The Lancet Oncology, Volume 14, Issue 11, Pages 1112 - 1120, October 2013
Effect of comprehensive lifestyle changes on telomerase activity and
telomere length in men with biopsy-proven low-risk prostate cancer:
5-year follow-up of a descriptive pilot study
Prof Dean Ornish MD et al
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.
