The 4 BREATHING SECRETS That Will TRANSFORM Your Health Today! | James Nestor

James Nestor 0:00 If you're not breathing correctly, you're never, ever gonna be healthy. These methods can have an incredible impact on both mental health and physical health. Some things that scientists thought were absolutely impossible have been proven to be absolutely possible by focusing on your breathing. It's hard to see someone who hasn't had a very profound reaction after 20 minutes, says, "Wow, I feel so good." [upbeat music]

Dr. Rangan Chatterjee 0:30 We can almost induce a feeling of anxiety and panic by changing the way that we breathe.

James Nestor 0:39 Of course we can, and if anyone wants to do that, you can start breathing in this very unhealthy way right now. [gasps] You will stimulate a sympathetic response, and that's easily measured. So, uh, I thought this was interesting as well, um, at UCSF, which is very close to my house, University of California, San Francisco, Dr. Margaret Chesney had worked for, for decades on National Institutes of Health Research, looking into something called continuous partial awareness, also known as email apnea. And what she had found was that when we sit down at our desks in the morning, [swallows] one estimate says that 80% of office workers do this. We open up our email, got Zoom on, got Twitter on, oh my God, I have 60 emails. We stop breathing. We just stop breathing, and then we go [gasps] . So she called it email apnea because we're so distracted and stressed out by what's going on. If you think about [clicks tongue] when you're extremely... Let's say there's a tiger coming around the corner here of my house. What am I gonna do? [gasps] I'm gonna be silent because that is a reflex reaction to be, to be very scared, to be silent so you don't become prey. And once it's on, once the fight is on, [gasps] I'm gonna breathe a ton, um, to, to get more ox- to get more energy, um, to my body, to feed more energy to my brain and heart and other essential muscles to get me out of that situation or to fight off that thing. But we do the same thing unconsciously at work. Uh, even though there's no tiger around, even though there's nothing threatening us, our sense of threat has become so sensitized that so many of us will stop breathing or start breathing completely dysfunctional. And she's found that if you do this for long enough, it can have some of the same effects on us as sleep apnea. By that, I mean neurological disorders, physical problems, again, spiking blood glucose, adrenaline. Um, and it's just something so few of us are aware of. And I was wearing a, a pulse ox and all these different... Measuring what happened. Every morning I'd put this stuff on and sit down. My breathing would go to hell every single morning. Um, and I realized that, you know, that's probably a reason why around 11:30 I'd get... I used to get this slight headache, used to feel kind of fatigued. It was still morning time, and I wasn't full of energy. And so by just switching your breathing, again, you can allow your body to work so much more efficiently.

Dr. Rangan Chatterjee 3:21 Yeah. I mean, thanks for sharing that. And I think that term email apnea is brilliant because it just brings it to life for people that, wow, who doesn't check email every day? Who doesn't spend a lot of time on their computers, particularly now more than, more than ever? And I, and I really... I, I, I... You know, I can't stop shaking the feeling. You mentioned the tiger, right? That might be popping around the block in San Francisco around from where you live, uh, which I hope is not happening. But-

James Nestor 3:48 [laughs]

Dr. Rangan Chatterjee 3:50 ... um, your body's actually doing what it's meant to do in response to a threat. Your body is meant to become anxious. It's meant to become hypervigilant. You're meant to be... Your blood sugar's meant to go up, right? Your blood pressure's meant to go up. All these things are happening to prepare you for danger so that you can escape from that danger. So actually, your body is functioning the way it is designed to function, given the fact that it perceives that to be a threat. So the problem is that we're perceiving the email inbox or the multiple screens open to be a threat, so your body is reacting in the same way. So it's not that there's anything wrong with people, right? I, I actually... I think it's very empowering, this. Your body's not broken. Actually, your body's doing what it's meant to do. You've just gotta give it a different signal. You've gotta just teach it, go, "Hey, you know what? I'm not in danger. There isn't a tiger there. It's just 20 emails," right? [laughs] So, um, I, I'm a big fan of talking to patients about transition times. So, um, a transition time, let's say from work to home life. Instead of just coming, uh, all ramped up from work into then trying to relax with your partner and your children, maybe have a five-minute transition where you do some breathing or you do some yoga, something just to move you, shift you from one gear to the other gear. And I, I've been talking to a lot of people, particularly during the pandemic about Zoom calls. I said, "Before you eat your lunch, just take a couple of minutes. Maybe get outside in the garden if you're lucky to have one. Maybe just slow down your breathing. Do two minutes of nasal breathing. Put your body in a different, uh, state and you will digest your food better. You'll crave different amounts." And it's... I've actually seen, uh, James, I'm not sure if you've come across this. I've not seen any research to support this, but I have seen with some patients in the last few years who thought they were reacting to a certain food. Now, of course, some people do react to certain foods, whether an intolerance or an allergy. But sometimes I've realized they were reacting to the way that they... Their body was whilst they were eating. So when they did a couple of minutes... I have a breath called the three, four, five breath, which I've been recommending for many years. Again, a similar theme, right? A longer exhale than an inhale. But people who, who try that three, four, five breath for two minutes Before they have their dinner. Sometimes they would say, "Hey, I'm not actually reacting to that food anymore." So I am saying, well, maybe it's the fact that you're eating in a completely stressed out state, your body's not able to receive that food. But when you chill out and relax, your body's like, "Hey, this food is okay."

James Nestor 6:28 Absolutely right. Again, it's... it comes down to nature, and I thought you made a really good point there. It's... There's nothing wrong with us feeding more circulation to our [laughs] skeletal muscles when we get threatened. This is really good. This is what allowed our species to survive in the wild for so long. It's that perceived danger and that perceived threat that is so sensitized right now that people will react to an email the same way that they would have reacted a thousand years ago to that tiger or to being attacked by a mammoth or whatever. And, and so, you know, some of this is, a lot of this is psychological, but the neat thing about breathing is by changing the way in which you breathe, you can actually change how your mind is processing thoughts and feelings and emotions. And we know that. Because this is a two-way street, so there are signals coming from your brain telling your organs what to do, but there are also signals coming from your organs telling your brain what to do. So another reason why s- that slower breathing works, you're like, [sighs] "I can actually... Not only do I feel better, I can think more clearly." Not a placebo. This is how it works in our bodies, and it's so important to acknowledge this throughout the day. Those transition times, what a wonderful thing to do, especially before a meal, especially if you have gut issues. Take a couple minutes, that's not asking a lot. Breathe calmly, relax yourself, and go in and eat, and I think that you'd be amazed by how, how quickly you will show benefits of digestion. I don't think it's too much of a, a mystery, um, why so... in so many cultures there's grace before a meal.

Dr. Rangan Chatterjee 8:17 Right.

James Nestor 8:18 You sit down, you calmly recite whatever phrase, doesn't matter what religion. You sit there a moment, you be thankful for the food you're about to eat, then you eat it. I think that there is a scientific foundation for how effective that is.

Dr. Rangan Chatterjee 8:33 I, I completely agree, and actually I, I... a few weeks ago, I finished writing my fourth book on, uh, weight loss for people who are looking to lose weight, and I've, I've written a section on this exact, exact area. What... exactly what you say, that actually, I don't think this is by accident. There are many benefits of doing this, and it's reflective of our busy, modern culture that we don't have time for this kind of stuff. You know, we've, we've evolved as humans. We don't need all that kind of slow stuff, that gratitude, that grace. But you know what? We're realizing more than ever now, actually, we are. It's a... As you say, it's a lost art. It's a lost art.

James Nestor 9:10 And just speaking, uh, to that, this 5.5 breaths a minute, 5.5 second inhale, exhale, this is nothing new either. Uh, this was all adapted, researchers found, from prayers, from Buddhist prayers, from Kundalini yoga prayers, from Catholic prayers. All of them that they looked at locked in to this respiration rate of about 5.5 seconds, and these res- Italian researchers said, "This is probably no coincidence." All these different cultures came to the same conclusion, that, wow, we feel so much more connected to ourselves, to the universe, to everything by reciting this prayer. A lot of that had to do, this is what the researchers said, to the respiration rate, to breathing in this certain way to calm your body and make you more receptive to that message.

Dr. Rangan Chatterjee 10:04 Yeah. Thanks, James. I was chatting to my, uh, videographer, Gareth, who's just nipped out at the moment, and I was saying, "Hey, I'm gonna talk to James. I know since you heard my chats with, uh, Patrick and Brian, he's changed his life. You know, he's now... He's tried the mouth taping at night. He sleeps better. He now runs. He does some light jogging, only nasal breathing, uh, and really feeling the benefits." But he said, "One thing I wonder if you could ask James about, um, is," he says, "when I go upstairs now, if I go up a lot of stairs and I nasal breathe, my recovery is so much quicker than when I mouth breathe." But you've already answered that, really. You said that throughout this conversation. You're, you're basically saying your physiology changes. It works more optimally when we breathe through our nose as opposed to our mouth. But there is another kind of real-life example. This was minutes before we started the call today. He said, "You know, it's just incredible." Um, and you mentioned athletes, and I just wonder if you could briefly... I mean, the time that we got left, I'd love to cover this and also maybe some of those more super breathing techniques. So if we could just cover athletics and kinda recovery and why people really should make the effort, I think it would be super helpful.

James Nestor 11:16 So the key with athletic performance is you wanna do more for longer in a state of pure efficiency, and we know that nasal breathing is gonna allow you to perform harder with a lower heart rate. You're gonna be getting more oxygen more efficiently by breathing less. Again, we know how counterintuitive this is, but the science is very clear on that. And you can see this with professional athletes who have adopted to nasal breathing. Sanya Richards-Ross, the best, uh, runner, sprinter, uh, for 10 years going. Uh, it's fascinating to look at pictures of her, uh, in the Olympics. Closed mouth, nasal breathing. All of her competitors [gasps] beside her breathing through the mouth. She's in front of the line winning golds time and time again. And she's just one example of what we've already known for decades. Dr. John Douillard has done tons of science, tons of work in this, looking at cyclists' nasal breathing versus mouth breathing. And looking at their endurance, looking at their performance, and looking at recovery, and it is such a drastic difference between those two. What... One reason why a lot of people give up is they try nasal bre... They've been habitually mouth breathing while they're jogging for sometimes decades. They try nasal breathing, they're like, "Ugh, I can't get enough air in there. I'm giving up." But sometimes it can take weeks or even months to truly acclimate this organ here to breathe properly. But once you do, the benefits are huge.

Dr. Rangan Chatterjee 12:57 Yeah.

James Nestor 12:57 And check out the work by Phil Maffetone, Dr. John Douillard, and some of the athletes that have adopted proper nasal breathing, or try... Most importantly, try it yourself. [laughs]

Dr. Rangan Chatterjee 13:08 Yeah.

James Nestor 13:08 And, and you can very clearly see the difference.

Dr. Rangan Chatterjee 13:10 Y- y- I would say to people, 'cause I've literally been experimenting this for maybe 12, 18 months now, uh, you know, when I go for a walk, I'm nasal breathing. Like, I'm... It's, you know, no question. I will make su- I don't think about it now, 'cause I know I do it. But initially I had to, you know, consciously think about it. I do... You know, I take the kids for walks. We all go, we're, we're, we're all sort of trying to spot if one of us is mouth breathing, 'cause I'm trying to instill it in my kids-

James Nestor 13:34 [laughs]

Dr. Rangan Chatterjee 13:35 ... from a young age, that this is important. Actually, I went for a run with my son yesterday. He's like, "Daddy, Daddy, look, that guy's running. He's mouth breathing. That guy's mouth breathing." I'm like, I'm sort of conflicted. Have I, have I started something [laughs] in him? I'm not sure. But, but on one level I like it, because I think, okay, as you said before, awareness is key, right? Without awareness, we can't make any change. So first of all, let's be aware of what's happening. Let's not beat ourselves up. Be aware, then let's go, "Well, maybe I'll start with a walk." Maybe a five-minute walk each day, nasal breathing, and see how you go. Um, and for me personally, now I sort of am getting into running. I was going to buy a heart rate monitor, and I thought, "You know what? Forget it." I, I, I sort of don't want more and more tech in my life. I'm trying to sort of go more minimalist, and I use, uh, nasal breathing as my barometer. As soon as I go too fast where I cannot nasal breathe and I have to open my mouth, that's my trigger to slow down, and I really feel I'm getting more efficient. And, uh, it, it feels really good. And you know what? I'm not stiff the next day or that evening. I, I recover quickly. Again, I will admit this is a subjective experience, but it backs up the data and the science that you've written about so beautifully in your book.

James Nestor 14:47 But there's... E- ex- exactly. It, it may be a subjective experience, but it's, it's grounded in real science. If, if you look at nasal breathing and you look at using that oxygen most efficiently, you are allowing your body to operate in an aerobic state for longer than, than to go anaerobic and have that lactic acid build up and, and all of that. And this is very well known, having that balance, again, of CO2 and oxygen. And something that Patrick Mc- McEwen told me, which I really liked, he said, "Never work out harder than you can breathe correctly." So once you've reached that threshold and you're breathing to you're like, "I really gotta breathe through my mouth," or you're breathing in a dysfunctional way, you have to slow down and work yourself back up. And by slowly working yourself up this way, your performance is just gonna shoot through the roof.

Dr. Rangan Chatterjee 15:39 Yeah.

James Nestor 15:39 And we've seen that time and time again. And again, th- these weren't studies that I was doing. These are studies that have been around for decades, that right now there's this new interest in breathing in athletics, and I have a feeling these people who are gonna be adopting these healthy breathing habits are just gonna show some incredible improvements.

Dr. Rangan Chatterjee 16:00 Yeah, no, absolutely. And it's, it's again, it's just reflective of culture. It's the more, now, we're quicker, faster. It's the, "I'm gonna work out, I'm gonna push it hard. I'm gonna, I'm gonna be grunting. I'm gonna be..." You know, it's, it's... I, I, I wonder, is it a Western thing? I guess it is on, on some level. Like, it's... I really feel we're at that point now in Western culture where we have to go, "Look, we do so many things beautifully well, but we're kind of a bit lost on some of these other things." And maybe just slowing down and doing less. When we, you know, in inverted commas "work out" or move our bodies, maybe use your nose as the barometer and then, you know, you'll be working on your efficiency. Maybe you'll go... You, you'll run less, but you'll run more efficiently, which actually will lead to you running more just a few months down the line.

James Nestor 16:46 Yeah. It still ties... There's nothing wrong with running further and running faster than a competitor, right? That's, that's human nature to wanna do that. But if you really wanna do that, you have to take control of the systems in your body, and you have to be operating more efficiently. Why waste energy? Like, why not store that energy, then use it to best your competitor?

Dr. Rangan Chatterjee 17:08 Yeah.

James Nestor 17:08 That's what sports performance is all about. And something you mentioned that, that I thought was interesting is in so many ways, like, what we know about eating now, food... I remember in the 80... Growing up in the '80s, just the only things that were around the house were just, like, processed food. And this was normal. White bread, Velveeta cheese, and everyone seemed to be eating this way. Well, we know that eating that stuff is bad news. I'd, I'd be hard-pressed to find someone who is gonna defend eating highly processed foods. It's bad news. It took us a while to get to this point, right? So, it, it took about maybe 20 years of science to come out. Now we all know it, and I really think breathing is this next thing. So 20 years ago... Even nowadays, some people are poo-pooing it, say, "How we breathe doesn't matter." The science is so clear, and you can go back in history thousands of years, again, and they have been studying this for so long. And-

Dr. Rangan Chatterjee 18:05 Yeah

James Nestor 18:05 ... it really feels like this wave of awareness is really-

Dr. Rangan Chatterjee 18:09 Yeah

James Nestor 18:09 ... starting to, to crash right now.

Dr. Rangan Chatterjee 18:11 No, I would agree, James. So, so just for the sort of final stage of this conversation then, um, we've... Just to sort of really put it in perspective, you know, we're, we're setting the scene that people are breathing too much, they're breathing too fast- And it's not necessarily how... Yeah, of course, breathing when you're working out and running, sure, work on it if you want to. But again, if you wanna do a sprint and you wanna breathe through your mouth- mouth a beat an opponent, that's okay. It's... What we're talking about is how do you habitually breathe, right? So, um, you know, because I know there's some confusion, so just to clarify, so what- what you're saying, I think, and certainly what I would say is practice breathing through your nose. Practice for a few minutes a day breathing less. Try and go for that six or even eight breaths a minute. See how that feels. Now, if you wanna go beyond that, if you wanna go into super breathing territory, right? The cool stuff that people get, "Oh, you know what? I wanna- I wanna do a marathon up Everest like Wim Hof or- or..." You know, which again appeals to us culture of doing more, and I wanna do all that crazy stuff. There are quite a few different methods, aren't there, where we consciously over-breathe. So you were talking about under-breathing.

Dr. Rangan Chatterjee 19:22 Now I wanna talk about, you know, Wim Hof, uh, the breathing technique or one of his breathing techniques, certainly the one I've experienced in a... when I saw him speak in LA a few years ago, and I recorded a- a podcast with him a few weeks back. It's not come out yet, and we actually did it where you actually, you know, for 30 or 40 breaths, you take these big breaths in and out, and then you do a hold. What is that doing? What... why should people think about these over-breathing practices? Did you try them as part of your research? Did you look into the research here? And what- what sort of... what- what would you tell people about these practices for those who are interested?

James Nestor 19:57 Sure. So the first thing, I just have to second something that you said. I'm talking about mouth breathing as a habit. Some people have written me and said, "I noticed I was laughing today and I took a few mouth breaths." And again, I'm like, "Ugh, I thought I had- I had made this very clear in the book." So I've been breathing through my mouth talking to you today.

Dr. Rangan Chatterjee 20:17 Yeah

James Nestor 20:17 Right? And when I swim in the ocean, I'm breathing through my mouth. When I'm laughing, I'm breathing through my mouth. This is perfectly fine and perfectly natural. So a few hundred breaths per day breathing through the mouth is fine. If we're taking 25,000, it's about that habit and that chronic breathing. Um, you- you want to be breathing through your nose as often as you can, but that doesn't mean you should hate yourself for laughing or for breathing through your mouth. [laughs] I just wanna make that really, really clear for everyone. [coughs] But the-

Dr. Rangan Chatterjee 20:50 Or swimmers, right? Swimmers. Swimmers.

James Nestor 20:52 Yeah.

Dr. Rangan Chatterjee 20:52 Like, you know, when you're swimming, you sort of have to take it... You don't have to, but you may gulp in a lot of water unless you breathe in through your mouth. So it's-

James Nestor 21:00 Absolutely

Dr. Rangan Chatterjee 21:01 ... it could be normal for swimming. It can be fine. You know, um-

James Nestor 21:04 I swim and surf almost every day out here in San Francisco, and I'll tell you, I'm not breathing through my nose when I'm doing that. It's impossible. There's-

Dr. Rangan Chatterjee 21:11 Yeah

James Nestor 21:11 ... there's saltwater up there. And there's nothing wrong with that.

Dr. Rangan Chatterjee 21:15 Exactly.

James Nestor 21:16 It's chronic. It's habit. So I... in- in the book, after, like, you get that foundation of healthy breathing that everyone can benefit from, I kept hearing about Wim Hof breathing, these intense pranayamas, holotropic breathwork, these long breath holds. I said, "This is completely counter to what I learned before. We shouldn't... Like, apnea's a bad thing. Over-breathing's a bad thing." All of that is true when it's unconscious. But when you consciously do it, when you place yourself into a position in which you tell yourself to follow with this ancient breathing technique, and some of these include mouth breathing-

Dr. Rangan Chatterjee 21:55 Yeah

James Nestor 21:56 ... exhaling through the mouth or even inhaling through the mouth, something amazing happens because you're allowing yourself to consciously take control of unconscious functions in your body. So with Wim specifically, what I thought was so interesting is we have this autonomic nervous system that turns us on for sympathetic stress or turns us off and relaxes us, parasympathetic. And we've been told, if you get a... pick up a textbook, it's gonna say this is autonomic, as in automatic, as in beyond our conscious control. But we can control it through breathing, and when we control our nervous system function, we can take control of our immune system functions as well. And we've seen this. People who have been practicing Wim's version, which the... he calls it Wim Hof Method, uh, but he's very clear that this stuff has been around for at least 1,000 years. He didn't invent anything. He was able to take this thing and distribute it to the masses, and he's done that better than anyone on the planet for breathing awareness. But it's no coincidence that the people who practice this, people with autoimmune diseases, with ar- arthritis, eczema, psoriasis, what- whatever, they can show a marked decrease in the symptoms of their problems, and sometimes they claim that they're completely healed by adopting these simple breathing habits. Because what they're doing is they're breathing in a way that purposely stresses themself out for a short amount of time so that they can spend the rest of the day relaxing and healing themselves. And again, seems a little counterintuitive. Why would I purposely wanna stress myself out if I'm stressed out throughout the rest of the day? The point is to focus that and to regain a balance in your body and in your health, and that's exactly what these more intense over-breathing practices do.

Dr. Rangan Chatterjee 23:54 I think what you said there about where this has come from, that nobody new has invented anything, you know, Wim hasn't, it's... these are all, uh, practices that have been there. Uh, but you also paid homage to Wim. He's very... he's- he's- he's got it out there to the masses in a fantastic way. You've said that, you know, that in the Indus Valley 5,000 years ago, there's- there's writings on this and that. You actually... I think you wrote the- about that yoga or the, or the res- the scriptures you saw showed yoga initially was just a breathing practice I think-

James Nestor 24:30 That's exactly true

Dr. Rangan Chatterjee 24:31 ... what you... It's that true?

James Nestor 24:32 The apps... There were no standing poses. There was no movement. It was focusing, meditating, [inhales] and breathing. Only in the last 100 years have we developed Vinyasa flow. That wasn't around until 100 years ago. And I wanna make this very clear to all the yogis out there, I do yoga all the time. Love it. I've seen the benefits. There's science proving the benefits. But this practice, this modern yoga that most of us do, is just that. It's modern. So the first yoga was a practice of breathing and focusing, and then it developed into holding one pose and breathing. Opening up this side [inhales] inhaling into that lung, opening up the other side. And then about 100 years ago, 110 years ago, those poses were combined into this sort of dance-like movement, which had nothing to do with the early yoga. So it, it really was all based on breathing and focusing on the breath.

Dr. Rangan Chatterjee 25:36 Yeah, amazing. And one of the... I think you quote someone in the book, um, I, I can't remember who it was, but someone said to you, "There are as many breath practices as there are diets." I've never heard that before. I thought that was incredible because you... We talked about conscious over-breathing, and, you know, if we had more time, I would talk about Tummo breathing and holotropic breathing. But you know what? It's all there in your book for people to read about. Um, but that is... W- who, who said that phrase? Who was it?

James Nestor 26:07 Uh, a free diver told me that, uh, very early on, which I thought was very surprising. I didn't know that there were different ways of breathing. This was years and years ago. But by adopting those, those different breathing practices, you can push your body into different states. You can relax yourself on purpose. You can stress yourself out on purpose, which has pronounced benefits to doing that as well. And again, you can find books. There's yoga books with 400 different breathing practices with all of these crazy names. All of that's great, but w- I wanted to focus on the general concept behind these. There are heavy breathing practices, over-breathing. There are... There's breath-holding, there's slow breathing, and there's nasal breathing. And you can call it whatever you want. You can practice the Chinese version of that, the Greek version of that, the Indian version of that. Doesn't matter because they're really all doing the same thing. To me, it's no coincidence that Wim Hof method, also known as Tummo, has so many of the same benefits of Sudarshan Kriya, which has been studied in 60 different independent studies to help people with anxiety, depression, autoimmune problems. There's, there's no coincidence that these things are helping people in the same way, because guess what? They have you breathe really intensely [inhales] and then breathe really slowly. It's almost the exact same practice, just coming in from different directions.

Dr. Rangan Chatterjee 27:31 Absolutely.

Dr. Rangan Chatterjee 27:32 Before we wrap up, you mentioned free diving, and I know you wrote a book on that. I haven't read it yet, and I am... Definitely it's on, right at the top of my list to, to, to sort of read, uh, when I, when I get some time. But one question I had about free divers who c- who obviously have masterful control of their breath, did you notice... Was there a theme that... You know, a free diver, by definition, needs to have a very high level of control over their breath. You know, a high degree of carbon dioxide tolerance, so they can actually go down and actually maintain that... You know, tolerate the buildup of carbon dioxide in their body without having that strong urge to, to, to breathe. Given the multiple benefits of improving your breathing, have you heard any stories in free divers that actually, a lot of them had mental health problems or depression or anxiety or, or autoimmune conditions that, that got better? Or the flip side is, was it those conditions that actually led them to free driving i- in the first place? I don't know. It's so interesting for me, that.

James Nestor 28:41 Many of them had anxiety issues, sometimes depression issues, sometimes addiction issues. There's a great film that, uh, somebody made, a, a very short film, Jonathan Rempel, about a free diver who had all of those things. And she found free diving... Because when you free dive, you are putting... It is almost like a forced meditation. You cannot free dive stressed out. You cannot free dive with anxiety. You cannot free dive with a sense of panic. You have to completely give yourself over to the water and connect so deeply in your body. And when you're down there, everything is silent, so you are so connected with your breath and with your brain on such an intimate level. And this reconnects people with themselves when they're up on dry land afterwards. And to... S- so some people have found that salvation through free diving, and so much of that is due to breath control. So I've never seen... Uh, I've met dozens and dozens of free divers. That, that book, Deep, looked at the ocean from the surface to the very bottom of the sea, looking at the human connection. So towards the surface, there was a lot of free diving, but I've never seen one who suffered from anxiety. I've never seen one who panicked, because you just can't do that when, when you're down deep in the water holding, holding your breath. There hasn't been any studies on this. I think it would be fascinating to look at the physiology of someone before and after training for free diving. Look at markers of panic. Look at other i- uh, issues, even blood glucose, um, and how they react. Because free diving is... That is the ultimate art of breathing. You're focused on your breath, connected to your breath the whole time

Dr. Rangan Chatterjee 30:31 ... it's breath, it's mindfulness, it's meditation. It's everything all in one, right? To be able to, to, to, to do that practice. And one study that we've not had a chance to talk about, which I've underlined heavily in my book, and I'd encourage people to read it in the book, it's, it's just this idea of fear and that lady who didn't... who had that genetic condition without the amygdala, the sort of emotional center, the fear center of the brain, and how basically you can't stress her out. She d- she would get scared of nothing, until carbon dioxide went into it. She got a dose of carbon dioxide, and that then stressed her out and scared her. I w- I won't sort of spoil the rest of the story there for people, but what, what's really incredible for that, and I really want people to get this, is that we think fear and anxiety is always about an external event. "Oh, that is happening to us." We, we forget that it can be biology, it can be physiology. And, and I really... I know how many people suffer from these sort of conditions, and I really, really want to encourage them that what James has been talking about, read the book, learn about these techniques, and start small, because it can really transform every aspect of your life. Um, James, look, I, I really... I don't say this often, but, but that is a phenomenal book. Uh, I, I feel quite lucky actually. I've got these early copies. They're still very sort of the early unproved manuscripts. Uh, so I feel I've got sort of something quite special here. Um, the, the podcast is called Feel Better, Live More because, James, I... It's pretty obvious, but fundamentally, I, I, I've seen time and time again where people feel better in themselves, they get more out of their lives. And I think it's pretty clear that you're making the case that if we breathe better, we're gonna live more. So I wonder if... You know, I, I want people to get inspired by this. I want them to get your book. But I want people to take action. I don't want them just to hear it and go, "That was interesting," and then get on with their lives. So I always like to leave the podcast with my guests with some sort of practical advice. I know you've covered a lot of it already, but just some sort of... What would you say? If someone, someone's heard this and are still skeptical, how would you encourage them to get going with a breathwork practice in their daily lives?

James Nestor 32:47 I would say go see for yourself, because you're, you're your best judge of this. If you have a blood pressure monitor, and a lot of people do, take your blood pressure before and after a simple breathing practice six times a minute. You could start with that. Start small, exactly as you had said, and give it a while. Um, by that, give it a week. So a- adopt a simple practice. And again, this isn't requiring you to go to a monastery or sit in a dark corner. You can adopt healthy breathing practices anywhere. And we know that there's a solid foundation of science between all of these things. We have seen people absolutely transform by adopting simple breathing habits. This is not a placebo effect. It's absolutely real, and I'm convinced. I've experienced this myself. I've talked to dozens and dozens of people who have also experienced it. I've talked to the leaders in the field who have introduced me to all of their data. And I, I find that this is an underappreciated and underacknowledged aspect of our health, but that's starting to change, and it couldn't happen sooner. Especially right now with... in the midst of a pandemic, focusing on your breathing can really have some transformative effects.

Dr. Rangan Chatterjee 34:03 I think we're all walking around with this reservoir of untapped potential that we don't even know how good we could feel, how fit we could be, how well we could sleep, how much less stress we could feel in our lives if we found the right breathing technique for us that's gonna suit, you know, our lifestyle and the way we choose to live. And I thought a good place to really think about this is by talking about, uh, Swami Rama, who we didn't talk about last time. Because I think he is really showing just how far you can go with this, and I, I'm not saying we all need to go that far, but I think it beautifully illustrates just what is possible when you really learn to harness the power of your breath.

James Nestor 34:51 Yeah. And, you know, before we get into Swami Rama, I just wanna mention, uh, pick up on one thing. We were just talking about kids, and we didn't mention this in the first chat either. But since the book has come out and since you and I chatted, how many months ago was that, I've heard from so many sleep medicine researchers, people who specialize in pediatrics. And what I learned from them is that the pandemic of ADHD, about 10% of the population in the US suffers from ADHD. Most are kids from age two to five, and then it picks up again from ages around 12 to 17. But most ADHD is tied directly to breathing and breathing quality. And they showed me the percentages of 75% of kids who have ADHD also have sleep disordered breathing. And by improving their breathing during the day and during the night, so many of these kids can overcome what is considered this psychological or neurological problem. And that has just blown me away, that simply breathing properly can have such a transformative effect. But then I was thinking about it more. I said, "This shouldn't be shocking," because if you're doing something wrong throughout the day, and if you're doing something 100% wrong for a third of your life, it's gonna destroy your body, and that's what we've been seeing with these kids for, with ADHD. And Dr. Steven Park at Albert Einstein College of Medicine that's doing some incredible work in this area as well. Looking at what happens when you allow a kid to breathe better, look at how quickly they're able to overcome some of these chronic issues. So I just wanted to tie that on, uh, before we talk about Swami Rama. But in many ways, I view that these things are related because it just shows you the potential of what breathing can do, not only to heal us of some chronic issues, but to also put us up that next rung of human potential. And I think that, uh, old Mr. Rama did that better than anyone. This is to give a little backstory on him. This is somebody who grew up in the Himalayas, and he was taught yoga and breathwork at the age of around four.

Dr. Rangan Chatterjee 37:31 Wow.

James Nestor 37:31 And he stuck with it his whole life, spent years in a cave honing this skill, and he got so good at it that by the time he was in his 30s, he went off and traveled the world. He studied at Oxford. He studied at various universities. He knew, like, eight different languages, and he was so impressive that researchers at the Menninger Clinic, which at the time was the largest psychiatric training facility in the US and the most renowned, a Navy physicist there had heard about all these things he was able to do. In other tests, he apparently was able to stop his heart with his... just by focusing on his mind and breath, and he was able to increase the temperature in his fingers. And this Navy physicist didn't believe these stories, even though the data was right there, so he brought Swami Rama into his facility and conducted a battery of tests, and they found that he was able to remain conscious while he lulled his brain into a delta state. So a delta state are the states of very deep sleep. We're supposed to be unconscious. We're supposed to be asleep, but he was able to remain conscious during these states. So that was pretty impressive. But what impressed them even more was that he was able to control his heart rate. He was able to increase it about 20 beats per minute within a space of about eight seconds, and he was actually able to make it beat at a rate of more than 300 beats per minute with his mind, [chuckles] and he did this for more than a minute. Um, that state, atrial fibrillation, is supposed to be, uh, you know, it will kill you after a while, but apparently Swami Rama could do this for about a half an hour to an hour. All of these things are medically impossible, and no one would believe it unless there was a real doctor there, researcher there recording the whole thing. And still, this was reported in The New York Times, so it was reported in Time Magazine, and still I get letters from doctors that say, "You should check your sources. This is obviously impossible. No one can do this." And, you know, how much more science do you need? Uh, but that has more to do with how people want to view the world than, than to actually look at data and numbers, so.

Dr. Rangan Chatterjee 40:10 Could he also change the temperature on his hands?

James Nestor 40:14 Yeah, I mean, there's a whole laundry list of things this guy could do.

Dr. Rangan Chatterjee 40:17 [laughs]

James Nestor 40:18 I didn't wanna bo- I didn't wanna bore you with it, but in another experiment, since you asked, of course-

Dr. Rangan Chatterjee 40:23 [laughs]

James Nestor 40:24 ... he was able to take his hand and focus on his hand and turn one area gray from lack of blood flow and the other area bright red, and they went and they measured the temperature on the same hand, and it varied by 11 degrees. [lips smack] So not only could he take over entire organs like the heart and the brain, but he could take over specific parts of his body and pinpoint where he wanted to control his conscious energy. And a few people who had studied with Rama have written me, and they said, "Oh, you know, it was great to read that you were able to track down this research and track down these studies, but this was child's play to him." [laughs] This was apparently nothing, and he's, he's now passed away, but I am now currently trying to get ahold of some other people who have learned Rama's methods and who can do things that, according to them, I've not seen any of this, will really be- make what Rama did in these studies seem very in- insignificant. So, uh, you know, COVID has put a big fork in that, but things are starting to open up, and I'm hoping to go back out into the field and, and to record and write about more of this stuff.

Dr. Rangan Chatterjee 42:01 I mean, it is interesting to hear the skepticism that will come back on these sort of extreme stories. You often, you often get the skepticism around Wim Hof as well. Um, it's still there even though I think he's shown through a lot of science. A lot of real-life people have adopted these and are writing and are sharing their experiences, so there's a lot of real-world data out there as well. Yet there is that skepticism, and it really speaks to what I was thinking about today, which is this, this untapped reservoir of potential that we all have within us. You know, the body's pharmacy that we're not properly opening up and accessing. And- I guess one of the reasons Wim has been so relatable to people is because, certainly in the Western world, I should be really clear, in the Western world it's because, you know, he l- you know, he kind of... The name Swami Rama, I guess, might put a block there for certain people. "Oh, that doesn't apply to me." And of course he was, you know, this guy was rocking meditation and breathwork at the age of four, which is fantastic, in the Himalayas as well. So it, it adds to this kind of romanticism and mystique that people then sort of feel, "Well, that's not relevant for me. I live in the middle of the city. I've gotta, you know, work six days a week. I've gotta do this and take my kids to afterschool club." You know, it, it seems quite distant, whereas Wim, I think to some people at least, feels a lot more relatable. But they both speak to the potential there. Because what, what you've just described, uh, Swami Rama doing, mind-blowing, incredible. But, you know, Wim has also done some incredible stuff where people have injected endotoxin, which would make most people sick, and through his breath, through his controlling his immune system, he doesn't get sick. And I, and I, I, again, I've been thinking about this theme recently, that, yes, we want science, and I know we want science, and it's great to get the science to really give it that validation to spread the message. But it feels to me on some level that breathing is so fundamental to who we are as humans that there's almost a three-dimensional quality to breathing. You know, the life force, the energy it gives us. As soon as we stop breathing, we die. Um, that actually I wonder sometimes, do we look at it through a very sort of one-dimensional, reductionist, scientific lens? Whilst that has merit, I sometimes wonder if we're missing some of that broader picture that some of, I guess, of these ancient practices may have been speaking about and talking about for many years.

James Nestor 44:41 Well, I think when it comes to people's apprehension, there's nothing much I can do about that. And the last thing I wanna do is to become an evangelist. I really wanna be even-keeled here and just provide what I have found, you know?

Dr. Rangan Chatterjee 44:58 Yeah.

James Nestor 44:58 I'm not the one doing the research here. I'm reporting. And there's a big difference in that. I think when you look at Wim Hof and Tummo, and I've gotten some blowback on this as well. I've had people say, "It is impossible for a human to sit in snow for eight hours at a time and melt a circle around themselves without wearing any clothes. This is scientifically impossible." And then I'll send them the study done by Herbert Benson at Harvard Medical School that was published in Nature, the most esteemed scientific journal on the planet, that shows that people can do this with their breathing. And that's usually when I never hear back from these people again. And that's fine, [laughs] right? So Wim has come up with the exact same resistance, but the difference is he's not wearing a robe, he's not wearing beads. He drinks beer, eats pasta, plays guitar, you know, just like every other middle-aged adult male. And so that has made him very, uh, a- approachable in many ways. He's also volunteered to do whatever study people wanna do. And I think what he's discovered, especially with the study with the endotoxin, when they first shot Wim up with, uh, the endotoxin of E. coli, and he didn't suffer any symptoms. And they said, "Oh, you're just a weirdo. There's no, there's no way anyone else can do this." He's like, "Well, let me take a group of people that you can pick. I'm gonna train them for four days, and then they're gonna come back and do exactly what I did," which is exactly what happened. So I think that it's this kind of science and this accumulation of data which is so necessary. You'll c- you'll certainly get to a point where people just don't wanna hear about it. If you look at climate change, how many studies are there showing climate change is real? Like 1,200, 1,300? And you still have people saying, "Ah, I don't believe any of that stuff." What can you do about that? To, to me, you can just offer them information, right? And if they wanna approach this in a scientific way with truly an open view, then they can do with that what, what they will and really look at the data. But when it comes to these superhuman feats of Swami Rama and Wim Hof, and even Chuck McGee has, has these to a certain extent, I don't view these as superhuman at all. These are human abilities that each and every one of us can hone. And when we hone them, we can maybe not be able to sit in snow for eight hours at a time and melt a circle around us, but we can improve our health. And I think that that is Wim's most impressive and important message. He's saying, "Don't go to Everest and run a half marathon in bare feet and bare-chested like me. I already did that. But why don't you take control of your breath? And then once you take control of your breath, you can use that to help establish better healthy habits throughout the day." And I think that's why he's resonated with so many people across the globe, is because he's allowing them to use something that we are all born with, right? It's our own natural human body to improve our condition.

Dr. Rangan Chatterjee 48:29 It's beyond health as well-

James Nestor 48:31 Yeah

Dr. Rangan Chatterjee 48:31 ... uh, James. It's, it, you know, everything we do in life, we're breathing whilst we're doing it, right? Y- we take our breath everywhere with us. It's n- no part of our life is, is lived separately to the breath. And therefore, improving our breath has the potential to improve- Every aspects of our life. You mentioned health, but our relationships can be significantly improved because if we can control our breath, we can breathe better, our stress levels will be lower. We, we deal with stress and friction much better. Your sleep quality can potentially be better. We spoke about that at the start, about nasal breathing at night. You know, yes, there's gonna be an impact on chronic disease as well, but it's... It is this three-dimensional kind of... Th- this is sort of what I was getting at, that it... You, you don't live your life without your breath, so improving the quality of your breath absolutely can have profound benefits whether you wanna climb Everest in your shorts, or whether you just wanna get through the day better, calmer, more peace. You know, and I guess that's why as a doctor, I'm so passionate about breathwork, and each of my four books, breathwork has come up in all of them even though I write about different topics, because the breath is central to so many different aspects of our lives.

James Nestor 49:55 I learned this from a sleep researcher and, and biochemist. He said that we get most of our energy not through food, but through our breath. So if you look at how glucose is broken down, it takes six times more oxygen than glucose to fuel us, and he broke down the whole chemical structure of how that works with oxidative phosphorylation and, and he said, "So if you explain to people that, you know, all of the food that they're focusing on every minute of the day, all of the supplements," yes, food is incredibly important for health and for energy. Of course it is. But that food can't do any of its magic if you don't have the breath there as well, if you don't have that proper and efficient supply of oxygen. So just as you mentioned, this is not woo-woo new age stuff. This is the most basic biochemistry in the human body, and breathing has to be considered as important as what we eat and how much we exercise and how well we sleep. It really does, and I think it's starting to. I think it's been pushed to the background for a little while now, but people are starting to recognize it. And just concerning how the human body is able to function better with breathing and what happens when we put the body in a state of nature, there's a quote by Albert Szent-Györgyi, who won the Nobel Prize for his work in vitamin C, that, that I love. And as you were talking, I was just reminded of this quote. He said, "More than 60 years of research on living systems has convinced me that our body is much more nearly perfect than the endless list of ailments suggests. Its shortcomings are due less to its inborn imperfections than to our abusing it." That's pretty wordy, but what he's saying is the further we put ourself away from nature, the sicker we're gonna get, and the more we return to the state in which we naturally evolved, the better we can get, and breathing, again, is a huge part of that. Returning your breathing to the way your ancestors used to breathe. Not superhuman breathing, not super turbo breathing. Just regular, natural human breathing is all you need. Follow your ancestors as the guide or any of the other 5,400 different mammals in the wild right now, and that to me is really the best teacher as far as breathing is concerned.

Dr. Rangan Chatterjee 52:48 To breathe well and to breathe optimally, we need a certain physical structure. We need a certain posture. We need to be able to get into certain positions. And I've read somewhere in your work, James, that 30% of breathing is dictated by posture, yet we're living in a society where many people have got rounded backs, sort of craned out necks. There's many reasons for that. Sedentary jobs, smartphones, laptops, whatever it is. But, you know, how, how does this play a role in our ability to breathe? Because some people will be hearing this and go, "Okay, James, you convinced me. I'm in. I'm, uh... I wa- I wanna breathe better. I, I wanna, I wanna get your book. I wanna check out the techniques. I wanna find the right one for me." But where does posture play a role, and what can people do about that?

James Nestor 53:41 Well, if you consider that in your chest right now are these two huge balloons, right? These, these are your lungs, and these balloons need to inflate properly and deflate for you to get a consistent and easy flow of air. And by getting that consistent and easy flow of air, you will be able to consistently and easily get a flow of oxygen, which is what is gonna fuel all of your cells. So when we're sitting like this, hunched over, which is how I sit a lot, or if we're sitting on a couch with our feet up, and if we're walking around with our shoulders like this, even if we wanted to take a full and easy breath, we can't, because we can't inflate those two balloons in our chest, those two lungs. So Dr. Belisa Vranich has done some amazing work in the biomechanics of breathing, and I talked with her recently. I've read her books, and they're fantastic if you're looking at the biomechanics of breathing. And she has found that most of us tend to breathe- Up and down, right? But what we should really be doing is to be breathing out and in. Because what you want to do is you want to be engaging the diaphragm and inhaling the lungs, air into the lungs very softly. So in order to do that, your ribcage needs to be flexible, right? And if you think about what yoga does, what is yoga more than just a way of stretching your ribcage and your intercostals so that you can breathe more easily? So Vranich has this test, it's called the BIC test, and what you do is you place your hands, and you put them above your hip bones, and you [inhales] breathe in, and you want to feel your hands moving out laterally, not just your stomach going out. That's where a lot of people get it wrong. Like, they think belly breathing is about pushing the stomach out. You want your, your belly around here to expand outward and inward. And if you can do that, then you're breathing correctly. If you can't and you feel no movement there, then you're an up-and-down breather. And, uh, the more you focus on this, on breathing out and in, the more you start to feel your diaphragm descen- descending in the proper way, and the more you, you start being able to breathe more easily. This has made an incredible difference for me in my understanding of breathing. Not only that, but also in athletic performance, whether I'm surfing or running or whatever. To focus on breathing outward and inward instead of up and down.

Dr. Rangan Chatterjee 56:39 Yeah, it's incredible, and it's, I guess, what you're showcasing there is that it doesn't matter if your posture's a bit altered from years of not breathing well and being hunched over. I guess the, the positive note is there's things you can do once you now flip that switch in your brain and say, "Right, okay, I'm gonna take breath seriously. I'm gonna start working on certain things. I'm gonna every day just try that and just see if I can get a bit more expansion out rather than up and down." I really think people are gonna start to feel those differences. And as I said earlier in our conversation, they're gonna start tuning into things that they, they weren't even aware of before. You know, um, I said, James, that I'm, uh, training for the London Marathon in October, and, um, I was actually challenged by a, a radio DJ last year [chuckles] to, to do it live on air, and I said yes. It was ch- due to be in 12 weeks at that time, and I wasn't a runner. But because of COVID and the restrictions, it's been delayed, it's been delayed. It's now meant to be happening this October. Now, at the time, I was having some hamstring issues, and I was put in touch with one of the best movement therapists I've ever come across, and I've, and I've dealt with many over the course of my career. And she's got this machine. There's only three of them in the world. She's got these machines where they can literally measure every bone in your body as you're running and see the positioning. And she just uses that as a tool. But what's interesting is that we do lots of things together, and it's, it's been transformative for me in my running, but also in my breathing. And once we did this thing where my, my spine, all the bones in my spine, one of the big problems for me is that they always face right. They never come round to midline and go to the left. This is something you, you really wouldn't know until you'd been on a machine like this, and you can actually see. And then a lot of my issues start to make a lot of sense. And she gave me this, uh, gorgeous spiral breathing exercise to do that took about three minutes. We did it together. I felt totally open, and my ribs expanded afterwards. So we went back on the machine. No word of a lie, everything came back online, and my spine is now going right, and then it, when I went, it's going all the way to the left. It's like... I said, "Helen, what I've... That has completely changed, yet all I've done is three minutes of breath work." She goes, "Yeah, I see this all the time. It's because once we can get this working better," you know, I don't wanna oversimplify what she does. Once the diaphragm's working better, more efficiently, you know, it affects everything around it. It affects your spine. And I guess I'm just sharing that with you because again, that is N equals one. That is just my own experience. But super, super powerful. So I do that three-minute spiral breathing exercise every day. I don't need any more motivation now because I've seen firsthand that my gaits, my biomechanics change simply on the back of it.

James Nestor 59:38 So this once again reminds me of another ancient quote I'm gonna bore you with that's about 1400 years old.

Dr. Rangan Chatterjee 59:43 I, I'm, I'm loving these quotes, man. Loving them.

James Nestor 59:45 [laughs] So this one I, I think speaks to exactly what you just said. It says, "What the bodily form depends on is breath, and what breath relies upon is form. When the breath is perfect, the form is perfect too." So if you are hesitant to think that your breathing may impact your posture, just consider those huge six liters of air, those two balloons in your body, and just take a deep breath [inhales] and feel what happens to your posture when you take a deep breath and feel what happens to your spine. I was talking to Dr. Andrew Weil about this, and he had learned from a doctor early on in his studies. He's a famous American doctor.

Dr. Rangan Chatterjee 1:00:42 Yeah, Andrew Weil.

James Nestor 1:00:42 I'm not sure if he's made it across the pond here. Um, but he said, "Just look at scoliosis." Um, so this is the sideways curvature of the spine. It comes on right before puberty and, and throughout puberty. And we still don't know what causes scoliosis. Sometimes MS can definitely influence it, and other diseases can influence it, but for the mass majority of people who have scoliosis, we don't know what causes it. How strange is that? [laughs] So many people have this, and we still don't know why they have it. So he was convinced from the doctor that he talked to that this starts early on when dysfunctional breathing is present, when people tend to breathe, tend to be turned like this too much, and tend to keep breathing into the right lung or tend to keep breathing into their left lung while they're sleeping, while they're awake, while they're playing. Just like you, I tend to be a left side, um, person. I- That's where my posture is. Whenever I get my spine cracked and fixed, uh, they say, every single person tells me that. They're like, "Why are you leaning to the left so much?" I don't know. It's just one of those things. So an extreme version of what you and I are both doing is scoliosis. So when someone has this dysfunctional breathing... Again, this is so hypothetical. You can't run a randomized-

Dr. Rangan Chatterjee 1:02:16 Yeah

James Nestor 1:02:16 ... controlled study of this, and no one ever should. But just as a thought experiment, I thought that that was interesting. And then I researched the work by Katharina Schroth, who was a teenager living in Dresden, Germany at the beginning of the 1900s. She had scoliosis. It was very bad. She was given, you know, a brace and a wheelchair and told that, "This is what you're gonna do the rest of your life. Uh, you're gonna be in this brace." And she realized that she had two lungs, and these acted like balloons, and that when you place something around a balloon and inflate it, whatever is around it will take that form. So she developed something called orthopedic breathing, where she would breathe into one lung and exhale, breathe into the other lung and exhale, and she actually breathed her spine straight and went and taught this to thousands and thousands of women. It's still being used at Johns Hopkins University. The pictures are there. The studies are there. And, uh, it's still interesting that so many people with scoliosis now are completely unaware of how breathing, just breathing and stretching, can have a really profound effect on posture. And for those of us lucky enough not to have scoliosis, how you breathe vastly affects your posture. If you're breathing unhealthy, it's gonna affect your posture. If you're breathing healthy, that's gonna improve your posture, and the proof is all over the place.

Dr. Rangan Chatterjee 1:03:59 Breathing better, able to, you know, being able to use our diaphragm more fully, um, breathing out and in rather than just up and down, you know, these things will have an impact on our lung capacity. And of course, lung capacity, you know, better lung capacity is gonna make you fitter if you're an athlete or certainly give you a better ability to go harder for longer. But I think lung capacity also really has benefits for us beyond fitness, for health, wellbeing, day-to-day health and wellbeing, but also longevity. Can you speak a little bit around lung capacity and, and just how important that is?

James Nestor 1:04:41 Sure. So larger lungs for athletes is a bigger gas tank. They can go longer without having to fill up, so obviously that's gonna affect their performance, and it's also gonna affect their recovery, as we were talking about earlier. But just having larger and healthier lungs has been discovered to have a profound effect on lifespan. And I found this in the Framingham Study, which is this 70-year-long longitudinal study focused on heart health, but what they found was that the most significant and accurate marker of lifespan wasn't genetics or exactly what we were eating. It was lung size and lung function, and they found this with a study of more than 5,200 people. The more quickly our lungs deteriorated, the more quickly we lost that lung capacity, the sooner we would die. And the better our lungs functioned, the bigger they were, the longer we would live. So there's been various studies done that have found the exact same results as the Framingham Study. I even found one study with something like 800... They looked at 800 people who had lung transplants, and they found that people who had been transplanted, larger lungs lived much longer lives. [laughs] So no matter how we get these large lungs, healthy lungs, they're gonna benefit us. They're gonna benefit our performance. They're gonna just benefit our health in general. Luckily, we don't need to go out and get larger lungs surgically implanted in our bodies. We can just breathe healthy, stretch, and exercise, and by doing those things, we can not only stave off the entropy of lung capacity... What happens after the age of about 30, we lose lung capacity every decade. It really drops off precipitously once we get into our 60s and 70s. We can reverse that and we can keep the same lung capacity and same lung f- lung function at the time when we need it most, and that's when we're older. We take in 30 pounds of air into our lungs and out of our lungs every single day. So if you think that that air and how we take that air in and how we expel it doesn't affect us, it's, it's crazy. So much more than, than food. And, and, uh, in my opinion, after talking to researchers for so many years, you can eat all the right foods, you can eat paleo or keto or vegan or whatever, you can exercise as much as you want, but if you're not breathing correctly, you're never, ever gonna be healthy. And I've seen this repeatedly with people who look to be the most fit people on the planet, and they have chronic respiratory problems, and they suffer from that in numerous ways. So once we take control of this c- unconscious ability to breathe, we can then harness all of the power within that and use it to do some incredible things. Some things that scientists thought were absolutely impossible have been proven to be absolutely possible by focusing on your breathing.

Dr. Rangan Chatterjee 1:08:05 Yeah. Well, we're gonna delve into that during this conversation today because there are so many fascinating stories that you've written about, research, you know, case studies. Um, really quite incredible. I mean, there's, there's, there's a... You know, you've done so many interviews since this book came out, and it is great for me as a, as a medical doctor to see that there appears to be a huge amount of interest now, you know, with, with books like yours really raising awareness of how important the way we breathe is.

Dr. Rangan Chatterjee 1:08:36 But I was really struck by your subtitle in the book. Um, and so the book's called Breath, but then the subtitle is The New Science of a Lost Art. Now, not only does that sound amazing [laughs] , there's, there's a real magic there. Uh, The New Science of a Lost Art. Science and art fascinates me because I say the practice of medicine is art and science. You know, it's not just science. It's not just looking at publications. It's how do you put that all together with the person in front of you, the patient in front of you, and how do you sort of blend it together to come up with the right solution for the right patients? So tell me about that subtitle in the context of the breath. Why is it a lost art?

James Nestor 1:09:20 Well, what I kept finding as I researched breathing and the art of breathing, starting from the last century to the century before that, and going back thousands of years, is people have been talking about this and writing about this and studying this for, for millennia. So, uh, the earliest dated conscious breathing practices date back, you know, about 3,000, 4,000 years. And if you look around the world, all of these different cultures started studying the same things. They started c- coming to the same conclusions about breathing. That if we do it improperly, our brea- our health is gonna suffer. If we do it properly, we can really help use that to help heal ourselves and to go up that next rung of human potential. So the thing that was frustrating is we would discover these things, and then for some reason, in some way, they would be ignored and lost. Then they would be rediscovered, renamed something else, rediscovered by someone else at a different time, and then be proven at that time and forgotten about. And this just kept happening over and over and over. I guess the more accurate title would be Lost and Found, because, 'cause that's what kept happening. And, and it really feels like right now we're at this moment where we have the instruments, we have the interest to really study breathing and to prove how it's working, how it alters our minds and our bodies, and how it can benefit us. And that would be the new science of that subtitle. Um, it's a new science, new measurements, looking at a very old practice.

Dr. Rangan Chatterjee 1:10:56 Yeah. It's interesting when you compare this to other old practices such as, uh, let's say traditional Chinese medicine, which for years has been telling us that different organs in the body function, uh, function in different ways at different times of the day. Something that Western medicine, until recently, has almost sort of looked down upon. That was... You know, the liver is the liver. The, the kidney is the kidney. But there's a lot of science now in circadian biology showing that these organs at different times in the day, there's different amounts of genetic expression, and they have different functions, different enzymatic functioning, and all kinds of things. Yet we need almost... Well, we've needed modern science now to go, "Oh, actually, yeah, you were right." Um, and, and I, and I, I sort of understand that. And you are a science journalist, so I guess you may... Or is it fair to say you always approach topics with a bit of skepticism? Because I, I, I kind of feel that is there not a little bit of arrogance in us as modern humans that we, we sort of feel that, you know, "Oh, prove it," you know, "Prove it." Like, we... You're saying this has been written about 5,000 years ago, so it's so striking that, that we've forgotten it. We, we, we, we need reminding of it. But then also, why is it at this moment in time, in 2020, why does there appear to be such an interest now in breathing and breathwork? Because, yes, your book is incredible, but Wim Hof has been gaining notoriety and popularity for, for a good few years now. Um, hopefully Patrick McKeown and with The Oxygen Advantage, that's getting more and more awareness. I mean, what is going on? What... Why, why are people interested now?

James Nestor 1:12:35 I think the, the main thing for me was I had no slant going into this story. I, I... There's no benefit for me to say nasal breathing is better than mouth breathing, or one version of breathing is better than, than the other. So, so my job as a journalist is to go in, talk to the experts in the field- ... accumulate as much information and objectively come out and, and give my, uh, assessment of, of this world, of breathing. So there was a lot of what I found which was not supported at all, but the areas that I focused on on the book have such a firm foundation of science. And I think a lot of it has to do with the way that science is set up, especially medical science right now, you know. Uh, at the beginning about half of the professors and doctors and other experts I talked to said, "Breathing doesn't matter." So how we do it does not matter. Nose, mouth, 20 times a day, 10 times a day, your body is gonna compensate, which is 100% true. Our bodies will compensate, but that doesn't mean they're fully working at their best potential. That doesn't mean we're healthy. Just getting by is different than being healthy. Then you have all these other researchers who have studied breathing for, for 50 years. Some of these researchers signed up for 50 years. They said, "How we breathe absolutely affects us." It even affects the density of our bones. It affects us down to the atomic level, subatomic level with electrons. So to, to think that how we breathe does not matter is not based in any real science. And, and again, my job was to go in and talk to these people and look at the studies and piece together a story from that.

Dr. Rangan Chatterjee 1:14:27 Yeah. Now, thanks for sharing that. Um, when I think about breathing and when I talk to people, whether it's my family, my friends, patients, I think people are starting to get awareness now that actually it's important. But there's a bit of confusion. There's so many different breathing methods out there, and I think some people struggle to know, well, what sort of breathing method should I do? And I really wanna sort of delve into that today in this conversation, but I guess before we do that, is it, is it worth clarifying, you know, what is the problem at the moment? What... Are there... Is there a base level breathing practice that everyone should do, for example? Because I think it'll be easy, and I wanna go into, you know, all k- different kinds of breathing, uh, practices, but I also wanna make sure we don't lose people so that they can see the big picture, but they also know a simple thing that they can take away and start applying.

James Nestor 1:15:26 Yeah, and that's a great question, and it's a question I had early on, because you've got dozens of books on breathing. There's some books on pranayama that have 300 different practices in it. [laughs] It's like, "Where, where do I begin here?" What I've found is so many of them all come to the same conclusion. They're all doing the same thing, so they're means to the same ends. So if you look at ancient Chinese practices of breathing, they are almost identical to ancient Hindu practices of breathing, which are almost identical to the yoga practices that are being used now or the other practices that are, uh, being used by psychiatrists for anxiety and depression. They're all doing the same thing. We know this from measurements. So what I tried to do in the book was not to focus on these individual breathing techniques but to focus on the larger story around it. How do they affect us? What are they? Where did they come from? Um, because it doesn't matter. You could call it by 12 different names. Slow breathing is slow breathing, and there's a very simple way of doing it. So the, the center of the book is a foundation of breathing that everybody can benefit from. And again, it doesn't matter who invented this or who claims to in- have invented this stuff or at what time. It's simple practices of breathing through the nose, exhaling more, breathing less, breathing slowly. So that's what I tried to focus on, the, the general view of this. And if you want more of the specifics, there's already a zillion books on, on the how to with, with hundreds of different practices.

Dr. Rangan Chatterjee 1:17:02 You're just past 8:00 AM at the moment in San Francisco, so I don't know what your normal wake-up time is, but have you done any breathwork this morning as a way of preparing for the day ahead?

James Nestor 1:17:13 I'm a night owl, so my normal wake-up time is much later than this, hence, hence the tea over here. [laughs] Um-

Dr. Rangan Chatterjee 1:17:19 Oh, wow.

James Nestor 1:17:21 But, uh, you know, people think that since I studied breathing for so many years I'd be the best breather in the world, and I'm, I'm not. I've got a lot of work to do. Um, but at least the, the first step about breathing is to be conscious of it and, and to understand that this isn't something that should just be running in the background, in the back of our minds, but something that we can take control of. So I'm acutely aware of when I'm breathing improperly, and I'm acutely aware of then how to fix it. So more intense breathwork practices I will do about three or four times a week, usually at night. But throughout the d- throughout the day I'm adopting very simple, healthy breathing habits, and that, that to me is, is one of the most important things about this. This isn't asking people to go out and run six miles a day or to completely change their lifestyle. You can adopt healthy breathing habits no matter what you're doing, if you're sitting in front of a computer, if you're watching Netflix, if you're walking around. And just by adopting those, you can have a transformative effect on your health. That sounds like a huge claim, but I've seen it, and the studies have shown it.

Dr. Rangan Chatterjee 1:18:29 Yeah. Oh, brilliant. Uh, and I think that's a great message for people. So let's dive into something that you have written about. You've touched on it in the conversation so far. Nasal breathing, okay? Um, and you know, for people who've, who've been listening to my podcast a while, they will have heard me talk about this with Brian McKenzie and with Patrick McKeown, right? Um, but I think we've got a lot of new listeners, and I think it's always reiterating how important it is to breathe through your nose. So, so what's going on? When someone breathes through their nose compared to their mouth, what is going on, and why does it make such a difference?

James Nestor 1:19:06 So when we breathe through our nose, we are humidifying air, we're pressurizing air, we are filtering that air out and we're conditioning it so that by the time that air gets to our lungs, it can more easily be absorbed and we can extract the oxygen from it. So we know this. This is... This has been proven time and time again. And yet about 25 to 50% of the population habitually mouth breathes. And when you mouth breathe, you get none of those benefits. You can almost think of the lungs as an external organ when you're mouth breathing, right? They're exposed to everything in your environment. And if you live in a city like I do, I don't want to expose my lungs to all those allergens and pollutants. So the quickest way of filtering air and conditioning it is this wondrous organ right in the front of our faces called the nose, and it is completely underappreciated and underused in society.

Dr. Rangan Chatterjee 1:20:06 Yeah. Absolutely. So how did you go from... I think I've read you say before, or I think maybe I heard it in an interview, that you used to be a mouth breather. Um, how did you become a nose breather? And is it possible for anyone to actually listen to this and go, "Okay, I hear you, James. There's all these benefits. I want those benefits. How do I start?"

James Nestor 1:20:32 Hm. Yeah, I remember breathing through my mouth as a kid. I see pictures of myself when I was young and I'm breathing through my mouth. Not all the time, but it definitely happened. And even until adulthood, I thought it was normal just to go to sleep with a pint of water by my bed every single night, to wake up every few hours with a dry mouth, take a swig of water, go back to sleep. I did that for decades till I met Dr. Jayakar Nayak down at Stanford, and he said, "This isn't normal at all. We should be breathing through our nose all the time, especially during sleeping hours. That's a third of your life, and if you're breathing through the mouth, you're just exposing yourself to everything in your environment, and also you're loosening the tissues at the back of your throat and making yourself more apt to snore and have sleep apnea," which is another thing that, that blew my mind. So, uh, you know, once you realize how dangerous mouth breathing is, you can then take a conscious effort to change it, how you're doing... how you're breathing throughout the day. But that won't help you when you're unconscious at night, right? So, so once I learned this, I was shutting my mouth all the time, practicing nasal breathing. At the beginning it was very difficult. I felt very congested here, but the nose is a use it or lose it organ. I also learned that from, from Stanford, that the more you use it, the more it's gonna open up. Those tissues are gonna acclimate and open up. So I focused on that, and at night, this sounds a little crazy, uh, but I used a little piece of tape, uh, which I still do just on my lips to train my mouth shut at night. And, uh, this sounds a little, you know, like, like New Age science, but it's, but it's not, because I heard from a breathing therapist at Stanford, Anne Kearney, who had used it herself and uses it for her patients, and talked to other researchers who did the same thing. Um, and that has helped me tremendously, and it's helped so many other people as well, and it's free.

Dr. Rangan Chatterjee 1:22:37 Yeah. Hey, James, look, I, I'm, I'm totally with you on that. It, it is incredible the difference. In fact, I actually spoke to a buddy this morning on the phone who I've not spoken to for a few months, and I said, "Hey." He was saying, "How's the podcast going?" I said, "Yeah, great. I'm actually speaking to someone, James Nestor, this afternoon. You got to get his book. It's just incredible. It's all about breathing." And he said to me that the thing he's changed a few months ago, um, was he started to tape his mouth up at night. And he said he cannot believe the difference. He said, "I don't wake up thirsty. I'm not groggy in the morning. I've got more energy, better cognition." You know, and, and I think for people who are skeptical, and I know they are out there. There, there even within my own family, there's skeptics to how important breathing is. I think it really is quite profound what you can feel like. You may not even know how good you can feel until you start breathing in a more optimal way. Um, but if you t- when you talk about tape over your mouth, some people I think will probably feel claustrophobic, and the thought of actually taping their mouth shut probably is gonna scare them. But, but you would say it's not like that, is it?

James Nestor 1:23:47 No. And, and just to, to second what you were saying, it's one thing to have a subjective experience and say, "Hey, I feel better after taping," and that means something, right? But it's another thing to measure this stuff. If we can measure it, we can study it. If we can study it, we can figure out if it's actually working, and that's exactly what we did work- working with, with Nayak at Stanford. So the measurements from these instruments aren't gonna lie. Yes, I felt better, but to me as a science journalist, it's much more convincing to have data. 'Cause what works with one person may not work with somebody else. And that's... They're finding right now that Stanford, Anne Kearney, is booting up a study of 200 people looking at sleep apnea and snoring and sleep tape. And, uh, I so happen to have a little role here. Um, and I wanna explain to people that don't... I would highly suggest not going on YouTube and looking how to sleep tape, 'cause there's a lot of really sketchy stuff there. All you need is a teeny piece of tape. I use a piece that big. It's about half the size of a postage stamp, and I put it right across my lips. I can still talk to you. I can still breathe from my mouth if, if I want. But it just reminds me when I'm unconscious to keep my jaw shut. And I can take it off with my tongue. So this is not a hostage situation, duct tape kinda thing. This is a teeny piece of tape just to train the mouth shut. And just anecdotally, I've received several dozen emails from people who have had chronic snoring for the past few decades, who have had even mild or moderate sleep apnea, and they've recorded their sleep and they no longer suffer from those things. So it's not psychosomatic, it's not a placebo effect. That's what happens when you close your mouth and you allow that air to be pressurized, push the soft tissues further back in your airway and open them up to breathe more efficiently. You get 20% more oxygen through a nasal breath than you do through a mouth breath. And if you think that's not gonna affect you over the long term, you're, you're nuts. It will have a tremendous effect on your health.

Dr. Rangan Chatterjee 1:26:01 Yeah.

Dr. Rangan Chatterjee 1:26:02 Absolutely. In your research, you know, you've mentioned sleep apnea, um, and, yeah, these, these problems we have, sleep problems are endemic now. You know, there's... It's, you know, sleep deprivation is an epidemic. There's many reasons for that of course. Um, but it, but it's really fascinating for me that, you know, I think back, I always try and look at the way we're suffering now or, or the maladies of, of the 21st century and try and put them in a, in an evolutionary perspective and a context and go, "Well, what's really going on here?" And I don't know if in your research, did you ever come across that sleep apnea and sleep problems are quite a modern problem? I mean, do we know if this existed 300, 400 years ago? Was, was any part of your research on this at all?

James Nestor 1:26:51 Well, we can't go back and test people, but what we can do is look at skeletons. And so I talked to the experts in the field, biological anthropologists, who look at the shape of skeletons. And our ancestors, anything older than around 400 years, maybe 500 years, they would have these very powerful jaws, and they would have these faces that grew outward, and these huge nasal apertures in the back. So from those skeletons, we can, we can decipher that these people had larger airways. They had more room to breathe. We know that obesity a- absolutely affects snoring and, and sleep apnea as well, and people are not, were not as obese as they are now, and that, that seems very clear and understood. But this idea that our ancestors had these huge, powerful faces and we do not is less acknowledged, and yet it's very clear in the skeletal record. And an example of this is looking at the teeth of an ancient skeleton. If you were to look at the teeth of one of your ancestors 400 years old, 4,000 years old, 40 thou- doesn't matter, on back, they would have perfectly straight teeth. There's like a 99.9% chance perfectly straight teeth. Today, 90% of us have some sort of crookedness in our teeth because our mouths have grown so small. With this, with a very small mouth, you also have a smaller airway, and that's one of the main reasons so many of us suffer from snoring, sleep apnea, respiratory problems. It's even implicated in asthma, allergies, and more.

Dr. Rangan Chatterjee 1:28:32 Yeah. Wow. And why do we think that's happened? Why, why have we got such a smaller mouth, smaller jaw? Are there some sort of theories out there?

James Nestor 1:28:39 [laughs] Yeah. There's, there's a few theories, but there's also some... a, a few absolute facts that have, that have been, uh, very clearly identified in the past 20 years, and that is when our food shifted from this wild, tough food where we were required to chew a lot more, food became soft, we chewed less, our mouths grew too small. Environmental inputs had some effect on that. When you're walking around breathing through your mouth, especially when you're a kid, your face will grow differently. It's so common that this is called adenoid face from when the adenoids or tonsils inflame and you have to walk around like this. But most of it is caused by food, by the softness of our diets. And there's been some incredible research done, done in this, and I just think it's so under-acknowledged the role that, that chewing, masticatory stress, plays in the structure of our faces. But it's also so simple. The less you use something, the less it's gonna develop. And especially this is important in infancy. They've done studies where they've looked at infants who have been bottle-fed versus those who have been breastfed. And when an infant is breastfed, it requires a tremendous amount of stress and exercise and helps push the face outward, which will then create a larger airway.

Dr. Rangan Chatterjee 1:30:07 Yeah. You know, it's incredible. You're talking about food that we chew more. And what you're fundamentally talking about is more natural foods, less highly processed, industrialized food. So we, we often think about food in the context of our health, our wellbeing. Particularly, a lot of people talk about it in the context of their weight. But you're sort of saying, yeah, sure, but what... you know, yes, your weight, but health and wellbeing is so broad. And now we're introducing mouth size and teeth strength and teeth structure and jaw structure into the potential benefits of eating real food.

James Nestor 1:30:47 Yeah. I mean, here again is an example of all these disparate people in these disparate areas of science all coming to the same general conclusion in just slightly different ways. So we're usually looking at foods in terms of cal- at least in the US, we're looking at it in terms of calories. We're not looking at it in terms of toughness or, or softness. And I think it's, it's quite interesting that even today you think about- What's considered healthy food today, oatmeal, avocados, yogurt, you know, goo bars, all this stuff is soft. It requires basically no chewing at all. And the less you're chewing, especially when you're younger, the less you'll be working out these muscles, the less you'll be developing your face.

Dr. Rangan Chatterjee 1:31:37 Yeah. And you said especially when you're younger. Now that's really interesting because one thing, yes, as a doctor, but also as a parent that I've always found quite curious is this idea that, oh, the adults will eat proper food, but the kids' menu... I don't know if it's the same in the States, the kids' menu is ch- generally full of junk. It's like the prop- the adults will all order the proper food, but the kids will have some sort of, I don't know, you know, hyper-processed, industrialized foods. And, you know, I am not blaming anyone or criticizing anyone for doing that. I understand that's the almost the conditioning as well. But one thing we have very much tried hard from a young age with our children is they eat the same as what we do. We eat as much as we can, uh, minimally processed, m- you know, food as close to nature as possible. And, you know, I appreciate we're lucky to be able to have access to that, but we do that, and that's what we give our kids. We don't make separate food for them. And it's just interesting. You know, you say all, all roads are sort of leading to Rome and the same place. Actually, yeah, eat the right diet. It's, it's almost like [laughs] it's basically what you're trying to say is live, eat, and breathe in the way that we have evolved to, and we will be more thriving, healthier, uh, happier human beings, I guess.

James Nestor 1:33:02 Yeah. Nature already did all of this for us. It's just in the last 100 r- years we thought that we were smarter than nature, and we thought we could take some, some side tracks into this and condense food down to one pill or some mush that you could squirt into your mouth and it would have the same effect. Yeah, we're not getting scurvy from that or beriberi from that. We're not getting these diseases that we used to suffer from, but we're also denying ourselves so many of the benefits. And exactly what, what you had said and y- there's this huge, I would even call it a revolution right now, in baby-led weaning, uh, which is not to give babies, infants this soft mush in jars, which we've only been doing for the past 100 years anyway, and look at what's happened. Look, [laughs] look at what's happened to our weight. Look at what's happened to our faces. Look to what happened to our teeth. I mean, on and on and on, is that is a modern invention. So to allow kids, especially early on, to be able to really work out that masticatory stress to, to chew properly is gonna have benefits down the road, and that's been very well proven at this time.

Dr. Rangan Chatterjee 1:34:17 Yeah. And I, and it really... You know, the, the phrase use it or lose it, which is, which is common parlance in the English language both in the US and in the UK. You know, we understand that, don't we, with muscles. We get that. You know, if I, if I do a bicep curl every morning, my bicep is gonna get stronger. If I stop doing it, over time it's gonna get smaller. I think we, we understand that with the, you know, our physical muscles. But as you say, I don't think we've thought about it in terms of our, our jaw, our mastication muscles. It's like if you don't chew regularly, if you're not sort of, um, having that stress put on your jaw like the stress on the bicep, what your jaw is then gonna adapt, is it's gonna adapt to what it feels that you need. Um, I think y- I, I think I've heard you mention before that there's something about chewing on one side as opposed to two sides, and I found that really interesting. So I'd love, I'd love to just explore that, but I also just wanna make sure we've covered that many people listen to this show. Some, uh, I'm sure are avid meat eaters, some are vegans. And when we talk about natural food, I think it's just important to say you, you can probably... You know, whilst obviously meat is quite tough and there's bones to chew on, you know, there's a lot of vegetables, like a carrots, for example, or, you know, a lot of tough veg that you have to chew. You can probably also get that sort of stress on the jaw, right? So I just wanna make sure we, we include everyone in this conversation, that they all feel as though this applies to them. Um, yeah. So I wonder if you could just expand on that at all.

James Nestor 1:35:54 Means to the same end. That, that's again, you've got these different people in these different camps. But of course, if you're chewing on carrots, if you're chewing on celery, I mean, just think of natural foods. Even wheat, uh, you know, we got really good at removing the bran and the germ from wheat and creating this, this processed white flour. And the same thing with rice. White rice, bran and germ removed. We just have this, this little seed left. So chewing is, is essential, especially with or early on to developing proper airway health, proper mouth. Uh, and we, we know that. And it's how you chew, what you're chewing is... I don't wanna get into that. That gets very, very political-

Dr. Rangan Chatterjee 1:36:35 Yeah. [laughs]

James Nestor 1:36:36 ... 'cause the carnivores are gonna say one thing, vegans are gonna say the other. But, but do not underestimate the power and benefits of chewing. And this is a whole new science that is really being, uh, deeply explored now, which I find is fascinating.

Dr. Rangan Chatterjee 1:36:51 Sorry to interrupt. If you're enjoying this conversation, there's loads more like it on my channel. Please do press subscribe and hit that bell. Now back to the conversation.

Dr. Rangan Chatterjee 1:37:01 You've had so many emails and so much feedback. You've mentioned that mouth taping at night is something that comes up regularly. What are some of the other things that come up where people have fed back to you that, "You know, I tried this, James, and actually this has now got better," et cetera, et cetera?

James Nestor 1:37:18 Well, a lot of people have written and said that they are so grateful for having this information, but behind their thankfulness, there's an irritation and a frustration that it took them reading a book to learn about these things, to learn how asthma can be significantly reduced. It can even be reversed by taking control of your breathing. And if you don't believe me, all you have to do is look at the dozens and dozens and dozens of scientific studies that have proven this, or talk to Patrick McKeown, whom I know was on your, your show. And this guy's, for 20 years, he's been teaching people how to reverse their asthma. So I think that some of this is due to, again, all of the noise. Um, it has to do with the internet. Everyone's got a voice now, which is great, but it's also problematic, as we're seeing. And it, it took, I guess, um, you know, someone to go in objectively and to really look at this stuff and, and to look at, at what had worked, and to talk to the people on, again, both sides. So I think that this knowledge is obviously a great thing, and that's the only thing that, that we really have right now that the internet can provide, is knowledge. People have access to information they would not have access to 20 years ago through podcasts like yours, through books, and I think that through that knowledge, people are becoming empowered to start to take control of their health in different ways, and to listen to experts who have years and years of experience actually helping people, not just conducting studies, but helping people day in and day out. And I think that that information and those perspectives are really the most valuable.

Dr. Rangan Chatterjee 1:39:09 It's interesting that there's an anger and a frustration coming through, and I can see why there would be an anger. Because if you can reduce how much you're taking your inhaler, let's say for asthma, if you can reduce your anxiety or even eliminate your anxiety by working on some breathing practices, you may well be thinking, "Well, why the hell have I not heard about this before when I've been to my doctor or my healthcare professional?" So I understand that anger, I really do.

James Nestor 1:39:40 Well, a lot of it comes to the capacity that healthcare professionals have with, with their patients. There's doctors in my family, we talk about this stuff all the time, and they're dealing with acute, often serious problems. So if I get in a car accident, the, the last thing I want is breathing practices. I want surgery.

Dr. Rangan Chatterjee 1:40:00 Yeah.

James Nestor 1:40:00 I want the latest in Western technology to help sew me up. But the people who have been left out in the cold are the people with these milder chronic issues. It's only when these milder chronic issues becomes really serious that people get treatment. But oftentimes, that's too late. And I heard this so many times through so many researchers and so many doctors over the years, and I'm still hearing it all the time. And there was a quote that actually Brian McKenzie told me, which I thought was great, is, "Eastern medicine is great if you want to live. Western medicine is great if you don't want to die." So there's a big difference in those two things, and I think that they both have enormous benefits, but we shouldn't be thinking that you have to pick one or the other.

Dr. Rangan Chatterjee 1:40:51 Oh, yeah.

James Nestor 1:40:51 And I think that's where it gets really problematic. If you have a very serious disease and Western medicine can help you, why on Earth wouldn't you help yourself through that? So it's about integrating these two things and knowing when to say when to each of them, which I think is really the key. And if you look at the top medical institutions in the world right now, this is the direction everything's going in.

Dr. Rangan Chatterjee 1:41:15 Yeah.

James Nestor 1:41:15 From Harvard to Stanford to Yale to Oxford, you know? And, and that's inspiring. It's taking a while to get there, but these scientific revolutions can take decades.

Dr. Rangan Chatterjee 1:41:26 You know, I love that quote that, that Brian shared with you. It's, it's really made me think, but it's spot on. You know, certainly in my 20 years experience of seeing patients, I'd have to say that is completely spot on. I, I recognize maybe five years in that actually, you know what? We- we're really good at acute. We're just not as good with this sort of chronic stuff a lot of the time. A- and, you know, I'm very proud to be a doctor, but I, I also, I think we should be honest and, and say, "Well, you know, these tools are great, but actually we're a bit limited. Can we get a bigger toolbox in certain areas?"

Dr. Rangan Chatterjee 1:42:00 One of the sort of modern voices who has really helped to elevate breathwork is Wim Hof. And, you know, I wanna talk about Wim's methods and some of the pros and the potential cons that some people talk about with those sort of hyperventilation type breaths. I think that's gonna be really important. But I wanted to ask you, James, I talk about breathwork a lot, and what I s- what I hear is there's a lot of confusion. There's a lot of confusion that, oh, you know, I'd be... I thought we need to breathe less.

James Nestor 1:42:35 Mm.

Dr. Rangan Chatterjee 1:42:36 But now you're saying to breathe 30 times, then hold my breath with the Wim Hof method. And I wonder if you could sort of unpick that for people. You know, what are the broad principles of these different breathing techniques, and when and how should people think about bringing them into their lives?

James Nestor 1:42:53 So I was as confused as anyone when I was researching this book and learned this exact thing. And when you start investigating different breathing methods, there are different breathing philosophies and different breathing camps. The, so the Buteyko people will say, "You only breathe very slowly. You only breathe through your nose. You never wanna over-breathe." And the Wim Hof people, including Wim himself, says, "No, breathe, everybody breathe. Go, go, go." So who's right? And they're both right, is what I learned. It just depends on what you wanna get out of your breath. So for the majority of the time, you do wanna breathe slowly, rhythmically, lightly through the nose. Okay? That is how you're gonna get the most oxygen, the most energy for the least effort, and that's exactly what you want throughout the day. But sometimes you wanna push your breath, and you want to use it to purposely stress your body out. A lot of you may be thinking, "Why do I ever wanna stress my body out?" Right? "I'm stressed throughout the day. I'm answering emails, dealing with calls, dealing with the kids, exercising." But that's exactly why you should use breathing to stress your body out, because what these practices do is they focus that stress into a controlled space in your day. So the Wim Hof Method, you're not gonna do that all day. Just like you wouldn't be going to the gym and lifting weights all day. It would destroy your body. Wim's method, you do it for about 20 minutes, and the point is that you use this method to purposely stress your body out so that the other 23 and a half hours of the day you can be in a state of calm and control. And, you know, Wim calls it the Wim Hof Method, but he's so clear that these practices have been around thousands and thousands of years. You can call it Tummo, you can call it Sudarshan Kriya, you can call it pranayama. Whatever. They're all doing the same thing. They're forcing you to over-breathe, to stress yourself out, then control your breath, and then to stress yourself out again, then control it again like interval training so that you can control your stress. And the science is very clear that these methods can have an incredible impact on both mental health and physical health, including autoimmune diseases.

Dr. Rangan Chatterjee 1:45:30 One of the most memorable bits in your book for me was when you were talking about your own experience of trying Tummo breathing. And, um, you said something to the effect of, "I was stressing my body out, but this stress felt very different to the stress that I feel when I'm running late for an important meeting." And I, and I, I thought that was really fascinating, this idea of stress, which we typically associate as being a bad thing. Certainly, the societal narrative around stress is stress is bad, we wanna avoid it. But that was a beautiful way of describing sort of helpful stress and unhelpful stress. Um, and I wonder if you could expand on that a little bit.

James Nestor 1:46:15 I think the difference is when you are rushing to a meeting, when you are trying to answer emails and trying to answer calls and getting very frustrated with the amount of work you have to do every day, there's no outlet for that stress. That stress seems to build and build and build, and it starts coming out in different ways. You get angry. You can't think straight. Your blood pressure goes up. You start clenching your fists or your muscles tighten. And that's such bad news, but if you clench your fist and tighten your muscles and control your breath and learn to do this consciously, you can learn what that stress feels like, and you can then learn to turn it off. So a lot of these practices have you do that to... I mean, Wim has... You know, you're holding your breath, and then you're breathing as hard as you can, and then you're holding your breath again and taking one breath and then exhaling it. So this is stressful to the body. But what the body doesn't want is to be in these states of low-grade stress throughout the day and throughout the night. Periodic stress is very good. Okay? Periodic stress is very good for the body. That's how we evolved. To go and run after a tiger or fight off someone and then to chill out for the rest of the day and the rest of the night. What's happening now is so many of us are staying in this chronic state of stress. It's like this IV drip of stress throughout the day. And you can see that in what this has done to our health. So inflammation is behind the vast majority of modern chronic diseases, whether you're looking at diabetes or heart disease or hypertension or whatever. And so this inflammation is exacerbated by this constant low-grade stress, whether that stress is coming from the foods you're eating, whether it's coming from the environment. So it's no coincidence that hunter-gatherer populations don't have any of these modern diseases that we have. It's no coincidence that our ancestors, as far as we can see, didn't have the vast majority of these diseases we have today either. So that's a long way of saying that controlling the stress and using breathing as your pressure release valve can have enormous benefits to your day-to-day health.

Dr. Rangan Chatterjee 1:48:46 We're living in incredibly stressful times at the moment. The world has significantly changed the way people live over the last 12, 15, 16 months or so. And stress, anxiety has ramped up in many ways for so many people. One thing I don't think people still quite fully understand is how intimately our stress levels are linked with the way that we breathe. And therefore, without that understanding, it's hard sometimes to persuade people that, hey, you know what? If you, [laughs] you literally can hack that system by working on your breath, not for hours a day, just a few simple things. You can actually start to change your biology. So can you speak a little bit to, to how stress and, and breath are linked?

James Nestor 1:49:34 Well, this is what's so great about breathing is you can feel the effects and you can see the effects immediately. When you're changing your diet, usually that takes a little while, right? To really see the transformative effects it has to eat a healthy diet. It'll take maybe a few days. But if you wanna lose weight, it's gonna take a few weeks or it's gonna take a few months. And, you know, so many of us today, we have a very short attention span. So I think that's one reason people fall off their diets. They're just like, "Ah, I'm sick of doing this." But with breathing, one of my favorite things to do is to put a pulse oximeter on someone, put a heart rate variability monitor on someone, have them breathe in a very specific way, and then watch what happens after a minute, right? Even after a few seconds, you can see this transformation taking place in your body. You can watch your blood pressure go down 10 or 15 points. I've seen mine even go down 20 points if I went from a state of being stressed to controlling my breathing and de-stressing myself through, through those means. So I think that that's what's so been-- that's what's been so convincing with, with a lot of the readers of the book and, and also to myself, is if you're able to improve your health and improve the efficiency of your body within a few minutes, just imagine what's gonna happen after a few days or a few weeks or a few months, and you start to understand how your breathing is such an integral part of your healing and your long-term health. So I could get into the biochemical processes of it, but that's the umbrella, right? That's the overview of what these things are doing. And again, if there are skeptics out there, and I hope there are, question what I'm saying, but then go and grab some of these monitors and breathe in a certain way and tell me what, what happens to your body and what happens to your brain. 'Cause what's happening in the body as well is happening in the brain. EEG patterns transform when we start breathing in a slow, rhythmic way. Different areas of the brain start coming online. You're able to think more clearly because you're allowing your brain to function at peak efficiency.

Dr. Rangan Chatterjee 1:51:58 I mean, feel free to expand on the biochemistry because, you know, in that section where you were talking about your own experience with Tummo breathing, you also had this gorgeous phrase that it was as if Tummo opened up your own body's pharmacy, and that stuck with me. I thought we, we've got these chemicals inside us already, but it seems as though certain breath practices can sort of unlock, like, that full potential that we're sort of maybe keeping suppressed because of the way we're breathing and the way we're living our daily lives.

James Nestor 1:52:31 Well, this is what's been so fascinating and great to see about what Wim has been doing. So he's had so many skeptics, too, over the last 20 years. He said, "Okay. Be, be skeptical. Uh, just take me into your lab and I'll do whatever. You can shoot me up with E. coli. Sure. Sounds great. You can take blood work at various levels while I breathe. Uh, we can bring in some other people. You can take their blood work and see what happens." And that's what he's shown. We've known this for a long time, that breathing in certain ways will create and trigger these responses in your body to release hormones, to release stress hormones, to release relaxing hormones, to open up the blood vessels. We, we already know all that, but I think that, you know, such a superhuman breather as Wim is, he's able to show the true potential of where breathing can take us. So I think that what he w- has shown is this stressful breathing can help the body better defend itself. It can bolster the immune function, which is why Wim Hof breathing has been shown to be so effective for some people with autoimmune diseases.

Dr. Rangan Chatterjee 1:53:40 Yeah.

James Nestor 1:53:40 Their immune systems have gone rampant. They're attacking healthy tissues in the body. That helps to reverse that. But we can also use breathing to release different feel-good hormones. And when we do that, we can trigger those releases at any time. And this is one of the reasons that I think Wim Hof breathing has become so popular, because it's so hard not to feel amazing at the end of that breathing session. If anyone out there has done it, it, it's hard to see someone who hasn't had a very profound reaction after 20 minutes, says, "Wow, I feel so good." You feel that good because you're triggering the release of these hormones in your body, and that's what's, um, uh, to me is allows people to keep coming back to this and to keep using it, because you're creating a positive feedback loop to allow yourself to heal and also to allow your monkey mind to be entertained by the constant good feelings, right? The constant sometimes hallucinations that some of these breathwork practices bring on. And it's great. I love the Wim Hof method. I, I do it as often as I can, which is usually a couple times a week. I also love Kundalini. I also love Sudarshan Kriya. But all of these things are essentially doing the same thing to your body and brain.

Dr. Rangan Chatterjee 1:55:04 Some people say that in a society full of stress, full of adrenaline already, that these hyperventilation practices like Tummo, like the Wim Hof methods, are not necessarily the best choices. So I wonder what you would say to that. Could this potentially be the wrong method for some people?

James Nestor 1:55:28 To me, it's just another option.

Dr. Rangan Chatterjee 1:55:31 Yeah.

James Nestor 1:55:31 It's just another tool you have in your back pocket. So people are gonna wanna come to breathing for different reasons, and there is no overarching prescription that you can use to cure everyone's woes. There is a foundation of healthy breathing that I tried to establish in the book. Said, "Okay, I don't care if you're an ultra-marathoner or an asthmatic or have long-haul COVID or are just anxious, here are some breathing practices that will help everybody." And there are zero side effects to this, right? You're only gonna feel better. You're only gonna be able to perform better. It's just like with food. We know that eating a healthy diet benefits everybody. But when you get into more specific chronic conditions, you're absolutely right. Some people with panic and anxiety would hate Wim Hof breathing, and they'd hate Sudarshan Kriya because these incorporate states of extreme hyperventilation, and that's gonna give them a lot of trouble. So with people like that, I would say start slow, right? Start with that five and a half seconds in, five and a half seconds out. That's even too much for a lot of people. So it's so important not to try to go and kick your breathing's butt, and this is what Westerners tend to do with everything, but to really dip into it slowly and become immersed into it at your body and your mind's own level of comfort. And so with people with anxiety and with people with asthma and panic, what I've tried to tell them is go very slowly. Start with three seconds in, three seconds out. And you would be amazed how few people have actually breathed in that way. Just three seconds in, three seconds out. Get comfortable with that and extend it. So if you're talking about someone who is already an extreme biohacker, you know, they're in constant ketosis and they're eating all the right stuff and taking all the right pills and potions, and they just wanna totally push it, go big then. Go do the Wim Hof method. Go try holotropic breathwork. That, that'll, uh, really, really send you on a whirl. And those people are already prepared, right? They're conditioned to do this. It's the same reason why you wouldn't say to somebody who's been sitting on a couch for the past year, "Go and run a marathon-"

Dr. Rangan Chatterjee 1:58:02 Yeah

James Nestor 1:58:02 ... "'cause it's gonna be really good for your body." Uh, you have to do what your body is, is telling you to do and, and to listen to your body and go into this stuff slowly.

Dr. Rangan Chatterjee 1:58:13 One of the things that I love personally with breathwork, and that I've seen so impactful with hundreds if not thousands of my patients, is that tuning into your breath tunes you into your body, right? You start to gain an awareness that often people have never had, certainly for many, many years, just to stop, quieten the noise, and actually listen to certain things. Like, you know, I,

Dr. Rangan Chatterjee 1:58:44 I'm interested as to what practices you do on a daily basis, if any. What I do, um, I usually tape my mouth at night, but I also love doing breath holds when I'm walking. And I know you have written about this in your book, but when I'm out for a walk, after about 5 or 10 minutes, I will do... You know, I will be breathing through my nose. I'll breathe out. I'll, um, you know, I'll, I'll sort of breathe out a normal exhale and then I'll see how far I can walk until I get that sort of medium air hunger, and then I'll do that 5 or 10 times. And what I love about that is, A, I can see myself getting better, so my body is better able to tolerate that carbon dioxide buildup compared to, let's say, two years ago. So that's really great to see. But also, if I haven't slept well or if I'm quite stressed and tense with work pressures and deadlines, I find I can't hold my breath as long, and it, it's almost like a early warning sign for me as to sort of what else is going on in my body. So that's one thing I love, and I would really encourage people to get into some form of breathwork because I think it, I think it kind of teaches you about yourself and your state of stress.

James Nestor 1:59:52 So breath holding has been a part of every breathing practice for thousands and thousands of years. Ancient Hindus were talking about breath holding, you know, 3,000, 4,000 years ago. The Chinese, ancient Chinese, were saying the exact same thing. Same exact practice. Different culture. Were they talking to one another then? I don't think so, and yet they came to the same conclusions. So to me, it's no coincidence that now modern science is really catching up to what our ancestors have been saying for so long. And we know that CO2 tolerance plays a huge role in panic, in asthma, in anxiety. We know that because the studies have shown very clearly that people who can't hold their breath for a very long time are much more susceptible to suffer from these conditions.

Dr. Rangan Chatterjee 2:00:42 Yeah.

James Nestor 2:00:42 I thought that this was fascinating. I went out to the Laureate Institute of Brain Research and met with Dr. Justin Feinstein, who is a neuropsychologist out there doing CO2 work, and he's one of the only researchers I've found doing work into this thing called CO2 and CO2 tolerance. And he had a huge NIH study looking at CO2 tolerance and panic. And he's the one who told me that so many of his patients over the years, he would ask them just to sit down and before he hooked them up to any monitors, he'd ask them just to take a sip of air and hold their breath, and this is what they did. [wheezing] Then he'd ask them to do it again. [wheezing] Usually they'd last about two seconds, three seconds. And you see this all the time with asthmatics and with people suffering from even anorexia and other fear-based disorders. So he kept wondering if- You could allow them to tolerate more CO2 if it would allow them to better control their condition. Because so much of their condition was caused by this perpetual hyperventilation. They were so scared of holding their breath because a breath hold to them reminded them of a panic attack or an asthma attack or an anxiety attack, that they had conditioned themselves to breathe like this all the time. [breathing] And this wasn't just a few people either. This is so common in communities of people who have those issues. So he has continued doing this research, and what I thought was even more fascinating is he's not the one who invented this stuff. You can look back more than 100 years and see researchers at Yale and Harvard and Boston University and University of Wisconsin doing work in CO2 and mental health conditions, and this stuff worked incredibly well. Not just breathing retraining, but actually having these people inhale a bit of CO2. And what does that do? It replicates holding your breath. That's what it does. Because when you hold your breath, your CO2 increases. These people couldn't hold their breath, so they allowed them to celebrate in the benefits of breath holding by giving them a mouthful of CO2. So I just kept finding these stories over and over again where we had learned this, it had been studied at the most prestigious medical institutions and proven to be incredibly effective, and then we had forgotten it. And now a few people are re-remembering it right now, and that's what's been exciting since the book has come out, is there seems to be a lot more interest in CO2 and CO2 tolerance, both in athletes and in people who are looking to overcome mental health issues.

Dr. Rangan Chatterjee 2:03:36 Yeah, I mean, just to recap for people, if they didn't hear our first conversation, if they're not familiar, that drive to breathe doesn't come from our oxygen levels dropping. It comes from our carbon dioxide levels building up, and if we can't tolerate that, we, we have to breathe, right? So, you know, this CO2, the carbon dioxide, uh, training that you're talking about can have... I could just see physiologically how many different conditions that could immediately have an impact on, particularly anxiety. I can... You can really see how it would help people. Um, you mentioned athletics. And I know you've written and spoken about, about, I think it was at the 1968 men's track and field team? And, you know, tell us a little bit about that and how athletes and fitness enthusiasts can use sort of breath holding and nasal breathing and, and all kinds of methods to actually improve their performance.

James Nestor 2:04:33 Well, again, these were methods that have been used for decades and decades, but kind of became less popular for s- for some reason in the last few decades. But one story in particular, which I thought was so interesting, was Carl Stough's work looking at a long exhale. So he was a choral conductor, and he found that so many of his singers were breathing these very shallow breaths. And when you breathe very shallowly, you don't have the resonance, and you can't carry a note for as long. So he started training them to exhale longer. And how our breath comes into our bodies, you l- the lungs just don't inflate on their own, right? They need something to do this. They're just like two balloons. But we have something called a diaphragm underneath the lungs, and when we breathe in, [inhales] that diaphragm lowers, and when we breathe out, [exhales] that diaphragm lifts up. So S- Stough found that even within his singers, they had such limited range of their diaphragms, and by extending the range of their diaphragms, they allowed themselves more lung capacity, and they could sing so much better. So he ended up going and retraining singers at the Met Opera who were already pretty good singers to begin with, but they were even better after he taught them these new tricks. And he got so popular that VA hospitals on the East Coast asked him to come in and help people with emphysema who were basically put on gurneys with an oxygen cannula up to their noses and fed a steady diet of antibiotics and left in the hospital to die. Nobody had any idea what to do with these people. Emphysemics lose the ability to engage their diaphragm. Parts of their lungs get inflamed and destroyed by emphysema. Those parts don't grow back, but if you engage more of your diaphragm, you can use the rest of the lung to compensate. So Stough was able to take these people who were literally left for dead, retrain them only in breathing, that's the only thing he did, and these people got up and left the hospital and went to live normal lives. And there's X-rays of this. There's data sheets of it. I have even heard from a few of these patients whom Stough treated, and they said he absolutely saved their lives. So that's a very long way of saying Stough then got even more popular that he was asked by the Olympic Committee, uh, for the US to come and retrain the runners for the Mexico City Olympics. And he used the exact same methods, engaging more diaphragmatic movement. And these runners went to Mexico City, which has an elevation of, like, 6,000 or 7,000 feet, and they were the only team not to use oxygen before and after, and they destroyed everybody. It's still the greatest performance of any track team in the history of the Olympics. And they were able to do this because they knew how to breathe properly. So a lot of trainers, Patrick McKeown being one, Brian Mackenzie being the other, they have adopted these same tricks, and they're using them to create these absolute monster of athletes right now.

Dr. Rangan Chatterjee 2:07:50 Yeah.

James Nestor 2:07:50 Uh, these people who are just really, uh, outperforming anything they were able to do before.

Dr. Rangan Chatterjee 2:07:55 [instrumental music] If you enjoyed that conversation, I think you are really going to enjoy the one I had with the former monk, Jay Shetty, on the simple things that you can do to train your mind. It's right there. Give it a listen, and let me know what you think. The monk mindset is about pursuing your truest goals, your truest self, and your most authentic, aligned goals.