The available information favours a greater impact of environmental exposures on intestinal type gastric cancer, and risk factors for the cardia and distal stomach cancers also appear to be different. We aimed to estimate the association between fruit and vegetable intake and gastric cancer, by location and histological type. We performed a population-based case–control study and a meta-analysis of studies addressing this issue. Incident cases (n=305) were identified in two large teaching hospitals (Porto, Portugal), and controls were randomly sampled among city dwellers (n=1129). Published studies were searched through PubMed, and effects were combined with random effects meta-analysis. In our case–control study, the odds ratio (OR) for the comparison of the highest vs. lowest tertile of fruit consumption was 0.47 [95% confidence interval (CI): 0.21–1.05] for cardia, 0.53 (95% CI: 0.35–0.80) for non-cardia cancer, 0.36 (95% CI: 0.20–0.62) for intestinal, and 1.00 (95% CI: 0.53–1.90) for the diffuse histological type. For vegetables, the corresponding OR was 0.59 (95% CI: 0.26–1.35), 0.85 (95% CI: 0.58–1.26), 0.95 (95% CI: 0.57–1.57), and 0.60 (95% CI: 0.32–1.14). In meta-analysis, considering fruit consumption (highest vs. lowest category), the combined OR was 0.58 (95% CI: 0.38–0.89) for cardia, 0.61 (95% CI: 0.44–0.84) for non-cardia, 0.49 (95% CI: 0.33–0.72) for intestinal type, and 0.82 (95% CI: 0.57–1.20) for diffuse type. Vegetables also decreased the risk of cardia (OR=0.63, 95% CI: 0.50–0.79), non-cardia (OR=0.75, 95% CI: 0.59–0.95), intestinal (OR=0.61, 95% CI: 0.44–0.86), and diffuse type (OR=0.67, 95% CI: 0.44–1.01). Fruit or vegetable intake was associated with a decreased risk of gastric cancer regardless of the anatomical location and the histological type, although dietary intake had a more clear-cut protective effect on intestinal type cancers.

Objective: To summarize the recommendations on folate intake and folic acid supplementation and fortification in the periconceptional period, aimed at prevention of neural tube defects (NTD), provided by official health organizations in different countries worldwide and WHO.Design: Information on recommendations for folate and folic acid intake in the periconceptional period was gathered from the websites of official national health organizations of several countries worldwide and from the WHO website.Setting: WHO, selected developed countries and emerging economies, totalling thirty-six countries worldwide (some European, BRICS, G8, Asian Tiger/Asian Dragon and Australia).Results: Recommendations differ between countries, although the majority (69·4 %) recommend a healthy diet plus a folic acid supplement of 400 µg/d from preconception (4–12 weeks) until the end of the first trimester of pregnancy (8–12 weeks). The same recommendation is issued by the WHO. Dosages for women at high risk of NTD are up to 4–5 mg/d (for 41·7 % of studied countries). The recommended intake for folate is in the range of 300–400 µg/d for women of childbearing age and 500–600 µg/d for pregnant women in different countries and WHO. Five countries emphasize the importance of a healthy diet rendering supplementation needless. By contrast, five others advise a healthy diet and supplementation plus mandatory fortification. Only one mentions the importance of ensuring an adequate folate status and refers to checking with a health-care provider on the need for supplements.Conclusions: Different recommendations regarding folate and folic acid, seeking NTD prevention, are available worldwide; however, most countries and WHO focus on a healthy diet and folic acid supplementation of 400 µg/d periconceptionally.

Background: Fruit and vegetable intake in children remains below recommendations in many countries. The long-term effects of early parental feeding practices on fruit and vegetable intake are not clearly established.