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

TLDR

This initiative builds a global consensus on core diagnostic criteria for adult malnutrition in clinical settings, convened by major global clinical nutrition societies. The report establishes a consensus diagnostic framework requiring at least one phenotypic and one etiologic criterion for malnutrition, and outlines steps to secure endorsements, identify overlaps with related syndromes, and promote validation studies. The consensus process used meetings, conferences, and emails to select a two‑step diagnostic approach—screening with any validated tool, then assessment using three phenotypic (weight loss, low BMI, reduced muscle mass) and two etiologic (reduced intake/assimilation, inflammation/disease burden) criteria, with phenotypic metrics for grading severity, and the framework is to be reviewed every 3–5 years. The consensus recommends using etiologic criteria to guide interventions and outcomes, classifies malnutrition into four etiology‑related categories, and proposes a global diagnostic scheme for adults in clinical settings.

Abstract

This initiative aims to build a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings.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.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.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.