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July 18, 2022

Vitamin D, omega-3 and exercise: a winning combination for healthy aging?

The ground-breaking, three-year DO-HEALTH trial recently published findings that shows a combination of high-dose vitamin D3 supplementation, omega-3 supplementation and simple home strength exercise (SHEP) helps in healthy aging. This articles explores the link between nutritional management and healthy aging and how these insights can inform innovation across the nutrition industry to better support older adults.

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Summary
  • The ground-breaking, three-year DO-HEALTH trial recently published findings that shows a combination of high-dose vitamin D3 supplementation, omega-3 supplementation and simple home strength exercise (SHEP) helps in healthy aging.
  • The discoveries reported by the DO-HEALTH study add to a growing body of positive research in the field of nutrition and cancer.
  • Read on for a round-up of the latest science exploring the link between nutritional management and healthy aging and how these insights can inform innovation across the nutrition industry to better support older adults. 
Doing more for healthy aging 

Cancer is the second biggest cause of death in older adults.1,2 In addition to advancing age, cancer development appears to be promoted by a number of lifestyle factors, including an unhealthy diet and low physical activity, which can be major challenges in the elderly.3 The benefits of nutrition and exercise for healthy aging are well-known, i. Research in the field demonstrates the potential of vitamin D and omega-3 fatty acids specifically in healthy aging. Vitamin D supplementation has been shown to limit the growth of cancer cells,4-14 whereas omega-3 fatty acids may inhibit carcinogenesis (the transformation of normal cells into cancer cells).15 Additionally, exercise can help to improve immune function and decrease inflammation; two factors which may lower the risk of cancer development.16-18

Paving the way: The DO-HEALTH trial

The broad aim of the DO-HEALTH study is to prolong healthy life expectancy in European seniors. As part of this, the trial explored the benefits of nutrition and exercise interventions on cancer risk, to ultimately help inform public health initiatives.19 Taking place between 2012 and 2017 across five countries in Europe, the DO-HEALTH study included 2,157 generally healthy and active older adults aged 70 years or older – i.e., an age where cancer risk is higher. Participants were divided into eight groups, where they were provided with either a placebo, one of the three interventions – 2,000 IU/day vitamin D3, 1g/day omega-3 or a simple home exercise program (SHEP) – or different combinations of the three. 

The secondary analysis found that the triple combination of vitamin D3, omega-3 and exercise had cumulative benefits on the risk of invasive cancer. Notably, the authors reached the conclusion that there was a cancer risk reduction when all three interventions were combined. Although further research is required to confirm these findings, this discovery is set to shape the future of cancer prevention strategies and could have significant positive implications for healthy aging and burdens on global healthcare services. 

Building on existing evidence 

In addition, emerging science shows that specific nutrients can support patients undergoing cancer therapy too. Many patients with cancer are at high risk for malnutrition both from the disease itself and its treatment – which can have an adverse impact on the health and survival of individuals, as well as the efficacy of oncology treatment, if not addressed properly. 

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) omega-3 fatty acids are emerging as a promising nutritional support to cancer treatment, where they have the potential to improve the effectiveness of immunotherapy and anti-inflammatory cancer drugs.20,21 Additional research published this year also shows that vitamin B5 has potential to stimulate anti-cancer immunosurveillance – a mechanism of the immune system that helps to recognize and destroy cancer cells – supporting anticancer therapy.22 Whereas vitamin E is shown to significantly improve the survival of patients undergoing immune checkpoint therapy (ICT).23 In mice models, vitamin E increased the antitumor efficacy of ICT immunotherapy. This highlights the important role nutrients can play at different stages in cancer support.

Supporting older adults more effectively 

dsm-firmenich is passionate about raising the standards of care and supporting the health and independence of the elderly with evidence-based nutritional products that put the individual first. As a science-based company, we remain at the pulse of emerging research and patient insights to inform our nutrition solutions – including those for optimized nutrition in cancer care. When you partner with us, you get access to the broadest ingredient offering in the industry, customized solutions and expert services, so you can navigate the health and nutrition market with ease.

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Connect with one of our experts to discover how we can support the development of medical nutrition products to address the dietary needs of patients with cancer, from concept to patient.

References

  1. Laconi et al. Cancer as a Disease of Old Age: Changing Mutational and Microenvironmental Landscapes. Br. J. Cancer 122 (2020).
  2. White et al. Age and Cancer Risk. Am. J. Prev. Med. 46 (2014).
  3. López-Otín et al. The Hallmarks of Aging. Cell 153 (2013).
  4. James et al. Effects of 1,25 Dihydroxyvitamin D3 and its Analogues on Induction of Apoptosis in Breast Cancer Cells. J. Steroid Biochem. Mol. Biol. 58 (1996).
  5. Kawa et al. Inhibitory Effect of 220-Oxa-1,25-Dihydroxyvitamin D3 on the Proliferation of Pancreatic Cancer Cell Lines. Gastroenterology 110 (1996).
  6. Campbell et al. Inhibition of Proliferation of Prostate Cancer Cells by a 19-Nor-Hexafluoride Vitamin D3 Analogue Involves the Induction of P21waf1, P27kip1 and E-Cadherin. J. Mol. Endocrinol. 19 (1997).
  7. Yanagisawa et al. Convergence of Transforming Growth Factor-β and Vitamin D Signaling Pathways on SMAD Transcriptional Coactivators. Science 283 (1999).
  8. Díaz et al. Apoptosis Is Induced by the Active Metabolite of Vitamin D3 and its Analogue EB1089 in Colorectal Adenoma and Carcinoma Cells: Possible Implications for Prevention and Therapy. Cancer Res. 60 (2000).
  9. Sundaram et al. The Vitamin D3 Analog EB 1089 Enhances the Antiproliferative and Apoptotic Effects of Adriamycin in MCF-7 Breast Tumor Cells. Breast Cancer Res. Treat. 63 (2000).
  10. Gaschott and Stein. Short-Chain Fatty Acids and Colon Cancer Cells: The Vitamin D Receptor-Butyrate Connection. Recent Results Cancer Res. 164 (2003).
  11. Jiang et al. Induction of Ovarian Cancer Cell Apoptosis b
  12. Li et al. p27Kip1 Stabilization and G1 Arrest by 1,25-Dihydroxyvitamin D3 in Ovarian Cancer Cells Mediated through Down-Regulation of Cyclin E/Cyclin-dependent Kinase 2 and Skp1-Cullin-F-Box Protein/Skp2 Ubiquitin Ligase. J. Biol. Chem. 279 (2004).y 1,25-dihydroxyvitamin D3 through the Down-Regulation of Telomerase. J. Biol. Chem. 279 (2004).
  13. Kumagai et al. 19-Nor-1,25(OH)2D2(a Novel, Noncalcemic Vitamin D Analogue), Combined with Arsenic Trioxide, Has Potent Antitumor Activity against Myeloid Leukemia. Cancer Res. 65 (2005).
  14. Moreno et al. Regulation of Prostaglandin Metabolism by Calcitriol Attenuates Growth Stimulation in Prostate Cancer Cells. Cancer Res. 65 (2005).
  15. Larsson et al. Dietary Long- Chain N−3 Fatty Acids for the Prevention of Cancer: a Review of Potential Mechanisms. Am. J. Clin. Nutr. 79 (2004).
  16. McTiernan. Mechanisms Linking Physical Activity with Cancer. Nat. Rev. Cancer 8 (2008).
  17. Hong and Lee. A Systematic Review of the Biological Mechanisms Linking Physical Activity and Breast Cancer. Phys. Act Nutr. 24 (2020).
  18. Wang and Zhou. Roles and Molecular Mechanisms of Physical Exercise in Cancer Prevention and Treatment. J. Sport Health Sci. 10 (2020).
  19. Bischoff-Ferrari et al. 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. Frontiers in Aging. (2022).
  20. Marshall et al. EPA and DHA omega 3s as a potential adjunct to chemotherapy in the treatment of cancer. AgroFOOD Industry Hi Tech. 28 (2017).
  21. Murphy et al. Nutritional intervention with fish oil provides a benefit over standard of care for weight and skeletal muscle mass in patients with non-small cell lung cancer receiving chemotherapy. Cancer, 117 (2011).
  22. Bourgin et al. Immunostimulatory effects of vitamin B5 improve anticancer immunotherapy. OncoImmunology. 11 (2022).
  23. Yuan et al. Vitamin E enhances cancer immunotherapy by reinvigorating dendritic cells via targeting checkpoint SHPI. Cancer Discov. 14 (2022).
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