Influence of Regular Physical Activity and Fitness on Stress Reactivity as Measured with the Trier Social Stress Test Protocol: A Systematic Review
Psychosocial stress is associated with multiple health complaints. Research to date suggests that regular physical activity (PA) and higher cardiorespiratory fitness may reduce stress reactivity and therefore contribute to a reduction of stress-related risk factors. While previous reviews have not differentiated between stressors, we focus on psychosocial stress elicited with the Trier Social Stress Test (TSST).
Our objective was to examine the effect of regular PA and cardiorespiratory fitness on stress reactivity, with a particular focus on the TSST. The TSST is the laboratory task most widely used to induce socio-evaluative stress and elicits stronger stress reactions than most other cognitive stressor tasks.
A systematic search within various databases was performed in January 2018. The following outcomes were considered: cortisol, heart rate, psychological stress reactivity, and potential moderators (age, sex, exercise intensity, assessment mode, and psychological constructs).
In total, 14 eligible studies were identified. Cortisol and heart rate reactivity were attenuated by higher PA or better fitness in seven of twelve studies and four of nine studies, respectively. Two of four studies reported smaller increases in anxiety and smaller decreases in calmness in physically active/fitter participants. Three of four studies found that higher PA/fitness was associated with more favorable mood in response to the TSST.
About half of the studies suggested that higher PA/fitness levels were associated with an attenuated response to psychosocial stress. Currently, most evidence is based on cross-sectional analyses. Therefore, a great need for further studies with longitudinal or experimental designs exists.
Compliance with Ethical Standards
No sources of funding were used to assist in the preparation of this article.
Conflict of interest
Manuel Mücke, Sebastian Ludyga, Flora Colledge, and Markus Gerber have no conflicts of interest relevant to the content of this review.
- 4.Middlebrooks JS, Audage NC. The effects of childhood stress on health across the lifespan. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2008.Google Scholar
- 10.Redmond N, Richman J, Gamboa CM, Albert MA, Sims M, Durant RW, et al. Perceived stress is associated with incident coronary heart disease and all-cause mortality in low- but not high-income participants in the Reasons for Geographic And Racial Differences in Stroke study. J Am Heart Assoc. 2013;2:e000447. https://doi.org/10.1161/JAHA.113.000447.CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Ludyga S. Sportaktivität, Stress und das Gehirn. In: Fuchs R, Gerber M, editors. Stressregulation und sport. Heidelberg: Springer; 2017. p. 275–91.Google Scholar
- 20.Sothmann MS. The cross-stressor adaptation hypothesis and exercise training. In: Acevedo EO, Ekkekakis P, editors. Psychobiology of physical activity. Champaign: Human Kinetics; 2006.Google Scholar
- 22.Luger A, Deuster PA, Kyle SB, Gallucci WT, Montgomery LC, Gold PW, et al. Acute hypothalamic–pituitary–adrenal responses to the stress of treadmill exercise. Physiologic adaptations to physical training. N Engl J Med. 1987;316:1309–15. https://doi.org/10.1056/NEJM198705213162105.CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Gerber M. Physiologische Wirkmechanismen des Sports unter Stress. In: Fuchs R, Gerber M, editors. Stressregulation und Sport. Heidelberg: Springer; 2017.Google Scholar
- 26.Jayasinghe SU, Lambert GW, Torres SJ, Fraser SF, Eikelis N, Turner AI. Hypothalamo-pituitary adrenal axis and sympatho-adrenal medullary system responses to psychological stress were not attenuated in women with elevated physical fitness levels. Endocrine. 2016;51:369–79. https://doi.org/10.1007/s12020-015-0687-6.CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Klaperski S, von Dawans B, Heinrichs M, Fuchs R. Effects of a 12-week endurance training program on the physiological response to psychosocial stress in men: a randomized controlled trial. J Behav Med. 2014;37:1118–33. https://doi.org/10.1007/s10865-014-9562-9.CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Gerber M, Ludyga S, Mücke M, Colledge F, Brand S, Pühse U. Low vigorous physical activity is associated with increased adrenocortical reactivity to psychosocial stress in students with high stress perceptions. Psychoneuroendocrinology. 2017;80:104–13. https://doi.org/10.1016/j.psyneuen.2017.03.004.CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Rimmele U, Zellweger BC, Marti B, Seiler R, Mohiyeddini C, Ehlert U, Heinrichs M. Trained men show lower cortisol, heart rate and psychological responses to psychosocial stress compared with untrained men. Psychoneuroendocrinology. 2007;32:627–35. https://doi.org/10.1016/j.psyneuen.2007.04.005.CrossRefPubMedGoogle Scholar
- 32.Chida Y, Steptoe A. Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: a meta-analysis of prospective evidence. Hypertension. 2010;55:1026–32. https://doi.org/10.1161/HYPERTENSIONAHA.109.146621.CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Forcier K, Stroud LR, Papandonatos GD, Hitsman B, Reiches M, Krishnamoorthy J, Niaura R. Links between physical fitness and cardiovascular reactivity and recovery to psychological stressors: a meta-analysis. Health Psychol. 2006;25:723–39. https://doi.org/10.1037/0278-6188.8.131.523.CrossRefPubMedPubMedCentralGoogle Scholar
- 36.Boutcher SH, Hamer M. Psychobiological reactivity, physical activity and cardiovascular health. In: Acevedo EO, Ekkekakis P, editors. Psychobiology of physical activity. Champaign: Human Kinetics; 2006. p. 161–76.Google Scholar
- 41.Kudielka BM, Hellhammer DH, Kirschbaum C. Ten years of research with the trier social stress test revisited. In: Harmon-Jones E, Winkielman P, editors. Social neuroscience. New York: The Guilford Press; 2007. p. 56–83.Google Scholar
- 56.Sommer M, Braumann M, Althoff T, Backhaus J, Kordon A, Junghanns K, et al. Psychological and neuroendocrine responses to social stress and to the administration of the alpha-2-receptor antagonist, yohimbine, in highly trained endurance athletes in comparison to untrained healthy controls. Pharmacopsychiatry. 2011;44:129–34. https://doi.org/10.1055/s-0031-1277166.CrossRefPubMedPubMedCentralGoogle Scholar
- 57.Jayasinghe SU, Torres SJ, Hussein M, Fraser SF, Lambert GW, Turner AI. Fitter women did not have attenuated hemodynamic responses to psychological stress compared with age-matched women with lower levels of fitness. PLoS One. 2017;12:e0169746. https://doi.org/10.1371/journal.pone.0169746.CrossRefPubMedPubMedCentralGoogle Scholar
- 59.Martikainen S, Pesonen A-K, Lahti J, Heinonen K, Feldt K, Pyhälä R, et al. Higher levels of physical activity are associated with lower hypothalamic–pituitary–adrenocortical axis reactivity to psychosocial stress in children. J Clin Endocrinol Metab. 2013;98:E619–27. https://doi.org/10.1210/jc.2012-3745.CrossRefPubMedPubMedCentralGoogle Scholar
- 64.Pruessner JC, Kirschbaum C, Meinlschmid G, Hellhammer DH. Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology. 2003;28:916–31. https://doi.org/10.1016/S0306-4530(02)00108-7.CrossRefPubMedGoogle Scholar
- 71.Gerber M. Sportliche Aktivität und Stressreaktivität: ein Review [Exercise and stress reactivity: a review]. Dt Zs Sportmed. 2008;59:168–74.Google Scholar
- 75.Armbruster D, Mueller A, Strobel A, Lesch K-P, Brocke B, Kirschbaum C. Predicting cortisol stress responses in older individuals: influence of serotonin receptor 1A gene (HTR1A) and stressful life events. Horm Behav. 2011;60:105–11. https://doi.org/10.1016/j.yhbeh.2011.03.010.CrossRefPubMedPubMedCentralGoogle Scholar
- 79.Lustyk MKB, Olson KC, Gerrish WG, Holder A, Widman L. Psychophysiological and neuroendocrine responses to laboratory stressors in women: implications of menstrual cycle phase and stressor type. Biol Psychol. 2010;83:84–92. https://doi.org/10.1016/j.biopsycho.2009.11.003.CrossRefPubMedPubMedCentralGoogle Scholar
- 80.Glynn LM, Christenfeld N, Gerin W. The role of rumination in recovery from reactivity: cardiovascular consequences of emotional states. Psychosom Med. 2002;64:714–26. https://doi.org/10.1097/01.PSY.0000031574.42041.23.CrossRefPubMedPubMedCentralGoogle Scholar