Anti-cancer plan: 3 measures significantly reduce the risk in older people

Age researcher Heike A. Bischoff-Ferrari, who conducts research at the University of Zurich, among others, reports on the astonishing results of the international DO-HEALTH study she led and on possible new ways of preventing cancer.

FOCUS online: With your study, you were able to show how the cancer risk of healthy older people can be reduced by up to 61 percent. That sounds remarkable. However, if you read on, some things will sound familiar. They looked at three factors: taking high doses of vitamin D, taking omega-3 fatty acids, and the effect of a simple at-home exercise program. All measures that have been discussed for a long time and are considered to be beneficial to health…

Heike A. Bischoff-Ferrari: … and that’s exactly the point: For the first time, we focused on what happens when you combine the three measures. To put it simply: every single measure can reduce the risk of cancer a little. On their own, the effects are small and not significant. What we have now seen are the so-called additive effects, which can arise when the individual measures have different mechanisms of action.

Can you explain why multi-pronged cancer prevention seems to be crucial?

Bischoff-Ferrari: Cancer development is recorded, so to speak, through three measures and each has a different effect. For a rough overview:

• Vitamin D suppresses the formation of cancer cells.
• Omega-3 fatty acids have an anti-inflammatory effect in an area relevant to the development of cancer.
• Physical activity triggers the death of cancer cells.

In all currently published studies, these measures are evaluated individually. With our more than 2,000 study participants, we have now had the overall package in view for three years, and we have been able to compare the effects of the individual measures. Similarly, novel cancer therapies aim to block multiple pathways of cancer development by combining multiple drugs.

You now hope that the results of the study could be influential for the future direction of cancer prevention, you say.

Bischoff-Ferrari: Yes, also in principle that prevention should be strengthened in medicine. At the moment, medicine is focused on the treatment of acute illnesses and prevention efforts are largely limited to screening and vaccination against certain diseases.

We have made it possible for people to live longer, but the increase in healthy life expectancy is not keeping pace. Based on our results, 35 people would have to be treated with the threefold combination examined to prevent a new cancer in three years.

Because cancer is one of the most common age-related diseases, and the preventative measures studied are safe and affordable, this could help save many people from cancer and save on healthcare costs. In fact, up to 20 percent of life is already spent in a disease state with a reduced quality of life. Modern medicine cannot be satisfied with this.

Let’s get specific: what dosages of vitamin D and omega-3 have been studied and what level of physical activity are we talking about?

Bischoff-Ferrari: For vitamin D, we worked with a daily dose of 2000 IU, in the common form of vitamin D 3. This dose is below the safe upper intake recommendation of the German Society for Nutrition (DGE) and international guidelines, but is 2.5 -fold higher than the recommendation of 800 IU per day to prevent vitamin D deficiency in older adults.

In the case of omega-3, a daily dose of 1 g was investigated, which corresponds to current recommendations for the prevention of cardiovascular diseases.

Are we talking about fish oil?

Bischoff-Ferrari: The omega-3 used for the study was seaweed-based marine omega-3. We chose this product for the DO-HEALTH study because the common omega-3 fish oil would have unblinded the study assignment in the event of a possible belching with a fishy aftertaste.

And what about the movement? To what extent were the study participants active, ergo: what would you recommend?

Bischoff-Ferrari: The DO-HEALTH participants, who were generally healthy at the start of the study and physically active in over 80 percent of the cases, have Do a simple strength training program for 30 minutes three times a week accomplished. It included arm strength exercises with a resistance band and leg strength exercises such as standing up from a sitting position and climbing stairs repeatedly.

For your study, you examined people aged 70 and over. Do the results also have significance for younger people?

Bischoff-Ferrari: First of all, we should be clear: the 70-year-olds are now the teenagers of the older population: the majority are completely immersed in life. We do know, however, that chronic diseases and cancer are increasing significantly at this age.

In this respect, it is enormously valuable to have a lever in prevention. But to answer your question: I don’t see any reason why our data shouldn’t be just as relevant for people aged 50 and under. Sure: for scientifically based statements, further research is required.