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Hey, folks, it's Ben Greenfield. And it's no secret that I'm somewhat obsessed with breathing. Not just to stay alive, but to actually make my body a lot better. I mean, in the past years I've written articles and everything from like combining ketosis and breath holds and free diving to how to make your own hyperbaric exercise with oxygen therapy device, to, you know, interviews with guys like Wim Hof for, you know, how to use breath for cold thermogenesis. And I've interviewed Laird Hamilton about his underwater breath hold workouts. I've talked about getting yourself high drug free with holotropic breathwork. I've talked about the use of fancy breath strips and these devices called like turbine devices to enhance nasal breathing. Plenty, plenty of previous episodes and previous articles that I've written and produced about breathing. And if you go to BenGreenfieldFitness.com OxygenAdvantage BenGreenfieldFitness.com OXYgenAdvantage I will link to all that previous content if you just want to geek out on breath and oxygen. However, there is a guy who I've been wanting to get on the show for a long time because his book is one of the best books on breathwork. And I finally managed to wrangle him onto the show. His name is Patrick McCown and he wrote this book called the Oxygen Advantage. And the things that he talks about in this book, everything from this test called the Bolt test, to why over breathing might be a bigger issue than under breathing, to the link between breathing and weight gain, to how to mess around with things like pulse oximeters. I mean, he's got all sorts of information that I haven't had a chance to talk about before on the show, believe it or not. And so I've got him here with me and I'm going to pick his brain about this book, the Oxygen Advantage, because I have plenty of questions that I think you guys are really going to benefit from. Who is Patrick? Well, he did his clinical training with something called the Buteyko breathing method in Moscow, Russia. And since then he spent the past 15 years working with tens of thousands of people around the world on everything from breathing pattern disorders to sleep disordered breathing to anxiety to performance breath work. And he works with some of the top athletes in the world now on their breath, like tennis players and cyclists and professional football players, MMA athletes, track and field athletes. So he's kind of like one of the go to guys in the world when it comes to breathwork and performance and breath work and health. And again, I'll link to him all of his books because he actually has eight books about breathwork, not just one. Although the one we're talking about today is called the Oxygen Advantage. So go to BenGreenfieldFitness.com OxygenAdvantage to get in on all that goodness. Patrick, welcome to the show, man.

Thanks so much, Ben. That's great. Great introduction.

Oh, thank you. I practiced many times in the mirror. In the mirror with my tank top on, flexing, showing my guns. It's what I do. Anyways, though, in your book, Patrick, one of the first things that really caused me to raise an eyebrow and realize you were going to talk about some unique things I hadn't heard about before was you talk about this thing that you call chronic overbreathing. Now, everybody you talk to, they talk about sleep apnea and not breathing enough. And you hear about people saying how you shouldn't shallow chest breathe when you're at work and always take deep belly breaths. But you say chronic over breathing is actually a big health problem. Can you explain why that is?

Sure. It would be characterized as a breathing pattern disorder. For about 20 years, I had chronic rhinitis, so my nose was blocked and as a result, I was breathing through an open mouth and I had asthma. And I was told that I was stopping my breath during my sleep and I was constantly tired, I was stressed, and that would have been a habit of chronically over breathing. In other words, breathing a volume of air that's greater than metabolic requirements than what we need. Because as human beings, we have to realize that we survive on food, water and air and the amount of food that we eat every Day must meet certain parameters and the amount of water that we drink, of course we can drink too little, we're dehydrated, but we can also drink too much. And that's often evident in marten runners, for example. But nobody talks about how much air should we breathe. And there's this myth that's often espoused and it's very commonly talked about. You know, if you're in a western yoga studio or Pilates or even stress counselors or. I hear it on the radio a lot. I hear it in magazine, I see read in magazines. Take a deep breath. Take a big breath. That this belief that if we take more air into our body that it's going to add more oxygen to the blood. And that's not true.

Because how is good breathing?

It's not true that if you take a big breath, you're going to get more oxygen into your blood and more oxygen to your tissues.

Yes, correct. Okay, so by breathing more. Because normal breathing, during normal breathing, when you're breathing is light and through the nose, driven by the diaphragm. So in the true sense of the word, we do encourage deep breathing. A deep breath just means that we're using the diaphragm. And if you breathe through your nose, you'll tend to use the diaphragm more than if you breathe through the mouth. For example, any of your listeners can demonstrate that all you have to do is look down at their chest, take a breath in through the mouth, and they'll see that it's the chest that will rise and fall. So it's a thoracic breath. And that would be a shallow breath.

Breathing through the nose called a thoracic breath.

A thoracic breath, because you're using the upper part of the thorax, you're using the upper chest. And it's not a very efficient way of breathing. And many people have developed that habit because mouth breathing is very, very common, even in children studied children. It shows that up to 50% of children studied are persistent mouth breathers. And it is a huge knock on effect on the development of a child, which is probably a different topic from what we're talking about. But when we breathe through the nose, we pick up a gas called nitric oxide that's released from the paranasal sinuses and we bring that nitric oxide into the lungs. Nitric oxide sterilizes the incoming air, it opens the airways, so it's a bronchodilator, but it also assists in what's called ventilation, perfusion. As human Beings, because we're sitting upright or we're standing. Most of the concentration of blood in the lungs is in the lower lobes of the lungs. But a lot of us are ventilating, our breathing is in the upper lobes. So there's a mismatch there. So when you breathe through your nose, you'll tend to activate the diaphragm. So you bring the air from the upper part of the lungs to the lower. But when you carry nitric oxide in the incoming air into the lungs, nitric oxide brings the blood from the lower parts of the lobes to the upper. So ventilation perfusion improves by virtue of nasal breathing. And this is why some theorists have suggested that, and I've seen it in a number of papers, between 5 and 15% improved oxygen uptake in the blood. True nose breathing through nose breathing.

Now you, you said, also you said something interesting. I believe you said that nitric oxide can sterilize the air when you breathe through nose. So does that mean, like, if, let's say I'm waiting like on that little Runway that you walk down the, the ramp to get onto an airplane where everybody's, you know, like farting and there's germs all over the carpet or like in the airplane itself or wherever, you're saying like, if I breathe through my nose, I'm actually going to sterilize that air like a, like a built in filter? In a way, yes.

Most of the people I would have worked with in the first 10 years would have been people with asthma, people with chronic colds, chest infections. And we've seen quite significant improvements to the instance of colds and chest infections through their breath.

It's interesting because you talk about the benefits of nasal breathing and it makes sense. I know you talk in the book not just about the nitric oxide release, but how about it warms and humidifies the incoming air, so when the air reaches your lungs, it's at a more, I guess, like biologically appropriate temperature. But you know, when I asked you this question I was asking about over breathing, can't you over breathe through your nose just as easily as you could over breathe through your mouth?

Yes, you can. It's very easy to measure somebody's blood oxygen saturation. You can buy a pulse oximeter. We use a brand, it's an American brand. You picked them up for about 90 to $100. We use one called Nonon, and it's a little finger probe you put on your finger and it'll tell you that your blood oxygen saturation is generally between 95 and 99%. If you start breathing more, you're not going to add any more oxygen to the blood. If the blood is already almost fully saturated, you can't add any more oxygen. It's like a glass of water that's full. If you keep pouring water into it, well, you're not going to add any more water into the glass.

So you couldn't, you couldn't go from like 97 to 98 by doing a whole bunch of like, like deep, no, like, don't believe so nasal breaths.

Because the problem there is by taking the deep breaths or the big breaths, you offload CO2 and carbon dioxide. It's not just a waste gas. People often talk about it bring in as much oxygen as possible and get rid of as much CO2. But the release of oxygen from the red blood cells is dependent on the presence of carbon dioxide. So if you are breathing hard, such as taking big breaths, well, you're going to offload CO2. So the bond between the red blood cells and oxygen is going to strengthen. But another role of carbon dioxide.

So basically the red blood cell is not going to release oxygen as readily as it normally would if I'm taking these great big breaths.

Exactly. The amount of oxygen delivered to the tissues is reduced when we breathe more than what we should do.

Okay, got it.

Not only that, but our blood vessels are the smooth muscle embedded in the blood vessels. And carbon dioxide is a relaxant of the smooth muscle. So if we're breathing hard again, the smooth muscle surrounding in the blood vessels is going to constrict. So our blood circulation can be impaired by breathing hard. So when people talk about cold hands, warm heart, it's not correct. Cold hands, you're breathing too much brain fog even, you know, like the amount of oxygen delivery and blood flow to the brain can reduce by between 25 to 50% from taking big breaths. That's why sometimes people feel dizzy. You know, if you tell them to take five or ten big breaths to start feeling lightheaded, that's not because of a super oxygenation, that's the opposite effect is happening.

So if you blow off too much carbon dioxide because you're breathing too heavily, whether you're breathing through your nose or through your mouth, if you're just like breathing too heavily, then that would put your body into, and correct me if I'm wrong here, a more alkaline state, wouldn't it? By breathing off CO2.

Yes, correct in the short term, but want to bring the ph back towards 7.365. So what it does is that the kidneys will dump bicarbonate and in that instance then PH will be normal, but you're going to have reduced buffering capacity, you will have reduced bicarbonate and reduced carbon dioxide. So now you're stuck in a more chronic state of hyperventilation. So short term over breathing, like it wouldn't really cause all that much harm in fairness, you know, if you're doing it for one or two minutes, it wouldn't do any harm.

Right.

It could stimulate the immune system.

You mean if you're, if you're doing like a Wim Hof style. Yeah, if you're doing like short periods of that during the day, that's actually going to, I mean and Wim shown that when I'm interviewed him, right. When I've interviewed him he's talking, talked about the decrease in inflammatory cytokines, the strength in the immune system, the ability to withstand the rigors of cold, etc. But what you're saying is if you're just like, like this.

All day long, you're going to breathe off a bunch of CO2, you're going to become overly alkalinic and basically you're not going to cause any additional oxygen saturation over and above what you'd normally have.

Exactly. You know people, it's very, very common for people to take big to breathe more than what they need. They're talking. Talking increases breathing. So if you've got somebody who's talking a lot throughout the day, a school teacher, somebody in sales, they'll often feel exhausted at the end of the day and they're feeling exhausted not because of the mental stimulation or the concentration, but it's just a very physical act of talking which is increasing ventilation. Stress. Stress increases breathing dramatically. So if an individual is subject to stress, their breathing gets faster, they sigh more, it's more upper chest, they mouth breathe, they take more air in and they can't think straight. And you can't think straight because the amount of oxygen that's going to be delivered to the brain is going to reduce and brain cells get very excited. So stress in the long term is very, very harmful for the human being. We're not able for it. Processed foods will also intensify breathing. You know, foods that stimulate breathing really? Yes, we would believe so. You know, in terms of, we use the bolt measurement as you were talking about and some people who from over consumption of processed and acidic foods that will have some impact on their breathing. And I think most people can experience that. They'll feel it the foods that will have least impact on breathing are raw foods, especially fruits and vegetables. Water has no effect on breathing.

So explain to me the mechanism here. So what you're saying is, let's say I eat hamburger and fries, right? Which I guess would be considered a little bit more of an acidic meal. Maybe throw a Coke in there or a cup of coffee or something like that. What you're saying is that that would stimulate me to over breathe more, because when I over breathe more, I'm becoming more alkalinic to rebalance the acidity of that food. Like the body's natural mechanism would be to adjust the physical by breathing in more and by exhaling more specifically by breathing off CO2.

Yes. Carbon dioxide is acidic, so the body, to bring ph back to normal breathing intensifies, CO2 is removed from the blood through the lungs and ph goes back to normal. We can't say that that's conclusive. It's still a very controversial area. The effect of food, acidic food, alkaline food, and the effect it's having on blood ph. But blood ph, the body always wants to go back to homeostasis. That blood ph is always 7.365. And there is a connection between the breath. We see that people, for instance, who go on fasting for five to 10 days, their breathing will improve dramatically, whereas people with a very processed diet, they'll tend to get breathless more easy. And if you look at the people who were obese, look at their breathing, it's really, really poor. You'll often notice it. They get breathless very easy. And it's not just because they're carrying the extra pounds, of course that's going to cause them to be breathless. But even if you're just sitting in a chair, their breathing is going to be very intense. And then when they sleep at night, their breathing is intense. So they're at a higher risk of obstructive sleep apnea or even just snoring.

So that actually that begs like the chicken and the egg question. Do you think that people who are obese, who are over breathing are over breathing because they've got crappy acidic diets that are causing them to want to breathe more so they become more alkalinic? Or do you think that a whole bunch of chronic over breathing because you have sleep apnea or whatever that's making you really alkalinic, makes you crave acidic, unhealthy foods to restore the proper alkalinity? Yeah, or the proper acidity rather.

This is the interesting one. I don't Think anybody is going to know for sure. It's kind of a hypothesis that's out there. It could be plausible. But we do know that when we change somebody's breathing that we often see a change in metabolism and people then who would have had cravings towards more processed foods. Now, is it because they're becoming more health conscious? The other aspect is that their breathing gets better so they can partake in physical exercise easier. Because before these individuals would go out and do physical exercise, they get too breathless, they're too embarrassed about it, or, you know, they might, they might feel too conscious about it, so they stop doing physical exercise. So that's why we say to people, you know, even if you're a couch potato, you can improve your, you can reduce your breathlessness by changing your breathing when you're sitting down. And this is evident by the Bolt score. And the Bolt score. It's a very, very simple test.

Yeah. Can I ask you one, one other question before we talk about the Bolt score?

Sure.

Because I do want to ask you about that. When you talk about over breathing, obviously you've mentioned before how short periods of time spent over breathing is not an issue. But since reading your book, I'm curious about all those people who are out there, maybe who are exercising, especially endurance athletes, for example, 60 to 90 minutes a day and in many cases breathing hard during those exercise sessions. Is that too much over breathing? Because I've thought about this before. Here's my thought pattern on this. It's like there's this idea that the heart is a battery, right. It has like a finite number of beats. And so you got to strike this sweet spot between exercising enough to where you decrease your heart rate the rest of the day so that the period of time that you spent with your heart re elevated isn't causing you to have more beats during the day. Right. So if I have a brief period time, I exercise during the day, but my heart rate because of that is lower the rest of my life. By the end of my life, I've had fewer heartbeats because of my exercise habits. Would breathing kind of like, is there a sweet spot with breathing to where I can breathe hard and deep and long and, and over breathe during my exercise sessions, but then that's resulting in me breathing less or being better able to control my breath pattern the rest of the day? Does that make sense? Is there, is there kind of like a.

Yes.

A time period during which you, you would over breathe that it does become deleterious, like 60 minutes or 90 minutes or anything like that.

Not so much a time period, but it's relative to. You can imagine two people going for a run and one person is breathing harder for that same level of physical exercise. And a strength and conditioning coach may say that the person is out of condition, but I work with football teams and these individuals are training. They're all training at pretty much the same rate, but yet some of the individuals have poor breathing habits and it's holding them back. It's normal for our breathing to increase during physical exercise because there's a metabolic demand for oxygen, but also the metabolism is generating more CO2 and the muscles get hotter. So when the muscles get hotter and there's increased carbon dioxide in the blood, more oxygen is delivered to those tissues because there's a right shift of what's called the oxyhemoglobin dissociation curve. So it is normal for our breathing to increase during physical exercise. But the real question is, how much does your breathing increase by? Because you will have individuals who have poor breathing habits during the day, and then that translates when they go and do physical exercise, they're breathing in excess of what they should be. And that's actually going to cause less oxygen to be delivered to the tissues. And that's why for recreational athletes, I would encourage them to nose breed nose breathing. You've got a better oxygen uptake in the blood, you've got a better oxygen delivered to the cells. The amount of oxygen that's taken up by the cells is better. There's also a better recovery. There's less stress in the heart. Because, as you say, I would totally agree with you, Ben. It was a very interesting study. It was conducted in 1908 by Jandal Henderson, and he was a Yale professor of gases and. Okay, basically. Professor Gases.

Is that what you said?

That's the thing that was this. Yeah, interesting. That was his. Is that's what he was described at the time.

But I. I've been called a professor of gases before, but for different reasons altogether. Anyways, though, so. So what about this dude?

So he. Well, he kind of conducted experiments with dogs and he changed the amount of air that was pumped into the dogs, and he regulated their heartbeat primarily through their breath, from 40 beats per minute up to 200 and back down again. And it didn't have very good consequences for the dogs. But his research, even though gruesome as it is, his research points to the whole relationship between how we breathe and cardiovascular cardio functioning, because there's a huge relationship between if we're breathing too Hard. The amount of blood flow that's delivered to the heart is going to reduce because the heart is a muscle. So the heart needs its own supply of blood flow and its own supply of oxygen. But if you get an individual who gets up on a treadmill to do a stress test and he's working himself too hard and he's very unfit and he's breathing really, really hard. Well, the whole purpose of that is to see, well, what effect is that having on the heart is to reduce coronary blood flow. Is it having alterations, ECG readings, for example, like ST segment depression or inverted T waves? Because that can be altered through your breathing. And just because that. Now it comes into my head that taking 30 big breaths in and out.

That was originally, that was called the hyperventilation provocation test. But doctors decided not to do it. And the reason being was because it caused ischemia, the amount of blood flow getting into the heart reduced. So it's something that will be suitable for a lot of people, but it mightn't be suitable for everybody. So we don't do it, we don't do the hyperventilation. But that's the effect over breathing can have quite a profound effect, you know.

Interesting. Yeah, that, that described me to a T when I used to exercise. I almost would. Would use breathing to get me tired, to make me feel like I was more tired during exercise, you know, even if I could be less tired by just doing deep nasal breathing. And since I've started to adopt more of the techniques that you discuss in the book. Right. Like deep nasal breathing during the day, not over breathing, not shallow chest breathing, kind of like striking that balance between breathing enough, but not taking these enormous nasal breaths throughout the day. I do the same during exercise. And so it's pretty seldom now during exercise where I open my mouth.

Right.

Unless I get very anaerobic. I actually take the same breath patterns into my workout now that I use during my day. And so I think that's a definite advantage when it comes to your exercise sessions, not putting you at risk of being too over breathed, if that's a word, and too, I guess, too alkalinic coming out of your exercise routine, in which case we all have learned you're going to crisp burger and coffee. So this bolt measurement, this bolt measurement that you talk about, explain to me what it is and why it's such a big part of the book. What's the bolt measurement?

So the bolt measurement is you take a normal breath, you have to be sitting down for about 10 minutes. First of all, you take a normal breath in through your nose, a normal breath out through your nose, and you pinch your nose and you count it in seconds. How many seconds does it take until you feel the first definite desire to breathe? So it's a measurement, it's not a measurement of how long you can hold your breath for. Your breath at the end of the bowl should be pretty normal, but it gives you very, very good feedback of relative degrees of breathlessness. So William McArdle, he wrote a book called Exercise Nutrition, and in that book he's talking about the normal breath hold time after an exhalation should be 40 seconds for an athlete. And 40 seconds is what we would be looking at as well. There's a correlation between spirometry and lung function. And Bolt, we've used it with thousands of individuals with asthma, exercise induced asthma, and anybody with a Bolt score of less than 20 seconds, there's no question that it indicates overbreathing.

Less than 20 seconds. So if I'm just breathing normally, so I sit for 10 minutes, so I'm not like gassed, and I breathe normally, I breathe in through my nose, normal breath out through my nose, not like a full forced exhalation of air, just a normal breath out. And then I wait. I should be able to wait at least 20 seconds.

It's a minimum that we'd be looking for. But you'd be so surprised. Like, I've worked with some of the elite athletes in the world, Olympic athletes, and their Bolt score has been as low as 10 seconds. Now, what that's telling me is that, yes, they're achieving what they achieve, but they're putting their body under a lot of stress to get there, because, you know, there's no point in doing physical exercise and you're breathing so hard and so intensely. Like, I had one cyclist who come into me and he told me that it would take him a half an hour to recover after a race that his breathing would be so intense for half an hour afterwards. And I said, listen, I said, that's a, that's a stress to the body. You know, this is where we want people to be able to recover easy. And a higher Bolt score, you get better oxygen delivery to the tissues, you're better able to sustain it. It's like economics, you know, if you've got a car, you've got a car that could be like a Toyota Prius or something that's doing 70 miles to the gallon, it's very economical with it, with its fuel, or you've got a Big Hummer, and that's doing 10 miles to the gallon. Well, humans are the same. How economical are you with your oxygen intake? So can you have light breathing during your physical exercise? And that's better? And, you know, I think that kind of makes sense. If you see somebody walking down the street and they're walking down the street and they're really breathless for the amount of exercise that they're doing, well, you're going to say, well, at the very least they're unhealthy or they're not fish, you know, so there's improvements to be made there. So I don't know.

Man, that Hummer comes in pretty handy during a zombie apocalypse when you got to go off road. Just saying, don't. Don't shove Hummers under the bus. Actually, you know what, that reminds me, because you talk about humming in the book. Yes. That's a good segue, huh? You talk about humming like you're a fan of humming. I thought that was kind of interesting. Why are you such a fan of humming?

It increases nitric oxide. So nitric oxide, the gas that's released from the paranasal sinuses into the nasal cavity. So pretty much every time you breathe through your nose, you carry nitric oxide into your lungs. But humming will increase nitric oxide production by 15 fold. So that's why there's some meditation techniques that. It involves humming. So there's vibration of the sinuses to produce nitric oxide.

That's really interesting. Yeah, I mean, I know humming, chanting, singing, things like that. They're really good for your vagus nerve health and for your parasympathetic nervous system. I'd never really read much about how dramatic of an increase in, like, sinus ventilation and nasal nitric oxide release they have until I read about that in your book, which is, you know, it's kind of cool. It's. It's like a little. A little hack you can use, I guess, during the day for that nitric oxide release. Right. Just start humming. Yes.

And once you're going around with your mouth closed during the day, but also at night, because if we have the mouth open at night, we have far higher tendency to wake up tired. And that's the way I was for 20 years. And here's an. Here's an indication of somebody who's heavy breathing all night long through an open mouth, we breathe faster, more upper chest, we're taking more air into our lungs, and we're waking up exhausted, you know, so it's a typical scenario of big breathing, is not good.

Yeah.

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Now back to the bolt measurement. You said 20 seconds would be considered like the. The minimum amount of time that you should be able to spend after you've exhaled through your nose. What would be a good score? What would be like a. What would be like a score to shoot for?

40.

40 seconds?

Yes, 40 seconds.

Nobody do this while you're driving, by the way. I don't want you to pass out. So wait. Wait until you're sitting somewhere to do the bolt score. Patrick, how would you get, like, let's say I was at. And I wasn't at 40. I forget what I was at, but I mean, I was above 20, but I definitely wasn't at 40. What are some ways that you can actually increase that bolt score? Like. Like what, What's a method one would use to get a higher bolt score?

Well, the first step is to switch to nose breathing, and that's nose breathing day and night. And that's not going to be enough. But it's a good start. We also practice different exercises. So these are different breathing exercises. And one exercise, it pretty much involves you tuning into your breath and feeling the cold air, say, coming into your nose and the warm air leaving your nose and really slowing down your breathing. So you're concentrating on slowing down your breathing so much that you feel that you're not getting enough air. Now, the feeling that you're not getting enough air is an indicator that carbon dioxide levels have increased in the blood because the primary stimulus to breathe is carbon dioxide. But you want to subject your body to the increased CO2 in the blood and the increased CO2 will penetrate the blood brain barrier and reset the breathing center so that your breathing can get lighter. And this is something that you do during rest. And by doing it during rest, your breathing becomes more efficient, your bolt score increases, and when you do physical exercise, you've got lighter breathing as a result of it. And that's one exercise.

So, like, if I was driving in my car, what I would focus on would be nasal breathing, but not deep nasal brain. Like, basically as little breathing as I could get by on without like, say, like having to yawn or needing to pass out.

Yeah. It's not like we have to be careful driving the car, but, you know.

It'S a horrible analogy, but, you know, a lot of people listening while they're, while they're driving their car or riding their bicycle. So it's, it's a fact that we have to fix.

It's really about slowing down the breath. So there's, there's a saying, you know, yoga in the Eastern world, it was all about subtle breathing and light breathing. They're saying, you know, that you should be breathing so soft that the fine hairs within the nostrils do not move. You know, the celia does not move. That almost to the point, you know, Lao Tzu was a Chinese philosopher. He said that the perfect person breeds as if they do not breathe. So it's really slowing down the breath and slowing down the breath to the point that you feel air hunger. And it's the air hunger that's the key aspect of it. Like, it's amazing what you'll experience. Within a few minutes, you'll have increased watery saliva in the mouth. And also about 70 to 80% of people will feel warmer. So because carbon dioxide is opening up the blood circulation, you know, we have 100,000 miles of blood vessels throughout the body, and we can influence that within three to five minutes through our breath. But here's what's more, Ben.

Carbon dioxide warms the body.

It. Well, because basically one of the, one of the functions of carbon dioxide is to relax smooth muscle that's embedded in both the airways and in the blood vessels.

So that's one of the reasons that like the, like the Wim Hof method, for example, works is I know with his style of breathing, you're kind of doing like a really deep inhale and then kind of a passive, passive exhale. So by the time you do that like 30 times, you've actually.

You'Ve held on to a lot of carbon dioxide, right? You've, you've kind of like no loaded Carbon dioxide. Well, if you're not breathing, like if you're exhaling less than you're inhaling, wouldn't you be holding on to more carbon dioxide and warming your body? Isn't that how like the whole cold prep breathing works?

Yeah. Do you know, it's, it's very interesting and how that's worked, I don't have an answer. I've looked at, I've looked at the studies. What the study I think it's by Cox was, was the, the author of it that he created a hypoxic hypocapnic response there. And we would create, when I'm doing, because we, I do breath holding all the time as well, but we create a hypoxic hypercapnic response. And the difference with our own breath hold techniques is that we would breathe, breathe in and breathe out and hold because it's only when you breathe out that you'll actually lower blood oxygen saturation. But while you breathe out, there's less, say air remaining in the lungs. So as a result then you get a stronger carbon dioxide response. So there's a different effect going on. So I don't have the full answer. You know, it could be the part of it is the cold water immersion that's happening with Wim Hofs and possibly it's just really stimulating the immune system that you're activating a sympathetic response to get the immune system into kind of, if you use the word, a protective mechanism and that the body then is able to protect itself.

Well, since a lot of it is through the nose too, I think there's probably a pretty big nitric oxide release. So you've likely got some vasodilation and some blood warming going on as well.

Yeah, possibly if people are doing it through the nose. And the other thing is like big breaths is all very well, but don't have the idea that it's going to add any more oxygen because it doesn't do that. And don't carry that idea into your normal way of living because if you think about people meditate and people meditate to relax and of course it's focusing on the breath and it's taking attention into the inner body. But how does our breath go during meditation? Our breath, if you do four or five or ten days of meditation, we'll save a passing of meditation. The breath on the second, third and fourth day will almost disappear to nothing. And that's the whole purpose of meditation. The meditation is designed not to take in bigger breaths. And that's how meditation is Helping people to relax. And what we're saying is, well really, really work on slowing down your breath. And there was an interesting study just come out of Stanford, it's only come out March of this year and they looked at you can influence your mental state by slowing down the breath that they said there's a pacemaker in the brain that when we get anxious our breathing gets faster. So it's our emotions affect our breathing, but also our breathing affects our emotions. So say people then who have breathing pattern disorders who tend to be breathing faster and using upper chest that's going to stimulate a more stress response in those individuals.

Right. Because you have like baroreceptors in your chest that can increase the release of cortisol. Right.

That could be happening. I'm looking specifically here when they were talking about the study about slow breathing and they were talking specifically what's happening in the brain. Like that could be of course other things that's going on. So I think it's a really good. Because modern life is pretty stressful for people. Even athletes, you know, prior to a game a lot of them get pre match anxiety. And what I have them do is I have them do reduced breathing for 15 minutes the night before a game.

With reduced breathing being the one where you breathe in through your nose, out through your mouth. And I think the exercise you give.

Is in and out through your nose.

I'm sorry, in and out through your nose. And I think the exercise you give in the book is you're like sitting down in a chair, kinda like looking in the mirror, totally relaxed and all you're doing is what you talked about before, trying to get away with as little breathing as possible.

Exactly. You're not holding your breath, you're not freezing the breath, you're really just focusing on it. And the whole objective is to really work on slowing down the breath. And it's really about slowing down the breath in, but not by taking a big breath in. So you're taking say we'll say a normal size breath in, but it's very, very slow. And then you have a completely relaxed breath out. And the objective like in simple terms is breathe less than what you were doing before you started. Now some people may feel a little bit of panic because if the air shortage gets too much. So if you feel a bit of panic, just abandon the exercise for say 30 seconds and then start it again. But we use this exercise for pretty much all individuals, no side effects and you'll feel the physiological benefits. And I also mentioned you will feel Increased watery saliva in the mouth. That's activation of the parasympathetic nervous system. So we do reduce breathing or the breathe light exercise to activate the parasympathetic nervous system. And then we do the breath holding to activate the sympathetic nervous system. And with the breath holding, we use pulse oximetry. So we observe that the blood oxygen saturation decreased to in around 80%.

Is that what you want, like, if you're exercising, because you give, like, some workouts in the book? Yes, actually, we should delve into those. But when you're talking about the workouts, I would love for you to talk a little bit about, like, what you should be looking for, because I've wondered this before. I've got like, a hypoxic air generator in the garage called a hypoxico, and it's next to the treadmill. And sometimes I'll go out there and I'll put the mask on and I'll do a workout. And during that, I'll test my pulse oximetry with one of those little fingertip measurements. And sometimes it'll be. Sometimes it'll drop from like 99 to 91, but sometimes it'll drop, you know, if I really push myself to 85 or to 80 or sometimes as low as, like, the mid-60s. I'm curious, A, what kind of breath hold workouts that you do with your athletes, and then B, what kind of drop in pulse oxygenation you have to get to before you start to get some of the big benefits of breath holding during exercise? If that's a complex enough question for you.

No, that's fine. You don't really have to drop it all that much. Once you go in below 94%, you're going into hypoxia, but ideally is to get below 90%. So.

Below 90?

Yeah, yeah, below 90. So we. We range to get from 80 to 90% and we don't encourage athletes. Now, sometimes our athletes do go below 80%. Sometimes you go into the six. We don't encourage it because people can get disoriented when oxygen levels drop too much. But at the same time, we want to push them. And the whole purpose of it would be, is to. It's pretty much like intermittent hypoxia training that you're pushing the body into a bout of oxygen deprivation and then normal oxygen, and that's causing then the body to make adaptations. Probably it's increasing the buffering capacity, you know, and also you're stimulating anaerobic glycolysis that you can imagine Say, a sprinter. So some of the sprinters that I would have been working for with track and field in the United states, they were 400 meters and I was looking at like, when are these guys going to be most tired? Well, it's going to be the last 20, 30 meters of a race. It's when fatigue sets in.

Right.

So some of their sessions, I would have them sprint with their mouth closed, which adds an extra load to. It's quite tough. It's adding an extra load onto their, onto their exercise. But I would stand at about the 15 or 20 meter mark from the finish. And when they seen me, I would have them breathe out and hold their breath until they, they pass the line.

Okay, so. So they're running like a 400 meter on the track. You're standing 20 meters from the finish line.

Yes.

They pass you, they blow everything out. And they just hold that out for those 20 meters till they cross the finish line.

Yes. They'd have a passive exhalation and they'd hold the breath. And the whole purpose of that was to add an extra load that we wanted to completely disturb the blood, the blood acid base. Because you see, during a sprint, during a normal sprint with normal breathing, you will go anaerobic, you know, for certainly after about the last 75% of it during a sprint is anaerobic. The first 25% is probably going to be aerobic and the blood oxygen saturation will drop to about 93%. But I wanted to completely disrupt that. I wanted to bring these guys from 93%, say down to 80% or 85%, and it's getting the body to make the adaptations that it will delay the onset of fatigue and possibly also it's training the central governor system. You know, if you believe that there's a central governor in the brain that's setting the limits of exertion, that when you're pushing the body into a little bit more extreme and not to the point that it's stressful, because these athletes are really, really well able for it. And, you know, I've looked at studies involving blood gases because it's free divers, for example. We can take the information from that. We look at how, how low do they drop the blood oxygen saturation and free diving, and we compare it to what we're doing so we can make the comparisons. There's a lot of studies now coming out of Paris, Paris 13 University, and very similar technique to what we've been teaching for 15 years. It's the exhale hold technique, and it's showing that, you know, the benefits in terms of stimulating anaerobic glycolysis, delaying the onset of lactic acid, delaying fatigue, is improving time performance. So I think it's something novel that can be introduced to sports. It's new. It's Saturdays. Yeah. But I think. I think it's promising.

Yeah. When I interviewed Ted Hardy, who's like, this freediving instructor that I did a course with in Fort Lauderdale, he talks a lot about, and he wrote an article for a really good magazine I subscribed to. It's like. It's like porn for fishing. It's called Spearing magazine. Great magazine. But he wrote an article in that magazine about how he'll go out and do just runs, right. Where every few minutes he'll hold his breath for 30 seconds or so, so his. His pulse ox will progressively grow lower and lower. And I agree with you. I think a big part of it, too, is kind of similar to what you get if you do, like, really hard sauna sessions, is you get an increase in your stress tolerance. You increase the rate of exertion you're able to achieve before the central governor in your brain begins to shut you down due to lack of oxygen or due to too much carbon dioxide or due to excessive heat or, you know, in the case of, like, cold therapy due to excessive cold, et cetera. So it's almost like, you know, that. That hormetic stressor. So it's just basically, you know, in your case, what you're doing with your runners is towards the very, very end, when they're really tired, at the end of a certain interval, you have them blow out all their air, they hold it out, they cross the finish line, and then they recover. And they do that again for a few times in a row.

Yes, that would be one. One of the ways that we would have worked with them. We also have exercise then to decongest the nose, which is based pretty much on a similar thing. You know, a lot of athletes get hay fever, and if you've got hay fever or your nose is blocked, it actually can adversely affect your sleep. And if your sleep isn't deep, if it's not good, you're more likely than to wake up tired and it's difficult to perform or to excel at the level you should be if you've got poor sleep. So we use the exercise. You know, you can open up your nose by holding your breath as well. And this one is simple. You could do this sitting in your sitting room. You take a small breath in through Your nose, small breath out through your nose. You pinch your nose and you walk around holding your breath, and you continue holding your breath and walking until you feel, say, a medium to strong air shortage. And then you let go of your nose. Breathe through your nose and calm your breathing and wait a minute and repeat it and do it five or six times and your nose will. You'll feel your nose is decongested. And we've had that studied. We've had it studied at a hospital here in Ireland, and it reduced rhinitis symptoms at 70% by 70%. And that's even if you've got a head cold, because think of the amount of cyclists who, for instance, get cyclist cough, or you overdo it during an endurance run and your lungs really feel raw and inflamed because if you're taking a large amount of dry, cold air into your mouth, it's basically sucking moisture out of the airways and it's going to contribute to inflammation and, and it will especially contribute to inflammation with people who are prone to asthma. So that's why we encourage nose breathing, because of course, the nose is going to moisten the incoming air so that the air is arriving into the lungs in a moistened and warm state.

Why do you have to pinch your nose when you do that? Why can't you just walk around kind of like holding your breath without pinching your nose?

You could, you could hold your breath. It's a little bit easier, though, when you pinch your nose. It's a little bit easier.

And, you know, because, you know, clear up can judge, like if you have a head cold or something like that, or you're congested from, I don't know, swimming or anything like that. You just basically hold your breath, you exhale through your nose, blow out all the air, pinch, and just walk around for a little while.

Yeah, walk around. And the whole objective is that this now is also a measurement of your upper tolerance of breathlessness. So we talked about the bolt, and that will measure kind of your relative breathlessness both during rest and during light physical exercise. And then we use the nose and blocking the measurement. So I would like athletes to be able to hold their breath for up to 80 paces.

And, you know, sometimes when I'm walking, I'll just like count how many paces I can take with my breath held.

But that's a. It's a great way. You know, there was a runner back in the, I think the 50s. His name was Emil's Autopeck, a Czech runner, one of the best runners, you know, that had ever competed, certainly at that time. And he's, he started off interval training, but he also started breath holding. And he would do something similar. He would breathe in, he'd breathe out, he'd hold his breath and he would hold his breath until he reached a certain poplar tree along a roadside, you know, and he kept on. Every day he held his breath until he passed one more tree. So he built up his tolerance of the blood gases.

That's great. That's what I do with telephone poles. I'll pass the telephone pole and just be like, all right, can I hold my breath for 30 paces or 40 paces? I've been able to since I started doing this for the past couple years. I do like, especially when I'm jet lagged or I've been traveling somewhere, it's a perfect workout because I want to go see the city, right? I want to go see where, where I've landed. But I also don't feel like a hard workout at the gym. I'll just go out on a walk. I'll breathe through my nose using a lot of the techniques you already talked about. But then like, I'll pass a telephone pole or tell myself, okay, every time I pass a stop sign or every time I cross a road, I'm gonna hold my breath. And I know for me, if I can go in in like that 70 to 80 pace range, that I'm doing pretty well as far as increasing my breath hold time. You even have like a, you have a trick in the book that you talk about to actually increase your breath hold time. It's like a baking soda trick. Can you go into that?

Sure, sure. Bicarbonate of soda, you can buy it in any supermarket. And it's probably better to get a good quality one, maybe to get one from natural food store, you know, one that doesn't have aluminum. But basically, if you take, say you don't want to take too much of it. If you take a half a teaspoon to a teaspoon, not a tablespoon but a teaspoon, and you could add it to sparkling water, carbonated water, and drink it, just drink a glass. But the bicarbonate of soda will increase your breath hold time by about, in studies it shows it increases breath hold time by about between 8 and 10%. But it also significantly acts as a buffer to acidity. So for instance, for sports that are involving anaerobic, anaerobic state, by taking the bicarbonate of soda, it can delay and offset the onset of lactic acid. So it's been measured and used or studied in times boxers boxing efficiency improved.

So is it possibly related to the bicarbonate carbon dioxide in the blood? It will dissociate into hydrogen ion and bicarbonate. So by ingesting bicarbonate, are you possibly increasing the buffering capacity in the blood? And maybe that's what's happening. Probably something similar to the exercise that we do. Because sometimes people would ask me if I felt that their symptoms were a little bit stubborn and I couldn't really shift it. I'd have them actually take the bicarbonate of soda and I'd use that because they made quicker recovery. It was just kind of a little bit of a launching pad for them just to start making some progress and then they'd find the exercises easier to do and they could stick with them that way.

Yeah, you can get a little bit of a similar effect with other kind of alkalinic substances like apple cider vinegar or even carbonated water. Just drinking Perrier or Pellegrino water can help with breath hold time a little bit. It's kind of. And with those, you have a little bit less risk of blowing out your pants as you do. You got to be careful. Like bicarbonate of soda. Most of the research that's done that shows it to be pretty efficacious without gastric distress involves like two to three hours leading up to the time when you want to use the baking soda for better acid tolerance or better breath hold time. You actually take small amounts or like a quarter teaspoon every 20 minutes for two or three hours. If you don't want to get that stool loosening effect of baking soda, Just gotta be careful. You don't wanna be halfway through your breath hold and have to pull out the dude wipes. You know, another thing that you talk about, Patrick, is like a way that you can help yourself to ensure that you actually do this nasal breathing for quite a long period of time. And like I mentioned in the introduction, I've talked about that turbine before, that thing you can put in your nose that a lot of Tour de France cyclists will use to open open up their nasal cavity for nasal breathing during exercise. You could even use one of these breathe right strips. But you talk about a different way to use a strip. You talk about like, I believe, taping your mouth shut rather than taping your nose open, taping your mouth shut. Can you go into how one would do that and why?

Sure. Primarily during sleep. This is something that we have advocated and I practice it myself. It's a very simple tape. Usually we buy it in a drugstore and we just fold over a tab on each end of it and we just place it across the lips. You could do it horizontally or you could do it vertically like. Of course common sense has to prevail. Don't do it if you're feeling tummy upset or if there's a risk of vomiting or if you've been drinking alcohol. Don't use it on young children. But other than that, don't tape kids.

Mouth shut before they go to bed. It's good advice.

Absolutely not. But you'd be surprised to have to kind of emphasize it. So. But we use it because it ensures nasal breathing during sleep. And there's no comparison. You know the difference between having the mouth open during sleep and having them out closed. There's literally no comparison. Now it's not that everybody will feel really alert when they wake up, but many, many people do. You know, the risk of sleep disorders are significantly more prevalent, including snoring, because snoring through the mouth and vibration of the soft palate. Obstructive sleep apnea, when basically you stop breathing during sleep, that significantly increases when we have the mouth open. So the quality of a person's sleep is so much better by breathing through the nose. Now the other aspect of it during sports, and I think the turban is an interesting product. Caucasians, especially if we've been mouth breeders during childhood, we can tend to have a narrow nasal cavity. Because this is really so important and a point that I want to stress. I was a mouth reader for all of my life and nobody once said, patrick, breathe through your nose. And I'm looking at studies now that 50% of kids are going around with the mouth open. If the mouth is open, the tongue isn't resting in the roof of the mouth. And basically it's by having the mouth closed and the tongue resting in the roof of the mouth that shapes the palate. So the tongue is a U shaped, it's wide. So by having it fit into the roof of the mouth, it drives the jaws forward, but it also creates a U shaped profile. So really when we look at this is if the mouth is open, it's almost as if the whole face sinks downwards. So the upper airways, which will consider consist of basically your nose and your throat that the upper airways reduce from chronic mouth breathing. So if the upper airway is reduced from chronic mouth breathing, it increases the risk of obstructive sleep apnea for lifelong. So as nose breathers and mouth Breathers during childhood. Studies as well show reduced respiratory muscle strength, reduced quality of life. And this is so, so well documented.

So it's, it's that classic like recessed jaw, weak look versus like that rugged, exaggerated jaw. You're saying you can have like a stronger square jaw or stronger, more square, square jawline, better forward position of the jaws, like high cheekbones, like everything that we like when it comes to like facial symmetry and facial characteristics by simply, you know, when you're a kid, avoiding a lot of this mouth breathing that a lot of kids these days do, you know, because of everything from whatever autoimmune issues and, and you know, stuffy noses to stress to all the other things that could cause one to become a mouth breather. What you're saying is it actually changes your face?

Yes.

That's crazy.

There is absolutely no question, like a lot of my work is with dentists, especially in giving talks. And there's some tremendous orthodontists in the United States. Dr. William Hang, Dr. Jim Bronson, and all of these are, they're all talking about, listen, we have to get kids breathing through their noses because this is an epidemic happening now on a good positive note, we're making advances. And the doctor who discovered obstructive sleep apnea back in the 1970s, his name is Dr. Christian Guillemine. So he's a French doctor who works from Stanford and he's now written papers in the last two to three years emphasizing the importance of nose breathing during childhood. Because he's saying if the mouth is open, these kids are going to have sleep disorder breathing. And he said literally their brains. I was at a talk of his when I was in Bordeaux, France, and he said, the kids brains are getting fried. And those were his words by virtue of having them out open during childhood. And the whole point of this here is the next generation. Nobody is telling these kids to breathe through their noses. You know, I think it's really important. It's important for adults, it's important of course, as parents, but it's really important for our kids because they are the next generation and we can prevent some of the issues from happening by just getting this little message out there.

Yeah, I mean, when I do those breath hold walks, a lot of times do them with my kids and I'll just like, I don't force them to do anything. I don't like to force stuff on my kids, but I'll tell them, hey, dad's gonna breathe through his nose all the way up until that telephone pole up there. And Then when I get to that telephone pole, I'm gonna hold my breath as long as possible. And a lot of times they'll do it with me. And I'll watch them kind of like out of the corner of my eye. And you can tell, like, if their mouth's, like, hanging open versus if their mouth is closed, their jaws kind of set and they're breathing through. Through their nose. Yeah. I mean, I never really realized the importance, though, when it comes to facial symmetry that you talk about in your book. And of course, the activation of the parasympathetic nervous system, some of the other benefits of nasal breathing that you talk about. But then you also talk about longevity, specifically by using the. I think you use the naked mole rat as an example.

Oh, yes.

I found that fascinating. Can you go into why you talk about the naked mole rat? And.

Yeah, it's because small creatures don't really live that long. You know, there's a saying from yoga, Eastern yoga, that your life is measured not by your years, but by the number of your breaths. And a mouse, for example, breeds very quickly and they last. Especially a rat. Say, for instance, they might last a couple of years, but there's a rash that's in Africa, and it's called a naked mole rat. Now, it's not the most attractive of creatures, but basically it lives underground and it lives in colonies where there's maybe 100 rats together and they're in darkness and they're in. The situation is that they're quite far underground. They can live as. As much as eight feet deep. And the amount of oxygen that's in their environment is actually lower than it would be in the atmosphere, but the amount of carbon dioxide is higher. And scientists are very interested because these rats are exposed to a lot of oxidative stress, which should, in theory, have a negative effect on them. But yet, when the scientists injected cancer into the naked mole rat, the rat is able to resist the cancer. So here scientists then are wondering, well, what's exactly going on here? And I don't know. I don't know what's going on, but most certainly they can live up to 30 years, 15 times more longer than their cousins. They're in a low oxygen, high carbon dioxide environment, and they're exposed to a lot of oxidative stress, and yet they can resist cancer. So I think there's something in that, you know, that that may be applicable to human life. And I think the whole thing about lower oxygen and high carbon dioxide, I think it's interesting, you know, because as human beings, we're not doing the same amount of physical exercise that we did by our ancestors. Yeah.

I'm actually going to link to this in the show notes because I sat in on a lecture when I was at this place called the Ancestral Health Symposium. It was called Living High and Healthy why Coloradans and Others who Live at High Altitude Live Longer and what Flatlanders Can Learn from Them. That's a mouthful. This dude named Todd Becker, and he actually gave this talk and he talked about how people in, like, Boulder, Colorado, live for a disproportionately longer amount of time, even when you account for. For factors like, you know, how much they exercise and the fact that they all eat expensive, healthy hippie food there. Like, the idea is that because of that reduced saturation of oxygen in the blood at high altitude, there may actually be some kind of a strange longevity benefit, which you wouldn't think. Right? You'd think, like, less oxygen, you might not live as long, but less oxygen means, like, less oxidation, right?

Yeah. And less oxidative stress and maybe less reactive oxygen species. Who knows? I, you know, I don't have. I remember looking at one study of the Indian army and they had 20,000 soldiers stationed at high altitude. And this was over a long, long period of time, many, many years. And the soldiers were so bored at high altitude that a lot of them were drinking excessively. Alcohol, excessive alcohol, etc. Because they had nothing to do.

Yeah, but altitude, everybody knows that.

When they compared the health of the soldiers living at high altitude, they had actually better health. They had reduced diseases than the guys who were at sea level. So I think there's something in that. Traditionally, if people got sick with tuberculosis, they were often sent, or even with asthma, they were sent into mountainous regions, not necessarily because the air was cleaner, but because of the atmospheric.

Concentration of oxygen.

Yeah. See, everybody's skinnier and bolder because nobody craves hamburgers because their blood's all.

Their blood's all. I guess it would be not too alkalinic. Right. They've got that perfect blend of acidity and alkalinity. This is fascinating. I think everybody should read this book. So if you're listening in, first of all, link to the book. I'll link to everything else that Patrick and I talked about. Just go to BenGreenfieldFitness.com OxygenAdvantage that's BenGreenfieldFitness.com oxygenadvantage I'll also put a link to that talk I was mentioning about longevity and altitude as well. That I saw over at the Ancestral Health Symposium. I'll link to Patrick's book. I'll even link to some tape you can give your kids to tape their mouth shut during sleep because Patrick said so. Anyways, though, Patrick, thanks for coming on the show and sharing this stuff with us, man. It's a fascinating book. I think everybody who's interested in breathing or at least as obsessed with breathing as I am should read it. Thanks for what you're doing and I simply love this stuff. So I appreciate your time today.

Great. And thanks very much, Ben. It was a great chat.

All right, folks. Well, I'm Ben Greenfield along with Patrick McCown, author of the Oxygen Advantage, signing out from BenGreenfieldFitness.com OxygenAdvantage have a healthy week.

You've been listening to the Ben Greenfield Fitness podcast.

Go to bed greenfieldfitness.com for even more cutting edge fitness and performance advice.

Sam.