diabetes and breathing

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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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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.

A Mystical Organ, and The 4 Best Ways to Keep Your Breathing Interesting

 
 

Listen to this post:

 

Greetings,

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

 
 
 
 

4 Thoughts


1. The 4 Best Ways to Keep Your Breathing Practice Interesting

  1. Try New Methods

    • Example: Trying a new method or breathing rate each week.

  2. Make it Harder

    • Example: Gradually increasing the sides of your box breath.

  3. Use it in Harder Situations

    • Example: Using nasal-only breathing during a run or workout.

  4. Focus on Compounding (my favorite)

    • Example: Using the same method with ridiculous consistency.

…

P.S. Any #1-3 can actually be applied in #4 too.

2. How Slow Breathing Helps Lower Your Blood Sugar, Diabetes or Not

Slow deep breathing activates the calming parasympathetic nervous system. This might increase insulin sensitivity and, in people without type-1 diabetes, stimulate insulin production. The immediate result is lower blood sugar.

So, diabetes or not, these blood-sugar-balancing effects are pretty phenomenal. But if you have diabetes, the compounded benefits get even more impressive.

In one long-term study, type-2 diabetics who practiced slow deep breathing for 15 min twice a day for one year improved their HbA1c by as much as 2%.

To put that in perspective, every 1% reduction in HbA1c reduces the risk of heart attack by 14%, the risk of death by 21%, and the risk of microvascular complications by 37% in people with type-2 diabetes.

With results like these and no adverse side effects, slow breathing just seems like a no-brainer for helping manage blood sugars.

3. A Breathing Grab Bag

Here’s a hodgepodge of interesting articles to browse this week:

4. To Understand the Benefits of Breathing, Do This

“Understanding is not conceptual, and therefore cannot be passed on. It is an immediate experience, and immediate experience can only be talked about (very inadequately), never shared.”

- Aldous Huxley

My attempts to convey the benefits of breathing are “very inadequate,” at best.

I can share how breathing lowers blood sugar or increases HRV, which is fun and exciting stuff. But to understand it requires that you experience it.

So pick a method that resonates with you and go experience it for yourself. It’s too simple not to.

“We must always remember that knowledge of understanding is not the same thing as the understanding, which is the raw material of that knowledge.”

…

P.S. I found these passages in the Brain Pickings Sunday Newsletter.

 
 
 
 

1 Quote

“The lungs are a mysterious and even mystical organ. They are our connection to the atmosphere, the organ that extracts the life force we need to exist.”

- Michael J Stephen, MD, Breath Taking

 
 
 
 

1 Answer

Answer: Your “mysterious and even mystical” lungs breathe approximately this many gallons of air each day.

…

(Cue the Jeopardy! music.)

…

Question: What is 2,000?

In good breath,

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

P.S. Me this past Saturday

 
 
 

Sign Up For The Breathing 411

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

 
 

Breathing Gives Us What Babies Want, 0.1 Hz, and The Miracle of the Nose

 
 

Listen to this post:

 

Hey,

Here’s your weekly dose of breathing and diabetes fun. Plus, a letter I wrote 10 years ago…

I hope you enjoy reading!

 
 
 
 

4 Thoughts


1. Breathing Gives Us What Babies Want

In the Paradox of Choice, Barry Schwartz discusses a fascinating study:

  • Group 1: Infants were able to control some dancing toys by turning their heads in their cribs. It made them really happy to see the toys.

  • Group 2: Got “a free ride.” They saw the same toys, but theirs just randomly appeared when the Group 1 babies made them turn on.

The Group 2 babies still found this very entertaining, at least at first. But they eventually lost interest, whereas Group 1 didn’t:

“The different reactions of the two groups caused researchers to conclude that it is not dancing toy animals that are an endless source of delight for infants, but rather having control. Infants kept smiling and cooing at the display because they seem to know that they made it happen.”

I think this study demonstrates why breathing (especially Wim Hof) is so impactful. It taps into a desire that’s in us since birth—the desire for control.

Breathing gives it to us, immediately. We can instantly change our state, and we know we made it happen, not some external force. We become Group 1.

It’s like what Barry Schwartz says when interpreting those babies’ reactions:

“I did this, isn’t it great? And I can do it again whenever I want.”


2. The Upside of Diabetes

“When I was eleven years old, I was diagnosed with Type 1 diabetes. This taught me a lot of responsibility at a young age…I have to incorporate a lot of “thinking ahead” and problem solving into my daily routine…Furthermore, it has taught me to always be positive and to be grateful for every opportunity I have…Although I do not enjoy having diabetes, it has definitely had a positive impact on my life.”

I wrote that 10 years ago when I was applying for graduate school.

Fast forward to today, and it’s often depressing researching about breathing and diabetes. As excited as I get about breathing, I’m also continuously reminded of all the ways diabetes is ruining my health. Thanks, science.

But in reality, I’ve always felt that diabetes is the best thing to ever happen to me. And I still 100% agree with everything I said 10 years ago.

I’m not saying diabetes doesn’t suck. But, I try not to forget that it could be a lot worse and that it has had many positive impacts on my life.

So here’s to keeping a positive outlook, while simultaneously being realistic, knowing that we need to take extra good care of our bodies and health.

…

P.S. This was inspired by my recent re-reading of The Upside of Stress.

P.P.S. You can read the letter by clicking here.


3. How Slow, Deep Breathing Taps into A Natural Rhythm in Our Bodies

“Noble’s research demonstrates how tiny mechanisms throughout our cardiovascular system oscillate at that same frequency of 0.1 Hertz. ‘It’s almost like an inherent rhythm,’ he says. ‘Your breath may be unlocking this rhythm that you already have going on in the background.’”

- How Slow, Deep Breathing Taps Into A Natural Rhythm In Our Bodies

I read this article first thing in the morning with a cup of coffee. It was so good, I think I starting buzzing at 0.1 Hz : ) It’s just so awesome seeing “breathing” continue to seep into popular resources like Discover Magazine.

Read it, practice it, share it, and enjoy it. As they say in the article, “All you need is a pair of lungs, and some discipline.”

…

P.S. Another reason this was so much fun to read was because a 411 reader sent it to me. It’s my favorite thing in the world when you all send me such good stuff. Thanks, as always, “Midnight Larry!”

4. How To Get The Benefits of Breathing Without the Mastery

“Happily, the benefits of training in meditation arrive long before mastery does.”

- Sam Harris

The same is true for slow breathing. And it’s simple to get the benefits of breathing without mastery: Just get started.

I still suck at breathing. I’m continuously working on it. But I’ve seen incredible benefits because I practice every single day.

So don’t worry about perfection or mastery. Just get started. The best way to do that? Just four minutes a day—two in the morning, two before bed.

…

P.S. This was inspired by a +1 from my favorite teacher, Brian Johnson.

Related Quote: "How do you best move toward mastery? To put it simply, you practice diligently, but you practice primarily for the sake of the practice itself." - Robert Greene, Mastery


 
 
 
 

1 Quote

“The nose is the silent warrior: the gatekeeper of our bodies, pharmacist to our minds, and weather vane to our emotions.”

- James Nestor, Breath

 
 
 
 

1 Answer

Answer: In a blue whale, this organ weighs over 1,500 lbs.

…

(Cue the Jeopardy! music.)

…

Question: What is its heart?

I wonder what it’s resonant frequency is… : )

In good breath,

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

P.S. bet u just loooove school

 
 
 

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.

 
 

Slow Breathing Really Does Help Everything, According to a 2020 Study

 
 

Listen to this post:

 

Hey,

It’s a fun post this week. Lots of good info, plus one of the best real-life breathing videos you’ll ever see.

I hope you enjoy it!

 
 
 
 

4 Thoughts


1. Slow Breathing Really Does Help Everything, According to a 2020 Study

“The results of this review provide evidence that HRVB and PB at approximately six breaths per minute have positive effects on a variety of physical, behavioral, and cognitive conditions.”

- Heart Rate Variability Biofeedback Improves Emotional and Physical Health and Performance: A Systematic Review and Meta Analysis

Good news. I’m not crazy, which is how I often feel after every paper I read leads me to say that “slow breathing helps with just about everything.”

But, that’s also the conclusion of a recent 2020 meta-analysis.

They found that, like we discuss all the time, slow breathing won’t “cure” any one particular thing. But, it does help many different things in small ways:

“The overall effect sizes are modest but highly significant, suggesting that these methods may not be sufficient for treating any one problem but may be useful as a complementary intervention.”

Amen to that. And like you already know, when combined and compounded, these small improvements add up to overall better health.

To learn more, click here and read my short summary of the study.

Or better yet, don’t read it. Instead, spend those few minutes breathing slowly and experiencing the positive benefits for yourself : )

…

Related: Breathing is the Compound Interest of Health and Wellness

Related: Cardiovascular and Respiratory Effect of Yogic Slow Breathing in the Yoga Beginner: What Is the Best Approach?



2. Diabetes Really Does Hurt Everything, According to Our 2020 Life Experience

Just kidding. Well, kinda.

But I believe the meta-analysis above in thought #1 highlights why slow breathing can be so beneficial for diabetes.

As we know, when not properly managed, diabetes hurts just about every aspect of health and wellness:

  • Anxiety

  • Distress

  • Autonomic function

  • Emotional regulation

  • Cardiovascular function

  • And on & on

So, if slow breathing helps many of these, even modestly, they’re still going to add up to considerable benefits for our diabetes control.

Of course, it’s not a cure-all. But slow breathing is possibly the simplest, safest, and most effective thing we can do to address many diabetic problems.

…

Related: Diaphragmatic breathing improves antioxidant status & HbA1c in type 2 diabetics


3. Breathing Exercises for Kids: Everything Parents Need to Know

“The cure? Take a deep breath. That sounds like a useless platitude. It’s not.”

- Breathing Exercises for Kids: Everything Parents Need to Know

Wow, this was a surprisingly good article. Quick and easy, and full of good information. It did have one typo about CO2, but I’ll let it slide since they provided so many awesome breathing books I can now get my daughter : )

And since they also provided this excellent advice for our children, nieces and nephews, and really just everyone in general:

“You practice every day, you slow breathe every day, even when you’re not anxious, and then even though you become a little bit anxious, you have the bandwidth to not fall off the edge.”

- Dr. Umakanth Katwa,
Director, Sleep Laboratory at Boston Children’s Hospital
Professor at Harvard Medical School

Sounds good to me.

Enjoy the excellent read!

…

Related: Watch this in action.

This is perhaps the best real-world 21-second breathing video ever recorded.

4. Words Are Not Always Adequate, or Important

“Again, the likely explanation is that what is most easily put into words is not necessarily what is most important.”

- Barry Schwartz, The Paradox of Choice

This is certainly true for breathing.

Heart rate variability, autonomic function, blood pressure, blood flow, anxiety, distress. Slow breathing helps them all, and they all sound good.

But are they what’s truly most important?

I think that 21-second YouTube video above is what’s most important.

And I don’t have words for that.

 
 
 
 

1 Quote

“Adopt the pace of nature: her secret is patience.”

- Ralph Waldo Emerson

 
 
 
 

1 Answer

Answer: Over 1.1 million children and adolescents below the age of 20 have this chronic disease, increasing their likelihood of anxiety and depression.

…

(Cue the Jeopardy! music.)

…

Question: What is type-1 diabetes?

In good breath,

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

P.S. WELL WHAT TIME DOES HE GET OFF?

 
 
 

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.

 
 

Coherent Breathing, Diabetes, and How All Top Performers Use The Breath

 
 

Listen to this post:

 

Thanks for clicking on another issue of The Breathing 411.

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

 
 
 
 

4 Thoughts

1. Why We Should Practice Coherent Breathing, in just Two Sentences

“When oscillations of two or more systems are synchronised it increases physiological efficiency by enabling the functions of these systems to be coordinated. This prevents energy being wasted on non productive functions.”

- The Functions of Breathing and its Dysfunctions and Their Relationship to Breathing Therapy

Coherent (or resonant) breathing synchronizes different body systems, and I thought those two sentences perfectly summarized why it’s so important:

It improves efficiency and conserves energy.

To experience this yourself, you might think finding your particular resonant breathing rate requires special biofeedback equipment…and you’d be right. 

Fortunately, however, a 2006 study found that we get most of the benefits by simply breathing at 5-6 breaths per minute. Meaning you can get started right now without any fancy gear. It’s as simple as using a phone app.

Here’s to synchronizing our breathing for optimal efficiency today.

Related Quote: “Did it matter if we breathed at a rate of six or five seconds, or were a half second off? It did not, as long as the breaths were in the range of 5.5.” - James Nestor, Breath

P.S. The two apps I recommend are iBreathe and BreathWrk.

2. All Things Breathing and Diabetes

Patrick McKeown and I sat down a couple of months ago to talk about all things breathing and diabetes. It was a surreal experience to be chatting with the person who has taught me so much. We covered a lot of material from both personal and scientific perspectives.

Watch the full interview on YouTube here.

I hope you enjoy watching and listening.

Related Links:

3. Mick Fanning’s Breathwork is the Key to His Success

“Fanning’s performance coach, Nam Baldwin says breathwork is the foundation of mental and physical performance.”

- Mick Fanning’s scoliosis led him to breath work. Now, it’s key to his success

Aside from diabetes, one reason I became interested in breathing was surfing. So, when I saw this headline, I couldn’t wait to read it.

And it was better than expected. It was impossible to pick just one quote to share, so here’s another gem from Mick himself:

“You can change your moods, your thought patterns, just by concentrating on breath… and the better you breathe the better you perform.”

Enjoy the great read!

4. Maybe All Top Performers Focus on Their Breath?

And it’s not just Mick Fanning. In The Mindful Athlete, we learn that many top-performing teams and athletes use breathing as a critical component of their practice. They might not use “breathwork,” but they certainly make focusing on their breath a daily routine, especially before games:

“If they're mindful athletes, most of them are actually bringing their attention not to the game ahead, but to the present moment: fully concentrating on their breathing and, in doing so, centering themselves in that calm place where they are able to be in touch with the space between stimulus and response.”

- George Mumford, The Mindful Athlete

We’re all athletes in the game of life. (Having a chronic disease like diabetes makes each day like the Super Bowl.) We might not have personal trainers, nutritionists, or millions of dollars. But we all have the breath. And we all have access to the same control and awareness that these top performers do.

Let’s use it wisely.

 
 
 
 

1 Quote


“What do Mahatma Gandhi, the martial artist Bruce Lee, Buddhist meditators, Christian Monks, Hawaiian kahunas, and Russian Special Forces have in common? They all used breathing to enhance their physical, mental, and spiritual well-being.”

- Richard P. Brown & Patricia L. Gerbarg,
The Healing Power of the Breath

 
 
 
 

1 Answer

Answer: The cardiovascular system shows resonance at approximately this frequency.

…

(Cue the Jeopardy! music.)

…

Question: What is 0.1 Hz?

In good breath,

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

P.S. …and the money will come

 
 
 

Sign Up For The Breathing 411

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

 
 

Breathing Through Negative Feedback Loops, and the WHM in 2.5 Minutes

 
 

Listen to this post:

 

Welcome back to another issue of The Breathing 411.

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

 
 
 
 

4 Thoughts

1. The Epiphenomena of Breathing

“However, a lightbulb also produces heat. Heat is not the function of the lightbulb, nor is it the reason we originally fashioned it […] It is an unintended by-product of the operation, not the true function. Heat is an epiphenomenon in this case.”

- Matthew Walker, Why We Sleep

Depending on you and your perspective, breathing can have many epiphenomena. For example, you might do a breathing practice to relax. But, as a by-product, it will also improve autonomic and cardiovascular function.

Perhaps your breathing practice is for better sleep. In this case, you’ll still experience the epiphenomena of better insulin sensitivity and better focus.

In fact, optimal breathing has so many “epi-benefits,” it’s hard to keep track. Luckily, you don’t have to. You simply pick one or two reasons that make sense for you, and let the rest happen on its own, like heat from a lightbulb.

Related Quote: “Replace the habit of taking short shallow breaths into the top of the lungs with the practice of taking a full deep breath. Nearly all of the benefits begin with this one simple change.” - Al Lee, Don Campbell, Perfect Breathing

2. The Negative Feedback of Stress in Diabetes, and What We Can Do About It

  • Diabetes is a chronic stressor. [1]

  • Chronic stress worsens blood sugar control. [2]

  • It also reduces HRV, increasing susceptibility to more stress. [3]

  • This then can increase anxiety. [4]

  • Leading to more stress and worse blood sugar control. [2]

  • Which then leads to the subjective feeling of more stress. [1]

It’s a merciless cycle.

Encouragingly, however: “Emerging evidence strongly suggests…that interventions that help individuals prevent or cope with stress can have an important positive effect on quality of life and glycemic control.”

You probably know where this is going : )

Slow breathing immediately helps:

  • It reduces chronic stress by increasing vagal tone. [5]

  • It improves both short- and long-term HRV. [6]

  • It reduces anxiety. [7]

  • It improves blood sugar control. [8]

The negative feedback loop of stress and diabetes won’t just go away. But slow breathing gives you an effective intervention you can use to help offset its harmful effects and prevent it from getting out of control forever.

Related Quote: “Slow breathing could be a simple beneficial intervention in diabetes.” - Nature Scientific Reports

3. How The Wim Hof Method Works, In 2.5 Minutes

“So what happens when you breathe this way is you stress your body out. […] You control your stress to a specific amount of time so that, for the rest of the day, you can chill out. So that is probably why Wim Hof’s method works so well.”

- James Nestor

Tomorrow is Wim Hof’s birthday. In that spirit, here’s a quick 2.5 minute clip of James Nestor explaining how the WHM works.

Enjoy!

Related: 20 One-Sentence Thoughts on the Wim Hof Method

Related Quote: “I’m not afraid of death, I’m afraid not to have lived fully.” - Wim Hof

4. We Are All Living Nasal Breathers

“All living things on our planet undergo a unescapable and predictable daily change in their environment: Day becomes night. […] To cope with this predictable daily change in light and dark, almost every living organism has developed an internal timing system, or circadian clock.”

- Satchin Panda, PhD, The Circadian Code

In The Circadian Code, we learn that, try as we might, we cannot override our circadian rhythm. Evolution programmed it into us. Trying to fight it with more coffee (talking to myself here) will only hurt us in the long run. We’re much better off aligning with it to achieve our best health outcomes.

This reminded me of a seemingly unrelated, yet similar concept: we’re all nasal breathers.  We can optimize our diets, exercise, and so on, but if we don’t breathe how evolution designed us to—through our nose—we’ll never reach our full health potential.

Related: Chronic sinus inflammation appears to alter brain activity

Related Quote: “Around 1500 BCE, the Ebers Papyrus, one of the oldest medical texts ever discovered, offered a description of how nostrils were supposed to feed air to the heart and lungs, not the mouth.” - James Nestor, Breath

 
 
 
 

1 Quote

“The power of the breath has been used not just to heal, but to attain extraordinary feats that appear to defy laws of physiology. […] With mastery of his breath and his meditative practices, Hof is redefining what is considered physiologically possible for a human.”

- Michael J Stephen, MD, Breath Taking

 
 
 
 

1 Answer

Answer: Although known as the Ice Man, Wim Hof has also completed a full marathon without water in this desert.

…

(Cue the Jeopardy! music.)

…

Question: What is the Namib Desert?

P.S. Here’s short clip of him walking. He’s mainly nose-breathing, probably to conserve water : )

In good breath,

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

P.S. Do drugs and stay out of school

 
 
 

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 To Be a Straight-A Breathing Student, and Why Diabetics “Get It”

 
 

Listen to this post in 5 min 51 sec:

 

Yesterday was 4-11.

Yesterday was World Breathing Day.

Yesterday was also my birthday.

It’s almost as if it was meant to be this week…

Alright, here are 4 thoughts, 1 quote, and 1 answer for the week. Enjoy!

 
 
 
 

4 Thoughts

1. How To Be a Straight-A Breathing Student

One of my favorite stories is the “50 lbs = A” parable. I even kept a post-it of that phrase on my monitor during my post-doc. As it goes, a professor found that grading ceramics students based on quantity—50 lbs gets you an A—led to better quality than grading them on one “masterpiece.”

The moral of the story: Quantity leads to quality.

Quality is obviously essential to breathing. We do take more than 20,000 breaths per day, as it is. But, perhaps what’s more important is just starting and sticking to a consistent breathing practice.

So for breathing, we might say: Focused quantity leads to quality.

You might not begin with perfect diaphragmatic breathing, proper tongue placement, or proper volume. But with a consistent practice, you’ll naturally start noticing and improving these things.

So how about we write our own parable, where 50 breaths = A.

Or maybe just 5 breaths or 5 minutes. Regardless, it’s the focused, consistent quantity that counts. Here’s to becoming straight-A breathing students today.

Related: “If you want to master a habit, the key is to start with repetition, not perfection […] You just need to practice it.” - James Clear, Atomic Habits

2. Why the Power of Breathing is Actually Easy to Explain to People with Diabetes

Ask a diabetic what affects their blood sugar. They’ll either start laughing, or immediately blurt out “everything!”

So then, when you tell them that breathing literally impacts almost every bodily function, they’ll get it:

Everything affects my blood sugar. Breathing affects everything.

It just makes common sense for us diabetics to optimize it.

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

Related Quote: “Breathing isn’t everything. But, breathing impacts everything.” - David Bidler

3. This Breathing Exercise Can Calm You Down in a Few Minutes

“Many people find benefit, no one reports side effects, and it’s something that engages the patient in their recovery with actively doing something.”

- Cynthia Stonnington, Chair, Department of Psychiatry and Psychology, Mayo Clinic, Phoenix, AZ

Here is yet another excellent article from Vice: This Breathing Exercise Can Calm you Down in a Few Minutes. In it, we learn about the power of resonant breathing from Cynthia Stonnington (above) and gain invaluable insights from a pioneer in breath research, Patricia Gerbarg.

Enjoy the awesome read!

Related: Decrease stress by using your breath (Mayo Clinic)

4. The Universal Structure of the Respiratory System

“There is something transcendent in the very structure of our respiratory system…Other examples of this configuration in nature abound—streaks of lightning converging into a single bolt only to diverge again as they approach the ground;

the tributaries of a riverbed unifying into one main waterway; the human body itself, branching from its trunk to arms and legs, then fingers and toes.

The lungs tap into something universal in their structure, maximizing uptake of the life force that surrounds all of us.”

- Michael J Stephen, MD, Breath Taking

Here's another gem from Breath Taking's prologue, reminding us just how remarkable, yet universal, the structure of our respiratory system is.

 
 
 
 

1 Quote

“The daily use of breath practices can turn back the tide of stress, counteract disease progression, and improve overall quality of life.”

- Richard Brown & Patricia Gerbarg

The Healing Power of the Breath

 
 
 
 

1 Answer

Answer: For every tooth you lose as an adult, your risk of this increases by 2%.

…

(Cue the Jeopardy! music.)

…

Question: What is obstructive sleep apnea?

(I learned this in Breath)

In good breath,

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

P.S. 100% me. (Looking at you Wibbs)

 
 
 

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.

 
 

A Danger of Breathwalking, and How I Almost Stepped on It

 
 

Listen to this post in 6 min 28 sec:

 

Welcome to another issue of The Breathing 411,

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

There’s also a fun bonus thought on the “Dangers of Breathwalking.”

I hope you enjoy it!

 
 
 
 

4 Thoughts

1. The Lungs Lead, Heart and Mind Follow

“This knowledge is spreading back to the West through disciplines such as yoga and mindfulness, but also through techniques aimed at improving endurance, and even intimacy. These practices demonstrate that the mind and the heart follow the lungs, not the other way around.”

- Michael J. Stephenson, MD from Breath Taking

Study after study has shown that breathing gives you access and control over your heart and mind, in ways such as increasing heart rate variability and synchronizing brain waves. That is, the lungs lead, the heart and mind follow.

But even with all this research, sometimes it takes an eloquent quote from a respected pulmonologist to make it seem so obvious.

Related: HBR: Why Breathing Is So Effective at Reducing Stress

Related Quote: “The obvious is that which is never seen until someone expresses it simply.” -Kahlil Gibran

2. Why Slow Nasal Breathing Could Be More Important in Type-2 Diabetes

Both type-1 and type-2 diabetes benefit from slow nasal breathing.

However, it could be more beneficial in type-2 diabetes since the primary issues there are reduced insulin production and reduced insulin sensitivity.

And it just so happens that slow breathing increases insulin production and improves insulin sensitivity. But maybe most importantly, nasal breathing helps you sleep better, which will indirectly boost insulin sensitivity.

Obviously, slow breathing isn’t going to cure you of type-2. But it’s safe, effective, and super practical. It seems like a no-brainer.

P.S. For T1Ds like me, all these things are still very helpful. We just won’t get the added benefit of increased insulin production…stupid pancreas…

3. How to Improve Concentration Using Your Breath

“by focusing on and regulating your breathing you can optimize your attention level and likewise, by focusing on your attention level, your breathing becomes more synchronized.”

- How to Improve Concentration Using Your Breath

In this great short article, you’ll learn that to improve your concentration, “It’s as simple as breathing through your nose.”

You’ll also get some excellent quotes from James Nestor and the director of the Yale Stress Center. Well worth the quick read. Enjoy!

Related: The nose knows: How breathing through your nose improves your health (This was linked in the Thrive article—it’s an excellent deep dive into the benefits of nose breathing, mainly from clinical doctors. I absolutely loved it. I just didn’t agree with the very last sentence.)

4. John Wayne’s Perfect Breathing Advice (almost)

“Talk low, talk slow, and don't talk too much.”

- John Wayne, Advice on acting

If we replace “talk” with “breathe,” we arrive at the perfect breathing advice:

Breathe low, breathe slow, and don’t breathe too much.

Extra Thought: The “Dangers” of Breathwalking

I’ve become somewhat obsessed with breathwalking. I use it in short 1-3 min intervals several times a day. It’s phenomenal. Thanks again, Louise!

Last Tuesday, I was walking around my backyard, completely focused on my breath. Then, I came about this close 🤏 to stepping on a snake. The snake had its head up, ready to bite. And here I am, Mr. Breathwalker, completely oblivious…lol.

Luckily, I managed to jump over it (maybe letting out a quick scream) and immediately starting laughing at the irony of the situation.

Focusing on your breath most certainly improves your concentration. But in the comfort of your backyard, that concentration might backfire!

Related: Thanks to M.C. for sharing this excellent 4.5 min video:

Breathwalking With Dr. Jim Nicolai | Andrew Weil, M.D.

 
 
 
 

1 Quote

“Few of these scientists set out to study breathing. But, somehow, in some way, breathing kept finding them.”

- James Nestor, Breath

 
 
 
 

1 Answer

Answer: In 2018, it was estimated that this percentage of the U.S. adult population had diabetes.

…

(Cue the Jeopardy! music.)

…

Question: What is 13%? (and 90-95% of those cases are type-2)

In good breath,

Nick Heath, T1D, PhD
Diabetes is Tiny. Breathing is Mighty.

P.S. Easter family get together

 
 

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…