Disease-related undernutrition in hospitals is reaching significant levels in European countries, and there have been a number of national initiatives to address this problem. This report reviews current practice and seeks to highlight problems in service provision. It identifies five barriers to proper nutritional care in hospitals common throughout Europe and makes recommendations to promote good practice guidelines for nutritional care and support in hospitals. It is based on the findings of a study carried out by a group of experts on nutrition programmes in hospitals, on behalf of the the Committee of Experts on Nutrition, Food and Safety and Consumer Health.