Cancer is the second leading cause of mortality in older adults, and it is considered a major age-related disease in the United States and Europe.
Accelerated aging and cancer development appear to be promoted by some of the same lifestyle-risk factors, such as low physical activity and an unhealthy diet.
Few cancers, such as lung cancer, can have preventive recommendations like smoking cessation, and other cancer-preventive treatments are largely restricted to vaccinations and screening methods.
But we lack the invention that would specifically note the small additive benefits of several public health strategies.
Although novel cancer treatments aim to block multiple pathways for cancer development by combining several agents, this concept has not been translated into cancer prevention.
In a new study, Bischoff-Ferrari and her colleagues wanted to fill these knowledge gaps by testing the effect of daily high-dose vitamin D3 (one form of vitamin D supplements), daily supplemental omega-3s, and a simple home exercise program, alone and in combination, on the risk of invasive cancer among adults aged 70 or older.
For the study, the researchers conducted the DO-HEALTH trial: a three-year trial in five European countries (Switzerland, France, Germany, Austria, and Portugal) with 2,157 participants.
“The aim of the present exploratory trial among 2,157 generally healthy adults aged 70 and older was to address these knowledge gaps by testing the effect of daily high-dose vitamin D3, daily supplemental omega-3s, and a simple home exercise program (SHEP), alone and in combination, on the risk of any invasive cancer among adults aged 70 and older.” Study mentions.
“In DO-HEALTH, our aim was to test promising combined interventions for cancer prevention taking advantage of potentially small additive benefits from several public health strategies,” explained Bischoff-Ferrari. “In fact, novel cancer treatments aim to block multiple pathways for cancer development by combining several agents. We translated this concept into cancer prevention.”
Study Methodology
The participants were randomized into eight different groups to test the individual and combined benefits of the interventions: group one received 2,000 IU per day of Vitamin D3 (equivalent to > 200% of the amount of current recommendations for older adults, which is 800 IU per day), 1g per day of omega-3s, and three times per week SHEP; group two vitamin D3 and omega-3s; group three vitamin D3 and SHEP; group four omega-3s and SHEP; group five vitamin D3 alone; group six omega-3s alone; group seven SHEP alone; and the last group received a placebo.
Participants received check-up phone calls every three months and had standardized examinations of health and function in the trial centers at baseline, year one, year two, and year three.
Simple treatments, promising results
The results show that all three treatments (vitamin D3, omega-3s, and SHEP) had cumulative benefits on the risk of invasive cancers.
Each of the treatments had a small individual benefit, but when all three treatments were combined, the benefits became statistically significant, and the researchers saw an overall reduction in cancer risk by 61%.
“This is the first randomized controlled trial to show that the combination daily vitamin D3, supplemental marine omega-3s, and a simple home exercise program may be effective in the prevention of invasive cancer among generally healthy and active adults aged 70 and older,” Bischoff-Ferrari commented.
Limitations of Study
- The trial size may be considered small for a cancer endpoint trial.
- The duration of the trial would be considered short. In general, many years may be needed to see the effects of decreasing exposures involved in the early stages of carcinogenesis.
Futuristic view of study
The results may impact the future of invasive cancer prevention in older adults. Bischoff-Ferrari concluded: “Our results, although based on multiple comparisons and requiring replication, may prove to be beneficial for reducing the burden of cancer.”
“Future studies should verify the benefit of combined treatments in the prevention of cancer, also extending to longer follow-ups beyond the three-year duration assessed in this trial.”
Journal Reference
- Heike A. Bischoff-Ferrari, Walter C. Willett, JoAnn E. Manson, Bess Dawson-Hughes, Markus G. Manz, Robert Theiler, Kilian Braendle, Bruno Vellas, René Rizzoli, Reto W. Kressig, Hannes B. Staehelin, José A. P. Da Silva, Gabriele Armbrecht, Andreas Egli, John A. Kanis, Endel J. Orav and Stephanie Gaengler, DO-HEALTH Research Group; Combined Vitamin D, Omega-3 Fatty Acids, and a Simple Home Exercise Program May Reduce Cancer Risk Among Active Adults Aged 70 and Older: A Randomized Clinical Trial. Front. Aging, 25 April 2022 | DOI: 10.3389/fragi.2022.852643