After Stressful Year, Women With Healthier Behaviors Have Less Telomere Shortening

By Lorraine L Janeczko

August 19, 2014

NEW YORK (Reuters Health) - Major life stressors are associated with accelerated telomere shortening in postmenopausal women, but healthy behaviors appear to protect against this effect, according to new research.

"Our findings are the first to suggest that perhaps it doesn't take decades to age cells, but that it can even happen in one year," lead author Dr. Eli Puterman of the University of California, San Francisco, told Reuters Health by email.

"We all age, this is unavoidable. But the stressful events that occur in our lives may in fact speed up the aging process, at least as seen in our immune system and our telomeres. Our findings suggest that how we live -- in terms of our health behaviors -- can make things worse or better," he added.

"The women in our study who didn't exercise, who slept and ate poorly had significant shortening of their telomeres over the year as a result of stressful events, but the women who ate and slept well and exercised, even if they experienced stress, seemed protected from stress in a way that their telomeres didn't shorten more than what was natural for them," Dr. Puterman said.

He and colleagues recruited 263 healthy women aged 50 to 65 years from the San Francisco Bay Area. They excluded current smokers as well as those with cancer within the past 10 years or any autoimmune disease, they report in Molecular Psychiatry, online July 29.

The researchers measured the women's telomere length at the beginning and end of one year and tracked their health behaviors and stress over the course of that year.

The women had their blood drawn at baseline and at the one-year follow-up. They recorded their leisure time physical activities, typical foods eaten and sleep quality at baseline, four months, eight months and at one year.

At one year, they all completed a 13-item checklist covering major adverse life stressors over the previous year, including loss of household, major financial problems, divorce, caregiving for a seriously ill adult or child, death of a family member or friend and sexual harassment. Each item carried 1 point.

The participants also rated their physical activity level on a scale from 0 (little activity) to 4 (exercise five or more days a week); the quality of their diet, from 1 (eating healthy foods rarely or never) to 9 (eating healthy foods twice a day or more); and overall sleep quality, from 1 (very bad) to 5 (very good).

Of the 239 women who returned for the one-year follow-up blood draw, most remained within 5% of their original telomere length, but the year's stressors and lifestyle predicted a significant change in length.

Overall, for every major life stressor the women experienced during the year, their telomere length decreased by 35 base pairs (p<0.05).

The women's health behaviors significantly moderated these effects, though, with women who maintained relatively higher levels of health behaviors (one standard deviation above the mean) appearing to be protected when exposed to stress.

Among the women with relatively poor health behaviors (1 standard deviation below the average sample mean), every additional stressor was related to accelerated telomere shortening over the year by an additional mean 76.5 base pairs (p=0.001) compared with women with no adverse stressors.

Among those with average levels of health behaviors, telomere shortening accelerated over the year by an additional 39.6 base pairs for every major life stressor that occurred, on average (p=0.04).

For women with very healthy behaviors (1 standard deviation above the average sample mean), life stressors were unrelated to telomere shortening (p>0.50).

"What was surprising was that these were, for the most part, well-educated, well-to-do women living in the San Francisco Bay Area, who were free of diseases. These women were at levels of psychological stress below the national norms at the start of the study so to find that stressful events impacts these women as well suggests that these effects extend to many people, even people we expect to be living good lives," Dr. Puterman observed.

Co-author Dr. Jeffrey Krauss of Stanford University in Stanford, California, told Reuters Health by email, "The study demonstrates that exercise, healthy diet, and sleep may help protect us at a cellular level from life's inevitable stressors. Physicians now have more evidence to promote healthy lifestyle choices, even (or especially) when patients are going through difficult, stressful periods."

Senior author and co-principal investigator Dr. Elissa S. Epel, also of the University of California, San Francisco, added in an email, "We are getting closer to understanding how telomere length dynamics function in daily life. It may be a measure that is helpful to monitor, to assess not just the risks, but the benefits of lifestyle changes."

The hopeful message of these findings is that healthy behaviors during highly stressful periods can perhaps attenuate immune cell aging, the authors wrote.

The authors cautioned that stress levels in the United States are currently at an all-time high and that stressed adults are less likely to engage in healthy behaviors.

"Although stress varies between individuals, it is not an individual problem. It is imperative that the health care system and policy makers find creative and powerful ways to promote engagement and maintenance of health behaviors, which in turn can help allay the destructive effects of the increasing levels of societal stress," they write.

Drs. Epel and two co-authors are cofounders of Telome Health, a diagnostic company measuring telomere biology.


Mol Psychiatry 2014.


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