dysfunction — Blog — The Breathing Diabetic

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.

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.

Since we cannot know all that there is to be known about anything, we ought to know a little about everything.” - Blaise Pascal

People with diabetes are at an increased risk of cardiovascular and autonomic problems. Diabetics also display altered respiratory control, for example, showing depressed (or enhanced) chemoreflexes.

However, previous studies have never examined these two aspects in an integrated fashion.

Integration Over Isolation

The problem with separately studying these systems is that the results might not be independent. For example, if a study shows that diabetics have decreased respiratory control, it might conclude that this is from diabetic nerve damage.

Likewise, if a study shows that cardiovascular function is depressed, it might also conclude that this is due to diabetic nerve damage.

However, if we study them together, we might find that there is a reciprocal relationship. Maybe the respiratory problems are causing cardiovascular issues? Perhaps it’s the other way around?

This study takes that approach and has some pretty remarkable conclusions.

Integrated cardiovascular/respiratory control in type 1 diabetes evidences functional imbalance: Possible role of hypoxia

(Click Here to Read Full Summary — I don’t say this often, but please read this one if you have diabetes)

Published in the International Journal of Cardiology, 2017.

In forty-six type-1 diabetics and 103 age-matched controls, they measured baroreflex sensitivity (BRS) as a marker of cardiovascular function and chemoreflexes as a marker of respiratory control.

Chemoreflexes estimate how sensitive you are to increasing CO2 (hypercapnic chemoreflex) and decreasing O2 (hypoxic chemoreflex).

The Hypothesis: If BRS and chemoreflexes are reduced, this would suggest diabetic nerve damage. However, if some are reduced while others are elevated, this reciprocal relationship might be showing autonomic dysfunction instead of diabetic nerve damage.

This is such an important distinction. “Damage” implies that the damage is done. “Dysfunction” implies that we could make it functional again.

Diabetics Have Worsened Cardiovascular and Respiratory Control

The results showed that subjects with diabetes had a lower BRS than the controls. They also had a suppressed hypoxic chemoreflex. However, they had an elevated hypercapnic chemoreflex. (Remember their hypothesis: if it was nerve damage, both of these chemoreflexes would be reduced.)

Interestingly, the diabetics also showed a lower oxygen saturation. And, they also had relatively high HbA1c’s (an average of 8.19%). A high HbA1c will decrease oxygen delivery to the tissues and cells.

Tissue Hypoxia is at the Root of Diabetic Complications

The reduced oxygen saturation and high HbA1c suggest a resting state of tissue hypoxia in diabetes. Over time, we become “numb” to this, which explains the decreased hypoxic chemoreflex.

The body compensates with an up-regulated hypercapnic chemoreflex, which leads to chronic activation of the sympathetic nervous system (fight or flight). Chronic sympathetic activation then suppresses our cardiovascular control.

It’s a vicious cycle with negative long-term implications:

Dysfunction, not Damage: A Silver Lining

“We show in the present study that what is normally called ‘autonomic neuropathy’ could be in many cases a functional condition of sympathetic activation, driven by many factors, one of which seems to be resting hypoxia.”

This is all actually good news. Their results suggest that diabetic autonomic imbalance is mainly functional and not related to nerve damage. In fact, the authors suggest that this imbalance likely leads to nerve damage, rather than being the result of it. Therefore, therapies targeting cardio-respiratory control could help reverse/prevent diabetic complications if caught early enough.

Break Out Your Slow Breathing Hammer

What are these therapies? One is slow breathing. Slow breathing will immediately improve cardiovascular and respiratory reflexes. It will also enhance oxygenation (when breathing through the nose).

I hate sounding like all I have is a “slow breathing hammer,” but it is just too important not to stress over and over again.

Here’s to taking the first step toward protecting our long-term health as diabetics.