Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Longitudinal association of telomere length and obesity indices in an intervention study with a Mediterranean diet: the PREDIMED-NAVARRA trial



Telomeres are nucleoprotein structures that protect the ends of eukaryote chromosomes. Shorter telomere length (TL) is associated with some age-related human disorders, but its relationship with obesity or adiposity parameters remains unclear.


The aim of this study was to assess the relationship between TL and changes in adiposity indices after a 5-year nutritional intervention.

Design and subjects:

TL was measured by quantitative real-time PCR in 521 subjects (55–80 years, 55% women). Participants were randomly selected from the PREDIMED-NAVARRA centre after they completed a 5-year intervention programme. Anthropometric parameters were directly measured by trained personnel at baseline and on a yearly basis thereafter. TL at baseline and changes in TL after a 5-year intervention were assessed.


Higher baseline TL significantly predicted a greater decrease in body weight (B=−1.09 kg, 95% confidence interval (CI): −2.01 to −0.16), body mass index (BMI) (B=−0.47 kg m−2, 95% CI: −0.83 to −0.11), waist circumference (B=−1.15 cm, 95% CI: −2.28 to −0.01) and waist to height ratio (B=−0.008, 95% CI: −0.010 to −0.001) in multiple-adjusted models. In addition, changes in TL during the 5-year intervention were inversely associated with changes in the four anthropometric variables. The reduction in adiposity indices during the intervention, associated with increasing TL, was even higher among subjects with the longest telomeres at baseline. Logistic regression analysis showed that the risk of remaining obese after 5 years was lower in those participants who initially had the longest telomeres and increased their TL after intervention (odds ratio=0.27, 95% CI: 0.03–2.03).


Our research suggests that TL is inversely associated with changes in obesity parameters. The assessment of TL can provide further insights for biological pathways leading to adiposity. We show for the first time an improvement of obesity indices when an increase in TL is observed after a 5-year Mediterranean diet intervention.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Get just this article for as long as you need it


Prices may be subject to local taxes which are calculated during checkout


  1. Blackburn EH . Structure and function of telomeres. Nature 1991; 350: 569–573.

    Article  CAS  Google Scholar 

  2. Njajou OT, Cawthon RM, Damcott CM, Wu SH, Ott S, Garant MJ et al. Telomere length is paternally inherited and is associated with parental lifespan. Proc Natl Acad Sci USA 2007; 104: 12135–12139.

    Article  CAS  Google Scholar 

  3. Aviv A, Chen W, Gardner JP, Kimura M, Brimacombe M, Cao X et al. Leukocyte telomere dynamics: longitudinal findings among young adults in the Bogalusa Heart Study. Am J Epidemiol 2009; 169: 323–329.

    Article  Google Scholar 

  4. Shen Q, Zhao X, Yu L, Zhang Z, Zhou D, Kan M et al. Association of leukocyte telomere length with type 2 diabetes in mainland Chinese populations. J Clin Endocrinol Metab 2012; 97: 1371–1374.

    Article  CAS  Google Scholar 

  5. Risques RA, Vaughan TL, Li X, Odze RD, Blount PL, Ayub K et al. Leukocyte telomere length predicts cancer risk in Barrett's esophagus. Cancer Epidemiol Biomarkers Prev 2007; 16: 2649–2655.

    Article  CAS  Google Scholar 

  6. Tzanetakou IP, Katsilambros NL, Benetos A, Mikhailidis DP, Perrea DN . ‘Is obesity linked to aging?’: adipose tissue and the role of telomeres. Ageing Res Rev 2012; 11: 220–229.

    Article  Google Scholar 

  7. Cui Y, Gao YT, Cai Q, Qu S, Cai H, Li HL et al. Associations of leukocyte telomere length with body anthropometric indices and weight change in Chinese women. Obesity (Silver Spring) 2013. doi:10.1002/oby.20321.

  8. Rankin JW, Andreae MC, Oliver Chen CY, O'Keefe SF . Effect of raisin consumption on oxidative stress and inflammation in obesity. Diabetes Obes Metab 2008; 10: 1086–1096.

    Article  CAS  Google Scholar 

  9. Suzuki K, Ito Y, Ochiai J, Kusuhara Y, Hashimoto S, Tokudome S et al. Relationship between obesity and serum markers of oxidative stress and inflammation in Japanese. Asian Pac J Cancer Prev 2003; 4: 259–266.

    Google Scholar 

  10. Valdes AM, Andrew T, Gardner JP, Kimura M, Oelsner E, Cherkas LF et al. Obesity, cigarette smoking, and telomere length in women. Lancet 2005; 366: 662–664.

    Article  CAS  Google Scholar 

  11. Buxton JL, Walters RG, Visvikis-Siest S, Meyre D, Froguel P, Blakemore AI . Childhood obesity is associated with shorter leukocyte telomere length. J Clin Endocrinol Metab 2011; 96: 1500–1505.

    Article  CAS  Google Scholar 

  12. Lee M, Martin H, Firpo MA, Demerath EW . Inverse association between adiposity and telomere length: The Fels Longitudinal Study. Am J Hum Biol 2011; 23: 100–106.

    Article  CAS  Google Scholar 

  13. Cherkas LF, Aviv A, Valdes AM, Hunkin JL, Gardner JP, Surdulescu GL et al. The effects of social status on biological aging as measured by white-blood-cell telomere length. Aging Cell 2006; 5: 361–365.

    Article  CAS  Google Scholar 

  14. Nordfjall K, Eliasson M, Stegmayr B, Melander O, Nilsson P, Roos G . Telomere length is associated with obesity parameters but with a gender difference. Obesity (Silver Spring) 2008; 16: 2682–2689.

    Article  Google Scholar 

  15. O'Callaghan NJ, Clifton PM, Noakes M, Fenech M . Weight loss in obese men is associated with increased telomere length and decreased abasic sites in rectal mucosa. Rejuvenation Res 2009; 12: 169–176.

    Article  CAS  Google Scholar 

  16. Gardner JP, Li S, Srinivasan SR, Chen W, Kimura M, Lu X et al. Rise in insulin resistance is associated with escalated telomere attrition. Circulation 2005; 111: 2171–2177.

    Article  CAS  Google Scholar 

  17. Njajou OT, Cawthon RM, Blackburn EH, Harris TB, Li R, Sanders JL et al. Shorter telomeres are associated with obesity and weight gain in the elderly. Int J Obes (Lond) 2012; 36: 1176–1179.

    Article  CAS  Google Scholar 

  18. Martinez-Gonzalez MA, Corella D, Salas-Salvado J, Ros E, Covas MI, Fiol M et al. Cohort profile: design and methods of the PREDIMED study. Int J Epidemiol 2012; 41: 377–385.

    Article  Google Scholar 

  19. Estruch R, Martinez-Gonzalez MA, Corella D, Salas-Salvado J, Ruiz-Gutierrez V, Covas MI et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med 2006; 145: 1–11.

    Article  Google Scholar 

  20. Cawthon RM . Telomere measurement by quantitative PCR. Nucleic Acids Res 2002; 30: e47.

    Article  Google Scholar 

  21. Elosua R, Marrugat J, Molina L, Pons S, Pujol E . Validation of the Minnesota leisure time physical activity questionnaire in Spanish men. The MARATHOM investigators. Am J Epidemiol 1994; 139: 1197–1209.

    Article  CAS  Google Scholar 

  22. Martinez-Gonzalez MA, Lopez-Fontana C, Varo JJ, Sanchez-Villegas A, Martinez JA . Validation of the Spanish version of the physical activity questionnaire used in the Nurses' Health Study and the Health Professionals' Follow-up Study. Public Health Nutr 2005; 8: 920–927.

    Article  Google Scholar 

  23. Martin-Moreno JM, Boyle P, Gorgojo L, Maisonneuve P, Fernandez-Rodriguez JC, Salvini S et al. Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol 1993; 22: 512–519.

    Article  CAS  Google Scholar 

  24. Hovatta I, de Mello VD, Kananen L, Lindstrom J, Eriksson JG, Ilanne-Parikka P et al. Leukocyte telomere length in the Finnish Diabetes Prevention Study. PLoS One 2012; 7: e34948.

    Article  CAS  Google Scholar 

  25. Svenson U, Nordfjall K, Baird D, Roger L, Osterman P, Hellenius ML et al. Blood cell telomere length is a dynamic feature. PLoS One 2011; 6: e21485.

    Article  CAS  Google Scholar 

  26. Nordfjall K, Svenson U, Norrback KF, Adolfsson R, Lenner P, Roos G . The individual blood cell telomere attrition rate is telomere length dependent. PLoS Genet 2009; 5: e1000375.

    Article  Google Scholar 

  27. Fitzpatrick AL, Kronmal RA, Gardner JP, Psaty BM, Jenny NS, Tracy RP et al. Leukocyte telomere length and cardiovascular disease in the cardiovascular health study. Am J Epidemiol 2007; 165: 14–21.

    Article  Google Scholar 

  28. Bischoff C, Petersen HC, Graakjaer J, Andersen-Ranberg K, Vaupel JW, Bohr VA et al. No association between telomere length and survival among the elderly and oldest old. Epidemiology 2006; 17: 190–194.

    Article  Google Scholar 

  29. Bekaert S, De Meyer T, Rietzschel ER, De Buyzere ML, De Bacquer D, Langlois M et al. Telomere length and cardiovascular risk factors in a middle-aged population free of overt cardiovascular disease. Aging Cell 2007; 6: 639–647.

    Article  CAS  Google Scholar 

  30. Diaz VA, Mainous AG, Player MS, Everett CJ . Telomere length and adiposity in a racially diverse sample. Int J Obes (Lond) 2010; 34: 261–265.

    Article  CAS  Google Scholar 

  31. Kim S, Parks CG, DeRoo LA, Chen H, Taylor JA, Cawthon RM et al. Obesity and weight gain in adulthood and telomere length. Cancer Epidemiol Biomarkers Prev 2009; 18: 816–820.

    Article  CAS  Google Scholar 

  32. Farzaneh-Far R, Lin J, Epel E, Lapham K, Blackburn E, Whooley MA . Telomere length trajectory and its determinants in persons with coronary artery disease: longitudinal findings from the heart and soul study. PLoS One 2010; 5: e8612.

    Article  Google Scholar 

  33. Al-Attas OS, Al-Daghri N, Bamakhramah A, Shaun Sabico S, McTernan P, Huang TT . Telomere length in relation to insulin resistance, inflammation and obesity among Arab youth. Acta Paediatr 2010; 99: 896–899.

    Article  CAS  Google Scholar 

  34. Lee CM, Huxley RR, Wildman RP, Woodward M . Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol 2008; 61: 646–653.

    Article  Google Scholar 

  35. Marin C, Delgado-Lista J, Ramirez R, Carracedo J, Caballero J, Perez-Martinez P et al. Mediterranean diet reduces senescence-associated stress in endothelial cells. Age (Dordr) 2012; 34: 1309–1316.

    Article  CAS  Google Scholar 

  36. Balasubramanyam M, Adaikalakoteswari A, Monickaraj SF, Mohan V. . Telomere shortening & metabolic/vascular diseases. Indian J Med Res 2007; 125: 441–450.

    CAS  PubMed  Google Scholar 

Download references


Research relating to this work was funded by grants from Línea Especial, Nutrición, Obesidad y Salud of the University of Navarra (LE/97), the Spanish Government (FIS-ISCIII: PI050976, PI070240, PI081943, PI1002293, RTIC 06/0045, CIBERobn, CNIC/06 and SAF-2010-20367) and the Government of Navarra (PI41/2005, PI79/2006, PI36/2008 and PI54/2009). The FPU fellowships to Sonia García-Calzón and to Alfredo Gea from the Spanish Ministry of Education, Culture and Sport are fully acknowledged. We thank all the participants in the trial for their enthusiastic and maintained collaboration, the personnel of the primary care centres from Navarra and other investigators of the PREDIMED group: Salas-Salvadó J, Estruch R, Covas MI, Fiol M, Ros E, Aros F, Gomez-Gracia E, Ruiz-Gutierrez V, Warnberg J, Saez G, Lapetra J, Serra-Majem L, Pinto L, Tur JA, Mitjavila MT, Portillo MP, Basora J, Fernandez-Crehuet J, Muñoz MA and Tello S. University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain: Toledo E, Sánchez-Tainta A, Sanjulián, Goñi E, Marques M, García-Arellano A, Zazpe I, Basterra-Gortari J, Martínez-Lapiscina EH and Buil-Cosiales P. University of Navarra, Primary Care Centres, Pamplona, Spain: Serrano-Martínez M, Díez-Espino J, Ortuño N, Berrade N, Extremera-Urabayen V, Arroyo-Azpa C, García-Pérez L, Villanueva Tellería J, Cortés Ugalde F, Sagredo Arce T, García de la Noceda Montoy M D, Vigata López M D, Arceiz Campo M T, Urtasun Samper A, Gueto Rubio M V and Churio Beraza B. We gratefully acknowledge technical assistance by Idoia Rodríguez and Mikel Alguacil.

Author information

Authors and Affiliations


Corresponding author

Correspondence to A Marti.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

García-Calzón, S., Gea, A., Razquin, C. et al. Longitudinal association of telomere length and obesity indices in an intervention study with a Mediterranean diet: the PREDIMED-NAVARRA trial. Int J Obes 38, 177–182 (2014).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • telomere length
  • adiposity
  • aging
  • nutritional intervention

This article is cited by


Quick links