GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community

GLIM Core Leadership Committee, GLIM Working Group

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Rationale: This initiative is focused on building a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. Methods: In January 2016, the Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. GLIM appointed a core leadership committee and a supporting working group with representatives bringing additional global diversity and expertise. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. Results: A two-step approach for the malnutrition diagnosis was selected, i.e., 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 the GLIM core and supporting working group members. The top five ranked criteria included three phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present. Phenotypic metrics for grading severity as Stage 1 (moderate) and Stage 2 (severe) malnutrition 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. Conclusion: A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure further collaboration and endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The diagnostic construct should be re-considered every 3–5 years.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalClinical Nutrition
Volume38
Issue number1
DOIs
Publication statusPublished - 01-02-2019

Fingerprint

Malnutrition
Consensus
Sarcopenia
Cachexia
Validation Studies
Postal Service
Telephone
Weight Loss
Body Mass Index
Eating
Communication
Inflammation
Muscles

All Science Journal Classification (ASJC) codes

  • Nutrition and Dietetics
  • Critical Care and Intensive Care Medicine

Cite this

GLIM Core Leadership Committee ; GLIM Working Group. / GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. In: Clinical Nutrition. 2019 ; Vol. 38, No. 1. pp. 1-9.
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abstract = "Rationale: This initiative is focused on building a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. Methods: In January 2016, the Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. GLIM appointed a core leadership committee and a supporting working group with representatives bringing additional global diversity and expertise. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. Results: A two-step approach for the malnutrition diagnosis was selected, i.e., 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 the GLIM core and supporting working group members. The top five ranked criteria included three phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present. Phenotypic metrics for grading severity as Stage 1 (moderate) and Stage 2 (severe) malnutrition 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. Conclusion: A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure further collaboration and endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The diagnostic construct should be re-considered every 3–5 years.",
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GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. / GLIM Core Leadership Committee; GLIM Working Group.

In: Clinical Nutrition, Vol. 38, No. 1, 01.02.2019, p. 1-9.

Research output: Contribution to journalArticle

TY - JOUR

T1 - GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community

AU - GLIM Core Leadership Committee

AU - GLIM Working Group

AU - Cederholm, T.

AU - Jensen, G. L.

AU - Correia, M. I.T.D.

AU - Gonzalez, M. C.

AU - Fukushima, R.

AU - Higashiguchi, T.

AU - Baptista, G.

AU - Barazzoni, R.

AU - Blaauw, R.

AU - Coats, A.

AU - Crivelli, A.

AU - Evans, D. C.

AU - Gramlich, L.

AU - Fuchs-Tarlovsky, V.

AU - Keller, H.

AU - Llido, L.

AU - Malone, A.

AU - Mogensen, K. M.

AU - Morley, J. E.

AU - Muscaritoli, M.

AU - Nyulasi, I.

AU - Pirlich, M.

AU - Pisprasert, V.

AU - de van der Schueren, M. A.E.

AU - Siltharm, S.

AU - Singer, P.

AU - Tappenden, K.

AU - Velasco, N.

AU - Waitzberg, D.

AU - Yamwong, P.

AU - Yu, J.

AU - Van Gossum, A.

AU - Compher, C.

AU - Jensen, Gordon L.

AU - Charlene, Compher

AU - Cederholm, Tommy

AU - Van Gossum, Andre

AU - Correia, Maria Isabel T.D.

AU - Gonzalez, M. Cristina

AU - Fukushima, Ryoji

AU - Higashiguchi, Takashi

AU - Higashiguchi, Takashi

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N2 - Rationale: This initiative is focused on building a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. Methods: In January 2016, the Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. GLIM appointed a core leadership committee and a supporting working group with representatives bringing additional global diversity and expertise. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. Results: A two-step approach for the malnutrition diagnosis was selected, i.e., 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 the GLIM core and supporting working group members. The top five ranked criteria included three phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present. Phenotypic metrics for grading severity as Stage 1 (moderate) and Stage 2 (severe) malnutrition 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. Conclusion: A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure further collaboration and endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The diagnostic construct should be re-considered every 3–5 years.

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