Several steps are involved in the process of improving dietary intake in hospitals. These include screening ofpatients to identify those at nutritional risk, monitoring dietary intake, modifying the hospital diet as necessary according to the patients' preferences, and ensuring that serving and ambience of mealtimes are focused on the patient with reduced appetite. In our institution we have implemented most of these steps gradually over a 10-year period. The results show that by combining regimens ranging from a regular hospital diet to total parenteral nutrition, food can constitute about 60% of total nutrient intake in at risk patients. Furthermore, further significant loss of body weight can be avoided in 90% of the patients and in those who cannot be weighed, dietary intake is satisfactory in 95% of the patients.