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Extracurricular physical activity and telomere length in childhood: findings from the INMA study

Pediatric Research (2025)Cite this article

Abstract

Background

Evidence on the link between physical activity (PA) and telomere length (TL) in childhood is scarce and inconsistent. This study examined the association between extracurricular PA at age 4 and changes in TL ranking from 4 to 8 years.

Methods

Longitudinal data from 547 children in the INMA birth cohort study (ages 4–8) were analyzed. Parent-reported extracurricular PA at age 4 was used to calculate metabolic equivalents (METs) in hours per day and categorized into tertiles (low, middle, and high). Leukocyte TL was measured at ages 4 and 8 using qPCR, with the primary outcome being the percentage change in TL ranking between ages 4 and 8. Multiple robust regression models were used for the main analyses.

Results

Children in the highest tertile of extracurricular PA (11.9–31.0 METs h/day) showed a significant 2.25% increase (95% CI: 0.01, 4.48; p = 0.04) in TL ranking between 4 and 8 years compared to the lowest tertile (2.2–7.8 METs h/day). No association was observed for moderate extracurricular PA (i.e., middle tertile) levels.

Conclusions

Higher levels of extracurricular PA were prospectively associated with TL rank changes from 4 to 8 years, suggesting its potential to reduce cellular damage and support healthy ageing.

Impact

  • Research shows an association between PA and TL maintenance in adults, but evidence in childhood is limited and inconsistent.

  • This study investigates the association between extracurricular PA and changes in TL ranking in children aged 4–8 years, finding that higher PA levels are linked to increased TL ranking, possibly slowing telomere shortening.

  • Findings support promoting PA in childhood to enhance cellular health and reduce chronic disease risk.

  • Results can inform strategies by healthcare professionals, educators, and policymakers to encourage PA in children.

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Fig. 1: Flow study diagram.

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Funding

This research was funded by Instituto de Salud Carlos III/Agencia Estatal de Investigación, grant number PI18/00825 Project: “Dieta y actividad física en embarazo y tras el nacimiento y longitud del telómero en niños y adolescentes: Proyecto TeloDiPA” and Unión Europea (FEDER) “Una manera de hacer Europa”; grant number PI15/00118: “Exposiciones ambientales a edad temprana y riesgo cardiovascular del adolescente (INMA-Cardio); and Generalitat Valenciana (GVA/2021/191). ISGlobal acknowledges support from the grant CEX2018-000806-S funded by MCIN/AEI/10.13039/501100011033, and support from the Generalitat de Catalunya through the CERCA Program.

Author information

Author notes

  1. These authors contributed equally: Desirée Valera-Gran, Daniel Prieto-Botella.

Authors and Affiliations

  1. Department of Surgery and Pathology, Miguel Hernandez University, Alicante, Spain

    Desirée Valera-Gran, Daniel Prieto-Botella & Eva-María Navarrete-Muñoz

  2. Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain

    Desirée Valera-Gran & Eva-María Navarrete-Muñoz

  3. Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain

    Desirée Valera-Gran, Jesús Vioque & Eva-María Navarrete-Muñoz

  4. Being + Doing & becoming Occupational Research Group (B+D+b), Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain

    Daniel Prieto-Botella

  5. Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium

    Dries S. Martens & Tim Nawrot

  6. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain

    Mikel Subiza-Pérez, Adonina Tardón, Sabrina Llop, Maribel Casas, Jesús Ibarluzea, Ana Fernández-Somoano, Jesús Vioque, Martine Vrijheid & Judith García-Aymerich

  7. Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain

    Mikel Subiza-Pérez & Jesús Ibarluzea

  8. Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, San Sebastián, Spain

    Mikel Subiza-Pérez & Jesús Ibarluzea

  9. Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK

    Mikel Subiza-Pérez

  10. Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile

    Fanny Petermann-Rocha

  11. Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Department of Medicine, Department of Medicine, University of Oviedo, Oviedo, Spain

    Adonina Tardón & Ana Fernández-Somoano

  12. The Health Research Institute of Asturias (ISPA), University of Oviedo, Oviedo, Spain

    Adonina Tardón

  13. Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain

    Sabrina Llop

  14. ISGlobal, Barcelona, Spain

    Maribel Casas, Martine Vrijheid & Judith García-Aymerich

  15. Universitat Pompeu Fabra, Barcelona, Spain

    Maribel Casas, Martine Vrijheid & Judith García-Aymerich

  16. Department of Public Health & Primary Care, University of Leuven (KU Leuven), Leuven, Belgium

    Tim Nawrot

Authors
  1. Desirée Valera-Gran
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  2. Daniel Prieto-Botella
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  3. Dries S. Martens
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  4. Mikel Subiza-Pérez
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  5. Fanny Petermann-Rocha
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Contributions

This study was conceptualized and designed by E.-M.N.-M. and D.V.-G. D.P.-B., D.S.M., and T.N. performed the acquisition, analysis, and interpretation of data. The formal statistical analysis was conducted by D.P.-B. and E.-M.N.-M. D.V.-G. and D.P.-B. prepared the first manuscript draft. Following drafts and the final manuscript version were written by D.V.-G. All authors critically reviewed the final manuscript and approved its submission to the journal. E.-M.N.-M. and D.V.-G. supervised the development of the study. E.-M.N.-M. is the guarantor.

Corresponding author

Correspondence to Desirée Valera-Gran.

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The authors declare no competing interests.

Ethics approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of General Hospital of the Department of Health of Alicante (protocol code Acta 2019/07 and date of approval on 31st July 2019). All parents/legal tutors provided their written consent at each phase of the study.

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Valera-Gran, D., Prieto-Botella, D., Martens, D.S. et al. Extracurricular physical activity and telomere length in childhood: findings from the INMA study. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04445-8

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