Poor nutritional status post stroke increases length of hospital stay and risk of complications and undernourishment on admission is an independent marker of poor outcome at six months post stroke. A large multicentre randomised controlled trial did not support the routine use of oral nutritional supplements in unselected patients with stroke. A meta-analysis combining data from the FOOD trial with data from the general elderly hospitalised population, however, did demonstrate a reduced mortality and fewer complications with the prescription of oral nutritional supplementation for patients identified as undernourished. This study highlighted the problem of patient compliance with supplementation over longer periods. There continues to be a lack of evidence on nutritional support such as food fortification and specific dietary advice.