This follow-up study compared ten men and 25 external controls who had biopsy-proven low-risk prostate cancer and had chosen to undergo active surveillance. Eligible participants were enrolled between 2003 and 2007 from previous studies and selected according to the same criteria. Men in the intervention group followed a program of comprehensive lifestyle changes (diet, activity, stress management, and social support), and the men in the control group underwent active surveillance alone. The authors took blood samples at 5 years and compared relative telomere length and telomerase enzymatic activity per viable cell with those at baseline, and assessed their relation to the degree of lifestyle changes. The results showed that relative telomere length increased from baseline by a median of 0.06 telomere to single-copy gene ratio (T/S) units (IQR-0.05 to 0.11) in the lifestyle intervention group, but decreased in the control group (-0.03 T/S units, –.05 to 0.03, difference p=0.03). Adherence to lifestyle changes was significantly associated with relative telomere length after adjustment for age and the length of follow-up. The authors conclude that a comprehensive lifestyle intervention was associated with increases in relative telomere length after 5 years of follow-up. Lancet Oncol. 2013 September. PMID: 24051140