Telomeres: the new biomarker of health

It has been over 500 years since Ponce De Leon embarked on his quest in search of the Fountain of Youth. 

Unfortunately despite our vast expanses in knowledge and understanding of the human body, we have yet to find the holy grail of anti-aging.  Social media and modern-day marketing, complete with a vast array of health tips, biohacking expert advice, dietary gimmicks, and quick-fix solutions, would lead you to believe otherwise.  If only it were that easy!  Staying healthy and aging well is a complicated business but at the foundation, it can be rather simple.  It all comes down to how our cells are aging on the inside that really matters.  Most of us are familiar with tracking our blood pressure, weight, laboratory data, and even body fat percentage as a biomarker to monitor and compare our level of health over time.  But there is more to the story than these basic numbers.   Enter telomeres and DNA testing which can reflect how you are aging on the inside.

Telomeres have garnered much attention in the past two decades. Telomere length specifically has been identified as one of the major determinants of aging and longevity in higher mammals.  Studies have demonstrated a direct correlation between telomere length and life expectancy, stress, DNA damage, and the onset of aging-related diseases.   Telomeres are the protective caps found at the ends of chromosomes that protect our genetic information during cellular division.  For our bodies to heal and function properly, cells must divide to produce new cells as well as replace old, worn-out cells.  Telomeres allow our cells to divide without damaging or scrambling the cells’ genetic information.  A great analogy for telomeres is the plastic tips on the shoelaces. They keep the chromosome ends from tangling and fraying much like the plastic tips due to your laces.   The normal process of cellular aging will result in shorter telomere length over time.  Measurement of telomere length can be compared in relation to chronological age to reflect how fast or slow the cells are aging.  This can be monitored and compared over time just like tracking your weight or blood pressure, albeit a bit more complicated.  

So why should you have any interest in checking your telomeres?  Telomere testing can be another biomarker or tool used to track your health.  Ultimately it may provide utility to monitor and influence positive lifestyle changes such as healthy diet, nutritional supplements, weight loss goals, exercise habits, and other factors known to influence telomere lengths.  Companies that measure telomere length include SpectraCell and Teloyears but more are on the horizon.  These are simple blood tests that allow you to determine your telomere length and tract effectiveness of your health behaviors.  The blood tests have been noted to be more reliable than saliva.  It is important to note that the accuracy and reliability of most testing is not 100%.

There is an increasing number of recommendations coming from literature and research into the best measures to maintain or even improve telomere length.  Many of these certainly focus on management and reversal of chronic disease through a reduction in inflammation, oxidative stress, production of nitric oxide and arginine, and improved mitochondrial function.  At the foundation of each of these are a low inflammatory diet, sleep, exercise, stress management, and nutritional supplements. Interestingly, fasting and caloric restriction are emerging topics that can play a role in life expectancy and telomere length.  

So where to start to have the biggest impact on preserving your telomere length?  The answer is simple — your fork!   An anti-inflammatory diet which includes ample fruits, vegetables, fiber, omega-3 fatty acids, cold-water fish, and high-quality vegetable proteins can help preserve telomere length.  The Nurses Health Study, one of the largest research studies into risk factors for major chronic diseases in women,  noted that adherence to a Mediterranean diet managed to preserve a telomere length that corresponded to 4.5 years of aging. Oxidative stress is thought to shorten telomere length by impacting aging in cellular tissues.  This highlights the need to include antioxidant supplements as well as foods high in phytochemicals and nutrients to reap these benefits. Fasting and intermittent fasting can also have a significant impact.  Remember fasting is when your cells are able to repair and clean up damage through a process called autophagy.  One more reason not to be eating 24-7 is the norm in today’s culture.  Be wise and avoid all those processed and refined carbs, added sugars, and unhealthy fats that can have a negative impact on your telomeres.  Just something to think about when you grab a quick-fix snack on the go. 

Research has also shown that a number of medications can slow the rate of telomere loss.  Some of these include cardiovascular medication such as ACE inhibitors, statins, aspirin, bioidentical hormone replacement therapy, and possibly Metformin.  A safer option for most people would be to consider appropriate supplementation in addition to a healthy anti-inflammatory diet and lifestyle.  Recent evidence suggests that a high-quality multivitamin can help maintain telomere length.  Correcting subclinical nutritional deficiencies that impact chronic diseases is also critical.  In fact, homocysteine levels have been inversely associated with telomere length suggesting that adequate folate and B vitamin levels may decrease the rate of telomere loss.  It is always important to remember that food is superior to dietary supplements due to the synergistic effect of a variety of compounds found in the original plant product. Of note, the exact dosage of these supplements has yet to be established.  

Self-care and daily lifestyle habits are other factors that impact the rate at which your telomeres shorten.  Countless studies have looked at exercise and its impact on telomere length.  A recent 30-year long study showed that people who practice moderate physical activity in midlife had longer telomeres in old age than participants who had low and or high physical activity.  These results suggest a dose-related link between the intensity of physical exercise, telomere length, and baselines DNA damage. Further research is needed however to find the optimal types and amount of exercise for preserving telomere length.  Meditation and mindfulness practices have also been shown to preserve as well as potentially impact telomere length.  It is well known that better mental health greatly contributes to physical health as well.  Some studies directly link meditation and positive psychological change with telomerase activity showing that mental health is an adjustable factor.   Lastly, do not forget the undeniable health benefits of getting ample sleep.  Your body repairs while you sleep.  This is reflected in the importance of 8 hours of nightly sleep for optimal telomere length. 

The most accurate measure of someone’s age and life expectancy still remains the date on their birth certificate.  However, the quest for the fountain of youth will endure.  Aging in a sense is not really a “disease” but something we all inevitably must face and it is doubtful that there will be a “cure”.  Until then, know that healthy lifestyle behaviors continue to demonstrate a significant impact on long term health and vitality as well as aging. As science progresses and testing and interpretation improve, telomere testing may become a more important biomarker in personalized medicine.   Stay tuned!