Engaging in exercise and taking nutritional supplements may reduce the risk of invasive cancer in healthy individuals aged 70 years or older, a new study suggests.

Researchers observed a 61% reduction in the risk of invasive cancer among patients who completed a home exercise program and took vitamin D3 and omega-3 fatty acids daily.

These results, from the DO-HEALTH trial (ClinicalTrials.gov identifier NCT01745263), were published in Frontiers in Aging.

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DO-HEALTH was a 3-year, double-blind, randomized controlled trial designed to evaluate the individual and combined benefits of 3 interventions —vitamin D3, omega-3 fatty acids, and a home exercise program of strength and balance training — on the risk of any invasive cancer.

The trial was conducted in 5 European countries. It enrolled 2157 generally healthy, community-dwelling adults aged 70 years or older. They were randomly assigned to 8 treatment groups:

  • Vitamin D3 (2000 IU/day) plus omega-3s (1 g/day) and exercise (n=264)
  • Vitamin D3 and omega-3s (n=265)
  • Vitamin D3 and exercise (n=275)
  • Omega-3s and exercise (n=275)
  • Vitamin D3 alone (n=272)
  • Omega-3s alone (n=269)
  • Exercise alone (n=267)
  • Placebo (n=270).

At baseline, patients had a median age of 74.9 years and a mean body mass index of 26.3 kg/m2. About 62% were women. Most (82.6%) were physically active, engaging in a moderate to high level of physical activity. A majority (59.3%) were vitamin D replete, and few (5.2%) were active smokers.


At a median follow-up of 2.99 years, 119 new cases of invasive cancer were self-reported, and 81 were verified.

The risk of invasive cancer was significantly lower in patients who received all 3 interventions, compared with the placebo group (adjusted hazard ratio [aHR], 0.39; 95% CI, 0.18-0.85; P =.017). There were 4 cases of invasive cancer in the combined intervention group and 12 in the placebo group. The number needed to treat with the triple combination to prevent 1 case of cancer was 35.

There were no significant differences in the risk of invasive cancer when researchers compared patients who received the individual interventions to control patients (those who did not receive the intervention of interest). The results with each intervention vs control were:

  • Vitamin D3 — 36 vs 45 cases of cancer (aHR, 0.76; 95% CI, 0.49-1.18; P =.225)
  • Omega-3s — 32 vs 49 cases (aHR, 0.70; 95% CI, 0.44-1.09; P =.115)
  • Exercise — 35 vs 46 cases (aHR, 0.74; 95% CI, 0.48-1.15; P =.183).

There was a significant difference in cancer risk when the researchers compared patients who received omega-3s plus exercise with control patients. However, there was no significant difference in cancer risk for patients who received omega-3s plus vitamin D3 or those who received vitamin D3 plus exercise, compared with control patients. The results with the double combinations vs control were:

  • Omega-3s plus vitamin D3 — 15 vs 28 cases of cancer (aHR, 0.53; 95% CI, 0.28-1.00; P =.051)
  • Vitamin D3 plus exercise — 11 vs 21 cases (aHR, 0.56; 95% CI, 0.30-1.04; P =.068)
  • Omega-3s plus exercise — 12 vs 26 cases (aHR, 0.52; 95% CI, 0.28-0.97; P =.039).

The researchers also looked at specific cancer types and found that none of the interventions — individually or in combination — reduced the risk of gastrointestinal cancer or breast cancer. However, the results suggested a potential reduction in prostate cancer risk with omega-3s alone (HR, 0.17; 95% CI, 0.04-0.75) or combined with exercise (HR, 0.12; 95% CI, 0.02-0.74).

Disclosures: This research was partly supported by Roche, DNP, NESTEC, Pfizer, and Streuli. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Bischoff-Ferrari HA, Willett WC, Manson JE, 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. Front Aging. Published online April 25, 2022. doi:10.3389/fragi.2022.852643