The American Society for Parenteral and Enteral Nutrition (ASPEN
), the European Society for Clinical Nutrition and Metabolism (ESPEN
), the Latin American Federation for Parenteral and Enteral Nutrition (FELANPE
), and the Parenteral and Enteral Nutrition Society of Asia (PENSA
) have released The GLIM Criteria for the Diagnosis of Malnutrition
—a Consensus Report from the Global Clinical Nutrition Community. The report provides a global, consensus scheme for diagnosing malnutrition in adults in clinical settings and has just been published in the latest issue of ASPEN’s Journal of Parenteral and Enteral Nutrition
and ESPEN’s Clinical Nutrition
The five criteria for malnutrition include non-volitional weight loss, low body mass index, and reduced muscle mass as phenotypic criteria, and reduced food intake/assimilation and inflammation/disease burden as etiologic criteria. It is proposed that the diagnosis of malnutrition be based upon the presence of at least one phenotypic criterion and one etiologic criterion.
Although malnutrition is a serious concern associated with adverse outcomes and cost, no single existing approach to malnutrition diagnosis has achieved broad global acceptance. In January 2016, the Global Leadership Initiative on Malnutrition (GLIM) working group convened to build the much-needed consensus.
Led by Dr. Gordon L. Jensen from ASPEN and Dr. Tommy Cederholm from ESPEN, the participating societies endorsed a two-step approach for the diagnosis of malnutrition. 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 GLIM team considered malnutrition criteria that were retrieved from established approaches to diagnosis. Potential criteria were subjected to a ballot among the team. “We brought the international community together to develop consensus criteria for diagnosing malnutrition that are simple and can be readily applied by clinicians and other health practitioners using available tools and methods in their region,” said Gordon L. Jensen, MD, PhD, Senior Associate Dean for Research, Professor of Medicine and Nutrition, The Larner College of Medicine, University of Vermont.
“We will seek to secure further collaboration and endorsements from leading nutrition professional societies, and to promote dissemination, validation studies, and feedback to secure future refinements of the diagnosis,” said Tommy Cederholm, MD, PhD, Professor of Clinical Nutrition, Head of Clinical Nutrition & Metabolism, Department of Public Health & Caring Sciences, Uppsala University, Sweden.