Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are among the most frequent etiologies for admission to the intensive care unit. These patients are at a high risk of malnutrition due to hypercatabolism caused by inflammation, drugs, and de-conditioning. Nutrition should support minimizing the loss of lean body mass and accurately meet energy demands. Additional use of omega-3 fatty acid, γ-linolenic acid, and antioxidant-enriched diets has been suggested in recent years as a tool to improve outcome in ALI/ARDS patients. More recent findings have taught us that too much of these supplements are detrimental and that the bolus administration may not be as efficient as continuous administration.