GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition community
Open accessAbstract
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.
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The 2019 GLIM consensus papers provided a framework for a globally accepted diagnostic process that should be valid for adults in most settings, irrespective of methodological availability and resources.
“These insights culminated in the 2019 GLIM consensus papers that provided a framework for a globally accepted diagnostic process that should be valid for adults in most settings, irrespective of methodological availability and resources.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The title and citation metadata (Abstract entry, pp. 32–40) identify this as a 2019 GLIM consensus report on criteria for diagnosing malnutrition, supporting the attribution of a diagnostic framework. The passages available in our copy do not establish that the process is valid for adults in most settings regardless of methods or resources; searches for those qualifications found no relevant passage. (LLM, conf=0.79)
Experimental — accuracy not yet measuredGLIM introduced an approach for malnutrition diagnosis in 2019 comprising screening followed by assessment of three phenotypic criteria (weight loss, low BMI, low muscle mass) and two etiologic criteria (reduced food intake/assimilation and inflammation/disease burden).
“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).”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The GLIM consensus process arrived at a two-step procedure starting with nutrition screening followed by diagnostic assessment for confirmation of malnutrition.
“The consensus process arrived at a two‐step GLIM procedure that starts with nutrition screening followed by diagnostic assessment for confirmation of malnutrition.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
A list of conditions was provided in the original guidance that could be used to determine assimilation challenges, but severity and duration were not considered at that time.
“A list of conditions was provided in the original guidance 3 , 4 , 5 that could be used to determine assimilation challenges. However, severity and duration were not considered at that time.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The available indexed passages contain bibliographic metadata, not the guidance itself. Searches for reduced assimilation, gastrointestinal conditions, and severity and duration found no passage addressing either the proposed list of conditions or whether the guidance considered severity and duration. (LLM, conf=0.72)
Experimental — accuracy not yet measuredChronic disease-related inflammation is generally mild to moderate and often recurrent and is likely to be associated with malignant disease, chronic obstructive pulmonary disease, congestive heart failure, chronic renal disease, or any disease with chronic or recurrent inflammation.
“Chronic disease‐related inflammation is generally mild to moderate and often recurrent and is likely to be associated with malignant disease, chronic obstructive pulmonary disease, congestive heart failure, chronic renal disease, or any disease with chronic or recurrent inflammation.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Acute disease/injury-related severe inflammation is likely to be associated with major infection, burns, trauma, or closed head injury.
“Acute disease/injury‐related severe inflammation is likely to be associated with major infection, burns, trauma, or closed head injury.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The indexed passages returned for searches on severe inflammation, burns, major infection, trauma, and closed head injury contain no body-text passage addressing the claimed association. They return only abstract or bibliographic material, so the claim cannot be verified from the available copy. (LLM, conf=0.70)
Experimental — accuracy not yet measuredThresholds for reduced muscle mass need to be adapted to race (Asia).
“Thresholds for reduced muscle mass need to be adapted to race (Asia).”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The indexed Abstract names reduced muscle mass as a diagnostic criterion, but does not discuss thresholds or adapting them by race. Searches for Asian populations, ethnicity, and muscle-mass cutoffs found no passage addressing that recommendation. (LLM, conf=0.70)
Experimental — accuracy not yet measuredAt least one phenotypic criterion and one etiologic criterion are required for the diagnosis of malnutrition.
“At least one phenotypic criterion and one etiologic criterion are required for the diagnosis of malnutrition.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The searches returned the stated criterion only in material labeled Abstract, with no matching passage from the paper’s full text. Under the evidence restriction, the available passages do not verify the claim. (LLM, conf=0.65)
Experimental — accuracy not yet measuredTransient inflammation of a mild degree does not meet the threshold for the etiologic criterion of inflammation.
“Note that transient inflammation of a mild degree does not meet the threshold for this etiologic criterion.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The available Abstract identifies inflammation or disease burden as an etiologic criterion, but does not say whether mild, transient inflammation meets it. Searches for the quoted threshold and for mild or transient inflammation found no passage addressing that distinction; the decisive text may be absent from the available copy. (LLM, conf=0.70)
Experimental — accuracy not yet measuredReduced assimilation of food/nutrients is associated with malabsorptive disorders such as short bowel syndrome, pancreatic insufficiency, and after bariatric surgery.
“Reduced assimilation of food/nutrients is associated with malabsorptive disorders such as short bowel syndrome, pancreatic insufficiency, and after bariatric surgery.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The available passages from our copy are bibliographic metadata (labelled Abstract; no page given), not discussion of reduced nutrient assimilation. Searches for the claimed association and for short bowel syndrome, pancreatic insufficiency, bariatric surgery, and malabsorptive disorders returned no relevant passage, so the claim cannot be checked against our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measuredOther acute disease/injury-related conditions are likely to be associated with mild to moderate inflammation.
“Other acute disease/injury‐related conditions are likely to be associated with mild to moderate inflammation.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The supplied passage contains only the paper’s title and author information. Searches of the indexed copy for the quoted sentence, acute disease or injury, and mild-to-moderate inflammation found no passage addressing the claimed association. (LLM, conf=0.72)
Experimental — accuracy not yet measuredGastrointestinal symptoms can impair food intake or absorption and should be considered supportive indicators.
“Consider gastrointestinal symptoms as supportive indicators that can impair food intake or absorption (dysphagia, nausea, vomiting, diarrhea, constipation, or abdominal pain).”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The available indexed passages contain bibliographic information but no discussion of gastrointestinal symptoms. Searches for “supportive indicators” and “reduced food intake or assimilation” found no passage addressing the claim, so the available copy cannot verify it. (LLM, conf=0.72)
Experimental — accuracy not yet measuredBioelectrical impedance analysis, dual-energy x-ray absorptiometry, computed tomography, magnetic resonance imaging, and ultrasound are methods that can be used to evaluate muscle mass when experience and relevant reference values are available.
“Bioelectrical impedance analysis, dual‐energy x‐ray absorptiometry, computed tomography, magnetic resonance imaging, and ultrasound are methods that can be used when experience and relevant reference values are available.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The available Abstract (page not indicated) identifies reduced muscle mass as a malnutrition criterion but does not describe how to measure it. Searches for the named imaging and impedance methods, ultrasound, and reference values found no passage addressing the claimed methods or conditions of use. (LLM, conf=0.72)
Experimental — accuracy not yet measuredReduced assimilation of food/nutrients is also associated with disorders such as esophageal strictures, gastroparesis, and intestinal pseudo-obstruction.
“It is also associated with disorders such esophageal strictures, gastroparesis, and intestinal pseudo‐obstruction.”
From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [3]
The available passages contain bibliographic information but no discussion of reduced nutrient assimilation or the listed disorders. Searches for the three disorders, gastroparesis, and reduced assimilation returned no relevant passage from our copy, so the claim cannot be verified from it. (LLM, conf=0.74)
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- Authors
- Jensen, G. L., Cederholm, T., Correia, M. I. T. D., Gonzalez, M. C., Fukushima, R., Higashiguchi, T., de Baptista, G. A., Barazzoni, R., Blaauw, R., Coats, A. J. S., Crivelli, A., Evans, D. C., Gramlich, L., Fuchs‐Tarlovsky, V., Keller, H., Llido, L., Malone, A., Mogensen, K. M., Morley, J. E., Muscaritoli, M., Nyulasi, I., Pirlich, M., Pisprasert, V., de van der Schueren, M., Siltharm, S., Singer, P., Tappenden, K. A., Velasco, N., Waitzberg, D. L., Yamwong, P., Yu, J., Compher, C., & Van Gossum, A.
- Affiliations
- University of Vermont (US)
- Uppsala University (SE)
- Universidade Federal de Minas Gerais (BR)
- Postgraduate Program in Health and Behavior Catholic University of Pelotas RS Brazil
- The University of Tokyo (JP)
- Fujita Health University (JP)
- Medicine Faculty Central University of Venezuela University Hospital of Caracas Chief Nutritional Support Unit Hospital Universitary/Academic of Caracas University Central of Venezuela
- University of Trieste (IT)
- Stellenbosch University (ZA)
- University of Warwick (GB)
- Nutritional Support Unit San Martín Hospital La Plata Argentina
- The Ohio State University (US)
- University of Alberta (CA)
- Hospital General de México (MX)
- University of Waterloo (CA)
- St. Luke's Medical Center (PH)
- American Society for Parenteral and Enteral Nutrition (US)
- Brigham and Women's Hospital (US)
- Saint Louis University Hospital (US)
- Sapienza University of Rome (IT)
- Alfred Health (AU)
- Imperial Oak Outpatient Clinic, Endocrinology, Gastroenterology and Clinical Nutrition Berlin Germany
- Khon Kaen University (TH)
- Amsterdam UMC Vrije Universiteit Amsterdam Department of Nutrition and Dietetics Amsterdam, the Netherlands; HAN University of Applied Sciences, Faculty of Health and Social studies Department of Nutrition and Dietetics Nijmegen the Netherlands
- Ministry of Science and Technology Thailand (TH)
- Tel Aviv University (IL)
- University of Illinois Chicago (US)
- Department of Nutrition Diabetes and Metabolismo. School of Medicine Pontificia Universidad Catolica de Chile
- Universidade de São Paulo (BR)
- Siriraj Hospital (TH)
- Peking Union Medical College Hospital (CN)
- University of Pennsylvania (US)
- Department of Gastroenterology Clinic of Intestinal Diseases and Nutritional Support Hopital Erasme, Free University of Brussels Brussels Belgium
- Corresponding author
- Jensen, Gordon L.
- ORCID
- Jensen, Gordon L.
- Cederholm, Tommy
- Correia, M. Isabel T.D.
- Fukushima, Ryoji
- Barazzoni, Rocco
- Blaauw, Renée
- Coats, Andrew J.S.
- Crivelli, Adriana
- Evans, David C.
- Gramlich, Leah
- Fuchs‐Tarlovsky, Vanessa
- Keller, Heather
- Malone, Ainsley
- Mogensen, Kris M.
- Morley, John E
- Muscaritoli, Maurizio
- Nyulasi, Ibolya
- Pirlich, Matthias
- Pisprasert, Veeradej
- Singer, Pierre
- Tappenden, Kelly A.
- Waitzberg, Dan L.
- Yu, Jianchun
- Compher, Charlene
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2018-09-02
- Volume
- 43
- Issue
- 1
- Pages
- 32-40
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- OpenAlex
- W2889765177
- Cited by
- 1,442
- References
- 4
- Citations by year
- 2026: 86 · 2025: 185 · 2024: 292 · 2023: 277 · 2022: 239 · 2021: 168 · 2020: 116 · 2019: 68 · 2018: 11
- FWCI
- 62.40
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Warwick Research Archive Portal (University of Warwick) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Pfizer
- Brigham and Women's Hospital
- Danone
- Academy of Nutrition and Dietetics
- Japan Society for the Promotion of Science (17K10608)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- malnutrition diagnosis, GLIM criteria, adults, malnutrition screening, low body mass index, inflammation, disease burden, hypophagia, cachexia, sarcopenia
- MeSH terms
- Adult, Aged, Cachexia, Female, Humans, Leadership, Male, Mass Screening, Middle Aged, Muscles, Nutritional Status, Phenotype, Societies, Scientific, Weight Loss, Nutrition Assessment, Body Mass Index, Practice Guidelines as Topic, Consensus, Malnutrition, Sarcopenia
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