Cortisol-Mediated Energy Allocation and Its Implications for Body Composition in Physically Active Adults: A Narrative Review
DOI:
https://doi.org/10.66687/jebmr.2.1.2026.31Keywords:
RED-S, stress adaptation, exercise, body composition, HPA axis, energy availability, CortisolAbstract
Background: The historical approach to metabolism as a simple equation of calories is insufficient to explain the intricate variety of hormones that affect partitioning of energy among tissues, including muscle, fat, and others. Stress is accompanied by a rise in the production of a glucocorticoid hormone of the adrenal cortex called cortisol, which is a master regulator of the allocation of energy during stress, but whose relationship to body composition is not mentioned so much in the guidance of nutrition and training plans in practice.
Methods: A review was conducted to synthesize the studies from the past 20 years examining the effect of exercise, energy status, and body composition on cortisol in various populations of physically active adults.
Result. Energy availability had the largest impact on cortisol. Decreases in energy always increased levels of cortisol and decreased anabolic hormones such as the Insulin-like Growth Factor-1 (IGF-1) and Testosterone. There was no significant difference in resting cortisol between different training status or competitive level, suggesting that cortisol's response to exercise or stress and the daily cortisol rhythm are more informative biomarkers. Inactive obese individuals have low cortisol, whereas more active or under-stressed obese individuals have higher cortisol levels. People with major depressive disorder or hypothyroidism show weak or no cortisol response to exercise; this means findings from healthy people do not apply to everyone. Importantly, a reduction in cortisol levels in response to stress is not necessarily an indicator of overtraining, as it may be a normal adaptive response. In a male athlete, testosterone is the primary hormone that regulates body fat, while higher body fat percentages may aid in adaptation through being a reservoir of cortisol. Moreover, vigorous exercise was shown to have a negative feedback effect on subsequent stress responses, and the location of the competition games was shown to have a significant effect on post-game cortisol, with home games showing a greater stress response irrespective of the result.
Conclusions: Resting cortisol is a poor marker of training status, and energy availability is the most important factor determining cortisol regulation. The interpretation of cortisol response should take into account energy status, performance outcomes, and individual health status. In athletes and clinical populations, monitoring levels of reactive cortisol in addition to the testosterone/cortisol ratio may be a more effective way to assess stress, recovery, and adaptation.
References
Isenmann, E., J. Dissemond, and S. Geisler, The Effects of a Macronutrient-Based Diet and Time-Restricted Feeding (16:8) on Body Composition in Physically Active Individuals-A 14-Week Randomised Controlled Trial. Nutrients, 2021. 13(9).
Johnson, N.A., et al., Physical activity in the management of obesity in adults: A position statement from Exercise and Sport Science Australia. J Sci Med Sport, 2021. 24(12): p. 1245-1254.
Kostenchak-Svystak, O., et al., THE INFLUENCE OF BODY COMPOSITION ON THE STATE OF THE CARDIOVASCULAR SYSTEM IN WOMEN. Georgian Med News, 2020(308): p. 58-62.
Ten Haaf, D.S.M., et al., Protein supplementation improves lean body mass in physically active older adults: a randomized placebo-controlled trial. J Cachexia Sarcopenia Muscle, 2019. 10(2): p. 298-310.
Kotarsky, C.J., et al., Time-restricted eating and concurrent exercise training reduces fat mass and increases lean mass in overweight and obese adults. Physiol Rep, 2021. 9(10): p. e14868.
Şenol, M.P., et al., Intuitive Eating Intervention in Physically Active Adults: Effects on Anthropometry, Athletic Performance, Eating Attitudes, and Body Image. Nutrients, 2025. 17(17).
Manore, M.M., Exercise and the Institute of Medicine recommendations for nutrition. Curr Sports Med Rep, 2005. 4(4): p. 193-8.
Maruszczak, K., et al., Sleep quality and body composition in active and inactive young adults. Sci Rep, 2025. 15(1): p. 39614.
Santi, A., et al., High Body Mass Index Masks Body Composition Differences in Physically Active Versus Sedentary Participants. Metab Syndr Relat Disord, 2018. 16(9): p. 483-489.
Moradell, A., et al., Longitudinal Changes in the Body Composition of Non-Institutionalized Spanish Older Adults after 8 Years of Follow-Up: The Effects of Sex, Age, and Organized Physical Activity. Nutrients, 2024. 16(2).
Longland, T.M., et al., Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. The American journal of clinical nutrition, 2016. 103(3): p. 738-746.
Stenqvist, T.B., et al., Impact of a 4-week intensified endurance training intervention on markers of relative energy deficiency in sport (RED-S) and performance among well-trained male cyclists. Frontiers in Endocrinology, 2020. 11: p. 512365.
Isola, V., et al., Changes in hormonal profiles during competition preparation in physique athletes. European Journal of Applied Physiology, 2025. 125(2): p. 393-408.
Liu, Y., et al., Coupling mechanisms between energy compensation and metabolic adaptation during high-intensity training in athletes: a longitudinal study based on multi-omics and individualized energy modeling. Scientific Reports, 2026.
Lukas, W.D., B.C. Campbell, and K.L. Campbell, Urinary cortisol and muscle mass in Turkana men. American Journal of Human Biology: The Official Journal of the Human Biology Association, 2005. 17(4): p. 489-495.
Azarbayjani, M.A., et al., Daily timing of salivary cortisol responses and aerobic performance in lean and obese active females. Bratisl Lek Listy, 2011. 112(4): p. 213-7.
Terink, R., et al., A 2 week cross-over intervention with a low carbohydrate, high fat diet compared to a high carbohydrate diet attenuates exercise-induced cortisol response, but not the reduction of exercise capacity, in recreational athletes. Nutrients, 2021. 13(1): p. 157.
Wong, T. and V. Harber, Lower excess postexercise oxygen consumption and altered growth hormone and cortisol responses to exercise in obese men. The Journal of Clinical Endocrinology & Metabolism, 2006. 91(2): p. 678-686.
Mangine, G.T., et al., Physiological differences between advanced CrossFit athletes, recreational CrossFit participants, and physically-active adults. PloS one, 2020. 15(4): p. e0223548.
Gubelmann, C., et al., Association of activity status and patterns with salivary cortisol: the population-based CoLaus study. European journal of applied physiology, 2018. 118(7): p. 1507-1514.
Gerber, M., et al., Effects of aerobic exercise on cortisol stress reactivity in response to the trier social stress test in inpatients with major depressive disorders: a randomized controlled trial. Journal of clinical medicine, 2020. 9(5): p. 1419.
Fothergill, M., S. Wolfson, and N. Neave, Testosterone and cortisol responses in male soccer players: The effect of home and away venues. Physiology & behavior, 2017. 177: p. 215-220.
Caplin, A., et al., The effects of exercise intensity on the cortisol response to a subsequent acute psychosocial stressor. Psychoneuroendocrinology, 2021. 131: p. 105336.
Latour, E., et al., Stressor-induced temporal cortisol deficiency as a primary trigger for adaptation to stress. International Journal of Environmental Research and Public Health, 2022. 19(9): p. 5633.
Ponce-González, J.G., et al., Physical fitness, adiposity and testosterone concentrations are associated to playing position in professional basketballers. Nutricion hospitalaria, 2015. 31(6): p. 2624-2632.
García, L.R., et al., Relationship between testosterone and cortisol with anthropometric characteristics in professional male soccer players. Retos: nuevas tendencias en educación física, deporte y recreación, 2024(61): p. 919-926.
Fernández, I.A., et al., An An exploratory observational study of the seasonal changes of body composition, bone parameters, testosterone, and cortisol in Spanish male professional soccer players. European Journal of Human Movement, 2025(54): p. 21-25.
Amani, M. and M. Dadmanesh, The effect of aerobic-resistance exercise on body composition, physical fitness, resting metabolism rate, serum cortisol and leptin of female with hypothyroidism. Journal of Physical Activity and Hormones, 2024. 1(2): p. 1.
Mangine, G.T., et al., Endocrine and body composition changes across a competitive season in Collegiate speed-power track and field athletes. The Journal of Strength & Conditioning Research, 2021. 35(8): p. 2067-2074.
Nies, M.A., K.Y. Chen, and J.S.V. Wal, Energy expenditure, body composition, and biochemical indicators in healthy community women. International journal of food sciences and nutrition, 2004. 55(3): p. 237-247.
Miah, R., Issahaku, A.R., Uddin, M.N. et al. Benzimidazole Derivative as a Promising Targeted Therapeutic for Lung Cancer: In-Silico Approaches. J Pharm Innov 21, 409 (2026).




