deep breathing

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Better Learning, Life's Lifeline, and How We Breathe is Who We Are

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4 THOUGHTS


1. How We Breathe is Who We Are

“Breathing is about much more than simple gas exchange or even cardiorespiratory fitness. We exhale and inhale more than twenty thousand times per day, and the way in which we do so has tremendous influence on how we move our body, and even our mental state. How we breathe, as Beth puts it, is who we are.”

- Peter Attia, MD, Outlive

I have nothing useful to add here, except a few of these 👏👏👏

P.S. The Beth mentioned was one of his colleagues, Beth Lewis.

2. Science or Prayer, Medicine or Meditation

A profound aspect of breathing is that, depending on our disposition, we can treat it like science or prayer, like diet or exercise, like medicine or meditation.

And the best part: No approach is right or wrong.

3. Alternate Nostril Breathing Improves Learning & Retention

“Our findings indicated that a single 30-minute session of deep alternate-nostril breathing significantly facilitated the retention of a newly acquired motor skill. Better retention was evident immediately, as well as 24 hours after breathing practice, suggesting that such simple practices can be exploited as an effective tool to enhance both short term and somewhat longer term retention of skilled movements.”

– Deep Breathing Practice Facilitates Retention of Newly Learned Motor Skills

I’ve shared this one before. However, I revisited it recently and thought I’d share it again.

The take-home is that we can use slow alternate nostril breathing immediately after learning a motor skill to improve that skill’s short and long-term retention.

Check out these 9 slides that describe the study with images.

4. It’s Made Simple by Simplified Controls

This is a genuinely mind-blowing analogy for all breathing practices:

“For example, consider a car. We hardly give it a second thought when we climb into a car and drive off to an appointment. … All we have to do is press on the gas pedal and hold the steering wheel, and away we go. Simple, yes? No, not simple at all, but it has been made simple by virtue of the simplified controls that enable us to effortlessly transform a volatile substance, gasoline, into a speedy and safe ride to our appointment.

Pranayama is like that. In fact, all effective spiritual practice is like that. We can take complex principles of transformation found in the human nervous system and, with a series of simple procedures, apply these for great spiritual benefit.”

- Yogani, Spinal Breathing Pranayama

1 Quote

“By developing the simple profound practice of mindful breathing, you have a lifeline that ties you to every dimension of your life.””
— Al Lee and Don Campbell

1 Answer

Category: Breathing 101

Answer: The amount of air left after a maximum exhalation, known as this, helps to ensure the alveoli do not collapse.

…

(Cue the Jeopardy! music.)

…

Question: What is residual volume?

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In good breath,

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


P.S. This is everything I hoped for

* 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.

 
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4 Thoughts, Reaching Blissful States, and Breathing and Brain Health

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4 THOUGHTS


1. In my Brain: 4 Random One-Sentence Breathing Thoughts

  1. Slow breathing is air appreciation.

  2. Fast breathing is air intoxication.

  3. Breath holding is air imagination.

  4. And all breathing is air medicine.

P.S. Here are 10 more random thoughts people seemed to enjoy.

2. Reaching Blissful States

Discussing advanced yogis that reach elated states during meditation:

“Their remarkable meditation skills bespeak what’s technically known as a “state by trait interaction,” suggesting the brain changes that underlie the trait also give rise to special abilities that activate during meditative states.”

– Daniel Goleman, Ph.D. & Richard Davidson, Ph.D., Altered Traits

These findings mean: the longer you practice, the more your brain changes, and the more likely you are to be physiologically capable of having profound meditations. They’re a “state by trait” effect, and they’re available to all of us—we just have to keep practicing 🙏

3. Slow Yogic Breathing and Brain Health

“To our knowledge, our study is the first report demonstrating the impact of a mind–body approach such as yogic breathing to modulate CSF dynamics”

– Immediate impact of yogic breathing on pulsatile cerebrospinal fluid dynamics

This study found that slow, deep, yogic breathing increased cerebrospinal fluid (CSF) flow toward the brain by 16-28%.

CSF plays crucial roles in cushioning the brain & spine, delivering nutrients & hormones to the brain, and removing waste from the brain.

Thus, CSF dynamics may be one way slow breathing techniques improve brain health 👏

4. The Power of Belly Breathing

The power of belly breathing is not in making your belly move with each breath. It’s in relaxing the belly, so it naturally rises & falls with the movement of the diaphragm.

1 Quote

“That’s life: starting over, one breath at a time.””
— Sharon Salzberg

1 Answer

Category: Respiratory Pressure Changes

Answer: During inhalation, the diaphragm contracts down and increases this pressure, which may play a role in modulating CSF flow up the spine.

…

(Cue the Jeopardy! music.)

…

Question: What is intra-abdominal pressure?

This week’s newsletter is brought to you by BreathLearning.com

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In good breath,

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


P.S. I need to adopt this practice

* 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.

 
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5 Great Apps, Less Work, and a Simple Way to Laugh More

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A New Breath-Based Stress-Reduction Protocol

A reminder that I’m leading a 4-week course starting May 7th called Breathing for Better Mental and Emotional Health.

Learn more about the course and enroll here.

The course is centered around a super simple yet extremely powerful protocol combining breathing, mindfulness, and remembered wellness.

4 THOUGHTS


1. Leading Mindfulness Researcher: Less Work, More Breathing

“[I]f you come away from this book with anything, I want it to be a clear sense of how important this is. We’re busy. We’re time-pressured. We are always under the gun. But twelve more minutes of work is simply not going to catch you up as much as sitting quietly, and on purpose, with your breath.”

– Amishi P. Jha, Ph.D., Peak Mind

 

I’ll repeat: “But twelve more minutes of work is simply not going to catch you up as much as sitting quietly, and on purpose, with your breath.” 👏👏👏

2. A Simple Way to Laugh More

“Laughing is the most therapeutic breathing exercise.”

I’ve been telling my wife I should make a self-deprecating breathing humor account on Instagram for like a year.

Well, I finally did it. Introducing: The Garlic Breath.

My wife thought of the name and made me a silly icon in like 30 seconds on Canva.

Go follow and share so we can make laughing a part of everyone’s day : )

3. Five Great Breathing Apps

Breathe: This is my current favorite because it lets you set breaths down to the 1/10th of a second. I’m weird and enjoy that kind of control. I use it to do 6-sec inhale and 8.6-sec exhale, which gets me to 4.11 breaths a minute. I’m kind of obsessed : ) (Apple) (Android)

Insight Timer: I use this one for background noise (I use the “Nature’s Melody” track based on what I learned about the power of water sounds in Blue Mind). I also use this app to insert bells periodically throughout my session so I know when to switch exercises without opening my eyes. (Apple) (Android)

The Breathing App: This one has my favorite sound on the planet. It’s so good. And it’s the easiest app to get started with. No emails, no nothing. Just download and start breathing. (Apple) (Android)

The Oxygen Advantage: Tons and tons of exercises and wisdom, all as a gift to the breathing community from Patrick 🙏 (Apple) (Android)

The Breath Source: This is a new one I haven’t used too often because I don’t like guided sessions that much. But if you do, it looks like one of the best ones out there. (Apple) (Android)

4. The Metaphorical Benefits of Belly Breathing for Emotional Stability

“Similarly, when we focus on our breathing down in the belly, we are tuning in to a region of the body that is far from the head and thus far below the agitations of our thinking mind. It is intrinsically calmer. So tuning in to the breath at the belly is a valuable way of reestablishing inner calmness and balance in the face of emotional upset or when you have a lot on your mind.”

- Jon Kabat-Zinn, Ph.D., Full Catastrophe Living

Although this analogy certainly isn’t true for everyone, I think it’s a neat way of framing the psychological benefits of belly breathing. We focus on the abdomen area because it’s “far from the head and thus far below the agitations of our thinking mind.”

1 Quote

“The next step is crucial: you give relaxed, careful attention to respiration and to the obvious, often neglected fact that each one of us is breathing. In other words, you are alive! Did you know that?””
— Larry Rosenberg

1 Answer

Category: Breathing Reflex

Answer: This breathing reflex typically has a deep inhale, a wide open jaw, and a shorter, more rapid exhale.

…

(Cue the Jeopardy! music.)

…

Question: What is a yawn?

In good breath,

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


P.S. Fellow introverts, try this

* 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.

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Four Qualities to Develop, and Why Breathing Might Be a Panacea

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4 Thoughts



1. Why Breathing Seems Like a Panacea

“Your body has numerous major systems, including the endocrine (hormone), cardiovascular, immune, gastrointestinal, and nervous systems. If you want to use the mind-body connection to lower your stress, cool the fires, and improve your long-term health, what’s the optimal point of entry into all these systems? It's the autonomic nervous system (ANS).” (my emphasis)

- Rick Hanson, PhD, Buddha’s Brain

And what’s the optimal point of entry into the ANS? The breath.

As Deb Dana says, “Breath is a direct, easily accessible, and rapid way to shape the state of the nervous system.”

When we change the breath, we change all the major systems of the body.

2. The Four Qualities of Breath We Want to Develop to Feel Better

“One of the essential techniques that I distill from this body of knowledge about pranayama is that the qualities of breath that you want to develop are to make it deeper, slower, quieter, and more regular.”

- Andrew Weil, MD, Breathing: The Master Key to Self Healing

This has become my new mantra.

Waiting in line at the grocery store: deeper, slower, quieter, & more regular.

At the park with my daughter: deeper, slower, quieter, & more regular.

Anywhere we find ourselves: deeper, slower, quieter, & more regular.

Why are these four qualities so powerful?

“When your breathing is deeper, slower, quieter, and more regular, you are feeling better, in both mind and body. Your nervous system is functioning more smoothly, and all your organs are operating more harmoniously as a result.”

Sounds good to me 🙏

3. It Only Makes Sense that the Breath is So Profound

“The act of breathing begins our life as we come out of the womb; in our last moment, when we cease breathing, our life is over. It only makes sense that the breath should also have a profound influence on all the moments in between.”

- Larry Rosenberg, Breath by Breath

Whenever all this breathing stuff just seems too good to be true, remember: It’s not (talking to myself here 😅). In fact, “it only makes sense” that breathing should have a “profound influence” on all aspects of our lives. 👏

4. Knowing Doesn’t Change Your Life; Doing Does

“But knowing something doesn't change your life. Doing something does. … [T]here's a huge difference between acquiring information and understanding it. And there's an even wider gap between understanding it and implementing it, or actually doing it.”

- Dr. Jason Selk & Tom Bartow, Organize Tomorrow Today

This is a perfect reminder that, although learning is incredible, practice is what changes our lives.

As Jon Kabat-Zinn says, “Try it for a few years and see what happens.”

Count me in. I hope you’ll join me 🙏

1 QUOTE

“By breathing less frequently, we begin to achieve elemental harmony.”
— Anyen Rinpoche & Allison Choying Zangmo
 

1 ANSWER

Category: Breathing Mechanics

Answer: The contraction of the diaphragm is controlled by this nerve.

…

(Cue the Jeopardy! music.)

…

Question: What is the phrenic nerve?

Extra: Ways to Decide if Breathwork Is Right for You

I wrote another guest blog post for ResBiotic titled Ways to Decide if Breathwork is Right for You.

It’s a 5-min read to help you pick which type of breathwork is right for you.

Enjoy!

In good breath,

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

P.S. welcome to the team

P.P.S. Slower, deeper, quieter, and more regular

Breathing for Diabetes Online Course ($99):

If you love learning about breathing, want to live a healthier life, or just want to support my work, I think you’ll really enjoy this class (diabetes or not).

 
 

* 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.

Sign Up For The Breathing 411

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Sit Up Straight, a Language of Energy, and Two Hours instead of One?

 
 

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4 Thoughts


1. Mindful Low-and-Slow Breathing is “Almost Always Helpful”

“Mindful low-and-slow breathing (Chapter 2) activates the parasympathetic (relaxation) nervous system and is therefore almost always helpful in reducing physiological arousal, including bringing down skin conductance. Reducing skin conductance with low-and-slow breathing is particularly helpful for a quick recovery break, between meetings, or as a break from challenging activities of the day.”

- Inna Khazan, PhD, Biofeedback and Mindfulness in Everyday Life

Mindful low-and-slow breathing is “almost always helpful in reducing physiological arousal.” <— sounds good to me.

Use it anytime, anywhere for a quick reset and recovery.

2. Sit Up Straight: Take a Full, Deep Breath

“Our thoracic curve affects lung function. When the thoracic curve become more pronounced (think hunchback), the lungs’ ability to expand decreases. Excessive thoracic curvature weakens respiratory muscles and restricts your ability to take a full, deep breath.”

- Pete Egoscue, Pain Free

We probably don’t need another reminder to sit up straight. We know good posture is essential for just about everything (especially breathing; and vice-versa, as good breathing can lead to better posture).

But, for some reason, it really stuck out here and has inspired me to make my posture a top priority. Maybe this passage will spark something for you too 🙏

3. Do This when Life Gets Complicated: Two Hours instead of One

“The non-negotiable part is key. When life gets complicated, these four practices are typically what we remove from our schedule, but the research shows this is the last choice we should make. When life gets complicated, lean into these practices, as they’re how you get the creativity needed to untangle the complicated.”

- Steven Kotler, The Art of Impossible

Kotler is discussing four key practices for “sustained peak performance” (which he says are gratitude, mindfulness, exercise, and sleep).

But the idea applies to anything we do for better health (like breathing).

When life gets absurdly busy, lean into these practices. As Gandhi said, “I have so much to accomplish today that I must meditate for two hours instead of one.”

4. Sleep Better with Breathing

Car accidents and heart attacks will spike today due to the time change (which is why I haven’t participated in two years—be the change you want to see style.)

However, most of us can’t just ignore it due to life and work obligations. The next best thing is protecting ourselves. Here’s how breathing can help:

 
 
 
 

1 QUOTE

“Within the rhythms and structure of your breath is coded a language of energy that your nervous system, glands, and mind understand.”

- Gurucharan Singh Khalsa, PhD, and Yogi Bhajan, PhD

 
 
 
 

1 ANSWER

Category: Sleep

Answer: Before the invention of electric light, people used to sleep about this many hours.

…

(Cue the Jeopardy! music.)

…

Question: What is ten hours?

In good breath,

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

P.S. My favorite childhood memory

P.P.S. Thanks to Laura from the MAPS Institute for sharing that funny post.

 
 
 

* 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.

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Wim Hof vs. Wim Hof, the Three P's, and Breathing like Journalists

 
 

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4 Thoughts


1. The 3 P’s of Breathing

  1. Physiology: The impact breathing has on your body.

  2. Psychology: The impact breathing has on your mind and emotions.

  3. Philosophy: The impact breathing has on how you live your life.

***

P.S. You can’t have any one P without the others : )

2. A Revolutionary Finding: The Two-Way Street of Breathing and Emotions

“Lo and behold, the participants started to feel the emotions that corresponded to the breathing patterns. In other words, when they took deep, slow breaths, the participants felt calm. And when they took rapid, shallow breaths, they felt anxious or angry. The finding that we can change how we feel by using our breath is revolutionary.” * (my emphasis)

- Emma Seppälä, Ph.D., The Happiness Track

We know that how we feel affects our breathing. However, research tells us it’s a two-way street: We can change our breathing to change how we feel.

Quite revolutionary, indeed.

***

P.S. This falls into the the 1st and 2nd “Ps” above. And if you apply it regularly, then the 3rd one as well : )

3. Wim Hof vs. Wim Hof: Which of His Components is Most Important?

A 2020 study that’s still in preprints (so it hasn’t undergone peer review yet) shed light on the individual components of the Wim Hof Method (WHM).

Here’s what they did:

  • One group practiced the breathing only.

  • One group practiced cold exposure only.

  • One group practiced cold and breathing.

  • One group was trained by Wim Hof.

  • One group was trained by a researcher.

Then, all the groups were injected with endotoxin, like the first WHM study.

Here are a few of the key findings:

  • Breathing by itself reduced inflammation significantly, but did not reduce flu-like symptoms.

  • Cold by itself reduced flu-like symptoms, but did not reduce inflammation. (This doesn’t mean cold exposure doesn’t reduce inflammation in general. It just means it didn’t lessen the acute ramp-up of inflammation brought on by the endotoxin.)

  • The combination of cold and breathing reduced inflammation even more. (So, cold exposure wasn’t helpful on its own for inflammation, but added a boost when combined with the breathing.)

  • The results were the same whether Wim trained them or not (this was most surprising to me).

As a breathing nerd, this paper was super satisfying to read.

But remember it’s still in preprints, so it could turn out there was a major flaw or bad data or something. But, still fun to geek out on nonetheless : )

4. Breathing Like Journalists: Slow Breathing for Everyday Life

“I call this approach, in which you fit deep work wherever you can into your schedule, the journalist philosophy. This name is a nod to the fact that journalists…are trained to shift into a writing mode on a moment’s notice”

- Cal Newport, Deep Work

Let’s adopt this journalist philosophy to our slow deep breathing practice, fitting it into our schedules wherever we can. This will allow us to flip the switch on our physiological and emotional state anytime, anywhere (see thoughts 1 & 2).

Here’s to becoming breathing journalists, today : )

Bonus Thought: Join a Breathing Experiment

My good breathing friend AJ Fisher is looking for participants for a breathing and exercise experiment. Essentially, you get her 8-week Breathography Course for free in exchange for some pulse oximeter measurements (that’s it!).

If you’re interested, you can learn more and sign up here:

Learn More about the Experiment

And, you can learn more about AJ and the amazing things she does here:

AJ’s Corectology Website

 
 
 
 

1 QUOTE

“There is a force within that gives you life. Seek that.”

- Rumi

 
 
 
 

1 ANSWER

Category: Designed for Breathing

Answer: Paradoxically, the narrower passages of the nose reduce this during sleep.

…

(Cue the Jeopardy! music.)

…

Question: What is upper airway resistance?

In good breath,

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

P.S. Me for the next 3 months:

P.P.S. ☝️My wife will attest that this is actually quite accurate for me…

 
 
 

* 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.

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.

 
 

Wim Hof vs. Slow Breathing, Part 2: The Famous Endotoxin Challenge

 
 

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4 Thoughts


1. Slow Breathing = Deep Meditation?

“When researchers at Harvard, Yale, and the Massachusetts Institute of Technology scanned the brains of experienced meditators, they discovered increased thickness in regions of the brain's cortex, or grey matter, related to focus and attention…But what's intriguing about this study is that breathing rate was used to determine how deep in meditation the subjects were able to get. The slower the breathing rate, the deeper in meditation participants became. And, the more pronounced their increase in grey matter.” *

- Leah Lagos, Heart Breath Mind

That deserves a 🤯

If slower breathing rates are a byproduct (and measure) of deeper meditation, I wonder if we can reverse engineer it…

2. The Deep Breath Hypothesis

“The Deep Work Hypothesis: The ability to perform deep work is becoming increasingly rare at exactly the same time it is becoming increasingly valuable in our economy. As a consequence, the few who cultivate this skill, and then make it the core of their working life, will thrive.”

- Cal Newport, Deep Work

And similarly, this couldn’t be any truer:

The Deep Breath Hypothesis: The ability to perform deep breathing is becoming increasingly rare at precisely the same time it is becoming increasingly valuable to our physiology. Consequently, the few who cultivate this skill, and then make it the core of their waking life, will thrive.

3. Wim Hof vs. Slow Breathing, Part 2: The Famous Endotoxin Challenge

I’ve called Wim Hof’s endotoxin study the “4-minute mile” of breathing.

So, you can only imagine my excitement when I found a study basically doing the exact same thing, but with slow breathing (it was perhaps the most excited I’ve ever been reading a paper, lol).

I produced an in-depth comparison of the studies here.

But, here are some of the take-home messages:

  • The WHM reduced fever and all other flu-like symptoms.

  • Slow breathing reduced headaches and eye sensitivity to light, but did not reduce fever or other flu-like symptoms (e.g., nausea and chills).

  • Slow breathing improved autonomic functioning as measured by HRV, suggesting participants had greater resiliency. HRV was not measured during the WHM experiment.

  • The WHM significantly reduced inflammatory cytokines. Slow breathing did not.

  • The WHM significantly increased anti-inflammatory cytokines (by up to 194%). Slow breathing did not.

There are many (many) caveats and differences between the studies, so if you’re interested, see the full write-up for more details and additional thoughts.

But based on these results, the WHM was decidedly more effective than slow breathing at reducing acute inflammation and fighting off flu-like symptoms.

4. How to Change Our Species (hint: breathe)

“And I would argue that we humans are most human when we’re improving ourselves. We, unlike any other animal, can consciously change ourselves, to improve ourselves in ways we choose. This distinguishes us from every other species alive today and, as far as we know, from every other species that has ever lived.” *

- Anders Ericsson and Robert Pool, Peak

We are the only species that can consciously change ourselves to improve in ways we choose. We’re also the only ones that can consciously change our breathing in ways we choose.

Maybe that’s a coincidence. But then again, maybe it’s not…

 
 
 
 

1 QUOTE

“Happiness lies in your own heart. You only need to practice mindful breathing for a few seconds, and you'll be happy right away.” *

- Thich Nhat Hanh

 
 
 
 

1 ANSWER

Category: Breathing Rates

Answer: These aquatic mammals breathe around 1.5 - 2.5 breaths per minute at rest.

…

(Cue the Jeopardy! music.)

…

Question: What are bottlenose dolphins?

In good breath,

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

P.S. haha anyways what’s up

 
 
 

* 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.

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.

 
 

Inner Resources, Better Blood Flow, and How to Focus on a Fuller Life

 
 

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4 Thoughts


1. Here is the Fastest Way to Achieve Well-Being

“So what is the fastest way to achieve well-being? It is so close to you that it can easily be overlooked. Your breath.  A rapid and reliable pathway into your nervous system, dedicated to helping you regain your optimal state.”

- Emma Seppälä, Ph.D., The Happiness Track

This is beautifully and perfectly said. Nothing to add here 🙏

2. On Sailboats, HRV, and Developing Your Inner Resources

“Developing inner resources is like deepening the keel of a sailboat so that you're more able to deal with the worldly winds—gain and loss, pleasure and pain, praise and blame, fame and slander—without getting tipped over into the reactive mode. Or at least you can recover more quickly.”

- Rick Hanson, Ph.D., Neurodharma

Although Dr. Hanson is talking about inner resources in general, this is an excellent analogy for why improving HRV via slow deep breathing is so helpful: it’s like deepening the keel of your physiological sailboat.

You will still be hit by life’s storms, but with higher HRV, you’ll remain steadier and recover quicker. We could say, then, that deep breathing = deep keel.

3. Slow Breathing for Better Blood Flow

“When [the small] blood vessels are relaxed, more blood can flow freely through them. When they become constricted, the same amount of blood flows through a narrower space, increasing your blood pressure.”

- Inna Khazan, Ph.D., Biofeedback and Mindfulness in Everyday Life

Slow breathing activates the calming parasympathetic nervous system, which relaxes the small blood vessels, lowers blood pressure, and improves blood flow.

This is a vital benefit of slow breathing because better blood flow is necessary for, well, just about everything (especially if you have diabetes).

So if you feel so inspired, give it a shot. Sit and breathe at 5-6 breaths/min for 2 min. Feel for yourself the rapid boost in blood flow to your hands and/or feet.

***

P.S. I’ve had cold hands & feet for as long as I can remember (thanks, diabetes). Although it’s improved considerably, one of my favorite things about slow breathing is the warmth I feel in them during and after my practice.

4. Control, and How to Focus on a Fuller Life

“Even if you don't have control over the outcome of the stressful situation, you may be able to exert some control over its impact…You can't always control what you feel or think, but you can control what you do. Focus on living a full life even though you don’t have [fill in your issue]…”

- Melanie Greenberg, Ph.D., The Stress-Proof Brain

When nothing seems to work, my blood sugars still go crazy, my insulin sensitivity is off, or I don’t sleep well, I always have the breath. I have something I can control, that gives me control.

It helps me focus on living a fuller life, and I hope it does for you too 🙏

 
 
 
 

1 QUOTE

“When you own your breath, nobody can steal your peace.”

- Unknown

P.S. Like a lot of what I share, this one is a reminder to myself : ) And it’s advice I haven’t been following that well lately (facepalm).

 
 
 
 

1 ANSWER

Category: Blood Flow

Answer: Although hemoglobin is best-known for releasing oxygen, it also releases this gas, which enhances blood flow and helps the oxygen actually get where it is needed most.

…

(Cue the Jeopardy! music.)

…

Question: What is nitric oxide?

In good breath,

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

P.S. hoppity hop, hop hop hop

 
 
 

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.

 
 

Effortless Inhales, Deepak on Smiling, and Maybe Loud Breathing is OK?

 
 

Listen Instead of Reading

 
 
 

4 Thoughts


1. The Breath Should Enter Very Subtly

“‘Very subtly’ means that when the nose draws in the outside air, it should draw it very subtly so that the ear should not hear it.  Being subtle and fine is the gate to life. … The inhalation should, therefore, be done in a subtle and fine way.”

- The Primordial Breath, Volume I

This is always my #1 tip for breathing: make it quiet and subtle. Remember, “Being subtle and fine is the gate to life…”

***

Related: How Breathing Boosts Creativity, Why We Sigh, and Where Rumi’s Soul Lives (see #4 and the 1 quote)

2. Effort Leads to Effortless

“It takes a lot of effort for our fitness to appear natural and effortless. But just because it appears effortless does not mean that no effort was made.”

- Haemin Sunim, The Things You Can See Only When You Slow Down

The same is true for breathing. To breathe in a “subtle and fine way” takes deliberate practice and effort. I’m still working on it. I hope you are too : )

3. Maybe Loud Breathing is OK in Modern Yoga Classes?

I’m clearly a big fan of quiet breathing : ) Traditional yoga practices are too.

However, if you go to a modern group yoga class, you’ll hear a lot of loud breathing. Physiologically, I’ve always thought it was wrong…

But maybe there’s more to that loud breathing than just physiology?

In The Joy of Movement, Kelly McGonigal tells us that loud breathing during yoga is a critical component of social bonding and group flow:

“Studies show that yoga, like dancing, can create social bonds. … The breath becomes the beat that drives the flow of poses, and the sound of the group inhaling and exhaling in unison provides a satisfying sensory feedback.”

Of course, you’re not going to hear me breathing loudly in class now (I’m an introvert, anyways 😂). But let’s not overlook the social and emotional bonding that it might bring. Perhaps they are most critical in today’s world.

***

P.S. Maybe we even naturally began loud breathing during group yoga classes out of a deep yearning for more social connection? Just a thought…

4. Smiling and Breathing, Part II

“Stop. Take three deep breaths and smile everywhere in your body, observing what’s happening in your body. Proceed now with kindness and understanding.”

- Deepak Chopra

To complement last week’s thought on smiling, I was searching for info on the Buddha’s half-smile, when I stumbled across this quote.

At first, it might seem cliché. But, like most great teachers, Deepak simply distilled the science of smiling and breathing into a practical exercise.

Remember what we learned last week:

The act of smiling makes you happier.

Slow deep breathing makes you happier.

So set your breathing timer, put a slight smile on your face (Buddha-style), and “proceed with kindness and understanding.”

 
 
 
 

1 QUOTE

“Can it really be so simple? Just breathing deeply? Is that it? The answer, friends, is yes.”

- Wim Hof

 
 
 
 

1 ANSWER

Category: Breathing 101

Answer: This is the volume of air remaining in the lungs after a maximum forceful exhale.

…

(Cue the Jeopardy! music.)

…

Question: What is residual volume?

In good breath,

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

P.S. which I’m about to elaborate on

 
 
 

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.

 
 

How Breathing Makes Everything Possible

 
 

Listen to this post in 5 minutes:

 

Greetings,

Here are four thoughts, one quote, and one answer for this week. Enjoy!

 
 
 
 

4 Thoughts

1. Breathing Makes Everything Possible

“That oxygen, life, and lungs all came into our world in relatively close succession is no coincidence.  Only with oxygen and some means of extracting it are all things possible—thinking, moving, eating, speaking, and loving.  Life and the breath are synonymous.”

- Michael J. Stephen, MD, Breath Taking

I often feel crazy. The more I learn about breathing, the more I feel like I must be falling for a big trick. It seems as if all of life’s problems come back to the breath. It really just seems too simple to be true.

Then, I read a beautiful quote like this. One that succinctly states just how breathing, quite literally, makes everything possible. And it reminds me that it is, in fact, the opposite: It’s not crazy that all of life’s problems come back to the breath. It would be crazy if they didn’t.

2. Lesser-Known Ways Nose Breathing Helps Diabetes

You probably know how indispensable nose breathing is by now. But there are other lesser-known reasons it is particularly helpful in diabetes.

In this recent article, I examine nasal breathing through the lens of diabetic complications, nasal and systemic nitric oxide, stress, and sleep.

It’s a different perspective, and I hope you learn something new about nose breathing, whether you have diabetes or not.

If you don’t have time to read it, here are a few take-home messages:

  • People with diabetes have reduced blood flow, reduced tissue oxygenation, and less bioavailable nitric oxide.

  • Nasal breathing increases blood flow, improves tissue oxygenation, and might increase an essential form of bioactive nitric oxide.

3. Take a Deep Breath (American Physiological Society)

“That’s the wonderful thing about it. There are no side effects. It’s cheap. And everyone has had the experience of taking a single deep breath—you take one, and you feel it; it’s relaxing.”

- Jack Feldman, PhD, Distinguished Professor in Neurobiology at UCLA

This one started out slow, but wow, there was so much good information, especially in the last section on “Slow Breathing and the Brain.”

Enjoy the excellent read:

Take a Deep Breath: Featured article from the January 2021 issue of The Physiologist Magazine

4. Why Most Breathing Advice for Beginners is Wrong

"Yes, in our hyperachieving, go-getter world, I’m telling you to lower the bar. Not because I don’t want you to achieve great things, but because I know that you need to start small in order to achieve them."

- BJ Fogg, Tiny Habits

Though well-meaning, most advice for starting a breath practice is wrong.

We’re told we need to do twenty minutes in the morning, twenty minutes before bed, and maybe six additional breathing "check-ins" throughout the day. It’s overwhelming just to think about it.

Sure, if your motivation is high, this approach might work. But it also might set you up for failure, instead of setting you up for long-term growth.

To make it stick, behavior change scientists say we need to start small. For example, starting with 1 minute is more valuable than starting with 1 hour.

And ironically, starting small is the only way to go big. As BJ tells us, "Over the last twenty years, I’ve found that the only consistent, sustainable way to grow big is to start small." Conversely, starting big often leads to giving up.

So let’s lower our breathing bars, start small, and create breathing habits that set us, and those we teach, up for lasting success.

Related: Stanford Researcher BJ Fogg on the ‘Tiny Habits’ That Lead to Big Breakthroughs

 
 
 
 

1 Quote

“Oxygen is the life force, the source of life’s infinite possibilities.”

- Michael J. Stephen, MD, Breath Taking

 
 
 
 

1 Answer

Answer: Over a lifetime, the average nose hair grows this long.

…

(Cue the Jeopardy! music.)

…

Question: What is over 6 feet?

This is the same resource as last week, but this is too ridiculous not to share : )

In good breath,
Nick

P.S. The dmv be like…

 
 

I'm Rucking 100 Miles + Diaphragmatic Breathing Improves HbA1c

 
One_Step_At_a_Time.png
 
 

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.

 
Hegde_Notes_Image_Good.png

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.

Breathe profoundly to reduce stress and anxiety

Profound-It-means-DEEP-2.jpg

Hi all,

Last week we learned some devastating statistics. (Do you remember that 1 in 3 adolescents meets the criteria for anxiety?)

The study I’m sharing this week shows you how to breathe (hint: deeply) to reduce anxiety.

The effectiveness of diaphragmatic breathing relaxation training for reducing anxiety
(Click here to read on website)

First, a quick rant. “Deep” breathing is not “big” breathing. Often, when someone says “take a deep breath,” we automatically take a big breath.

But, a deep breath simply brings air into the lower lungs (“right before the bottom”) where the largest concentration of blood is due to gravity. It doesn’t have to be (and usually shouldn’t be) big. Maybe we should call in “Profound Breathing”?

OK, rant complete.

In this study, patients with mild-to-moderate anxiety were given instructions on diaphragmatic breathing. They were told to take 10 diaphragmatic breaths, twice daily, which doesn’t sound like too much to ask. They performed this over an 8 week period.

The results showed that diaphragmatic breathing significantly reduced anxiety when assessed on the Beck Anxiety Inventory (BAI) scale. Their average scores dropped from ~19 down to ~5 (lower is better).

The participants also improved physiological indicators of stress, including reducing their heart rate, breathing rate, and skin conductance.

Like I said last week, this isn’t woo-woo pseudoscience. Correct breathing changes your physiology to reduce stress and anxiety.

And the best part is that you can use deep breathing anytime you (or your clients or friends) feel stressed. And you can know that you are changing your physiology to promote relaxation.

In good breath,
Nick

P.S. Did you check out HHPF last week?