Exercise delays aging: evidence from telomeres and telomerase —a systematic review and meta-analysis of randomized controlled trials

ObjectiveTo systematically evaluate the regulatory effects of exercise intervention on telomere length (TL) and telomerase activity (TA), and to provide evidence for formulating precise exercise prescriptions based on telomere protection.MethodsDatabases including China National Knowledge Infrastruc...

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Main Authors: Liang Sun, Tingran Zhang, Lanfang Luo, Yi Yang, Chuanqiushui Wang, Jiong Luo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Physiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2025.1627292/full
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author Liang Sun
Tingran Zhang
Lanfang Luo
Yi Yang
Chuanqiushui Wang
Jiong Luo
author_facet Liang Sun
Tingran Zhang
Lanfang Luo
Yi Yang
Chuanqiushui Wang
Jiong Luo
author_sort Liang Sun
collection DOAJ
description ObjectiveTo systematically evaluate the regulatory effects of exercise intervention on telomere length (TL) and telomerase activity (TA), and to provide evidence for formulating precise exercise prescriptions based on telomere protection.MethodsDatabases including China National Knowledge Infrastructure, Wanfang, VIP, PubMed, Web of Science, Cochrane Library, and Embase were searched to collect randomized controlled trials (RCTs) regarding the regulation of TL and TA by exercise intervention up to February 2025. The Cochrane risk assessment tool was used to evaluate the quality of the included literature. Meta-analysis, heterogeneity test, subgroup analysis, sensitivity analysis, univariate meta-regression analysis, and publication bias test were conducted using Review Manager 5.3 and Stata 18.0 software.ResultsExercise intervention significantly maintained TL (SMD = 0.59, 95% CI: 0.14–1.06, P = 0.01) and enhanced TA (SMD = 0.35, 95% CI: 0.20–0.51, P < 0.00001). A single study suggests high-intensity interval training (HIIT) may maintain TL (SMD = 0.66, P = 0.01), but this requires further validation due to limited evidence. Aerobic exercise (AE) consistently increased TA (SMD = 0.33, P = 0.0001), while resistance exercise (RE) showed non-significant trends (SMD = 0.16, P = 0.43). Subgroup analysis by sex showed a trend toward greater TL maintenance in females (SMD = 0.48, P = 0.06) compared to males (SMD = 0.38, P = 0.40). An exercise duration of ≥16 weeks was necessary for significant effects. High heterogeneity (I2 = 92% for TL) was partially explained by measurement methods, age, and baseline health.ConclusionExercise maintains TL and enhances TA, potentially contributing to delayed aging. AE shows robust effects on TA, while HIIT and RE require further research due to limited studies. Future studies should standardize measurement methods and explore confounders like diet and genetics.Systematic Review RegistrationPROSPERO, identifier CRD420251006569.
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spelling doaj-art-2d66482eb79b4f639775d5388445633d2025-08-20T03:30:33ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-06-011610.3389/fphys.2025.16272921627292Exercise delays aging: evidence from telomeres and telomerase —a systematic review and meta-analysis of randomized controlled trialsLiang Sun0Tingran Zhang1Lanfang Luo2Yi Yang3Chuanqiushui Wang4Jiong Luo5School of Physical Education, Southwest University, Chongqing, ChinaSchool of Physical Education, Southwest University, Chongqing, ChinaSchool of Physical Education, Chongqing Mining Engineering School, Chongqing, ChinaSchool of Physical Education, Southwest University, Chongqing, ChinaSchool of Physical Education, Southwest University, Chongqing, ChinaSchool of Physical Education, Southwest University, Chongqing, ChinaObjectiveTo systematically evaluate the regulatory effects of exercise intervention on telomere length (TL) and telomerase activity (TA), and to provide evidence for formulating precise exercise prescriptions based on telomere protection.MethodsDatabases including China National Knowledge Infrastructure, Wanfang, VIP, PubMed, Web of Science, Cochrane Library, and Embase were searched to collect randomized controlled trials (RCTs) regarding the regulation of TL and TA by exercise intervention up to February 2025. The Cochrane risk assessment tool was used to evaluate the quality of the included literature. Meta-analysis, heterogeneity test, subgroup analysis, sensitivity analysis, univariate meta-regression analysis, and publication bias test were conducted using Review Manager 5.3 and Stata 18.0 software.ResultsExercise intervention significantly maintained TL (SMD = 0.59, 95% CI: 0.14–1.06, P = 0.01) and enhanced TA (SMD = 0.35, 95% CI: 0.20–0.51, P < 0.00001). A single study suggests high-intensity interval training (HIIT) may maintain TL (SMD = 0.66, P = 0.01), but this requires further validation due to limited evidence. Aerobic exercise (AE) consistently increased TA (SMD = 0.33, P = 0.0001), while resistance exercise (RE) showed non-significant trends (SMD = 0.16, P = 0.43). Subgroup analysis by sex showed a trend toward greater TL maintenance in females (SMD = 0.48, P = 0.06) compared to males (SMD = 0.38, P = 0.40). An exercise duration of ≥16 weeks was necessary for significant effects. High heterogeneity (I2 = 92% for TL) was partially explained by measurement methods, age, and baseline health.ConclusionExercise maintains TL and enhances TA, potentially contributing to delayed aging. AE shows robust effects on TA, while HIIT and RE require further research due to limited studies. Future studies should standardize measurement methods and explore confounders like diet and genetics.Systematic Review RegistrationPROSPERO, identifier CRD420251006569.https://www.frontiersin.org/articles/10.3389/fphys.2025.1627292/fullexerciseagingtelomerestelomerasemeta analysis
spellingShingle Liang Sun
Tingran Zhang
Lanfang Luo
Yi Yang
Chuanqiushui Wang
Jiong Luo
Exercise delays aging: evidence from telomeres and telomerase —a systematic review and meta-analysis of randomized controlled trials
Frontiers in Physiology
exercise
aging
telomeres
telomerase
meta analysis
title Exercise delays aging: evidence from telomeres and telomerase —a systematic review and meta-analysis of randomized controlled trials
title_full Exercise delays aging: evidence from telomeres and telomerase —a systematic review and meta-analysis of randomized controlled trials
title_fullStr Exercise delays aging: evidence from telomeres and telomerase —a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Exercise delays aging: evidence from telomeres and telomerase —a systematic review and meta-analysis of randomized controlled trials
title_short Exercise delays aging: evidence from telomeres and telomerase —a systematic review and meta-analysis of randomized controlled trials
title_sort exercise delays aging evidence from telomeres and telomerase a systematic review and meta analysis of randomized controlled trials
topic exercise
aging
telomeres
telomerase
meta analysis
url https://www.frontiersin.org/articles/10.3389/fphys.2025.1627292/full
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