[Agentic artificial intelligence in nutrition: from isolated screening tools to autonomous nutritional support...

Artificial intelligence (AI) is progressively transforming the field of nutrition, evolving from early applications focused on food recognition, dietary intake estimation, and malnutrition screening to more complex systems capable of integrating clinical, anthropometric, biochemical, dietary, functional, and contextual data. Within this emerging landscape, artificial intelligence agents, or agentic AI systems, represent a new generation of digital tools characterized by their ability to reason, plan, use external tools, maintain longitudinal memory, and coordinate tasks within predefined boundaries. This review analyzes the potential role of AI agents in nutrition based on some recent studies addressing their application in digital health, public nutrition, nutritional oncology, laboratory medicine, and personalized preventive programs. The available evidence suggests that AI agents may provide value in three major areas: automated and multimodal nutritional assessment, generation of personalized dietary recommendations, and longitudinal coordination of nutritional interventions in patients with chronic diseases, cancer, or cardiometabolic risk. In public health, agentic models may facilitate scalable precision nutrition strategies, particularly in communities with limited access to dietitians, nutrition specialists, or healthcare resources. In oncology, these systems could integrate malnutrition screening, body composition assessment, symptoms, oncological treatments, and dietary preferences in order to anticipate nutritional deterioration and activate early interventions. In laboratory medicine, AI agents may link biomarkers, omics data, and clinical outcomes to support more dynamic and individualized nutritional decision-making. Their implementation poses important challenges, including insufficient clinical validation, risk of errors or hallucinations, cultural and socioeconomic biases, privacy concerns, professional responsibility, interoperability, and the need for continuous human supervision. In conclusion, agentic AI represents a relevant evolution for both clinical and community nutrition. Nevertheless, its incorporation into practice should be gradual, regulated, explainable, prospectively evaluated, and subordinated to clinical judgment and patient values.