{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T07:57:47Z","timestamp":1768982267173,"version":"3.49.0"},"reference-count":34,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T00:00:00Z","timestamp":1640649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Social Science Foundation of China (NSSFC)","award":["20BSH066"],"award-info":[{"award-number":["20BSH066"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>This study aimed at assessing the correctness of a caregiver\u2019s perception of their child\u2019s diet status and to determine the factors which may influence their judgment. 815 child-caregiver pairs were recruited from two primary schools. 3-day 24-h recall was used to evaluate children\u2019s dietary intake, Chinese Children Dietary Index (CCDI) was used to evaluate the dietary quality. Multivariate logistic regression models were used to explore the factors that could influence the correctness of caregiver\u2019s perception. In the current study, 371 (62.1%) children with \u201chigh diet quality\u201d and 35 (16.1%) children with \u201cpoor diet quality\u201d were correctly perceived by their caregivers. Children who were correctly perceived as having \u201cpoor diet quality\u201d consumed less fruits and more snacks and beverages than those who were not correctly perceived (p &lt; 0.05). Obese children were more likely to be correctly identified as having \u201cpoor diet quality\u201d (OR = 3.532, p = 0.040), and less likely to be perceived as having \u201chigh diet quality\u201d, even when they had a balanced diet (OR = 0.318, p = 0.020). Caregivers with a high level of education were more likely to correctly perceive children\u2019s diet quality (OR = 3.532, p = 0.042). Caregivers in this study were shown to lack the ability to correctly identify their children\u2019s diet quality, especially amongst children with a \u201cpoor diet quality\u201d. Obesity, significantly low consumption of fruits or high consumption of snacks can raise caregivers\u2019 awareness of \u201cpoor diet quality\u201d.<\/jats:p>","DOI":"10.3390\/nu14010125","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T06:55:03Z","timestamp":1640674503000},"page":"125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Caregiver Perceptions of Child Diet Quality: What Influenced Their Judgment"],"prefix":"10.3390","volume":"14","author":[{"given":"Lijing","family":"Shao","sequence":"first","affiliation":[{"name":"School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Ren","sequence":"additional","affiliation":[{"name":"School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanming","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Yang","sequence":"additional","affiliation":[{"name":"School Research Center for Woman and Child Health, Wuhan University of Science and Technology, Wuhan 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing","family":"Xiang","sequence":"additional","affiliation":[{"name":"School Research Center for Woman and Child Health, Wuhan University of Science and Technology, Wuhan 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liping","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuefeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7772-7943","authenticated-orcid":false,"given":"Jing","family":"Zeng","sequence":"additional","affiliation":[{"name":"School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China"},{"name":"School Research Center for Woman and Child Health, Wuhan University of Science and Technology, Wuhan 430065, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJMoa1614362","article-title":"Health effects of overweight and obesity in 195 countries over 25 years","volume":"377","author":"Afshin","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Zhang, J., Wang, H., Wang, Z., Du, W., Su, C., Zhang, J., Jiang, H., Jia, X., Huang, F., and Ouyang, Y. (2018). Prevalence and stabilizing trends in overweight and obesity among children and adolescents in China, 2011\u20132015. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5483-9"},{"key":"ref_3","unstructured":"The State Council Information Office of the People\u2019s Republic of China (2021, June 02). Press Briefing for the Report on Chinese Residents\u2019 Chronic Diseases and Nutrition 2020 (In Chinese), Available online: http:\/\/www.gov.cn\/xinwen\/2020-12\/24\/content_5572983.htm."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Magriplis, E., Michas, G., Petridi, E., Chrousos, G.P., Roma, E., Benetou, V., Cholopoulos, N., Micha, R., Panagiotakos, D., and Zampelas, A. (2021). Dietary Sugar Intake and Its Association with Obesity in Children and Adolescents. Children, 8.","DOI":"10.3390\/children8080676"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1017\/S1368980016002305","article-title":"Discretionary food and beverage consumption and its association with demographic characteristics, weight status, and fruit and vegetable intakes in Australian adults","volume":"20","author":"Sui","year":"2017","journal-title":"Public Health Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.jand.2015.05.020","article-title":"Sugar-sweetened beverages and obesity risk in children and adolescents: A systematic analysis on how methodological quality may influence conclusions","volume":"116","author":"Keller","year":"2016","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.mcna.2017.08.009","article-title":"Dietary Management of Obesity: Cornerstones of Healthy Eating Patterns","volume":"102","author":"Smethers","year":"2018","journal-title":"Med. Clin. N. Am."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Hwang, S.B., Park, S., Jin, G.R., Jung, J., Park, H., Lee, S., Shin, S., and Lee, B.-H. (2020). Trends in Beverage Consumption and Related Demographic Factors and Obesity among Korean Children and Adolescents. Nutrients, 12.","DOI":"10.3390\/nu12092651"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"416","DOI":"10.3109\/09637486.2015.1025716","article-title":"Effect of fruits and vegetables on metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials","volume":"66","author":"Shin","year":"2015","journal-title":"Int. J. Food Sci. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1093\/ije\/dyw319","article-title":"Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies","volume":"46","author":"Aune","year":"2017","journal-title":"Int. J. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1016\/S0140-6736(17)32253-5","article-title":"Prospective Urban Rural Epidemiology (PURE) study investigators. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): A prospective cohort study","volume":"390","author":"Miller","year":"2017","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4082\/kjfm.20.0225","article-title":"Fruit Intake to Prevent and Control Hypertension and Diabetes","volume":"42","author":"Park","year":"2021","journal-title":"Korean J. Fam. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1080\/10408398.2015.1008980","article-title":"Fruit and vegetable consumption and risk of cardiovascular disease: A meta-analysis of prospective cohort studies","volume":"57","author":"Zhan","year":"2017","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.jand.2015.11.010","article-title":"Development of a dietary index to assess overall diet quality for Chinese school-aged children: The Chinese children dietary index","volume":"116","author":"Cheng","year":"2016","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zhang, J., Wang, D., Eldridge, A.L., Huang, F., Ouyang, Y., Wang, H., and Zhang, B. (2017). Urban-Rural Disparities in Energy Intake and Contribution of Fat and Animal Source Foods in Chinese Children Aged 4\u201317 Years. Nutrients, 9.","DOI":"10.3390\/nu9050526"},{"key":"ref_16","first-page":"403","article-title":"Nutrition quality of school lunch for children aged 9-12 years in Wuhan City and its relationship with physical development","volume":"48","author":"Liu","year":"2019","journal-title":"Wei Sheng Yan Jiu"},{"key":"ref_17","first-page":"349","article-title":"Unhealthy dietary habits among toddlers in Rome (Italy): A cross sectional study","volume":"74","author":"Operamolla","year":"2018","journal-title":"Ig. Sanita Pubbl."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1079\/BJN20051418","article-title":"Consistent dietary patterns identified from childhood to adulthood: The cardiovascular risk in Young Finns Study","volume":"93","author":"Mikkila","year":"2005","journal-title":"Br. J. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.appet.2018.04.018","article-title":"An investigation of maternal food intake and maternal food talk as predictors of child food intake","volume":"127","author":"DeJesus","year":"2018","journal-title":"Appetite"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1017\/S136898001700012X","article-title":"Potential in-class strategies to increase children\u2019s vegetable consumption","volume":"20","author":"Sharp","year":"2017","journal-title":"Public Health Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e689","DOI":"10.1542\/peds.2013-2690","article-title":"Parental underestimates of child weight: A meta-analysis","volume":"133","author":"Lundahl","year":"2014","journal-title":"Pediatrics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1007\/s10826-014-9945-0","article-title":"Parental perception of child\u2019s body weight: A systematic review","volume":"24","author":"Tompkins","year":"2014","journal-title":"J. Child Fam. Stud."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1002\/2327-6924.12463","article-title":"Parental perception of child\u2019s body mass index and health within primary care","volume":"29","author":"Reyes","year":"2017","journal-title":"J. Am. Assoc. Nurse Pract."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1002\/osp4.531","article-title":"Underestimation of overweight weight status in children and adolescents aged 0\u201319 years: A systematic review and meta-analysis","volume":"7","author":"Alshahrani","year":"2021","journal-title":"Obes. Sci. Pract."},{"key":"ref_25","first-page":"439","article-title":"The transition of Chinese dietary guidelines and food guide pagoda","volume":"20","author":"Ge","year":"2011","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1007\/s00394-020-02425-8","article-title":"The overall diet quality in childhood is prospectively associated with the timing of puberty","volume":"60","author":"Duan","year":"2021","journal-title":"Eur. J. Nutr."},{"key":"ref_27","first-page":"105","article-title":"Revision of the Chinese children dietary index","volume":"41","author":"Qiao","year":"2019","journal-title":"Acta Nutr. Sin."},{"key":"ref_28","unstructured":"Chinese Nutrition Society (2014). Dietary Reference Intakes for Chinese, Version 2013, Science Press."},{"key":"ref_29","unstructured":"National Health Commission of the People\u2019s Republic of China (2018). Screening for Overweight and Obesity among School-Age Children and Adolescents, Standards Press."},{"key":"ref_30","first-page":"106","article-title":"Investigation on school lunch and nutritional status in primary schools and middle","volume":"37","author":"Huang","year":"2017","journal-title":"J. Shanghai Jiaotong Univ. (Med. Sci.)"},{"key":"ref_31","first-page":"75","article-title":"The Status Quo of Nutrition Knowledge, Attitude and Behavior of Residents in One District of Hami City in Xinjiang","volume":"25","author":"Wuerlajiafu","year":"2019","journal-title":"Food Nutr. China"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1161\/CIR.0b013e31824607ee","article-title":"Evaluating parents and adult caregivers as \u201cagents of change\u201d for treating obese children: Evidence for parent behavior change strategies and research gaps: A scientific statement from the American Heart Association","volume":"125","author":"Faith","year":"2012","journal-title":"Circulation"},{"key":"ref_33","first-page":"833","article-title":"Prevalence of and contributing factors for overweight and obesity among Montenegrin school children","volume":"5","author":"Milica","year":"2015","journal-title":"Eur. J. Public Health"},{"key":"ref_34","first-page":"221","article-title":"Parental perception of children\u2019s weight status and sociodemographic factors associated with childhood obesity","volume":"75","author":"Jamaluddi","year":"2020","journal-title":"Med. J. Malays."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/1\/125\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:54:49Z","timestamp":1760169289000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/1\/125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,28]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["nu14010125"],"URL":"https:\/\/doi.org\/10.3390\/nu14010125","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,28]]}}}