It is well documented that hospital malnutrition and inadequate food intake are very common, and many patients lose weight during admission. Rapid weight loss may have adverse effects on the outcome of illness and increase mortality and total costs of treatment. In 1999 the Council of Europe established a Commission of Experts to collect information regarding nutrition programmes in hospitals. The aim was to review the current practice in Europe regarding food provision and to issue guidelines to improve the nutritional care and support of hospitalized patients. Five major barriers for proper nutritional care in European hospitals were defined: (1) Lack of clearly defined responsibilities in planning and managing nutritional care; (2) Lack of sufficient education with regard to nutrition among all staff groups; (3) Lack of influence of patients; (4) Lack of cooperation between different staff groups; and (5) Lack of involvement of hospital administration. To solve the problem of hospital malnutrition, a combined team–effort is needed from national authorities and all staff involved in the nutritional care and support, including hospital managers.