***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Because fruits and vegetables are rich in bioactive compounds with potential cancer-preventive actions , increased consumption may reduce the risk of ovarian cancer . Evidence on the association between fruit and vegetable intake and  ovarian cancer risk  has not been consistent . We analyzed and pooled the primary data from 12 prospect i ve studies in North America and Europe .  Fruit and vegetable intake  was measured at baseline in each study using a vali date d food-frequency question naire . To summarize the association between fruit and vegetable intake and ovarian cancer , study -specific relative risks ( RR ) were estimated using the Cox proportional hazards model , and then combined using a r and om-effects model . Among 560,441 women , 2,130 cases of invasive epithelial ovarian cancer occurred during a maximum follow-up of 7 to 22 years across studies . Total fruit intake was not associated with ovarian cancer risk — the pooled multivariate RR for the highest versus the lowest quartile of intake was 1.06 [ 95 % confidence interval ( 95 % CI ) , 0.92 - 1.21 ; P value , test for trend = 0.73 ; P value , test for between- studies heterogeneity = 0.74 ] . Similarly , results for total vegetable intake indicated no significant association ( pooled multivariate RR , 0.90 ; 95 % CI , 0.78 - 1.04 , for the highest versus the lowest quartile ; P value , test for trend = 0.06 ; P value , test for between- studies heterogeneity = 0.31 ) . Intakes of botanically defined fruit and vegetable groups and individual fruits and vegetables were also not associated with ovarian cancer risk . Associations for total fruits and vegetables were similar for different histologic types . These results suggest that fruit and vegetable consumption in adulthood has no important association with the risk of ovarian cancer Background A series of recent reports from large-scale cohort studies involving more than 100,000 subjects reported no or only very small inverse associations between fruit and vegetable intake and overall cancer incidence , despite having sufficient power to do so . To date , however , no such data have been reported for Asian population s. Objective To provide some indication of the net impact of fruit and vegetable consumption on overall cancer prevention , we examined these associations in a pooled analysis of large-scale cohort studies in Japanese population s. Methods We analyzed original data from four cohort studies that measured fruit and vegetable consumption using vali date d question naires at baseline . Hazard ratios ( HRs ) in the individual studies were calculated , with adjustment for a common set of variables , and combined using a r and om-effects model . Results During 2,318,927 person-years of follow-up for a total of 191,519 subjects , 17,681 cases of overall cancers were identified . Consumption of fruit or vegetables was not associated with decreased risk of overall cancers : corresponding HRs for the highest versus lowest quartiles of intake for men and women were 1.03 ( 95 % CI , 0.97–1.10 ; trend p = 1.00 ) and 1.03 ( 95 % CI , 0.95–1.11 ; trend p = 0.97 ) , respectively , for fruit and 1.07 ( 95 % CI , 1.01–1.14 ; trend p = 0.18 ) and 0.98 ( 95 % CI , 0.91–1.06 ; trend p = 0.99 ) , respectively , for vegetables , even in analyses stratified by smoking status and alcohol drinking . Conclusions The results of this pooled analysis do not support inverse associations of fruit and vegetable consumption with overall cancers in the Japanese population Abstract Objective To assess the prospect i ve associations between consumption of ultra-processed food and risk of cancer . Design Population based cohort study . Setting and participants 104 980 participants aged at least 18 years ( median age 42.8 years ) from the French NutriNet-Santé cohort ( 2009 - 17 ) .  Dietary intakes were collected using repeated 24 hour dietary records , design ed to register participants ’ usual consumption for 3300 different food items . These were categorised according to their degree of processing by the NOVA classification . Main outcome measures Associations between ultra-processed food intake and risk of overall , breast , prostate , and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors . Results Ultra-processed food intake was associated with higher overall cancer risk ( n=2228 cases ; hazard ratio for a 10 % increment in the proportion of ultra-processed food in the diet 1.12 ( 95 % confidence interval 1.06 to 1.18 ) ; P for trend<0.001 ) and breast cancer risk ( n=739 cases ; hazard ratio 1.11 ( 1.02 to 1.22 ) ; P for trend=0.02 ) . These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet ( lipid , sodium , and carbohydrate intakes and /or a Western pattern derived by principal component analysis ) . Conclusions In this large prospect i ve study , a 10 % increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10 % in risks of overall and breast cancer . Further studies are needed to better underst and the relative effect of the various dimensions of processing ( nutritional composition , food additives , contact material s , and neoformed contaminants ) in these associations . Study registration Clinical trials.gov NCT03335644 OBJECTIVE Assumptions have linked orange juice ( OJ ) consumption with weight gain and adverse effects on health due to its sugar content ; however , epidemiologic studies have not shown increased risk for overweight or obesity with the consumption of 100 % OJ . The aim of this study was to verify whether the combination of a reduced-calorie diet ( RCD ) and 100 % OJ contribute to weight loss , promote changes in glucose and lipid metabolism , and improve diet quality in obese individuals . METHODS A r and omized controlled trial with 78 obese patients ( age 36 ± 1 y , body mass index [ BMI ] 33 ± 3 kg/m2 ) were enrolled in two groups : Individuals in the OJ group su bmi tted to an RCD that included OJ ( 500 mL/d ) , and individuals in the control group su bmi tted to an RCD without OJ . Body composition , biochemical biomarkers , and dietary intake were analyzed over a 12-wk period . RESULTS Both treatments had similar outcomes regarding body weight ( -6.5 kg ; P = 0.363 ) , BMI ( -2.5 kg/m2 ; P = 0.34 ) , lean mass ( -1 kg ; P = 0.29 ) , fat mass ( -5 kg ; P = 0.58 ) , body fat ( -3 % ; P = 0.15 ) , and waist-to-hip ratio ( -0.1 ; P = 0.79 ) . Insulin levels in the OJ group decreased by 18 % ( P = 0.05 ) , homeostasis model assessment -insulin resistance by 33 % ( P = 0.04 ) , total cholesterol by 24 % ( P = 0.004 ) , low-density lipoprotein cholesterol by 24 % ( P ≤ 0.001 ) , and high-sensitivity C-reactive protein levels by 33 % ( P = 0.001 ) compared with the control group . Consumption of energy and nutrients was similar between the two groups , but vitamin C and folate increased by 62 % ( P ≤ 0.015 ) and 39 % ( P = 0.033 ) , respectively , after OJ intervention . CONCLUSION When consumed concomitantly with an RCD , OJ does not inhibit weight loss ; ameliorate the insulin sensitivity , lipid profile , or inflammatory status , or contribute nutritionally to the quality of the diet The association between drinking 100 % fruit juice and long-term weight gain is controversial and has been investigated in few studies . We examined whether 100 % fruit juice consumption was associated with weight change in a large prospect i ve cohort of postmenopausal women . We analyzed data from 49,106 postmenopausal women in the United States enrolled in the Women 's Health Initiative between 1993 and 1998 . Food frequency question naires at baseline and year 3 assessed food and beverage intake . Body weight was measured at in-person clinic visits . We used linear mixed effects modeling to determine the association between change in 100 % fruit juice consumption and 3-year weight change over the same time period . Covariates of interest included age , demographic factors , smoking , body mass index , hormone replacement therapy , lifestyle factors , change in whole fruit intake , and change in sugar-sweetened beverage intake . The mean weight change was 3.2 lbs . over 3 years . In multivariable adjusted analyses , each 1 serving/day increase in 100 % fruit juice intake was associated with a 3-year weight gain of 0.39 lbs . ( 95 % confidence interval : 0.10 , 0.69 ) . In conclusion , an increase in 100 % fruit juice consumption was associated with a small amount of long-term weight gain in postmenopausal women The importance of vegetable and fruit intakes for the prevention of  fracture in older women is not well understood . Few studies have explored vegetable and fruit intakes separately , or the associations of specific types of vegetables and fruits with fracture hospitalisations . The objective of this study was to examine the associations of vegetable and fruit intakes , separately , and specific types of vegetables and fruits with fracture-related hospitalisations in a prospect i ve cohort of women aged ≥70 years .  Vegetable and fruit intakes were assessed at baseline ( 1998 ) in 1468 women using a food frequency question naire .  The incidence of fracture-related hospitalisations over 14.5 years of follow-up was determined using the Hospital Morbidity Data Collection , linked via the Western Australian Data Linkage System . Fractures were identified in 415 ( 28.3 % ) women , of which 158 ( 10.8 % ) were hip fractures . Higher intakes of vegetables , but not fruits , were associated with lower fracture incidence . In multivariable-adjusted models for vegetable types , cruciferous and allium vegetables were inversely associated with all fractures , with a hazard ratio ( HR ) ( 95 % confidence interval ) of 0.72 ( 0.54 , 0.95 ) and 0.66 ( 0.49 , 0.88 ) , respectively , for the highest vs. lowest quartiles . Increasing vegetable intake , with an emphasis on cruciferous and allium vegetables , may prevent fractures in older postmenopausal women Dietary recommendations to promote health include fresh , frozen and tinned fruit , but few studies have examined the health benefits of tinned fruit . We therefore studied the association between tinned fruit consumption and mortality . We followed up participants from three prospect i ve cohorts in the United Kingdom : 22,421 participants from the European Prospect i ve Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort ( 1993–2012 ) , 52,625 participants from the EPIC-Oxford cohort ( 1993–2012 ) , and 7440 participants from the Whitehall II cohort ( 1991–2012 ) , all reporting no history of heart attack , stroke , or cancer when entering these studies . We estimated the association between frequency of tinned fruit consumption and all cause mortality ( primary outcome measure ) using Cox regression models within each cohort , and pooled hazard ratios across cohorts using r and om-effects meta- analysis .  Tinned fruit consumption  was assessed with vali date d food frequency question naires including specific questions about tinned fruit . During 1,305,330 person years of follow-up , 8857 deaths  occurred . After adjustment for lifestyle factors and risk markers the pooled hazard ratios ( 95 % confidence interval ) of all cause mortality compared with the reference group of tinned fruit consumption less often than one serving per month were : 1.05 ( 0.99 , 1.12 ) for one to three servings per month , 1.10 ( 1.03 , 1.18 ) for one serving per week , and 1.13 ( 1.04 , 1.23 ) for two or more servings per week . Analysis of cause-specific mortality showed that tinned fruit consumption was associated with mortality from cardiovascular causes and from non-cardiovascular , non-cancer causes . In a pooled analysis of three prospect i ve cohorts from the United Kingdom self-reported tinned fruit consumption in the 1990s was weakly but positively associated with mortality during long-term follow-up . These findings raise questions about the evidence underlying dietary recommendations to promote tinned fruit consumption as part of a healthy diet OBJECTIVE Our purpose was to measure the agreement , reliability , construct validity , and feasibility of a measurement tool to assess  systematic review s ( AMSTAR ) . STUDY DESIGN AND SETTING We r and omly selected 30 systematic review s from a data base . Each was assessed by two review ers using : ( 1 ) the enhanced quality assessment question naire ( Overview of Quality Assessment Question naire [ OQAQ ] ) ; ( 2 ) Sacks ' instrument ; and ( 3 ) our newly developed measurement tool ( AMST 
    Output:
    
RESULTS The results showed that the degree of processing influences the health effects of fruit-based products .
Fresh and dried fruits appeared to have a neutral or protective effect on health , 100 % fruit juices had intermediary effects , and high consumption of canned fruit and sweetened fruit juice was positively associated with the risk of all-cause mortality and type 2 diabetes , respectively .