After regular cold exposure, your body gets used to it. (Michele Ursi/Shutterstock)
In a nutshell
- Cold-water immersion’s benefits are time-dependent: while inflammation increases immediately, stress reduction only occurs 12 hours after exposure
- Regular cold showers led to 29% fewer sick days at work, but didn’t affect how long illnesses lasted when people did get sick
- While some benefits were observed for sleep quality and overall wellbeing, most effects faded after 90 days, suggesting more research is needed on long-term impacts
Inflammation spike has scientists rethinking cold exposure benefits
ADELAIDE, Australia — In recent years, social media has turned ice baths from an athlete’s recovery tool into a mainstream wellness trend, with influencers and celebrities touting their supposed benefits for everything from mood enhancement to immune system boosting. Now, a new systematic review and meta-analysis cuts through the hype and reveals how cold-water immersion (CWI) actually affects the human body.
Analyzing data from 11 studies with 3,177 participants, researchers from the University of South Australia found that while cold-water immersion may offer some health benefits, these effects are highly time-dependent and context-specific. Their results are published in the journal PLOS ONE.
“Cold-water immersion has been extensively researched and used in sporting contexts to help athletes recover, but despite its growing popularity among health and wellbeing circles, little is known about its effects on the general population,” explains lead researcher Tara Cain, a research assistant with the university’s Allied Health & Human Performance program, in a statement.
The timing of cold water’s effects turned out to be crucial. While many people seek out ice baths for immediate stress relief, the research showed that significant stress reduction only occurred 12 hours after exposure. This delayed benefit suggests that the body’s response to cold exposure isn’t as straightforward as previously believed.
The research also revealed surprising findings about inflammation.
“At first glance this seems contradictory, as we know that ice baths are regularly used by elite athletes to reduce inflammation and muscle soreness after exercise,” explains co-researcher Dr. Ben Singh. “The immediate spike in inflammation is the body’s reaction to the cold as a stressor. It helps the body adapt and recover and is similar to how exercise causes muscle damage before making muscles stronger, which is why athletes use it despite the short-term increase.”
To understand these effects, the research team examined studies where participants were immersed in water ranging from 7ยฐC to 15ยฐC (44.6ยฐF to 59ยฐF). The exposure times varied dramatically, from just 30 seconds to two hours. While most studies looked at traditional ice baths, one large trial focused on cold showers, making the findings relevant to people who might not have access to specialized equipment.
The immune system findings proved particularly interesting. Although blood markers showed no immediate boost to immunity, one large study of over 3,000 participants found that people who took regular cold showers were 29% less likely to call in sick to work. However, when they did get sick, their illnesses lasted just as long as everyone else’s. This suggests that cold exposure might help people cope better with illness rather than preventing it entirely.
Sleep quality improvements emerged as another potential benefit, though primarily in male participants. The research showed better sleep scores among those who practiced cold-water immersion compared to control groups. However, the lack of female participants in these studies means we don’t yet know if women would experience the same benefits.
Quality of life measurements revealed short-term gains that faded over time. “We also noted that participants who took 20, 60, or 90 second cold showers reported slightly higher quality of life scores. But again, after three months these effects had faded,” Cain notes. This finding raises important questions about how long people need to continue cold exposure to maintain any benefits.
The research also highlighted important safety considerations, especially for certain groups. “Knowing this, people with pre-existing health conditions should take extra care if participating in cold-water immersion experiences as the initial inflammation could have detrimental health impacts,” warns Dr. Singh. This caution is particularly relevant given the growing popularity of cold exposure practices.
The current cold plunge trend shows no signs of slowing down. However, this research suggests that people might need to adjust their expectations about what cold exposure can and cannot do for their health.
Safety Considerations
The research emphasizes several important safety aspects of cold-water immersion. The initial inflammatory response could pose risks for people with pre-existing health conditions. Additionally, the wide range of protocols used in different studies, from very brief cold showers to extended ice baths, suggests that people should start gradually and pay attention to how their body responds.
While cold-water immersion shows promise for specific health outcomes, more research is needed to establish optimal protocols and understand who might benefit most. As Cain notes, “Right now, there isn’t enough high-quality research to say exactly who benefits most or what the ideal approach is to cold-water immersion. More long-term studies, among more diverse populations, are needed to understand its lasting effects and practical applications.”
Paper Summary
Methodology
The research team conducted a systematic review and meta-analysis, searching ten major medical and scientific databases for randomized controlled trials involving healthy adults exposed to cold water. They specifically looked for studies where participants underwent cold-water immersion at temperatures of 15ยฐC or below, for at least 30 seconds, with immersion at chest level or higher. The team excluded studies involving elite athletes or people with chronic conditions, focusing instead on the general population.
Results
The analysis revealed several time-dependent effects:
- Inflammation increased significantly immediately and one hour after exposure
- Stress levels showed no immediate change but decreased significantly at the 12-hour mark
- Immune function showed no significant immediate changes, though long-term benefits were observed
- Sleep quality improved with regular cold exposure
- Quality of life showed short-term improvements that didn’t persist beyond 90 days
- Mood remained unchanged, contrary to popular claims
Limitations
Several important limitations affect the interpretation of these results. Most notably, only one study included female participants, severely limiting the applicability of findings across genders. Additionally, the studies varied widely in their protocols, from water temperature to exposure duration, making direct comparisons challenging. Small sample sizes in many of the included studies also impact the generalizability of results.
Discussion and Takeaways
This research suggests that cold-water immersion’s effects are more nuanced than typically portrayed in popular media. While some benefits do exist, they often follow different timelines than expected and may not align with common claims. The findings indicate that CWI might be most effective when used strategically, with an understanding of its delayed effects on stress and inflammation.
Funding and Disclosures
The research was supported by a Medical Research Future Fund Emerging Leader Grant (GNT1193862) awarded to Carol Maher. The authors declared no competing interests.
Publication Information
The study, titled “Effects of cold-water immersion on health and wellbeing: A systematic review and meta-analysis,” was published in PLOS ONE on January 29, 2025. The research was conducted by investigators from the Alliance for Research in Exercise Nutrition and Activity (ARENA) at the University of South Australia.
I tried it at the LA Athletic Club…didn’t do a thing but make you super cold!! Never do it again…
The exact wrong conclusion drawn. People who took cold showers were 29% less likely to call in sick but their illnesses lasted just as long. Your conclusion: it may help them cope better. Uh, no, if they were coping better with illness their spells would be shorter. Do you have anyone who knows research writing these articles based on research? Doesn’t seem like it…