The Association of Lifestyle and Mood with Long-Term Levels of Cortisol: A Systematic Review

Abstract

Objectives: To critically review evidence for associations between long-term cortisol levels, mood, and lifestyle factors.Systematic searches of electronic databases (MEDLINE, EMBASE, PsycINFO, WoS, and CINAHL) were conducted up to 21/11/2020 to identify observational and interventional studies (n = 4971) reporting associations between one or more lifestyle or mood factor with cortisol outcomes measured over ≥4 weeks in healthy adults. Quality of included studies was assessed using Downs and Black checklist. The quality of evidence supporting the associations of lifestyle and mood with long-term cortisol levels was assessed as being of moderate-to-poor quality. Observational studies (n = 25) indicated positive associations for BMI/body weight (ESr, pooled effect size correlation = 0.15, p