A Comprehensive, Multidisciplinary, Personalized, Lifestyle Intervention Program Is Associated with Increased Leukocyte Telomere Length in Children and Adolescents with Overweight and Obesity

Abstract

Leucocyte telomere length (LTL) is a robust marker of biological aging and is associated with obesity and cardiometabolic risk factors in childhood and adolescence. We investigated the effect of a structured, comprehensive, multidisciplinary, personalized, lifestyle intervention program of healthy diet and physical exercise on LTL in 508 children and adolescents (239 males, 269 females; 282 prepubertal, 226 pubertal), aged 10.14 ± 0.13 years. Participants were classified as obese (n = 267, 52.6%), overweight (n = 174, 34.2%), or of normal BMI (n = 67, 13.2%) according to the International Obesity Task Force (IOTF) cutoff points and were studied prospectively for one year. We demonstrated that LTL increased significantly after 1 year of the lifestyle interventions, irrespective of gender, pubertal status, or body mass index (BMI). Waist circumference was the best negative predictor of LTL at initial assessment. The implementation of the lifestyle interventions also resulted in a significant improvement in clinical (BMI, BMI z-score and waist to height ratio) and body composition indices of obesity, inflammatory markers, hepatic enzymes, glycated hemoglobin (HbA1C), quantitative insulin sensitivity check index (QUICKI), and lipid profile in all participants. These findings indicate that the increased LTL may be associated with a more favorable metabolic profile and decreased morbidity later in life.

Association between Telomere Length and Pediatric Obesity: A Systematic Review

“…Among these full-text articles, 13 were excluded for the following reasons: namely reviews/systematic reviews, duplicate papers, other age group or information that did not meet the eligibility criteria and the purpose of this systematic review. Finally, 16 full-text articles [ 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ] were considered eligible and were included to our qualitative synthesis. The study selection procedure is detailed in the respective flow chart ( Figure 1 ).…”

“…The age ranged from 2 to 18 years and the percentage of boys was between 46.0% and 67.7%. The majority of the included studies (15/16) used quantitative real-time PCR (qPCR) to evaluate telomere length [ 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 95 , 96 , 97 , 98 , 99 ], while one study (1/16) used terminal restriction fragmentation (TRF) method [ 94 ]. Most studies (8/11) measured telomere length from leukocytes.…”

“…The ages ranged from 7 to 16 years and the percentage of boys was between 36.0% and 48.6%. All of the included studies used quantitative real-time PCR (qPCR) to evaluate telomere length and measured telomere length from leukocytes [ 95 , 96 , 97 , 98 , 99 ]. Lifestyle interventions in all five studies included dietary and physical activity interventions, and in all of them, participants are reported to have lost weight.…”

“…Lifestyle interventions in all five studies included dietary and physical activity interventions, and in all of them, participants are reported to have lost weight. Of the five studies that evaluated the effect of a lifestyle intervention program in obese or overweight children, three demonstrated a significant increase in TL as a result of a decrease in BMI [ 95 , 98 , 99 ]. In two of the studies, TL increased following two months of intervention, while in the study conducted by our group, TL increased in all subjects following twelve months of intervention [ 95 ].…”

“…Of the five studies that evaluated the effect of a lifestyle intervention program in obese or overweight children, three demonstrated a significant increase in TL as a result of a decrease in BMI [ 95 , 98 , 99 ]. In two of the studies, TL increased following two months of intervention, while in the study conducted by our group, TL increased in all subjects following twelve months of intervention [ 95 ]. In two studies, TL did not show a significant change [ 96 , 97 ].…”