Abstract
The integration of large language models (LLMs) into clinical nutrition marks a transformative advancement, offering promising solutions for enhancing patient care, personalizing dietary recommendations, and supporting evidence-based clinical decision-making. Trained on extensive text corpora and powered by transformer-based architectures, LLMs demonstrate remarkable capabilities in natural language understanding and generation. This review provides an overview of their current and potential applications in clinical nutrition, focusing on key technologies including prompt engineering, fine-tuning, retrieval-augmented generation, and multimodal integration. These enhancements increase domain relevance, factual accuracy, and contextual responsiveness, enabling LLMs to deliver more reliable outputs in nutrition-related tasks. Recent studies have shown LLMs' utility in dietary planning, nutritional education, obesity management, and malnutrition risk assessment. Despite these advances, challenges remain. Limitations in reasoning, factual accuracy, and domain specificity, along with risks of bias and hallucination, underscore the need for rigorous validation and human oversight. Furthermore, ethical considerations, environmental costs, and infrastructural integration must be addressed before widespread adoption. Future directions include combining LLMs with predictive analytics, integrating them with electronic health records and wearables, and adapting them for multilingual, culturally sensitive dietary guidance. LLMs also hold potential as research and educational tools, assisting in literature synthesis and patient engagement. Their transformative promise depends on cross-disciplinary collaboration, responsible deployment, and clinician training. Ultimately, while LLMs are not a replacement for healthcare professionals, they offer powerful augmentation tools for delivering scalable, personalized, and data-driven nutritional care in an increasingly complex healthcare environment.