplementary Material for: Parental perceptions of preschool children’s weight status in China: A cross-sectional study

Objectives: Currently, overweight/obesity rates among children are increasing. Moreover, parents generally misunderstand their children’s weight status. The correct perception of overweight/obesity in early childhood is very important for children’s growth and development. The purpose of this study was to investigate parental perceptions of children’s weight status. Methods: We analyzed data from a questionnaire study conducted among 1971 preschool children in local kindergartens from December 1, 2021, to January 31, 2022, and classified the participants as having non-overweight and overweight/obesity according to the International Obesity Task Force (IOTF) criteria. Parents were asked whether they perceived their children to have non-overweight or overweight/obesity. We analyzed the related factors that parents underestimated or overestimated their children's weight status. Results: The rate of overweight/obesity in preschool children was 17.9%. Parental perceptions of children’s weight status were inconsistent with children’s real weight (kappa=0.351,p<0.001). The correctness of mother’s perceptions of chilren’s weight was higher than that of father’s. Among children who were affected by overweight/obesity, 68.5% of parents underestimated their children’s weights. Mothers with overweight/obesity had a 1.56 times greater risk of underestimating the children’s weight than mothers who were affected by non-overweight (P=0.010, OR: 1.56, 95%CI: 1.11-2.18). Children’s sex and families with siblings were independent risk factors for parents to overestimate children's weight. Conclusion: Parents were highly likely to misinterpret the weight status of their children who were affected by overweight/obesity. Mothers with overweight/obesity were more likely to underestimate their children’s weight.