Global nutrition group issues consensus criteria for malnutrition diagnosis

12 Sep 2018 --- Evidence of malnutrition can be seen broadly around the world. The World Health Organization (WHO) claims that 1.9 billion adults are overweight or obese and 462 million adults are currently underweight. Despite serious concerns associated with malnutrition’s adverse outcomes and cost, no single existing approach to malnutrition diagnosis has achieved broad global acceptance, until now. Members of the Global Leadership Initiative on Malnutrition (GLIM) have outlined five criteria for malnutrition, in a consensus report, which has been published in the latest issue of both the Journal of Parenteral and Enteral Nutrition and Clinical Nutrition.

The report, titled The GLIM Criteria for the Diagnosis of Malnutrition – a Consensus Report from the Global Clinical Nutrition Community, was led by Gordon Jensen, M.D., Ph.D., senior associate dean for research at the Larner College of Medicine at the University of Vermont (UVM) and Tommy Cederholm, M.D., Ph.D., a professor at Uppsala University in Sweden, representing the American Society for Parenteral and Enteral Nutrition (ASPEN) and European Society for Clinical Nutrition and Metabolism (ESPEN), respectively.

The report provides a global, consensus scheme for diagnosing malnutrition in adults in clinical settings. The five criteria for malnutrition include involuntary weight loss, low body mass index and reduced muscle mass as phenotypic (physical) criteria and reduced food intake/assimilation and inflammation/disease burden as etiologic criteria. It is proposed that the diagnosis of malnutrition can be based upon the presence of at least one phenotypic criterion and one etiologic criterion.

The four participating societies endorsed a two-step approach for the diagnosis of malnutrition. Initially, a screening takes place to identify “at risk” status by the use of any validated screening tool and secondly, assessment for diagnosis and grading the severity of malnutrition.

“We brought the international community together to develop consensus criteria for diagnosing malnutrition that is simple and can be readily applied by clinicians and other health practitioners using available tools and methods in their region,” notes Jensen, who is also a professor of medicine and nutrition and food sciences at UVM.

“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,” says Cederholm, a professor of clinical nutrition and Head of Clinical Nutrition & Metabolism in the Department of Public Health & Caring Sciences at Uppsala University in Sweden.

Last week, NutritionInsight published an article on medical nutrition and reported on the growing understanding of the significance among MDs. “Growing clinical data is continuously underbuilding the importance of nutrition for clinical patients, prompting growing interaction between the medical and nutritional worlds,” Professor André Van Gossum, M.D, European Society for Clinical Nutrition and Metabolism (ESPEN) Chairman, told NutritionInsight at the 40th edition of the ESPEN Congress. You can read more on this here.