Purpose of review <p>This narrative review examines current approaches to nutritional status assessment in population-based surveys, emphasizing the complementary roles of anthropometric measurements, body composition analysis, and biochemical indicators. It aims to critically analyze methodological advances, operational constraints, and emerging strategies to improve the quality and applicability of nutritional surveillance in public health.</p> Recent findings <p>Anthropometry remains the most widely used method due to its feasibility and scalability, although its diagnostic capacity is limited. Body composition techniques provide more detailed insights into tissue distribution but are constrained by cost and infrastructure requirements. Biochemical indicators offer high sensitivity for detecting metabolic and micronutrient alterations, yet their use in large-scale surveys is restricted by logistical and ethical challenges. The COVID-19 pandemic exposed vulnerabilities in data collection systems and highlighted the need for more resilient surveillance approaches. In parallel, digital technologies have expanded possibilities for data integration and analysis, although their implementation remains uneven across settings.</p> Summary <p>A comprehensive approach to nutritional assessment requires the integration of complementary methods to address the multidimensional nature of malnutrition and chronic disease monitoring. Strengthening population-based surveys depends on balancing methodological rigor with operational feasibility, alongside investments in infrastructure, workforce capacity, and data governance. Advances in digital health may enhance surveillance systems, but their impact will depend on equitable implementation and alignment with public health priorities and equity-oriented strategies.</p>