Written by Joyce Smith, BS. Vitamin D and Omega-3 supplementation in combination with an exercise program did not improve blood pressure, fracture rate, infection rate or rate of cognitive decline in the healthy older participants over a 3-year period.
By 2050 our aging population with age-related chronic diseases is projected to double 1,2. There is also speculation as to whether supplementation with vitamin D 3 and omega-3 fatty acids 4,5 in combination with exercise 6 might prevent or slow down chronic disease progression. Although studies have shown that older adults lack sufficient vitamin D, omega-3s and exercise, there are no available studies that demonstrate a health benefit for healthy older adults who have adequate Vitamin D and omega-3 levels and who participate in regular exercise 7,8.
Thus a randomized, double-blind, placebo-controlled trial 9 was designed to investigate whether vitamin D, omega-3s, and a strength-training exercise program, alone or in combination, would improve six health outcomes among older adults. Included were 2,157 adults aged 70 years or older with no major health events in the previous 5 years but with sufficient mobility and good cognitive status. Individuals were included between December 2012 and November 2014, and final follow-up was in November 2017. The comparative treatment arms were randomly assigned as follows:
- 2000 IU vitamin D3 plus placebo
- 1g omega-3 (330mgEPA, 660 mg DHA) plus control
- 30 min. 3x weekly of a strength training program plus a control exercise
The trial was carried out in seven centers: Switzerland, France, Germany, Portugal, and Austria and involved a baseline with 12, 24, and 36 month follow-ups and 3-month telephone calls. Participants were assessed for the effect of the different interventions on the following clinical outcomes over the 3 years of follow-up:
- Systolic/diastolic blood pressure (for cardiovascular health)
- Nonvertebral fractures (for bone health)
- Physical performance [Short Physical Performance Battery (SPPB) for bone health]
- Infection rate ( for immune system health)
- Cognition [Montreal Cognitive Assessment (MoCA) for brain health]
Among the 1,900 participants who completed the trial, supplementation with vitamin D3 and omega-3 supplements and strength-training exercise did not generate statistically significant differences in improvement (either alone, or in combination) for the six clinical outcomes in the cohort of generally healthy older adults. Among all three groups Short Physical Performance Battery (SPPB) scores for bone health declined (P=0.001) and Montreal Cognitive Assessment (MoCA) improved significantly (P<0.001) while no significant differences were seen in blood pressure and infection rates. Comparing the three treatment groups to their respective controls, researchers found no significant differences in for bone health (based on non-vertebral fractures) or cognitive function.
Overall, treatment with vitamin D3, omega-3s, or a strength-training exercise program found no statistically significant differences in improvement in systolic or diastolic blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function and, therefore, do not support the effectiveness of these 3 interventions for the tested clinical outcomes among relatively healthy older adults.
Source: Bischoff-Ferrari, Heike A., et al. “Effect of Vitamin D Supplementation, Omega-3 Fatty Acid Supplementation, or a Strength-Training Exercise Program on Clinical Outcomes in Older Adults: The DO-HEALTH Randomized Clinical Trial.” Jama 324.18 (2020): 1855-1868.
© 2020 American Medical Association. All rights reserved.
Posted February 23, 2021.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
- Aloia JF, Mikhail M, Fazzari M, Islam S, Ragolia L, Guralnik J. Physical Performance and Vitamin D in Elderly Black Women-The PODA Randomized Clinical Trial. The Journal of clinical endocrinology and metabolism. 2019;104(5):1441-1448.
- World Health Organization. WHO. World report on ageing and health. World Health Organization; 2015.
- Lips P, Cashman KD, Lamberg-Allardt C, et al. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol. 2019;180(4):P23-p54.
- Ian Givens D, Gibbs RA. Current intakes of EPA and DHA in European populations and the potential of animal-derived foods to increase them. The Proceedings of the Nutrition Society. 2008;67(3):273-280.
- Del Gobbo LC, Imamura F, Aslibekyan S, et al. ω-3 Polyunsaturated Fatty Acid Biomarkers and Coronary Heart Disease: Pooling Project of 19 Cohort Studies. JAMA Intern Med. 2016;176(8):1155-1166.
- Kalache A, Gatti A. Active ageing: a policy framework. Advances in gerontology = Uspekhi gerontologii. 2003;11:7-18.
- Manson JE, Cook NR, Lee IM, et al. Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer. The New England journal of medicine. 2019;380(1):23-32.
- Manson JE, Cook NR, Lee IM, et al. Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease. The New England journal of medicine. 2019;380(1):33-44.
- Bischoff-Ferrari HA, Vellas B, Rizzoli R, et al. Effect of Vitamin D Supplementation, Omega-3 Fatty Acid Supplementation, or a Strength-Training Exercise Program on Clinical Outcomes in Older Adults: The DO-HEALTH Randomized Clinical Trial. Jama. 2020;324(18):1855-1868.