The Global Leadership Initiative on Malnutrition (GLIM)

A lack of global consensus on diagnostic criteria for malnutrition in adults in diverse health care settings limits our ability to share meaningful data and compare promising interventions. The Global Leadership Initiative on Malnutrition (GLIM) is a collaborative global effort to address this shortcoming. A current understanding of the interplay between malnutrition, disease, and inflammation was used to create a simple diagnostic framework comprising etiologic and phenotypic criteria. It was specifically designed to accommodate healthcare settings where skilled nutrition expertise, laboratory assessments, and high technology body composition methodologies may not be readily available. The purpose of this article is to present controversies, limitations, and research gaps that have been recognized through our ongoing review of GLIM-related research literature and procedures. We share these issues and the ongoing efforts of GLIM working groups to address them. The use of GLIM malnutrition criteria that closely resemble those found in other validated tools raises the opportunity to further standardize malnutrition language and severity cutoffs used to characterize malnutrition criteria.