GLIM consensus approach to diagnosis of malnutrition: A 5‐year update
Gordon L. Jensen, Tommy Cederholm, María Isabel Toulson Davisson Correia, Marı́a Cristina González, Ryoji Fukushima, Veeradej Pisprasert, Renée Blaauw, Diana Cárdenas, Fernando Carrasco, Alfonso J. Cruz‐Jentoft, Cristina Cuerda, David C. Evans, Vanessa Fuchs‐Tarlovsky, Leah Gramlich, Hanping Shi, Jeanette M. Hasse, M. Hiesmayr, Naoki Hiki, Harriët Jager‐Wittenaar, Mohammad Shukri Jahit, Anayanet Jáquez, Heather Keller, Stanisław Kłęk, Ainsley Malone, Kris M. Mogensen, Naoharu Mori, Manpreet S. Mundi, Maurizio Muscaritoli, Doris Hui Lan Ng, Ibolya Nyulasi, Matthias Pirlich, S. Schneider, M.A.E. de van der Schueren, S. Siltharm, Pierre Singer, Alison Steiber, Kelly A. Tappenden, Jianchun Yu, A. Van Gossum, Jaw‐Yuan Wang, Marion F. Winkler, Charlene Compher, Rocco Barazzoni
Abstract
BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 that comprised screening followed by assessment of three phenotypic criteria (weight loss, low body mass index [BMI], and low muscle mass) and two etiologic criteria (reduced food intake/assimilation and inflammation/disease burden). This planned update reconsiders the GLIM framework based on published knowledge and experience over the past 5 years. METHODS: A working group (n = 43 members) conducted a literature search spanning 2019-2024 using the keywords "Global Leadership Initiative on Malnutrition or GLIM." Prior GLIM guidance activities for using the criteria on muscle mass and inflammation were reviewed. Successive rounds of revision and review were used to achieve consensus. RESULTS: More than 400 scientific reports were published in peer-reviewed journals, forming the basis of 10 systematic reviews, some including meta-analyses of GLIM validity that indicate strong construct and predictive validity. Limitations and future priorities are discussed. Working group findings suggest that assessment of low muscle mass should be guided by experience and available technological resources. Clinical judgment may suffice to evaluate the inflammation/disease burden etiologic criterion. No revisions of the weight loss, low BMI, or reduced food intake/assimilation criteria are suggested. After two rounds of review and revision, the working group secured 100% agreement with the conclusions reported in the 5-year update. CONCLUSION: Ongoing initiatives target priorities that include malnutrition risk screening procedures, GLIM adaptation to the intensive care setting, assessment in support of the reduced food intake/assimilation criterion, and determination of malnutrition in obesity.