TY - JOUR
T1 - GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community
AU - GLIM Core Leadership Committee, 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. J.S.
AU - Crivelli, A. N.
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.
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.
PY - 2019/2
Y1 - 2019/2
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 (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.
AB - 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 (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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U2 - 10.1002/jcsm.12383
DO - 10.1002/jcsm.12383
M3 - Article
C2 - 30920778
AN - SCOPUS:85063647783
VL - 10
SP - 207
EP - 217
JO - Journal of Cachexia, Sarcopenia and Muscle
JF - Journal of Cachexia, Sarcopenia and Muscle
SN - 2190-5991
IS - 1
ER -