Pigs face challenges to their health and well-being throughout their lifetimes. Proper nutrition may increase their resilience and prevent disease. In this chapter, we first discuss the essential contribution of balanced energy and protein levels to achieving optimal health and performance. We then discuss several mineral, vitamins and types of fiber and conclude with the essential subject of feed ingredients. A case study illustrates how characteristics of feed form and structure may have contradictory impacts on the gastric health and performance of pigs. Proper nutrition depends not only on the feed, but also on the farm situation. Feeding for optimal performance can increase the risk of health problems, necessitating a delicate balancing act. In farms with a good health status, feeding for optimal performance may be the logical strategic choice. Under more challenging health conditions, safer diets may be formulated with the trade-off being suboptimal performance results.