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But not a reduction in how many days people felt ill. I wonder if this speaks more to self-help style "leaders take a cold shower in the morning to get their day started" jump-start to your day than to any health consequences.

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As someone who has taken cold showers. I can say that there are definitely physiological changes resulting from cold showers. The hard part is forcing yourself to step into freezing cold water while knowing that relief is just at the turn of a dial.

I'm interested, can you please elaborate on the changes you noticed?

"shrinkage" ?

It doesn't necessarily have an impact on health but it reliably creates an intense response: https://en.wikipedia.org/wiki/Diving_reflex ctrl+f "cold"

Cold showers have been a part of some exercise/health regimens for a while. https://www.outsideonline.com/2086911/iceman-cometh

I get in while it's hot, and then turn it to cold.

I agree. The attitude of foregoing comfort up front for the greater reward of a cold shower (in my opinion). Delayed gratification.

It requires me to immediately face harsh conditions until I adjust to the cold and then it is awesome.

Given that it is a clinical trial with random assignment, and assuming that compliance was not a major issue, I think we can assume this is not about pre-existing tendencies toward self-help leadership styles. However, I suppose there could be something to what you are saying, as in 'look the part, be the part.' If I were to speculate I'd suppose that exposure to the hot and cold elements expands the sensory experience, and expanded sensory experiences often stimulate the brain and its capacity to adapt.

I took cold showers in the evening. First few months, sicknesses just felt less bad. After about five months, I stopped to need sick days. I also need less warm cloth normally now, basically my body reacts less badly to cold.

I needed frequent sick days back then when I started (it was long term bad health state).

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