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

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.