HbA1c

Heroes, the Healing Power of Breathing, and the Key to Living Longer


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Reading Time: 1 min 46 sec

I hope the next 27ish breaths are the most nourishing of your day.



4 THOUGHTS

1. A 2023 Review: Mindfulness Slightly Improves HbA1c in Diabetes

“Previous systematic reviews and meta-analyses have shown that mindfulness interventions are effective in improving glycemic control in people with type 2 diabetes. The reduction in HbA1c levels is approximately 0.3%”

- Hamasaki (2023), Medicines

A 0.3% improvement is not super meaningful. However, they also found that mindfulness helped reduce stress, anxiety, and depression in people with diabetes. Together, that’s still pretty neat 👏

2. But Mindfulness Helps in Less Quantifiable Ways, Too

For diabetes (or any condition), mindfulness helps in less quantifiable ways, too. Perhaps the most important is that, with increased awareness, we begin to notice variability in our symptoms. This gives us back some control over our condition:

“Put plainly, paying attention to variability helps us see that symptoms come and go, which helps us home in on the situations and circumstances that might contribute to these fluctuations so that we might exert some control over them. Having that kind of increased control gives rise to solutions that otherwise would not be forthcoming, as well as more optimism and less stress, which give rise to greater health in general.”

- Ellen Langer, Ph.D., The Mindful Body

Sounds good to me 👏👏👏

3. Nasal Breathing while Walking: The Key to Living Longer?

I feel obliged to share this amazing passage I read on Thursday morning in 52 Ways to Walk (such a good book, too):

“Obsessed with notions of health, he was fascinated by his breathing. In fact, Kant developed a technique of breathing solely through his nose—250 years before scientists recognized the role of nasal breathing for good health. Kant was so determined to breathe only through his nose that he refused to walk with a companion, fearful that conversation might inadvertently make him inhale through his mouth. Kant lived to just short of his eightieth birthday, a phenomenal age in 1804.”

4. The Healing Power of Breathing

The healing power of breathing is less about actual physical healing (although it can do that) and more about giving us back agency.

Controlling our breath shows us that we can control our mental and physical state, and this provides a sense of agency in all of life.

By controlling our breath, we become our own healers (and heroes).


1 Quote

In order to heal, you may wish to become your own hero.”
— Gabor Maté, MD

1 Answer

Category: Slow Breathing & Pain

Answer: Slow breathing is thought to increase the release of these, which help explain its pain-reducing effects.

(Cue the Jeopardy! music.)

Question: What are endorphins?


In good breath,

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


P.S. thank u for coming to my ted talk

iCalm for Focused Relaxation

If you haven’t already, try iCalm. They called it “meditation in a bottle”…I gave in and bought…and now I use it almost daily, lol. Use discount code NICK20 for 20% off.


Amazon Associate Disclosure

I’ve been recommending books for almost 6 years. Yet somehow, I just discovered that I could be an Amazon affiliate [face-palm]. In any case better late than never. Now, any Amazon link you click is an affiliate link. As an Amazon Associate, I earn from qualifying purchases. So, if you’d like to support my work, buying books through these links is helpful : )

* An asterisk by a quote indicates that I listened to this book on Audible. Therefore, the quotation might not be correct, but is my best attempt at reproducing the punctuation based on the narrator’s pace, tone, and pauses.


 

Breathing & Love, Rising Above the Clouds, and 4 Years in 4 Points

 
 

Listen Instead of Reading


 
 
 

4 Thoughts


1. Demonstrations of Breathing & Love

Demonstrations of love are small, compared with the great thing that is hidden behind them.

- Khalil Gibran

Call it what you’d like, prana, qi, & so on, but the same is true: Demonstrations of breathing are small compared with the great thing that is hidden behind them.

2. Breathing for Diabetes: 4 Years in 4 Bullet Points

Based on about 4 years of research and self-practice, the 4 key ways that regular breathing practices help diabetes are by:

3. Breathing for (non) Diabetics: “Raising Our Heads Above the Clouds

But many of the same interventions that can help us get our heads above water can just as effectively be devoted to raising our heads above the clouds.

- Steven Kotler and Jamie Wheal, Stealing Fire

This is unquestionably true for breathing. Although everything I read, practice, and share is focused on keeping my “head above the water” as a diabetic, they can also “raise your head above the clouds” if you’re not diabetic.

Interesting side note: it’s typically broken people that find supplemental modalities like breathing—I guess because we need them the most : ) But if you’re not broken, all the benefits of breathing will be even more helpful.

So here’s to using our breathing to stay afloat, or rise above the clouds, today.

4. The Buddha, 20 Years after Enlightenment

Did you know that the Buddha was still meditating 20 years after his enlightenment? (I guess it never ends, folks 😄)

What kind of meditation, you might wonder? “Mindfulness of breathing.

Extra Thought: Take High Altitude Yoga Alongside Me One Last Time

My wife is moving on to a new yoga adventure 🎉. But, she’ll be teaching the High Altitude Yoga class we designed together one last time.

The class incorporates slow breathing, breath holds, and yoga into a challenging but fun 45-min flow.

It’s $8 and happening tomorrow morning (Tuesday, Dec 14) at 6:15 a.m. EST. I’ll be there, and I hope you’ll join me in taking it!

 
 

1 QUOTE

“Relaxing the breath, breathe in. Relaxing the breath, breathe out. Then joy arises naturally.”

- Bhante Gunarantana

The Four Foundations of Mindfulness in Plain English

 
 

 
 

1 ANSWER

Category: The Diaphragm

Answer: This organ rests on the top of the diaphragm.

(Cue the Jeopardy! music.)

Question: What is the heart?

P.S. This was inspired by Jill Miller’s amazing line: “Thank you from the bottom of my heart. Which is of course, my diaphragm.” (Makes me laugh every time.)


In good breath,

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

P.S. and I’ve never respected anything more

 
 
 

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.

 
 

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/

 

I'm Rucking 100 Miles + Diaphragmatic Breathing Improves HbA1c

 
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Announcement:
I’m Rucking 100 Miles for Chronic Disease

On Leap Day, February 29th, I’m going to ruck 100 miles to raise money for the Health and Human Performance Foundation (HHPF).

If you’ve been following me for a little while, you know I’m a huge fan of their mission. They are an amazing nonprofit raising awareness around the benefits of breathing for chronic disease, stress, and anxiety.

Given the impacts breathing has had on my life, I wanted support their cause. What better way than a ridiculously long walk?

I am wearing a weighted rucksack to symbolize the extra weight we carry around as those living with chronic disease. Yet, despite that weight, we can still accomplish anything. In fact, that weight makes us stronger. I wholeheartedly believe diabetes has made stronger.

We are setting up a donations page on HHPF, which I’ll be sending out separately. If you feel so inspired, donate to help support their great mission. And please support me by telling others, sharing our posts on Instagram, and spreading the word about HHPF.

Thank you in advance for your support!

Now, on to the science.

 

 

Last week, we learned that diaphragmatic breathing improved HRV and lowered HbA1c. This week’s research reveals that it also improves antioxidant status in type 2 diabetics.

Diaphragmatic Breathing Exercise as a Therapeutic Intervention for Control of Oxidative Stress in Type 2 Diabetes Mellitus

(Read the Full Summary)

This is one of the early papers I posted to The Breathing Diabetic. I often go back through important papers to reinforce the ideas and see if I notice new things I missed before.

This one did not disappoint. Just re-reading all of my notes on this one energized me (image below). I’m fascinated with breathing, but sometimes I need a paper like this to remind me how important it is to get this research out.

The Breathing Protocol

One hundred and twenty three type-2 diabetics participated in this study. Sixty were placed in the diaphragmatic breathing group, and 63 served as controls.

The participants were instructed to lie down, place one hand on their chest, one hand on their belly, and breathe deeply and slowly, only allowing the hand on their belly to move.

This protocol is almost identical to the Oxygen Advantage “Breathe Light Advanced” exercise.

They were asked to perform this procedure for 15-20 minutes, twice a day, for 3 months.

Breathing Improves Oxidative Stress and HbA1c

At the end of the 3 months, participants in the breathing group had significantly lowered their oxidative stress by increasing antioxidant levels.

Additionally, they decreased their HbA1c by 3%. Now, this isn’t 3% as in dropping from 9% down to 6% (like last week’s study). This was 3% of their original value. Not quite as significant, but still encouraging. And, remember the study from last week didn’t see major improvements in HbA1c until the 12 month follow-up.

In short, diaphragmatic breathing led to:

  • Decreased oxidative stress

  • Better blood sugars

In good breath,
Nick

P.S. Here’s the first page of my notes on this article. I was clearly excited the first time I read it too.

 
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One year of slow breathing increases HRV and reduces HbA1c

 
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It’s rare to find a long-duration breathing study. Typically, they examine effects lasting only minutes to hours. Then, it’s up to us to extrapolate the long-term benefits. This paper was different.

Effect Of Diaphragmatic Breathing On Heart Rate Variability In Ischemic Heart Disease With Diabetes

(Read Full Summary)

They asked participants to perform 10-15 minutes of slow deep breathing, twice a day, for one year. The researchers followed up with them at the 3 and 12 month marks.

(Side Note: This is basically what I have been doing for the past 2 years. I perform 15 minutes of slow breathing in the morning and ~5-10 in the evening before bed.)

The results were amazing.

  • Heart rate variability (HRV) increased significantly at the 3 and 12 month marks.

  • HbA1c dropped slightly at 3 months, and then significantly at 12 months.

The drop in HbA1c (3-month average blood sugar) was impressive, with one group experiencing a 2% decrease: They dropped from an average of 8.95% down to 6.95%. That’s like going from an average blood sugar of around 200 mg/dL down to 150 mg/dL. Even if you don’t have diabetes, you can appreciate the significance of these findings.

Participants who did not comply with the breathing protocol experienced a worsening of their HRV and HbA1c over time.

Of course, we need to take these results with a grain of salt. Over the course of the 1-year study, participants could have made other changes (diet, exercise, and so on) that would also influence the findings.

Nonetheless, this study is encouraging and corroborates the “N=1” experiment I have been performing on myself over the past few years.

The results also remind us that persistence is key. If they had stopped the study at 3 months, the improvements in HbA1c would not have been significant. It wasn’t until the 12 month follow-up that major improvements in blood sugars were observed.

Check out the full review to learn more.

In good breath,
Nick

P.S. Gonna need a bigger backpack.