Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition

Rocco Barazzoni*, Gordon L. Jensen, Maria Isabel T.D. Correia, Maria Cristina Gonzalez, Takashi Higashiguchi, Han Ping Shi, Stephan C. Bischoff, Yves Boirie, Fernando Carrasco, Alfonso Cruz-Jentoft, Vanessa Fuchs-tarlovsky, Ryoji Fukushima, Steve Heymsfield, Marina Mourtzakis, Maurizio Muscaritoli, Kristina Norman, Ibolya Nyulasi, Veeradej Pisprasert, Carla Prado, Marian van der SchuerenSadao Yoshida, Jianchun Yu, Tommy Cederholm, Charlene Compher

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

118 Citations (Scopus)


The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic- and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.
Original languageEnglish
Pages (from-to)1425-1433
JournalClinical Nutrition
Issue number6
Publication statusPublished - 1 Jun 2022


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