Peter Attia: “I Changed my Mind on Sauna”

I stumbled across this video where Dr Peter Atia a well-known physician had several interesting things to say about saunas and our health I'd like to hear what he has to say in an interview and then I'd like to sprinkle in some additional information especially cracking open some of the studies to see if there's truth to the claims here here's Dr AA on why he changed his mind about sauna use something else I've changed my mind on yeah I'm way way way more bullish on sauna than I before I used to be in the camp of

SAA feels great it maybe even helps you sleep a bit better um that's probably about it like there's no way you're going to really live longer because you're in a sauna and while truthfully we don't have really great prospective data um or sorry I should say we have good prospective data we don't have good randomized data real quick here in Translation Dr AA is talking about prospective data meaning we have good ass asstive studies that are pre-planned and follow people's habits over time but we don't have good randomized data meaning intervention studies these are the

type of studies that give us definitive ideas on causation because we're controlling for all other variables and simply changing one thing called an intervention you can imagine it's extremely difficult if not almost impossible to put people into one group getting sauna treatment and then and uh the comparison group gets nothing obviously it introduces a potential for what's known as the placebo effect where participants think something will affect them so they are more prone to experience an effect not because the intervention causes a true effect but simply because the belief itself there are many many instances

of that happening in science and that's why having a proper control especially a placebo group is critical for reducing that risk that all said I actually slightly ever so slightly disagree with Dr AA here because there are some decent randomized control trials on sauna use like these as a start usually I'm the conservative one when it comes to interventions but there have been randomized control trials on sauna dating back over two decades now they still largely suffer from the whole you know Placebo issue that I mentioned but they are randomized and controlled to the best

possible anyway I wanted to explain the distinction here I think this is one of those things where the burden of evidence in the non-randomized data is so strong it's becoming hard to ignore so most of the research in this subject has come out of Finland and the son surprise yeah um and so there's the obvious issues with this right right the people who can afford danuna are by definition going to have more time on their hands more disposable income probably more education like all of the standard uh things on top of that if you're going

to choose to sauna because you believe it's healthy what else are you doing because you believe it is healthy I mean right so so you know if if the data showed that Sauna versus non sauna was like a 5% Improvement in mortality it would be hard to get that excited about it but when you look at the largest published series on this you see a benefit in all cause mortality a relative absolute pardon me a relative risk reduction of 40% and an absolute risk reduction of like 18% those are those are high numbers those are

ridiculous numbers okay so he's getting into the long-term data the prospective data that he mentioned earlier so are the effects that big and can we possibly contr control for some of the Hidden factors that he mentioned we can lean on this finished study which I'll likely cover more in the future but I'd like to touch on it in relation to all cause mortality as Dr AA mentioned similar work in this study researchers recruited over 2,000 participants and followed them and their habits over 20 years and then Quantified sauna use or no SAA use and the

relationship to death otherwise called all cause of mortality well what did they find well in this table they quantify the all cause mortality risk in these people based on the amount of sauna the top the reference there the one is the people who sauna once per week or less the two sections underneath are all cause mortality risk relative to the reference when doing sauna more than once per week the risk is reduced by 30 to 40% confirming Dr aa's point but the data that we went over is largely unadjusted meaning it's a pretty pure correlation

except that the researchers is controlled for age on the other hand the researchers did perform more robust adjustments for things like weight blood pressure blood cholesterol containing lipoprotein smoking alcohol consumption previous heart disease type 2 diabetes overall cardiorespiratory Fitness resting heart rate physical activity and socioeconomic status after adjusting for all those factors the all cause mortality risk reduction was still maintained now to be clear this still doesn't eliminate the possibility for confounding variables as in something else explaining these results since as Dr AA pointed out people who sauna more often may simply be more aware

of the potential benefits so they may have a more Leisure Time uh they may have more time to go to the gym uh they may have healthier habits and so on however what I love that the researchers did here is use multiple adjustments for some major confounding factors for example if a person is generally healthier then that would reflect in their cardiorespiratory Fitness as well as their blood pressure as well as their heart rate and physical activity they'd be accounted for by one but likely many of those controls then Leisure Time and overall wealth would

be accounted for in socioeconomic status or at least a high likelihood and even if a few fall between the cracks it's unlikely that they'd actually sway the analysis all that to say that Dr AA is spoton oh and by the way there's something a bit comical but important that contributed to possibly increased sudden cardiac death in people doing sauna I'll discuss that at the end I'd like to touch on some other aspects first but first I've been analyzing a lot of studies on sauna therapy across a number of different protocols and I've compiled all the

protocols across a multitude of studies from infrared to steam and so on including the common themes of what's shown to be most effective it's available for the physionic Insiders and is continuously updated as new therapies are released if you're interested the Insiders includes those protocols but also many other protocols a massive library of application folus videos monthly podcast and much more it's linked in the description box if you're so inclined hope to see you there anyway there's more to be said about sauna so let's get to it if you think about what the mechanism of

action is yeah I was going to ask you next is it heat chock proteins is it something else I think it's many things I think it's heat chock proteins I think it's nitric oxide I think it's like literally vascular tone right reduction in blood pressure in Spitfire mode a few of the mentioned mechanisms heat shock proteins and Nitro oxide from sauna use well for one heat chock proteins which are well proteins inside the cell that attach to functional proteins within the cell and stabilize them essentially if the cell undergo stress components of the cell can

be damaged and heat shock proteins can bind to various molecules in the cell and stabilize them disallowing them from unfolding and becoming inert if this lasts long term it might protect against other stressors that our cells experience anyway there have been studies that have looked at heat shock proteins in sauna use and identified as seen here that a single bout of sauna can increase she heat shock proteins in the body both conditions orange and green were exposed to sauna so there's no control condition as we can see the after the first sauna here there's an

increase in HSP abbreviation for heat shock protein however h should be noted that heat shock proteins normalize or reduce long term because after 10 sauna sessions heat shock proteins have reduced but importantly they are still increased relative to Baseline I'd like to look at more data on the topic but it seems to be true that sauna does induce heat shock proteins although I'm not entirely convinced it occurs long term at least not based on these data but what about nitric oxide well briefly nitric oxide is a molecule that when released from the endothelial cells inside

your blood vessels your arteries can bind smooth muscle cells also found in your arteries and Signal them to relax this relaxation is called a vasodilation and allows blood pressure to be reduced because there is more room for the same blood volume to move through so to assess the role sauna has on nitric oxide we can lean on this study and we look at the nitric oxide levels and we can see the vertical axis is the amount of nitric oxide so both lines indicate groups where Sona was applied there is again no control group this is

a confusing way to show the data so I'll just point your attention to focus on the far right so two c and the far left one one indicates no Sonic exposure so Baseline 2 C indicates a full day after the 10th sauna session evidently there is a long-term effect of increasing nitric oxide which is encouraging I would actually like to see error bars or standard deviations but if we suspend our need for exactness which is difficult for me to do at times if I'm honest but uh these data indicate Dr AA is again on the

mark also Dr AA mentions this um it's an SL you know increase in heart rate and cardiac output so there's a bit of an exercise benefit um I don't know if bdnf I think bdnf has been measured I can't recall that could be another uh potential benefit so my guess is brain derve neurot Factor yeah I think it's probably half a dozen things that are all moving in the right direction so Dr AA mentions sauna is like exercise mimetic and that's likely true but as he also mentions it might not be exclusively that and that

is likely also true oh and on the bdnf front he remembers correctly bdnf a molecule that's been identified as being highly beneficial for our brain is also elevated according to this study okay so we covered a ton of information so what are the key takeaways oh and that thing I teased earlier about the uh increased Health complications from sauna in this study the researchers mentioned there were some more serious complications like sudden cardiac death if people consumed alcohol while saing so obviously death is tragic but I'm not sure why people felt inclined to get to

drinking seems unwise when you're already sweating heavily anyway that's the caution although I think you already realize that's obvious don't drink in sauna and wear seat belt while you're at it in your in your car okay the takeaways it's pretty simple Dr AA is correct and if you can manage it using a sauna more than once per week seems to provide some outsized health benefits that ultimately yield a reduction in all cause mortality of up to 40% reduced risk which is a huge relative effect and if you're so inclined to learn more like the effect

on your heart I'd recommend this linked video it goes far more into depth thanks for tuning in [Music]