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    "key": "adam-2017",
    "id": "TAP-RDN-0051",
    "locale": "en",
    "path": "/research/adam-2017/",
    "title": "TAP reading note: Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis",
    "description": "Flatter diurnal cortisol slopes were modestly associated with poorer health: pooled r=.147 (95% CI .112–.183), and r=.138 (.005–.267) in prospective studies. These results support research on diurnal rhythms and health, not diagnosis of an individual's stress from a single measurement.",
    "rights": "© The Allostasis Project. All rights reserved. Reproduction or adaptation requires separate permission, subject to applicable legal exceptions.",
    "version": "1.0",
    "updatedAt": "2026-10-29",
    "editorial": {
      "contentType": "evidence-review",
      "reviewState": "draft",
      "reviewedAt": null,
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      "updatedAt": "2026-10-29",
      "version": "1.0",
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        "ai": {
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          "scope": "Assisted source comparison, evidence extraction and bilingual research-note preparation. The materials consulted and unresolved scientific issues are specified in each note.",
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      "revisions": [
        {
          "date": "2026-10-29",
          "version": "1.0",
          "description": "Added the cortisol-slope synthesis, high heterogeneity and the unresolved mortality text–interval discrepancy."
        }
      ]
    },
    "original": {
      "id": "adam-2017",
      "title": "Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis",
      "authors": "Adam EK · Quinn ME · Tavernier R · McQuillan MT · Dahlke KA · Gilbert KE",
      "journal": "Psychoneuroendocrinology",
      "year": "2017",
      "url": "https://doi.org/10.1016/j.psyneuen.2017.05.018",
      "doi": "10.1016/j.psyneuen.2017.05.018",
      "pmid": "28578301"
    },
    "references": [
      {
        "id": "adam-2017",
        "title": "Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis",
        "authors": "Adam EK · Quinn ME · Tavernier R · McQuillan MT · Dahlke KA · Gilbert KE",
        "journal": "Psychoneuroendocrinology",
        "year": "2017",
        "url": "https://doi.org/10.1016/j.psyneuen.2017.05.018",
        "doi": "10.1016/j.psyneuen.2017.05.018",
        "pmid": "28578301"
      }
    ],
    "sections": [
      {
        "id": "finding",
        "title": "What the study found",
        "paragraphs": [
          "Flatter diurnal cortisol slopes were modestly associated with poorer health: pooled r=.147 (95% CI .112–.183), and r=.138 (.005–.267) in prospective studies. These results support research on diurnal rhythms and health, not diagnosis of an individual's stress from a single measurement."
        ]
      },
      {
        "id": "limits",
        "title": "Scope & limitations",
        "paragraphs": [
          "80 studies with 179 associations spanning mental and physical health outcomes.",
          "Heterogeneity was high (I²=83.23%); effect conversion, adjustment and publication-bias handling varied. The bias-adjusted mortality HR was 1.69 (.55–5.2), crossing 1 although the text calls it significant. This unresolved inconsistency prevents a claim of a robust significant mortality association."
        ]
      },
      {
        "id": "sample",
        "title": "Population & sample",
        "paragraphs": [
          "80 studies with 179 associations spanning mental and physical health outcomes."
        ]
      },
      {
        "id": "exposure",
        "title": "Exposure or intervention",
        "paragraphs": [
          "Flatter versus steeper diurnal slopes; multiple outcomes within studies were averaged before synthesis."
        ]
      },
      {
        "id": "outcomes",
        "title": "Outcomes",
        "paragraphs": [
          "Mental and physical health, prospective health outcomes and mortality, kept distinct from individual risk scoring."
        ]
      },
      {
        "id": "duration",
        "title": "Time frame",
        "paragraphs": [
          "Search through 31 January 2015; cross-sectional and prospective studies with varying follow-up."
        ]
      },
      {
        "id": "funding",
        "title": "Research funding",
        "paragraphs": [
          "Support included Northwestern Institute for Policy Research faculty and graduate funding; see the acknowledgements."
        ]
      },
      {
        "id": "conflicts",
        "title": "Research conflicts of interest",
        "paragraphs": [
          "The authors declare no conflicts and report that funders were not involved in analysis or interpretation."
        ]
      },
      {
        "id": "basis",
        "title": "Reading scope",
        "paragraphs": [
          "Full-text selection/synthesis methods, overall, prospective and mortality results, and limitations. Original mortality estimates and synthesis code remain to be checked."
        ],
        "links": [
          {
            "label": "Full text in PubMed Central",
            "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5568897/"
          }
        ]
      }
    ]
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}