![]() The core GLIM leadership committee then created a larger supporting working group comprised of invited members that brought additional global diversity and expertise to the consensus effort. A core leadership committee with representatives of several of the global clinical nutrition societies ASPEN ( ESPEN ( FELANPE ( and PENSA ( was constituted to form GLIM.There was strong commitment for reaching broader global consensus in defining and characterizing malnutrition.It was recognized that there was considerable consensus among stakeholders around many malnutrition diagnosis issues.The purpose of this specific initiative is to reach global consensus on the identification and endorsement of criteria for the diagnosis of malnutrition We also sought to clarify overlaps with related disease classifications including cachexia. GLIM has engaged several of the clinical nutrition societies with global reach to focus on standardizing the clinical practice of malnutrition diagnosis. In order to respond to the needs of the clinical nutrition and medical communities the Global Leadership Initiative on Malnutrition (GLIM) was convened in January 2016. Thus, there is an urgent need to establish a global consensus to be used in clinical care settings for adults. Our evolving understanding of the contributions of disease/inflammation may render some concepts of malnutrition in the current International Classifications of Diseases (ICD-10) ( ) inconsistent with approaches or nomenclature that are currently used in clinical practice and research. No single existing approach has secured broad global acceptance (1, 4-8). Thus malnutrition is associated with adverse functional and clinical outcomes.Īlthough malnutrition is a global concern, there has been a fundamental lack of consensus on diagnostic criteria. Altered body composition manifests as a decrease in any marker of muscle mass (fat-free mass, muscle mass index or body cell mass). Inflammation contributes to malnutrition through associated anorexia and decreased food intake as well as altered metabolism with elevation of resting energy expenditure and increased muscle catabolism. The malnutrition that is associated with disease or injury invariably consists of a combination of reduced food intake or assimilation and varying degrees of acute or chronic inflammation, leading to altered body composition and diminished biological function (1-3). undernutrition, may be caused by compromised intake or assimilation of nutrients but there is growing appreciation that malnutrition may also be caused by disease-associated inflammatory or other mechanisms. However, with improvements in agriculture, education, public health, healthcare, and living standards, nutrition disorders and related conditions now encompass the full scope of undernutrition, micronutrient abnormalities, obesity, cachexia, sarcopenia, and frailty (1, 2). Malnutrition due to disease, poverty, hunger, war, and natural catastrophe is a fate suffered by greater than 1 billion of the world’s population. KEYWORDS: Global Initiatives in Leadership on Malnutrition The diagnostic construct should be re-considered every 3-5 years.A consensus scheme for diagnosing malnutrition in adults in clinical settings is conceptualized.The recommended approach supports classification of malnutrition into four etiology-related diagnosis categories.To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present.The top five ranked criteria included three phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). ![]() The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment.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.A two-step approach for the malnutrition diagnosis was selected.On 2020 the Global Leadership Initiative on Malnutrition (GLIM) was called by the local PBCN (Philippine Board of Clinical Nutrition) and appointed a committee to work on and finish this nutritional assessment profile. This initiative is aimed at building a local consensus around core diagnostic criteria for malnutrition in adults in clinical settings Adult Medical Nutrition Fellowship Program, The Medical City Ortigas Avenue, Pasig City, Metro-Manila, Philippines.Rodriguez Avenue, Quezon City, Metro-Manila, Philippines Institutions where research was conducted
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