![]() ![]() ![]() Altered body composition manifests as a decrease in any marker of muscle mass (fat‐free mass, muscle mass index or body cell mass). 1, 2, 3 Inflammation contributes to malnutrition through associated anorexia and decreased food intake as well as altered metabolism with elevation of resting energy expenditure and increased muscle catabolism. The malnutrition that is associated with disease or injury invariably consists of a combination of reduced food intake or assimilation and varying degrees of acute or chronic inflammation, leading to altered body composition and diminished biological function. undernutrition, may be caused by compromised intake or assimilation of nutrients but there is growing appreciation that malnutrition may also be caused by disease‐associated inflammatory or other mechanisms. However, with improvements in agriculture, education, public health, healthcare, and living standards, nutrition disorders and related conditions now encompass the full scope of undernutrition, micronutrient abnormalities, obesity, cachexia, sarcopenia, and frailty. Historically, starvation and famine were prevalent causes of malnutrition and they remain so today. Malnutrition due to disease, poverty, hunger, war, and natural catastrophe is a fate suffered by greater than 1 billion of the world's population. The recommended approach supports classification of malnutrition into four etiology‐related diagnosis categories. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. ![]() Phenotypic metrics for grading severity as Stage 1 (moderate) and Stage 2 (severe) malnutrition are proposed. To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present. The top five ranked criteria included three phenotypic criteria (weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). Potential criteria were subjected to a ballot among the GLIM core and supporting working group members. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. A two‐step approach for the malnutrition diagnosis was selected, i.e., first screening to identify “at risk” status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. ![]()
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