Healthy dietary patterns, typical healthy foods and risk of endometrial cancer: a systematic review and meta-analysis of observational studies

Abstract

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.