Personalized Nutritional Assessment and Intervention for Athletes: A Network Physiology Approach.

Nutritional assessment and intervention in athletes, a central focus of sports medicine and healthcare, has increasingly shifted in recent years toward precision nutrition-an approach that individualizes dietary recommendations according to genetic profile, microbiome composition, lifestyle factors, and health status. Despite its promising potential, this approach faces significant limitations, including the challenge of integrating complex and dynamic interactions among multilevel indicators, and the relatively high costs associated with omics technologies. The aim of this paper is to propose a nutritional assessment and intervention model grounded in the Network Physiology of Exercise, an emerging scientific field that investigates the horizontal and vertical dynamic interactions among nested physiological levels and conceptualizes athletes as complex adaptive systems (CAS). The proposal integrates social, environmental, behavioral and psychobiological information, extracted particularly from semi-structured interviews based on CAS properties. Accordingly, the traditional dietary assessment tools are replaced by open and guided interviews that allow professionals and practitioners to co-construct meaningful insights and extract qualitative data through a reflexive thematic analysis. From a CAS perspective, the multidimensional and multi-timescale personal and environmental constrains affecting their eating behavior were integrated through a hierarchically nested organization. Eliciting the dynamics of emotional contexts, behavioral patterns, and psychophysiological states, the interviews become both a method of assessment and an intervention in itself.