Analysis of stable carbon and nitrogen isotopes from soft or mineralized tissues is a direct and widely-used technique for modeling diets. In addition to its continued role in paleodiet analysis, stable isotope analysis is now contributing to studies of physiology, disease, and nutrition in archaeological and living human populations. In humans and other animals, dietary uptake and distribution of carbon and nitrogen among mineralized and soft tissue is carried out with varying efficiency due to factors of internal biology. Human pathophysiologies may lead to pathology-influenced isotopic fractionation that can be exploited to understand not just skeletal health and diet, but physiological health and nutrition. This study reviews examples from human biology, non-human animal ecology, biomedicine, and bioarchaeology demonstrating how stable isotope analyses are usefully applied to the study of physiological adaptation and adaptability. Suggestions are made for future directions in applying stable isotope analysis to the study of nutritional stress, disease, and growth and development in living and past human populations. Am. J. Hum. Biol. 25:445–456, 2013. © 2013 Wiley Periodicals, Inc.