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Background: Nutritional status impacts quality of life and prognosis of patients with respiratory diseases, including idiopathic pulmonary fibrosis (IPF). However, there is a lack of studies performing an extensive nutritional assessment of IPF patients. This study aimed to investigate the nutritional status and to identify nutritional phenotypes in a cohort of IPF patients at diagnosis., Methods: Patients underwent a thorough pulmonary and nutritional evaluation including questionnaires on nutritional status, and physical activity, anthropometry, body impedance, dynamometry, 4-m gait speed and blood tests., Results: 90 IPF patients (78.9% males, mean age 72.7 years) were enrolled. The majority of patients were classified as Gender-Age-Physiology Index stage 2 (47, 52.2%) with an inactive lifestyle according to International Physical Activity Questionnaire score (39, 43.3%), and had mean forced vital capacity and diffusing capacity for carbon monoxide 86.5% and 54.2%, respectively. In regards to nutritional phenotypes, the majority of patients were normally nourished (67.8%, 95% CI 58.6-77.7%), followed by non-sarcopenic obese (25.3%, 95% CI 16.1-35.2%), sarcopenic (4.6%, 95% CI 0.0-14.5%) and sarcopenic obese (2.3%, 95% CI 0.0-12.2%). Among the normally nourished, 49.2% showed early signs of nutritional and physical performance alterations, including body mass index ≥30 kg·m -2 in 4.3%, history of weight loss ≥5% in 11.9%, and reduction of gait speed and hand grip strength in 11.9% and 35.6%, respectively. Low vitamin D values were observed in 56.3% of cases., Conclusions: IPF patients at diagnosis are mainly normally nourished and obese, but early signs of nutritional and physical performance impairment can already be identified at this stage., Competing Interests: Conflict of interest: P. Faverio reports personal fees from Boehringer Ingelheim and grants from Roche, outside the submitted work. Conflict of interest: A. Fumagalli has nothing to disclose. Conflict of interest: S. Conti has nothing to disclose. Conflict of interest: F. Madotto has nothing to disclose. Conflict of interest: F. Bini has nothing to disclose. Conflict of interest: S. Harari reports personal fees from Actelion, Roche and Boehringer Ingelheim, outside the submitted work. Conflict of interest: M. Mondoni has nothing to disclose. Conflict of interest: T. Oggionni has nothing to disclose. Conflict of interest: E. Barisione reports personal fees from Chiesi Farmaceutici, Boehringer Ingelheim and GlaxoSmithKline, outside the submitted work. Conflict of interest: P. Ceruti has nothing to disclose. Conflict of interest: M.C. Papetti has nothing to disclose. Conflict of interest: B.D. Bodini has nothing to disclose. Conflict of interest: A. Caminati reports personal fees from Roche and Boehringer Ingelheim, outside the submitted work. Conflict of interest: A. Valentino has nothing to disclose. Conflict of interest: S. Centanni has nothing to disclose. Conflict of interest: D. Noè has nothing to disclose. Conflict of interest: M. Della Zoppa has nothing to disclose. Conflict of interest: S. Crotti has nothing to disclose. Conflict of interest: M. Grosso reports personal fees from Chiesi Farmaceutici and Johnson & Johnson, outside the submitted work. Conflict of interest: S.G. Sukkar has nothing to disclose. Conflict of interest: D. Modina has nothing to disclose. Conflict of interest: M. Andreoli has nothing to disclose. Conflict of interest: R. Nicali has nothing to disclose. Conflict of interest: G. Suigo has nothing to disclose. Conflict of interest: F. De Giacomi has nothing to disclose. Conflict of interest: S. Busnelli has nothing to disclose. Conflict of interest: E. Cattaneo has nothing to disclose. Conflict of interest: L.G. Mantovani has nothing to disclose. Conflict of interest: G. Cesana has nothing to disclose. Conflict of interest: A. Pesci has nothing to disclose. Conflict of interest: F. Luppi reports lectures fee from Roche and from Boehringer Ingelheim., (Copyright ©The authors 2022.)