LLL Overview

Life Long Learning programme in Clinical Nutrition and Metabolism

Life Long Learning (LLL) How to Start
Online Courses Live Courses
Credit ESPEN LLL Final Examination
JSPEN and LLL Link to LLL Special Issue: "Parenteral and Enteral Nutrition"

Life Long Learning (LLL)

The European Society for Clinical Nutrition and Metabolism ("ESPEN"), an academic society with abundant human resources and research achievements in clinical nutrition, has always attached great importance to nutrition education. In 2005, ESPEN launched its "Life Long Learning (LLL) programme", an innovative nutrition education programme for medical professionals. LLL is a type of Web-based e-learning and consists of easily accessible "online courses", as well as face-to-face "live courses" for more comprehensive learning. Using top leaders in each field, the Society's LLL offers educational content approved by consensus at ESPEN and featuring as much evidence-based advanced knowledge in clinical nutrition as possible. In addition, the content is reexamined every few years to ensure that it is very appealing to clinical nutrition professionals wanting high-quality nutrition support. Currently, LLL is available to members of Societies for Clinical Nutrition and Metabolism throughout the world, as well as to nutrition support professionals. In Japan too, JSPEN-organized live courses are offered as part of an exchange program between ESPEN and JSPEN.

LLL online courses at ESPEN's website can be taken free of charge by anyone with an email address, simply by creating an account, with no ESPEN membership required. Ranging from introductory to in-depth studies, many topics pertaining to clinical nutrition are available. If there is a topic you are interested in, why not give it a try? Texts, tests, and other materials are generally written in English, but there is value in studying, even with a dictionary in hand, as the content is superb.

How to Start

To enroll in LLL, you must create an account (individually register). Special qualifications are not required, and registration and participation are free (for online courses). From the homepage of ESPEN's website at http://www.espen.org (Figure 1), click on LLL and "Join LLL for Free" to open the account registration page (Figure 2). Items required for registration are a username, password, email address, name, and address (country and city only). The registration information is based on your email address; thus, it is difficult to make changes later. It is recommended that you use a personal email address that is unlikely to change.lll_jukouhouhou

Online Courses

LLL consists of 38 "topics" (Figure 1). Each topic is divided into 2 to 6 "modules" to which additions and revisions are made as needed. Multiple languages other than English are also offered for the convenience of program participants. Each module includes "cases" and "self-tests." Through repeated practice, participants can improve their ability. When participants have passed the self-tests for all modules of a topic, they can take the "grading quiz" (graduation test) for the topic. However, even though the self-tests can be taken any number of times, a grading quiz can only be taken twice. Be careful, because if you fail a grading quiz a second time, you can no longer pass the given topic. Over 25,000 participants worldwide have taken our online courses.

Live Courses

Live courses (fee-based) corresponding to each of the online course topics are offered during the ESPEN Annual General Meeting and when hosted by each country's Society for Clinical Nutrition and Metabolism. As mentioned, the purpose of the live courses is to help participants acquire a more thorough understanding of particularly important points in the online course content. The content is basically in line with that of the online courses. Participation is limited to 50 or less per course. A 4-hour course period covers 3 to 5 modules and includes lectures (Figure 3), cases (Figure 4), and discussion. Participants who pass a test are issued a "diploma" (passing certificate), and those who fail are issued a certificate of attendance. There is no limit on how many times a live course can be taken, so a course can be taken multiple times until passed. ESPEN 2014 offered 18 courses and had attracted a total of about 20,000 participants.


Credits are awarded to recognize competence gained from LLL courses taken. For online courses, participants acquire 1 credit for taking a module and passing a self-test, and 4 credits for passing a topic's grading quiz. For live courses, participants are awarded 4 credits for a course if they pass a test and obtain a certificate (diploma). (It used to be 3 credits, so past data may show 3 credits; however, it will actually be counted as 4 credits retroactively.) When total credits reach 100, the "ESPEN LLL Final Examination" can be taken and, if passed, the "ESPEN European Diploma in Clinical Nutrition and Metabolism" will be awarded.

ESPEN LLL Final Examination

ESPEN LLL Final Examinations are held at the time of the ESPEN Annual General Meeting each September. A 100-question exam is prepared based on what participants have studied, and three (3) hours are allotted to complete it. Participants who achieve the passing score of 80% are awarded an ESPEN diploma. Over a hundred persons worldwide have passed the ESPEN LLL Final Examination. As of September 2019, diplomas have been granted to 30 persons in Japan.

From ESPEN Facebook page


The Japanese Society for Clinical Nutrition and Metabolism has actively developed educational activities and enhanced basic education in nutritional therapy. Furthermore, with the full cooperation of ESPEN, JSPEN has promoted the introduction of intermediate and advanced LLL courses in international nutrition education to Japan. LLL live courses have been offered since 2009, with a total of 54 courses over 8 periods offered by the year 2013. Out of a total of 584 persons who have participated, 413 have passed, contributing to a pass rate of 71%, which exceeds the pass rate of live courses hosted by ESPEN. The courses have the same content as those hosted by ESPEN, but with lectures being given by Japanese instructors in Japanese, gaps created by language, region, culture, and race are eliminated, making the courses easier to take. Also, when tests are passed, the same credits can be acquired as with ESPEN-hosted LLL courses, making it possible to accumulate credits toward taking the ESPEN LLL Final Examination. There is no need to travel to Europe. Participants can take courses in Japan relatively easily and economically. Additionally, since classes are small, instructors and participants can engage in lively debate and discussion. Thus, there are many advantages. Physicians must take these live courses to be qualified as accredited physicians or supervisory physicians recognized by the Japanese Society for Clinical Nutrition and Metabolism, and to renew such accreditation.

LLL is open to all healthcare professionals. To improve your skills and ability to work with patients, enroll in LLL and take advantage of the JSPEN-LLL live courses that are available!

Link to LLL Special Issue: "Parenteral and Enteral Nutrition"

Special Issue: Learning through ESPEN-LLL (Part 1)

Special Issue: Learning through ESPEN-LLL (Part 2)

List of Special Issues