A diet free of wheat and other gluten-containing foods is followed by individuals with celiac disease and by unaffected persons. Although the evidence and pathophysiology of gluten-induced symptoms are well established in celiac disease, they are still limited in non-celiac patients. At present, a gluten-free diet is often seen as a healthy lifestyle change instead of an adequate dietary therapy required for a specific condition. Consequently, the market for gluten-free products is steadily growing and improving; in fact, pseudocereals and genetically modified foods and crops are gaining importance in attempts to cover the dietary and nutritional needs of a population that demands it. There is currently interest not only in modifying crops to improve their agronomic traits and product flavor and appearance, but also to improve the nutritional content of crops and/or to silence certain genes with greater risk of allergenicity. However, the gluten-free diet trend is not hazard free, and many people can end up struggling with dietary disorders after making this decision. Therefore, we should be familiar with and take into account the potential shortage of certain nutrients in some of the gluten-free alternative products, which are now being fortified to prevent nutrient deficiencies and their consequences.

Introduction:Parenteral nutrition (PN) in childhood is a treatment whose characteristics are highly variable depending on the age and pathology of the patient. Material and methods: The Standardization and Protocols Group of the Spanish Society for Parenteral and Enteral Nutrition (SENPE) is an interdisciplinary group formed by members of the SENPE, the Spanish Society of Gastroenterology, Hepatology and Pediatric Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH) that intends to update this issue. For this, a detailed review of the literature has been carried out, looking for the evidences that allow us to elaborate a Clinical Practice Guide following the criteria of the Oxford Center for Evidence-Based Medicine. Results: This manuscript summarizes the recommendations regarding indications, access routes, requirements, modifi cations in special situations, components of the mixtures, prescription and standardization, preparation, administration, monitoring, complications and home NP. The complete document is published as a monographic number. Conclusions: This guide is intended to support the prescription of pediatric PN. It provides the basis for rational decisions in the context of the existing evidence. No guidelines can take into account all of the often compelling individual clinical circumstances.

El oxígeno y/o la luz son los principales causantes de la degradación de los componentes de la nutrición parenteral (NP), especialmente de vitaminas y lípidos. La oxidación de algunas vitaminas y la peroxidación lipídica son catalizadas por la luz, siendo la presencia de oxígeno el factor decisivo del proceso. El material de la bolsa en contacto con la NP debe ser químicamente inerte, como el etilvinilacetato (EVA) o el polipropileno. El cloruro de polivinilo (PVC), además de ceder a los lípidos el plastifi cante tóxico dietilhexilftalato (DEHP), también adsorbe otros componentes de la NP.