Knowing Is Not Eating: Child-Reported Food Perception Versus Actual Dietary Intake in Southern Peru

Background/Objectives: Understanding whether children’s perceptions of food, that is, what a child recognizes as healthy, are associated with their actual consumption is key to designing effective nutritional interventions, but this has rarely been directly tested in the children themselves. This study aimed to determine whether children’s food perceptions are associated with their actual recent intake. Methods: As secondary objectives, the cultural salience of foods perceived as healthy and unhealthy was characterized in 129 schoolchildren (52 girls, 77 boys; ages 8–12) at a school in Moquegua, southern Peru, using an open-ended listing task (five healthy foods and five unhealthy foods) and Smith’s salience index, and this perception was compared with their reported intake from a 24-h recall (breakfast and lunch; n = 128), classified according to NOVA criteria and the Peruvian Dietary Guidelines. Results: Apples (S = 0.334) and soda (S = 0.312) were the foods with the highest salience in the healthy and unhealthy domains, respectively. Notably, 85.2% of the children reported at least one healthy food in their actual intake, and 38.3% reported at least one unhealthy food. No association was found between food perception and actual consumption (U = 1072.0, p = 0.633); this result was unaffected by the order in which the instruments were administered (χ2 = 0.000, p = 1.000) and showed no significant differences by sex (p > 0.05 in all comparisons). Conclusions: These findings did not provide evidence of an association between children’s nutritional knowledge and their actual eating habits in this sample and suggest that nutrition education programs targeting schoolchildren in the Peruvian Southern Andes should not assume, based solely on these findings, that teaching children to recognize healthy foods is necessarily sufficient to change their actual diet.