#254 - AMA #47： Cold therapy： pros, cons, and its impact on longevity
Episode Stats
Words per Minute
166.60426
Summary
In today's episode, we dive into all things related to cold therapy, including what we know and don't know about cold therapy and the potential benefits and potential cons around cold therapy. Plus, we discuss some early predictions for the 2019 Formula 1 season.
Transcript
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hey everyone welcome to a sneak peek ask me anything or ama episode of the drive podcast
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i'm your host peter atia at the end of this short episode i'll explain how you can access
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the ama episodes in full along with a ton of other membership benefits we've created
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or you can learn more now by going to peter atia md.com forward slash subscribe so without further
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delay here's today's sneak peek of the ask me anything episode
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welcome to ask me anything episode 47 i'm once again joined by nick stenson in today's episode
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we dive into all things related to cold therapy for those of you who are regular listeners of
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the podcast or maybe follow me on social media you probably notice i spend quite a bit of time
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talking about the benefits of heat exposure in particular around saunas but we do receive just
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as many questions about cold exposure and the benefits thereof so we decided to do a dedicated
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ama around the topic where we incorporated all of those questions for this ama we focus on what we
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do and don't know around cold therapy including the different types of cold therapies this would be
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showers cold plunges and cryotherapy as the three main types how can cold therapy affect mood or
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even be a treatment for depression talk about claims that cold therapy can help activate brown
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adipose tissue or bat for metabolic health talk about what happens if you exercise in the cold
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any potential downsides around cold therapy talk about potential geroprotective benefits around cold
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therapy that is to say does cold therapy provide any benefit in terms of slowing aging and or delaying
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death living longer and then we talk about the consensus or lack thereof around what an effective cold
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therapy protocol should look like one thing to note is this is an audio only ama there's no video for it
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however the show notes will display anything i reference and more so without further delay i hope you enjoy
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all right peter welcome to another ama how you doing i'm doing very well so peter for today's ama we're
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really focusing on one core topic that we get asked about a lot which is everything around cold therapy
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and so for people who listen to the podcast follow you on social media we've spent some time recently
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talking about the benefits of sauna and heat and way back in the day i think it was on ama 16 you and bob
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talked about hot and cold and we've kind of updated your thoughts on hot therapy but we haven't touched
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on cold and so what we did is we just compiled all those questions around cold exposure cold therapy
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and if that has potential similar benefits to sauna and so we'll hopefully cover them all today
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including really what we know and don't know about cold therapy how it can affect mood or be a
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treatment for depression what we know about the claims that it helps activation of brown adipose
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tissue for metabolic health any potential cons around cold therapy are there possible geoprotective
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benefits exercising the cold and ultimately do we know anything around a consensus for an effective
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cold therapy protocol so if all goes according to plan that's what we'll cover today
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anything you want to add before we start jumping into that only that i am exceptionally happy that the f1
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season as of our recording is finally back it's a very difficult time for me when f1 is not happening
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so leave it at that for those listening at the time of this recording it's friday before f1 starts on
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sunday so practice we've just finished f1 and f2 for the first race so how many episodes of drive to
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survive have you watched i'm trying to nurse it along i've only watched five of ten so far
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and uh i will say that of the first five number four is my favorite so far okay and how are you thinking
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about this season any early predictions knowing again that by the time this comes out a lot more will
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be known but we're recording this completely brand new to the season certainly going by what we saw in the
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testing week red bull looked incredibly strong the top three look predictably strong in red bull mercedes
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and ferrari i think the two biggest surprises were the strength of aston martin which were horrible last
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year and the not only the continued weakness of mclaren but it looks like mclaren took a step back
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again that could all be untrue by the time the season unfolds but that's really interesting
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mclaren of course have a new rookie driver oscar piastri who i don't know i think seems like the real
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deal you know just because you win f3 and f2 doesn't mean you're going to succeed in f1 but
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and i don't know oscar but i know people who do know him and they the way they speak about him
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suggests he will have a great future in f1 so if that's true then it's it's always great to see
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someone like that in the rookie season obviously ferrari have a new team principal which i think will
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help them a lot as you know i was never a fan of their previous team principal i thought he was a clown
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so i like i i hope it's a better season than last season from a competitive standpoint i believe it
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will be last season ended quite competitively but began well it sort of began competitively between
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red bull and ferrari and ended more competitively between red bull and mercedes i i would like it to
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be just more competitive if it were a four horse race this year that would be amazing yeah it'll be
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uh it'll be fun to see how these first few races unfold all right so all right back to cold yeah
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much to your sadness we're going to move away from f1 so i think with cold i think it'd be helpful just
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to start with what are even the most common cold exposure therapies when people hear other people talk
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about yeah i'm doing cold therapy this is how i use cold i think it'd be helpful just to understand
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what that even means yeah there are many ways to think about this i think the two most common ways
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to think about it and the ways that we'll talk about it are cold water immersion which will kind
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of abbreviate cwi if i get lazy and then whole body cryotherapy which is usually abbreviated wbc of
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course i'm not referring to the world boxing council for those boxing fans out there so cold water
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immersion as it suggests is you are immersed in cold water the most common protocols you'll see
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could be as cold frankly as ice water so that's 32 degrees but typically in research studies you're
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kind of seeing more sort of 40 degrees fahrenheit up into the 60s and the variability you see in
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temperatures comes down to the duration of immersion so once you're in sort of the 30s and 40s we're
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talking about two to three minutes and once you're talking about these 30 minute protocols you're
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you're typically up at slightly higher temperatures okay so a couple other terms right so head out
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immersion refers to a submersion basically to the sternum or neck but there are some protocols that
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will be submersion to waste only so we'll when that is relevant we'll try to comment on that now the
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problem with this subject matter and i'll just sort of preface this all up front is we rely heavily on
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meta-analyses but as you've probably heard me say 500 times now on this podcast a thousand sows ears
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makes not a pearl necklace so a meta-analysis can only be as good as the sum of its parts and if its
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parts are very heterogeneous which they often are but not heterogeneous in the right way then your
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analyses are somewhat limited so one of the challenges here is you're trying to ascertain
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information from highly variable studies talking about wbc whole body cryo these are things you
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wouldn't do this at home unless you're insanely wealthy and you would have your own chamber and
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your own nitrogen tank so these are things that you typically go and do someplace else so you go to
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these cryogenic chambers you see these places all over the place and you basically stand in a tube
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that blasts liquid nitrogen inside and these temperatures are pretty cold right so this will
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be anywhere from minus 160 to minus 260 degrees fahrenheit and again at that point it's hard to
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understand what those temperatures mean most of us have no sense of what that really means for what
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it's worth that's kind of like minus 110 to minus 160 degrees celsius and you might say well gosh how can a
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person tolerate that well again you have to remember there's a totally different conductivity of gas
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versus liquid so because it's a gas that's coming at you it's not going to be nearly as capable of
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extracting heat from your body nevertheless you tend to sit in these things for about three minutes i've
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done a bunch of whole body cryo back in the day i my daughter used to take drum lessons next to a place
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that had a whole body cryo thing and this is back when i was training a lot so i would uh every time
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i took her to drum lessons i would go and get a three minute session where i'd stand in the tube for
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three minutes you put little booties on so your feet don't freeze but otherwise you're standing there
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in your in your gitch and uh you know it's cold but truthfully anybody who's done both will tell you that
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cold water immersion is much subjectively colder than whole body cryo but anyway it's a long-winded answer
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but just so folks have a sense of what we're talking about and within those it seems although
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you do see cryotherapy and you see a lot of stuff around that like you said that's one where you have
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to go to a place where things like an ice bath or cold plunge is much more accessible to people and i
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think because of that we receive a lot more questions around those two things in particular ice bath cold
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plunge and so what do we know about some of the benefits of cold exposure therapies like those
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two things yeah so to build on that we're going to spend much more time talking about cold water
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immersion for two reasons maybe three reasons one we're getting more questions about it two it's more
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accessible all you need is a tub to do it i mean you know when i started doing it i just would go out
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and buy ice at the grocery store and stick it into my bathtub so i'd put cold water in the bathtub and
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then just dump ice into it and then sit in it and then of course you can have cold plungers which cost
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a fraction of what a whole body cryo device looks like the other reason we're going to spend more
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time talking about cold water immersion is there's simply much more literature on it thank you for
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