Combination of Public Health Interventions May Significantly Reduce Invasive Cancer Risk Among Elderly Adults


Study shows high-dose vitamin D, omega-3s, and a simple home strength exercise program led to a cumulative reduction in cancer risk by 61% in healthy adults 70 years of age and older.

Combining 3 affordable public health interventions was found to significantly reduce the risk of invasive cancers in healthy older adults, in a study published in Frontiers in Aging. The study investigators found that a combination of high-dose vitamin D, omega-3s, and a simple home strength exercise program (SHEP) led to a cumulative reduction in cancer risk by 61% in healthy adults 70 years of age and older.

The study findings, which are the first to illustrate the combined benefits of these public health interventions in preventing invasive cancers, may impact the future of cancer prevention in older adults, according to the study investigators. They noted prior prevention efforts in this population did not examine the impact of simple public health measures.

“Preventive efforts in middle-aged and older adults today are largely limited to screening and vaccination efforts,” Heike Bischoff-Ferrari, University Hospital Zurich, said in a press release.

Previous studies have highlighted how vitamin D may help prevent the growth of cancer cells; how omega-3 may hinder the transformation of normal cells into cancer cells; and have shown that exercise improves immune function and decreases inflammation, all of which may help in the prevention of cancer. However, there was a lack of robust clinical studies showing the efficacy of these 3 interventions, alone or combined.

The investigators tested the effect of daily high-dose vitamin D3, daily supplemental omega-3s, and a home exercise program, alone and in combination, on the risk of invasive cancer among adults 70 years of age and older. DO-HEALTH was a 3-year trial conducted in 5 European countries with 2157 participants.

“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,” Bischoff-Ferrari said in the press release. “In fact, novel cancer treatments aim to block multiple pathways for cancer development by combining several agents. We translated this concept into cancer prevention.”

The participants were randomized into 8 different groups to test the individual and combined benefit of the interventions:

  • Group 1 received 2000 IU per day of vitamin D3, 1 gram per day of omega-3s, and 3 times per week SHEP.
  • Group 2 received 2 vitamin D3 and omega-3s.
  • Group 3 received vitamin D3 and SHEP.
  • Group 4 received 4 omega-3s and SHEP.
  • Group 5 received vitamin D3 alone.
  • Group 6 received omega-3s alone.
  • Group 7 received SHEP alone.
  • Group 8 received a placebo.

Check-up phone calls every 3 months and standardized examinations of health and function in the trial centers at baseline were conducted for participants in year 1, year 2, and year 3.

All 3 treatments (vitamin D3, omega-3s, and SHEP) were found to have cumulative benefits on the risk of invasive cancers. Each treatment had a small individual benefit, but when all 3 treatments were combined, the benefits became statistically significant, with an overall reduction in cancer risk by 61%, according to the investigators.

“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 said in the press release.

The study authors concluded that although the results were based on multiple comparisons and required replication, they may prove beneficial in 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,” Bischoff-Ferrari said in the press release.


A combination of three simple treatments may reduce invasive cancer risk by 61% among adults aged 70+. EurekAlert! April 25, 2022. Accessed April 27, 2022.

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