Purpose of review: The purpose of this review is to summarize the most recent clinical trials addressing nutritional issues in the older adult. We specifically focused on clinical trials during the past year from September 2002 to September 2003. Recent findings: Obesity in the elderly is increasing in prevalence, along with concomitant macro- and micronutrient deficiencies. Specific food choices (fish, nuts, legumes) may enhance the nutritional status of older adults. Micronutrient deficiencies have been associated with cognitive impairment. Diets based on complex carbohydrates, fibers, red wine, fresh fruit and vegetables, and nonanimal fat may protect against age-related cognitive impairment and dementia. Supplementation with vitamin D at specific doses appears to reduce the risk of fracture, whereas excess supplementation with vitamin A may increase fracture risk. Antioxidant therapy may slow the progression of age-related cataracts. Structured mechanisms for providing nutritional supplements to hospitalized elders increases total energy intake. Summary: Micronutrient deficiencies are common and supplementation appears to improve outcomes. Geriatric obesity will grow to epidemic proportions in the next few decades. Additional research is needed to guide supplementation recommendations and prevent malnutrition in a growing elderly population. © 2004 Lippincott Williams & Wilkins.