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. 2025 Jun:49:11-20.
doi: 10.1016/j.clnu.2025.03.018. Epub 2025 Apr 5.

The GLIM consensus approach to diagnosis of malnutrition: A 5-year update

Tommy Cederholm  1 , Gordon L Jensen  2 , M Isabel T D Correia  3 , M Cristina Gonzalez  4 , Ryoji Fukushima  5 , Veeradej Pisprasert  6 , Renee Blaauw  7 , Diana Cardenas Braz  8 , Fernando Carrasco  9 , Alfonso J Cruz Jentoft  10 , Cristina Cuerda  11 , David C Evans  12 , Vanessa Fuchs-Tarlovsky  13 , Leah Gramlich  14 , Han Ping Shi  15 , Jeanette M Hasse  16 , Michael Hiesmayr  17 , Naoki Hiki  18 , Harriët Jager-Wittenaar  19 , Shukri Jahit  20 , Anayanet Jáquez  21 , Heather Keller  22 , Stanislaw Klek  23 , Ainsley Malone  24 , Kris M Mogensen  25 , Naoharu Mori  26 , Manpreet Mundi  27 , Maurizio Muscaritoli  28 , Doris Ng  29 , Ibolya Nyulasi  30 , Matthias Pirlich  31 , Stephane Schneider  32 , Marian de van der Schueren  33 , Soranit Siltharm  34 , Pierre Singer  35 , Alison Steiber  36 , Kelly A Tappenden  37 , Jianchun Yu  38 , André van Gossum  39 , Jaw-Yuan Wang  40 , Marion F Winkler  41 , Rocco Barazzoni  42 , Charlene Compher  43
Affiliations
Free article

The GLIM consensus approach to diagnosis of malnutrition: A 5-year update

Tommy Cederholm et al. Clin Nutr. 2025 Jun.
Free article

Abstract

Background: The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 comprised of screening followed by assessment of three phenotypic criteria: weight loss, low 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 five years.

Methods: A GLIM working group (n = 43 members) conducted a literature search spanning 2019-2024 using the keywords "Global Leadership Initiative on Malnutrition or GLIM". Prior GLIM activities providing guidance for use of the criteria on muscle mass and inflammation were reviewed. Successive rounds of review and revision were used to achieve consensus.

Results: More than 400 scientific reports are 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 judgement 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. Following 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.

Keywords: Assessment; Inflammation; Malnutrition; Muscle; Screening.

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Conflict of interest statement

Conflict of interest Tommy Cederholm disclosed receiving lecture honoraria from Fresnius-Kabi, Nutricia/Danone, and Nestle. M. Isabel T. D. Correia reported support from Abbott, Baxter, Danone, Fresenius, Nestlé for lectures and educational materials. David Evans disclosed support from Abbott Nutrition for consulting and speaking honoraria; Fresenius Kabi for consulting and speaking honoraria; and Alcresta Therapeutics for consulting and speaking honoraria. M. Cristina Gonzalez disclosed receiving honoraria and/or paid consultancy from Abbott Nutrition, Nutricia, and Nestle Health Science Brazil. Jeanette Hasse disclosed serving on the Speakers bureau for Alcresta Therapeutics. Ainsley Malone disclosed that she is an employee of ASPEN. Kris M. Mogensen disclosed serving as an Advisory Board Member for American Regent. Manpreet Mundi disclosed research grants from Nestle and Northsea as well as service on the advisory boards of Baxter, NutriShare, and Otsuka. Alison Steiber reported that she is an employee of the Academy of Nutrition and Dietetics and that she has received grant funding from the Academy of Nutrition and Dietetics Foundation and the Administration for Community Living. All other authors reported no disclosures.

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