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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.
Lancet Oncol. 2013 Oct; 14(11):1112-1120.LO

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.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Ornish D
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.
Lin J
Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA.
Chan JM
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.
Epel E
Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
Kemp C
Preventive Medicine Research Institute, Sausalito, CA, USA.
Weidner G
Department of Biology, San Francisco State University, San Francisco, CA, USA.
Marlin R
Preventive Medicine Research Institute, Sausalito, CA, USA.
Frenda SJ
Preventive Medicine Research Institute, Sausalito, CA, USA.
Magbanua MJM
Department of Urology, Helen Diller Family Comprehensive Cancer Center, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Daubenmier J
Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Estay I
Preventive Medicine Research Institute, Sausalito, CA, USA.
Hills NK
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Chainani-Wu N
Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA.
Carroll PR
Department of Urology, Helen Diller Family Comprehensive Cancer Center, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Blackburn EH
Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA.

MeSH

AgedCase-Control StudiesDNADietExerciseFollow-Up StudiesHumansLife StyleMaleMiddle AgedPilot ProjectsPolymerase Chain ReactionPrognosisProstatic NeoplasmsTelomeraseTelomere Homeostasis

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

24051140

Clinical Trial Links

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Citation

Ornish, Dean, et al. "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." The Lancet. Oncology, vol. 14, no. 11, 2013, pp. 1112-1120.
Ornish D, Lin J, Chan JM, et al. 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. Lancet Oncol. 2013;14(11):1112-1120.
Ornish, D., Lin, J., Chan, J. M., Epel, E., Kemp, C., Weidner, G., Marlin, R., Frenda, S. J., Magbanua, M. J. M., Daubenmier, J., Estay, I., Hills, N. K., Chainani-Wu, N., Carroll, P. R., & Blackburn, E. H. (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. The Lancet. Oncology, 14(11), 1112-1120. https://doi.org/10.1016/S1470-2045(13)70366-8
Ornish D, et al. 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. Lancet Oncol. 2013;14(11):1112-1120. PubMed PMID: 24051140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Ornish,Dean, AU - Lin,Jue, AU - Chan,June M, AU - Epel,Elissa, AU - Kemp,Colleen, AU - Weidner,Gerdi, AU - Marlin,Ruth, AU - Frenda,Steven J, AU - Magbanua,Mark Jesus M, AU - Daubenmier,Jennifer, AU - Estay,Ivette, AU - Hills,Nancy K, AU - Chainani-Wu,Nita, AU - Carroll,Peter R, AU - Blackburn,Elizabeth H, Y1 - 2013/09/17/ PY - 2013/9/21/entrez PY - 2013/9/21/pubmed PY - 2013/12/16/medline SP - 1112 EP - 1120 JF - The Lancet. Oncology JO - Lancet Oncol VL - 14 IS - 11 N2 - 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. SN - 1474-5488 UR - https://www.unboundmedicine.com/medline/citation/24051140/full_citation DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓162]

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