Integrating nutritional value into Life Cycle Assessment (LCA) is essential for developing food system policies and interventions that simultaneously address environmental sustainability and human health. This Perspective explores recent conceptual and empirical evolutions in nutritional LCA (nLCA), drawing on expert talks, interdisciplinary stakeholder deliberations, and case studies presented at the 23rd International Union of Nutritional Sciences – International Congress of Nutrition, held in Paris in August 2025. We discuss methodological frameworks for incorporating nutritional quality into environmental footprint modelling, focusing on the selection of functional units and application of holistic nutrient profiling systems, such as the Nutritional Value Score. Case studies from Africa and Asia demonstrate the utility of nLCA to identify highly nutritious, lower-impact foods that mass- or energy-based denominators often overlook under attributional LCA. We argue that while plant-source foods frequently exhibit lower footprints, certain animal-source foods (such as small fish, dairy, eggs, and organ meats) can also be competitive when evaluated per unit of nutritional value. Finally, we highlight persistent challenges, including regional data gaps, lack of harmonisation in nutritional functional units, scope limitations, and risks of overinterpreting small differences in impact scores. While methodological refinement is still required, we conclude that nLCA offers a promising route for aligning agricultural, health, and environmental objectives, facilitating the development of more coherent food systems policies and programmes.