GLIM Criteria for the Diagnosis of Malnutrition: A Consensus Report From the Global Clinical Nutrition Community

Gordon L. Jensen*, Tommy Cederholm, M. Isabel T.D. Correia, M. Christina Gonzalez, Ryoji Fukushima, Takashi Higashiguchi, Gertrudis Adrianza de Baptista, Rocco Barazzoni, Renée Blaauw, Andrew J.S. Coats, Adriana Crivelli, David C. Evans, Leah Gramlich, Vanessa Fuchs-Tarlovsky, Heather Keller, Luisito Llido, Ainsley Malone, Kris M. Mogensen, John E. Morley, Maurizio MuscaritoliIbolya Nyulasi, Matthias Pirlich, Veeradej Pisprasert, Marian de van der Schueren, Soranit Siltharm, Pierre Singer, Kelly A. Tappenden, Nicolas Velasco, Dan L. Waitzberg, Preyanuj Yamwong, Jianchun Yu, Charlene Compher, Andre Van Gossum

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.

Original languageEnglish
Pages (from-to)32-40
Number of pages9
JournalJournal of Parenteral and Enteral Nutrition
Issue number1
Publication statusPublished - 1 Jan 2019

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