BackgroundFew studies investigated associations between dietary patterns and overweight/obesity among Chinese preschool children. Thus, the study aimed to explore dietary patterns among preschool children in the Dongcheng District of Beijing, and their associations with overweight/obesity.MethodsWith a stratified proportionate cluster sampling, the study included 3,373 pairs of preschool children and their guardians. Children’s weight and height were measured by school nurses, and their food and beverage consumption frequencies were reported by guardians via a food frequency questionnaire. Children’s age, gender, physical activity time, and sedentary time, as well as their parents’ highest level of educational attainment, occupation, weight, and height were also collected. Dietary patterns were identified through an exploratory factor analysis. Among these identified dietary patterns, the one with the largest factor score was defined as the predominant dietary pattern for each child. Associations between predominant dietary patterns and overweight/obesity were tested by two-level random-intercept logistic models with cluster-robust standard errors.ResultsFour dietary patterns, i.e., a “Sugar-sweetened beverage (SSB) and snack” pattern, a “Chinese traditional” pattern, a “Health conscious” pattern, and a “Snack” pattern, were identified. Among the children, 21.02% (95% CI: 19.68% to 22.43%) were predominated by the “SSB and snack” pattern, 27.78% (95% CI: 26.29% to 29.32%) by the “Chinese traditional” pattern, 24.90% (95% CI: 23.47% to 26.39%) by the “Health conscious” pattern, and 26.30% (95% CI: 24.84% to 27.81%) by the “Snack” pattern. After controlling for potential confounders, the “SSB and snack” pattern characterized by fresh fruit/vegetable juice, flavored milk drinks, carbonated drinks, flavored fruit/vegetable drinks, tea drinks, plant-protein drinks, puffed foods, fried foods, and Western fast foods was associated with a higher risk of overweight/obesity (OR: 1.61, 95% CI:1.09 to 2.38), compared with the “Chinese traditional” pattern.ConclusionsA preference for foods high in energy density but low in nutritional value was prevalent among preschool children in the Dongchen District of Beijing. Comprehensive measures to simultaneously reduce consumption of SSBs and unhealthy snacks among preschool children should be taken urgently to fight against rising childhood obesity in China, particularly in metropolises.