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the literature suggests long-term chronic stress may have a larger cumulative effect." ​ Physical Activity ​ Controversial data on the lifestyle factors impact on telomere length ​A choice of a particular diet This 2017 systematic review and meta-analysis (the highest quality of the scientific evidence) [Perez, 2017] reviewed "RCTs that evaluated the effects on telomere length of the following diets: calorie restriction, high-fat diet, Mediterranean diet, micronutrient supplementation, or combinations of different interventions." The study concluded that, "​ The available evidence suggests that there is no effect of diet on telomere length , but the strong heterogeneity in the type and duration of dietary interventions does not allow any final statement on the absence of an effect of diet on telomere length." ​ Smoking "the difference in LTL (leukocyte telomere length) between smokers and non-smokers is extremely unlikely to be explained by a linear, causal effect of smoking