Background: The Mediterranean Diet (MedDiet) is the dietary pattern par excellence for managing and preventing metabolic diseases, such as Type 2 Diabetes (T2DM). The MedDiet incorporates spices and aromatic herbs, which are abundant sources of bioactive compounds. The aim of this study was to analyze the effect of all aromatic herbs and spices included in the MedDiet, such as black cumin, clove, parsley, saffron, thyme, ginger, black pepper, rosemary, turmeric, basil, oregano, and cinnamon, on the glycemic profile in T2DM subjects. Methods: PubMed, Web of Science, and Scopus databases were searched for interventional studies investigating the effect of these aromatic herbs and spices on the glycemic profile in T2DM subjects. Results: This systematic review retrieved 6958 studies, of which 77 were included in the qualitative synthesis and 45 were included in the meta-analysis. Our results showed that cinnamon, turmeric, ginger, black cumin, and saffron significantly improved the fasting glucose levels in T2DM subjects. The most significant decreases in fasting glucose were achieved after supplementation with black cumin, followed by cinnamon and ginger, which achieved a decrease of between 27 and 17 mg/dL. Conclusions: Only ginger and black cumin reported a significant improvement in glycated hemoglobin, and only cinnamon and ginger showed a significant decrease in insulin.

The main dietary guidelines recommend restricting total and saturated fat intake in the management of high blood cholesterol levels for cardiovascular risk. These recommendations are usually oversimplified by considering that all red meats should be limited and replaced by white meats. However, lean red meat can be as low in fat as white meat. We examined the effects of red meat (lean breed lamb) and lean white meat (chicken) intake on the lipid profile of a group of women with stable life conditions (nuns living in convents). An open-label, randomised, cross-over study was carried out in thirty-six nuns who consumed either lamb or chicken three times per week for 5-week periods with their usual diet. Clinical, dietary and biochemical variables were evaluated at baseline and the end of each diet period. A validated FFQ was used to assess nutrient intake and monitor compliance. The results showed neither between-diet differences in lipid responses nor differences from baseline in total cholesterol, LDL-cholesterol or TAG for any diet period. In conclusion, consumption of lean red meat (lamb) or lean white meat (chicken) as part of the usual diet is associated with a similar lipid response. These two foods can be exchanged in a healthy diet to increase palatability.

Background: Delirium or an acute confusional state (ACS) is characterised as being a frequent and complex hospital complication in older adult patients, which can affect their level of independence and increase patient morbidity and mortality. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium, leading to longer hospital and ICU stays, increased mortality and long-term impairment. Objectives: This review aims to assess existing evidence of interventions that can be considered effective for the management and prevention of delirium in ICUs, reducing short-term morbidity and mortality, ICU and hospital admission times and the occurrence of other long-term complications. Methodology: For this systematic review, we searched Medline, PubMed, Cochrane Library, CINHAL, LILACS, SciELO and Dialnet from January 2018 to August 2024, in English, Spanish and French. MeSH descriptors were adjusted to search the different databases. We also checked Prospero for ongoing systematic reviews. Main results: The electronic search yielded a total of 2656 studies, of which 14 trials met the eligibility criteria, with a total of 14,711 participants. We included eight randomised clinical trial (RCTs), four cohort analyses, one systematic review and one observational trial, including participants over 65 years admitted to the ICU. Ten of these studies were based on pharmacological interventions, three of them examined non-pharmacological interventions and the remaining study examined mixed (pharmacological and non-pharmacological) interventions. Six placebo RCTs were included, plus four reported comparisons between different drugs. Regarding non-pharmacological interventions, nursing programmes focused on optimising modifiable risk factors or the use of therapies such as bright light are emerging. Regarding mixed interventions, we found the combination of invasive techniques and with sedoanalgesia. Conclusions: Due to its satisfactory level of sedation, dexmedetomidine is presented as a viable option because, although olanzapine offers safer results, postoperative administration angiotensin inhibitor systems significantly reduced the incidence of delirium. As for propofol, no significant differences were found. Among the non-pharmacological and mixed therapies, bright light therapy was able to reduce the incidence of delirium, and the combination of epidural/general anaesthesia was effective in all subtypes of delirium. Concerning the remaining interventions, the scientific evidence is still insufficient to provide a definitive recommendation.

Objective: To estimate the efficiency of a nurse‐led telephone program for nonadherent to treatment Type 2 diabetics with comorbid depression (TELE‐DD program).Design: Secondary analysis of cost‐consequence and budget impact, utilizing data from a randomized clinical trial conducted in the primary healthcare setting. The target population consisted of Type 2 diabetic patients with comorbid depression who were nonadherent to their pharmacological treatment.Method: The average cost per controlled patient (glycated hemoglobin < 7%) and the incremental cost‐effectiveness ratio were calculated. Similarly, the budgetary impact over 1 year of implementing this program in the region of reference of the randomized clinical trial was assessed.Results: The number of controlled patients is higher in the TELE‐DD group at 6, 12, and 18 months. The average cost per controlled patient was higher in the TELE‐DD group than in the control group at 6 months (€160.31 vs. €49.79), but lower at 12 (€150.09 vs. €179.59) and 18 months (€209.22 vs. €376.88). The incremental cost‐effectiveness ratio at 6, 12, and 18 months was €254.47, €143.65, and €177.46, respectively. The budget impact analysis revealed that implementing the TELE‐DD program would result in a reduction of €721,940.68 in expenditure for the funder in the first year of application.Conclusions: A nurse‐led telephone program for nonadherent Type 2 diabetics with comorbid depression is an efficient option in the management of healthcare resources. These results highlight the role of nursing in chronic patient management and the efficient use of healthcare resources.Trial Registration: ClinicalTrials.gov Identifier: NCT04097483.

Shift work is associated with an increased risk of metabolic disorders, including type 2 diabetes, largely due to circadian misalignment, irregular meal patterns and suboptimal diet quality. Chrononutrition, which focuses on aligning nutrient intake with circadian rhythms, has emerged as a promising strategy to improve metabolic health. Protein intake plays a key role in glucose homoeostasis, and high-protein hypoenergetic diets have shown benefits in people with type 2 diabetes. However, the effects of higher evening protein intake in shift workers remain unclear. This trial aims to analyse the effect of three hypoenergetic diets differing in macronutrient composition and distribution throughout the day on glycaemic control, body composition and other secondary outcomes in shift workers with overweight or obesity and prediabetes or type 2 diabetes. This is a 12-week, three-arm, parallel-group, single-blind randomised controlled trial including 126 shift workers. Participants are randomised equally to: (A) a high-protein diet with protein-enriched dinner (50–60 % of daily protein); (B) a high-protein diet with protein-restricted dinner (10–20 % of daily protein) or (C) a normoproteic control diet with usual protein distribution. Primary outcomes include changes in glycaemic control and dual-energy X-ray absorptiometry-derived body composition. Secondary outcomes are lipid profile, sleep quality and quality of life. Other clinical and lifestyle parameters are evaluated to monitor changes throughout the intervention. Assessments are performed at baseline, week 6 and week 12. All analyses will follow the intention-to-treat principle. This study will provide new evidence on how evening protein intake may influence metabolic health in populations exposed to circadian disruption.