A small pilot study shows for the first time that changes in diet, exercise, stress management and social support may result in longer telomeres, the parts of chromosomes that affect aging.
It is the first controlled trial to show that any intervention might lengthen telomeres over time.
The study will be published online in The Lancet Oncology.
The study was conducted by scientists at UC San Francisco and the Preventive Medicine Research Institute, a nonprofit public research institute in Sausalito, Calif. that investigates the effect of diet and lifestyle choices on health and disease. The researchers say they hope the results will inspire larger trials to test the validity of the findings. 
“Our genes, and our telomeres, are not necessarily our fate,” says lead author Dean Ornish, UCSF clinical professor of medicine, and founder and president of the Preventive Medicine Research Institute.
“So often people think ‘Oh, I have bad genes, there’s nothing I can do about it,’” Ornish says. “But these findings indicate that telomeres may lengthen to the degree that people change how they live. Research indicates that longer telomeres are associated with fewer illnesses and longer life.”Ten of the patients in the study embarked on lifestyle changes that included: a plant-based diet, moderate exercise and stress reduction.
Study of early-stage prostate cancer patients
Telomeres are the protective caps on the ends of chromosomes that affect how quickly cells age. They are combinations of DNA and protein that protect the ends of chromosomes and help them remain stable. As they become shorter, and as their structural integrity weakens, the cells age and die quicker.
In recent years, shorter telomeres have become associated with a broad range of aging-related diseases, including many forms of cancer, stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis and diabetes.
For five years, the researchers followed 35 men with localized, early-stage prostate cancer to explore the relationship between comprehensive lifestyle changes, and telomere length and telomerase activity. All the men were engaged in active surveillance, which involves closely monitoring a patient’s condition through screening and biopsies.
Ten of the patients embarked on lifestyle changes that included: a plant-based diet (high in fruits, vegetables and unrefined grains, and low in fat and refined carbohydrates); moderate exercise (walking 30 minutes a day, six days a week); stress reduction (gentle yoga-based stretching, breathing, meditation). They also participated in weekly group support.  
They were compared to the other 25 study participants who were not asked to make major lifestyle changes.
The group that made the lifestyle changes experienced a “significant” increase in telomere length of approximately 10 percent. Further, the more people changed their behavior by adhering to the recommended lifestyle program, the more dramatic their improvements in telomere length, the scientists learned.
By contrast, the men in the control group who were not asked to alter their lifestyle had measurably shorter telomeres– nearly 3 percent shorter– when the five-year study ended. Telomere length usually decreases over time.
Possibilities for general population
The researchers say the findings may not be limited to men with prostate cancer, and are likely to be relevant to the general population.   
“We looked at telomeres in the participants’ blood, not their prostate tissue,” says Ornish.
The new study is a follow up to a similar, three-month pilot investigation in 2008 in which the same participants were asked to follow the same lifestyle program. After three months, the men in the initial study exhibited significantly increased telomerase activity. Telomerase is an enzyme that repairs and lengthens telomeres.   
The new study was designed to determine if the lifestyle changes would affect telomere length and telomerase activity in these men over a longer time period.
“This was a breakthrough finding that needs to be confirmed by larger studies,” says co-senior author Peter Carroll, professor and chair of the UCSF Department of Urology.
“Telomere shortening increases the risk of a wide variety of chronic diseases,” Carroll says. “We believe that increases in telomere length may help to prevent these conditions and perhaps even lengthen lifespan.”
Other co-authors from UCSF include senior author and Nobel laureate Elizabeth Blackburn, professor of biochemistry and biophysics, Jue Lin, associate research biochemist, June Chan, associate professor of epidemiology & biostatistics, Elissa Epel, associate professor of psychiatry, Mark Jesus Magbanua, associate specialist, Jennifer Daubenmier and Nancy Hills, associate adjunct professors, and Nita Chainani-Wu, assistant clinical professor.  
The research was supported by the U.S. Department of Defense, the National Institute of Health and National Cancer Institute, Furlotti Family Foundation, Bahna Foundation, DeJoria Foundation, Walton Family Foundation, Resnick Foundation, Greenbaum Foundation, Natwin Foundation, Safeway Foundation and the Prostate Cancer Foundation.
Lin, Epel and Blackburn were co-founders of Telome Health Inc., a diagnostic company that assess telomere biology– THI had no relationship to this study. Ornish works with Healthways Inc. to educate and support people in making healthier behaviors.