Recognizing malnutrition in adults with critical illness: Guidance statements from the Global Leadership Initiative on Malnutrition

Fukushima R 1 , Compher CW 2 , Correia MITD 3 , Gonzalez MC 4 , McKeever L 5 , Nakamura K 6 Show all authors , Lee ZY 7 , Patel JJ 8 , Singer P 9 , Stoppe C 10 , Ayala JC 11 , Barazzoni R 12 , Berger MM 13 , Cederholm T 14 , Chittawatanarat K 15 , Cotoia A 16 , Lopez-Delgado JC 17 , Earthman CP 18 , Elke G 19 , Hartl W 20 , Hasan MS 21 , Higashibeppu N 22 , Jensen GL 23 , Lambell KJ 24 , Lew CCH 25 , Mechanick JI 26 , Mourtzakis M 27 , Nogales GCC 28 , Oshima T 29 , Peterson SJ 30 , Rice TW 31 , Rosenfeld R 32 , Sheean P 33 , Silva FM 34 , Tah PC 35 , Uyar M 36

Affiliations 

  • 1 Department of Surgery Teikyo University School of Medicine, Department of Health and Dietetics, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan. Electronic address: ryojif@med.teikyo-u.ac.jp
  • 2 Biobehavioral Health Sciences Department and Nutrition Programs, University of Pennsylvania School of Nursing, Philadelphia, PA, USA. Electronic address: compherc@upenn.edu
  • 3 Department of Surgery, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: isabeldavissoncorreia@gmail.com
  • 4 Postgraduate Program in Nutrition and Food, Federal University of Pelotas, RS, Brazil. Electronic address: cristinabgs@hotmail.com
  • 5 Department of Clinical Nutrition, Rush University Medical Center, Chicago IL, USA. Electronic address: Liam_McKeever@Rush.edu
  • 6 Department of Critical Care Medicine, Yokohama City University Hospital, Kanagawa, Japan. Electronic address: mamashockpapashock@yahoo.co.jp
  • 7 Department of Anaesthesiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Cardiac Anesthesiology and Intensive Care Medicine, Charité Berlin, Berlin, Germany. Electronic address: zheng_yii@hotmail.com
  • 8 Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, 9200 West Wisconsin Avenue, HUB, 8th floor, Milwaukee, WI 53225, USA. Electronic address: jpatel2@mcw.edu
  • 9 Intensive Care Unit, Herzlia Medical Center, Reichman University, Herzlia and Institute for Nutrition Research, Intensive Care Department, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel. Electronic address: Pierre.singer@gmail.com
  • 10 Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital, Würzburg, Würzburg, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Charité Berlin, Berlin, Germany. Electronic address: christian.stoppe@gmail.com
  • 11 Department of Surgery, Clinica del Country, Assistant Professor of Medicine, FUCS, Bogotá, Colombia. Electronic address: jayalaacosta@gmail.com
  • 12 Department of Medical, Technological and Translational Sciences, University of Trieste, Ospedale di Cattinara, Trieste, Italy. Electronic address: barazzon@units.it
  • 13 Faculty of Biology and Medicine, Lausanne University, Lausanne, Switzerland. Electronic address: mette.berger@unil.ch
  • 14 Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, and Theme Inflammation & Aging, Karolinska University Hospital, Stockholm, Sweden. Electronic address: tommy.cederholm@uu.se
  • 15 Division of Trauma and Surgical Critical Care, Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. Electronic address: kaweesak.chittaw@cmu.ac.th
  • 16 Department of Medical and Surgical Science, University Hospital of Foggia, Italy. Electronic address: antonella.cotoia@unifg.it
  • 17 Medical ICU, Clinical Institute of Internal Medicine & Dermatology (ICMiD), Hospital Clínic de Barcelona, Barcelona, Spain. Electronic address: juancarloslopezde@hotmail.com
  • 18 Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE, USA. Electronic address: earthman@udel.edu
  • 19 Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany. Electronic address: gunnar.elke@uksh.de
  • 20 Department of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Marchioninistr. 15, D-81377 Munich, Germany. Electronic address: whartl@med.uni-muenchen.de
  • 21 Department of Anaesthesiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia. Electronic address: shahnaz@ummc.edu.my
  • 22 Department of Anesthesia and Critical Care, Kobe City Medical Center General Hospital, Japan. Electronic address: gashibe@gmail.com
  • 23 Dean's Office and Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA. Electronic address: Gordon.jensen@med.uvm.edu
  • 24 Nutrition and Dietetics Department, Alfred Health, Melbourne, Australia. Electronic address: k.lambell@alfred.org.au
  • 25 Department of Dietetics and Nutrition, Ng Teng Fong General Hospital, Faculty of Health and Social Sciences, Singapore Institute of Technology, Singapore, Republic of Singapore. Electronic address: Charles_lew@nuhs.edu.sg
  • 26 Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: jeffreymechanick@gmail.com
  • 27 Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada. Electronic address: mmourtzakis@uwaterloo.ca
  • 28 Department, Guillermo Almenara Hospital de Salud, Lima, Peru; San Martín University and San Ignacio de Loyola University Both in Lima Perú, Peru. Electronic address: mito_jm@hotmail.com
  • 29 Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba City, Chiba Prefecture, Japan. Electronic address: t_oshima@chiba-u.jp
  • 30 Department of Clinical Nutrition, College of Health Sciences, Rush University Medical Center, Chicago, IL, USA. Electronic address: sarah_j_peterson@rush.edu
  • 31 Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: Todd.Rice@Vanderbilt.edu
  • 32 Casa de Saude São Jose, Rede Santa Catarina, Rio de Janeiro, RJ, Brazil. Electronic address: ricardorosenfeld57@gmail.com
  • 33 Department of Applied Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, CTRE 439, Maywood, IL 60153, USA. Electronic address: psheean1@luc.edu
  • 34 Nutrition Department and Graduate Programs in Nutrition Science and Health Science, Federal University of Health Science of Porto Alegre, Porto Alegre, RS, Brazil. Electronic address: flaviams@ufcspa.edu.br
  • 35 Department of Dietetics, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia. Electronic address: pctah76@gmail.com
  • 36 Ege University Faculty of Medicine, Ege University Hospital, Department of Anesthesiology and Intensive Care, Bornova, Izmir, Turkey. Electronic address: mehmet.uyar@ege.edu.tr
Clin Nutr, 2025 Mar 28.
PMID: 40169339 DOI: 10.1016/j.clnu.2025.03.011

Abstract

BACKGROUND: Patients with critical illness may present with disease-related malnutrition upon intensive care unit (ICU) admission. They are at risk of development and progression of malnutrition over the disease trajectory because of inflammation, dysregulated metabolism, and challenges with feeding.

METHODS: The Global Leadership Initiative on Malnutrition (GLIM) convened a panel of 36 clinical nutrition experts to develop consensus-based guidance statements addressing the diagnosis of malnutrition during critical illness, using a modified Delphi approach with a requirement of ≥75% agreement.

RESULTS: CONCLUSION: Research using consistent etiologic and phenotypic variables offers great potential to assess the efficacy of nutrition interventions for critically ill patients with malnutrition. Assessment of these variables at during and beyond the ICU stay will clarify the trajectory of malnutrition and enable exploration of impactful treatment modalities at each juncture. GLIM offers a diagnostic approach that can be used to identify malnutrition in critically ill patients.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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