Unhealthy lifestyle impacts on biological systems involved in stress response: Hypothalamic-pituitary-Adrenal axis, inflammation and autonomous nervous system

Laura Mandelli, Yuri Milaneschi, Sarah Hiles, Alessandro Serretti, Brenda W. Penninx

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)


An unhealthy lifestyle has a critical role in the pathogenesis and course of several chronic disorders. It has been hypothesized that lifestyle may also impact biological systems involved in stress response. A global index of unhealthy lifestyle was calculated based on the cumulative presence of five self-reported lifestyle habits (smoking, excessive alcohol use, drug use, low physical activity and short sleep) in 2783 participants (18-65 years) from the Netherlands Study of Depression and Anxiety. The functioning of biological stress systems was based on multiple physiological measures of cortisol, inflammatory cytokines and autonomic cardiac activity. The unhealthy lifestyle index was associated with hyperactivity of hypothalamus-pituitary-Adrenal axis and increased inflammation, indicating that with increasing unhealthy habits, the level of biological stress increases. No association with the autonomic nervous system activity was observed; however, the use of drugs increased parasympathetic cardiac activity and significantly impacted on ANS. Results were not impacted by a recent episode of depression or anxiety disorder. An unhealthy lifestyle may unfavorably impact on biological systems involved in stress response, which may underlie progression of several psychiatric as well as somatic chronic disorders.
Original languageEnglish
Pages (from-to)127-135
Number of pages9
JournalInternational Clinical Psychopharmacology
Issue number3
Publication statusPublished - 1 May 2023


  • HPA axis
  • autonomic nervous system
  • inflammation
  • lifestyle
  • stress response

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