There has been significant improvement in understanding of clinical nutrition and metabolism in recent decades. Numerous studies have shown that inappropriate or inadequate nutrition can lead to disease, hampered recovery or adverse effects on treatment, and treatment failure. Continuing progress in this area has elucidated the impact of nutrition and metabolism on the course of disease.

However, various challenges that impede adequate clinical nutrition are emerging. The world population is gradually aging, including the people of Korea. The overall health of the elderly in the modern age is much better than in the past. Therefore, there is a continuing increase in the number of elderly patients in their 80s and 90s who are suitable for active and invasive treatment that was previously not available to them. Thus, the number of patients at risk of malnutrition is increasing.

The rising obesity rate is also a challenge related to nutrition. The morbidly obese population, previously considered exclusive to Western countries, is gradually increasing in Asian countries and is regarded as a societal problem. Morbid obesity itself is subject to nutritional and metabolic treatment and is a risk factor for adverse effects in various diseases.

Sarcopenia is common in older and obese populations with a sedentary lifestyle and is associated with poor health outcomes. Although the individual and economic costs of sarcopenia are widely recognized, current understanding of its pathophysiology is incomplete, with no unified diagnostic criteria. The effectiveness of dietary change as a prevention or treatment strategy for sarcopenia is also uncertain.

In addition, although everyone is aware of the importance of clinical nutrition, it often is overlooked. As medical care is highly specialized and fragmented, the primary care physician responsible for the patient can focus on their area of specialty and neglect clinical nutrition, allocating a relatively small amount of treatment resources despite its importance.

Therefore, a multidisciplinary team including clinical physicians, nutrition experts, and dietitians is important. In-depth understanding of and collaboration with clinical nutrition will greatly contribute to the advancement of health care. The Annals of Clinical Nutrition and Metabolism, published in collaboration with the Korean Society of Surgical Metabolism and Nutrition and the Korean Society for Parenteral and Enteral Nutrition, can serve as a cornerstone in this development.