Wellness, Actually Grabbag! Which wellness fads actually hold up?

Short answer

Cold showers cut sick days taken but not actual illness; vampire facials have almost no evidence and a documented HIV transmission cluster from a spa in 2018; EMF meters detect ordinary 60-hertz household current and visible light carries vastly more energy than your Wi-Fi; vibration plates don't help balance and may slightly raise fall risk. The ones worth your time are pelvic floor therapy, fiber from food for constipation, and living kidney donation, which carries close to average long-term kidney risk and puts you at the top of the list if you ever need a kidney yourself.

People stop me all the time with a wellness question that doesn't need an hour of my life. Vampire facials. Salt lamps. That gadget that beeps red when you walk past a microwave. So we collected a dozen of them and answered them fast. Here's what survived.

The ones that don't do what they claim

Start with cold showers. A 2016 Dutch study had people finish their normal warm shower with 30, 60, or 90 seconds of cold water every day for a month. The cold-shower group took fewer sick days from work. They did not get sick less often. They got sick the same amount and went to work anyway, which is arguably a public health problem rather than a benefit. The trial also couldn't be blinded, for obvious reasons. You know when your shower is cold. Duration didn't matter either: 30 seconds worked the same as 90.

Vampire facials: you draw blood, spin it in a centrifuge to concentrate the platelets, microneedle the face, and smear the plasma into the tiny wounds. The theory is growth factors from the platelets boosting collagen. The evidence is thin. There's a little for acne scarring, and even there it isn't clear it beats plain microneedling. For general wrinkles and glow, there are small studies, mostly from people selling the procedure. There is also real downside. In 2018, people contracted HIV at a spa performing these. That's not a typical complication, but anyone taking your blood and putting it back on your bleeding face should be a legitimate medical operation.

Vibration plates were sold to me as a balance intervention, which is the one plausible use. Balance genuinely matters as you age. Proprioception declines, and practicing it is the piece people skip after they've sorted out strength training and cardio. You can practice for free by standing on one foot while the coffee brews, near a counter. But vibration plates have been tested in trials, and they don't improve balance. Participants using them may have been slightly more likely to fall, presumably because doing squats on a shaking platform is not a low-risk activity. As for shaking the fat off, that isn't how fat works. Use one inside a calorie deficit and you'll lose weight from the calorie deficit. If you like standing on it in the morning playing a game on your phone, that's fine. It's a relaxation device.

Salt lamps do nothing. The claim is that they emit beneficial ions into the air. Sodium chloride does not ionize at anything close to the temperature inside a 15-watt bulb. If it did you'd be generating chlorine gas, which is not the wellness outcome anyone is after. They also absorb moisture from the air and sweat a little, and there have been house fires from water reaching the electrical components. What a salt lamp is actually good for is a dim reddish light at night, low on blue light, which suppresses melatonin. Read a book next to it. That's the product.

Chin-sculpting stickers and the broader genre of face patches: no evidence. Some of the ingredients do something briefly. A snug patch can push fluid out of tissue the way a cold compress does. Caffeine is a vasoconstrictor and can slightly reduce swelling. Hydrogel moisturizes. None of that changes your jaw shape, which is determined by your genetics the same way your nose and cheekbones are. If you want a marginal, 20-minute improvement that only you will notice, this qualifies. The eye stickers, the forehead stickers, the mouth stickers, all the same.

EMFs and farmed salmon: the scares with a kernel of truth

The EMF meters people buy online are measuring reality and then lying about what it means. Everything is an electromagnetic field. Your outlets at 60 hertz, or 50 in Europe, generate one. Your lights generate one. Visible light carries an electromagnetic field enormously stronger than anything from your Wi-Fi router or microwave. The only reason your meter doesn't scream in a lit room is that light oscillates around 10¹⁴ times per second, far beyond the meter's resolution. Household current at 60 hertz it can detect. That's the whole trick. If electromagnetic fields genuinely frightened you, you'd have to live in total darkness.

None of this is ionizing radiation. It doesn't carry enough energy to break chemical bonds and damage DNA, the way UV does. A kid standing in front of a running microwave is fine. It doesn't penetrate skin, and it's less energy than the kid gets standing in front of a lamp.

There is one real signal, and it isn't the one being sold. Correlational data from several places has linked living near high-voltage power lines to certain very rare childhood leukemias. Not confirmed, not necessarily causal, but on the radar. The reason there's even a question is that those lines generate a magnetic field at scale, on the order of 0.3 to 0.4 microteslas, which is far stronger than what a microwave's current produces and can bathe an entire house continuously. Chronic exposure at that level might matter. Your household electronics are not in that category.

Then there's salmon. An Instagram post making the rounds calls farmed salmon the most toxic food in the world, claims the fish are sedated and 95% go deaf, says petroleum dyes color the flesh, and puts dioxin levels tenfold above beef, chicken, pork, and eggs.

The most toxic food in the world, if we're being literal, is the death cap mushroom. Among things people eat on purpose, it's fugu. And if you count by bodies, it's aflatoxin from poorly stored grain and peanuts, which causes liver cancer and kills roughly 100,000 people a year in sub-Saharan Africa. Salmon is not in the running. Nor are the fish sedated; farmers want them eating, swimming, and putting on muscle.

The deafness claim has something to it. Farmed salmon grow faster than wild ones, and fast-growing salmon develop crystals in the inner ear that can affect their hearing. That's sad, and a fair point about how we treat farmed animals, but it tells you nothing about whether the fish is safe to eat.

The pink color comes from astaxanthin, which goes into the feed rather than being sprayed on the fillet after harvest. Wild salmon get the identical molecule from krill and shrimp. The farmed version is synthesized instead of extracted, and the molecule doesn't know the difference.

On dioxins, apex predator fish do concentrate environmental contaminants like mercury, arsenic, and dioxins. But wild salmon carry about three times the dioxin of farmed salmon, because farmed fish are mostly raised on plant-based diets, and both sit well below World Health Organization risk thresholds. The dose makes the poison.

Salmon is one of the best sources of the beneficial omega-3 fatty acids and, if you don't love sardines, the best tasting one. Eat it.

What the evidence actually supports

Pelvic floor therapy deserves more enthusiasm than it gets. Your pelvic floor is a muscle group holding up your organs, and pregnancy stresses it badly, because babies and a uterus full of fluid are heavy. A pelvic floor therapist trains and strengthens those muscles. Ideally you see one before, during, and after pregnancy. Kegels, tightening the way you would to stop yourself from urinating, then holding and releasing, are one standard exercise, but pelvic floor therapy goes well beyond that, and for some problems Kegels are the wrong treatment. That's why you want a person, not a video.

A weak pelvic floor makes it hard to exercise, makes you leak when you sneeze or run, and can cause fecal incontinence. The ad campaigns selling pads for "little leaks" have normalized something that is common but treatable. You shouldn't have to pee yourself when you sneeze, and this should be covered by every insurer and by Medicaid. Men have pelvic floors too; theirs just don't get pregnancy loaded onto them.

Fiber, specifically psyllium husk and beta glucan, came up together but they're different fibers. Psyllium husk is the best source of insoluble fiber, the kind that moves things along. Beta glucan, found in oats, is soluble, and it works more by gluing things together and slowing transit. Both improve pooping. Oat consumption has been linked to lower LDL cholesterol; psyllium husk, being insoluble, has not. Colon cancer prevention is where the story falls apart. People have proposed the link, but trials that shift people's fiber intake have not shown a reduction in colon cancer. And get all of this from food rather than pills and powders when you can.

Living kidney donors are heroes, and the numbers make the case. About 100,000 people in the United States are waiting for a kidney. We do roughly 27,000 transplants a year, about 6,000 of them from living donors and the remaining 21,000 or so from deceased donors. Around 5,000 people on the list die each year or become too sick to transplant. That's about 13 people a day.

Screening to become a donor is intense, by design. The goal is to confirm that whatever eventually kills you, it won't be kidney disease. No diabetes, not too overweight, no unexplained protein or blood in the urine, plus a battery of other tests. After donation, the remaining kidney grows and takes over. The rate at which living donors go on to need dialysis or a transplant themselves is about the same as the national average, which is very low. I'd flag that you would expect it to be better than average, given how rigorously donors are screened. The fact that it merely matches the rest of us suggests a modest hit, which is what you'd predict. Regret after donation is vanishingly rare, and most donors are extremely happy about it.

If you're interested and don't have a specific recipient, look into altruistic chains. Someone needs a kidney, their spouse isn't a match, but the spouse agrees to donate to a stranger they do match if their partner receives one from someone else. You can link these into long chains. One more thing that should be better known: prior living donors go straight to the top of the list if they ever need a kidney themselves. The average wait in the US is about four and a half to five years depending on region. Donors get one right away.

The Body Keeps the Score, and the limits of a good idea

Bessel van der Kolk's 2014 book argues that overwhelming experiences, particularly chronic childhood abuse and neglect, aren't stored as ordinary memories but as fragmented physiologic states. The body gets stuck in threat mode. The amygdala runs hot. It's a classic pop science book in that it cites real research and then leans hard on one slice of neuroscience while ignoring a great deal of the rest.

The load-bearing finding is brain imaging showing that Broca's area, responsible for speech, goes quiet when people recall trauma. From there the book leaps to a much bigger claim: that trauma can't be addressed with words, and must instead be processed physiologically through yoga, neurofeedback, eye movement exercises, and more recently MDMA-assisted therapy.

That leap is probably wrong. The argument that trauma fails to encode as memory runs against most of the data, which suggests trauma is remembered too well. People have vivid, intrusive recollections of what happened to them. The classic treatment of this is Richard McNally's Remembering Trauma from 2003.

There's also an echo in the book of the recovered-memory movement of the late 1990s, when people guided by therapists came to "remember" childhood events that never occurred. That does serious damage, to the person whose memories are being implanted and to the family members being accused.

The book gets something right. Childhood trauma has lifelong consequences, and pushing people to take that seriously is worthwhile. But there's no good evidence that body-based approaches outperform ordinary talk therapy.

Black cumin seed and turmeric

These actually do something, and that shouldn't surprise anyone. Plants contain compounds, compounds are biologically active, and most of our pharmaceuticals started this way. Aspirin came from willow bark, someone isolated the active ingredient, and now we synthesize it.

Black cumin contains thymoquinone, an HMG-CoA reductase inhibitor. That's the same mechanism as statins. So there's a small statin in your black cumin seed, and randomized trials show it lowers LDL by about 15 points. The oil form works better than the seed, because the compound is fat soluble and the seed isn't absorbed as readily. Turmeric is weaker: roughly 5 mg/dL of LDL reduction, plus reductions in fasting glucose of up to about 10 mg/dL in randomized trials.

All modest next to pharmaceutical-grade options. I don't recommend sourcing your medications from unregulated plant products. They're less effective, less pure, and full of other compounds that may interact with your other medications or cause off-target effects. People reach for these because natural sounds safer, which is the naturalistic fallacy, and nature is full of things that will kill you dead. There is real value in purified substances made in a lab. If you want black cumin or turmeric in your cooking because you like the taste, enjoy it.

For what it's worth, black tea contains compounds that lower cholesterol by about the same 15 points, and bergamot has a modest LDL-lowering effect as well. Combine black tea and bergamot and you have Earl Grey. Tea. Hot.

Bottom line

Of the dozen things listeners asked about, the ones with real support behind them are pelvic floor therapy, fiber from food for your bowels and oats for your cholesterol, and living kidney donation. Cold showers may change your sick-day behavior without changing your illness. Vampire facials, vibration plates, salt lamps, face stickers, and consumer EMF meters have essentially nothing behind them, and a couple carry small real risks. Farmed salmon is fine and good for you. Black cumin and turmeric do lower LDL a little, which is a reason to appreciate them and not a reason to skip a statin.

Here's our discussion from the episode:

I covered this in depth on Wellness, Actually, listen below.

Wellness, Actually Podcast

"What's the deal with cold showers, vampire facials, EMFs, and other wellness fads? (Grab bag)" — Listen to the full episode, including the week's health news and listener Q&A.

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