Gielen · The American journal of clinical nutrition 2018 · meta-analysis of cross-sectional studies · n=146,114 participants (87 studies)

Body mass index is negatively associated with telomere length: a collaborative cross-sectional meta-analysis of 87 observational studies.

Cited 178 times in the scientific literature.

Level 3 - non-randomized controlled study

Meta-analysis of cross-sectional observational studies

PubMed 30535086 · doi:10.1093/ajcn/nqy107 · record verified 2026-08-30

What was done

A collaborative cross-sectional meta-analysis of 87 distinct observational study samples (146,114 total individuals) evaluated the relationship between body mass index (BMI) and leukocyte telomere length (TL). Study-specific age- and sex-adjusted regression coefficients for both absolute TL (base pairs [bp]) and relative TL (telomere-to-single-copy gene ratio [T/S ratio]) against BMI were pooled using random-effects models. Subgroup analyses were stratified by age (young: 18–60 y; middle: 61–75 y; old: >75 y), sex, and ethnicity.

What was found

In the total pooled sample, each 1-unit increase in BMI corresponded to a -3.99 bp difference in TL (95% CI: -5.17, -2.81 bp) and a -1.58 × 10⁻³ unit relative T/S ratio difference (-0.16%; 95% CI: -2.14 × 10⁻³, -1.01 × 10⁻³). Among young adults (18–60 y), the inverse association was stronger: each 1-unit increase in BMI corresponded to a -7.67 bp difference (95% CI: -10.03, -5.31 bp) and a -2.58 × 10⁻³ unit T/S ratio difference (-0.26%; 95% CI: -3.92 × 10⁻³, -1.25 × 10⁻³). The associations were predominantly observed in the white pooled population, with no significant differences between sexes.

Why it matters

This large meta-analysis demonstrates a consistent inverse association between adiposity and leukocyte telomere length across adult populations, suggesting that excess weight is associated with accelerated cellular aging, particularly earlier in adulthood.

Limits

All included studies were cross-sectional, precluding causal inference or determination of whether longitudinal changes in weight alter telomere shortening rates. The findings were predominantly observed in white populations, limiting generalizability to other racial and ethnic groups. Residual confounding from unmeasured lifestyle and health factors across heterogeneous studies cannot be excluded.

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