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GLIM consensus approach to diagnosis of malnutrition: A 5-year update

Jensen GL, Cederholm T, Correia MITD, Gonzalez MC, Fukushima R, Pisprasert V, et al.

JPEN J Parenter Enteral Nutr, 2025 Apr 14.
PMID: 40223699 DOI: 10.1002/jpen.2756

BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 that comprised screening followed by assessment of three phenotypic criteria (weight loss, low body mass index [BMI], and low muscle mass) and two etiologic criteria (reduced food intake/assimilation and inflammation/disease burden). This planned update reconsiders the GLIM framework based on published knowledge and experience over the past 5 years.
METHODS: A working group (n = 43 members) conducted a literature search spanning 2019-2024 using the keywords "Global Leadership Initiative on Malnutrition or GLIM." Prior GLIM guidance activities for using the criteria on muscle mass and inflammation were reviewed. Successive rounds of revision and review were used to achieve consensus.
RESULTS: More than 400 scientific reports were published in peer-reviewed journals, forming the basis of 10 systematic reviews, some including meta-analyses of GLIM validity that indicate strong construct and predictive validity. Limitations and future priorities are discussed. Working group findings suggest that assessment of low muscle mass should be guided by experience and available technological resources. Clinical judgment may suffice to evaluate the inflammation/disease burden etiologic criterion. No revisions of the weight loss, low BMI, or reduced food intake/assimilation criteria are suggested. After two rounds of review and revision, the working group secured 100% agreement with the conclusions reported in the 5-year update.
CONCLUSION: Ongoing initiatives target priorities that include malnutrition risk screening procedures, GLIM adaptation to the intensive care setting, assessment in support of the reduced food intake/assimilation criterion, and determination of malnutrition in obesity.
Fulltext Sarcopenic obesity: Call to action and nutritional agenda from the international clinical nutrition community

Barazzoni R, Ballesteros MD, Bischoff SC, Blaauw R, Boirie Y, Carey S, et al.

Clin Nutr, 2026 Jun;61:106645.
PMID: 41990558 DOI: 10.1016/j.clnu.2026.106645

Sarcopenic obesity (SO; defined as obesity with low skeletal muscle function and mass) has been recently recognized as a relevant obesity phenotype, with substantial negative clinical impact. The prevalence of SO is likely increasing, due to the growing prevalence of major SO risk factors, including sedentary lifestyle, obesity-induced non-communicable diseases with muscle-catabolism, and a general global increase in the older adult population. Structured obesity management, including anti-obesity medications, also commonly leads to variable reductions in muscle mass with potential SO risk. Here, an international network of clinical nutrition Societies, including the European Society for Clinical Nutrition and Metabolism (ESPEN), the Latino American Federation of Nutritional Therapy, Clinical Nutrition and Metabolism (Federación Latinoamericana de Terapia Nutricional, Nutrición Clínica y Metabolismo - FELANPE), the Parenteral and Enteral Nutrition Society of Asia (PENSA), and the South African and Australasian Societies for Parenteral and Enteral Nutrition (SASPEN and AuSPEN) recognize SO as a research and clinical priority, with major implications for nutrition and nutritional care. They hereby promote a nutrition network focusing on SO nutritional implications, clinical nutrition research on SO, and implementation of SO diagnosis and treatment in routine clinical practice. The current paper includes statements on SO diagnosis, promoting simple tools based on the recent consensus-based Sarcopenic Obesity Global Leadership Initiative (SOGLI) diagnostic algorithm, and its relationship with malnutrition/undernutrition. Statements are also provided on nutritional prevention of SO through healthy diet and adequate protein and micronutrient provision, on the role of nutritional care in obesity with sarcopenia, and on nutrition-based strategies to minimize and monitor the risk of sarcopenia during obesity management. The relevance of multimodal treatment approaches including both optimal nutrition and exercise is also emphasized. This SOGLI Nutrition network hereby calls for coordinated action, including scientific, educational and advocacy initiatives, to raise awareness of SO and the key role of nutrition and nutritional care in its prevention and treatment, in order to reduce the burden of morbidity and mortality in the growing population of persons with obesity worldwide.
Fulltext COVID-19 infection in patients on long-term home parenteral nutrition for chronic intestinal failure

Pironi L, Jezerski D, Sobocki J, Lal S, Vanuytsel T, Theilla M, et al.

Clin Nutr ESPEN, 2023 Jun;55:212-220.
PMID: 37202049 DOI: 10.1016/j.clnesp.2023.03.008

BACKGROUND AND AIMS: To investigate the incidence and the severity of COVID-19 infection in patients enrolled in the database for home parenteral nutrition (HPN) for chronic intestinal failure (CIF) of the European Society for Clinical Nutrition and Metabolism (ESPEN).
METHODS: Period of observation: March 1st, 2020 March 1st, 2021.
INCLUSION CRITERIA: patients included in the database since 2015 and still receiving HPN on March 1st, 2020 as well as new patients included in the database during the period of observation. Data related to the previous 12 months and recorded on March 1st 2021: 1) occurrence of COVID-19 infection since the beginning of the pandemic (yes, no, unknown); 2) infection severity (asymptomatic; mild, no-hospitalization; moderate, hospitalization no-ICU; severe, hospitalization in ICU); 3) vaccinated against COVID-19 (yes, no, unknown); 4) patient outcome on March 1st 2021: still on HPN, weaned off HPN, deceased, lost to follow up.
RESULTS: Sixty-eight centres from 23 countries included 4680 patients. Data on COVID-19 were available for 55.1% of patients. The cumulative incidence of infection was 9.6% in the total group and ranged from 0% to 21.9% in the cohorts of individual countries. Infection severity was reported as: asymptomatic 26.7%, mild 32.0%, moderate 36.0%, severe 5.3%. Vaccination status was unknown in 62.0% of patients, non-vaccinated 25.2%, vaccinated 12.8%. Patient outcome was reported as: still on HPN 78.6%, weaned off HPN 10.6%, deceased 9.7%, lost to follow up 1.1%. A higher incidence of infection (p = 0.04), greater severity of infection (p

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