TPV Podcast Episode 355: Compression on Your Health

On this episode, Sarah and Stacy put on their myth-busting helmets and tackle all things compression wear. Wired bras, shapewear, and compression stockings – what effects do these garments have on our health? What does the science show? And how can you determine if and when shapewear is right for you? This and more on episode 355. Enjoy!

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The Paleo View (TPV), Episode 355: Compression on Your Health

- (0:41) Welcome
  - Welcome back listeners to The Paleo View to episode 355!
  - We are glad you are here!
  - This week’s topic is one that Stacy asked Sarah about long ago, and it has taken her that long to do the research
    - There are a lot of myths around this topic, so this show is more of a myth-busting discussion
    - Be warned listeners, Stacy and Sarah may agree to disagree on various points within this discussion
  - This show is sponsored by Butcher Box, one of The Paleo View’ longtime partners on the podcast
    - Stacy and Sarah are so glad to have them back and look forward to telling listeners more about their products
    - You can get $15 off your first order plus free bacon by visiting https://www.butcherbox.com/thepaleoview/
  - The topic this week is wired bras, shapewear, and compression stockings
    - This has been a blog post topic bubbling in Stacy’s head for two years
    - However, when Stacy started staying home and left her corporate job, she started wearing wired bras less often and made a statement regarding how she had lowered her risk of breast cancer – which wasn’t a true statement, as addressed by her followers
    - Stacy thought it was a scientific fact because it is mentioned so often that wired bras increase your risk of breast cancer
  - Where Stacy thinks that Sarah and her will have some nuances on their discussion is on Shapewear because Stacy has personally worn body shapewear on almost a daily basis, which she found did have positive impacts
  - Sarah found that this was a challenging topic to research
    - To ease the research process, Sarah divided the topic of compression garments into three main areas
      - Shapewear
      - Bras
      - Compression stockings
    - From here Sarah tried to look into what research has been done on each one of these individually
  - Tangent – corset wear and corset training can cause a lot of health issues, which has been known for a long time now
    - This is a different thing because it is no longer a normal fashion anymore
    - Shapewear today doesn’t compare even close to the same level of compression that corsets did/do
    - So for today’s discussion, corsets are not a part of the discussion
  - Stacy just wants to take a moment to honor Sarah’s soapbox about women’s appearances
    - Stacy is living for that and is here for it
  - There is societal normalcy that you may want to participate in when it comes to wired bras and shapewear
    - Stacy lost a lot of weight and had a lot of sagging skin; her shapewear gave her comfort during a certain time in her journey
- (14:05) Research on Compression Garments
  - There is a difference between low-pressure compression garments vs. medium compression garments
    - High pressure would be corset training
  - There is some science that separates out low pressure vs. medium pressure garments
  - There are some documented effects of shapewear, specifically with Gastroesophageal Reflux Disease
    - There have been studies comparing individuals wearing compression garments on the abdomen and those who experience rapid weight gain, as the symptoms are very similar
    - What has come out of this research is a substantial increase in acid reflux, to the point where one paper showed a higher risk of hernias in the top of the stomach
    - So with abdominal compression, there is a doubling of the amount of reflux and a slowing down of reflux clearing after meals
  - This particular study looked at people who already had GERD (Gastroesophageal Reflux Disease)
    - They were then studying the occurrence of reflux after a meal and showing that when these individuals had abdominal compression garments on they had twice the amount of reflux events, compared to not wearing anything
    - There have been no studies looking at healthy people without a GERD diagnosis, looking to see if they wear a compression garment if they will develop acid reflux as well
    - It is important to say that the science does not support the statement that wearing abdominal compression garments causes reflux
    - If you do all of these diet and lifestyle things correct, it should mean that you don’t have acid reflux
    - Would compression wear cause acid reflux?
      - There is no way to answer that question at this point
    - Stacy notes that while the science might not be there (yet) that if one is wearing compression wear and is experiencing digestive issues, there may be symptoms to take personal note of
  - Sarah noted that there are plenty of doctors who have been interviewed who have noted that they have seen increased IBS symptoms and urinary incontinence when patients wear compression garments
    - So while the science is not there, Sarah would definitely suggest experimenting with this if you wear tight compression garments and you experience these symptoms – try a week without them, and see what happens
  - There is another study that looked at the higher end of medium compression garments worn to control swelling and scar formation after having a tummy tuck
    - They weren’t looking at women who have had an abdominoplasty, they were looking at this type of compression garment because of one of the risks associated with this surgery – deep vein thrombosis (DVT)
    - They were looking to see if the DVT was related not to the surgery itself but to the compression garment worn after surgery
    - They did see a more sluggish blood flow in the femoral vein when women were wearing that compression garment
      - It was made worse by certain body positions that slowed down blood flow
    - There are other benefits and studies showing that if you discontinue wearing the compression garment before the scar is completely matured, that the scar can get much worse
    - So there are other reasons for this compression garment
    - Sarah thought this was an interesting additional thing to look at
    - This is a much higher form of compression than what is normal for shapewear, but it does imply that there is an additional thing to think about for people with blood clotting disorders
  - There was another study that Sarah looked at that researched similar garments being worn for postpartum hemorrhage treatment
    - This measured blood flow in the legs and showed no change, but they were focused on arteries and not veins
  - There are 600 studies looking at different types of compression wear on exercise performance and muscle recovery
  - It is worth noting that there are other therapeutic uses of compression garments
    - After plastic surgery
    - Varicose vein management
    - Wound healing
    - Lymphodema
    - Scar management
    - None of what Stacy and Sarah are discussing today is centered on these well established medical procedures that use compression garments
      - These are different situations
  - There are trends and styles that mimic compression garments and let’s be honest, they aren’t fun
- (32:20) Bras and Cancer
  - Both Stacy and Sarah have heard claims, but never dove into the research to see if this statement was supported, that bra wearing (especially wired bras) was associated with an increased risk of breast cancer
  - It turns out that this urban legend originated from a paper from 1991 that was a fairly small study
    - There was a nonstatistically significant trend towards increased breast cancer incidents with wired bra wearing
    - This is where understanding what statistical significance means is really helpful
    - There was high variability in this study, so it is really hard to make average statements because your data is all over the place
    - This 1991 paper, with low-quality data, became an urban legend that caused people to throw out their bras based on this fear factor
  - There was a really well-done study out of the Seattle area that looked at women with cancer and match controls
    - It was a prospective study
    - They looked at bra wearing habits and separated out all the different aspects of bra wearing to determine if there was any link between these aspects and breast cancer incidents
    - They found absolutely zero links
    - This was a 2016 study that conclusively showed that bra wearing does not increase cancer risk
  - Sarah did find a case study of a woman who developed Mondor’s disease from wearing too tight of a bra
    - This is something that was seen with a very high level of compression
  - There are no concerns in regards to breast health when women are wearing normal well-feeling bras
  - We as consumers have to learn to look a little deeper
- (41:28) The Conclusive Science
  - Shapewear has this whole body image part of the conversation
    - Why are we feeling pressure to wear this stuff in the first place?
  - But as Sarah was getting into the research on compression garments, what stood out and is very well studied is the benefits of compression stalkings in particular on athletic performance
  - There has been a lot of studies showing a significant, although modest effect, in strength training athletes wearing compression stockings during and after working out can decrease delayed muscle soreness and improve muscle recovery
    - Any small impact that you can have on improving muscle recovery in strength training equals bigger gains, which is something strength training athletes are all about
  - There is also an effect on endurance athletes
    - A lot of studies have shown that endurance athletes will also have better muscle recovery after training
    - There is also a small improvement in performance in endurance athletes
      - Most of that research has been done on lower body compression
    - There is a couple of studies who have started to look at upper body compression and the results are mixed at this point, there isn’t enough data
  - These studies essentially say that by applying some compression to the muscles you are allowing for things like lactic acid build up in the muscles to flush more efficiently and you are allowing the actual repair of muscle fibers to occur more efficiently
  - There have been a few studies that have branched out into those who are not athletes
    - One that stood out to Sarah was looking at patients who had at least two cardiovascular disease risk factors
      - When they were wearing compression garments they fatigued more quickly
      - This shows that studies done on athletes aren’t always applicable to us “normal people”
      - If you are an active person with a sport, playing with compression wear is interesting
      - However, if you don’t experience these results, it shouldn’t come as a surprise as these studies show results in elite athletes

- (47:48) Closing Thoughts
  - Stacy thanked Sarah for always digging into the science and for being our honest voice and for holding us all accountable to the scientific truth
  - Sarah has the rule for herself that she won’t write about or recommend or create resources around something just because it worked for her
    - Evidence led has become her guiding point when creating resources
    - She really tries to understand the full body of scientific literature
    - Sarah is much more interested in understanding the why’s behind contradictory information and trying to form a detailed picture
      - Instead of trying to simplify everything as right or wrong
  - Thank you, listeners, for being here and for hanging tough!
  - Sarah thinks Butcher Box is the right stuff
    - Step by step Butcher Box looks after your health from the farm to your plate by sending you a curated collection of high-quality meat to your door on a subscription basis
  - Thank you Butcher Box for sponsoring this show!
    - If you want to get $15 off and free bacon you can go to https://www.butcherbox.com/thepaleoview/
    - No coupon code required