With half of adults over the age of 85 living with frailty, preventative measures are sorely needed. However, investigators at Brigham and Women’s Hospital have concluded that dietary supplementation with either vitamin D3 or marine omega-3 fatty acids is not the answer for generally healthy older adults.
The researchers analyzed data from the VITamin D and OmegA-3 TriaL (VITAL), a clinical trial of more than 25,000 U.S. adults also led by Brigham investigators. The new ancillary study was published in JAMA Network Open in September 2022.
“These findings do not suggest a role for vitamin D3 or omega-3 supplements in most healthy, community-dwelling older adults,” says corresponding author Ariela Orkaby, MD, MPH, of the Brigham’s Division of Aging. “We should consider deprescribing unnecessary pills and instead promoting healthy lifestyle habits. Regular exercise and the Mediterranean diet are proven strategies for preventing frailty and should be encouraged for all older adults.”
Examining the Efficacy of Vitamin D3 and Omega-3 Fatty Acids
Previous studies have suggested that vitamin D3 could stave off cancer, heart disease, stroke, and other ailments due to the anti-inflammatory properties of the supplements. Results, though, were far from definitive. The Brigham launched VITAL in 2010 to explore the issue more rigorously, accounting for omega-3 fatty acids as well. The intervention consisted of daily doses of vitamin D3 (2000 IU) and omega-3 fatty acids (1 gram).
VITAL participants completed questionnaires before the trial began, six months after its start, and annually over a five-year period. Data analysis for the ancillary study on frailty took place from December 2019 to March 2022.
Assessment of frailty included measures of physical function, cognition, mood, and general health. The primary outcome was the change in frailty score over time, as defined by the Rockwood frailty index. In a subgroup of 1,054 patients, the Fried physical phenotype was also measured at baseline and at follow-up years 2 and 4. Investigators found that neither vitamin D3 nor omega-3 fatty acid supplementation affected frailty scores during the time period.
“There had been a sense of optimism that taking these supplements could help relatively healthy adults reduce frailty risk,” Dr. Orkaby says. “But we had a resounding answer that at least at these doses, over these periods, and in these patients, there was no signal at all. If you’re looking for that magic pill that will help older healthy adults stay healthy, it’s not vitamin D3 nor omega-3-fatty acids.”
Shifting the Focus to Other Dietary Supplements
While the results of the ancillary study were disappointing, Dr. Orkaby sees a bright side: Geriatricians and other clinicians have evidence that vitamin D3 and omega-3-fatty acids are not beneficial for this patient population, and researchers can turn their attention to other supplements that might be helpful.
“Our time with patients is so limited. It can be tempting just to tell them that trying a supplement might ease their aches and pains, help them live longer, or prevent frailty,” she says. “But it’s simply not turning out to be true. It’s the hard work of moving every day, having a balanced diet—those are the things that are ultimately going to make a difference in terms of healthy aging.”