Abstract
Telomeres are tandem repeat DNA sequences located at distal ends of chromosomes that protect against genomic DNA degradation and chromosomal instability. Excessive telomere shortening leads to cellular senescence and for this reason telomere length is a marker of biological age. Abnormally short telomeres may culminate in the manifestation of a number of cardio-metabolic diseases. Age-related cardio-metabolic diseases attributable to an inactive lifestyle, such as obesity, type 2 diabetes mellitus and cardiovascular disease, are associated with short leukocyte telomeres. Exercise training prevents and manages the symptoms of many cardio-metabolic diseases whilst concurrently maintaining telomere length. The positive relationship between exercise training, physical fitness and telomere length raises the possibility of a mediating role of telomeres in chronic disease prevention via exercise. Further elucidation of the underpinning molecular mechanisms of how exercise maintains telomere length should provide crucial information on how physical activity can be best structured to combat the chronic disease epidemic and improve the human health span. Here, we synthesise and discuss the current evidence on the impact of physical activity and cardiorespiratory fitness on telomere dynamics. We provide the molecular mechanisms with a known role in exercise-induced telomere length maintenance and highlight unexplored, alternative pathways ripe for future investigations.
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References
Blackburn EH. Structure and function of telomeres. Nature. 1991;350(6319):569–73.
Blackburn EH. Switching and signaling at the telomere. Cell. 2001;106(6):661–73.
Bodnar AG, Ouellette M, Frolkis M, et al. Extension of life-span by introduction of telomerase into normal human cells. Science. 1998;279(5349):349–52.
Daniali L, Benetos A, Susser E, et al. Telomeres shorten at equivalent rates in somatic tissues of adults. Nat Commun. 2013;4:1597.
Brouilette S, Singh RK, Thompson JR, et al. White cell telomere length and risk of premature myocardial infarction. Arterioscler Thromb Vasc Biol. 2003;23(5):842–6.
Samani NJ, Boultby R, Butler R, et al. Telomere shortening in atherosclerosis. Lancet. 2001;358(9280):472–3.
Mainous AG 3rd, Codd V, Diaz VA, et al. Leukocyte telomere length and coronary artery calcification. Atherosclerosis. 2010;210(1):262–7.
Zee RY, Castonguay AJ, Barton NS, et al. Mean leukocyte telomere length shortening and type 2 diabetes mellitus: a case-control study. Transl Res. 2010;155(4):166–9.
Salpea KD, Talmud PJ, Cooper JA, et al. Association of telomere length with type 2 diabetes, oxidative stress and UCP2 gene variation. Atherosclerosis. 2010;209(1):42–50.
Ma H, Zhou Z, Wei S, et al. Shortened telomere length is associated with increased risk of cancer: a meta-analysis. PLoS One. 2011;6(6):e20466.
Epel ES, Blackburn EH, Lin J, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA. 2004;101(49):17312–5.
Puterman E, Lin J, Krauss J, et al. Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter. Mol Psychiatry. 2014;20(4):529–35.
Armanios M, Blackburn EH. The telomere syndromes. Nat Rev Genet. 2012;13(10):693–704.
Thompson PD, Buchner D, Pina IL, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation. 2003;107(24):3109–16.
Sigal RJ, Kenny GP, Wasserman DH, et al. Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006;29(6):1433–8.
Lemanne D, Cassileth B, Gubili J. The role of physical activity in cancer prevention, treatment, recovery, and survivorship. Oncology (Williston Park). 2013;27(6):580–5.
Moyzis RK, Buckingham JM, Cram LS, et al. A highly conserved repetitive DNA sequence, (TTAGGG)n, present at the telomeres of human chromosomes. Proc Natl Acad Sci USA. 1988;85(18):6622–6.
Chen W, Kimura M, Kim S, et al. Longitudinal versus cross-sectional evaluations of leukocyte telomere length dynamics: age-dependent telomere shortening is the rule. J Gerontol A Biol Sci Med Sci. 2011;66(3):312–9.
Verdun RE, Karlseder J. Replication and protection of telomeres. Nature. 2007;447(7147):924–31.
Oikawa S, Kawanishi S. Site-specific DNA damage at GGG sequence by oxidative stress may accelerate telomere shortening. FEBS Lett. 1999;453(3):365–8.
Kawanishi S, Oikawa S. Mechanism of telomere shortening by oxidative stress. Ann N Y Acad Sci. 2004;1019:278–84.
von Zglinicki T. Oxidative stress shortens telomeres. Trends Biochem Sci. 2002;27(7):339–44.
Herbig U, Jobling WA, Chen BP, et al. Telomere shortening triggers senescence of human cells through a pathway involving ATM, p53, and p21(CIP1), but not p16(INK4a). Mol Cell. 2004;14(4):501–13.
de Lange T. How shelterin solves the telomere end-protection problem. Cold Spring Harb Symp Quant Biol. 2010;75:167–77.
Chin L, Artandi SE, Shen Q, et al. p53 deficiency rescues the adverse effects of telomere loss and cooperates with telomere dysfunction to accelerate carcinogenesis. Cell. 1999;97(4):527–38.
Nandakumar J, Cech TR. Finding the end: recruitment of telomerase to telomeres. Nat Rev Mol Cell Biol. 2013;14(2):69–82.
Griffith JD, Comeau L, Rosenfield S, et al. Mammalian telomeres end in a large duplex loop. Cell. 1999;97(4):503–14.
Broccoli D, Smogorzewska A, Chong L, et al. Human telomeres contain two distinct Myb-related proteins, TRF1 and TRF2. Nat Genet. 1997;17(2):231–5.
Takai KK, Hooper S, Blackwood S, et al. In vivo stoichiometry of shelterin components. J Biol Chem. 2010;285(2):1457–67.
van Steensel B, de Lange T. Control of telomere length by the human telomeric protein TRF1. Nature. 1997;385(6618):740–3.
van Steensel B, Smogorzewska A, de Lange T. TRF2 protects human telomeres from end-to-end fusions. Cell. 1998;92(3):401–13.
Kim SH, Beausejour C, Davalos AR, et al. TIN2 mediates functions of TRF2 at human telomeres. J Biol Chem. 2004;279(42):43799–804.
Zhang Y, Chen LY, Han X, et al. Phosphorylation of TPP1 regulates cell cycle-dependent telomerase recruitment. Proc Natl Acad Sci USA. 2013;110(14):5457–62.
Wang F, Podell ER, Zaug AJ, et al. The POT1-TPP1 telomere complex is a telomerase processivity factor. Nature. 2007;445(7127):506–10.
Denchi EL, de Lange T. Protection of telomeres through independent control of ATM and ATR by TRF2 and POT1. Nature. 2007;448(7157):1068–71.
Bae NS, Baumann P. A RAP1/TRF2 complex inhibits nonhomologous end-joining at human telomeric DNA ends. Mol Cell. 2007;26(3):323–34.
Sarthy J, Bae NS, Scrafford J, et al. Human RAP1 inhibits non-homologous end joining at telomeres. EMBO J. 2009;28(21):3390–9.
Martinez P, Thanasoula M, Carlos AR, et al. Mammalian Rap1 controls telomere function and gene expression through binding to telomeric and extratelomeric sites. Nat Cell Biol. 2010;12(8):768–80.
Martinez P, Blasco MA. Telomeric and extra-telomeric roles for telomerase and the telomere-binding proteins. Nat Rev Cancer. 2011;11(3):161–76.
Sfeir A, de Lange T. Removal of shelterin reveals the telomere end-protection problem. Science. 2012;336(6081):593–7.
de Lange T. How telomeres solve the end-protection problem. Science. 2009;326(5955):948–52.
Benetti R, Garcia-Cao M, Blasco MA. Telomere length regulates the epigenetic status of mammalian telomeres and subtelomeres. Nat Genet. 2007;39(2):243–50.
Blasco MA. The epigenetic regulation of mammalian telomeres. Nat Rev Genet. 2007;8(4):299–309.
Gonzalo S, Jaco I, Fraga MF, et al. DNA methyltransferases control telomere length and telomere recombination in mammalian cells. Nat Cell Biol. 2006;8(4):416–24.
Redon S, Reichenbach P, Lingner J. The non-coding RNA TERRA is a natural ligand and direct inhibitor of human telomerase. Nucleic Acids Res. 2010;38(17):5797–806.
Greider CW, Blackburn EH. Identification of a specific telomere terminal transferase activity in Tetrahymena extracts. Cell. 1985;43(2 Pt 1):405–13.
Wright WE, Piatyszek MA, Rainey WE, et al. Telomerase activity in human germline and embryonic tissues and cells. Dev Genet. 1996;18(2):173–9.
Broccoli D, Young JW, de Lange T. Telomerase activity in normal and malignant hematopoietic cells. Proc Natl Acad Sci USA. 1995;92(20):9082–6.
Wernig A, Schafer R, Knauf U, et al. On the regenerative capacity of human skeletal muscle. Artif Organs. 2005;29(3):192–8.
Chen CH, Chen RJ. Prevalence of telomerase activity in human cancer. J Formos Med Assoc. 2011;110(5):275–89.
Kim NW, Piatyszek MA, Prowse KR, et al. Specific association of human telomerase activity with immortal cells and cancer. Science. 1994;266(5193):2011–5.
Vaziri H, Benchimol S. Reconstitution of telomerase activity in normal human cells leads to elongation of telomeres and extended replicative life span. Curr Biol. 1998;8(5):279–82.
Wojtyla A, Gladych M, Rubis B. Human telomerase activity regulation. Mol Biol Rep. 2011;38(5):3339–49.
Smogorzewska A, de Lange T. Regulation of telomerase by telomeric proteins. Annu Rev Biochem. 2004;73:177–208.
Wang F, Lei M. Human telomere POT1-TPP1 complex and its role in telomerase activity regulation. Methods Mol Biol. 2011;735:173–87.
Liu JP, Chen SM, Cong YS, et al. Regulation of telomerase activity by apparently opposing elements. Ageing Res Rev. 2010;9(3):245–56.
Zhou J, Ding D, Wang M, et al. Telomerase reverse transcriptase in the regulation of gene expression. BMB Rep. 2014;47(1):8–14.
Cesare AJ, Reddel RR. Alternative lengthening of telomeres: models, mechanisms and implications. Nat Rev Genet. 2010;11(5):319–30.
Nabetani A, Ishikawa F. Alternative lengthening of telomeres pathway: recombination-mediated telomere maintenance mechanism in human cells. J Biochem. 2011;149(1):5–14.
Heaphy CM, Subhawong AP, Hong SM, et al. Prevalence of the alternative lengthening of telomeres telomere maintenance mechanism in human cancer subtypes. Am J Pathol. 2011;179(4):1608–15.
Bojovic B, Booth RE, Jin Y, et al. Alternative lengthening of telomeres in cancer stem cells in vivo. Oncogene. 2014;34:611–20.
Silvestre DC, Pineda JR, Hoffschir F, et al. Alternative lengthening of telomeres in human glioma stem cells. Stem Cells. 2011;29(3):440–51.
Neumann AA, Watson CM, Noble JR, et al. Alternative lengthening of telomeres in normal mammalian somatic cells. Genes Dev. 2013;27(1):18–23.
Hemann MT, Greider CW. Wild-derived inbred mouse strains have short telomeres. Nucleic Acids Res. 2000;28(22):4474–8.
Zijlmans JM, Martens UM, Poon SS, et al. Telomeres in the mouse have large inter-chromosomal variations in the number of T2AG3 repeats. Proc Natl Acad Sci USA. 1997;94(14):7423–8.
Wright WE, Shay JW. Telomere dynamics in cancer progression and prevention: fundamental differences in human and mouse telomere biology. Nat Med. 2000;6(8):849–51.
Vina J, Sanchis-Gomar F, Martinez-Bello V, et al. Exercise acts as a drug; the pharmacological benefits of exercise. Br J Pharmacol. 2012;167(1):1–12.
Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ. 2006;174(6):801–9.
Powell KE, Paluch AE, Blair SN. Physical activity for health: what kind? How much? How intense? On top of what? Annu Rev Public Health. 2011;32:349–65.
Shalev I, Entringer S, Wadhwa PD, et al. Stress and telomere biology: a lifespan perspective. Psychoneuroendocrinology. 2013;38(9):1835–42.
Shiels PG, McGlynn LM, MacIntyre A, et al. Accelerated telomere attrition is associated with relative household income, diet and inflammation in the pSoBid cohort. PLoS One. 2011;6(7):e22521.
Nettleton JA, Diez-Roux A, Jenny NS, et al. Dietary patterns, food groups, and telomere length in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2008;88(5):1405–12.
Lee M, Martin H, Firpo MA, et al. Inverse association between adiposity and telomere length: the Fels Longitudinal Study. Am J Hum Biol. 2011;23(1):100–6.
Garcia-Calzon S, Gea A, Razquin C, et al. Longitudinal association of telomere length and obesity indices in an intervention study with a Mediterranean diet: the PREDIMED-NAVARRA trial. Int J Obes (Lond). 2014;38(2):177–82.
Buxton JL, Das S, Rodriguez A, et al. Multiple measures of adiposity are associated with mean leukocyte telomere length in the northern Finland birth cohort 1966. PLoS One. 2014;9(6):e99133.
Kim S, Parks CG, DeRoo LA, et al. Obesity and weight gain in adulthood and telomere length. Cancer Epidemiol Biomark Prev. 2009;18(3):816–20.
Valdes AM, Andrew T, Gardner JP, et al. Obesity, cigarette smoking, and telomere length in women. Lancet. 2005;366(9486):662–4.
Chen S, Yeh F, Lin J, et al. Short leukocyte telomere length is associated with obesity in American Indians: the Strong Heart Family study. Aging (Albany NY). 2014;6(5):380–9.
Bekaert S, De Meyer T, Rietzschel ER, et al. Telomere length and cardiovascular risk factors in a middle-aged population free of overt cardiovascular disease. Aging Cell. 2007;6(5):639–47.
Diaz VA, Mainous AG, Player MS, et al. Telomere length and adiposity in a racially diverse sample. Int J Obes (Lond). 2010;34(2):261–5.
Buxton JL, Walters RG, Visvikis-Siest S, et al. Childhood obesity is associated with shorter leukocyte telomere length. J Clin Endocrinol Metab. 2011;96(5):1500–5.
Al-Attas OS, Al-Daghri N, Bamakhramah A, et al. Telomere length in relation to insulin resistance, inflammation and obesity among Arab youth. Acta Paediatr. 2010;99(6):896–9.
Nordfjall K, Eliasson M, Stegmayr B, et al. Telomere length is associated with obesity parameters but with a gender difference. Obesity (Silver Spring). 2008;16(12):2682–9.
Garcia-Calzon S, Moleres A, Marcos A, et al. Telomere length as a biomarker for adiposity changes after a multidisciplinary intervention in overweight/obese adolescents: the EVASYON study. PLoS One. 2014;9(2):e89828.
Shen Q, Zhao X, Yu L, et al. Association of leukocyte telomere length with type 2 diabetes in mainland Chinese populations. J Clin Endocrinol Metab. 2012;97(4):1371–4.
Testa R, Olivieri F, Sirolla C, et al. Leukocyte telomere length is associated with complications of type 2 diabetes mellitus. Diabet Med. 2011;28(11):1388–94.
Olivieri F, Lorenzi M, Antonicelli R, et al. Leukocyte telomere shortening in elderly Type2DM patients with previous myocardial infarction. Atherosclerosis. 2009;206(2):588–93.
Sampson MJ, Winterbone MS, Hughes JC, et al. Monocyte telomere shortening and oxidative DNA damage in type 2 diabetes. Diabetes Care. 2006;29(2):283–9.
Gardner JP, Li S, Srinivasan SR, et al. Rise in insulin resistance is associated with escalated telomere attrition. Circulation. 2005;111(17):2171–7.
Zhao J, Zhu Y, Lin J, et al. Short leukocyte telomere length predicts risk of diabetes in American Indians: the strong heart family study. Diabetes. 2014;63(1):354–62.
You NC, Chen BH, Song Y, et al. A prospective study of leukocyte telomere length and risk of type 2 diabetes in postmenopausal women. Diabetes. 2012;61(11):2998–3004.
Panayiotou AG, Nicolaides AN, Griffin M, et al. Leukocyte telomere length is associated with measures of subclinical atherosclerosis. Atherosclerosis. 2010;211(1):176–81.
Fitzpatrick AL, Kronmal RA, Gardner JP, et al. Leukocyte telomere length and cardiovascular disease in the cardiovascular health study. Am J Epidemiol. 2007;165(1):14–21.
Yang Z, Huang X, Jiang H, et al. Short telomeres and prognosis of hypertension in a Chinese population. Hypertension. 2009;53(4):639–45.
Demissie S, Levy D, Benjamin EJ, et al. Insulin resistance, oxidative stress, hypertension, and leukocyte telomere length in men from the Framingham Heart Study. Aging Cell. 2006;5(4):325–30.
van der Harst P, van der Steege G, de Boer RA, et al. Telomere length of circulating leukocytes is decreased in patients with chronic heart failure. J Am Coll Cardiol. 2007;49(13):1459–64.
Willeit P, Willeit J, Brandstatter A, et al. Cellular aging reflected by leukocyte telomere length predicts advanced atherosclerosis and cardiovascular disease risk. Arterioscler Thromb Vasc Biol. 2010;30(8):1649–56.
Farzaneh-Far R, Cawthon RM, Na B, et al. Prognostic value of leukocyte telomere length in patients with stable coronary artery disease: data from the Heart and Soul Study. Arterioscler Thromb Vasc Biol. 2008;28(7):1379–84.
Brouilette SW, Moore JS, McMahon AD, et al. Telomere length, risk of coronary heart disease, and statin treatment in the West of Scotland Primary Prevention Study: a nested case-control study. Lancet. 2007;369(9556):107–14.
Haycock PC, Heydon EE, Kaptoge S, et al. Leucocyte telomere length and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2014;349:g4227.
Zee RY, Castonguay AJ, Barton NS, et al. Relative leukocyte telomere length and risk of incident ischemic stroke in men: a prospective, nested case-control approach. Rejuvenation Res. 2010;13(4):411–4.
Perez-Rivera JA, Pabon-Osuna P, Cieza-Borrella C, et al. Effect of telomere length on prognosis in men with acute coronary syndrome. Am J Cardiol. 2014;113(3):418–21.
Cawthon RM, Smith KR, O’Brien E, et al. Association between telomere length in blood and mortality in people aged 60 years or older. Lancet. 2003;361(9355):393–5.
Epel ES, Merkin SS, Cawthon R, et al. The rate of leukocyte telomere shortening predicts mortality from cardiovascular disease in elderly men. Aging (Albany NY). 2009;1(1):81–8.
Lee HW, Blasco MA, Gottlieb GJ, et al. Essential role of mouse telomerase in highly proliferative organs. Nature. 1998;392(6676):569–74.
Herrera E, Samper E, Martin-Caballero J, et al. Disease states associated with telomerase deficiency appear earlier in mice with short telomeres. EMBO J. 1999;18(11):2950–60.
Rudolph KL, Chang S, Lee HW, et al. Longevity, stress response, and cancer in aging telomerase-deficient mice. Cell. 1999;96(5):701–12.
Perez-Rivero G, Ruiz-Torres MP, Rivas-Elena JV, et al. Mice deficient in telomerase activity develop hypertension because of an excess of endothelin production. Circulation. 2006;114(4):309–17.
Wong KK, Maser RS, Bachoo RM, et al. Telomere dysfunction and Atm deficiency compromises organ homeostasis and accelerates ageing. Nature. 2003;421(6923):643–8.
Chang S, Multani AS, Cabrera NG, et al. Essential role of limiting telomeres in the pathogenesis of Werner syndrome. Nat Genet. 2004;36(8):877–82.
Bhayadia R, Schmidt BM, Melk A, et al. Senescence-induced oxidative stress causes endothelial dysfunction. J Gerontol A Biol Sci Med Sci. 2016;71(2):161–9.
Fernandez-Sanchez A, Madrigal-Santillan E, Bautista M, et al. Inflammation, oxidative stress, and obesity. Int J Mol Sci. 2011;12(5):3117–32.
Li H, Horke S, Forstermann U. Vascular oxidative stress, nitric oxide and atherosclerosis. Atherosclerosis. 2014;237(1):208–19.
Watson JD. Type 2 diabetes as a redox disease. Lancet. 2014;383(9919):841–3.
Fredman G, Ozcan L, Tabas I. Common therapeutic targets in cardiometabolic disease. Sci Transl Med. 2014;6(239):239ps5.
Salpea KD, Maubaret CG, Kathagen A, et al. The effect of pro-inflammatory conditioning and/or high glucose on telomere shortening of aging fibroblasts. PLoS One. 2013;8(9):e73756.
Kurz DJ, Decary S, Hong Y, et al. Chronic oxidative stress compromises telomere integrity and accelerates the onset of senescence in human endothelial cells. J Cell Sci. 2004;117(Pt 11):2417–26.
Ottaviani A, Gilson E, Magdinier F. Telomeric position effect: from the yeast paradigm to human pathologies? Biochimie. 2008;90(1):93–107.
Baur JA, Zou Y, Shay JW, et al. Telomere position effect in human cells. Science. 2001;292(5524):2075–7.
Robin JD, Ludlow AT, Batten K, et al. Telomere position effect: regulation of gene expression with progressive telomere shortening over long distances. Genes Dev. 2014;28(22):2464–76.
Koering CE, Pollice A, Zibella MP, et al. Human telomeric position effect is determined by chromosomal context and telomeric chromatin integrity. EMBO Rep. 2002;3(11):1055–61.
Hernandez-Caballero E, Herrera-Gonzalez NE, Salamanca-Gomez F, et al. Role of telomere length in subtelomeric gene expression and its possible relation to cellular senescence. BMB Rep. 2009;42(11):747–51.
Ning Y, Xu JF, Li Y, et al. Telomere length and the expression of natural telomeric genes in human fibroblasts. Hum Mol Genet. 2003;12(11):1329–36.
Codd V, Nelson CP, Albrecht E, et al. Identification of seven loci affecting mean telomere length and their association with disease. Nat Genet. 2013;45(4):422–7 (7e1–2).
Masi S, D’Aiuto F, Martin-Ruiz C, et al. Rate of telomere shortening and cardiovascular damage: a longitudinal study in the 1946 British Birth Cohort. Eur Heart J. 2014;35(46):3296–303.
Baragetti A, Palmen J, Garlaschelli K, et al. Telomere shortening over 6 years is associated with increased subclinical carotid vascular damage and worse cardiovascular prognosis in the general population. J Intern Med. 2015;277(4):478–87.
Cherkas LF, Hunkin JL, Kato BS, et al. The association between physical activity in leisure time and leukocyte telomere length. Arch Intern Med. 2008;168(2):154–8.
Du M, Prescott J, Kraft P, et al. Physical activity, sedentary behavior, and leukocyte telomere length in women. Am J Epidemiol. 2012;175(5):414–22.
Ludlow AT, Zimmerman JB, Witkowski S, et al. Relationship between physical activity level, telomere length, and telomerase activity. Med Sci Sports Exerc. 2008;40(10):1764–71.
Savela S, Saijonmaa O, Strandberg TE, et al. Physical activity in midlife and telomere length measured in old age. Exp Gerontol. 2013;48(1):81–4.
Song Z, von Figura G, Liu Y, et al. Lifestyle impacts on the aging-associated expression of biomarkers of DNA damage and telomere dysfunction in human blood. Aging Cell. 2010;9(4):607–15.
Cassidy A, De Vivo I, Liu Y, et al. Associations between diet, lifestyle factors, and telomere length in women. Am J Clin Nutr. 2010;91(5):1273–80.
Diaz VA, Mainous AG 3rd, Everett CJ, et al. Effect of healthy lifestyle behaviors on the association between leukocyte telomere length and coronary artery calcium. Am J Cardiol. 2010;106(5):659–63.
Fujishiro K, Diez-Roux AV, Landsbergis PA, et al. Current employment status, occupational category, occupational hazard exposure and job stress in relation to telomere length: the Multiethnic Study of Atherosclerosis (MESA). Occup Environ Med. 2013;70(8):552–60.
Kim JH, Ko JH, Lee DC, et al. Habitual physical exercise has beneficial effects on telomere length in postmenopausal women. Menopause. 2012;19(10):1109–15.
Garland SN, Johnson B, Palmer C, et al. Physical activity and telomere length in early stage breast cancer survivors. Breast Cancer Res. 2014;16(4):413.
Loprinzi PD. Leisure-time screen-based sedentary behavior and leukocyte telomere length: implications for a new leisure-time screen-based sedentary behavior mechanism. Mayo Clin Proc. 2015;90(6):786–90.
Sjogren P, Fisher R, Kallings L, et al. Stand up for health—avoiding sedentary behaviour might lengthen your telomeres: secondary outcomes from a physical activity RCT in older people. Br J Sports Med. 2014;48(19):1407–9.
Washburn RA, Smith KW, Jette AM, et al. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993;46(2):153–62.
Lee JY, Bang HW, Ko JH, et al. Leukocyte telomere length is independently associated with gait speed in elderly women. Maturitas. 2013;75(2):165–9.
Maeda T, Oyama J, Sasaki M, et al. The physical ability of elderly female Japanese patients with cerebrovascular disease correlates with telomere length in their peripheral blood leukocytes. Aging Clin Exp Res. 2011;23(1):22–8.
Maeda T, Oyama J, Higuchi Y, et al. The physical ability of Japanese female elderly with cerebrovascular disease correlates with the telomere length and subtelomeric methylation status in their peripheral blood leukocytes. Gerontology. 2011;57(2):137–43.
Bendix L, Gade MM, Staun PW, et al. Leukocyte telomere length and physical ability among Danish twins age 70+. Mech Ageing Dev. 2011;132(11–12):568–72.
Baylis D, Ntani G, Edwards MH, et al. Inflammation, telomere length, and grip strength: a 10-year longitudinal study. Calcif Tissue Int. 2014;95(1):54–63.
Soares-Miranda L, Imamura F, Siscovick D, et al. Physical activity, physical fitness, and leukocyte telomere length. Med Sci Sports Exerc. 2015;47(12):2525–34.
Zhu H, Wang X, Gutin B, et al. Leukocyte telomere length in healthy Caucasian and African-American adolescents: relationships with race, sex, adiposity, adipokines, and physical activity. J Pediatr. 2011;158(2):215–20.
Garatachea N, Santos-Lozano A, Sanchis-Gomar F, et al. Elite athletes live longer than the general population: a meta-analysis. Mayo Clin Proc. 2014;89(9):1195–200.
Werner C, Furster T, Widmann T, et al. Physical exercise prevents cellular senescence in circulating leukocytes and in the vessel wall. Circulation. 2009;120(24):2438–47.
LaRocca TJ, Seals DR, Pierce GL. Leukocyte telomere length is preserved with aging in endurance exercise-trained adults and related to maximal aerobic capacity. Mech Ageing Dev. 2010;131(2):165–7.
Denham J, Nelson CP, O’Brien BJ, et al. Longer leukocyte telomeres are associated with ultra-endurance exercise independent of cardiovascular risk factors. PLoS One. 2013;8(7):e69377.
Denham J, O’Brien BJ, Prestes PR, et al. Increased expression of telomere-regulating genes in endurance athletes with long leukocyte telomeres. J Appl Physiol (1985). 2015;120(2):148–58.
Mathur S, Ardestani A, Parker B, et al. Telomere length and cardiorespiratory fitness in marathon runners. J Investig Med. 2013;61(3):613–5.
Laine MK, Eriksson JG, Kujala UM, et al. Effect of intensive exercise in early adult life on telomere length in later life in men. J Sports Sci Med. 2015;14(2):239–45.
Mason C, Risques RA, Xiao L, et al. Independent and combined effects of dietary weight loss and exercise on leukocyte telomere length in postmenopausal women. Obesity (Silver Spring). 2013;21(12):E549–54.
Krauss J, Farzaneh-Far R, Puterman E, et al. Physical fitness and telomere length in patients with coronary heart disease: findings from the Heart and Soul Study. PLoS One. 2011;6(11):e26983.
Osthus IB, Sgura A, Berardinelli F, et al. Telomere length and long-term endurance exercise: does exercise training affect biological age? A pilot study. PLoS One. 2012;7(12):e52769.
Ponsot E, Lexell J, Kadi F. Skeletal muscle telomere length is not impaired in healthy physically active old women and men. Muscle Nerve. 2008;37(4):467–72.
Venturelli M, Morgan GR, Donato AJ, et al. Cellular aging of skeletal muscle: telomeric and free radical evidence that physical inactivity is responsible and not age. Clin Sci (Lond). 2014;127(6):415–21.
Collins M, Renault V, Grobler LA, et al. Athletes with exercise-associated fatigue have abnormally short muscle DNA telomeres. Med Sci Sports Exerc. 2003;35(9):1524–8.
Rae DE, Vignaud A, Butler-Browne GS, et al. Skeletal muscle telomere length in healthy, experienced, endurance runners. Eur J Appl Physiol. 2010;109(2):323–30.
Kadi F, Ponsot E, Piehl-Aulin K, et al. The effects of regular strength training on telomere length in human skeletal muscle. Med Sci Sports Exerc. 2008;40(1):82–7.
Ornish D, Lin J, Daubenmier J, et al. Increased telomerase activity and comprehensive lifestyle changes: a pilot study. Lancet Oncol. 2008;9(11):1048–57.
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):1112–20.
Melk A, Tegtbur U, Hilfiker-Kleiner D, et al. Improvement of biological age by physical activity. Int J Cardiol. 2014;176(3):1187–9.
Puterman E, Lin J, Blackburn E, et al. The power of exercise: buffering the effect of chronic stress on telomere length. PLoS One. 2010;5(5):e10837.
Denham J, Marques FZ, Charchar FJ. Leukocyte telomere length variation due to DNA extraction method. BMC Res Notes. 2014;7(1):877.
Aviv A. The epidemiology of human telomeres: faults and promises. J Gerontol A Biol Sci Med Sci. 2008;63(9):979–83.
Aviv A, Hunt SC, Lin J, et al. Impartial comparative analysis of measurement of leukocyte telomere length/DNA content by Southern blots and qPCR. Nucleic Acids Res. 2011;39(20):e134.
Martin-Ruiz CM, Baird D, Roger L, et al. Reproducibility of telomere length assessment: an international collaborative study. Int J Epidemiol. 2015;44(5):1673–83.
Bouchard C, Daw EW, Rice T, et al. Familial resemblance for VO2max in the sedentary state: the HERITAGE family study. Med Sci Sports Exerc. 1998;30(2):252–8.
Bouchard C, An P, Rice T, et al. Familial aggregation of VO(2max) response to exercise training: results from the HERITAGE Family Study. J Appl Physiol (1985). 1999;87(3):1003–8.
Dyrstad SM, Hansen BH, Holme IM, et al. Comparison of self-reported versus accelerometer-measured physical activity. Med Sci Sports Exerc. 2014;46(1):99–106.
Garriguet D, Colley RC. A comparison of self-reported leisure-time physical activity and measured moderate-to-vigorous physical activity in adolescents and adults. Health Rep. 2014;25(7):3–11.
Tully MA, Panter J, Ogilvie D. Individual characteristics associated with mismatches between self-reported and accelerometer-measured physical activity. PLoS One. 2014;9(6):e99636.
Ludlow AT, Witkowski S, Marshall MR, et al. Chronic exercise modifies age-related telomere dynamics in a tissue-specific fashion. J Gerontol A Biol Sci Med Sci. 2012;67(9):911–26.
Werner C, Hanhoun M, Widmann T, et al. Effects of physical exercise on myocardial telomere-regulating proteins, survival pathways, and apoptosis. J Am Coll Cardiol. 2008;52(6):470–82.
Wolf SA, Melnik A, Kempermann G. Physical exercise increases adult neurogenesis and telomerase activity, and improves behavioral deficits in a mouse model of schizophrenia. Brain Behav Immun. 2011;25(5):971–80.
Chilton WL, Marques FZ, West J, et al. Acute exercise leads to regulation of telomere-associated genes and microRNA expression in immune cells. PLoS One. 2014;9(4):e92088.
Laye MJ, Solomon TP, Karstoft K, et al. Increased shelterin mRNA expression in peripheral blood mononuclear cells and skeletal muscle following an ultra-long-distance running event. J Appl Physiol (1985). 2012;112(5):773–81.
Ludlow AT, Lima LC, Wang J, et al. Exercise alters mRNA expression of telomere-repeat binding factor 1 in skeletal muscle via p38 MAPK. J Appl Physiol (1985). 2012;113(11):1737–46.
Schuler G, Adams V, Goto Y. Role of exercise in the prevention of cardiovascular disease: results, mechanisms, and new perspectives. Eur Heart J. 2013;34(24):1790–9.
Sanz C, Gautier JF, Hanaire H. Physical exercise for the prevention and treatment of type 2 diabetes. Diabetes Metab. 2010;36(5):346–51.
Slentz CA, Houmard JA, Kraus WE. Modest exercise prevents the progressive disease associated with physical inactivity. Exerc Sport Sci Rev. 2007;35(1):18–23.
Oeseburg H, de Boer RA, van Gilst WH, et al. Telomere biology in healthy aging and disease. Pflugers Arch. 2010;459(2):259–68.
Khansari N, Shakiba Y, Mahmoudi M. Chronic inflammation and oxidative stress as a major cause of age-related diseases and cancer. Recent Pat Inflamm Allergy Drug Discov. 2009;3(1):73–80.
Ludlow AT, Spangenburg EE, Chin ER, et al. Telomeres shorten in response to oxidative stress in mouse skeletal muscle fibers. J Gerontol A Biol Sci Med Sci. 2014;69(7):821–30.
Gleeson M, Bishop NC, Stensel DJ, et al. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011;11(9):607–15.
Leeuwenburgh C, Heinecke JW. Oxidative stress and antioxidants in exercise. Curr Med Chem. 2001;8(7):829–38.
Shin YA, Lee JH, Song W, et al. Exercise training improves the antioxidant enzyme activity with no changes of telomere length. Mech Ageing Dev. 2008;129(5):254–60.
Dinami R, Ercolani C, Petti E, et al. miR-155 drives telomere fragility in human breast cancer by targeting TRF1. Cancer Res. 2014;74(15):4145–56.
Luke B, Lingner J. TERRA: telomeric repeat-containing RNA. EMBO J. 2009;28(17):2503–10.
Benetti R, Gonzalo S, Jaco I, et al. A mammalian microRNA cluster controls DNA methylation and telomere recombination via Rbl2-dependent regulation of DNA methyltransferases. Nat Struct Mol Biol. 2008;15(9):998.
Yamada Y, Nishida T, Horibe H, et al. Identification of hypo- and hypermethylated genes related to atherosclerosis by a genome-wide analysis of DNA methylation. Int J Mol Med. 2014;33(5):1355–63.
Ribel-Madsen R, Fraga MF, Jacobsen S, et al. Genome-wide analysis of DNA methylation differences in muscle and fat from monozygotic twins discordant for type 2 diabetes. PLoS One. 2012;7(12):e51302.
Denham J, Marques FZ, O’Brien BJ, et al. Exercise: putting action into our epigenome. Sports Med. 2014;44(2):189–209.
Voisin S, Eynon N, Yan X, et al. Exercise training and DNA methylation in humans. Acta Physiol (Oxf). 2015;213(1):39–59.
McGee SL, Hargreaves M. Histone modifications and exercise adaptations. J Appl Physiol (1985). 2011;110(1):258–63.
Denham J, O’Brien BJ, Marques FZ, et al. Changes in the leukocyte methylome and its effect on cardiovascular-related genes after exercise. J Appl Physiol (1985). 2015;118(4):475–88.
Guilleret I, Benhattar J. Unusual distribution of DNA methylation within the hTERT CpG island in tissues and cell lines. Biochem Biophys Res Commun. 2004;325(3):1037–43.
Zhu J, Zhao Y, Wang S. Chromatin and epigenetic regulation of the telomerase reverse transcriptase gene. Protein Cell. 2010;1(1):22–32.
Renaud S, Loukinov D, Bosman FT, et al. CTCF binds the proximal exonic region of hTERT and inhibits its transcription. Nucleic Acids Res. 2005;33(21):6850–60.
Liu L, Saldanha SN, Pate MS, et al. Epigenetic regulation of human telomerase reverse transcriptase promoter activity during cellular differentiation. Genes Chromosomes Cancer. 2004;41(1):26–37.
Benetti R, Gonzalo S, Jaco I, et al. A mammalian microRNA cluster controls DNA methylation and telomere recombination via Rbl2-dependent regulation of DNA methyltransferases. Nat Struct Mol Biol. 2008;15(3):268–79.
Borghini A, Giardini G, Tonacci A, et al. Chronic and acute effects of endurance training on telomere length. Mutagenesis. 2015;30(5):711–6.
Loprinzi PD, Loenneke JP, Blackburn EH. Movement-based behaviors and leukocyte telomere length among US adults. Med Sci Sports Exerc. 2015;47(11):2347–52.
Weischer M, Bojesen SE, Nordestgaard BG. Telomere shortening unrelated to smoking, body weight, physical activity, and alcohol intake: 4576 general population individuals with repeat measurements 10 years apart. PLoS Genet. 2014;10(3):e1004191.
Yang JH, Han H, Jang SY, et al. A comparison of the Ghent and revised Ghent nosologies for the diagnosis of Marfan syndrome in an adult Korean population. Am J Med Genet A. 2012;158A(5):989–95.
Kingma EM, de Jonge P, van der Harst P, et al. The association between intelligence and telomere length: a longitudinal population based study. PLoS One. 2012;7(11):e49356.
Mirabello L, Huang WY, Wong JY, et al. The association between leukocyte telomere length and cigarette smoking, dietary and physical variables, and risk of prostate cancer. Aging Cell. 2009;8(4):405–13.
Woo J, Tang N, Leung J. No association between physical activity and telomere length in an elderly Chinese population 65 years and older. Arch Intern Med. 2008;168(19):2163–4.
Loprinzi PD. Cardiorespiratory capacity and leukocyte telomere length among adults in the United States. Am J Epidemiol. 2015;182(3):198–201.
Maynard S, Keijzers G, Hansen AM, et al. Associations of subjective vitality with DNA damage, cardiovascular risk factors and physical performance. Acta Physiol (Oxf). 2015;213(1):156–70.
Simpson RJ, Cosgrove C, Chee MM, et al. Senescent phenotypes and telomere lengths of peripheral blood T-cells mobilized by acute exercise in humans. Exerc Immunol Rev. 2010;16:40–55.
Bruunsgaard H, Jensen MS, Schjerling P, et al. Exercise induces recruitment of lymphocytes with an activated phenotype and short telomeres in young and elderly humans. Life Sci. 1999;65(24):2623–33.
Hovatta I, de Mello VD, Kananen L, et al. Leukocyte telomere length in the Finnish Diabetes Prevention Study. PLoS One. 2012;7(4):e34948.
Botha M, Grace L, Bugarith K, et al. The impact of voluntary exercise on relative telomere length in a rat model of developmental stress. BMC Res Notes. 2012;5:697.
Acknowledgments
The authors would like to express their gratitude to the Federation University Australia “Self-sustaining Regions Research and Innovation Initiative”, an Australian Government Collaborative Research Network (CRN).
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Joshua Denham is supported by an Australian Post-graduate Award scholarship. Fadi Charchar is supported by the Lew Carty Charitable fund and National Health and Medical Research Council. No other sources of funding were used to assist in the preparation of this article.
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Joshua Denham, Brendan O’Brien and Fadi Charchar declare that they have no conflicts of interest relevant to the content of this review.
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Denham, J., O’Brien, B.J. & Charchar, F.J. Telomere Length Maintenance and Cardio-Metabolic Disease Prevention Through Exercise Training. Sports Med 46, 1213–1237 (2016). https://doi.org/10.1007/s40279-016-0482-4
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DOI: https://doi.org/10.1007/s40279-016-0482-4