COVID-19

The Breathing 4.1.1. - Are Type 1 Diabetics Protected from COVID-19?

 

Welcome to the "The Breathing 4.1.1."

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

 
 
 
 

4 THOUGHTS

1. Are Type-1 Diabetics Protected from Serious COVID-19 Complications?

Not exactly breathing related, but a short article recently published in Medical Hypotheses proposed the following: Type-1 diabetics might be "spared" from the more severe complications of COVID-19 because we produce higher quantities of a specific class of pro-inflammatory cytokines called Th-1.

Thus, the reason our insulin-producing beta cells are destroyed might be the same reason we’re protected from COVID-19. Awesome, I guess?

Click Here to Read the Article

Thanks to Craig Kasper (also a type-1 diabetic) at Bravest for sharing this article with me!

2. Inhale-to-Exhale Ratio: Does it Matter?

Most studies show that either (1) an equal inhale-to-exhale ratio or (2) a longer exhale are both useful for improving cardiovascular and autonomic function. Longer exhalations are associated with more relaxation, whereas equal breaths are more balancing for the nervous system.

But the most critical factor is finding which approach feels most comfortable to you. And this is backed by science.

3. Inverting the Breathing Gears for Down-Regulation

The Skill of Stress course is excellent. I’m working my way through it slowly, but one thing I loved was Emily’s way of inverting the "Breathing Gears" to down-regulate.

Here’s the idea. If you’re stressed and breathing in and out through your mouth, don’t immediately try to switch to nasal in, nasal out. Gear down slowly. For example, you could follow this progression to downshift your nervous system:

  1. Mouth in, Mouth out (Progressive)

  2. Nasal in, Mouth out (Down)

  3. Nasal in, Nasal out (Regulation)

4. Why Wim Hof Doesn’t Care about Nose or Mouth Breathing

"Just breathe mother f*****!" is a famous Wim Hof one-liner. Along with his saying that "any hole will do" when asked how to breathe during his method.

But James Nestor nailed it when Joe Rogan recently asked him why Wim doesn’t care about nose or mouth: "He wants to make this easy and accessible for people…so many people can’t breathe through their noses…"

Wim’s advice to "use any hole" is to simply make it easier and more accessible. And it’s excellent advice if you’re going to do it for 20-30 mins a day. There will only be problems if mouth breathing becomes habitual (like it did for me).

 
 
 
 

1 QUOTE

"Therefore, any conditions to affect normal respiratory route during sleep (nasal breathing) can…have negative effects on sleep and daily life."

Park, C.-S., Sleep Medicine Research, 2014

 
 
 
 

1 ANSWER

Answer: The farthest distance droplets from a sneeze can travel.

…

(Cue the Jeopardy music.)

…

Question: What is 27 feet?

In good breath,
Nick

P.S. His Poor Elbows.

 

Could nasal nitric oxide help to mitigate the severity of COVID-19?

 

“We have too many high sounding words, and too few actions
that correspond with them.” - Abigail Adams

 
 
 
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When the pandemic began, many people in the “breathing community” immediately started talking about nasal nitric oxide because of its antiviral and antimicrobial effects. Nose breathing seemed like washing your hands: Of course, no scientific studies were showing it worked for this specific virus yet, but it made it common sense to practice it anyways.

Now that we’re getting back to normal (despite the record number of cases in some parts of the world), nose breathing is more important than ever. And it looks like many in the scientific community agree.

Last month, a Commentary was published in Microbes and Infection titled “Could nasal nitric oxide help mitigate the severity of COVID-19?” [1]. (I saw this article through the Oxygen Advantage newsletter…thanks, Patrick!) It’s a short and easy read that I highly recommend. 

Click here to read the full commentary

Here’s one of my favorite quotes from it:

 
 

“Mouth breathing during sleep may therefore worsen the symptoms of COVID-19, consistent with the observation that symptoms of respiratory infections are usually worse in the morning.”

 
 
 
 

LA Times Article on Inhaled Nitric Oxide for COVID-19

About two months ago, a good friend, and reader of this newsletter, shared this article from the LA Times with me. I think it pairs nicely with the commentary above:

How a discovery that brought us Viagra could help those battling the coronavirus

Click Here to Read the Article

Here’s my favorite quote from that one:

“In 2004, researchers at the University of Leuven in Belgium discovered yet another property of nitric oxide: It killed coronaviruses.

More specifically, it killed the coronavirus that leapt from bats to humans and sparked the 2003 epidemic of severe acute respiratory syndrome, the disease better known as SARS.”

Here’s to putting science into action by simply breathing through your nose while you’re out and about.

In good breath,
Nick

P.S. How to Enunciate Correctly in 4 Steps.

[1] Martel, J., Ko, Y. F., Young, J. D., & Ojcius, D. M. (2020). Could nasal nitric oxide help to mitigate the severity of COVID-19?. Microbes and infection, 22(4), 168–171. Advance online publication. https://doi.org/10.1016/j.micinf.2020.05.002

 

Slow Breathing & High Blood Pressure: What it Means for Diabetes and COVID-19

 
 
 
 

“Trees and plants depend on the weather to flourish but I make my own weather, yea I transport it with me.” - Og Mandino

 
 
 
 
 

Recent reports have shown that high blood pressure is associated with negative outcomes from COVID-19.  

As people with diabetes, we already knew we were at higher risk when it comes to COVID-19. But, anywhere from 40%-80% of diabetics suffer from hypertension. That, on top of our compromised immune systems, is why we have to be more vigilant than ever with our health and well-being.

Thus, keeping our blood pressure under control should be a primary focus during these uncertain times.

A 2019 Meta-Analysis Shows Significant Reductions in Blood Pressure

I say this often, but meta-analyses are my favorite studies to read. They synthesize findings from all of the scientific literature on a particular topic in an easy-to-follow format.  

The one I’m sharing this week looked at slow breathing and blood pressure:

Device and non-device-guided slow breathing to reduce blood pressure: A systematic review and meta-analysis

Published in Complementary Therapies in Medicine, August 2019

(Click Here To Read The Full Summary)

On average, they found that slow breathing reduced systolic blood pressure by 5.62 mmHg. Slow breathing reduced diastolic blood pressure by 2.67 mmHg.

Additionally, the longer participants practiced, the more significant the reduction in blood pressure. For example, in the studies where subjects practiced slow breathing for more than 200 minutes per week, the average drop in systolic blood pressure was 14 mmHg.

These improvements are significant. Blood pressure reductions of these magnitudes have been shown to reduce the overall risk of cardiovascular death. Obviously, there are no studies explicitly looking at COVID-19 yet. Still, it seems safe to assume that these reductions would be beneficial, especially if you have diabetes.

Breathing as a Complementary Therapy

Slow breathing is not a cure-all. As the name of this journal implies (Complementary Therapies in Medicine), it is complementary, not a replacement. But, slow breathing is free and has no adverse side effects, so why not use it as another way of controlling your blood pressure, stress, and anxiety during these unsettled times?

In good breath,
Nick

P.S. When Quarantine is Over.

P.P.S. Happy Mother’s Day to all of the amazing moms out there!

 
 

Breathing and COVID-19 (Plus 4.5 Ways to Increase Nitric Oxide)

 
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I’ve stated previously that nitric oxide (NO) is my favorite gas. Recently, the breathing community has jumped on it for its antiviral effects. The thought is that nasal NO could serve as our first line of defense against COVID-19.

While I see how that argument makes sense, I don’t think anyone really believes nasal breathing alone will stop COVID-19. Yes, it might help, but to think it will stop it completely is rather naive. So, please, wash your hands AND breathe through your nose :)

But none of that is the point of this week’s post. We know nitric oxide has amazing benefits (it’s still my favorite!). But what if your blood sugars are stopping you from realizing its full potential?

Vasorelaxation by Red Blood Cells and Impairment in Diabetes. Reduced Nitric Oxide and Oxygen Delivery by Glycated Hemoglobin

(Click Here to Read the Full Summary)

I uploaded this paper to The Breathing Diabetic on December 11, 2018! I knew it was important, but re-reading my notes emphasized just how meaningful this research is.

Here are the important points:

  • Diabetics suffer from a lack of bioavailable nitric oxide. Because bioavailable NO is critical for whole-body oxygenation, this could play a major role in diabetic complications.

  • High blood sugar changes the configuration and binding properties of blood proteins. This changes how they store NO, explaining the lack of bioavailable NO stated above.

The net outcome is that sustained high blood sugar reduces oxygen delivery to the tissues.

I think you can immediately see the importance of this finding. Luckily, there are things we can do to increase our nitric oxide and oxygenation.

1. Control Your Blood Sugars

No surprise here, but you need to get your blood sugars in range. Breathing can help (I might be a little biased…).

There is also a positive feedback loop that speeds up the process. Better blood sugars will increase bioavailable NO and enhance blood flow, which will lead to better oxygenation, which will improve insulin sensitivity, and so on.

2. Breathe Through Your Nose 24/7

The second thing you can do is start breathing through your nose 24/7. The paranasal sinuses continuously release NO into the airways. That NO travels into your lungs, redistributes blood flow, and improves oxygen uptake. Nasal breathing is an easy and proven way to increase NO and whole-body oxygenation.

3. Start Humming

Humming can significantly increase nitric oxide. I haven’t dug into the papers yet (they’re on my list), but people I trust, like Patrick McKeown, have.

I now do 7-8 minutes of humming before bed every night. I set my breathing app to 4 breaths/min and hum on the exhale. Despite making me feel silly, humming has a mind-calming effect that I enjoy before falling asleep.

4. Supplement with Beetroot Powder

Finally, you can supplement to increase NO. I am a novice here, but I have tried BeetElite by Human after hearing Tim Ferriss recommend it. It seemed to give me a slight boost of energy while I was sitting in the sauna (which is another way [#4.5] to increase nitric oxide, but I’ll leave that science to Rhonda Patrick). As with any supplement, make sure you have no contraindications before taking it.

In good breath,
Nick

P.S. If you want to learn more about breathing, nitric oxide, and COVID-19, Patrick McKeown is holding a free 20-minute Zoom meeting to discuss the topic.

Here are the details:

Topic: Breathing Exercises to help defend against CoVid19
Time: Mar 26, 2020 05:00 PM Dublin (1:00 PM EDT)
https://zoom.us/j/542438957
Meeting ID: 542 438 957

Learn more here: https://www.instagram.com/p/B-ANbRfgE_v/