Protein-energy malnutrition (PEM) has still a high prevalence in European Hospitals. Furthermore, during hopitalization the patient's nutrient requirements may not be met. This may further worsen malnutrition and increase the risk of PEM related complications. Outcome can be improved by an higher awareness of the presence of PEM in hospitalized patients, adequate initial and follow-up assessment of the nutritional status and the implementation of appropriate nutritional interventions during hospital stay. New achivements in the knowledge of the metabolic regulation and the physiopathology of malnutrition allow a tailored nutritional support in specific clinical conditions. Metabolic therapy with hormones and drugs seems also to be promising but it needs further evaluations. More widespread education in clinical nutrition is required to transfer knowledge to everyday clinical practice.
