The Impact of Health Promotion Interventions on Telomere Length: A Systematic Review.

Qiao, Shan; Jiang, Yanping; Li, Xiaoming

OBJECTIVES The aim of this study was to evaluate the effectiveness of health promotion interventions in delaying telomere shortening (a biomarker for aging). DATA SOURCE PubMed, PsychINFO, EMBASE, CINAHL, and Cochrane Library databases. STUDY INCLUSION AND EXCLUSION CRITERIA Inclusion criteria: (1) empirical studies involving human subjects; (2) health promotion intervention studies including both randomized control trials (RCTs) and non-RCTs.; (3) measured telomere length as an intervention outcome; and (4) were written in English. Exclusion criteria: (1) observational studies without any health promotion intervention practices and (2) did not report intervention effects. DATA EXTRACTION Data extraction was performed by two reviewers following the preferred reporting items for systematic reviews and meta-analysis guidelines. DATA SYNTHESIS Substantial heterogeneity in intervention type and study design in the included studies precluded a meta-analysis. We conducted a narrative synthesis instead. RESULTS Thirty studies were included in the review, of which 16 were RCTs. One-third of the included studies reported significant intervention impacts in delaying telomere shortening, with relatively consistent significant results emerged from weight-loss interventions and interventions involving multiple lifestyle modification components (eg, diet and exercise). Most of supplement intervention studies observed null effects in telomere length. CONCLUSIONS Weight-loss and comprehensive lifestyle intervention strategies show encouraging impacts in delaying telomere shortening. More rigorous studies targeting populations at different age stages through life span are needed.