Associations between fruit and vegetable (FV) consumption and mental health are suggested, largely from observational studies. This systematic review aimed to identify and summarise all published controlled intervention studies investigating the effects of FV consumption on mental health in adults. Four academic databases (Medline, PsycINFO, PubMed, Web of Science) were searched on 16 September 2022, over all years, for studies that used an intervention design; included FV consumption; included an appropriate non-FV-consumption control; used a validated measure of mental health and were conducted in healthy adults or adults with solely a depressive or anxiety-related condition. Study details were tabulated and combined using meta-analyses. Risk of bias was assessed using the domains of the Cochrane Collaboration. Six studies, enrolling 691 healthy adults and reporting on one or more mental health outcomes, were found. Meta-analyses found small and imprecise effects of FV consumption for: psychological well-being (4 studies, 289 participants) standardised mean difference (SMD) = 0·07 (95 % CI −0·17, 0·30), P = 0·58, I2 = 0 %; depressive symptomology (3 studies, 271 participants) SMD = –0·15 (95 % CI −0·40, 0·10), P = 0·23, I2 = 47 % and anxiety-related symptomology (4 studies, 298 participants) SMD = –0·15 (95 % CI −0·39, 0·08), P = 0·20, I2 = 71 %. Some benefit for psychological well-being was found in change-from-baseline data: SMD = 0·28 (95 % CI 0·05, 0·52), P = 0·02, I2 = 0 %. Risk of bias was high in many studies. Limitations include the consideration only of published studies and stem from the studies found. Given the few, limited studies available and the small size of effects, stronger evidence is needed before recommending FV consumption for mental health.

In May 2021, the Scientific Advisory Committee on Nutrition (SACN) published a risk assessment on lower carbohydrate diets for adults with type 2 diabetes (T2D)(1). The purpose of the report was to review the evidence on ‘low’-carbohydrate diets compared with the current UK government advice on carbohydrate intake for adults with T2D. However, since there is no agreed and widely utilised definition of a ‘low’-carbohydrate diet, comparisons in the report were between lower and higher carbohydrate diets. SACN’s remit is to assess the risks and benefits of nutrients, dietary patterns, food or food components for health by evaluating scientific evidence and to make dietary recommendations for the UK based on its assessment(2). SACN has a public health focus and only considers evidence in healthy populations unless specifically requested to do otherwise. Since the Committee does not usually make recommendations relating to clinical conditions, a joint working group (WG) was established in 2017 to consider this issue. The WG comprised members of SACN and members nominated by Diabetes UK, the British Dietetic Association, Royal College of Physicians and Royal College of General Practitioners. Representatives from NHS England and NHS Health Improvement, the National Institute for Health and Care Excellence and devolved health departments were also invited to observe the WG. The WG was jointly chaired by SACN and Diabetes UK.

Chronic inflammation has been considered as the main cause of chronic diseases. Zn has anti-inflammatory effects by decreasing the expression of inflammatory markers. The present systematic review and meta-analysis study aims to evaluate the impact of Zn supplementation on inflammation. PubMed (Medline), Scopus, Web of Science, and Embase databases were searched up to 10 December 2020. Controlled trials which have investigated the effects of Zn supplementation on serum/plasma levels of inflammatory cytokines in subjects aged >15 years were included. A pooled meta-analysis was performed using a random effect model. Sensitivity analysis was performed to determine the robustness of the observed effect sizes. A total of twelve studies was included in meta-analysis. Zn could decrease IL-6 levels (standardised mean difference (SMD) = −0·76 pg/ml; 95 % CI −1·28, −0·24; P = 0·004). There was no significant change in TNF-α (SMD = 0·42 pg/ml; 95 % CI −0·31, 1·16; P = 0·257) and IL-2 levels (SMD = 1·64 pg/ml; 95 % CI −1·31, 4·59; P = 0·277) following Zn supplementation. However, Zn could increase IL-2 significantly after the deletion of one arm in sensitivity analysis (SMD = 2·96 pg/ml; 95 % CI 2·03, 3·88; P < 0·05). Conclusively, Zn supplementation can decrease the IL-6 level. Zn increased IL-2 level after the sensitivity analysis. Zn supplementation has not ameliorative effects on TNF-α.

This meta-analysis aimed to study the relationship between abdominal obesity and the risk of CVD by waist circumference (WC), waist:hip ratio (WHR) and waist:height ratio (WHtR). We systematically searched PubMed, Embase and Web of Science. Prospective studies that estimated cardiovascular events by WC, WHR and WHtR were included in this study. Pooled relative risks with 95 % CI were calculated using random effects models. A total of thirty-one studies were included in the meta-analysis, including 669 560 participants and 25 214 cases. Compared the highest with the lowest category of WC, WHR and WHtR, the summary risk ratios were 1·43 (95 % CI, 1·30, 1·56, P < 0·001), 1·43 (95 % CI, 1·33, 1·54, P < 0·001) and 1·57 (95 % CI, 1·37, 1·79, P < 0·001), respectively. The linear dose–response analysis revealed that the risk of CVD increased by 3·4 % for each 10 cm increase of WC, and by 3·5 and 6·0 % for each 0·1 unit increase of WHR and WHtR in women, respectively. In men, the risk of CVD increased by 4·0 % for each 10 cm increase of WC, and by 4·0 and 8·6 % for each 0·1 unit increase of WHR and WHtR, respectively. Collectively, abdominal obesity is associated with an increased risk of CVD. WC, WHR and WHtR are good indicators for the prediction of CVD.

Fe-deficiency anaemia is considered an important public health problem both in wealthier countries and in those of medium and low income, especially in children under 5 years of age. The shortage of studies with national representativity in medium-income countries, such as Brazil, prevents the knowledge of the current situation and its associated factors. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of Fe-deficiency anaemia in Brazilian children under 5 years of age and determined the factors involved in the variability of the estimates of prevalence. We collected fifty-seven studies from the databases MEDLINE, LILACS and Web of Science, along with the reference lists of included articles. We contacted authors for unpublished data. We did not restrict publication timespan and language. This systematic review and meta-analysis was reported according to the guidelines by PRISMA. The pooled prevalence of anaemia in Brazil was 40·2 (95 % CI 36·0, 44·8) %. The age range of the child and the period of data collection were associated with the anaemia prevalence. The pooled prevalence of anaemia was higher in children under 24 months of age (53·5 v. 30·7 %; P < 0·001) and in studies with data collected before 2004 (51·8 v. 32·6 %; P = 0·001). The efforts made by the Brazilian government were successful in the reduction of anaemia in children under 5 years of age in Brazil in the evaluated period. However, prevalence remains beyond acceptable levels for this population group.

In the present study, we analysed the effects of SNP rs174547 (T/C) in the fatty acid desaturase 1 (FADS1) gene on long-chain PUFA levels. Four databases were searched to retrieve related literature with keywords such as fatty acid (FA), SNP, FADS1 and rs174547. A meta-analysis of the data was performed using Stata12.0 software, including summary statistics, test for heterogeneity, evaluation of publication bias, subgroup analysis and sensitivity analysis. The associations between rs174547 in FADS1 and seven types of FA, and Δ-5 (D5D) and Δ-6 fatty acid desaturase (D6D) activity were assessed based on the pooled results from eleven papers. A total of 3713 individuals (1529 TT and 2184 TC + CC) were included. The results demonstrated that minor C allele carriers of rs174547 had higher linoleic acid (LA; P < 0·001) and α-linolenic acid (P = 0·020) levels, lower γ-linolenic acid (GLA; P = 0·001) and arachidonic acid (P = 0·024) levels, and lower D5D (P = 0·005) and D6D (P = 0·004) activities than the TT genotype group. Stratification analysis showed that minor C allele carriers of rs174547 had higher LA and lower GLA levels and lower D6D activities in plasma (LA, P < 0·001; GLA, P < 0·001; D6D activity, P < 0·001) samples and in Asian populations (LA, P < 0·001; GLA, P = 0·001; D6D activity, P = 0·001) than the TT genotype group. In conclusion, minor C allele carriers of the SNP rs174547 were associated with decreased activity of D5D and D6D.

Evidence suggests that eating nuts may reduce the risk of CVD. This study was intended to pool the data of all randomised controlled trials (RCT) available to determine if pistachios confer a beneficial effect on anthropometric indices, inflammatory markers, endothelial dysfunction and blood pressure. Without language restriction, PubMed, Scopus, Cochrane Library and Web of Science were searched for articles published from the earliest records to June 2019 investigating the effect of pistachio consumption on inflammation, endothelial dysfunction and hypertension. Mean difference (MD) was pooled using a random effects model. The Cochrane risk of bias tool was used to evaluate the quality of the studies. The meta-analysis of thirteen RCT with 563 participants indicated that pistachio consumption significantly decreased systolic blood pressure (SBP) (MD: −2·12 mmHg, 95 % CI −3·65, −0·59, P = 0·007), whereas changes in flow-mediated dilation (MD: 0·94 %, 95 % CI −0·99, 2·86, P = 0·813), diastolic blood pressure (MD: 0·32 mmHg, 95 % CI −1·37, 2·02, P = 0·707), C-reactive protein (MD: 0·00 mg/l, 95 % CI −0·21, 0·23, P = 0·942), TNF-α (MD: −0·09 pg/ml, 95 % CI −0·38, 0·20, P = 0·541), body weight (MD: 0·09 kg, 95 % CI −0·38, 0·69, P = 0·697), BMI (MD: 0·07 kg/m2, 95 % CI −0·16, 0·31, P = 0·553) and waist circumference (MD: 0·77 cm, 95 % CI −0·09, 1·64, P = 0·140) were not statistically significant. This systematic review and meta-analysis suggested the efficacy of pistachio consumption to reduce SBP levels. However, further large-scale studies are needed to confirm these results.

The effects of resistant starch on glycaemic control are controversial. In this study, a systematic review and meta-analysis of results from nineteen randomised controlled trials (RCT) was performed to illustrate the effects of resistant starch on glycaemic control. A literature search was conducted on PubMed, Scopus and Cochrane electronic databases for related publications from inception to 6 April 2020. Key inclusion criteria were: RCT; resistant starch as intervention substances and reporting glucose- and insulin-related endpoints. Exclusion criteria were: using type I resistant starch or a mixture of resistant starch and other functional food ingredients as intervention; using substances other than digestible starch as controls. The effect of resistant starch on fasting plasma glucose was significant (effect size (ES) –0·09 (95 % CI –0·13, −0·04) mmol/l, P = 0·001) compared with digestible starch. Subgroup analyses revealed that the ES was larger when the dosage of resistant starch was more than 28 g/d (ES –0·16 (95 % CI –0·24, –0·08) mmol/l, P < 0·001) or the intervention period was more than 8 weeks (ES –0·12 (95 % CI –0·18, –0·06) mmol/l, P < 0·001). The effect on homoeostatic model assessment (HOMA)-insulin resistance (IR) was significant (ES –0·33 (95 % CI –0·51, –0·14), P = 0·001). However, the effects on other insulin-related endpoints were not significant, including fasting plasma insulin, four endpoints from the frequently sampled intravenous glucose tolerance test (insulin sensitivity index, acute insulin response, disposition index and glucose effectiveness) and HOMA-β. The current study indicated moderate effects of resistant starch on improving glycaemic control.

Although grape polyphenols can decrease chronic inflammations, their effect on C-reactive protein (CRP) levels is still controversial. So, this meta-analysis was conducted to investigate the effect of grape products containing polyphenols on CRP concentrations. In order to collect the relevant randomised controlled trials (RCT), the databases of PubMed, Scopus, Web of Science and Google Scholar were searched up to 30 March 2020. The random effects model, standardised mean difference (SMD) and 95 % CI were applied in data analysis. Meta-analysis was conducted over seventeen eligible RCT containing a total of 668 participants. The study registration number is CRD42018110169. Based on the results, grape products containing polyphenols decreased CRP levels significantly (SMD = −0·229; 95 % CI −0·41, −0·05; P = 0·013). Sensitivity analysis was performed by removing each individual study and the results did not change. According to the subgroup analysis, higher doses of grape polyphenols (>500 mg/d) and longer intervention periods (≥12 weeks) had significant effects on CRP levels. Furthermore, grape polyphenols significantly reduced the CRP levels in patients with a clinical condition. In the same vein, grape seed extract and other grape products, such as grape extract, juice and raisins, decreased CRP levels significantly. According to the meta-regression results, the CRP level depends on the dose and duration of the grape polyphenol supplementation. Based on the findings, grape products containing polyphenols had a significant effect on CRP levels. Further well-designed and long-term clinical trials are highly recommended to achieve more comprehensive and accurate results.

Olive oil consumption has been suggested to be inversely associated with breast cancer risk, probably due to its high MUFA and polyphenol content. The purpose of this meta-analysis was to assess the association between olive oil and breast cancer risk, including assessing the potential for a dose–response association. We performed a systematic search of PubMed, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials through June 2020, identifying ten observational studies (two prospective studies and eight case–control studies) for meta-analysis. We estimated summary OR and 95 % CI for the highest v. lowest olive oil intake category across studies using random effect models and assessed the dose–response relationship between olive oil and breast cancer risk using restricted cubic splines. The summary OR comparing women with the highest intake to those with the lowest category of olive oil intake was 0·48 (95 % CI 0·09, 2·70) in prospective studies and 0·76 (95 % CI 0·54, 1·06) in case–control studies, with evidence of substantial study heterogeneity (prospective I2 = 89 %, case–control I2 = 82 %). There was no significant dose–response relationship for olive oil and breast cancer risk; the OR for a 14 g/d increment was 0·93 (95 % CI 0·83, 1·04). There may be a potential inverse association between olive oil intake and breast cancer; however, since the estimates are non-significant and the certainty level is very low, additional prospective studies with better assessment of olive oil intake are needed.

Inflammation is a major cause of chronic diseases. Several studies have investigated the effects of soya intake on inflammatory biomarkers; however, the results are equivocal. The aim of this study was to conduct a systematic review and meta-analysis of clinical trials that evaluated the effect of soya consumption on inflammatory biomarkers. Medline, Scopus, ISI Web of Science and Google Scholar were systematically searched, up to and including May 2020, for clinical trials that evaluated the effects of soya and soya products on TNF-α, IL-6, IL-2, IL-1β and interferon γ (IFN-γ) in adults. A random effects method was used to calculate overall effects, and subgroup analyses were performed to discern probable sources of inter-study heterogeneity. A total of twenty-eight clinical trials were included. Although soya consumption reduced TNF-α (Hedges’ g = –0·28; 95 % CI –0·49, –0·07), it had no significant effect on IL-6 (Hedges’ g = 0·07, 95 % CI –0·14, 0·28), IL-2 (mean difference (MD) = –1·38 pg/ml; 95 % CI –3·07, 0·31), IL-1β (MD = –0·02 pg/ml; 95 % CI –0·08, 0·03) and IFN-γ (MD = 1685·82 pg/ml; 95 % CI –1604·86, 4976·50). Subgroup analysis illustrated a reduction in TNF-α in parallel designed studies, at dosages ≥100 mg of isoflavones, and in unhealthy subjects. The present study showed that high doses of isoflavones in unhealthy subjects may yield beneficial effects on TNF-α.

Polycystic ovary syndrome (PCOS) is defined as a reproductive endocrine disease that results in a low-grade inflammatory and pro-oxidant state. Dietary factors, including n-3 fatty acids, may have a key role in improving metabolic disorders in PCOS patients. The present study aimed to investigate the influence of n-3 fatty acid supplementation on inflammatory and oxidative stress (OS) markers in patients with PCOS. A systematic literature search of Medline/PubMed, Cochrane Central Register of Controlled Trials, Scopus and Lilacs, until November 2019, was conducted. Randomised clinical trials that reported inflammatory and OS markers as endpoints in women with PCOS receiving n-3 fatty acid supplementation were included. The pooled estimates of the weighted mean differences (WMD) and the standard mean differences (SMD) were calculated. Random effects models were adopted to measure the pooled outcomes. Among the 323 studies retrieved, ten fulfilled the inclusion criteria for a meta-analysis. We founded a significant decrease in high-sensitivity C-reactive protein (hs-CRP) (SMD –0·29 (95 % CI –0·56, –0·02) mg/l) and an increase in adiponectin (WMD 1·42 (95 % CI 1·09, 1·76) ng/ml) concentrations in the intervention group when compared with the placebo group. No statistically significant results were found in the meta-analysis for visfatin, nitric oxide, GSH or malondialdehyde levels or total antioxidant capacity. The data suggest that supplementation of n-3 fatty acids could reduce the inflammatory state in women with PCOS, through a decrease in hs-CRP and an increase in adiponectin levels.

The aim of this study was to determine the effects of Mg supplementation on anthropometric indices consisting of body weight, waist circumference (WC), BMI and body fat percentage. In this systematic review and dose–response meta-analysis, we searched PubMed, Cochrane Library, Scopus, Web of Science and Google Scholar from databases inception up to February 2020 for relevant randomised controlled trials. Quality of evidence was evaluated using the Cochrane Collaboration Tool. All the outcomes of this meta-analysis were pooled using the random effect model. Analysis of dose–response for Mg dosage was carried out using a fractional polynomial model. The systematic review and meta-analysis include twenty-eight randomised clinical trials, comprising 2013 participants. There were no significant changes in anthropometric indices after Mg supplementation in the overall analysis. However, subgroup analysis revealed that Mg supplementation decreases WC in subjects with BMI > 30 kg/m2 (obese) (twelve trials, n 997 participants; weighted mean difference = –2·09 cm, 95 % CI –4·12, –0·07, P = 0·040; I2 = 0 %). Dose–response analysis revealed a non-significant non-linear effect of supplementation dosage on anthropometric indices. The results suggest that Mg supplementation is associated with lower WC only in obese subjects. However, more high-quality studies are needed to clarify the nature of this association.

We aimed to fully review the association of empirical dietary patterns with the risk of non-communicable chronic diseases and to rate the quality of the evidence. Published meta-analyses of observational studies investigating the association of empirically derived dietary patterns with the risk of chronic diseases were identified by searching PubMed and Scopus till September 2019. Two independent reviewers extracted the information and rated the quality of the evidence by NutriGrade score. For each meta-analysis, cross-sectional and case–control studies were excluded and then summary relative risk was recalculated by using a random-effects model. Sixteen meta-analyses of prospective cohort studies, reporting eighteen SRR for healthy dietary patterns and sixteen SRR for unhealthy patterns obtained from 116 primary prospective cohort studies with 4·8 million participants, were included. There was moderate quality of evidence for the inverse association of healthy dietary patterns with the risk of type 2 diabetes (T2D), fracture and colorectal and breast cancers. There was also low-quality evidence for the inverse relation between healthy dietary patterns and the risk of all-cause and cardiovascular mortality, depression, CHD and respiratory diseases. There was moderate quality of evidence for a positive association between unhealthy dietary patterns and the risk of T2D, fracture and the metabolic syndrome. Adopting a healthy dietary pattern may reduce the risk of T2D, CHD and premature death. More research is needed for outcomes for which the quality of the evidence was rated low, such as respiratory disease, mental illness and site-specific cancers.

β-Glucan has been reported for its health benefits on blood lipids in hypercholesterolaemic individuals for years. However, people have paid little attention to the effects of β-glucan in populations with mild hypercholesterolaemia as well as the various delivering matrices. Our objective was to perform a meta-analysis to analyse the effects of β-glucan with different delivering matrices in mildly hypercholesterolaemic individuals. After conducting a comprehensive search in Web of Science, PubMed, Scopus and Cochrane Library, a total of twenty-one randomised controlled trials involving 1120 participants were identified to measure the pooled effect. The overall results indicated that consuming a dose of ≥3 g/d of β-glucan for at least 3 weeks could significantly reduce total cholesterol (TC) (−0·27 mmol/l, 95 % CI −0·33, −0·21, P < 0·001) and LDL-cholesterol (−0·26 mmol/l, 95% CI −0·32, −0·20, P < 0·001) compared with the control group in mildly hypercholesterolaemic individuals, while no significant difference was observed in TAG (−0·03 mmol/l, 95% CI −0·11, 0·06, P = 0·521) and HDL-cholesterol (0·01 mmol/l, 95% CI −0·03, 0·04, P = 0·777). There was evidence for modest unexplained heterogeneity in the meta-analysis. In conclusion, β-glucan can significantly reduce risk factors like TC and LDL-cholesterol for CVD in mildly hypercholesterolaemic individuals; furthermore, it appears that the effects of food matrices with both ‘solid products’ and ‘liquid products’ where β-glucan was incorporated into were ranked as the best way to exert its beneficial properties, while ‘liquid’ and ‘solid’ products were ranked as the second and third positions, respectively.

Type 2 diabetes mellitus is a chronic disease increasing in global prevalence. Although habitual consumption of walnuts is associated with reduced risk of CVD, there is inconsistent evidence for the impact of walnut consumption on markers of glycaemic control. This systematic review and meta-analysis aimed to examine the effect of walnut consumption on markers of blood glucose control. A systematic search of Medline, PubMed, CINAHL and Cochrane databases (to 2 March 2019) was conducted. Inclusion criteria were randomised controlled trials conducted with adults which assessed the effect of walnut consumption on fasting blood glucose and insulin, glycated Hb and homeostatic model assessment of insulin resistance. Random effects meta-analyses were conducted to assess the weighted mean differences (WMD) for each outcome. Risk of bias in studies was assessed using the Cochrane Risk of Bias tool 2.0. Sixteen studies providing eighteen effect sizes were included in the review. Consumption of walnuts did not result in significant changes in fasting blood glucose levels (WMD: 0·331 mg/dl; 95 % CI −0·817, 1·479) or other outcome measures. Studies were determined to have either ‘some concerns’ or be at ‘high risk’ of bias. There was no evidence of an effect of walnut consumption on markers of blood glucose control. These findings suggest that the known favourable effects of walnut intake on CVD are not mediated via improvements in glycaemic control. Given the high risk of bias observed in the current evidence base, there is a need for further high-quality randomised controlled trials.

We conducted a meta-analysis of randomised controlled trials (RCT) to examine the effects of strawberry interventions on cardiovascular risk factors. We searched multiple databases including PubMed, Web of Science and Scopus to identify eligible studies published before 19 May 2019. The endpoints were blood pressure, total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, TAG, fasting blood glucose, endothelial function and inflammatory factors. Pooled analyses were performed using random- or fixed-effects models according to a heterogeneity test. We also conducted sub-group analyses by baseline endpoint levels. We included eleven RCT in this meta-analysis (six for blood pressure, seven for lipid profile, seven for fasting blood glucose and six for C-reactive protein (CRP)). Overall, the strawberry interventions significantly reduced CRP levels by 0·63 (95 % CI −1·04, −0·22) mg/l but did not affect blood pressure, lipid profile or fasting blood glucose in the main analyses. Our analysis stratified by baseline endpoint levels showed the strawberry interventions significantly reduced TC among people with baseline levels >5 mmol/l (−0·52 (95 % CI −0·88, −0·15) mmol/l) and reduced LDL-cholesterol among people with baseline levels >3 mmol/l (−0·31 (95 % CI −0·60, −0·02) mmol/l). There was little evidence of heterogeneity in the analysis and no evidence of publication bias. In summary, strawberry interventions significantly reduced CRP levels and may improve TC and LDL-cholesterol in individuals with high baseline levels.

Findings for the roles of dairy products, Ca and vitamin D on ovarian cancer risk remain controversial. We aimed to assess these associations by using an updated meta-analysis. Five electronic databases (e.g. PubMed and Embase) were searched from inception to 24 December 2019. Pooled relative risks (RR) with 95 % CI were calculated. A total of twenty-nine case–control or cohort studies were included. For comparisons of the highest v. lowest intakes, higher whole milk intake was associated with increased ovarian cancer risk (RR 1·35; 95 % CI 1·15, 1·59), whereas decreased risks were observed for higher intakes of low-fat milk (RR 0·84; 95 % CI 0·73, 0·96), dietary Ca (RR 0·71; 95 % CI 0·60, 0·84) and dietary vitamin D (RR 0·80; 95 % CI 0·67, 0·95). Additionally, for every 100 g/d increment, increased ovarian cancer risks were found for total dairy products (RR 1·03; 95 % CI 1·01, 1·04) and for whole milk (RR 1·07; 95 % CI 1·03, 1·11); however, decreased risks were found for 100 g/d increased intakes of low-fat milk (RR 0·95; 95 % CI 0·91, 0·99), cheese (RR 0·87; 95 % CI 0·76, 0·98), dietary Ca (RR 0·96; 95 % CI 0·95, 0·98), total Ca (RR 0·98; 95 % CI 0·97, 0·99), dietary vitamin D (RR 0·92; 95 % CI 0·87, 0·97) and increased levels of circulating vitamin D (RR 0·84; 95 % CI 0·72, 0·97). These results show that whole milk intake might contribute to a higher ovarian cancer risk, whereas low-fat milk, dietary Ca and dietary vitamin D might reduce the risk.