TY - JOUR
T1 - GLIM Criteria for the Diagnosis of Malnutrition
T2 - A Consensus Report From the Global Clinical Nutrition Community
AU - Jensen, Gordon L.
AU - Cederholm, Tommy
AU - Correia, M. Isabel T.D.
AU - Gonzalez, M. Christina
AU - Fukushima, Ryoji
AU - Higashiguchi, Takashi
AU - de Baptista, Gertrudis Adrianza
AU - Barazzoni, Rocco
AU - Blaauw, Renée
AU - Coats, Andrew J.S.
AU - Crivelli, Adriana
AU - Evans, David C.
AU - Gramlich, Leah
AU - Fuchs-Tarlovsky, Vanessa
AU - Keller, Heather
AU - Llido, Luisito
AU - Malone, Ainsley
AU - Mogensen, Kris M.
AU - Morley, John E.
AU - Muscaritoli, Maurizio
AU - Nyulasi, Ibolya
AU - Pirlich, Matthias
AU - Pisprasert, Veeradej
AU - de van der Schueren, Marian
AU - Siltharm, Soranit
AU - Singer, Pierre
AU - Tappenden, Kelly A.
AU - Velasco, Nicolas
AU - Waitzberg, Dan L.
AU - Yamwong, Preyanuj
AU - Yu, Jianchun
AU - Compher, Charlene
AU - Van Gossum, Andre
N1 - Funding Information:
Gordon L Jensen: Conflicts of interest/ financial disclosures – none Tommy Cederholm: Conflicts of interest/ financial disclosures – none M. Isabel T.D. Correia: Conflicts of interest/ financial disclosures – none M. Christina Gonzalez: Conflicts of interest/ financial disclosures – none Ryoji Fukushima: Research grant from Taiho Pharmaceutical Factory, Inc.; Honoraria from Otsuka Pharmaceutical Factory, Inc., Terumo Corporation, and Abbotte Japan Co., Ltd. Takashi Higashiguchi: Conflicts of interest/ financial disclosures – none Gertrudis Adrianza de Baptista: Conflicts of interest/ financial disclosures – none Rocco Barazzoni: Conflicts of interest/ financial disclosures – none Renée Blaauw: Conflicts of interest/ financial disclosures – none Andrew JS Coats: Conflicts of interest/ financial disclosures – none Adriana Crivelli: Conflicts of interest/ financial disclosures – none David C Evans: Paid for consulting by Coram / CVS Infusion (Parenteral Nutr. Advisory Board) and Lyric; Abbott Nutrition and Lyric both paid Evan’s institution for research grants; Paid by Abbott Nutrition for speaking honoraria Leah Gramlich: Conflicts of interest/ financial disclosures – none Vanessa Fuchs-Tarlovsky: Hospital General de México, Mexico City (honoraria and travel expenses),Tata Memorial Hospital India (travel expenses), UPAEP (Puebla Autonomus University – travel expenses); professional societies including FELANPE, PENSA, the Academy of Nutrition and Dietetics, and the Colegio Mexicano de Nutriologos (travel expenses); and an industry sponsor, Fresenius Kabi (travel expenses). Heather Keller: Paid by Nestle Health Sciences for Manuscript focused on dysphagia; Paid for development of educational presentations including service on speakers’ bureaus by Abbott Nutrition and Nestle Health Sciences; Travel/accommodations expenses covered or reimbursed by Abbott Nutrition Luisito Llido: Conflicts of interest/ financial disclosures – none Ainsley Malone: Conflicts of interest/ financial disclosures – none Kris M Mogensen: Board membership with ThriveRx; Consultancy from Pfizer, Employment with Brigham and Women’s Hospital, Honoraria from Abbott Nutrition Health Institute and Baxter, Royalties from Wolf Rinke Associates John E Morley: Conflicts of interest/ financial disclosures – none Maurizio Muscaritoli: Conflicts of interest/ financial disclosures – none Ibolya Nyulasi: Conflicts of interest/ financial disclosures – none Matthias Pirlich: Consultancy from seca GmbH, Hamburg, Germany Veeradej Pisprasert: Conflicts of interest/ financial disclosures – none Marian de van der Schueren: Conflicts of interest/ financial disclosures – none Soranit Siltharm: Conflicts of interest/ financial disclosures – none Pierre Singer: Grants from Baxter, B Braun, Abbott, and Fresenius Kabi; Honoraria from Baxter, B Braun, Fresenius Kabi, GE, and Cosmed Kelly A. Tappenden: Conflicts of interest/ financial disclosures – none Nicolas Velasco: Conflicts of interest/ financial disclosures – none Preyanuj Yamwong: Conflicts of interest/ financial disclosures – none Jianchun Yu: Conflicts of interest/ financial disclosures – none Dan L. Waitzberg: Paid by Fresenius-Kabi as a member of Member of the Felanpe Award; Paid by Danone for Overview of enteral nutrition in healing manuscript preparation; Travel expenses paid for by Fresenius-Kabi and Nestle for Aspen and Espen conferences in 2018 Andre Van Gossum: Conflicts of interest/ financial disclosures – none Charlene Compher: Conflicts of interest/ financial disclosures – none
Publisher Copyright:
© 2018 Elsevier Ltd, the European Society for Clinical Nutrition and Metabolism and American Society for Parenteral and Enteral Nutrition. All rights reserved
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/1
Y1 - 2019/1
N2 - Background: This initiative aims to build a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. Methods: The Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. Results: A 2-step approach for the malnutrition diagnosis was selected, that is, first screening to identify at risk status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among GLIM participants that selected 3 phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and 2 etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least 1 phenotypic criterion and 1 etiologic criterion should be present. Phenotypic metrics for grading severity are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology-related diagnosis categories. Conclusions: A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The construct should be re-considered every 3–5 years.
AB - Background: This initiative aims to build a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. Methods: The Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. Results: A 2-step approach for the malnutrition diagnosis was selected, that is, first screening to identify at risk status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among GLIM participants that selected 3 phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and 2 etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least 1 phenotypic criterion and 1 etiologic criterion should be present. Phenotypic metrics for grading severity are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology-related diagnosis categories. Conclusions: A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The construct should be re-considered every 3–5 years.
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U2 - 10.1002/jpen.1440
DO - 10.1002/jpen.1440
M3 - Article
C2 - 30175461
AN - SCOPUS:85053240497
VL - 43
SP - 32
EP - 40
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
SN - 0148-6071
IS - 1
ER -