energy

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When Laughter Occurs, Choosing Joy, and a New Favorite Passage

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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 19 sec

I hope the next 35ish breaths are the most nourishing of your day.


4 THOUGHTS

1. This May Be My New Favorite Passage on Mindfulness

“Cultivating mindfulness is a way to pour energy in the form of attention, awareness, and acceptance into what is already right with you, what is already whole, as a complement to, not a substitute for, whatever help and support and treatments you may be receiving or need—if you need any at all—and see what happens.”

- Jon Kabat-Zinn, Ph.D., The Healing Power of Mindfulness

I could read that all day. And I can think of no better motivation for practicing mindfulness than that passage 👏

2. When Laughter Occurs…

“When laughter occurs, respiratory exchange processes are enhanced, blood pressure is reduced, and the body produces endorphins which act not only as mood enhancers, but also as a natural pain killer. Psychological enhancements include reduced anxiety and stress as well as increased self-esteem and self-efficacy”

- Brett Bartholomew, Conscious Coaching

Just a reminder to laugh a little bit today…it’s the most therapeutic breathing exercise : )

3. How Breathing Impacts Whole-Body Energy

“The nose, trachea (windpipe), lungs, circulatory system, and their attendant muscles all act to transport or modify oxygen from the surrounding air to make it readily available to individual cells. Each of these organs plays a crucial role in determining oxygen supply, and therefore energy availability, to cells at various levels within the body. Consequently, a change in functioning in any one of these systems could potentially alter the course of energy production within the entire body.”

- Alan Hymes, MD, Science of Breath

Sometimes, it seems crazy that breathing can have such a profound influence on our bodies and minds. Then, you read a passage like this from an MD and realize it’s not so crazy after all.

Because our breathing determines oxygen supply (and therefore energy availability), any change we make “could potentially alter the course of energy production within the entire body.” 👏

4. Choose Joy to Make It Effortless

“Almost anything can be made pleasurable if we don’t tell ourselves we have to do it. When we make it fun, trying becomes unnecessary. Consider how odd it sounds to try to eat something you like eating or do something you like doing. ... If we enjoy doing something, it will feel effortless. When we’re mindfully engaged, we don’t notice the presence or absence of effort.”

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

This is a nice reminder that if we find a way to make our breathing/mindfulness/(whichever wellness practice you do) more enjoyable, it will become effortless. And if it’s effortless & enjoyable, we’ll be more consistent, and we’ll get much more out of it.

Deal of the Week: ResBiotic

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If you’re looking for an effective and simple way to support gut and lung health, check them out. They're offering 411 readers 15% off with the code BREATH411 at checkout.

Let me know what you think if you try it out!

1 Quote

“You didn’t come into this world. You came out of it, like a wave from the ocean. You are not a stranger here.””
— Alan Watts

1 Answer

Category: Oxygen Transport

Answer: Approximately this percentage of total oxygen transported in the blood is carried by hemoglobin, with the remaining dissolved directly in the plasma.

…

(Cue the Jeopardy! music.)

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Question: What is 98%?


1 Spots Left

I have 1 spots left in October for my 8-week program for overcoming stressful life setbacks. Email nick@thebreathingdiabetic.com with subject line “breath” to learn more.

In good breath,

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


P.S. hey sorry i overreacted

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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Diverse Tactics (part 2), Less Relaxation, and How to Feel Confident

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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 😊

 

4 Thoughts



1. Less Relaxation, More Self-Regulation

“Many people believe that biofeedback is a way to learn to relax. While it is true that you can learn to relax using biofeedback, relaxation is not the main goal. The main goal is self-regulation, which means being able to activate your nervous system most optimally for action and being able to relax and recover after the action is complete.”

- Inna Khazan, Ph.D.

Biofeedback and Mindfulness in Everyday Life

The same is true for breathing without biofeedback. Of course, there are methods for relaxing (those are some of my favorites).

But, we’re ultimately learning to regulate our nervous systems so they work optimally for action, for real life. Then, we relax and recover afterward : )

2. “Rule 1: The actions of confidence come first; the feelings of confidence come later.”

“This is a key point. If we want to do anything with confidence—speak, paint, make love, play tennis, or socialize—then we have to do the work. We have to practice the necessary skills over and over, until they come naturally. If we don’t have adequate skills to do the things we want to do, we can’t expect to feel confident.”

- Dr. Russ Harris, The Confidence Gap

And if we want to feel confident we can breathe to self-regulate in any situation, we have to practice these skills over and over. Until they come naturally.

We could say: The action of breathing comes first; the good feelings and self-regulation come later.

***

P.S. We can also apply this concept to being consistent. There are plenty of days when I don’t feel like doing my breathing practice (yes, even The Breathing Diabetic has days where he doesn’t want to breathe 😂). But, I always just start. The action comes first; the motivation comes later.

3. Diverse Tactics Part 2: Breathing Hammers and Nails

“The integration of a wide variety of perspectives is necessary for a more complete understanding of the full depths of human potential, as too much focus on a single perspective runs the risk of giving a distorted view of human nature. As Maslow said, ‘I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.’”

- Scott Barry Kaufman, Ph.D., Transcend

Building off last week, here’s another excellent reminder that we need a wide range of methods, in breathing and life, to become the best version of ourselves.

But specifically for the breath, if we only have one breathing hammer, we’ll assume every problem is a nail. Let’s be mixed-breathing artists instead : )

4. Our Lungs and the Possibilities of the World

“Our lungs developed to utilize oxygen and efficiently drive our metabolic reactions. We are aerobic creatures, and if the lungs are our most important organ, then oxygen is the most important gas in the atmosphere. […] With oxygen, the possibilities of the world opened up.”

- Michael J Stephen, MD, Breath Taking

Just an elegant reminder of how vital our lungs and oxygen are—they literally open the possibilities of the world to us 🙏


1 QUOTE

“The lung changes the breath…into food for the vital spirit.”

- Alessandro Benedetti (1497)

1 ANSWER

Category: Energy Production

Answer: Oxygen is vital because of its ability to generate ~18x more of these “energy molecules” than anaerobic fermentation.

…

(Cue the Jeopardy! music.)

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Question: What are adenosine triphosphate (ATP) molecules?

In good breath,

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

P.S how self-help authors get ideas for their next book

 
 

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

Sign Up For The Breathing 411

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

 
 

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.

 
 

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

 

As a person with type 1 diabetes, my experience with nasal breathing has been nothing short of miraculous.  It's been such a simple change, yet its impacts on my energy and blood sugars have been profound. I feel it would be irresponsible not to share it with other people with diabetes.

Luckily, people much brighter than me have become fascinated by the nose too.  Whole books have now been written on the topic.  It has been featured in popular sources such as Outside Magazine and the Cleveland Clinic.  An article published in Frontiers in Human Neuroscience even concluded that “nasal stimulation represents the fundamental link between slow breathing techniques, brain and autonomic activities and psychological/behavioral outputs.”

But after several years of research, I have come to realize that the reasons nose breathing is so helpful for diabetes go far beyond the “obvious ones.” 

Of course, the usual suspects are essential, such as the warming and humidifying of the incoming air and the natural slowing of the breath.  But to fully understand the benefits for diabetes requires a synthesis of research from different fields, such as diabetic complications, the metabolites of nitric oxide, chronic stress, and sleep.

Let’s start with diabetic complications.

Oxidative Stress and Inflammation Reduce Blood Flow

Over time, the oxidative stress and chronic inflammation associated with diabetes can damage blood vessels, resulting in poor circulation. 

Less blood flow means that less oxygen reaches the cells, tissues, and organs. 

As a result of this poor circulation (and other complications), people with diabetes have an increased incidence of retinopathy, kidney disease, and foot problems.

Nose breathing—specifically inhaling through the nose—immediately helps with this.  For example, one small study showed that just five minutes of inhaling through the nose and exhaling through the mouth increased tissue oxygenation by 10%.  This increase was due to nitric oxide.

Nitric oxide is continuously produced in the paranasal sinuses.  When you breathe in through your nose, nitric oxide is carried into the lungs, where it opens up the blood vessels and improves blood flow in the lungs.  This results in better gas exchange and better blood oxygenation.

But that’s only the beginning of NO’s benefits.

How Nitric Oxide Helps with Blood Flow and Oxygenation

Typically, the nitric oxide produced in your nose is treated separately from the nitric oxide produced throughout the rest of your body.  Although it is known that that inhaling nitric oxide has effects outside of the lungs, scientists have not known how. Researchers at the Cleveland Clinic have recently shed light on the issue.

In a 2019 study, they did something simple yet meaningful.  The researchers had participants inhale extra nitric oxide, and they measured what happened in the blood afterward.  If nitric oxide’s journey ended in the lungs, they wouldn’t see any signs of it in distant blood samples.

The results showed the opposite. 

They found that inhaling nitric oxide significantly increased circulating levels of a specific form of the molecule, SNO-Hb.  These findings matter because, in a separate study published in PNAS in 2015, a different group of researchers found that SNO-Hb played an essential role in whole-body oxygenation.  Without it, mice received less blood flow to the heart and even had smaller litter sizes.

Why This is Important to Diabetes

The complications of diabetes also impact nitric oxide.  Sustained high blood sugars alter how hemoglobin stores nitric oxide. 

The end result is that people with diabetes generally have less SNO-Hb. 

And, as we just learned, SNO-Hb is critical to blood flow and tissue oxygenation. 

So, putting it all together:

  • People with diabetes suffer from poor circulation and insufficient oxygen.

  • Our noses are a source of nitric oxide—breathing through our nose utilizes it.

  • Inhaling nitric oxide increases an essential form of NO called SNO-Hb.

  • SNO-Hb is critical to improving blood flow and increasing whole-body oxygenation.

Therefore, nose breathing could be especially helpful in diabetes by maintaining normal SNO-Hb levels and hence helping improve blood flow and oxygenation throughout the body.*  Mouth breathing would not provide these benefits.

How High Blood Sugars Reduce Oxygen Delivery

In addition to altering how nitric oxide is stored, high blood sugar also modifies the relationship between oxygen and hemoglobin.  Specifically, it tightens the bond between them.

As a result, less oxygen can be delivered to the places it is needed.  (For the breathing nerds out there, it causes a left shift in the oxyhemoglobin dissociation curve.)  This problem might be further exacerbated by stress.

Chronic Stress and Carbon Dioxide Alter Oxygen Availability

Diabetes also causes chronic stress—a less intense but sustained fight or flight stress response.  This stress causes people with diabetes to have anywhere from 14% to 20% more cases of anxiety than those without it.  Moreover, it has been reported that up to 40% of the diabetic population show symptoms of anxiety.  A 2013 meta-analysis, including over 12,000 people with diabetes, also found significant associations between diabetes and an increased probability of anxiety disorder or anxiety symptoms.

Chronic stress and anxiety, such as that experienced in diabetes, are often associated with overbreathing.  Overbreathing, or hyperventilation, simply refers to breathing more than your metabolic demands at any given moment, and is often associated with mouth breathing. Consequently, the body gets rid of too much carbon dioxide, which alters the pH of the blood.

This has a similar effect on oxygen and hemoglobin as high blood sugar. 

That is, it tightens the bond between them, reducing the amount of oxygen that can be delivered to the cells and tissues (this is known as the Bohr effect).

Together, we see that the high blood sugar and chronic stress associated with diabetes combine to reduce oxygen availability to the cells and tissues.

When we switch to nose breathing, the volume of each breath is naturally reduced.  This helps normalize carbon dioxide levels and restore blood pH to normal levels, which will improve oxygen delivery.** 

Combining this with the earlier discussion on nitric oxide, we see how this one simple change (nose breathing) helps offset some diabetic complications.

Nose Breathing, Sleep, and Diabetes: The Missing Link to Better Blood Sugar Control

If we breathe nasally during sleep, all of the benefits of nose breathing continue throughout the night. Of all the things nose breathing helps with, this might be the most critical for diabetes.

We have already discussed that diabetes causes chronic stress, which can lead to more rapid breathing.  Nose breathing helps naturally slow down the breath.  This will help you shift from a stressful sympathetic state to a calming parasympathetic state.  This shift is significant for people with diabetes who exhibit less parasympathetic tone at night than non-diabetics.  Thus, nasal breathing at night helps us increase parasympathetic tone and enjoy better sleep.

Receptors in your nose also act to maintain rhythmic breathing during sleep.  This might help explain why nose breathing reduces the risk of obstructive sleep apnea when compared to mouth breathing.  Diabetes is associated with a significantly increased risk of obstructive sleep apnea. So, if nasal breathing at night can help reduce this risk, it could be especially beneficial.

Lastly, we know that inadequate sleep causes insulin resistance.  By getting deeper, more restorative sleep, insulin sensitivity can be improved.  This could potentially lead to better morning blood sugars (that was my experience), setting you up for a better day of glucose control.

The More Subjective but Most Important Benefit of Nasal Breathing for Diabetes

Altogether, nasal breathing increases blood flow, improves tissue oxygenation, and appears to increase an essential form of bioactive nitric oxide that people with diabetes have less of.  It also improves sleep quality by helping us flip to a more calming state and by reducing the incidence of sleep apnea.  This can help improve insulin sensitivity.

When we combine all of these together, nasal breathing's net benefit can be simply stated as:

It gives you more energy. 

And it’s harder to objectively measure, but perhaps the best aspect of increased energy levels is more motivation to take care of your blood sugars. 

Diabetes is an exhausting full-time job that can lead to physical and emotional burnout.  Having more energy and enthusiasm to manage the disease could be the most valuable aspect of something as simple as breathing through your nose.

Footnotes:

*The levels of NO inhaled in the 2019 Cleveland Clinic study were greater than those produced in the nose.  But, the study validated that there is a mechanism by which NO that is introduced into the lungs can be transported throughout the body as SNO-Hb.  Thus, nasal breathing would only act to bring SNO-Hb up to normal physiological levels, whereas mouth breathing would rob the body of this important physiological process.

**This discussion is centered around the regular blood sugar fluctuations associated with diabetes and not diabetic ketoacidosis.

 
 

The Breathing 411 - Understand This, and You Will Understand Breathing

 

Happy Monday. I hope you enjoy this edition with a cup of coffee : )

Enjoy 4 thoughts, 1 quote, and 1 answer (like "Jeopardy") related to breathing.

 
 
 
 

4 THOUGHTS

1. Understand This, and You Will Understand Breathing

Breathing information is often contradictory:

  • Wim Hof tells you to breathe more oxygen.
    Patrick McKeown tells you to breathe less.

  • Oxygen is your body’s most important energy source.
    But the exhale is the most important part of the breath.

  • You need to teach yourself to tolerate higher levels of carbon dioxide.
    Carbon dioxide also causes fear in people who literally can’t feel fear.

  • Lung capacity determines longevity.
    But you also shouldn’t take big breaths.

  • And on & on

To understand breathing, you must accept that all of these are right, and all of them are wrong. It depends on the circumstance.

Despite its simplicity, breathing is one of the most complex functions in the human body. Blanket statements on "right or wrong" simply cannot be made without context. We must embrace the contradictions.

2. Should You Be Breathing Even Slower?

A study published in 2006 found that resonance frequency was inversely correlated with height. That is, the taller you are, the slower you need to breathe to synchronize your heart rate, breathing rate, and autonomic nervous system.

In their excellent book, The Healing Power of the Breath, Richard Brown and Patricia Gerbarg give this specific recommendation: "For people who are over six feet tall, the ideal resonant rate is three to three and a half breaths per minute."

So, if you’re over six feet tall, you might find that breathing slower than the typical recommendation of 5-6 breaths per minute works better for you. I fall into that category, and I’ve found 3 - 3.5 breaths per minute (currently 7 sec inhale, 11 sec exhale) to be my sweet spot.

3. What is Hyperventilation?

"Respiratory alkalosis is caused by hyperventilation or a respiratory rate in excess of that needed to maintain normal PCO2." - Essentials of Pathophysiology, pg. 205

"Hyperventilation is a term that describes breathing beyond that which is required to meet the metabolic needs of the body as reflected in the production of carbon dioxide." - Respiratory Physiology, pg. 128

Here are two different textbook definitions of hyperventilation. It’s actually pretty straightforward. And, as you can see, it doesn’t involve huffing and puffing. Thus, we can hyperventilate without even knowing it.

Two easy ways to check if you are overbreathing are the BOLT score and the CO2 Tolerance Test.

Two easy ways to fix it are to breathe through your nose and make your breathing quiet while at rest.

Thanks to 411 reader W.H. for inspiring this thought.

4. Is Breathing Woo-Woo?

It fascinates me that breathing, your body’s most important function, has kind of a "woo-woo" reputation. It shouldn’t. There is a mountain of scientific evidence showing its efficacy for health and wellness. For example, I have reviewed over 80 scientific papers, and HHPF seems to post a new one every day.

But you actually don’t need any of the science. Here is the quickest way to determine for yourself:

Hold your breath.

I think you will agree "breathing" isn’t woo-woo after only a few seconds.

Thanks to fellow breathing nerd R. vdC. for inspiring this thought.

 
 
 
 

1 QUOTE

"The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function."

- F. Scott Fitzgerald

 
 
 
 

1 ANSWER

Answer: The estimated prevalence of this condition is about 23% in women and 50% in men.

…

(Cue the Jeopardy music.)

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Question: What is sleep-disordered breathing?