Supplementation with daily high-dose vitamin D3 plus omega-3s, combined with SHEP, showed cumulative reduction in the cancer risk in generally healthy and active and largely vitamin D-replete adults ≥70 years.
We observed dynamic trajectories of ageing where transitioning to a healthier state became less likely with advancing age and among women.
Individualized public health efforts may be warranted even in active older adults, as profiles were less favorable in subgroups of older age, female sex and higher BMI.
Iron deficiency is frequent among relatively healthy European older adults, with people aged ≥ 80 years and residence in Austria and Portugal associated with the highest risk.
DO-HEALTH was registered under the protocol NCT01745263 at the International Trials Registry ( clinicaltrials.gov ), and under the protocol number 2012-001249-41 at the Registration at the European Community Clinical Trial System (EudraCT).
These findings suggest that iron deficiency may play a role in low-grade chronic inflammation among relatively healthy older adults.
Among relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.
Among adults without major comorbidities aged 70 years or older, treatment with vitamin D3, omega-3s, or a strength-training exercise program did not result in statistically significant differences in improvement in systolic or diastolic blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function. These findings do not support the effectiveness of these 3 interventions for these clinical outcomes.
DO-HEALTH is a multi-center clinical trial among 2157 community-dwelling European men and women age 70 and older. The 2x2x2 randomized-control factorial design trial tested the individual and additive benefit, as well as the cost-effectiveness, of 3 interventions: vitamin D 2000 IU/day, omega-3 fatty acids 1000 mg/day (EPA + DHA, ratio 1:2), and a 30-minute 3 times/week home exercise (strength versus flexibility). Each treatment tested has shown considerable prior promise from mechanistic studies, small clinical trials, or large cohort studies, in the prevention of common age-related chronic diseases, but definitive data are missing. DO-HEALTH will test these interventions in relation to 6 primary endpoints (systolic and diastolic blood pressure, non-vertebral fractures, Short Physical Performance Battery score, the Montreal Cognitive Assessment, and risk of infections), plus several secondary endpoints explored in ancillary studies (i.e. rate of any falls and injurious falls, joint pain, oral health, quality of life, and incident frailty). As the 3 interventions have distinct mechanisms of action for each of the 6 primary endpoints, a maximum benefit is expected for their additive benefit as a “multi-modal” intervention. The trial duration is 3 years with in-person contacts with all participants at 4 clinical visits and by quarterly phone calls. Baseline and follow-up blood samples were collected in all participants to measure changes in 25-hydroxyvitamin D and poly-unsaturated fatty acid concentrations. Our objective was to test interventions that are expected to promote healthy aging and longer life expectancy and that can be easily and safely implemented by older community-dwelling adults.
Diet patterns associated with low chronic inflammation may modulate cognitive decline. We investigated an empirical dietary pattern (EDP) associated with inflammation in five European countries and its association with cognitive changes over 3-years. This prospective study included 2157 community dwelling-seniors 70 years and older, followed for 3 years as part of DO-HEALTH, a randomized clinical trial. At baseline, participants completed a food frequency questionnaire and C-Reactive Protein (CRP) and interleukin-6 (IL-6) was measured. We used the Montreal Cognitive Assessment (MoCA) every year of the study. Based on reduced rank regression, we estimated a dietary pattern associated with CRP and IL-6. To evaluate the association between the EDP and cognitive changes over time, we used repeated measure linear regression models adjusting for age, total calories, BMI, study center, time, alcohol intake, education, physical activity, presence of depression symptoms, hypertension, diabetes or heart disease. The EDP was characterized by higher intakes of red and organ meat, refined grains, legumes, poultry and white fish, and lower intakes of coffee, tea, ginger, nuts and cheese. In multivariate adjusted models, participants with lowest adherence to the EDP (range -7.3 to -0.3) increased their MoCA scores 0.7 points over three years whereas those with highest adherence (range 0.4-10.1) increased their MoCA scores only by 0.2 points (p=0.01). In conclusion, a low inflammatory diet was associated with better cognitive function over time among adults ≥70 years from five European countries. This finding supports the role of diet in the promotion of cognitive health among older adults.