In 1977 poor nutritional status and malnutrition was already detected in surgical patients. Still, disease related malnutrition is a much underrated public health issue and has also become an enormous economical concern. It is estimated that over 50 million Europeans are at risk. A study performed in the UK in 2005 estimated the cost of malnutrition to the UK to be € 10.6 b per year, double the projected € 5.1 b cost of obesity. Two population groups are at particularly high risk: hospitalized patients and residents of nursing homes.