BACKGROUND: Empirical studies on occupation as a determinant of health could be advanced with research incorporating biological measures of health. Telomere length and telomerase function are promising biomarkers of the interaction of genetics, lifestyle, and behaviour; however, they have not been used in occupational therapy research. PURPOSE: This paper reviews current evidence on the role of physical and mindfulness activities in sustaining telomeres. The findings are applied to the study of occupation, health, and aging. METHOD: A rapid review was conducted with an evidence synthesis of 23 studies published from 2008 to 2014. FINDINGS: Mindfulness activities may preserve telomeres, slow cell senescence and death, and sustain health through mediating life stressors. Inconsistencies exist for the effect of physical activities on telomeres. IMPLICATIONS: Similar research examining a range of occupations may help to identify the health-promoting benefits of occupation and inform lifestyle interventions.