Journal of Sport and Health Science · Mar 17, 2026

Effects of a year-long aerobic exercise intervention on neuroendocrine, autonomic, and neural correlates of stress, emotion, and cardiovascular disease risk in midlife adults

By Gianaros PJ, Wan L, DeCataldo MK et al.

PURPOSE: The study aimed to test whether an aerobic exercise intervention that improves cardiorespiratory fitness reduces (a) biomarkers of cardiovascular disease (CVD) risk and (b) indicators of stress- and emotion-related neuroendocrine, autonomic, and neural activity. METHODS: In a preregistered 12-month clinical trial, 130 healthy adults aged 26 to 58 years (mean age = 41.4 years; 67.7% female) were randomized to (a) a 150 min per week of moderate-to-vigorous aerobic exercise group or (b) health-information control group. Intervention effects were examined for: (a) cardiometabolic and vascular risk factors (triglycerides, total cholesterol, high-density lipoproteins, glycosylated hemoglobin, pulse-wave velocity); (b) indicators of neuroendocrine and autonomic activity (hair cortisol, heart rate variability); (c) biomarkers of systemic and vascular inflammation (interleukin-6, intercellular adhesion molecule-1); and (d) neural, cardiovascular, and subjective responses to functional magnetic resonance imaging stressor and emotion task paradigms. RESULTS: There were 41 and 40 participants in the exercise and control groups, respectively, who completed follow-up assessments. In planned intention-to-treat analyses using generalized linear mixed models, a group-by-time interaction indicated that the exercise group exhibited a decrease from baseline to follow-up relative to the control group in hair cortisol (Between-Group Difference = -0.62; 95% confidence interval (95%CI): -1.14 to -0.10, p(False Discovery Rate) = 0.039). This reduction was also observed in per protocol analyses. No other effects on remaining outcomes were consistently observed in planned and per protocol analyses. CONCLUSION: A 12-month moderate-to-vigorous aerobic exercise intervention that improved cardiorespiratory fitness also reduced the stress-related biomarker, hair cortisol, but not other indicators of psychological stress and negative emotion processes implicated in CVD risk.

doi.org/10.1016/j.jshs.2026.101135Open accessPubMed 41856274Interventions