Denham · PloS one 2013 · cross-sectional study · n=123

Longer leukocyte telomeres are associated with ultra-endurance exercise independent of cardiovascular risk factors.

Cited 120 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional observational study comparing ultra-marathon runners to healthy controls

PubMed 23936000 · doi:10.1371/journal.pone.0069377 · record verified 2026-08-30

What was done

Leukocyte telomere length (T/S ratio) was measured using real-time quantitative PCR in 67 male ultra-marathon runners and 56 apparently healthy male controls. Differences in telomere length were evaluated using age-adjusted models and models further adjusted for cardiovascular risk factors and markers of inflammation/adhesion molecules.

What was found

Ultra-marathon runners had 11% longer leukocyte telomeres than controls in age-adjusted analyses (runners: T/S ratio = 3.5 ± 0.68 vs controls: 3.1 ± 0.41; β = 0.40, SE = 0.10, P = 1.4 × 10(-4)). The difference remained statistically significant after adjustment for cardiovascular risk factors (P = 2.2 × 10(-4)), which the authors estimated as translating to a 16.2 ± 0.26 year difference in biological age and a 324–648 base pair difference. Neither traditional cardiovascular risk factors nor markers of inflammation/adhesion molecules explained the difference.

Why it matters

This study provides evidence that chronic ultra-endurance exercise is associated with longer leukocyte telomeres rather than accelerated cellular aging, independent of standard cardiovascular risk factors.

Limits

The cross-sectional design prevents causal inference and cannot exclude selection bias or residual confounding (such as unmeasured lifestyle or genetic factors). The sample size was modest (n = 123) and limited strictly to males. Telomere length was measured only in leukocytes rather than multiple tissue types.

Cited by