Spiritual walking and stress resilience integrating psychological endocrine and genetic evidence from a longitudinal Iraqi cohort

Physical activity benefits stress and anxiety, yet spiritually motivated walking may confer distinct psychobiological advantages compared with competitive sports. While prior studies have been largely cross-sectional, the longitudinal dynamics of psychological, endocrine, and genetic interactions remain underexplored.

We conducted a mixed cross-sectional and longitudinal study including three hundred adults in Iraq (n = 100 athletes, n = 100 spiritual walkers, n = 100 sedentary controls). Subjects were tracked across four waves: baseline (T0), immediate post-activity (T1), 1-month follow-up (T2), and 3-month follow-up (T3). The results revealed perceived stress (PSS-10), state anxiety (STAI-S), salivary cortisol and DHEA-S (ELISA), and genotyping of BDNF Val66Met (rs6265) and 5-HTTLPR. Analyses used ANOVA/ANCOVA, linear mixed models (LMM), and regression models with FDR correction.

Across the waves studied, spiritual walkers consistently showed lower levels of stress and anxiety compared to both athletes and control groups (all p ≤ 0.01). Longitudinal linear mixed models corroborated enduring disparities at T3, wherein the spiritual walkers exhibited the most advantageous psychological profile. Endocrine assessments indicated diminished cortisol levels and increased DHEA-S concentrations in walkers, resulting in a persistently favorable cortisol/DHEA-S ratio relative to the other groups. Genetic analyses indicated that BDNF Met/Met and 5-HTTLPR S/S carriers reported heightened distress; however, these effects were less pronounced among walkers. An integrated model elucidated 51.8% of the variance in anxiety, identifying cortisol (β = 0.42) and DHEA-S (β=−0.35) as the most significant predictors.

Spiritually motivated walking correlated with persistent decreases in stress and anxiety, along with improved regulation of the HPA-axis and a reduction in genetic vulnerability, effects that persisted for up to 3 months following the intervention. These results underscore the practical applicability of culturally relevant, affordable interventions that incorporate spiritual walking into community mental health initiatives, considering biological factors.