The Global Leadership Initiative on Malnutrition was convened by several of the major global clinical nutrition societies to build consensus on criteria for diagnosis of malnutrition (ie, undernutrition) for adults in clinical settings. The malnutrition criteria for consideration were identified from existing widely used approaches. They were then ranked by ballot among the Global Leadership Initiative on Malnutrition participants. There was strong endorsement of 3 phenotypic criteria (weight loss, low body mass index, and reduced muscle mass) and 2 etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). A consensus construct is proposed for the diagnosis of malnutrition that requires at least 1 phenotypic criterion and 1 etiologic criterion. Phenotypic metrics are suggested for severity grading. The etiologic criteria are intended to help guide interventions and anticipated outcomes. Going forward, our immediate priorities include promoting dissemination, implementation, validation studies, and feedback.
Gordon L. Jensen, MD, PhD, is senior associate dean for research and professor of medicine and nutrition, Larner College of Medicine, University of Vermont, Burlington.
Tommy Cederholm, MD, PhD, is professor, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, and Theme Aging, Karolinska University Hospital, Stockholm, Sweden.
G.L.J. and T.C. are co–first authors of this article.
Correspondence: Gordon L. Jensen, MD, PhD, Office of the Dean, E-126 Given Bldg, 89 Beaumont Ave, Burlington, VT 05405 (Gordon.Jensen@med.uvm.edu).