Increased telomerase activity and comprehensive lifestyle changes: a pilot study

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The Lancet Oncology, Volume 9, Issue 11, Pages 1048 - 1057, November 2008

doi:10.1016/S1470-2045(08)70234-1

Increased telomerase activity and comprehensive lifestyle changes: a pilot study

Prof Dean Ornish MD, Jue Lin PhD, Daubenmier PhD, Gerdi Weidner PhD,

Elissa Epel PhD, Colleen Kemp MSN, Mark Jesus M Magbanua PhD, Ruth Marlin MD,

Loren Yglecias BA, Prof R Carroll MD, Prof H Blackburn PhD.

Summary

Background

Telomeres are protective DNA-protein complexes at the end of linear chromosomes

that promote chromosomal stability. Telomere shortness in human beings is

emerging as a prognostic marker of disease risk, progression, and premature

mortality in many types of cancer, including breast, prostate, colorectal,

bladder, head and neck, lung, and renal cell. Telomere shortening is

counteracted by the cellular enzyme telomerase. Lifestyle factors known to

promote cancer and cardiovascular disease might also adversely affect telomerase

function. However, previous studies have not addressed whether improvements in

nutrition and lifestyle are associated with increases in telomerase activity. We

aimed to assess whether 3 months of intensive lifestyle changes increased

telomerase activity in peripheral blood mononuclear cells (PBMC).

Methods

30 men with biopsy-diagnosed low-risk prostate cancer were asked to make

comprehensive lifestyle changes. The primary endpoint was telomerase enzymatic

activity per viable cell, measured at baseline and after 3 months. 24 patients

had sufficient PBMCs needed for longitudinal analysis. This study is registered

on the ClinicalTrials.gov website, number NCT00739791.

Findings

PBMC telomerase activity expressed as natural logarithms increased from 2·00 (SD

0·44) to 2·22 (SD 0·49; p=0·031). Raw values of telomerase increased from 8·05

(SD 3·50) standard arbitrary units to 10·38 (SD 6·01) standard arbitrary units.

The increases in telomerase activity were significantly associated with

decreases in low-density lipoprotein (LDL) cholesterol (r=?0·36, p=0·041) and

decreases in psychological distress (r=?0·35, p=0·047).

Interpretation

Comprehensive lifestyle changes significantly increase telomerase activity and

consequently telomere maintenance capacity in human immune-system cells. Given

this finding and the pilot nature of this study, we report these increases in

telomerase activity as a significant association rather than inferring

causation. Larger randomised controlled trials are warranted to confirm the

findings of this study.

Funding

US Department of Defense (US Army Medical Research Acquisition Activity

W81XWH-05-1-0375, Fort Detrick, Frederick, MD, USA); Henry M Foundation

for the Advancement of Military Medicine (contract 56422; Rockville MD, USA)

from the National Center for Complementary and Alternative Medicine (NCCAM) of

the National Institutes of Health (grant number K01AT004199; Bethesda, MD, USA);

Bahna Foundation (Stamford, CT, USA); DeJoria Foundation (Los Angeles, CA, USA);

Kerzner Foundation (New York, NY, USA); Bernard Osher Foundation (San Francisco,

CA, USA); Walton Family Foundation (Bentonville, AK, USA); Jeff Family

Foundation (Wilton, CT, USA); Safeway Foundation (Pleasanton, CA, USA).

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