Abstract
This study examined the relationship between the Diet Balance Index (DBI) and bone mineral density (BMD) in preschool children, along with other influencing factors. DBI was calculated using the adjusted Chinese Diet Balance Index for preschoolers (DBI_C), incorporating High Bound Score (HBS), Low Bound Score (LBS), and Diet Quality Distance (DQD). BMD was assessed using Z-scores and categorized into insufficient BMD (IB) (BMD Z-score > 0) and normal BMD (NB) (BMD Z-score ≤ 0). A logistic regression model analyzed the link between DBI quartiles and BMD, while binary logistic regression identified other factors influencing BMD. The study involved 1,277 children (1,231 NB, 46 IB) aged 3-6 years. BMD levels varied significantly based on factors such as age, mother's working status, chest circumference, waist circumference, hip circumference, HBS, salt score, and drinking water score. Results indicated that children with higher HBS in the second quartile had a significantly higher risk of BMD insufficiency. Chest circumference and drinking water score were identified as significant factors affecting BMD. This study underscores the importance of a balanced diet and regular BMD monitoring for promoting healthy bone development in preschool children.