An embodied kitchen assistant must do more than recognize food in isolated frames. It must track ingredient states over time and integrate visual observations with recipe and nutritional knowledge to support constraint-aware decision-making. We formalize this capability as \emph{Embodied Nutrition Management}: perceiving nutrition-relevant events, maintaining a persistent food state, and using it for knowledge-grounded planning. Existing benchmarks evaluate static food understanding or embodied cooking actions, but do not measure whether an agent can continuously update and use nutrition-relevant states in dynamic kitchens. To fill this gap, we introduce \textbf{NutriBench-Kitchen}, a benchmark containing 1,500 manually verified question--answer pairs from 160 cooking videos. It covers five task families: Ingredient Entry, Memory Management, Recipe Query, Long-Term Planning, and Short-Term Planning, spanning food-state construction, maintenance, knowledge retrieval, and decision-making across different planning horizons. Evaluations of proprietary and open-source large vision-language models reveal a substantial gap from human performance, particularly in quantitative ingredient estimation, long-term state tracking, and reasoning under interacting constraints. We further introduce \textbf{Nutri-Vgent}, a diagnostic long-video agent with separate episodic, food-state, and recipe memories. Its consistent improvements demonstrate the value of explicit state representations and structured memory for nutrition management. Together, NutriBench-Kitchen and Nutri-Vgent provide a testbed for studying persistent state tracking and knowledge-grounded reasoning in dynamic kitchens. Code is available at https://github.com/V1ol1n/NutriBench-Kitchen.
The rapid integration of Large Vision-Language Models (VLMs) into critical infrastructure promises to revolutionize personalized healthcare and dietary management. However, in the domain of food systems, autonomous agents face a unique and persistent challenge: the "Systemic Information Asymmetry" between visual appearance and intrinsic nutritional composition. Existing benchmarks primarily focus on coarse-grained classification tasks, such as food category recognition, which fail to evaluate the intricate reasoning chain required for real-world dietary management -- specifically, the ability to traverse from identifying hidden ingredients to estimating physical mass, and finally synthesizing safety-critical medical advice. In this paper, we introduce OmniFood-Bench, a comprehensive benchmark constructed from the MM-Food-100K dataset. Unlike previous works, OmniFood-Bench evaluates VLMs across three progressive capabilities: Basic Perception (Ingredients & Cooking Methods), Quantitative Reasoning (Portion Size & Nutritional Profiling), and Safety-Critical Advisory (Disease-Specific Recommendations). We evaluate six state-of-the-art VLMs, including gpt-5.1, gemini-3-flash, and qwen3-vl-8B. Our extensive experiments reveal a startling "Semantic-Physical Gap": while models achieve near-human accuracy in naming dishes, they exhibit catastrophic failure in mass estimation and frequently hallucinate benign advice for high-risk diabetic profiles. This work establishes a rigorous standard for trustworthiness in autonomous agents deployed for public health. The code and datasets are available in: https://anonymous.4open.science/r/OmniFood-Bench-7D0B
Food-as-Medicine requires models to reason beyond what a dish is or what nutrition it contains: they must decide whether a concrete food choice is appropriate for a specific health condition. Existing food AI benchmarks primarily evaluate dish recognition, recipe understanding, nutrient estimation, or general nutrition question answering, leaving this health-aware decision layer largely untested. We introduce FAM-Bench, a multi-modal Food-as-Medicine benchmark with 2500 nutrition-expert-verified instances across 13 diet-related health conditions. The benchmark contains two complementary tasks: dish-level suitability assessment, where models judge whether a dish is suitable for a condition from its image and ingredient list, and comparative dish analysis, where models rank four candidate dishes by condition-specific suitability. Both tasks require integrating ingredient evidence, visual preparation cues, and clinical nutrition constraints, providing a standardized testbed for grounded health-aware reasoning in language and vision-language models.
Multimodal Large Language Models (MLLMs) are increasingly used for dietary assessment from meal images, where retrieval-augmented grounding was shown to sharpen nutrition estimates. However, we find this premise no longer holds for current MLLMs. A modern MLLM's direct estimate now matches or surpasses the full retrieval pipeline. This raises a question: if retrieval no longer improves the overall estimate, can it still deliver the two things clinicians value, accurate portions and a traceable, item-by-item record? We pursue this while preserving what matters for clinical adoption: minimal user burden (a single, unannotated meal image), explainability (an auditable record), and privacy (locally hosted inference). We introduce Open-KNEAD, a knowledge-grounded agentic framework for meal nutrition estimation that is training-free and locally deployable. Each decomposed food item is grounded to a Food and Nutrient Database for Dietary Studies (FNDDS) code via selective, nutrient-aware retrieval, composing an auditable per-item record. Across two open MLLM families and three cuisines, Open-KNEAD improves portion estimates over both prior grounding methods and direct estimation in most backbone-dataset settings. An agent-internal recipe-prior step further recovers the invisible cooking-added energy that biases estimates on non-US cuisine. The advantage is largest on the dietitian-verified ACETADA dataset, where the local open agent surpasses the direct portion estimates of two frontier closed models by roughly 30% and 53%, all while keeping every meal image on local hardware. We release the Open-KNEAD framework and its agent-ready FNDDS knowledge base.