Dean Ornish1, Jue Lin2, June M Chan3, Elissa Epel4, Colleen Kemp5, Gerdi Weidner6, Ruth Marlin5, Steven J Frenda5, Mark Jesus M Magbanua7, Jennifer Daubenmier8, Ivette Estay5, Nancy K Hills9, Nita Chainani-Wu10, Peter R Carroll7, Elizabeth H Blackburn2. 1. Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Preventive Medicine Research Institute, Sausalito, CA, USA. Electronic address: dean.ornish@pmri.org. 2. Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA. 3. Department of Urology, Helen Diller Family Comprehensive Cancer Center, School of Medicine, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA. 4. Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA. 5. Preventive Medicine Research Institute, Sausalito, CA, USA. 6. Department of Biology, San Francisco State University, San Francisco, CA, USA. 7. Department of Urology, Helen Diller Family Comprehensive Cancer Center, School of Medicine, University of California San Francisco, San Francisco, CA, USA. 8. Department of Medicine, University of California San Francisco, San Francisco, CA, USA. 9. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA. 10. Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA.
Abstract
BACKGROUND: Telomere shortness in human beings is a prognostic marker of ageing, disease, and premature morbidity. We previously found an association between 3 months of comprehensive lifestyle changes and increased telomerase activity in human immune-system cells. We followed up participants to investigate long-term effects. METHODS: This follow-up study compared ten men and 25 external controls who had biopsy-proven low-risk prostate cancer and had chosen to undergo active surveillance. Eligible participants were enrolled between 2003 and 2007 from previous studies and selected according to the same criteria. Men in the intervention group followed a programme of comprehensive lifestyle changes (diet, activity, stress management, and social support), and the men in the control group underwent active surveillance alone. We took blood samples at 5 years and compared relative telomere length and telomerase enzymatic activity per viable cell with those at baseline, and assessed their relation to the degree of lifestyle changes. FINDINGS: Relative telomere length increased from baseline by a median of 0·06 telomere to single-copy gene ratio (T/S)units (IQR-0·05 to 0·11) in the lifestyle intervention group, but decreased in the control group (-0·03 T/S units, -0·05 to 0·03, difference p=0·03). When data from the two groups were combined, adherence to lifestyle changes was significantly associated with relative telomere length after adjustment for age and the length of follow-up (for each percentage point increase in lifestyle adherence score, T/S units increased by 0·07, 95% CI 0·02-0·12, p=0·005). At 5 years, telomerase activity had decreased from baseline by 0·25 (-2·25 to 2·23) units in the lifestyle intervention group, and by 1·08 (-3·25 to 1·86) units in the control group (p=0·64), and was not associated with adherence to lifestyle changes (relative risk 0·93, 95% CI 0·72-1·20, p=0·57). INTERPRETATION: Our comprehensive lifestyle intervention was associated with increases in relative telomere length after 5 years of follow-up, compared with controls, in this small pilot study. Larger randomised controlled trials are warranted to confirm this finding. FUNDING: US Department of Defense, NIH/NCI, Furlotti Family Foundation, Bahna Foundation, DeJoria Foundation, Walton Family Foundation, Resnick Foundation, Greenbaum Foundation, Natwin Foundation, Safeway Foundation, Prostate Cancer Foundation.
BACKGROUND: Telomere shortness in human beings is a prognostic marker of ageing, disease, and premature morbidity. We previously found an association between 3 months of comprehensive lifestyle changes and increased telomerase activity in human immune-system cells. We followed up participants to investigate long-term effects. METHODS: This follow-up study compared ten men and 25 external controls who had biopsy-proven low-risk prostate cancer and had chosen to undergo active surveillance. Eligible participants were enrolled between 2003 and 2007 from previous studies and selected according to the same criteria. Men in the intervention group followed a programme of comprehensive lifestyle changes (diet, activity, stress management, and social support), and the men in the control group underwent active surveillance alone. We took blood samples at 5 years and compared relative telomere length and telomerase enzymatic activity per viable cell with those at baseline, and assessed their relation to the degree of lifestyle changes. FINDINGS: Relative telomere length increased from baseline by a median of 0·06 telomere to single-copy gene ratio (T/S)units (IQR-0·05 to 0·11) in the lifestyle intervention group, but decreased in the control group (-0·03 T/S units, -0·05 to 0·03, difference p=0·03). When data from the two groups were combined, adherence to lifestyle changes was significantly associated with relative telomere length after adjustment for age and the length of follow-up (for each percentage point increase in lifestyle adherence score, T/S units increased by 0·07, 95% CI 0·02-0·12, p=0·005). At 5 years, telomerase activity had decreased from baseline by 0·25 (-2·25 to 2·23) units in the lifestyle intervention group, and by 1·08 (-3·25 to 1·86) units in the control group (p=0·64), and was not associated with adherence to lifestyle changes (relative risk 0·93, 95% CI 0·72-1·20, p=0·57). INTERPRETATION: Our comprehensive lifestyle intervention was associated with increases in relative telomere length after 5 years of follow-up, compared with controls, in this small pilot study. Larger randomised controlled trials are warranted to confirm this finding. FUNDING: US Department of Defense, NIH/NCI, Furlotti Family Foundation, Bahna Foundation, DeJoria Foundation, Walton Family Foundation, Resnick Foundation, Greenbaum Foundation, Natwin Foundation, Safeway Foundation, Prostate Cancer Foundation.
Authors: Samuel J Ridout; Kathryn K Ridout; Hung-Teh Kao; Linda L Carpenter; Noah S Philip; Audrey R Tyrka; Lawrence H Price Journal: Adv Psychosom Med Date: 2015-03-30
Authors: Adam M Staffaroni; Duygu Tosun; Jue Lin; Fanny M Elahi; Kaitlin B Casaletto; Matthew J Wynn; Nihar Patel; John Neuhaus; Samantha M Walters; Elissa S Epel; Elizabeth H Blackburn; Joel H Kramer Journal: Neurobiol Aging Date: 2018-05-08 Impact factor: 4.673
Authors: J Kellogg Parsons; John P Pierce; James Mohler; Electra Paskett; Sin-Ho Jung; Michael J Morris; Eric Small; Olwen Hahn; Peter Humphrey; John Taylor; James Marshall Journal: BJU Int Date: 2017-05-21 Impact factor: 5.588
Authors: Ashley E Mason; Frederick M Hecht; Jennifer J Daubenmier; David A Sbarra; Jue Lin; Patricia J Moran; Samantha G Schleicher; Michael Acree; Aric A Prather; Elissa S Epel Journal: Psychosom Med Date: 2018-09 Impact factor: 4.312
Authors: Daniel A Galvão; Dennis R Taaffe; Nigel Spry; Robert A Gardiner; Renea Taylor; Gail P Risbridger; Mark Frydenberg; Michelle Hill; Suzanne K Chambers; Phillip Stricker; Tom Shannon; Dickon Hayne; Eva Zopf; Robert U Newton Journal: Nat Rev Urol Date: 2016-03-08 Impact factor: 14.432