How Modern Science Supports Ancient Yoga, plus Comfort in Breathwalking

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Listen Instead of Reading

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The way you breathe might affect your insulin sensitivity. And the way you walk definitely affects your ability to withstand discomfort.

Let’s find out how…

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4 Thoughts

1. Longer Exhalations are Naturally Relaxing

“It's helpful to extend your exhalations because the ‘rest and digest’ parasympathetic nervous system handles exhaling while also slowing your heart rate. So, longer exhalations are naturally relaxing.”

- Rick Hanson, Ph.D., Neurodharma

Just a friendly reminder that extending the exhalation is one of the fastest ways to naturally relax. That is all : )

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Related: Longer Exhalations Are an Easy Way to Hack Your Vagus Nerve

Related: BBC: Why slowing your breathing helps you relax

2. How Breathing Might Help with Insulin Sensitivity

“These observations demonstrate that hypoxia rapidly regulated the inhibition of the insulin signaling pathway […] During reoxygenation, the ability of insulin to stimulate phosphorylation of insulin receptor and signaling proteins was restored after 45 min.”

– Hypoxia Decreases Insulin Signaling Pathways in Adipocytes

Insulin resistance is a critical factor in diabetes and overall metabolic health. In this paper, we learn that low tissue oxygen (hypoxia) can trigger insulin resistance. Encouragingly, however, reoxygenation restored it.

This is one reason why optimal breathing is so essential for metabolic health, especially for people with diabetes. By practicing slow nasal breathing, we increase our blood and tissue oxygenation. This could potentially maintain, or even restore, insulin sensitivity.

Of course, there is no research showing that slow nasal breathing does this—no one is going to fund that study : ) But, given what we know about slow breathing, tissue oxygenation, and blood flow, it seems reasonable to hypothesize that it would help. I know have certainly noticed a difference.

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Related: The Lesser-Known Benefits of Nasal Breathing, Designed for Diabetes

3. “Role of respiration in mind-body practices: concepts from contemporary science and traditional yoga texts”

“Traditional yoga texts also suggest a solution for the imbalance in prana, through slow, deep breathing. … The beneficial effects of deep breathing are supported by contemporary science.”

- Telles et al. (2014), Frontiers in Psychiatry

I’ve shared a quote from this paper before, but if you haven’t read the full thing, it’s well worth it. It describes how modern science supports ancient yogic breathing, for example, how “Conventional physiology has found benefits of deep breathing supporting the importance given to regulating the breath in yoga.”

Another interesting idea they mention is that breathing “acts as both a top-down and bottom-up mind-body practice.” It makes perfect sense, but I hadn’t thought about it that way.

Ancient Yogic Wisdom + Modern Science = A Fantastic Read

Enjoy!

4. Finding Comfort in Breathwalking

“To take my mind off the discomfort, I settle into a respiratory rhythm. I take one step as I breathe in, then two steps as I breathe out. One step breathing in, two steps breathing out. Over and over, focusing only on the breath.”

- Michael Easter, The Comfort Crisis

Easter spent more than a month in a remote region of Alaska. And this book that came out of it is incredible—a perfect blend of science and storytelling.

Of course, this part stood out to me : )

Easter is making a ridiculous walk back to camp with a ton of weight. He naturally settles into his breath, and this gives him comfort and endurance.

As he puts it, “There's science behind this. Brazilian researchers found that people who are able to detach from their emotions during exercise, for example, not thinking about or putting a negative valence on their burning legs and lungs, almost always perform better.”

So aside from the mechanics and oxygenation, here’s another way in which breathwalking can be beneficial. It helps you detach from your emotions. As Easter tells us, you’ll “almost always perform better.” Sounds good to me.

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Related: Breathwalking with Gandhi

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1 Quote

“He let me see that, because the breath is so unassuming, I had been undervaluing it. I was looking for a complicated path to enlightenment, when this simple one was right before me.”

- Larry Rosenberg, Breath by Breath

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1 Answer

Category: Hypoxia

Answer: A blood oxygen saturation below approximately this value is considered hypoxic.

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(Cue the Jeopardy! music.)

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Question: What is 90%?

P.S. Different places give slightly different numbers…sometimes it’s 94%, sometimes 92%.

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In good breath,

Nick Heath, T1D, PhD
“Breathing is the compound interest of health & wellness.”

P.S. What if?

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Sign Up For The Breathing 411

Each Monday, I curate and synthesize information from scientific journals, books, articles, and podcasts to share 4 thoughts, 1 quote, and 1 answer (like "Jeopardy!") related to breathing. It’s a fun way to learn something new each week.

The Breathing 4.1.1.

I am trying a new format this week. I’m calling it “The Breathing 4.1.1.”

Below, I share 4 thoughts, 1 quote, and 1 answer (think “Jeopardy”). Enjoy!

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4 THOUGHTS

1. Expert Q&A on Sleep Tape

James Nestor’s first "expert Q&A" episode has been released. It’s on sleep tape with Dr. Mark Burhenne. I especially appreciated Dr. Burhenne’s confidence in recommending that people wear mouth tape. Watch Interview Here.

2. An Easy Hack for Dropping SpO2 during Breath Holds

I’m always playing around with my breath holds. Lately, I’ve been performing a full exhale before each hold.

Normal Breath In —> Fast and Complete Exhale Out —> Hold

I’ve seen additional SpO2 drops of 5-10% (!). My breath holds are not as long, but I’m getting into intermittent hypoxia easier. I really try to empty my lungs as much as possible to get more significant drops in SpO2.

3. Is Tissue Hypoxia Really the Problem?

“In this, chronic overbreathing will not create ‘hypoxia’ in tissues; this is a fact that many Buteyko adherents consistently get wrong.  The real damage from overbreathing comes from the constant energy the body has to expend to run more cells anaerobically and to constantly buffer for carbon dioxide deficiencies.” - James Nestor, Breath

I talk about tissue hypoxia a lot. Here, James says that it’s not necessarily tissue hypoxia that’s the problem, but the body’s response to prevent it from happening that causes the damage. In any case, the underlying issue is the same: We need to get an adequate supply of oxygen for our cells to function correctly.

4. A Simple Way the Breathe Light

Teaching people to breathe "light" is often tricky. However, in Restoring Prana, Robin Rothenberg provides one of the most practical ways I’ve heard: Imagine taking up less space with each breath. I imagine less air being pulled into my nose with each inhale, and each exhale disturbing less air around me. Give it a shot.

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1 QUOTE

“He who tastes a grain of mustard seed knows more of its flavor than he who sees an elephant load of it.” - Yogi Mamacharaka, Science of Breath

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1 ANSWER

Answer: The amount of water used to humidify the air we breathe each day.

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(Cue the Jeopardy music.)

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Question: What is 1 pint? [1]

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In good breath,
Nick

P.S. Coming to you live from…

[1] Essentials of Pathophysiology (3rd Edition), Carol Mattson Porth

Can Overbreathing Cause Osteoporosis?

“Life-transforming ideas have always come to me through books.” - Bell Hooks

This week, I want to look at a few fascinating passages on overbreathing from “Breath: The New Science of A Lost Art.”

Let’s start with James Nestor’s insight into tissue hypoxia (my bold for emphasis):

“In this, chronic overbreathing will not create ‘hypoxia’ in tissues; this is a fact that many Buteyko adherents consistently get wrong.  The real damage from overbreathing comes from the constant energy the body has to expend to run more cells anaerobically and to constantly buffer for carbon dioxide deficiencies.”

So James is saying that tissue hypoxia itself is not the problem with overbreathing. The damage occurs because of the body’s response to prevent tissue hypoxia from happening.

Overbreathing and Cell Metabolism

Aerobic = “With Oxygen”

Anaerobic = “Without Oxygen”

This damage occurs partially because of sustained anaerobic metabolism. We have all probably heard of aerobic and anaerobic exercise. Slow and steady is typically aerobic, fast and intense is usually anaerobic. We don’t have to think about it. When we push ourselves, our oxygen supply can’t keep up, and our body naturally switches to anaerobic metabolism.

This anaerobic switch creates a more acidic local environment, which will help release oxygen from the hemoglobin and help restore aerobic energy production.

But, with chronic overbreathing, this aerobic balance cannot be achieved.  So your cells are running as if you’re always doing high-intensity training…not the most efficient way to spend your day.

But that’s not even the worst part of overbreathing.

Restoring pH Balance Causes the Real Damage

The body is always trying to find balance, and this is especially true for pH. Blood pH is kept in a tight range (around 7.4) to allow the body to function correctly.

When we chronically overbreathe, we offload too much carbon dioxide, which increases pH. The body compensates through a process called “buffering,” where the kidneys begin releasing bicarbonate into the urine to restore pH balance. The real damage comes from what bicarbonate takes with it:

“This occurs because as bicarbonate leaves the body, it takes magnesium, phosphorus, potassium, and more with it. Without healthy stores of these minerals, nothing works right: nerves malfunction, smooth muscles spasm, and cells can’t efficiently create energy.” - James Nestor

Overbreathing Weakens Our Bones

All of which leads us to how overbreathing can contribute osteoporosis:

“Constant buffering also weakens the bones, which try to compensate by dissolving their mineral stores back into the bloodstream. (Yes, it’s possible to overbreathe yourself into osteoporosis and increased risk of bone fractures.)” - James Nestor

Alright, let’s break these steps down to see how this happens:

1. Overbreathing offloads too much carbon dioxide, preventing adequate oxygen delivery to the cells.

2. The cells compensate with chronic anaerobic metabolism.

3. The kidneys compensate by excreting bicarbonate into the urine to balance pH.

4. The excretion of bicarbonate “steals” important minerals from the blood.

5. The bones then compensate by dissolving minerals back into the blood, which weakens them.

It is simultaneously amazing and scary what our bodies are capable of.  

There is Always Good News

Although this negative feedback loop is alarming, there is a way to prevent or reverse it: Stop overbreathing.

And the best way to do that? Breathe through your nose, breathe slowly, and breathe slightly less than you think you need.

In good breath,
Nick

P.S. Just Along for the Ride.

Breathing Restores Autonomic Control in Type-2 Diabetics with Complications

“Quit worrying about your health. It’ll go away.” - Robert Orben

As people with diabetes (type 1 or 2), we know our bodies are under extra stress. This is due to things like fluctuating blood sugars and chronic inflammation. These factors can gradually accumulate into nerve damage and a variety of other long-term complications.  

However, we have recently learned that some “long-term complications” are functional and reversible (at least in their early stages). One way to reverse them is slow breathing.

Slow breathing treats the root cause of many complications, tissue hypoxia, which then restores autonomic functioning. This has been proven in several studies involving people with type-1 diabetes. However, most participants had not yet developed severe complications.

Putting Slow Breathing to the Test

It seems reasonable to assume that slow breathing would have the same effects in type 2s. But, what if these people with type-2 diabetes have chronic kidney disease? With a severe complication such as this, could slow breathing still have the same benefits?

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Trained breathing-induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease

Published in Acta Diabetologica, 2016

Click Here to Read the Full Summary

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The Study Group and Breathing Protocol

This study had 26 type-2 diabetic patients, 12 of which had diabetic kidney disease, and 24 non-diabetic controls. The protocol was simple: They had the participants lay down and breathe normally for five minutes, followed by two minutes of slow breathing at 6 breaths per minute.

The primary outcome was a change in baroreflex sensitivity (BRS). BRS measures your body’s ability to quickly adjust blood pressure to meet the current demands of your situation. It is thought to be an overall measurement of autonomic and cardiovascular control. In general, diabetics have lower BRS scores than non-diabetics.

Slow Breathing Improves Autonomic Function in Diabetics With Kidney Disease

At baseline, the type-2 diabetics had a lower resting oxygen saturation and lower BRS. When they switched to breathing at 6 breaths per minute, their oxygen saturation and BRS both increased significantly. Their blood pressure also reduced.

Perhaps most importantly, these same changes were observed in the diabetics with kidney disease. Both sets of diabetics (kidney disease and no complications) showed similar increases in BRS and oxygen saturation.  This indicates that, even in diabetics with severe complications, slow breathing can acutely reverse autonomic dysfunction.

Getting Back to Tissue Hypoxia

The authors suggest that these improvements in autonomic function were due to increases in tissue oxygenation. Similar to the study we featured on type-1 diabetes, they indicate that by increasing tissue oxygen levels, sympathetic activity is reduced, and autonomic balance is restored.

A New Model of Diabetic Complications

These results again indicate that autonomic dysfunction is not an expression of nerve damage. Instead, it is a reversible phenomenon that might actually be the precursor to nerve damage.  This paradigm-shifting view opens the door to new opportunities for treating autonomic dysfunction in diabetics.

In good breath,

Nick

P.S. A Zoom Meeting I would Look Forward To.

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P.P.S. James Nestor’s new book, Breath: The New Science of a Lost Art, comes out tomorrow. I don’t know James, but from the podcast interviews I’ve heard so far, this sounds like a must-read if you’re into all this “breathing” stuff :)

And if you really want to geek out, James and Patrick McKeown got together for an hour long conversation on all things breathing. Watch/Listen Here.

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Lack of Oxygen Might be the Root Cause of Diabetic Complications

Since we cannot know all that there is to be known about anything, we ought to know a little about everything.” - Blaise Pascal

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People with diabetes are at an increased risk of cardiovascular and autonomic problems. Diabetics also display altered respiratory control, for example, showing depressed (or enhanced) chemoreflexes.

However, previous studies have never examined these two aspects in an integrated fashion.

Integration Over Isolation

The problem with separately studying these systems is that the results might not be independent. For example, if a study shows that diabetics have decreased respiratory control, it might conclude that this is from diabetic nerve damage.

Likewise, if a study shows that cardiovascular function is depressed, it might also conclude that this is due to diabetic nerve damage.

However, if we study them together, we might find that there is a reciprocal relationship. Maybe the respiratory problems are causing cardiovascular issues? Perhaps it’s the other way around?

This study takes that approach and has some pretty remarkable conclusions.

Integrated cardiovascular/respiratory control in type 1 diabetes evidences functional imbalance: Possible role of hypoxia

(Click Here to Read Full Summary — I don’t say this often, but please read this one if you have diabetes)

Published in the International Journal of Cardiology, 2017.

In forty-six type-1 diabetics and 103 age-matched controls, they measured baroreflex sensitivity (BRS) as a marker of cardiovascular function and chemoreflexes as a marker of respiratory control.

Chemoreflexes estimate how sensitive you are to increasing CO2 (hypercapnic chemoreflex) and decreasing O2 (hypoxic chemoreflex).

The Hypothesis: If BRS and chemoreflexes are reduced, this would suggest diabetic nerve damage. However, if some are reduced while others are elevated, this reciprocal relationship might be showing autonomic dysfunction instead of diabetic nerve damage.

This is such an important distinction. “Damage” implies that the damage is done. “Dysfunction” implies that we could make it functional again.

Diabetics Have Worsened Cardiovascular and Respiratory Control

The results showed that subjects with diabetes had a lower BRS than the controls. They also had a suppressed hypoxic chemoreflex. However, they had an elevated hypercapnic chemoreflex. (Remember their hypothesis: if it was nerve damage, both of these chemoreflexes would be reduced.)

Interestingly, the diabetics also showed a lower oxygen saturation. And, they also had relatively high HbA1c’s (an average of 8.19%). A high HbA1c will decrease oxygen delivery to the tissues and cells.

Tissue Hypoxia is at the Root of Diabetic Complications

The reduced oxygen saturation and high HbA1c suggest a resting state of tissue hypoxia in diabetes. Over time, we become “numb” to this, which explains the decreased hypoxic chemoreflex.

The body compensates with an up-regulated hypercapnic chemoreflex, which leads to chronic activation of the sympathetic nervous system (fight or flight).  Chronic sympathetic activation then suppresses our cardiovascular control.

It’s a vicious cycle with negative long-term implications:

Dysfunction, not Damage: A Silver Lining

“We show in the present study that what is normally called ‘autonomic neuropathy’ could be in many cases a functional condition of sympathetic activation, driven by many factors, one of which seems to be resting hypoxia.”


This is all actually good news.  Their results suggest that diabetic autonomic imbalance is mainly functional and not related to nerve damage.  In fact, the authors suggest that this imbalance likely leads to nerve damage, rather than being the result of it. Therefore, therapies targeting cardio-respiratory control could help reverse/prevent diabetic complications if caught early enough.

Break Out Your Slow Breathing Hammer

What are these therapies? One is slow breathing. Slow breathing will immediately improve cardiovascular and respiratory reflexes. It will also enhance oxygenation (when breathing through the nose).

I hate sounding like all I have is a “slow breathing hammer,” but it is just too important not to stress over and over again.

Here’s to taking the first step toward protecting our long-term health as diabetics.

In good breath,
Nick

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P.S. A great podcast was recently released with James Nestor, author of the soon-to-be-released book: “Breath - The New Science of a Lost Art”. (The book looks terrific, so I pre-ordered my copy about a week ago.)

You can basically learn everything you’ll ever need to know about breathing in this quick 35-minute interview. I loved it.

Listen to the podcast here.