#254 - AMA #47: Cold therapy: pros, cons, and its impact on longevity
In this AMA episode, Peter Attia, MD, and Nick Stenson discuss cold therapy, exploring different types like cold water immersion and cryotherapy. They delve into its effects on mood, brown adipose tissue, potential downsides, and geroprotective benefits, aiming to understand effective protocols.
Deep Dive Analysis
7 Topic Outline
Introduction to Cold Therapy AMA
F1 Season Update and Predictions
Overview of Common Cold Exposure Therapies
Defining Cold Water Immersion (CWI)
Defining Whole Body Cryotherapy (WBC)
Comparing Subjective Experience: CWI vs. WBC
Rationale for Focusing on Cold Water Immersion
3 Key Concepts
Cold Water Immersion (CWI)
Cold Water Immersion involves submerging the body in cold water, with common research protocols using temperatures from 40 to 60 degrees Fahrenheit. The duration of immersion varies, with colder temperatures (30s-40s F) typically used for 2-3 minutes, and slightly higher temperatures for up to 30 minutes. Protocols can involve submersion to the sternum/neck (head-out immersion) or waist-only.
Whole Body Cryotherapy (WBC)
Whole Body Cryotherapy involves standing in a specialized chamber that blasts liquid nitrogen gas, exposing the body to extremely cold temperatures ranging from minus 160 to minus 260 degrees Fahrenheit (minus 110 to minus 160 degrees Celsius). Sessions typically last about three minutes and are usually performed at dedicated facilities, as opposed to at home.
Meta-analysis limitations
Meta-analyses, while useful, are only as strong as the individual studies they aggregate. If the underlying studies are highly varied or heterogeneous in their design and methodology, the conclusions drawn from the meta-analysis can be limited and less reliable, making it challenging to ascertain clear information.
5 Questions Answered
The two most common types are cold water immersion (CWI), which involves being immersed in cold water, and whole body cryotherapy (WBC), which involves standing in a chamber blasted with liquid nitrogen gas.
Cold water immersion protocols can range from ice water (32 degrees Fahrenheit) up to the 60s, with colder temperatures (30s-40s F) typically used for shorter durations (2-3 minutes) and higher temperatures for longer durations (e.g., 30 minutes).
Whole body cryotherapy chambers blast liquid nitrogen at temperatures ranging from minus 160 to minus 260 degrees Fahrenheit (minus 110 to minus 160 degrees Celsius) for about three minutes per session.
Despite the much lower temperatures in whole body cryotherapy, cold water immersion is subjectively felt as much colder due to the significantly different thermal conductivity of liquid versus gas.
Cold water immersion is more accessible to the average person, as it can be done in a tub or with a relatively inexpensive cold plunge device, and there is also a greater volume of scientific literature available on it compared to whole body cryotherapy.
3 Actionable Insights
1. DIY Cold Plunge Setup
To make cold water immersion accessible at home, fill a bathtub with cold water, add ice from the grocery store, and then sit in it. This method allows you to experience cold therapy without specialized equipment.
2. Cold Water Immersion Protocol
For cold water immersion, immerse yourself in water typically between 40-60°F. If the temperature is 30-40°F, aim for 2-3 minutes; for higher temperatures up to the 60s, protocols can extend to 30 minutes.
3. Whole Body Cryotherapy Protocol
To undergo whole body cryotherapy, stand in a cryogenic chamber that blasts liquid nitrogen at temperatures from -160 to -260°F for about three minutes. Ensure you wear booties to prevent your feet from freezing.
2 Key Quotes
a thousand sows ears makes not a pearl necklace
Peter Attia
anybody who's done both will tell you that cold water immersion is much subjectively colder than whole body cryo
Peter Attia