By Sara Glanz, MS, RD, LD, CNSC
Just in time for Malnutrition Awareness Week, a new set of malnutrition diagnostic criteria has emerged from the world stage. In an effort to establish global consensus regarding malnutrition diagnosis, experts from leading clinical nutrition organizations united as the Global Leadership Initiative on Malnutrition (GLIM) was established in January 2016 and sought to bring unity and standardization to the world of malnutrition.
The New Criteria
GLIM leadership reviewed existing malnutrition screening and diagnostic parameters to first establish what was most relevant and valid. Leaders in clinical nutrition provided their insight and voted on each criterion. The following criteria were selected by global consensus as the official criteria for malnutrition diagnosis:
Phenotypic Criteria
- Non-volitional weight loss
- Low body mass index (BMI)
- Reduced muscle mass
Etiologic Criteria
- Reduced food intake or assimilation
- Disease burden/inflammation
Click here to review the details and cut-points for each parameter.
Using the New Criteria
GLIM leadership suggests that a malnutrition diagnosis be made when an individual meets at least one phenotypic and one etiologic criterion. The phenotypic criteria are well-established effects and manifestations of malnutrition, while the etiologic criteria drive interventions. The phenotypic criteria also determine whether the malnutrition is of a moderate or severe degree. Severe malnutrition is present if at least one severe phenotypic criterion is met.
Click here to familiarize yourself with the moderate and severe levels of malnutrition.
What’s Next?
Like any new assessment technique, you can expect to see these criteria popping up in validation studies in the next few years. Even though the criteria were derived from validated assessment standards and expert recommendation, they must be properly vetted to establish their clinical relevance. Ultimately, GLIM hopes this new set of global standards will help to elevate the importance of malnutrition in the clinical realm and may assist with revising ICD codes to better reflect malnutrition as it exists and affects individuals.
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Other Malnutrition Resources
Webinar: A Dietitian’s Guide To Identifying, Documenting and Treating Malnutrition
Improving Your Malnutrition Care Plans Is As Easy As 1-2-3
What NFPE Training Looks Like
Getting Acquainted with Pediatric Malnutrition
Sara Glanz, MS, RD, LD, CNSC is a travel dietitian for Dietitians On Demand. She is passionate about empowering dietitians to be more involved with the interdisciplinary healthcare team. Her favorite adventures while on assignment include: The 17-Mile Drive in Monterey, CA; Lake Placid, NY; Montreal, Canada; and of course, the Jelly Belly® Jelly Bean and Ben & Jerry’s® ice cream factories located in Fairfield, CA and Burlington, VT, respectively.
Reference:
Jensen GL, Cederholm T, Correia MITD, Gonzalez C, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition community. JPEN. 2018. DOI: 10.1002/jpen.1440.