Tag Archive for: stress management

How to Get More Benefits from 10,000 Steps per Day

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By Nicole Molumphy

Many of you are familiar with the 10,000-steps-a-day walking trend, but you may not know where it originated. The idea of walking 10,000 steps per day did not come from scientific research; rather, it came from a marketing campaign for a pedometer ahead of the 1964 Tokyo Olympics. Since the Japanese symbol for 10,000 looks somewhat similar to a person walking (see image below), the pedometer was named Manpo-kei or 10,000 steps meter, and the 10,000-step-a-day walking trend was born.

 

 

We know walking is good for us, but what do researchers have to say about this 10,000 number? Is this the right number of steps? What are the health benefits of reaching this number?

A 2023 research study showed 8,000 to be the sufficient number of steps to yield significant health benefits. In this study, participants who took 8,000 steps or more on one or two days during the week showed substantially lower cardiovascular and all-cause mortality risk.

Stanford Lifestyle Medicine Movement and Exercise pillar member Corey Rovzar, PhD, DPT, puts the 8 and 10 thousand numbers into perspective. “What is more important than hitting an exact number is that you’re moving more throughout the day,” says Dr. Rovzar. “If looking at a pedometer and trying to hit 8,000 steps will help you move more, then it’s a great tool, but rather than fixating on an exact step count, I recommend you think about your day and envision opportunities to move.”

Rather than walking all 8,000 steps in one go, which would take about 80 minutes at three miles per hour, Dr. Rovzar recommends walking the 8,000 steps throughout the day, such as in the morning and evening and after each meal. For example, you could split the 8,000 steps (80 minutes of walking) into four, 20-minute walks. If you stick to the 10,000-step goal (100 minutes of walking), that breaks down to five, 20-minute walks. This recommendation is good news for those who sit at a desk since taking several short walks during the workday is a perfect way to take a break. “It is important to note that all steps count! Even a few steps to the bathroom or to another room contributes to this overall count,” says Dr. Rovzar.

Ideas on How to Meet Your 10,000 Steps Goal:

  • Take the stairs instead of the elevator.
  • Walk more during errands by parking your car farther away from your destination or getting off the bus or train a stop early.
  • Walk more during your work day by taking a “walking meeting” or walking while on the phone.
  • Walking after each meal can help with digestion, blood sugar management, and cardiovascular health.
  • Walk every morning, evening, and during your lunch break. Even 10 to 15 minutes of walking can add up to 1,000 steps.
  • Catch up with a friend by going on a walk instead of meeting for coffee.
  • Use a step tracker to help you stay motivated and track your progress.

How to Get More Out of Your 10,000 Steps

If you’re already walking 8 to 10 thousand steps daily, you may be ready to take your walking to the next level. If so, Dr. Rovzar recommends adding modifiers to your walking routine to help you meet additional fitness goals, such as improving balance or building muscle.

Here are a few of Dr. Rovzar’s recommendations for intensifying your daily stroll and gaining more health benefits:

1) Cardiovascular (Endurance) Modifier:

Interval walking

Interval walking involves alternating fast and slow walking cycles. Researchers recommend five intervals of fast and slow phases, each lasting roughly three minutes. The effort expended should be 40 percent of your maximum effort for the slow phase and 70 percent for the fast phase.

2) Muscular Strength Modifiers:

Walk up and down hills or stairs multiple times

If you are looking for strength benefits, hills may become your new best friend. Walking hills or stairs not only has excellent aerobic benefits but also serves as a great form of strength training.

Add ankle and wrist weights or wear a weighted backpack

Another strength training modification is adding weight to your walk, either with ankle or wrist weights or by rucking. The term rucking originated during boot camp training and involves using weighted vests or backpacks while hiking or walking.

3) Balance Modifiers:

Take side steps

March (i.e., lift your knees as you walk)

Walk backwards

It is essential to perform balancing exercises as we age. Implementing side steps, marching, or walking backward are great ways to train your body to handle non-forward-facing movements, enhance joint mobility, and improve flexibility. Balance training is also an effective way to strengthen different muscle groups. For example, side steps engage your abductors, which are hip muscles involved in getting out of your car and transitioning out of bed in the morning.

4) Cognition Modifier:

Dual-task training

Cognition may also be enhanced with walking practices, like dual-task training. This practice involves performing a mental task while walking, such as talking to someone while walking, keeping step time to a metronome, or counting backward from 100. Combining the mental task with the physical action of walking forces the walker to increase concentration, which sharpens the mind and improves balance and stability.

Whole Body Health Benefits

In addition to the physical benefits walking offers, Dr. Rovzar says that walking improves mental clarity and well-being. Taking a step away from work and going on an outdoor walk can help you overcome mental roadblocks. Studies have found mental health benefits from walking outside in nature, including decreased cortisol levels, diastolic and systolic blood pressure, and pulse rate. While using a treadmill may be a great way to multitask and get in extra movement, there are considerable mental health benefits from taking a break outside, getting fresh air, and stopping to smell roses and pet dogs on your walk.

“We often strive to maximize our time working, but in reality, you might not be saving yourself time by omitting the breaks,” says Dr. Rovzar. “I recommend getting out of your work environment and going for an outdoor walk every couple of hours during the workday, even if it’s just five-minutes of movement to get your blood flowing.”

Practice of the Month:

Walk 5 Days per Week for 30 minutes with a Modifier

The US guideline for moderate physical activity is 150 minutes per week (which breaks down to five 30-minute brisk walks with a modifier per week). To ensure you’re improving muscle strength, balance, endurance, and cognition every week, Dr. Rovzar recommends assigning different modifiers to different days.

Sample Walking Routine (30 minutes per walk):

Monday: Walking up and down hills on Mondays (endurance)

Tuesday: Rucking (strength)

Wednesday: Incorporating intervals of side-stepping, marching, and walking backward (balance)

Thursday: Interval walking (endurance)

Friday: Adding ankle and wrist weights (strength) while counting backward from 100 with each step (cognition)

 

If a 30-minute walk seems too daunting, Dr. Rovzar suggests starting with 10 minutes of walking and incrementally working your way up to 30 minutes daily. “Much of this comes down to goal setting,” she says. “If you set too lofty of a goal, it becomes unachievable, but if you break your goal down to an amount that seems feasible and perhaps try it just for a week, it becomes more likely you will remain consistent in attaining it.”

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Jumping into the Ice Bath Trend! Mental Health Benefits of Cold Water Immersion

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By Maya Shetty, BS

Key Takeaways

  • Research shows that cold water immersion (CWI) may improve mental health by increasing endorphin and norepinephrine levels. 
  • CWI may also improve resilience to stress by decreasing cortisol levels.
  • CWI can be adapted to meet different wellness goals, whether for immediate relief or long-term mental health benefits.
    • For individuals seeking a quick boost in mood, daily cold water face immersions and occasional full-body plunges might be beneficial.
    • For those aiming for long-lasting benefits such as lowered cortisol levels, enhanced mood regulation, and increased resilience to stress, research shows that consistent full-body CWI may be beneficial.

Have you ever considered how taking a cold plunge might affect your mental state? Beyond the initial shock, CWI is proving to have profound effects on brain health and mental well-being. Initially popular as a recovery technique among athletes, it has now evolved into a bold wellness practice for those seeking to enhance their overall health. This practice, which involves plunging into cold water (roughly 10-15°C, 50-60°F), has ignited significant research interest, and emerging studies now suggest that CWI can improve mood, decrease stress, and potentially slow the progression of neurodegenerative diseases.

“I personally do cold water immersion and find it to be an immensely rejuvenating activity,” says Stanford Psychiatrist, Vanika Chawla, MD, member of the Lifestyle Medicine Cognitive Enhancement pillar.

CWI can take many forms, each involving its own protocol and equipment. The most common forms include:

  • Ice Baths: Traditionally utilized by athletes for recovery after intense physical activity, ice baths require submerging the body up to the neck in ice-cold water. Also known as cold plunging, this practice generally lasts only a few minutes and involves limited movement.
  • Cold Showers: A more accessible form of CWI, taking cold showers can offer many of the same benefits as ice baths but are easier to incorporate into daily routines.
  • Open Water Swimming: This active form of CWI involves swimming in cold rivers, lakes, or oceans, allowing for longer exposure times to the cold.
  • Cryotherapy Chambers: Though they do not involve water, cryotherapy chambers expose the body to extremely cold air temperatures for brief periods, stimulating a physiological response similar to that achieved through water immersion.

Choosing the type, temperature, and duration of CWI depends on your cold tolerance and the resources available to you. It is generally recommended to aim for a temperature that feels uncomfortable but still safe (no colder than 10°C, 50°F). If you have any form of access to cold water, whether it be a lake, a river, or your home shower and bathtub, you can participate in CWI and begin to explore its benefits.

Can Cold Water Plunges Improve Mental Health?

While the idea of diving into extremely  cold water seems unappealing to most, recent studies have shown that CWI offers emotional benefits. In 2021, researchers recruited undergraduate students to take a 20-minute dip in chilly sea water (13.6°C, 56.5°F) and report their emotions before and after using a Profile of Mood States questionnaire. Compared to controls, the students who engaged in CWI experienced a shift in mood, noting a significant decrease in negative emotions like tension, anger, depression, fatigue, and confusion. Moreover, they experienced boosts in positive emotions such as vigor and self-esteem. Further research involving thirty-three adults new to cold-water swimming highlighted similar benefits. After immersing in a cold bath (20°C, 68°F) for just five minutes, participants reported feeling more active, alert, attentive, proud, and inspired.

These studies, which utilize self-reported questionnaires, indicate that cold-water immersion may significantly enhance mood and overall psychological well-being. It appears to activate traits associated with increased motivation and vitality, while simultaneously diminishing feelings of distress and nervousness. 

How to Lower Cortisol Levels Naturally

CWI presents a unique stimulus for the body, prompting significant shifts in its hormonal stress response, particularly involving cortisol, a key regulator of stress. Unlike other stress hormones such as noradrenaline, cortisol levels remain relatively unchanged during the initial shock of cold water. Research highlights an intriguing aspect of cortisol dynamics: while levels do not significantly change during CWI, they significantly decrease afterward.

For example, a study concluded that a one-hour CWI session, whether in thermoneutral (32°C, 90°F), cooler (20°C, 68°F), or cold (14°C, 57°F) water, did not lead to an increase in blood cortisol concentrations. Instead, cortisol levels tended to decrease across all temperatures tested and remained below initial levels an hour after immersion. These findings suggest that cortisol production is not significantly activated by CWI, contrary to what might be expected under typical stress conditions. In fact, CWI may have potent stress-modulating effects. Further research indicates that cortisol levels remain considerably lower for up to three hours after just 15 minutes of CWI (10°C, 50°F). This pattern of response reveals a sophisticated regulatory mechanism, suggesting that CWI can effectively diminish feelings of stress following a session.

CWI may have the potential to modify our body’s stress response to stressors in everyday life. In a study where participants engaged in winter swimming (water 0-2°C, 32-36°F) for twenty seconds or cryotherapy (-110°C, -166°F) for two minutes, three times a week for twelve weeks, the body adapted remarkably. After just four weeks, participants showed significantly lower cortisol levels post-exposure, with levels continuing to drop in the following weeks. This adaptation contrasted with the noradrenaline response, which remained consistent even as the body became accustomed to the cold stress. This reduced cortisol response not only diminished the stress perceived from cold but also potentially enhanced the body’s capacity to manage other stressors more effectively. 

The main take away from this study is that by reducing cortisol production in response to repeated cold exposure, participants might also release less cortisol in response to other stressors in everyday life, thus fostering a more resilient physiological state over time.

“Resilience is the ability to adapt to life’s stressors and adversities,” says Dr. Chawla. “The body and mind are interconnected, therefore greater physiological resilience may lead to greater psychological resilience as well.”

How Cold Water Immersion Impacts the Brain

CWI has been scientifically observed to influence brain function, affecting mood, stress response, and potentially brain health through several mechanisms. The immediate physiological response triggered by CWI is largely due to the dramatic change in temperature. A dense concentration of cold receptors in the skin detects this change, leading to a surge of electrical impulses from peripheral nerve endings to the brain. This intense stimulation activates various neural pathways, initiating a cascade of chemical responses designed to help the body manage and adapt to the stressor.

During the initial shock of CWI, the body experiences stress and discomfort due to the sudden drop in temperature. To counteract this, endorphins, the body’s natural pain relievers, are released. These endorphins not only reduce pain but also enhance feelings of well-being, akin to the “runner’s high” that often occurs in other physically demanding or stressful situations. 

CWI also activates the sympathetic nervous system (SNS), which controls our “fight-or-flight” responses. This activation leads to a significant increase in noradrenaline (also known as norepinephrine), an excitatory neurotransmitter that not only helps manage stress but also boosts energy and focus. The surge in noradrenaline increases blood flow to the brain, potentially causing feelings of euphoria.

These two neurotransmitters play complementary roles. While norepinephrine prepares the body to handle acute stress by enhancing alertness and readiness, endorphins work to soothe pain and promote a positive mood. This dual response helps individuals cope with the immediate impacts of cold exposure more comfortably and can make the experience of cold water immersion more tolerable–and potentially even rewarding.

Regarding whether CWI has long-term positive effects on the brain, research indicates inconsistent results with respect to the increase of endorphin levels. It is possible that not everyone experiences this endorphin response to CWI, and among those who do, the effect may diminish over time, as the body becomes accustomed to the cold exposure. On the contrary, the increase in noradrenaline continues with each session of CWI, even after the body has adapted after months of regular practice. 

These findings underscore the potential of CWI to be used as a reliable tool for improving energy, focus, and mood. These findings also point to the potential of CWI to be used in the treatment of neurological conditions that involve low noradrenaline, including anxiety and depression. However, more research is needed to understand if CWI has long-term effects on emotional well-being outside the water.

Also, CWI may improve brain function through the release of cold-shock proteins, which are produced by the body in response to cold conditions. Animal studies reveal that proteins like RNA binding protein (RBM3) play a crucial role in repairing and regenerating nerve cell connections after they’ve been exposed to cold. Additionally, studies have demonstrated that over-expressing RBM3 can help prevent neuronal connection loss in mice with neurodegenerative diseases. Although there is limited evidence in humans, these findings in mice suggest that regular CWI could potentially boost the expression of such beneficial proteins in humans, offering protection against or slowing the progression of neurodegenerative diseases by preserving and reinforcing neural connections. 

Reaction to Cold Water: Full-Body vs. Facial Immersion

Physiological responses to CWI differ significantly based on whether the exposure is to the full body or just the face. Full-body immersion exposes a significant surface area to cold, inducing thermal stress that can substantially lower skin and core body temperatures. This extensive exposure activates the sympathetic nervous system, which in turn triggers a release of neurotransmitters and hormones that drive the stress response. Consequently, this leads to vasoconstriction, an increased heart rate, and a heightened metabolic rate, all of which help preserve body heat and maintain core temperature.

In contrast, immersing just the face in cold water activates parasympathetic activity, which is responsible for “rest and digest” functions in the body. This effect is likely due to the mammalian diving reflex—an evolutionary adaptation that optimizes respiration and conserves oxygen by preferentially directing oxygen to vital organs. The diving reflex is mediated by the vagus nerve, which activates the parasympathetic system and releases a sense of calm. The trigeminal nerve in the face also plays a crucial role when stimulated by cold, sending signals that further enhance parasympathetic output, decreasing heart rate, and boosting digestive activity. 

These differences highlight how CWI can be strategically used to target specific physiological responses and therapeutic outcomes, depending on whether the exposure is localized to the face or involves the entire body.

“I sometimes recommend facial cold water immersion to my patients as part of the T in TIPP skills to help people with emotion regulation. TIPP stands for temperature, intense exercise, progressive muscle relaxation, and paced breathing,” says Dr. Chawla. “These skills involve changing your body chemistry to shift emotions. Some people find brief facial immersion in cold water or taking a cold shower to be helpful in shifting their body chemistry and thereby shifting their emotional state.” 

Safety Considerations

CWI can offer several health benefits, but it’s essential to approach this practice with caution due to potential risks. One of the most obvious risks is hypothermia, as immersing in cold water significantly drops body temperature. To prevent hypothermia, limit immersion time to no more than 10 minutes. 

Furthermore, it is important to understand the cold shock response. Entering cold water suddenly can trigger an involuntary gasp reflex followed by hyperventilation. Hyperventilation increases the risk of drowning (especially in open water plunging) and can also lead to arrhythmias or even a heart attack, particularly in those with underlying heart issues. To better manage the cold shock response, it’s advised to enter the water slowly, allowing your body to adjust to the temperature gradually. 

It is also important to never swim alone regardless of your swimming strength or experience. Having a partner ensures that help is readily available in case of an emergency, such as cramps, sudden illness, or difficulty in the water.

Finally, remember to allow your body to gradually acclimatize to whatever CWI technique you choose. If you are a beginner, begin with shorter durations (2 minutes) in warmer water (roughly 20°C, 68°F), progressively moving to colder temperatures with longer durations as your body adapts.

“This intervention is not for everyone. It’s important for people to consider what works best for their individual needs,” says Chawla. “If you are going to try CWI, be mindful of how it impacts your mind and body and incorporate the activity into your routine accordingly.”

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