CELAYA PEREZ, Sebastián. X Jesús Culebras lecture. Clinical nutrition: from super specialization to community care. []. , 36, 5, pp.1223-1230.   24--2020. ISSN 1699-5198.  https://dx.doi.org/10.20960/nh.02838.

Clinical nutrition has evolved in our country from the super-specialization of parenteral nutrition (PN) in the Intensive Care Unit (ICU) up to the community care of health. In the beginning, PN was used in a minimum percentage of hospitalized patients; the development of the enteral nutrition (EN) meant an extension of the beneficiaries to achieve a correct nutritional contribution. By getting involved in the diet code the responsibility was extended to the entire hospitalized population. Artificial nutrition techniques were subsequently extended to the patient's home and consolidated with the inclusion of the home enteral nutrition (HEN) in the Spanish National Health Service (SNS) portfolio.

To improve the prevention of malnutrition, after the PREDYCES study, the Multidisciplinary Consensus emerged and later the Alianza Más Nutridos was developed, in which the field of clinical nutrition was extended to Primary Care and nursing homes.

The last step is community health care, a strategy that is based on the concept that health is more than the absence of disease along with the need to involve citizens in their own decisions about their lifestyle and how to address health problems.

: Clinical nutrition; Parenteral nutrition; Enteral nutrition; Community health care.

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