TL;DR
Adherence to high-quality, nutrient-dense plant-based diets may lower breast cancer risk, and protective associations were stronger in premenopausal women and ER-positive subtypes.
Evidence regarding the combined influence of healthy plant-based dietary patterns and lifestyle behaviours on obesity-related cancer outcomes remains limited. We prospectively investigated the associations of the healthy plant-based diet-lifestyle (hPDI-Lifestyle) score with obesity-related cancer incidence and mortality in the UK Biobank. Among 104,713 eligible participants, 93,763 were included in the primary complete-case analyses. The hPDI-Lifestyle score integrated healthy plant-based dietary quality, physical activity, smoking status, and sleep duration. Restricted cubic spline analyses were used to examine dose–response relationships, and Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the three outcomes, including sex-stratified analyses. Several sensitivity analyses were conducted to assess the robustness of the findings. During median follow-up periods of 16.3, 15.0, and 15.1 years, respectively, 2,258 incident obesity-related cancers, 1,095 obesity-related cancer deaths, and 6,215 all-cause deaths were documented. Higher hPDI-Lifestyle scores were associated with lower risks of obesity-related cancer mortality and all-cause mortality. For obesity-related cancer incidence, an inverse association was observed overall, whereas sex-stratified analyses showed no statistically significant association among women. Compared with participants in the lowest tertile, those in the highest tertile had lower risks of obesity-related cancer incidence (HR: 0.82, 95% CI: 0.74–0.92), obesity-related cancer-specific mortality (HR: 0.66, 95% CI: 0.56–0.77), and all-cause mortality (HR: 0.64, 95% CI: 0.60–0.68). Each 1-SD increment in the hPDI-Lifestyle score was associated with 8, 18, and 22% lower risks of obesity-related cancer incidence, obesity-related cancer-specific mortality, and all-cause mortality, respectively. Higher hPDI-Lifestyle scores were associated with lower risks of obesity-related cancer incidence, cancer-specific mortality, and all-cause mortality. These findings require confirmation in more representative populations and intervention studies before preventive implications can be established.
Background Previous observational studies have investigated the associations between adherence to healthy dietary patterns and endometrial cancer risk; however, pooled quantitative evidence synthesizing healthy dietary patterns and typical healthy foods remains limited. Therefore, we conducted this systematic review and meta-analysis to quantitatively synthesize available evidence on healthy dietary patterns, typical healthy foods and endometrial cancer risk. Methods Studies published up to February 2026 were systematically identified using PubMed, ISI Web of Science, Embase and China National Knowledge Infrastructure (CNKI) databases. Random- effects or fixed-effects models were used to calculate pooled relative risks (RRs) with corresponding 95% confidence intervals (CIs) where appropriate. Heterogeneity across studies was quantified using Cochran’s Q test and the I2 statistics. Results Thirty-five articles with a total of 533,828 participants and 17,758 endometrial cancer cases were included in our analysis. Compared with the lowest intake of healthy dietary patterns, the highest intake was associated with a 22% lower risk of endometrial cancer (RR = 0.78; 95% CI: 0.65- 0.93, P = 0.006).Additionally, the highest intakes of total vegetables (RR = 0.83;95%CI:0.75-0.92, P = 0.001) and whole grains (RR = 0.90; 95%CI:0.84-0.98, P = 0.012) were significantly associated with reduced risk of endometrial cancer. Comparatively, high intakes of fruits and fish showed no statistically significant association with endometrial cancer risk (P>0.05). Conclusions This systematic review and meta-analysis showed that high intakes of healthy dietary patterns, vegetables and whole grains were significantly with a lower risk of endometrial cancer. Further studies, particularly well-designed prospective cohort studies, are needed to confirm these findings.
This study indicates that higher dietary TAC intake is associated with a reduced risk of breast cancer, and well-designed longitudinal studies are warranted to confirm these findings.
Dietary patterns rich in vegetables, fruits, fish, lean meat, dairy products and unsaturated fats were significantly associated with reduced TC risk, whereas starchy foods, seafood, seaweed, processed meats, instant foods, fast food and Western patterns increased risk.
Higher adherence to the PHD and HPDI was associated with lower colorectal cancer risk in 204,369 UK Biobank participants followed for 11 years. Comparing highest versus lowest adherence, hazard ratios were 0.66 (95% CI: 0.58–0.75) for the PHD and 0.77 (95% CI: 0.68–0.87) for the HPDI. Associations were consistent across tumour subsites. Dietary patterns that emphasise plant-based foods and environmental sustainability may play an important role in colorectal cancer prevention(1–3). The Planetary Health Diet (PHD)1, which promotes high intake of plant foods with limited animal-source and ultra-processed foods, and the Healthy Plant-Based Diet Index (HPDI)(3), which prioritises healthy plant foods over less healthy plant and animal foods, have both been proposed as cancer-preventive dietary patterns(2,3). Higher adherence to these diets may reduce colorectal cancer risk through increased intake of dietary fibre, antioxidants, and anti-inflammatory compounds, alongside lower consumption of red and processed meats, which are linked to carcinogenesis via inflammation, insulin resistance, and alterations in the gut microbiome(4). However, prospective evidence directly comparing the PHD and HPDI in relation to colorectal cancer risk remains limited. We therefore examined the associations between adherence to these dietary patterns and incident colorectal cancer in the UK Biobank. This prospective study included 204,369 participants from the UK Biobank cohort (mean age 56.5 years; 54.3% women). Adherence to the PDH and HPDI was assessed using repeated 24-hour dietary recalls and rescaled from 0 to 1 to ensure comparability. Incident colorectal cancer, including proximal and distal colon cancer, was ascertained through linkage to national cancer registries and hospital admission records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Models were adjusted for sociodemographic characteristics, lifestyle behaviours, multimorbidity, and body mass index (BMI). During a median follow-up of 11 years (interquartile range: 10.2–11.7), 2,220 participants developed colorectal cancer, 822 proximal and 637 distal colon cancer. Higher adherence to both the PHD and the HPDI was associated with a lower risk of colorectal cancer. Comparing the highest versus lowest quartile of adherence, HRs were 0.66 (95% CI: 0.58–0.75) for the PHD and 0.77 (95% CI: 0.68–0.87) for the HPDI. Similar associations were observed for distal colon cancer (PHD: HR 0.71, 95% CI: 0.55–0.91; HPDI: HR 0.73, 95% CI: 0.57–0.92). Associations for proximal colon cancer were slightly weaker but remained significant (PHD: HR 0.75, 95% CI: 0.61–0.94; HPDI: HR 0.86, 95% CI: 0.77–0.99). Greater adherence to the PHD and HPDI was associated with a substantially lower risk of colorectal cancer, with consistent associations across tumour subsites. These findings support the potential role of environmentally sustainable and plant-forward dietary patterns in colorectal cancer prevention and strengthen the evidence base for integrating planetary health principles into public health nutrition strategies.
Background: Epidemiological evidence suggests that green leafy vegetables (GLV) may reduce the risk of cardiovascular disease (CVD). However, the relationship remains incompletely understood due to inconsistencies between findings from observational studies and randomized controlled trials (RCTs). Therefore, a comprehensive synthesis of evidence across study designs is warranted. This systematic review and meta-analysis aimed to evaluate the association between GLV consumption and CVD risk, as well as related cardiovascular risk factors, including blood pressure (BP) and endothelial function, based on evidence from observational studies and RCTs. Methods: Systematic searches of PubMed, EMBASE, APA PsycInfo, and Ovid databases were conducted through 30 October 2024. Risk of bias was assessed using the ROBINS-E tool for observational studies and the RoB 2 tool for RCTs. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated for observational studies, whereas mean differences (MDs) were used for RCT outcomes. Random-effects meta-analyses were performed, and heterogeneity was evaluated using Cochran’s Q and I2 statistics. Results: Higher GLV consumption was significantly associated with a reduced risk of CVD in observational studies (RR: 0.89; 95% CI: 0.82–0.97; p < 0.01; I2 = 80%; Q = 55.88) and lower CVD mortality (RR: 0.79; 95% CI: 0.62–0.97; p < 0.01; I2 = 80%; Q = 4.93). However, pooled analysis of seven RCTs showed no significant improvement in vascular function following GLV intake (MD: −0.37; 95% CI: −1.90 to 1.16; p = 0.64; I2 = 88%; Q = 18.59). No significant associations were observed between GLV consumption and hypertension risk in observational studies, nor were significant effects found on systolic or diastolic BP in RCTs. Conclusions: Higher GLV consumption may be associated with a lower risk of CVD in observational studies. However, evidence from RCTs remains limited and inconclusive. Further well-designed clinical trials are needed to confirm these associations, establish dose–response relationships, and elucidate the mechanisms underlying the cardioprotective effects of GLVs to support evidence-based dietary recommendations.
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