Part 1: The Effects of Cold Exposure Training and a Breathing Exercise on the Inflammatory Response in Humans: A Pilot Study

Listen or Download Podcast Version:

Citation

Zwaag J, Naaktgeboren R, van Herwaarden AE, Pickkers P, Kox M. The Effects of Cold Exposure Training and a Breathing Exercise on the Inflammatory Response in Humans: A Pilot Study. Psychosom Med. 2022 May 1;84(4):457-467. doi: 10.1097/PSY.0000000000001065. Epub 2022 Feb 23. PMID: 35213875; PMCID: PMC9071023.

4 FUNDAMENTALS

 

1. Essential Background Material

 

The PNAS Wim Hof study showed for the first time that participants were able to willfully influence their innate immune response and reduce inflammation associated with endotoxin injection.

 

However, during the injection, two different WHM breathing exercises were used (see original Science 411 for more).  Moreover, the participants were trained by Wim Hof himself, which could introduce a placebo effect. 

 

From practical and clinical perspectives, it’s vital to know which breathing exercise was responsible for the anti-inflammatory effects and if the same results can be achieved by an independent trainer (not Wim Hof).  Moreover, knowing how much training is needed to get the results is necessary. 

 

That’s what this study aimed to discover.  The three questions it answers are:

1.     Which WHM breathing exercise is most effective for reducing inflammation?

2.     How long do people need to train to achieve the anti-inflammatory effects?

3.     Can the same results be obtained by an independent trainer (not Wim Hof)?

 

 

2. What Did this Research Do?

 

Forty male participants were randomized into four different groups:

 

  • Intensive Training by Wim Hof (n=10): Four days of training with Wim for 2 hours every morning.

  • Intensive Training by Independent Instructor (n=10): Four days of training with an independent instructor who was part of the research team.

  • Short Training by Wim Hof (n=10): Two hours of training with Wim.

  • Short Training by Independent Instructor (n=10): Two hours of training with the independent instructor.

 

The 2-hour short training occurred on the day of the experiment.  Note that this was only breath training, not cold and meditation.

 

On Experiment Day

 

In the morning, half of the participants were randomized to perform the standard Wim Hof breathing (30 deep breaths, hold after exhale, inhale and hold for 10 seconds, repeat) for 1.5 hours.

 

The other half performed the modified Wim Hof breathing (30 deep breaths, inhale and hold for 10 seconds while squeezing all muscles) for 1.5 hours.

 

Both groups rested for 1.5 hours.  Then, in the afternoon, they performed the other breathing exercise for 1.5 hours.

 

Primary Outcome

 

The researchers were most interested in adrenaline release during the breathing, as this is what they found to be linked with the anti-inflammatory effects of Wim’s method in the original PNAS study.  It was measured every 30 min during the breathing sessions.

 

 

3. What Were the Major Findings?

  •  In the morning, both breathing exercises initially spiked adrenaline to similar levels.

  • However, the standard WHM breathing achieved more sustained elevated adrenaline levels at the 1.5 h mark than the modified breathing.

  • In the afternoon, neither breathing exercise significantly increased adrenaline.

  • Adrenaline levels were not significantly different between the participants trained by Wim or the independent instructor.

  • Adrenaline levels were not significantly different between the 4-day and 2-hour training groups.

 

 

4. Why Do These Results Matter?

 

The original PNAS study found that the initial spike in adrenaline associated with WHM breathing was the source of the anti-inflammatory effects.

 

Here, we learn that to get that adrenaline spike (and thus the anti-inflammatory effects):

  • We can use the standard or modified WHM breathing (this is critical for people who cannot tolerate hypoxia).

  • We can train for just two hours instead of four days.

  • We can use an independent trainer (not Wim Hof himself).

  • We should practice in the morning only.

 

1 BIG TAKEAWAY

 

If performed in the morning, the anti-inflammatory effects of Wim Hof breathing can be achieved with or without breath holds in just 2 hours of instruction from an independent trainer.

 

 

 

1 PRACTICAL APPLICATION

 

NOTE: To use the method, it’s critical that you work with a certified Wim Hof instructor or obtain a physician’s approval to ensure you do not have any contraindications. 

 

These results suggest that we should practice the WHM in the morning to maximize the anti-inflammatory effects.

 

Even more importantly, they also show us that we can use WHM breathing without hypoxia if we have any condition preventing us from doing long breath holds.

 

Most practically, the first page of this PDF gives the precise instructions used in this study.