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Journal Article Consensus Statement Ppublish 1 citation

PubMed: 42664568 DOI: 10.1016/j.clnu.2026.106768

Global Leadership Initiative on Indications to Nutritional Therapy and Support (GLINTS): A consensus report from the global clinical nutrition community.

Clin Nutr 65:106768

Authors: Stanislaw Klek, Rocco Barazzoni, Renée Blaauw, Rosa Burgos, Diana Cardenas, Tommy Cederholm, Charlene Compher, Paola Sanchez-Corrales, Rhiannon Crane, Cristina Cuerda, Joseph Hartono, Laurence Genton, Olga Gomez, Harriët Jager-Wittenaar, Shukri Jahit, Ajay Jain, Anayanet Jaquez, Gordon Jensen, Nicole Kiss, Alessandro Laviano, Dileep N Lobo, Doris Ng, Ibolya Nyulasi, Yoshinaga Okugawa, Stacy Pelekhaty, Matthias Pirlich, Veeradej Pisprasert, Kalliopi Anna Poulia, Andrés Sanchez, Stéphane M Schneider, Marian A E de van der Schueren, Mireille Serlie, Anna-Lena du Toit, Simon Gabe

Affiliations

  • Department of General Surgery and Intestinal Failure, Center for Minimally Invasive and Robotic Surgery, Stanley Dudrick's Memorial Hospital in Skawina, Poland.
  • Department of Medical, Technological and Translational Sciences, University of Trieste, Ospedale di Cattinara, Trieste, Italy.
  • Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Nutritional Support Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Nutrition Unit, Gustave Roussy, France.
  • Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
  • University of Pennsylvania, School of Nursing, Department of Biobehavioral Health Science Philadelphia, Pennsylvania, USA.
  • Hospital Dr Rafael Ángel Calderón Guardia, Universidad Latina de Costa Rica, San José, Costa Rica.
  • Director Nutrition and Dietetics, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Secretary and Council Member Australasian Society of Parenteral and Enteral Nutrition (AuSPEN), Australia.
  • Nutrition Unit, Hospital General Universitario Gregorio Marañón, Department of Medicine, University Complutense, Madrid, Spain.
  • Indonesian Central Army Gatot Soebroto Hospital, Jakarta, Indonesia.
  • Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
  • Colegio Mexicano de Nutrición Clínica y Terapia Nutricional, Mexico City, Mexico.
  • Hanze University of Applied Sciences Groningen, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; Radboud University Medical Center, Department of Gastroenterology and Hepatology, Dietetics, Nijmegen, the Netherlands; Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Research Unit Experimental Anatomy, Brussels, Belgium.
  • National Cancer Institute, Putrajaya, Malaysia.
  • Division of Pediatric Gastroenterology Hepatology and Nutrition, Saint Louis University, Saint Louis, MO, USA.
  • Facultad de Ciencias de la Salud, Pontificia Universidad Católica Madre y Maestra (PUCMM), Recinto Santiago, Unidad de Investigación, Clínica Universitaria Unión, Dominican Republic.
  • Dean's Office and Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA.
  • Deakin Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
  • Department of Translational and Precision Medicine, Sapienza University of Rome, Italy.
  • Nottingham Digestive Diseases Centre, Division of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
  • Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore.
  • Department of Genomic Medicine, Mie University Hospital, Tsu, Mie, Japan.
  • Department of Clinical Nutrition, University of Maryland Medical Center, Baltimore, MD, USA.
  • Imperial Oak Outpatient Clinic (Praxis Kaisereiche), Berlin, Germany.
  • Division of Clinical Nutrition, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40000, Thailand.
  • Laboratory of Dietetics and Quality of life, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece.
  • Center for Obesity and Metabolic Diseases, Bupa Santiago Clinic, Santiago, Chile.
  • Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
  • HAN University of Applied Sciences, Dept. of Nutrition, Dietetics and Lifestyle, Nijmegen, the Netherlands; Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, the Netherlands.
  • Department of Endocrinology and Metabolism, University of Amsterdam, Amsterdam, the Netherlands.
  • Dietetics Department, Groote Schuur Hospital, University of Cape Town, South Africa.
  • Lennard Jones Intestinal Failure Unit, St Mark's, LNWUH Trust, London, UK.

Abstract

BACKGROUND & AIMS

Providing clear guidance for nutritional interventions is a precondition for the fight against the consequences of (risk of) malnutrition/undernutrition. Therefore, a group of international experts representing major global and regional clinical nutrition societies decided to clarify indications for nutritional therapy and support. The initiative was named the Global Leadership Initiative on Indications to Nutritional Therapy and Support (GLINTS).

METHODS

The study used a modified Delphi methodology to develop expert consensus. Eight major statements were formulated. The process combined quantitative scoring of agreement with qualitative free-text feedback to support the revision of statements between rounds. The modified Delphi process was conducted through three sequential web-based survey rounds administered using Qualtrics (Qualtrics, Provo, UT), allowing iterative refinement of the statements and reassessment of agreement after structured panel feedback.

RESULTS

Consensus was reached on indications for nutritional therapy/support: (i) malnutrition/undernutrition defined by the GLIM criteria, (ii) risk of malnutrition/undernutrition, and (iii) reduced oral intake. Enteral tube feeding is indicated when oral nutritional intake provides less than 50% of estimated energy and nutrient requirements and no significant improvement in intake is expected. Intestinal failure is an indication for parenteral nutrition, and supplemental parenteral nutrition may be used when oral and/or enteral nutrition fails to provide adequate energy and protein intake despite appropriate optimization strategies. All statements reached the level of consensus at 85% or greater.

CONCLUSIONS

Consensus on when to start nutritional therapy/support was reached by the modified Delphi process. These defined and agreed recommendations may contribute to better nutritional care.

MeSH

Feedback, Malnutrition, Parenteral Nutrition, Therapeutics, Enteral Nutrition