diabetes

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An Incredible Study, Meaningful Change, and Gratitude Right Now

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Listen Instead of Reading

If you enjoy listening, you can subscribe to the audio version on Spotify, Apple Podcasts, and Audible so you don’t even have to look at the email 😊

Reading Time: 1 min 43 sec

I hope the next 26’ish breaths are the most nourishing of your day.


4 THOUGHTS

1. Carve a Canyon: How to Produce Meaningful Changes with Breathing

“Rather, I think the power of breathwork to change the function of the nervous system can be compared to the way water cuts a canyon through rock. It’s the constant stimulus, the constant pressure, that produces huge changes, so that what appears to be a very gentle force produces very large results.”

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

This analogy is why I appreciate gentle and easy breathing exercises.

Of course, intense sessions can provide rapid transformations.

But one strong thunderstorm rarely carves a lasting canyon.

It’s the gentle, constant force of simple techniques, applied over years & years, that often produces the most meaningful change.

2. There’s Something in the Air (this is truly an incredible study)

In The Mindful Body, Ellen Langer, Ph.D., describes an incredible study. Participants were led into an empty room. Beforehand, one of three things had happened:

  1. Meditators had meditated for 45 minutes and then left.

  2. People had watched a stressful video for 45 minutes, then left.

  3. Or the room was just empty for 45 minutes.

Participants entering after the meditators or stressful video watchers found the room more appealing and enlivening <—that’s pretty neat.

But wildly, only the group entering after the meditators improved their reaction time in a mindfulness test.

As Dr. Langer summarized, “These mysterious results suggest that somehow our mindfulness leaves a residue in the air and as such may affect the mindfulness of others.” 🤯

3. What Sets Breath & Mindfulness Apart: They Empower You

Breathing and mindfulness for people (with diabetes) are different than most approaches.

Instead of focusing solely on blood sugar control and doing everything “perfect,” these practices empower you to reduce stress, improve mental and emotional health, and cultivate resilience.

The goal isn't perfect numbers; it's peace of mind and lifelong agency.

4. Experience Gratitude Right Now

I shared this breath last year, but we can never do it too much 😊

Take a few conscious breaths and think to yourself: “This is great! I have an abundance of the most valuable resource known to our species, and I don't even have to work that hard to get it.”

1 Quote

“We die with each out-breath, only to be breathed back to life with the next in-breath.””
— Jon Kabat-Zinn, Ph.D.

1 Answer

Category: Cognitive Function

Answer: Slow breathing (and mindful breathing) both improve this, allowing us to better resist distractions.

…

(Cue the Jeopardy! music.)

…

Question: What is inhibition or impulse control?

In good breath,

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


P.S. My two rules are:

iCalm for Focused Relaxation

I know I’m a broken record, but I can’t recommend iCalm enough. I take 1/2 shot before my coffee and absolutely love it. Give it a try!

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.

 
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Mindful Sauna, Focus on You, and Singing for Better Breathing

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Listen Instead of Reading

If you enjoy listening, you can subscribe to the audio version on Spotify, Apple Podcasts, and Audible so you don’t even have to look at the email 😊

Reading Time: 2 min 15 sec

I hope the next 34ish breaths are the most nourishing of your day.


4 THOUGHTS

1. How Jon Kabat-Zinn Got Introduced to Mindfulness (it’s not what you might think)

“I would actually say that the sauna at MIT was probably my first and most powerful meditation teacher. And I used to go with some of my graduate student friends and sit in the sauna and crank the heat up as far as it would go. And you'd have to breathe more slowly in the sauna because it was so hot to just not burn your nostrils. And it was helpful if you didn't move around too much because even that took a lot of energy. And it was also helpful if you didn't think all that much.”

- Jon Kabat-Zinn, Ph.D., Meditation for Optimum Health

This is a neat story for sauna lovers and a nice metaphorical reminder that sometimes stressors help us most in cultivating peace.

2. Sing More for More Efficient Breathing

“Singing provides our lungs with a workout, resulting in enhanced respiratory muscles and more efficient breathing. Researchers call this optimized breathing, and arguably, it’s exactly what we need as we walk, particularly if we sing in rhythm with our feet.”

– Annabel Streets, 52 Ways to Walk

As an overly self-conscious person, I can’t bring myself to sing while walking. But this passage has inspired me to sing more (when no one is listening, of course 😂). I hope it does the same for you.

3. Focus on You: What Sets Breathing Apart from Traditional Diabetes Approaches

Traditional approaches to diabetes often forget that we’re people (with diabetes), not diabetic people. They seem to only focus on our disease, not on us.

Breathing and mindfulness are different. They are about bringing awareness to what’s right with you—what’s already whole.

They build resilience, compassion, and agency despite your condition, enhancing you as a person rather than only focusing on your diabetes.

Sometimes, they do end up helping your diabetes, and sometimes, they don’t. But either way, you have peace of mind and a better life.

4. What Matters is That We’re in the Water

Here’s a memorable passage from Tsoknye Rinpoche on how to deal with the ups and downs of our contemplative practice:

“Remember that meditation experiences keep rising and falling, like our moods or the stock market. Sometimes we feel clear, light, and elated, like we’re making rapid progress. Other times we feel sluggish or agitated, like we’re not getting anywhere, like anything but meditation would be better. Just keep going without getting too caught up in our shifting experiences. … In the end, our experiences are like waves in the ocean, but despite their ups and downs, what matters is that we're still in the water.”

👏👏👏

1 Quote

“I think that working with the breath can be a very powerful technique to center the mind. To help you work more effectively. To help you deal with all of the challenges that life throws in your way, every day. And to really turn your direction away from the material world toward the non-physical world.””
— Andrew Weil, MD

1 Answer

Category: The Nose

Answer: Nasal congestion is generally caused by this, which makes breathing more challenging and reduces the nose’s ability to clear mucous (which exacerbates the congestion further).

…

(Cue the Jeopardy! music.)

…

Question: What is inflammation of the nasal mucosal?

In good breath,

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


P.S. No just that one thing

iCalm for Focused Relaxation

I know I’m a broken record, but I can’t recommend iCalm enough. I take 1/2 shot before my coffee and absolutely love it. Give it a try!

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.

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

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Listen Instead of Reading

If you enjoy listening, you can subscribe to the audio version on Spotify, Apple Podcasts, and Audible so you don’t even have to look at the email 😊

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.

 
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Why 6 Breaths/Minute Improves Heart Health & Quality of Life in Diabetes

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Slow breathing is a highly effective yet overlooked therapy for diabetes.

 

It profoundly changed my life with diabetes, leading me to spend the past 5 years trying to understand it and share it with others.

 

I’ve found that it’s not going to fix everything (of course).  It may not even impact your blood sugars.  But, without question, two things it will do are improve your heart health and your quality of life.

 

And it’s available anytime, anywhere (no pre-authorization required). 

 

I think it’s a no-brainer for better health, and I hope this article inspires you to give it a try.

 

 

What is Slow Breathing? (and why was 6 breaths/minute in the title?)

 

Slow breathing is broadly defined as breathing at a rate of less than 10 breaths per minute.  More specifically, it usually refers to breathing at a rate of about 4.5 to 7 breaths per minute.

 

And even more specifically, almost every study on slow breathing and diabetes has used 6 breaths per minute.  And they’ve found some pretty remarkable things.

 

But before we get to that, let’s take a quick look at the breath-heart connection.

 

 

Understanding the Breath-Heart Connection: Respiratory Sinus Arrhythmia and Heart Rate Variability

 

When we inhale, our heart rate increases.  When we exhale, it decreases (if you’d like more details, here’s a blog I wrote for ResBiotic that explains it fully).  This is known as respiratory sinus arrhythmia (RSA).

 

RSA is one of the underlying principles of heart rate variability (HRV).  Generally speaking, HRV is the beat-to-beat time variability of heart rate.  Research shows that higher HRV indicates a more balanced nervous system and better cardiovascular health.  For these reasons, higher HRV is associated with a better quality of life.

 

And it turns out that people with diabetes typically have worse HRV than non-diabetics.  (A negative side-effect of researching diabetes is that it reminds me of everything it adversely affects.  However, it’s also encouraging to find simple tools like breathing that can help (not fix) some of the problems).

 

 

HRV is Reduced in Diabetes

 

A 2018 meta-analysis found that patients with type-2 diabetes had significantly lower HRV than those without it.  Diabetics with chronic complications have even lower HRV. 

 

The lower HRV observed in people with diabetes is likely related to many negative aspects of the disease, such as chronic stress, inflammation, and increased oxidative stress. 

 

Perhaps unsurprisingly, low HRV is associated with adverse outcomes in diabetes.  For example, people with diabetes and low HRV are at increased risk of coronary heart disease.  Moreover, low HRV is an early marker of cardiac autonomic neuropathy, which can lead to heart disease, the number one cause of mortality in people with diabetes.

 

Sounds depressing, right?

 

 

Enter the Heart-Boosting Power of Slow Breathing

“When we breathe slowly at around 6 breaths per minute, we synchronize signals coming from our cardiovascular, respiratory, and autonomic nervous systems.  ”

When we breathe slowly at around 6 breaths per minute, we synchronize signals coming from our cardiovascular, respiratory, and autonomic nervous systems. 

 

To get a little more technical, we have baroreceptors monitoring blood pressure. They sense the changes in heart rate that accompany each breath.  Then, they send their own signals to the heart. 

 

For example, as blood pressure rises, they tell the heart to slow down.  And as blood pressure falls, they tell the heart to speed up.

 

Here’s the issue: there’s about a 5-second lag for signals.  Thus, they end up getting mingled together with the signals from the breath.  One may be trying to increase heart rate while the other is trying to slow it down.

 

But when we breathe at about 6 breaths per minute, we synchronize these messages.  (To breathe at 6 breaths per minute, we need about a 5-second inhale and 5-second exhale (or 4/6 also works). This matches the time lag from the baroreceptors.)

 

When the signals get synchronized, great things happen.  Each breath amplifies heart rate oscillations, leading to greater HRV.  This also balances the nervous system, making us calm and relaxed.  If we do this regularly, it can significantly improve our quality of life.

 

Let’s break these down into a little more detail and look at 4 positive outcomes we get from slow breathing.

 

 

The 4 Key Benefits of Heart-Breath Synchronization for Diabetes

 

1. Improved Heart Rate Variability

 

This is the most potent effect.  As mentioned, when we breathe slowly, we amplify the heart rate oscillations occurring with each breath.  This increases HRV, a critical problem in diabetes.

 

One study published in Nature found that just 2 minutes of slow breathing at 6 breaths/min could bring the HRV of type-1 diabetics to levels of non-diabetic controls.  (Side note: this was the paper that convinced me to start sharing this information.  Nature is one of the most prestigious journals in the world.  If they’re talking about slow breathing and diabetes, I realized my results weren’t so crazy after all.)

 

A long-term study of people with type 2 diabetes and ischemic heart disease found that one year of slow diaphragmatic breathing significantly increased HRV, and this wasn’t even at precisely 6 breaths per minute. Just slowing down the breath was enough to boost HRV.

 

And better HRV means better cardiovascular health and a longer life.

 

It also means more resiliency to diabetic stressors, but I’ll save that for another blog post.

“And better HRV means better cardiovascular health and a longer life.”

 

2. Efficiency and Blood Flow

 

When bodily messages come into harmony, it creates efficiency.  Efficiency means your body doesn’t have to work as hard to complete its normal processes.

 

This efficiency also improves blood flow, a fundamental problem in diabetes.  For example, the same 2-minute study mentioned above found that slow breathing also improved arterial function.  Better arteries, more blood flow, and less chance of complications.

 

 

3. Reduced Blood Pressure

 

Slow breathing has consistently been shown to lower blood pressure.  A 2019 meta-analysis found an average systolic blood pressure reduction of about 5 points from slow breathing for about 20 minutes daily.

 

The blood pressure-reducing effects of slow breathing have also been shown in diabetes.  In a study of 65 type-2 diabetics with hypertension, slow breathing significantly reduced systolic and diastolic blood pressure.

 

These results are significant because Johns Hopkins Medical Center reports that people with diabetes are twice as likely to develop hypertension.  It’s also estimated that anywhere from 40 to 80% of diabetics have hypertension.  Moreover, a person with diabetes and hypertension is four times more likely to develop heart disease.  For these reasons, preventing and treating hypertension is a chief concern in people with diabetes.

 

Slow breathing provides one complementary therapy for doing just that.

 

 

4. Less Stress & Anxiety

 

And lastly, we can’t discuss heart problems without discussing stress.  We know when we’re stressed, we have chronic activation of the sympathetic (fight-or-flight) nervous system.  This raises heart rate and blood pressure, adding extra strain on our hearts.

 

Fortunately, slow breathing is one of the fastest and most effective ways to alleviate stress. You’ve probably been told at some point in your life to “just take a deep breath.”  It turns out there’s some solid science for this statement.

 

Slowing down the breath, especially with a longer exhalation, increases activity in the parasympathetic nervous system (rest-and-digest), reducing stress and increasing relaxation. Slow breathing also reduces activity in the amygdala (often referred to as the “fear center”), which also helps reduce stress.

 

 

Slow Breathing is a Superpower for Your Heart

 

To recap, slow breathing at about 6 breaths per minute is excellent for our hearts, especially if you have diabetes.

 

It harmonizes messages being sent from the cardiovascular and autonomic nervous systems.  This leads to a ton of benefits, but here are 4 critical ones for diabetic heart health:

 

  • Improved heart rate variability

  • Increased efficiency and blood flow

  • Lower blood pressure

  • Less stress and anxiety

 

For these reasons, the paper published in Nature concluded:

“Slow breathing could be a simple beneficial intervention in diabetes.”
— Nature Scientific Reports

 

Simple and beneficial, indeed.

 

 

Start Improving Your Heart Health Today

 

I hope this article motivates you to start a slow breathing practice.

But, if you’d like some more help, you can check out the Breathing for Diabetes Online Course, which covers everything you need to get started.

I hope you’ll check it out, and if you have any questions about slow breathing in general, please email me at nick@thebreathingdiabetic.  I always respond within 5 days (but usually ~2).

Breathing for Diabetes Online workshop

This may be your key to a healthy, more fulfilling life with diabetes.

 
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Wim Hof & Diabetes: A Complete Guide to the Benefits and 5 Real Dangers

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The Wim Hof Breathing Method (WHM) is used by millions of people worldwide.  And if you search around, you’ll find some hefty claims, along with some inspiring success stories.  It seems to help with just about everything.

But what about diabetes? 

As a type-1 diabetic, a researcher, and an intermittent WHM practitioner (see my full story here), I recently decided to dig into the science and feasibility of the WHM for diabetes.  I found some fascinating things about inflammation and quality of life that make it appealing. 

But, at the same time, some real dangers might be overlooked by non-diabetics who practice and teach Wim’s method.  And there might be better approach for people with diabetes. 

However, I’m getting ahead of myself.  Let’s start off with the basics.

 

 What is the Wim Hof Breathing Method?

 The WHM generally consists of controlled hyperventilation and breath holds.  Most people use the following steps:

  •  30 big breaths (nose or mouth) at a comfortable pace.

  • After the last breath, hold with your lungs empty (after exhaling).

  • Hold as long as it is comfortable for you.

  • When you hit your limit, inhale fully and hold for another 10-15 seconds.

  • Repeat

 That is considered “one round.”  Wim generally suggests 3-4 rounds every day, first thing in the morning (this turns out to be critical).

In addition to the breathing, the full WHM consists of cold exposure and meditation.  But for our purposes, we’ll focus on the breathing because that’s what gets a lot of attention (and the most common starting point before getting into the cold).

 

 

Validated by Science: Direct Control of the Autonomic and Immune Systems

 The WHM is one of just a few breathing methods with scientific studies published directly on it. 

The most famous is the 2014 PNAS study.  PNAS is a top-notch journal, so this one put Wim on the map scientifically.

In the study, participants learned the WHM from Wim himself over a few days.  Then, they were brought into a lab and injected with an endotoxin.  Lots of people have been injected with this toxin, so scientists have a pretty good idea of what happens afterward: fever, chills, nausea, headache, and so on.

Thirty minutes before injection, the participants started doing the WHM breathing.  Then, they were injected and continued doing the breathing (they modified it slightly after 1 h) for another 2.5 h.  That’s a total of 3 hours of WHM breathing (!).  But the results were incredible.




All the WHM-trained participants reduced basically every symptom associated with the endotoxin injection. 

Moreover, they significantly increased anti-inflammatory cytokines while suppressing pro-inflammatory ones. 

This was the first time (basically ever) that a person could take direct control of their autonomic and immune systems.  I call this study the “4-minute mile” of breathing.

“The PNAS Wim Hof study is the “4-minute mile” of breathing, showing that the impossible was possible.”



What about Chronic Inflammation?

Those results are pretty intriguing since a huge problem with diabetes is immune and autonomic dysfunction.  But most of us diabetics probably don’t want to hyperventilate for 3 hours a day to reduce our inflammation.

Fortunately, another study decided to investigate the more long-term effects of the WHM on inflammation in people with spondyloarthritis.

Participants practiced the WHM for 8 weeks. (Note that this was the full WHM, which includes cold.  However, recent research still in pre-prints has shown that the breathing alone is really helpful for inflammation.)  It looks like they spent about 45- 60 min a day doing these exercises (still a lot, but much better than hyperventilating for 3 hours).

After the 8 weeks, measurements showed that they reduced overall levels of several inflammatory markers.  Moreover, the participants’ quality of life scores all went up.

Sounds great so far, right?

Well, yes.  But we next need to learn how it works, which will shed more light on how it might impact diabetes specifically.

 

 

How Does the WHM Work?  Stress, Stress, and More Stress

As mentioned, the WHM consists of hyperventilating and holding your breath.  Both of these are stressors.  In fact, they are really, really stressful.  The PNAS study we mentioned earlier found that when the participants did the breathing, their adrenaline rose higher than people bungee jumping for the first time.  That’s a lot of stress.

Counterintuitively, it turns out that intense short-term stress is actually good for you.  I won’t go into the details here (and honestly, I don’t understand it enough to speak intelligently on it), but separate fields of science called “psychoneuroendocrinology” and “neuroimmunology” have shown that short-term stress boosts our immune system and lowers inflammation.

It appears that the WHM might trigger this effect perfectly.

“Short-term stress boosts our immune system and lowers inflammation.”

 

 

Intermittent Hypoxia

Moreover, during the breath-hold portion, people drop their blood oxygen saturation significantly (sometimes to half of where they started).  This is yet another short-term stressor that can also be therapeutic. 

It turns out that intermittent bouts of low oxygen, followed quickly by normal oxygen levels, can improve insulin sensitivity, lower blood sugar, boost immune function, and increase blood flow to the brain.

Together, we see that the WHM combines two intense stressors over a short period: hyperventilation and breath holds.  These trigger some positive adaptations that at least partially explain the benefits of the WHM (although there’s a lot of brain stuff happening, too—see the WHM & Diabetes Masterclass below for more).

All of this brings us back to diabetes and this question: Isn't stress bad for people with diabetes?

 

 

The 5 Dangers of WHM and Diabetes

Here’s where things get interesting for diabetics.

 

1. Blood Sugar

Because the WHM is an intense stressor, it will almost certainly raise your blood sugar in the short term (of course, everyone is different, but this has been my experience).

Thus, if your blood sugar is already high, practicing the WHM might not be a good idea.

(Paradoxically, there is also a chance it could improve insulin sensitivity over time due to the intermittent hypoxia.  This has never been proven with Wim’s method, just my logical deduction.)

 

2. Anxiety and Panic Disorder

Here’s another thing to consider.  The WHM involves hyperventilation, which is a common symptom associated with anxiety and panic attacks.

People with diabetes have a much higher prevalence of anxiety and panic disorder.  Thus, we run a much higher risk of experiencing adverse effects from this aspect of the WHM. 

Putting our body through that intense stress and the associated blood sugar increase might leave us feeling worse than when we started.

 

3. Autonomic Dysfunction

Additionally, people with diabetes generally have worse autonomic nervous system functioning than their non-diabetic counterparts.  This shows up consistently as lower heart rate variability (HRV) levels and lower baroreflex sensitivity, even in seemingly healthy diabetics.

Thus, putting our nervous system into fight-or-flight overload might exacerbate underlying nervous system issues rather than alleviate them.

 

4. Cardiovascular Complications and Hypoxia

People with diabetes suffer from higher rates of cardiovascular disease than non-diabetics (and it’s the #1 cause of death in people with diabetes).  Thus, dropping our blood oxygen saturation to the extremely low levels experienced during the WHM might put too much stress on our hearts.  (Again, my speculation, but there isn’t any research on WHM and diabetes to know for sure.)

 

5. Poor Everyday Breathing

Lastly, because WHM encourages hyperventilation, there is a chance this would carry over into your everyday breathing. Of course, this is not what Wim suggests, it’s just a side-effect many people experience—myself included—if you’re not taught proper breathing in addition to the WHM.

If you’re constantly taking bigger breaths, especially through the mouth, it will put you in a chronic state of low-grade stress, intensifying the above-mentioned dangers.  This could cause more cardiovascular stress, more nervous system dysregulation, more anxiety, and worse blood sugar control.

 

 

So, What Should We Do as Diabetics?

 Let’s recap.

The potential benefits:

  1. Improved quality of life

  2. Lower inflammation

  3. Better immune function

  4. Better insulin sensitivity (my speculation)

  5. More energy (we didn’t talk about this, but it’s something most practitioners say)

 

The potential dangers:

  1. Short-term increase in blood sugar

  2. Increase in symptoms of anxiety and panic

  3. Dysfunctional nervous system

  4. Added stress on your heart

  5. Poorer everyday breathing 

With this information, I hope you can decide whether the WHM is suitable for you (or for your clients if you work with people with diabetes).  And if you are going to practice the WHM, I suggest finding a certified coach to start out safely. There are tons of them listed here.

If You Want More Information

If you want more information, I put together a 40-min Wim Hof and Diabetes Mini Masterclass ($99 value) as a free bonus to my Breathing for Diabetes Online Workshop. This class goes into more detail than is possible here.

And, by getting the workshop, you’ll learn where I suggest you start before diving into the WHM: slow breathing.

If you’re interested, you can learn more below.

The Breathing for Diabetes Online Workshop

Created for diabetics, by a diabetic.

From Wim Hof to slow breathing, this workshop covers everything you need to know to use breathing to reduce your stress, improve your sleep, better manage the inevitable ups & downs, and live an overall healthier life with diabetes.

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.

 
 

Ujjayi isn’t Ocean, Well-Being, and Why You Should Teach “Brooklyn” Yoga

 
 

Listen Instead of Reading

 

This week, you’re going to learn:

  • That Ujjayi and Ocean breathing are different,

  • How to breathe for inflammation, and

  • A story I listened and laughed at more times than I’m proud to admit…

I hope you enjoy it!

 
 
 
 

4 Thoughts


1. Ujjayi vs. Ocean Breathing (turns out they’re different)

“Ujjayi pranayama, which is performed by lightly tightening the glottis and breathing with a whispering sound and then exhaling out of either the left or right nostril, stimulates the vagus through massaging the larynx and downregulating the sympathetic nervous system. … Ocean breath is sometimes used synonymously with ujjayi, but the two are separate practices.”

- Eddie Stern, One Simple Thing

I thought Ujjayi and Ocean breathing were the same thing. So, I found this passage fascinating (especially that Ujjayi uses an exhale through one nostril). I messaged Eddie about it, and he kindly responded with even more value.

He added that, for Ocean breathing, “the sound is made not so much by the tightening of the glottis, but by creating a continuum of pressure from the high nasal cavity, through the throat, into the thorax.”

That means there are two key differences between Ujjayi and Ocean breathing:

  • Ujjayi: sound comes from the glottis, and the exhale is through only one nostril.

  • Ocean: sound comes from the nose to thorax, and the exhale is through both nostrils.

My favorite part about breathing is continuously learning that I have so much more to learn : ) Thanks, Eddie!

***

Related: Hatha Yoga Pradipika (#51-53)

Related: My Conversation with Eddie on All Things Breathing

Related Quote: “The surest way to prevent yourself from learning a topic is to believe you already know it.” - James Clear

2. Slow Breathing for Oxidative Stress and Inflammation

Diabetes and its associated blood sugar fluctuations lead to chronic oxidative stress and inflammation. What can slow deep breathing do?

  • JACM (2011): “Diaphragmatic breathing, likely through the activation of the parasympathetic nervous system…reduces reactive oxygen species production.”

  • Nature (2017): “…our results lead to the hypothesis that slow breathing may exert some antioxidant effect, possibly via parasympathetic stimulation.”

  • PLOS One (2013): “RR [relaxation response] practice…reduced expression of genes linked to inflammatory response and stress-related pathways.”

Taken together, these results suggest that slow breathing could be a simple and effective way to reduce oxidative stress and inflammation in diabetes. 

But you don’t need diabetes to benefit. These two complications are present in many acute and chronic conditions, so the above results will help everyone.

3. “Why Your Breath is Connected to Your Well-Being”

“As deep breaths slow your heart rate, for example, your vagus nerve recognizes the cues of safety and sends that information to parts of the body so they can turn off their defenses, such as those that arise from a sense of anxiety or threat.”

- Why Your Breath is Connected to Your Well-Being

This is an awesome little article on breathing and well-being, focusing mainly on the vagus nerve.

You will learn how vagal tone is connected with social situations, how compassion can increase respiratory sinus arrhythmia (a marker of vagal activity), and 4 simple ways to calm your whole body.

I hope you enjoy it as much as I did.

4. Why You Should Start Teaching “Brooklyn” Yoga

“One new meditator kept coming to interviews with a chronic lament: ‘The breath is so boring!’

Finally, I asked him if he'd ever heard of Brooklyn yoga? He said no. I told him to close his mouth tight and close off both nostrils with his fingers. We sat that way for some time until finally he let go of his nose and gasped for air.

‘Was that breath boring?’, I said.”

- Larry Rosenberg, Breath by Breath

I must have listened to this story about 10 times in a row and laughed more with each one. It brilliantly captures the importance of breathing—no science or technical jargon needed.

So if anyone tells you breathing is boring, doesn’t work, or is pseudo-science, teach them a little “Brooklyn” yoga—you might just change their mind : )

***

P.S. When I ran in and told my wife the story (yes, I was excited, lol), she didn’t get the “Brooklyn” part. Neither do I, but I think that’s the point : )

Related: Is Breathing Woo-Woo? (Thought #4)

 
 
 
 

1 Quote

“If one wants longevity, one should let the spirit and the breath pour into each other.”

–Tao Tsang

Translation from The Primordial Breath

 
 
 
 

1 Answer

Category: Vagus Nerve Function

Answer: Activation of the vagus nerve releases this chemical, which stimulates muscle contractions in the parasympathetic nervous system and slows the heart rate.

…

(Cue the Jeopardy! music.)

…

Question: What is acetylcholine?

In good breath,

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

P.S. No I don’t “meditate”

 
 
 

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 I Trained for Altitude and Why We All Benefit from Breath Training

 
 

Listen Instead of Reading

 

Autonomic Neuroscience says slow breathing is for diabetes & hypertension.

Harvard Medical School says yogic breathing is for stress.

And Tibetan Yoga says breath training is for everyone.

Let’s see how…

 
 
 
 

4 Thoughts


1. How I Trained for High Altitude (it’s not what you might think)

I thought, “I’m The Breathing Diabetic. I better be able to handle some altitude.”

But I didn’t train how you might think. Of course, I initially started with more breath holds. But I realized that the issue at altitude is lower air pressure.

- How I Trained for High Altitude Blog Post

This one was slightly too long to fit in as a “Thought,” so I made it a really short blog post.

Give it a read to learn my somewhat odd training method for my recent hike up to 13,200 feet…and to see if it actually worked (pictures included).

Please respond to this email if you have any thoughts on my reasoning…it was my first time at altitude, so I’d appreciate any feedback or thoughts you have.

***

Related: How To Breathe To Live Longer

2. Slow Breathing for Diabetes and High Blood Pressure

“Even in already well controlled diabetic patients, guided breathing had beneficial influences on cardiovascular autonomic control and a measurable impact on BP control.  It enriches available options for non-pharmacological blood pressure…reduction.”

- Effects Of Guided Breathing On Blood Pressure And Heart Rate Variability In Hypertensive Diabetic Patients

According to Johns Hopkins, approximately two-thirds of adult diabetics have high blood pressure or take medication for it. And people with diabetes and hypertension are 4x more likely to develop heart disease.

Fortunately, this study found that just 12 minutes a day of slow breathing (with no changes to medication) led to significantly lower blood pressure, increased heart rate variability, and a reduced spontaneous breathing rate (indicating reduced sympathetic arousal).

All of which led to this remarkable final statement: “If consistently used, guided breathing enhances restoration of physiological autonomic balance in patients with diabetes and hypertension.” Amen 🙏

Here’s to controlling our breath to control of our blood pressure, today.

3. Harvard Medical School: “Yogic Breathing Improved University Students' Response to Stress”

“When we anticipate a stressful situation, our breathing and heart rates naturally go up…but the yogic breathing group seemed to show protection against that type of stress. Their heart rate increased only slightly when they knew a stressful situation was coming.”

- Yogic breathing improved university students' response to stress

Enjoy this excellent and quick write-up showing that yogic SKY breathing can significantly reduce the stress response. It’s from the Beth Israel Deaconess Medical Center, a world-class teaching hospital of Harvard Medical School.

The next thought builds off of this idea of “protection against stress”…

4. What Turbulence Can Teach Us About Breathing

When you’re flying and hit turbulence, you’re told to put on your seatbelt.

It’s reactive.

It’s similar to when turbulence hits in our lives. We react. We start eating healthy or meditating or exercising more.

But a regular breathing practice is proactive.

It helps you avoid turbulence altogether.

Or, if you can’t avoid the turbulence, it’s like your seatbelt. You’re already fastened in. You don’t need to rush back to your seat. You’re ready.

 
 
 
 

1 Quote

“Because the breath is such an excellent and abundant support for life and vitality for every being on the planet, everyone can benefit from training in the breath.”

– The Tibetan Yoga of Breath

 
 
 
 

1 Answer

Category: Hypoxia and Red Blood Cells

Answer: During hypoxia, this organ releases additional red blood cells to increase your oxygen carrying capacity.

…

(Cue the Jeopardy! music.)

…

Question: What is the spleen?

In good breath,

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

P.S. “sorry, it’s my first day!”

 
 
 

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.

 
 

Nerdy Warriors of the Breath, Investing, and a Useful Look at HRV

 
 

Listen Instead of Reading

 

Greetings,

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

Enjoy!

 
 
 
 

4 Thoughts


1. A Practical Look at HRV and Resiliency

“Resilience is the ability to return to normalcy, according to Jen Baker, director of athletics and recreation at John Hopkins University, a graduate of the US Naval Academy. It's your ability to bounce back and thrive, replace worry with objective things, to navigate and take steps forward.”

- Belisa Vranich & Brian Sabin, Breathing for Warriors

Slow breathing significantly increases heart rate variability (HRV) and, subsequently, increases resiliency. This has been shown time and time again. But, from a practical perspective, what does it mean to “increase resiliency?”

Does it mean you’ll never experience stress or anxiety again? No, certainly not. What it means is that the stressors won’t feel as severe and, as Jen Baker says, that you’ll bounce back faster. The stress is the same. You’re different.

So here’s to not trying to escape the world and its stressors, but instead having the tools—one being slow breathing—to bounce back to normalcy faster.

***

Related Quote: “To say that learning breath control is the most important component to forging mental toughness would not be an overstatement.” -Mark Divine, Retired U.S. Navy SEAL Commander

Related Quote: “By modulating the stress response via vagal stimulation from conscious breathing exercises, people can bolster their resilience to all forms of negative stressors; diabetes is no exception.” - Evan Soroka, Yoga Therapy for Diabetes

2. Where Are You Investing Your Breathing: GameStop or Real Estate?

Slow breathing methods can be “life-changing,” according to James Nestor. But, “they can also take a while, especially for those with…chronic conditions.” On the other end of the spectrum, he says methods like Tummo restore balance with a “violent shove,” which can also be helpful for some.

So how do you know which is right for you?

I liken it to investing. Slow, nasal breathing is like putting your money in real estate or an index fund. It’s pretty safe. There will be fewer ups and downs, and you’re almost guaranteed a positive return.

The “violent shove” techniques, on the other hand, are like investing in GameStop or crypto. You might see some incredible benefits in just one day. But, you also risk a significant loss the next if you're not diligent with it.

So the question is: Are you looking for short-term gains or long-term compounding? Are you timing the market or playing the long game? Maybe you want to have a “diversified portfolio” : ) There’s no right or wrong answer. Only you know which approach is right for you.

3. “'Email Apnea' Is a Real Thing-Here's How to Stop Holding Your Breath While Working (and Feel Less Stressed)”

“Learning (and really practicing) basic breathing techniques can also help reverse the effects of email apnea; it'll help you improve awareness of your own breath and breathing habits and teach you how to breathe more easily during times of stress.”

- Real Simple, ‘Email Apnea’ is a Real Thing

This article provides an excellent summary of email apnea and some practical things you can do to reduce how often it occurs. Or, at the very least, to help reverse some of its harmful effects.

As someone who still (after years of a daily breathing practice) occasionally experiences this, I thoroughly enjoyed the read. I hope you do too!

4. Nerdy Warriors of the Breath

“The old-school philosophers knew it was really hard to live in integrity with our highest ideals. They told us we needed to be WARRIORS of the mind, not mere librarians of the mind.”

- Brian Johnson

Meaning we have to live our philosophy, not simply recite it to other people. The same is true with breathing. But, with breathing, both are critical.

We have to be warriors of the breath. We have to live it and practice it, in easy and difficult circumstances. But, we also need to be librarians of the breath.

We need to have the science ready in our back pocket. We need to intrigue people with the experience, then back it up with the science, or vice-versa.

So here’s to being nerdy warriors of the breath, accomplishing great things with our practice, and then explaining the physiology of how it worked : )

***

Related: Breathing Science Library

Related: Rucking 100 Miles for Breathing

Extra Thought: Breathing I’m Exploring

I try my best to be a breathing warrior, and I practice every single day. I don’t share too much about it because everyone’s practice is their own. But, here are a couple of new things I’ve tried recently:

Breathwrk App: I’ve been having fun doing 1-3 min of each breath they offer. I use it sporadically throughout the day just to try something different. My three favorite breaths so far are:

  1. No Worries

  2. Clear Mind

  3. Calm

Open: I’ve also taken a few on-demand breathwork classes through Open. I usually enjoy being in control, but I have genuinely loved these classes. Here are my two favorites (thanks Crussen!):

  • Heart Coherence (this one was truly incredible)

  • Symmetry (box breathing w/music—an excellent mix)

Here’s to never-ending growth, learning, and exploration of the breath.

 
 
 
 

1 Quote

“There is another side of Kanchenjunga and of every mountain—the side that has never been photographed and turned into postcards. That is the only side worth seeing.”

- Thomas Merton

 
 
 
 

1 Answer

Category: Breathing in Libraries

Answer: One of the first mentions of nasal breathing in a medical text occurred in this year and document.

…

(Cue the Jeopardy! music.)

…

Question: What is 1500 BCE, in the Ebers Papyrus?

P.S. I found this in Breath.

In good breath,

Nick Heath, T1D, PhD
Diabetes is Tiny. You are Mighty.

P.S. “NO GAME SCHEDULED”

 
 
 

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.

 
 

Phil Mickelson, and How Modern Science Helps Explain 2000-Year-Old Wisdom

 
 

Listen Instead of Reading

 

Hey,

Here are 4 thoughts, 1 quote, and 1 answer for this week. Enjoy!

 
 
 
 

4 Thoughts


1. The Real Lesson from Phil Mickelson: For Diabetes, and Life in General

Phil Mickelson used controlled breathing throughout the PGA Championship. So, when he won, it was an exciting moment for the breathing community.

But do you know what happened for the next tournament? He played poorly.

Of course, with sports, we accept that this is just part of the game. Even with his focused breathing, no one can win them all.

But do you apply this concept in your life, especially if you have diabetes?

Do you remember that life is more complex than sports? There’s no “one thing” that will ensure you always win.

But, and this is important, Phil still finished that next lousy round of golf. He didn’t just walk off the course because he wasn’t winning.

And that’s what we have to do. A high blood sugar doesn’t mean we should give up on our protocol. A poor night of sleep doesn’t mean this breathing stuff doesn’t work. Life is hard, and we all have off days. But, that’s precisely when we need our fundamentals the most.

Here’s to knowing we’ll have bad days and weeks, and finishing anyway, knowing we’ll eventually be on top again.

***

P.S. I know nothing about golf, so thanks to my dad for pointing out how bad Mickelson played when we hung out on Father’s Day, sparking this thought : )

2. Breathing is a Scalpel to Your Brain and Emotions

In 2017, a group of Stanford researchers discovered a small cluster of neurons that control your breathing—the breathing “pacemaker neurons.”

It turns out that these neurons extend to other parts of the brain that control emotions, and it’s a two-way street: The emotional areas can influence your breathing, but your breathing can also influence them.

On a recent RadioLab Podcast (aptly titled “Breath”), after learning this, Molly Webster likened her breathing to a scalpel to her brain and emotions:

“I feel like, in a way, he almost gave me like a scalpel to get inside my own brain and control it…If I actually change my breathing, it will change this breath pacemaker region, and it will send an ‘I’m chill’ signal to the fight or flight directly, and it will calm down.”

This brought a massive smile to my face. What a perfect analogy.

Practically and scientifically, you can know that when you take control of your breath, you take control of a small cluster of neurons that talk to other regions of your brain. So the scalpel is right there in your nose. Use it when needed.

***

P.S. Thanks to one of my best friends, Capt J.G., for sending me this podcast.

3. “Breathing Exercises for Better Metabolic Health”

“Research shows that controlled breathing can positively impact our nervous system, reducing stress and maybe even improving glucose control.”

- Levels, Breathing Exercises for Better Metabolic Health

This article is a perfect synthesis of research and practical advice on how breathing might help with blood sugars. It’s basically my entire website summarized into a 6-minute read…I feel rather long-winded now : )

Please read and share this one!

***

Related: My recent conversation with Evan Sorkoa, author of Yoga Therapy for Diabetes, on all things breathing, yoga, and diabetes.

Related: The Lesser-Known Benefits Of Nasal Breathing, Designed For Diabetes

Related: Why Slow Breathing is Beneficial for Diabetes

4. Moderate Breathing, in Moderation

“All breathing in moderation, including moderate breathing.”

A reader helped me add this one to the list of “Breathing Graffiti.” Thanks, M. Night Larry. It’s clever, and it has lots of practical wisdom too.

Remember that we take over 20,00 breaths a day. So Wim Hof is OK now and then. Breath holds are OK now and then. (If you’re in good health, of course.)

All breathing in moderation, even moderate breathing. That’s a simple and valuable principle to live by.

 
 
 
 

1 Quote

“When the mental state is disturbed, the life energy (prana) gets unbalanced and this leads to irregular breath; hence to regulate the mental state the yoga practitioner should regulate the breath.”

Hatha Yoga Pradipika, 300 A.D., from Role of respiration in mind-body practices: concepts from contemporary science and traditional yoga texts

***

P.S. This was from almost 2000 (!) years ago. The neurons controlling how this works (Thought #2) were only discovered in 2017. The paper linked above provides additional insight into the science behind this ancient wisdom.

 
 
 
 

1 Answer

Category: Breathing in History

Answer: The healing power of the breath was recognized this far back.

…

(Cue the Jeopardy! music.)

…

Question: What is 7000 BCE? (pg. 58)

In good breath,

Nick Heath, T1D, PhD
Diabetes is Tiny. You are Mighty.

P.S. You know. Like a book.

 
 
 

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.

 
 

Oxidative Stress and Civilized vs. Wild Breathing

 
 

Listen to this Post as a 5-min Podcast:

 

"You cannot breathe your way out of a Big Mac."

But apparently, slow breathing might help it taste better (see #3 below).

Ok, let’s get to it. Here are 4 thoughts, 1 quote, and 1 answer for the week. Enjoy!

 
 
 
 

4 THOUGHTS

1. Is There Really “Dysfunctional” Breathing?

"Breathing is one of the body’s critical functions.  When its fundamental processes break down, the body will compensate, calling on structures such as the core muscles to help maintain respiration."

– Patrick McKeown, The Breathing Cure (pg. 152)

Breathing is the body’s most critical function. So as Patrick tells us, even if we do it incorrectly, the body will compensate by activating whatever muscles are needed to keep it going. Breathing takes precedence over everything.

So, we might say that breathing will always remain "functional" in that it will always do its main task of keeping us alive. But, it might be severely inefficient.

Thus, "dysfunctional" breathing is really just inefficient breathing.

This gives us two options. We can develop optimal breathing, which uses the nose and activates the diaphragm. Or, we can ignore our breathing and let the body compensate on its own, usually in ways that are detrimental to our health.

I say we choose option 1.

2. Diabetes, Oxidative Stress, and Slow Breathing

High blood sugars generate free radicals. These excess free radicals deplete antioxidants and ultimately cause oxidative stress. This negative feedback loop has been described as the "single unifying mechanism for diabetic complications."

To combat this, people with diabetes would ideally find a way to both reduce free radical production and increase antioxidant defenses. Slow breathing provides a natural and effective method of doing just this.

For example, slow diaphragmatic breathing reduces post-meal oxidative stress. It also reduces oxidative stress associated with intense, long-duration exercise. The hallmark paper on slow breathing & diabetes published in Nature even said:

"…our results lead to the hypothesis that slow breathing may exert some antioxidant effect, possibly via parasympathetic stimulation."

Taken together, slow breathing appears to be a simple and effective way to help with oxidative stress in diabetes. Quite amazing.

3. Apparently Slow Breathing Makes Food Taste Better

"Smooth, relatively slow breathing maximises delivery of the particles to the nose. Food smells and tastes better if you take your time."

- Vice, Apparently Slow Breathing
Makes Food Taste Better

This was a fun read from Vice. At first, I thought it seemed a bit silly. But the study was originally published in PNAS, so maybe there’s something to it?

If we pair this advice with Ch. 7 of Breath, we might say that to enjoy a meal, breathe slowly and chew more. I’m constantly working on the chew more part…

Enjoy!

4. Take the Nose, Take the Life

"Ancient Egyptian cultures also recognized the importance of the breath, the evidence of which we see today in the many ancient statues that had their noses broken off but otherwise were left untouched. This defacement was no accident, but a deliberate act by conquering groups to take the life, in this case the breath of life, away from these icons."

- Michael J. Stephen, MD, Breath Taking

This is on the first page of the book. Although Dr. Stephen never mentions the power of the nose again, it’s a rather remarkable statement that emphasizes just how important the breath (and nose) were to ancient cultures.

Related: The Warren Buffets of Nose Breathing (Thought #2 )

 
 
 
 

1 QUOTE

"Civilized man may properly be said to be an open mouthed animal; a wild man is not."

- George Catlin, The Breath of Life (1864)

 
 
 
 

1 ANSWER

(This one blows my mind…)

Answer: The inner surface of this organ has as many hair follicles as your head.

…

(Cue the Jeopardy! music.)

…

Question: What is your nose?

In good breath,
Nick

P.S. He was the dog.

 
 

Investing, Sleep, and the Most Important Rest in a Day

 

Greetings,

Here are four thoughts, one quote, and one answer (like "Jeopardy!") to consider this week. Enjoy!

 
 
 
 

4 THOUGHTS

As I have been making my way through Patrick McKeown’s latest book, The Breathing Cure, I’ve been reminded of just how powerful all this breathing stuff is. Patrick has sections on breathing for diabetes, epilepsy, hypertension, and more.

Of course, despite the catchy title, breathing does not "cure" any of these ailments. Still, it’s quite remarkable to see all the conditions it can help with.

Upon reflection, this makes a lot of sense if we remember that breathing is like an index fund for health. It invests a small amount into a wide range of the body’s functions, such as lung and heart health, autonomic balance, and sleep.

Over time, these tiny improvements combine and compound into overall better health. And as Patrick’s new book shows, these benefits can be helpful in many different conditions.

The key, however, is to find a breathing practice that is right for you, get started, and be consistent. Here’s to safely investing in your health today.

P.S. Unlike most financial investments, however, you also get an immediate return on investment with breathing. For example, just two minutes of slow breathing can improve autonomic balance and enhance decision-making.

2. Mouth Tape is Passive Income for Your Health

Wealthy people grow their wealth in their sleep.

Healthy people grow their health in their sleep.

Taping your mouth at night is like passive income for your health. It requires only a small upfront investment: putting the tape on before you go to sleep. All of the benefits—like deeper sleep, improved mental clarity, and reductions in sleep apnea—come without any additional effort.

Thus, we might be wise to take the advice of a 1983 paper published in the journal Sleep: "While asleep, shut your mouth and save your brain."

3. Slower Breathing Facilities Eudaimonia via Your Vagus Nerve

"This accumulating body of evidence suggests that slow-paced breathing is a cost-free and readily available way to facilitate eudaimonia by lowering blood pressure, improving psychophysiological well-being, and increasing happiness."

- Christopher Bergland—Slower Breathing Facilitates Eudaimonia…

As you will learn in this article, Eudaimonia is "the condition of human flourishing or living well." So, when a headline implies that slow breathing might help us achieve this, I’m all in. This quick read lived up to its promise. Enjoy!

4. Breathing Tranquility

"Tranquility. It’s the feeling we have when we truly TRUST ourselves. When we know we’re headed in the right direction and we’re able to quit comparing ourselves to everyone else and stop second guessing ourselves every 5 seconds."

- Brian Johnson

Although slow breathing induces a sense of tranquility, that’s not what this made me think of. It made me think of the tranquility that can come when you find the right breathing practice for you.

We’re all different, and there’s no "perfect" method for everyone. Tranquility comes when you find the one that’s right for you and you know you’re headed in the right direction, whether it’s the latest popular technique or not.

My breathing tranquility? Seven seconds in, eleven seconds out. Repeat.

 
 
 
 

1 QUOTE

"Sometimes the most important thing in a whole day is the rest we take between two deep breaths."

– Etty Hillesum

 
 
 
 

1 ANSWER

Answer: By consuming oxygen, carbon, and hydrogen and giving off carbon dioxide and water, these two processes are fundamentally alike.

…

(Cue the Jeopardy! music.)

…

Question: What are combustion and human respiration?

In good breath,
Nick

P.S. Follow me for more financial advice

 
 

On Excellent Scientific Statements and Being Reasonable with Breathing

 

Greetings,

Here are 4 thoughts, 1 quote, and 1 answer related to breathing. Enjoy!

 
 
 
 

4 THOUGHTS

1. 18 Excellent Statements from Scientific Papers

"With breathing interventions being relatively rapid interventions to implement and also demonstrating a wide range of positive clinical outcomes, breathing interventions warrant closer consideration from healthcare professionals."

- Psychophysiology (2017)

Over the past few years, I have accumulated over 500 pages of notes on over 100 scientific articles on breathing. I’ve recently been going back through them as part of a project I’m working on.

In this post, I share 18 of the best "one-liners" I’ve come across. Enjoy!

2. Breathing, Autonomic Function, and Diabetes

One of the most significant benefits of slow breathing is its positive effects on autonomic function. This is typically measured by heart rate variability (HRV) and baroreflex sensitivity (BRS)—higher HRV and BRS indicate better function.

Perhaps unsurprisingly, people with diabetes generally suffer from lower HRV (Benichou et al. 2018; Kudat et al. 2006) and BRS (Bernardi et al. 2017; Esposito et al. 2016). This is due to many factors, such as fluctuating blood sugars and resting tissue hypoxia, which cause autonomic imbalance (Bianchi et al. 2017).

Encouragingly, slow breathing at a rate of 4-6 breaths per minute is an effective way of increasing HRV (Steffen et al. 2021; Russell et al. 2017; Tavares et al. 2017; Chen et al. 2016; Lin et al. 2014; Van Diest et al. 2014; Vaschillo et al. 2006) and BRS (Rosengård-Bärlund et al. 2011; Bernardi et al. 2011; Joseph et al. 2005).

Slow breathing improves these markers by stimulating the vagus nerve, which activates the calming parasympathetic nervous system (Gerritsen and Band 2018). This helps people with diabetes restore autonomic balance.

It is simple and immediately useful, seeming too good to be true. But alas, science agrees: “Slow breathing could be a simple beneficial intervention in diabetes.”

3. How Stuff Works: Why Breathing Through Your Nose Is Best

"But wait, there's more. Breathing through your nose also increases the amount of oxygen in your blood more than mouth breathing, which is essential to virtually every cell, organ and tissue in your body."

- How Stuff Works
Why Breathing Through Your Nose is Best

This excellent article succinctly summarizes the benefits of nose breathing. It’s short, sweet, and packed full of great information. Enjoy!

4. With Breathing, Be Reasonable Not Rational

"Do not aim to be coldly rational when making financial decisions. Aim to just be pretty reasonable. Reasonable is more realistic and you have a better chance of sticking with it for the long run, which is what matters most."

- Morgan Housel, The Psychology of Money

I find many parallels between health and wealth. Here is another. We often get too bogged down with doing everything rationally. "This study said 20 minutes of slow breathing is best" or "That one said three times a day is needed."

Rather than following scientific studies exactly, I believe it’s better to aim for being "pretty reasonable." Find the time of day that works best with your schedule. Find the method that works best for you. Two slow breaths are better than no slow breaths. Four minutes a day is still better than zero minutes a day.

With breathing, be reasonable, not rational.

 
 
 
 

1 QUOTE

“But the nostrils, with their delicate and fibrous linings for purifying and warming the air in its passage, have been mysteriously constructed, and designed to stand guard over the lungs.”

– George Caitlin (1864), The Breath of Life

 
 
 
 

1 ANSWER

Answer: The internal surface area of these organs can be a great a 100 sq. meters, about half the size of a tennis court.

…

(Cue the Jeopardy! music.)

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Question: What are the lungs?

In good breath,
Nick

P.S. No I need these

 
 

Become A World-Class Breather

 

Greetings,

Here are four thoughts, one quote, and one answer to start off February. Enjoy!

 
 
 
 

4 THOUGHTS

1. Become a World-Class Breather

"World-class performers are less about complexity and more about optimizing simplicity…It’s about the fundamentals. But small, daily improvements on the fundamentals every day done with ridiculous consistency creates insane revolutions over time."

- Robin Sharma, Optimize Interview

Becoming a world-class breather is actually quite simple: reduce the complexity, optimize the simplicity.

Of course, you can still utilize a variety of advanced techniques. Kobe Bryant didn’t only practice shooting free throws, and Tom Brady doesn’t only practice taking snaps. But it all starts with optimizing the fundamentals.

The best way to do that? Nose, belly, quiet, slow, repeat. Let those benefits compound into "insane revolutions over time."

P.S. Don’t forget James Clear’s advice: We have to start before we can optimize.

P.P.S. I condensed the quote, but I’ve never heard so many buzzwords stringed together so eloquently and with so much conviction : ) Enjoy listening.

2. What Optimal Breathing Can Do for Diabetes 

Although it’s not a panacea, improving our breathing might be the simplest thing we can do for our overall health. And for diabetes, in particular, optimal breathing has several direct and indirect benefits that are especially useful.

For example, it can improve cardio-autonomic function, reduce stress and anxiety (see next thought), improve blood flow, and improve sleep. These benefits can lead to better insulin sensitivity, more stable blood sugars, and less risk of long-term complications. Not bad for something as simple as breathing.

3. Harvard Business Review: Why Breathing Is So Effective at Reducing Stress

"So what makes breathing so effective? It’s very difficult to talk your way out of strong emotions like stress, anxiety, or anger…But with breathing techniques, it is possible to gain some mastery over your mind."

- Harvard Business Review,
Research: Why Breathing Is So Effective at Reducing Stress

So much goodness in this quick article. It’s a nice complement to last week’s thought on using breathing instead of thinking, and much more. Enjoy!

4. A Breathing Competition?

Compete: from Latin competere,

in its late sense 'strive or contend for (something)'

from com = 'together' + petere = 'aim at, seek'

- Apple Dictionary

So to "compete" literally means to strive for something together. In that case, we can consider this newsletter to be a breathing competition, with all of us striving to become world-class breathers together.

I hope you enjoy this competition as much as I do.

This thought was inspired by this Optimize +1

 
 
 
 

1 QUOTE

"The pattern of your breathing affects the pattern of your performance. When you are under stress, deep breathing helps bring your mind and body back into the present."

– Gary Mack, Mind Gym

 
 
 
 

1 ANSWER

Answer: This is the longest recorded breath-hold that didn’t use pure oxygen inhalation.

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(Cue the Jeopardy! music.)

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Question: What is 11 min 35 sec?