February 5, 2020

Telomeres, Inflammation, and Dietary Supplements

New research shows dietary supplements protect telomere length
Nutritional supplements may positively affect telomere length and aging, according to a recent intervention study.


Tsoukalas D, Fragkiadaki P, Docea AO, et al. Association of nutraceutical supplements with longer telomere length. Int J Mol Med. 2019;44(1):218-226.


To determine if nutritional supplements can impact telomere length


Intervention study


Forty-seven healthy outpatients (aged 40 to 55 years) with no history of disease who visited a private clinic in Athens, Greece, for a routine checkup. Individuals with a history of any chronic medical illness were excluded. All participants had never taken nutritional supplements before the study. The 16 participants in the intervention group received supplements; the 31 in the comparator/control group did not receive supplements.


The nutritional supplement intervention included the following:

  • 1 capsule containing a mix of vitamins including vitamins C, E, K2 (as MK-7), B1, B6, B12, niacin, and beta-carotene
  • 4,000 IU of vitamin D (2,000 IU as a drop and 2,000 IU in capsule form)
  • 2 capsules of omega 3-6-9 combination formula
  • 4 capsules of an antioxidant formulation of vitamins and minerals (no phytochemicals)
  • Probiotics (containing specific strains of Lactobacillus spp and Bifidobacterium spp) combined with prebiotics
  • Coenzyme Q10 (CoQ10) as ubiquinol
  • L-glutamine combined with oligofructose (FOS)

Outcome Measures

Quantitative fluorescent in situ hybridization (Q-FISH) was used to measure telomere length in leukocytes at baseline and after 6 to 12 months.

Key Findings

Independent of sex and age, the nutritional supplement group experienced a statistically significant increase in telomere length compared to the control group. There was a 10% increase in telomere length on average in the supplemented group (P<0.05).

Practice Implications

This study is a nice illustration of the positive impact that nutritional supplements can have on health and aging, but it’s only part of the story. Telomere shortening, inflammation, chronic illness, and accelerated aging are all interrelated.

In this study, it is plausible that the dietary supplements used in the intervention group helped protect telomere length via the anti-inflammatory pathway. Interestingly, there are many ways to impact both telomere length and chronic inflammation, including diet, physical activity, and sleep, to name a few. All of these strategies have been shown to influence both telomere length and inflammation.1-3

We no longer see [telomeres] as merely caps on the ends of chromosomes; we now know they are complex nucleoproteins that play an active role in protecting patients from the ills of aging.

For example, adherence to the Mediterranean diet is associated with longer telomeres. This was illustrated by the population-based study featuring a cohort of the Nurses’ Health Study that was published in 2014 in The British Medical Journal.4 Boccardi et al also published data in 2013 showing that high adherence to the Mediterranean diet not only correlated with longer telomeres, but it also was associated with higher telomerase activity.5 It’s worth noting that the present study did not measure telomerase activity, and the authors cite that as a limitation.

Regarding diet, it goes both ways: An unhealthy diet is associated with shorter telomeres. Studies have shown that consumption of sugary soda drinks correlates with shorter telomeres.6,7 This is not surprising because research draws a clear link between unhealthy eating and increased internal inflammation.8

Physical activity has also been linked with longer telomeres and protection against many age-related diseases. More research is needed to determine optimal levels of physical activity as it relates to telomere protection; however, research shows that exercise upregulates genetic expression involved in telomere homeostasis.9 We also know that telomere length is shorter in people who are sedentary, as illustrated by a 2014 randomized, controlled study that looked at physical activity in the elderly.10

Of course, the combination of a healthy diet and physical activity can encourage weight loss, which has also been shown to lengthen telomeres.11

Lack of sleep can also negatively impact telomere length, inflammation, and risk of chronic illness. In 2012 findings from the Whitehall II Cohort Study, involving 434 healthy adults with an average age of 63.3 years, demonstrated that telomere length was shorter in the male participants who slept only 5 hours per night compared to those who slept 7 or more hours per night.12

Over the past decade, the research has eloquently transformed our understanding of telomeres. We no longer see them as merely caps on the ends of chromosomes; we now know they are complex nucleoproteins that play an active role in protecting us from the ills of aging. Telomere research also paints a perfect picture of how an integrative approach can make an important difference clinically. By combining diet, lifestyle, and dietary supplements, integrative practitioners can help patients reduce inflammation while increasing the likelihood of healthy aging. This latest study adds to a growing list of integrative approaches that can help lengthen telomeres.

Study Limitations

This study has 2 key limitations:

  1. Study size. More research involving a larger patient population is warranted.
  2. Intervention size. Such an extensive intervention brings up issues of patient compliance, cost to the patient, and the inability to identify exactly which nutrient or group of nutrients can influence telomere length.

Categorized Under


  1. Liang G, Schernhammer E, Qi L, Gao X, De Vivo I, Han J. Associations between rotating night shifts, sleep duration, and telomere length in women. PloS One. 2011;6(8):e23462.
  2. Paul, L. Diet, nutrition and telomere length. J Nutr Biochem. 2011;22(10):895-901.
  3. Puterman E, Lin J, Blackburn E, O’Donovan A, Adler N, Epel E. The power of exercise: buffering the effect of chronic stress on telomere length. PloS One. 2010;5(5):e10837.
  4. Crous-Bou M, Fung TT, Prescott J, et al. Mediterranean diet and telomere length in Nurses’ Health Study: population based cohort study. BMJ. 2014;349:g6674.
  5. Boccardi V, Esposito A, Rizzo MR, Marfella R, Barbieri M, Paolisso G. Mediterranean diet, telomere maintenance and health status among elderly. PLoS One. 2013;8(4):e62781.
  6. Leung CW, Laraia BA, Coleman-Phox K, et al. Sugary beverage and food consumption, and leukocyte telomere length maintenance in pregnant women. Eur J Clin Nutr. 2016;70(9):1086-1088.
  7. Leung CW, Laraia BA, Needham BL, et al. Soda and cell aging: associations between sugar-sweetened beverage consumption and leukocyte telomere length in healthy adults from the National Health and Nutrition Examination Surveys. Am J Public Health. 2014;104(12):2425-2431.
  8. Minihane AM, Vinoy S, Russell WR, et al. Low-grade inflammation, diet composition and health: current evidence and its translation. Br J Nutr. 2015;114(7):999-1012.
  9. Balan E, Decottignies A, Deldicque L. Physical activity and nutrition: two promising strategies for telomere maintenance? Nutrients. 2018;10(12):1942.
  10. Sjögren P, Fisher R, Kallings L, Svenson U, Roos G, Hellénius ML. Stand up for health—avoiding sedentary behaviour might lengthen your telomeres: secondary outcomes from a physical activity RCT in older people. Br J Sports Med. 2014;48(19):1407-1409.
  11. Carulli L, Anzivino C, Baldelli E, Zenobii MF, Rocchi MB, Bertolotti M. Telomere length elongation after weight loss intervention in obese adults. Mol Genet and Metab. 2016;118(2):138-42..
  12. Jackowska M, Hamer M, Carvalho LA, Erusalimsky JD, Butcher L, Steptoe A. Short sleep duration is associated with shorter telomere length in healthy men: findings from the Whitehall II Cohort Study. PLoS One. 2012;7(10):e47292.