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GLIM Criteria for the Diagnosis of Malnutrition: A Consensus Report From the Global Clinical Nutrition Community
Author(s) -
Jensen Gordon L.,
Cederholm Tommy,
Correia M. Isabel T.D.,
Gonzalez M. Christina,
Fukushima Ryoji,
Higashiguchi Takashi,
Baptista Gertrudis Adrianza,
Barazzoni Rocco,
Blaauw Renée,
Coats Andrew J.S.,
Crivelli Adriana,
Evans David C.,
Gramlich Leah,
FuchsTarlovsky Vanessa,
Keller Heather,
Llido Luisito,
Malone Ainsley,
Mogensen Kris M.,
Morley John E,
Muscaritoli Maurizio,
Nyulasi Ibolya,
Pirlich Matthias,
Pisprasert Veeradej,
van der Schueren Marian,
Siltharm Soranit,
Singer Pierre,
Tappenden Kelly A.,
Velasco Nicolas,
Waitzberg Dan L.,
Yamwong Preyanuj,
Yu Jianchun,
Compher Charlene,
Gossum Andre
Publication year - 2019
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1440
Subject(s) - malnutrition , medicine , grading (engineering) , intensive care medicine , cachexia , pathology , cancer , civil engineering , engineering
Abstract 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.