In a large study, age researcher Heike A. Bischoff-Ferrari discovered three measures that can drastically reduce the risk of cancer in old age. In an interview with FOCUS Online, she explains what is important in the implementation.

The age researcher Heike A. Bischoff-Ferrari, who conducts research at the University of Zurich, among other things, reports in an interview with FOCUS Online about the astonishing results of the international DO-HEALTH study she led and about 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.

Heike A. Bischoff-Ferrari is a geriatrician and geriatric researcher. She is director of the Center for Age and Mobility at the University Hospital Zurich and the City Hospital Waid. She also coordinates and directs the DO-HEALTH study.

What are we talking about exactly?

Bischoff-Ferrari: In people without previous cancer, the double combination of vitamin D plus omega-3 already showed a 51 percent reduction in cancer. And the combination of vitamin D and the simple exercise program reduced the risk by 53 percent. The three-way combination was the most effective, reducing the number of new cancer cases by 61 percent.

Can you explain why it is obviously crucial to take a multi-pronged approach to cancer prevention?

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

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 diseases 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 three-way combination tested to prevent a new cancer in three years.

Since cancer is one of the most common age-related diseases, and the preventive measures studied are safe and affordable, this could 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?

Heike A. 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 internationally guidelines, but is 2.5 times higher than the recommendation of 800 IU per day for prevention of 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?

Heike A. Bischoff-Ferrari: The omega-3 used for the study was marine algae-based 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?

Heike A. Bischoff-Ferrari: The DO-HEALTH participants, who were generally healthy at the beginning of the study and physically active in more than 80 percent of the cases, carried out a simple strength program three times a week for 30 minutes. It included arm strength exercises with a resistance band and leg strength exercises such as standing up from a seated position and climbing stairs repeatedly.

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

Heike A. Bischoff-Ferrari: First of all, we should be clear: Today’s 70-year-olds are 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.