Introduction

Dear Editor,

I read the article “Dietary adequacies and anthropometric measurements in children with poor appetite according to their mothers” by Bozbulut et al., recently published in the Turkish Journal of Pediatrics, which presents an important evaluation of discrepancies between maternal perception and objective nutritional indicators among children aged 2-9 years.¹

The findings contribute valuable insight, particularly in outpatient pediatric settings where appetite-related concerns are common. However, the manuscript does not sufficiently address the remaining knowledge gaps or propose practical strategies that could translate these findings into improved outcomes.

First, the study highlights that 55% of mothers perceived their children as underweight, although nearly 90% had a normal body mass index age. Exploring the sociocultural determinants underlying these perceptions would strengthen the interpretation, as cultural norms and expectations frequently shape parental judgments about appetite and body size.²

Second, the reported nutrient adequacy, particularly the apparently high protein intake despite perceived poor appetite, raises concerns about the accuracy of maternal reporting. Three-day dietary recalls are inherently vulnerable to recall bias and overestimation. Complementing parental reports with observational measures or school meal records could help minimize reporting discrepancies.

Third, although weak positive correlations were identified between anthropometric z-scores and nutrient adequacy ratios, the clinical significance of these modest associations remains uncertain. Longitudinal studies may help determine whether these associations persist in children with chronic appetite issues.

In conclusion, Bozbulut et al.¹ provide important evidence underscoring the limitations of relying solely on maternal perception when evaluating nutritional status. The findings reinforce the necessity of objective anthropometric assessment and professional guidance to prevent unnecessary parental anxiety and potentially inappropriate feeding practices. In this context, the validated Comprehensive Feeding Practices Questionnaire (CFPQ) may serve as a useful complementary instrument.³

I look forward to further research in this area, particularly studies that address the limitations and practical implications of appropriate feeding practices. I believe this article will spark important discussions among clinicians and researchers and to contribute to improving nutritional care for children.

Author contribution

The authors confirm contribution to the paper as follows: Study conception and design: JSR , SP; data collection: JSR; analysis and interpretation of results: JSR; draft manuscript preparation: JSR; critical revision and supervision: SP. All authors reviewed the results and approved the final version of the manuscript.

Source of funding

The authors declare the study received no funding.

Conflict of interest

The authors declare that there is no conflict of interest.