Zie ook in gerelateerde artikelen meer artikelen gerelateerd aan preventie van kanker

5 februari 2025: Bron: Europese DO-Health studie  

Kanker is voor ouderen in de leeftijd van 70 plus voor 40 tot 60 procent te voorkomen met een combinatie van vitamine D Omega-3 vetzuren en een eenvoudig thuisoefenprogramma (SHEP) zo blijkt uit een analyse van 3 jaar bij totaal 2,157 deelnemers aan een gerandomiseerde studie als onderdeel van de doorlopende Europese DO-Health studie . Van de deelnemers was de gemiddelde leeftijd 74.9 jaar; 61.7% vrouw; 40.7% met 25-OH vitamine D waarde onder 20 /ml, 83% was op z'n minst matig lichamelijk actief.

Over een mediane follow-up van 2.99 jaren, werden 81 patiënten met invasieve kanker gediagnosteerd en officieel vastgesteld. Zie karakteristieken van alle deelnemers in onderstaande grafiek. (tekst gaat verder onder grafiek)

www.frontiersin.org

Specifieke vormen van kanker en overlijden aan kanker:

Met betrekking tot vooraf gespecificeerde vormen van kanker zie (Table 2), waren de aantallen laag en moeten met voorzichtigheid worden bekeken om daaruit conclusies te trekken. Geen van de drie genoemde middelen / behandelingen verminderde het aantal spijsverteringskanker (n = 22) of borstkanker bij vrouwen (n = 13). Echter omega-3 alleen [HR 95% CI = 0.17 (0.04–0.75); 2 vs. 12 gevallen] en in combinatie met het thuisprogramma SHED zou de kans op prostaatkanker verminderen [HR 95% CI = 0.12 (0.02–0.74); 0 vs. 6 gevallen] (n = 14). Overlijden aan kanker was geen doel op zich en daar waren slechts 8 overlijdens. (Supplementary Figure S1).


Resultaten zoals in abstract weergegeven:

Voor de drie genoemde niet toxische middelen geeft de adjusted hazard ratios (HRs, 95% CI, gevallen van kanker tussen interventie en controlegroep) waren 0.76 (0.49–1.18; 36 vs. 45) voor vitamin D
3,
0.70 (0.44–1.09, 32 vs. 49) voor omega-3s
0.74 (0.48–1.15, 35 vs. 46) voor SHEP het thuisoefenprogramma.
Voor combinaties van twee behandelingen / middelen was de adjusted hazard ratios 0.53 (0.28–1.00; 15 vs. 28 gevallen van kanker) voor omega-3s plus vitamin D3
;
0.56 (0.30–1.04; 11 vs. 21) voor vitamin D3
 plus SHEP het thuisoefenprogramma;
0.52 (0.28–0.97; 12 vs. 26 cases) voor omega-3s plus SHEP het thuisoefenprogramma.
Voor alle drie de middelen / behandelingen samen was de adjusted hazard ratios 0.39 (0.18–0.85; 4 vs. 12 gevallen van kanker).

De conclusie: Suppletie met dagelijkse hoge doseringen vitamine D3 plus omega-3 vetzuren, gecombineerd met SHEP, liet een cumulatieve vermindering zien van het kankerrisico bij over het algemeen gezonde en actieve volwassenen van ≥70 jaar met veelal afwijkende vitamine D waarden.

Het volledige studierapport is gratis in te zien of te downloaden. Klik daarvoor op de titel van he abstract:

Heike A. Bischoff-Ferrari,,
Heike A. Bischoff-Ferrari1,2,3*Walter C. WillettWalter C. Willett4JoAnn E. MansonJoAnn E. Manson5Bess Dawson-HughesBess Dawson-Hughes6Markus G. ManzMarkus G. Manz7Robert Theiler,Robert Theiler1,2Kilian Braendle,Kilian Braendle1,2Bruno VellasBruno Vellas8Ren RizzoliRené Rizzoli9Reto W. KressigReto W. Kressig10Hannes B. StaehelinHannes B. Staehelin10Jos A. P. Da SilvaJosé A. P. Da Silva11Gabriele ArmbrechtGabriele Armbrecht12Andreas Egli,Andreas Egli1,2John A. Kanis,John A. Kanis13,14Endel J. OravEndel J. Orav15Stephanie Gaengler,DO-HEALTH Research GroupStephanie Gaengler1,2DO-HEALTH Research Group
  • 1Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
  • 2Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
  • 3University Clinic for Aging Medicine, Zurich City Hospital-Waid, Zurich, Switzerland
  • 4Department of Epidemiology and Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
  • 5Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
  • 6Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
  • 7Department of Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
  • 8UMR INSERM 1027, Gérontopôle de Toulouse, Institut Du Vieillissement, Center Hospitalo-Universitaire de Toulouse, Toulouse, France
  • 9Division of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
  • 10University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
  • 11Centro Hospitalar e Universitário de Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • 12Klinik für Radiologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
  • 13Center for Metabolic Diseases, University of Sheffield Medical School, Sheffield, United Kingdom
  • 14Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
  • 15Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, United States

Objective: The aim of this study was to test the individual and combined benefit of vitamin D, omega-3, and a simple home strength exercise program on the risk of any invasive cancer.

Design: The DO-HEALTH trial is a three-year, multicenter, 2 × 2 × 2 factorial design double-blind, randomized-controlled trial to test the individual and combined benefit of three public health interventions.

Setting: The trial was conducted between December 2012 and December 2017 in five European countries.

Participants: Generally healthy community-dwelling adults ≥70 years were recruited.

Interventions: Supplemental 2000 IU/day of vitamin D3, and/or 1 g/day of marine omega-3s, and/or a simple home strength exercise (SHEP) programme compared to placebo and control exercise.

Main outcome: In this pre-defined exploratory analysis, time-to-development of any verified invasive cancer was the primary outcome in an adjusted, intent-to-treat analysis.

Results: In total, 2,157 participants (mean age 74.9 years; 61.7% women; 40.7% with 25-OH vitamin D below 20 /ml, 83% at least moderately physically active) were randomized. Over a median follow-up of 2.99 years, 81 invasive cancer cases were diagnosed and verified. For the three individual treatments, the adjusted hazard ratios (HRs, 95% CI, cases intervention versus control) were 0.76 (0.49–1.18; 36 vs. 45) for vitamin D3, 0.70 (0.44–1.09, 32 vs. 49) for omega-3s, and 0.74 (0.48–1.15, 35 vs. 46) for SHEP. For combinations of two treatments, adjusted HRs were 0.53 (0.28–1.00; 15 vs. 28 cases) for omega-3s plus vitamin D3; 0.56 (0.30–1.04; 11 vs. 21) for vitamin D3 plus SHEP; and 0.52 (0.28–0.97; 12 vs. 26 cases) for omega-3s plus SHEP. For all three treatments combined, the adjusted HR was 0.39 (0.18–0.85; 4 vs. 12 cases).

Conclusion: Supplementation with daily high-dose vitamin D3 plus omega-3s, combined with SHEP, showed cumulative reduction in the cancer risk in generally healthy and active and largely vitamin D–replete adults ≥70 years.

Clinical Trial Registration: ClinicalTrials.gov, Identifier: NCT01745263.

Data Availability Statement

The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author.

Ethics Statement

The studies involving human participants were reviewed and approved by the ethical and regulatory agencies. All participants signed the informed consent, and the ethical and regulatory agencies of all five countries approved the study protocol. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

HB-F had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: HB-F, with input by SG, EO, BV, JK, WW, JM, BD-H, RR, RT and HS. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: HB-F, with input by all authors. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: HB-F, EO and SG. Obtained funding: HB-F. Administrative, technical, or material support: HB-F, BV, RR, RK, JD, GA and AE.

Funding

The study was funded by the Seventh Research Framework Program of the European Commission (Grant Agreement No. 278588), and within this framework, also by the University of Zurich (Chair for Geriatric Medicine and Aging Research), DNP, Roche, NESTEC, Pfizer, and Streuli (Grant Agreements: N/A). The funding/supporting organizations had no role in the design and conduct of the study, including collection, management, analysis, and interpretation of the data and preparation, review or approval of the manuscript, or decision to submit the manuscript for publication.

Conflict of Interest

As part of the DO-HEALTH independent and investigator-initiated clinical trial, HB-F reports as the PI of the DO-HEALTH trial, grants from the European Commission (Grant Agreement No. 176;278588), from the University of Zurich, from NESTEC, from PFIZER Consumer Healthcare, from Streuli Pharma, plus non-financial support from DSM Nutritional Products and from Roche Diagnostics. Furthermore, HB-F reports speaker fees from Wild, Pfizer, Vifor, Mylan, Roche Diagnostics, and independent and investigator-initiated grants from Pfizer and from Vifor, outside the submitted work. JM reports grants from the National Institutes of Health, grants and non-financial support from Mars Symbioscience, outside the submitted work. BV reports personal fees from BIOGEN, CERECIN, ROCHE, and MSD, outside the submitted work. RR reports personal fees from Abiogen, Danone, Echolight, EMF, Mithra, ObsEva, Pfizer Consumer Health, and Theramex, outside the submitted work. JS is the scientific director of Forum D: a website dedicated to the critical revision and dissemination of knowledge regarding the medical uses of Vitamin D. EO reports a grant from Zurich University, during the conduct of the study.

The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors, and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Acknowledgments

We thank all the members of the DO-HEALTH Research Group, and we are grateful to the patients for their participation in, and commitment to, this study. Dissemination to participants and related patient and public communities: Study results will, after scientific publication, be disseminated to the public in general through social media platforms and public events organized by our center.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fragi.2022.852643/full#supplementary-material

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Keywords: vitamin D, omega-3, exercise, prevention, cancer, healthy aging, co supplementation, combined treatment

Citation: Bischoff-Ferrari HA, Willett WC, Manson JE, Dawson-Hughes B, Manz MG, Theiler R, Braendle K, Vellas B, Rizzoli R, Kressig RW, Staehelin HB, Da Silva JAP, Armbrecht G, Egli A, Kanis JA, Orav EJ and Gaengler S (2022) 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 3:852643. doi: 10.3389/fragi.2022.852643

Received: 11 January 2022; Accepted: 16 March 2022;
Published: 25 April 2022.

Edited by:

Guillermo Lopez Lluch, Universidad Pablo de Olavide, Spain

Reviewed by:

Leo Pruimboom, Pontifical University of Salamanca, Spain
Jesus Del Pozo Cruz, Sevilla University, Spain

Copyright © 2022 Bischoff-Ferrari, Willett, Manson, Dawson-Hughes, Manz, Theiler, Braendle, Vellas, Rizzoli, Kressig, Staehelin, Da Silva, Armbrecht, Egli, Kanis, Orav and Gaengler. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Heike A. Bischoff-Ferrari, Heike.Bischoff@usz.ch

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


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