Why 70% Of People Are BREATHING WRONG & How To FIX IT For Better Health! | James Nestor

James Nestor 0:00 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.

Dr. Rangan Chatterjee 0:24 [outro music]

Dr. Rangan Chatterjee 0:29 What percentage of Western populations are thought to breathe through their mouth, and why is that so problematic?

James Nestor 0:39 Well, it's hard to pin down exactly how many people are habitual mouth breathers, but the percentages that I've seen in studies range from about 25% all the way up to 50%. Kids tend to mouth breathe more than adults. Females tend to mouth breathe more than males. And we know that about 60 to 70% of the population sleeps with an open mouth. So it's the majority, in some cases, of us are sleeping or are breathing with an open mouth throughout hours and hours of the day, which is bad news across the board.

Dr. Rangan Chatterjee 1:19 If someone is sleeping with their mouth open, we say bad news, but what's actually going on in the body? What, what actually happens? So, and why should people care about changing from mouth breathing to nose breathing?

James Nestor 1:33 So I've been sleeping with an open mouth as far as I've known. Uh, I'm sure it began in childhood. I was definitely sleeping with an open mouth in adulthood, which is why I would go to sleep with this by my bed every single night. Didn't matter if I was in a hotel, if I was camping, I would always have water by my bed because I would wake up, my mouth would be parched dry. So not only does it dehydrate us, we lose about 40% more moisture breathing through the mouth, but it changes the pH in our mouths, which makes us more susceptible to cavities. And dentists have known this for more than 100 years. There's studies dating back over 100 years that say that mouth breathing directly contributes to cavities. Dr. Mark Burhenne, who's a dentist out here and a sleep researcher, he believes that mouth breathing is the number one cause of cavities, even beyond sugar consumption. So not only does it mess up our mouths, but we're also exposing ourselves to everything in the external environment. So when we mouth breathe, our lungs become an external organ. If you live in a city like I do, that means you're making yourself so much more susceptible to inhaling pollution, allergens, even viruses and other pathogens. So our nose is our first line of de- defense for the body, and it's really important to breathe through your nose at night as well because it helps to push back those tissues at the back of the throat, and it can, in some cases, make you less susceptible to snoring and sleep apnea.

Dr. Rangan Chatterjee 3:06 I mean, those potential downsides are, you know, pretty serious, but the potential upside is also pretty profound there. And I've got to say a big thank you to you actually, James, because the first time you came on my podcast, you shared a tip, a very, a very simple tip that has been transformative within my own family home, okay? Um, I have had other experts on before talking about the breath, nasal breathing. You know, brilliant people like Brian McKenzie, Patrick McKeown, um, and my audience have always responded really well to those conversations. But you gave a tip about just a small bit of tape when you put on your mouth. Nothing to make you feel claustrophobic or as if you can't breathe, just a small bit of tape, like a stamp, a postage stamp size, I think is what you said. My wife implemented that tip immediately. And I tell you what happened. Yeah, like you said, she, she wasn't drinking during the night. Normally, she has a big glass of water, and she drinks several times throughout the night. But the most striking thing was I've always been the early riser in the house, and I, I love that time to myself. I'm downstairs, I make my coffee, I do some reading, and then a couple of days later, my wife, Ed, rocks up at 6:00 AM into the kitchen. I'm like, "Hey, babe, what-- Is everything okay?" She goes, "Yeah, I feel great." I'm like, "What are you doing?" She goes, "Oh, no, I just woke up. I, I feel great. I've come down." That was not a one-off. That has continued. So essentially, we have, we have really experimented this, with this. We have seen times when she doesn't wear the tape and times where she does, and she gets up earlier, and she feels fresher. So this has been completely game-changing, and I, I just wanna say a big thank you for that.

James Nestor 4:57 Well, I wish I could be responsible for that hack, and if so, I'm sure I would have made a billion dollars and would be calling in from my yacht in Monte Carlo. But I had learned about this from researchers in the field, and it sounded so sketchy to me. Then I went on YouTube and saw stuff that was even sketchier. So this idea of sleep taping, to a lot of people, it reminds them of a hostage situation, which is bad, or some bondage thing, which for some of us is bad. I guess some people enjoy that, and that's great. But what-- the only thing it's really doing is that it's training your mouth to be shut. This isn't hermetically sealing your mouth up, okay? It's just a little piece of tape. And if your mouth is shut at night, that means you're nasal breathing, and if you're nasal breathing, you're better protecting your lungs. You're breathing more healthily. You're breathing more efficiently. Your heart rate's gonna go down, likely. And you're gonna be able to celebrate in so many other benefits. So there's nothing sketchy about that, nothing controversial about the fact that when we nasal breathe, we can sleep better. And I-- this has been completely transformative for me as well, and if there's one thing I've heard from people in the last year since the book has come out, received thousands of letters- From people saying, "I no longer snore." Some people say, "I no longer have sleep apnea. Here's my sleep data." People with kids who had ADHD and other developmental problems are saying their kids are sleeping so much better using this. So you know, again, I would love to take credit, but it's really the researchers who have been spending decades and decades researching the difference between nasal breathing and mouth breathing, the importance of nasal breathing at night, that should really take the credit for that.

Dr. Rangan Chatterjee 6:37 What was really striking in our first conversation just about a year ago now, was the realization that you approached the whole of breathing and breathwork through the mind of a skeptic. You, you know, you weren't sure. You're like, "Well, what is all this? Is it really true?" You know, I really... A- and I find that fascinating that w- through that lens you found the research, you found the science, and then you've arguably written one of the most impactful books on breathwork and breathing of all time. You know, given the, the impact your book has had, the reach it's had, the way it's really putting it on the map in a way that very few books have managed to do. What do you attribute that to?

James Nestor 7:23 Well, it's interesting that we look at journalism now as being different from skepticism, but in my mind, journalism is you are paid to be a skeptic. You are paid to be truly objective. But there's so much BS from both sides of the argument now, of whether you're talking about medicine or politics or the environment or whatever, that you can't really make out what's really true throughout all of that noise, everyone constantly yelling at you. So I don't view myself so much as, you know, a dyed-in-the-wool skeptic. I do view myself as a science journalist, and so my job is to go out and listen to everybody and interview everybody. I probably did 200, 300 interviews for this book. Uh, you know, I spent so many years looking at the real science and talked to experts in the field. But I also talked to people who were breathing therapists, who weren't experts in the medical science of breathing, but who were clinicians, who worked with people for decades and decades and helped teach thousands of people how to breathe better and saw how they improved. So in a lot of ways, I just viewed this book as me doing my job. I have no skin in the game, um, on one side of the camp or the other camp to believe anything. But I do have an interest in looking at data and looking at what's been measured and looking at what has worked. And so that's how I wanna continue approaching subjects, is to call BS when I see it, but at the same time, be open-minded enough to really listen to everybody and look at what they've done and see where the truth lies.

Dr. Rangan Chatterjee 9:10 Yeah. Given that 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 9:29 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 11:20 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 11:50 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 12:11 Yeah.

James Nestor 12:11 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 13:01 Oh, yeah.

James Nestor 13:01 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, 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 13:36 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're, we're really good at acute. We're just not as good with this sort of chronic stuff a lot of the time. And, 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

Dr. Rangan Chatterjee 14:06 we get a bigger toolbox in certain areas?" 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 14:46 Mm-hmm.

Dr. Rangan Chatterjee 14:46 "But now you're saying to breathe 30 times and 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 15:03 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 17:40 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 want to 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 18:25 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? Hermetic 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 20:56 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, 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 21:45 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 24:09 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 24:42 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 s- you know, such a superhuman breather as Wim is, he's able to show, uh, 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-

Dr. Rangan Chatterjee 25:50 Yeah

James Nestor 25:50 ... diseases. 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 27:14 Some people say that in a society full of stress, full of adrenaline already, that these hyperventilation practices like Tummo, like the Wim Hof Method, 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 27:39 To me, it's just another option.

Dr. Rangan Chatterjee 27:41 Yeah.

James Nestor 27:41 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. [laughs] 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 30:13 Yeah.

James Nestor 30:13 "This is 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 30:24 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, 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 five 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 five 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 32:02 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, three thousand, four thousand 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 32:53 Yeah.

James Nestor 32:53 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 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. [inhales] [exhales rapidly] Then he'd ask them to do it again. [inhales] [exhales rapidly] 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. [exhales rapidly] 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 a hundred 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 35:47 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

Dr. Rangan Chatterjee 36:17 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 36:44 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 40:01 Yeah.

James Nestor 40:01 Uh, these people who are just really, uh, outperforming anything they were able to do before.

Dr. Rangan Chatterjee 40:07 For me, I mean, fascinating to hear that, but this is not just about performance, because I'm currently training to do the London Marathon in, in October. Never done a marathon before. Two years ago, I probably wouldn't have considered myself a runner, certainly not a long-distance runner. Long story as to how this came about, but I have got really clear in my goals for this. Um, you know, and one of my goals is I am going to complete the London Marathon nasal breathing the entire way round. Okay, that is my goal. Now, some people say, "Oh, you're not gonna manage it," or, you know, you... And, and I'm not saying everyone has to do this. I know there are times when you wanna mouth breathe and run faster and maybe move more oxygen. I, I, I get that. But what I'm noticing, and when I speak to other runners who've, you know, recreational runners who've moved from mouth breathing to nasal breathing, it's not... Yes, performance can get better a lot of the time after a bit of, uh, crossover periods, but recovery tends to be quicker. Uh, sleep is often better afterwards. People who wear trackers, heart rate comes down a lot quicker afterwards. You know, these are super important metrics for overall health and wellbeing. So I kind of, I really wanna emphasize that point because it ain't just about getting faster. It is a, it is about doing a lot of these activities in a, in a way that's just more physiologically sort of harmonious with our bodies and the way they're meant to work. Do you know what I mean?

James Nestor 41:37 Yeah. I'm glad you brought that up because this is also something that Brian Mackenzie has mentioned to me various times. He's dealing with the very elite level of athletes. So sometimes these people are entering zone five, zone four, you know, even, and some mouth breathing can help them-

Dr. Rangan Chatterjee 41:53 Yeah

James Nestor 41:53 ... when they are absolutely peaking during a competition. That's perfectly fine to occasionally breathe through your mouth, and I just wanna make that really clear 'cause some people have written so confused. They're trying not to ever open their mouth during the day and say, "Oh, God, what, what have I done here?" So right now, I'm breathing through my mouth a little bit, right? Uh, when we laugh, we breathe through our mouth. I'm gonna sigh right now. [yawns] I'm breathing through my mouth. This is perfectly fine. I'm talking about habitual breathing.

Dr. Rangan Chatterjee 42:25 Yeah.

James Nestor 42:25 And that includes in athletic performance. So Brian trained some of the, some of his athletes, when they really reach these extreme states, you might wanna default to mouth breathing for about 15 seconds and then bring it back down, and that's great. So with jogging, the whole point of athletic performance is To work at peak efficiency, especially when you're competing, why would you wanna be expending energy on something if you didn't have to? An then analogy that I've used before, it's imagine you're in a car and would you at every stop sign just be revving the motor? Would you just be peaking the RPMs like every single time you could without moving fast? No. You want to be working that car at the level of the performance you need. So if you wanna go fast, yeah, pedal to the metal. But the rest of the time, it should be operating in a state of efficiency. Your body is no different. We have this huge piston right here in our chest, right? And it's called a diaphragm, and it goes up and down just like a piston. So if you can allow that diaphragm to go up and down fewer times, and each time it goes up and each time it goes down, you get more energy, why on earth wouldn't you want to do that? And so that's what nasal breathing can help you do. You tend to take very deep breaths when you're nasal breathing, especially when you're working out, and you will be taking slower breaths. So you will be able to gain more energy with less effort. And I'm very curious to see what happens, Rangan. I hope you don't get hurt, 'cause then this whole theory is just thrown out the window.

Dr. Rangan Chatterjee 44:08 Uh, there's a lot of pressure now not to [laughs]

James Nestor 44:11 Yeah. No

Dr. Rangan Chatterjee 44:11 ... once again hurt. Um, these analogies with exercise, uh, with diet, they're, they're, they're so apt. We don't see breathing in the same way, but we really should. You know, we don't... We understand that people have gotta find the right diet for them. They can, you know, there's some broad principles that kind of most people, not everyone, most people would agree on. And but within that, you can experiment to find what really works for you. And I kinda see breathwork and breathing practice in the same way. There are some broad things. You know, generally speaking, we want to be breathing through our nose as much as possible. But there are various techniques we might want to use at various times to get a certain effect. And y- as you say, there is that confusion, and it becomes oversimplified. "Oh, I tried that. It doesn't work. You know, I'm not gonna bother with breathing." And really, we need a bit more nuance than that. And I, I've gotta say, I think your book does a, a fantastic job of that nuance there and showing that there's all these different methods, these different techniques. You know, J- James, w- you know, I'm really struck chatting to you that when you tell these stories, there's still this real passion and fire in your belly that I heard from you almost 12 months ago when we first spoke. And, you know, your book has been a global smash hit, right? You will have done hundreds of interviews, short-form ones on television shows, long-form ones like on my podcast and other long-form shows. Why are you still so passionate about it? Do you ever get bored talking about this stuff? 'Cause I never get that impression from you that you're done talking about it.

James Nestor 45:50 Well, either I'm a great actor, which I'm not, or I'm genuinely interested in this stuff, and I'm more interested in it now than I ever was. And I know that sounds like a cliché, but it's, it's really true. I get really turned on by this because I know how much it can help people. I know how much it's helped me, and it's helped the hundreds of other people that I've talked to and the thousands of people that I've heard from. And what I like about breathing so much is it's free. It's available to everybody. You can use it when you want to. You can use it on the couch. You can use it on your bicycle. You can use it during a conference call. It's always with us. And so if it's always with us, we always have an opportunity to do it a little better. And this doesn't require you to wear special robes and to sit in a corner for an hour a day. It's something that, just as you had mentioned, you're walking around, "I'm gonna try my breath holds." Um, you're sitting watching TV, "Oh, I'm gonna try to breathe more slowly." You can really do it at any time and always get the benefits from it. And then that's really the last thing, is I have seen no negative side effects to breathing better. You only get benefits from it. And it's a small ask for a lot of people. It's, it's one thing to ask someone to go, who's a carnivore, to go vegan or, or keto. It's another thing to ask them just to take something they're already doing all day and to slightly tweak it so that they could be a little bit healthier and, in some cases, be a lot healthier. So I think that's the thing that keeps me really excited about this. Another thing is I have been lucky enough to speak at various medical schools in the US here, at Harvard, at Stanford, at Yale, and I am seeing the excitement within these places. Uh, which is ironic because so much of the research that I put in this book was researched at these institutions. And these people are like, [laughs] "Where do you find this stuff?" And I've said, "In your medical library. Here, here it is. Here are the 20 papers I found there." And that's what's really exciting because I really believe that this, you know, this message shouldn't be a us against them or this or that.

Dr. Rangan Chatterjee 48:16 Yeah.

James Nestor 48:17 It needs to be a collaboration, and it needs to be based on real science, real measurements. And that's what this stuff is based on. And so to be able to now collaborate with some of these people is an absolute thrill, you know? It's making my days a, a little more hectic, but, uh, it's something that I'll never give up doing, and there's various initiatives we're trying to put together right now that are all volunteer based, trying to get the word out, you know, especially to kids, especially to people in developing nations who this stuff could really help.

Dr. Rangan Chatterjee 48:51 I mean, the subtitle, I think, of your book says it all, The New Science of a Lost Art. You really give homage to where this comes from in all the interviews I've seen you, you do before. Tell us a little bit about that, some of these origins.

James Nestor 49:04 So again, my job was to look at the full story of conscious breathing. Um, and I had no interest in just focusing on one thing or the other, which is why this book was such an absolute nightmare to, to write and put together. [laughs] 'Cause when you're taking something that's been around for 5,000 years and misunderstood for most of that time, there's a lot of weeds to go through to, to find the real kernels of truth. But, uh, one of the most interesting things that I'm able to do as a researcher is to look through history and make these connections, and this is the part of book research I actually love the most, is to read these ancient texts and to see so much of what they've been saying we have then rediscovered, but we have just rephrased it in different ways. So and that includes ancient Chinese texts of the Tao, um, to ancient Hindu texts. And, uh, I was able to meet with, uh, Sergio Alvarez De Rose, uh, who is a real scholar of the ancient Hindu texts, and he's the one who really was able to point out the texts that, that showed me that this concept we have today of yoga, of this vinyasa flow, of these movements, and then you hold a pose, and then you move again, which I'm a huge fan of, I do it all the time, I love it, that has nothing to do with ancient yoga. So ancient yogis didn't move around. They sat in one place and breathed. So yoga was a entire technology of breathing. And it started in the Indus Valley civilization about 5,000 years ago, even longer than that. There are figurines and there are sculptures of people in conscious breathing poses, unmistakable poses. So scholars attribute that as the beginning of yoga and of breathwork. It had probably been around for thousands of years before that. And then we get into when people started writing these practices down, the Rigveda, other books in yoga, and they start really describing the specifics on how to do these practices. They collect them all. Uh, Patanjali's Yoga Sutras is the famous text really codifying and including all of these different practices. But what was so interesting to me, one of the many things that was interesting, was to see this tract in ancient Hindu text, right? Understanding breathing, adopting these specific practices. Then seeing the exact same tract in ancient Chinese texts, saying the exact same stuff, you know, just in different words. And so you know that there's something there. These people didn't have pulse oximeters. They weren't able to check blood pressure. But what they did have was time. They had time, and they had patience to look at what worked and what didn't work. And luckily, today, we have all these instruments to measure what they were saying and to actually see how it pans out, and it turns out that so much of what they were saying was 100% true. And again, don't believe me. You can see this in the measurements on modern machines.

Dr. Rangan Chatterjee 52:25 Uh, I spoke to Ryan Holiday a little while ago on the show, and a similar theme came up, which is some of these truths that he writes about, um, you know, you can see, yes, in ancient Greek texts and Roman texts and Indian texts and Chinese texts, you know, very different civilizations at different times and different parts of the planet. Uh, we were just talking about how that should just give us more confidence that, hey, this stuff is real. It's so humbling, and I think it should be very humbling for modern humans. You know, if we... I think we do sometimes have this arrogance that we've got all this incredible science now, and I, I'm not against it. I think it's great to have the science to, to back stuff up, but it's also very humbling to know, actually, you know what? Humans have been pretty clever for a long period of time, and they kind of figured out a lot of stuff that they kind of just knew worked.

James Nestor 53:18 Well, I think we are apprehensive about things that we've discovered in the past because a lot of that stuff was false. If you look at all the hucksters, all the snake oil salesmen at the beginning of the century, I think this is what made people so paranoid about accepting and using things that weren't in the system, even though a lot of people didn't realize a lot of what was in the system was also false and didn't work-

Dr. Rangan Chatterjee 53:44 Yeah

James Nestor 53:44 ... and had been co-opted by, by corporate. Look at sugar. Look what happened to our diet. Eat more processed grain, everybody. It's good for you. Let's put that at the very top of the US food pyramid. We know that stuff is a disaster for our health, right? Um, and yet it's taken us 50 years to start to reverse that. So even when you think about nasal breathing, here's a quote from the Tao that's about 1,300 years old. It says, "The breath inhaled through the mouth is called Ni Chi or adverse breath. Be extremely careful not to breathe your breath through the mouth." I mean, this is [laughs] goes to do with ev- everything that we, uh, had just been mentioning about nasal breathing. And I sprinkled the, the book, uh, some of these quotes throughout it, but there were so many more that were even more profound. They just happened to be even longer. So I think that this idea that whatever is new is better, we know this is false. Because if you look at medicine, and this is something that three different doctors told me about, uh, years ago. They said about 50 to 70% Of what we've known about medicine in the past has been proven wrong, including now. Today, about 50 to 70% of how we're treating ourselves with medicine will be proven wrong-

Dr. Rangan Chatterjee 55:14 Yeah

James Nestor 55:14 ... in the future. So when you think about things like that, you, you think that, "Oh, that's impossible. How can that be?" Look at all the procedures we used to do 20 years ago. Look at all the different drugs we used to use 20 years ago that aren't being used now. So if you think about some of these practices which have really been time proven over hundreds or thousands of years, why would a practice continue if it weren't working? You know, books were extremely valuable back in the day. Why would they continue to fill their books with the same exact message over and over-

Dr. Rangan Chatterjee 55:52 Yeah

James Nestor 55:52 ... if this stuff wasn't working? You could say, "Or maybe they were clueless," or, "This is spiritual stuff and it doesn't apply to us now." That's fine, but again, as I keep mentioning, we have instruments to measure it. So, so why not? If something sounds crazy, that's fine, be skeptical, but measure it. That's how science is supposed to work. Science is supposed to be the exploration of the unknown, right? You're not supposed to keep proving the same thing over and over again, which is what so much of science is doing right now. You're supposed to explore the unknown, and it's those scientists and researchers which really change our worldview and, in many cases, have drastically changed our understanding of health. And those are the people that I try to track down and write about.

Dr. Rangan Chatterjee 56:36 Yeah. I, I think it was in first year or second year at Edinburgh Medical School, we were told the exact same thing by one of our professors. "50% of what we're teaching you is gonna be false." The problem is we don't know what, which is the 50%.

James Nestor 56:49 Yeah.

Dr. Rangan Chatterjee 56:50 Um, and I think we all need just to keep that humbleness and humility as we, as we go through the world thinking, "You know, is this really true, or may we just be seeing one side of this here?" It's, it's kind of super fascinating. I mean, you mentioned scientists and researchers. I would also add to that, um, clinicians. I, I, I really love chatting to experienced clinicians who have... You know, these are often N equal one things. I, I totally understand you. There's no... You know, you can't replicate proper science done in proper conditions that can be repeated over and over again. But I think sometimes we get the ideas from clinicians who say, "You know what? I'm trying this and I'm, I'm seeing this over and over again that this is helping people and this is working." Um, and, and I know certainly that's been a huge part of my own journey, a real frustration that the tools I was taught I found brilliant for some people, but for a lot of my patients, I thought, "This is just really limited. I don't really feel I'm helping them. I feel I'm often just putting a sticking plaster on their symptom." And, you know, speaking to breathwork, about six or seven years ago, I started talking to patients about something that I call the three, four, five breath. Breathe in for three, hold for four, breathe out for five. And I've written about it before, and I still get messages from people saying, "This is my go-to for anxiety. Uh, this is my go-to before, you know, before a stressful meeting. It just helps to calm me down," or students before their exams. And again, there's no research done yet on the three, four, five breath, but the principle of a longer exhale than inhale, consciously slowing down your breath. I mean, there's research on that. It's just something I've found to be super practical that people can put in their back pocket. They don't need to remember anything complicated. Wherever they are, they can access it there and then without spending a single penny.

James Nestor 58:44 Well, what, what you found is, uh, I believe it is, uh, scientifically validated because just as you mentioned there briefly, when you're inhaling, you're eliciting a sympathetic response, which is why your heart rate goes up, right? You're activating your body. And when you exhale or hold your breath, you're relaxing your body. So if you're exhaling or holding your breath for three-quarters of the time you're breathing, you're gonna become more relaxed. So all those things are measured. Some people prefer the four, seven, eight breathing.

Dr. Rangan Chatterjee 59:19 Yeah.

James Nestor 59:19 I've noticed with people with anxiety or asthma, that's way too long.

Dr. Rangan Chatterjee 59:24 It's, it's too long-

James Nestor 59:25 Um-

Dr. Rangan Chatterjee 59:25 ... isn't it, to do?

James Nestor 59:27 Yeah, but if you look at four, seven, eight too, it's just doing the, the exact same thing.

Dr. Rangan Chatterjee 59:32 Yeah.

James Nestor 59:32 Box breathing, what's that doing? Four in, four hold, four out, four hold. Three-quarters of the time you're holding your breath or exhaling. So this is, this is kind of what I was talking about. You find just these same variations on the same themes that are eliciting the same responses. And in my opinion, and this is just my opinion, I believe that the information, the data we get from clinicians who deal with people day in, day out, who have dealt with thousands of people, that in many ways is more important and valuable than a study with 20 people in a controlled environment. And the reason I say this is because the randomized controlled studies are, that's the gold standard, and it's fantastic. Double-blind, I love it. But look at all the different drugs and procedures that have passed through that gold standard, and look at how many of those drugs are no longer used because they killed people or made them sicker. So there's something slightly off with that. It's only when you get these things out to huge groups of people-

Dr. Rangan Chatterjee 1:00:44 Yeah

James Nestor 1:00:44 ... if you can do randomized double-blind controlled studies in enormous groups of people, which is basically impossible, that you get the real kernel of truth there.

Dr. Rangan Chatterjee 1:00:55 Yeah.

James Nestor 1:00:55 So if we know that's not possible to have these huge randomized studies with thousands and thousands of people, what's the next best thing? An objective, scientifically minded clinician who sees what has worked- Who adjusts his or her own practices to suit the patients and watches what happens. To me, that's solid gold right there, and that's why I think so many of these breathing practices have been developed by clinicians, right? And they've been tweaked by clinicians who have found just small little alterations here and there will have an even better effect and a better outcome.

Dr. Rangan Chatterjee 1:01:36 Before when we were talking about, you know, being in a car accident and wanting the very best treatment that modern medicine has, and contrasting that with the sort of more chronic conditions where we can put in practices like breathwork or, or preventive, uh, practices like breathwork to stop people getting ill in the first place. I think that broadly works, but when you were talking about Carl Stough's work with emphysema, these are people, you know, severely ill, p- at the end of life, having huge benefit from learning to use their diaphragm better. I mean, that also speaks to the fact that it's about integrating it everywhere. Yes, it's prevention, but also when people are seriously ill, yeah, maybe they have to take some medication, but you can also do breathing practices as well. I have several patients who use breathing practices. They've got very advanced pain from autoimmune arthritis type conditions, and breathwork actually reduces their need for pain medication. Breathwork helps them sleep better. So again, just emphasizing it's not either/or. It can just be part of that armory that we're using no matter what we're facing. If we wanna stay healthy and well, we can implement breathwork practices. But if we are severely ill as well, we can also use certain ones, I think, to help us.

James Nestor 1:02:56 Yeah, that's really true. You know, one thing that Michael Galb, who's a doctor and dentist and sleep researcher, and he's on every board of dentistry, uh, imaginable, and he's been doing this stuff for 30 years, he said that... He's like, "Oh, I only deal with the walking dead. It's only when people get so bad that they come to me, and then, oh my God, now I have to fix you of, of that problem." The point with so much of health, if you look at health from an ancient yoga perspective, if you look at health from an ancient Chinese perspective or a Persian perspective, it is to not get sick. [chuckles] Uh, health is, is used to as a preventative maintenance. You don't want to get sick. You stop paying your doctor when you get sick in Chinese medicine, and you continue paying as long as you're healthy. That seems like an, an interesting way of doing this. I'm not saying that's the best way to go, but it's, it's interesting that they've taken that philosophy. So yeah, I wanna be clear that breathing is so effective as preventative maintenance to keep a healthy lung volume as you grow older, to keep yourself calm, to keep yourself running efficiently. It's f- very effective for that. But for even acute serious problems, it depends what that problem is.

Dr. Rangan Chatterjee 1:04:12 Yeah, sure.

James Nestor 1:04:12 Stage four cancer, don't just do breathwork and stop everything else. That's a, a bad idea, and that this is where I think that people get the wrong idea about this. They wanna learn something and say, "Oh, this is gonna fix me. I'm gonna ditch everything else and just go into this." Well, that's where you get into real trouble. But for people with these longstanding chronic respiratory issues and autoimmune issues, breathwork can be incredibly effective. Alyssa Epell, um, she is a researcher here at University of California, San Francisco, just completed a study in rheumatoid arthritis and breathwork and cold exposure, basically the Wim Hof method. And you're starting to see this all over the place right now because, I think that this is one of the reasons, there's no drawbacks to breathing better. You know? There's some drawbacks. There's always side effects to taking certain pharmaceutical drugs.

Dr. Rangan Chatterjee 1:05:10 Yeah.

James Nestor 1:05:10 Even though the health benefits are gonna far outweigh those side effects most of the time. But learning how to breathe better has zero negative side effect. And for people with COPD and emphysema, what I've found that was so sad is Carl Stough found a way of helping so many of these people. And again, the science is there. It's validated. But when he left the hospital system, so did his research.

Dr. Rangan Chatterjee 1:05:40 Yeah.

James Nestor 1:05:40 So does his practice. And emphysemics are treated much the same they were in the 1950s right now. And I think some of that is due to cost. It's very expensive to have a personalized respiratory therapist train each and every patient. But it also has to do with, uh, apprehension within, uh, the larger medical community that breathwork could actually benefit people with emphysema. All you have to do is look at the science, and you'll see the answer to that question.

Dr. Rangan Chatterjee 1:06:15 What goes wrong, James? What happens? We were born as babies, right? We, um [lips smack] you know, presumably a lot of us at that point have got good posture. We've got good positioning of everything. We're able to breathe. What happens so that we then need these dozens, these hundreds of breathing practices to sort of enhance our health? You know, to... Presumably some of them are just bringing us back to where we might have been had we not sort of gone off track somewhere. What has happened to us as a species whereby we need so much help at learning how to do one of the most basic and most important functions that exists?

James Nestor 1:07:02 Well, I think you can see right now what's happening with the different ways that we've found are very effective for healing our bodies and healing our minds, is the further we get away from the modern environment that we've lived in all our lives- The healthier we get.

Dr. Rangan Chatterjee 1:07:19 Yeah.

James Nestor 1:07:20 If we replace processed food, and cookies, and Fritos, and tortilla chips, and all that other stuff that we've been told is healthy with the food our ancestors ate, we can vastly improve our health. If we get rid of the phones that we have on or the laptops at night, if we regulate the amount of time we spend on the internet and social media, this can have a vast effect on our mental health. So we've lost the ability to breathe properly. You can see the proof all over the place. The first thing that we've lost is the skeletal structure of our faces, and as we mentioned in the last podcast, this is due to the shrinking of our mouths caused by lack of breastfeeding and lack of chewing when we're young. If we don't have that stress, our faces don't build properly, and if they don't build properly, our mouths will grow too small, which is why we have crooked teeth. Our teeth have nowhere to go, so they grow in crooked, and having that smaller mouth also impacts the sinus cavities. So this is not a theory. It's not a hypothesis. This is a fact, and if you don't believe me, you can just look at ancient skulls, which is something I did for a few months with some real leaders in the field. I was absolutely shocked to see I could not find an ancient skull with crooked teeth. I could not find an ancient skull that ever had their wisdom teeth removed or braces, um, or any sort of dentistry or orthodontics. They didn't need any of that stuff. Just like today we need supplements, vitamins, goos, powders to supplement a diet that is so devoid of proper nutrition, if you look at our ancestors, they needed none of that stuff. Were they popping their vitamin C so they wouldn't get scurvy? [chuckles] Or their vitamin D so they wouldn't get rickets? No. Their environment provided all of that because of course it did. We evolved from a wild environment, which is why other animals that live in the wild don't need any of these interventions that we need now to be healthy, okay? It's only when we put them in zoos and feed them a Western diet and acclimate them to our modern environment that they get really sick. So breathing is a huge part of this because losing the ability to breathe, losing the anatomy to breathe properly, then gaining these very improper habits that make it very hard to breathe in just a healthy way, it's dramatically affected our health, and we could talk about the anatomical changes. We could talk about posture. We could talk about pollution, but it's really been a perfect storm of different modern-day environmental inputs which have made us the worst breathers in the animal kingdom.

Dr. Rangan Chatterjee 1:10:21 Well, a couple of things to pick up on. A lot of... There's a lot of young parents who listen and, and watch this show. You mentioned last time about chewing real food and how important that is, but y- we also have this modern fear sometimes that we shouldn't give our kids these foods. It needs to be mushed and pureed and soft, and it, it all kind of speaks to what you were just saying, doesn't it, about how far removed our lifestyles now are compared to how we've evolved. And so, you know, what are some of those simple things that people can think about doing with their children whilst they're still young to, to enhance their breathing, you know, in childhood and beyond?

James Nestor 1:11:02 I was talking to my mom about this when I was first researching this book. I said, "Hey, what did I eat when I was young?" I was trying to understand why my mouth was so small, why I needed extractions and braces, and how that might have impacted my breathing and how it might have impacted my facial form, and she said, "You know, when I was growing up in the '70s and '80s, nobody was breastfeeding." She said, "No, absolutely not. Everyone was bottle-fed, and then you were weaned onto Gerber applesauce di- directly onto it." And I just thought that was interesting, but she, she said that it wasn't even something people talked about. This is just what it was done because modern science had said, "Oh, bottle feeding is better. You have to wean onto canned and bottled and, and jarred processed foods. That's... This is the scientifically sound way of doing it." And as she was talking, I was thinking about how odd this is that all of our ancestors up until 200 years ago were breastfed, and then they were weaned onto hard foods. These foods were not processed before they were given to kids, and if that was so injurious to health, why are we all here today? [chuckles]

Dr. Rangan Chatterjee 1:12:24 [chuckles]

James Nestor 1:12:24 And why did they all have perfectly straight teeth and were able to breathe so much more efficiently and effortlessly than we are right now? So I think it's just this lap and a lap of, of truly long-term thinking that has given us this new worldview that everything new has been both vetted and is better for our health. So to a- answer your... That's a very long way of saying, to answer your question specifically, there's this huge movement called baby-led weaning. I am not the expert in this, um, so I will not speak very in detail about this, but this is all about returning our kids and returning infants to their natural way- Of developing proper facial structure. And it does that by incorporating as much breastfeeding as a mother is able to do, as long as a mother is able to do it, and then weaning onto hard foods, just like our ancestors did. And it sounds dangerous, but again, if you look at the past and if you look at indigenous cultures right now who don't have processed food, uh, you know, they, they turn out just fine and they don't have any of the, many of the chronic problems that we have later on in life.

Dr. Rangan Chatterjee 1:13:51 Yeah. I mean, even related to that, you see this, you know, in cafes and restaurants. I'm not talking about babies now, but, you know, kids as they get older. There's kids meals and there's adult meals. You go out somewhere and it's like, oh, there's real food on the adults menu, and on the kids menu it's chicken nuggets and fries. And again, I'm not-- I'm super clear I'm not trying to criticize anyone for the choices they make with their own children. I understand that there's certain things that are normal in society that we often end up doing without thinking about it. But I just, I've always found it quite fascinating that we have kids meals as well as adult meals, because food is food, right? [chuckles]

James Nestor 1:14:30 And if anyone needs more vitamins and proper nutrients, it would be the kid. But instead, we just put about 50% more sugar in the kids meals-

Dr. Rangan Chatterjee 1:14:40 Yeah

James Nestor 1:14:40 ... and remove all the vegetables. I never thought about this, but, but I think that that's a very clear reflection on how far divorced we are from where we really need to be, and how many more benefits a kid would get, not only in the nutrition of eating proper quote unquote "adult food," but also in the masticatory stress, the chewing stress, which kids need so much more than adults because they're developing very quickly.

Dr. Rangan Chatterjee 1:15:10 Yeah. Changing tacks slightly. I went for a walk this morning, and I was really thinking about the second conversation. You know, the first one I enjoyed so much. My audience loved it. James, it's the most viewed video on my entire YouTube channel. I don't know what happened with that one, but people absolutely loved it. I think over half a million people so far. So-

James Nestor 1:15:32 Yeah

Dr. Rangan Chatterjee 1:15:32 ... it was like, okay, how-- where can we go in this conversation that we didn't cover first time round? And we've obviously done that a lot so far. But I kept coming up with this idea of untapped potential. I thought, you know, from reading your book again, from thinking about breathing, 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 1:16:38 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 and 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 is 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 1:19:17 Wow.

James Nestor 1:19:18 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, [laughs] 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 1:21:57 Could he also change the temperature on his hands?

James Nestor 1:22:01 Yeah, I mean, there's a whole laundry list of things this guy could do.

Dr. Rangan Chatterjee 1:22:04 [laughs]

James Nestor 1:22:05 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 1:22:10 [laughs]

James Nestor 1:22:11 ... he was able to take his hand-

Dr. Rangan Chatterjee 1:22:14 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

James Nestor 1:22:23 ... 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. 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 1:23:58 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, live 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... Well, 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 after-school 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,

Dr. Rangan Chatterjee 1:25:42 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, but 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 1:26:38 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 1:26:55 Yeah.

James Nestor 1:26:55 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, [chuckles] 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 s- 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 1:30:26 It's beyond health as well-

James Nestor 1:30:28 Yeah

Dr. Rangan Chatterjee 1:30:28 ... uh, James. It's, i- 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. In 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 1:31:52 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 1:34:45 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 1:35:38 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 and 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 distent- 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 1:38:37 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 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've 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 at one point it's going all the way to the left. It's like... I said, "Helen, what I've... That has completely changed, and all I've done is three minutes of breathwork." 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 that. 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 gait, my biomechanics change simply on the back of it.

James Nestor 1:41:35 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 1:41:40 I, I'm, I'm loving these quotes, man. Loving them.

James Nestor 1:41:42 [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 1:42:39 Yeah. I know Weil.

James Nestor 1:42:39 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? [chuckles] 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 1:44:13 Yeah

James Nestor 1:44:13 ... 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 1:45:56 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 1:46:39 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. [chuckles] 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, lung function at the time when we need it most, and that's when we're older. So across the board, you can only get benefits from having larger, healthier lungs, and healthy breathing and stretching is the number one most effective way of doing that.

Dr. Rangan Chatterjee 1:49:14 I mean, I wonder how many of the benefits of exercise on longevity and wellbeing may be related to lung capacity. Because obviously, if you, if you go for a run, you're gonna... Whatever your current state is, you're gonna have to work that diaphragm harder. You're gonna have to work those lungs harder. They're gonna be coming back a little bit stronger than had you not done that. And yeah, it just makes you think all the research on exercise and movement, how much of that is related to our diaphragm [chuckles] and our lung capacity. Do you know what I mean?

James Nestor 1:49:47 Endurance athletics is absolutely determined by lung capacity. Look at VO2 max, right?

Dr. Rangan Chatterjee 1:49:53 Yeah.

James Nestor 1:49:53 This, this is the measure of athletic endurance, and this is what Brian MacKenzie and Patrick McKeown have been saying for years, and years, and years now. Uh, you cannot perform up to a competitive level if your lungs are too small, if you don't know how to breathe properly. And this is one reason why some people think that female athletes are at a natural disadvantage. Not only are their airways different because they have different facial structure, but they also have smaller lungs. People with XX chromosomes have smaller lungs, and by having those smaller lungs, they will have less energy. And, uh, the good news is we can do something about that. We can drastically affect our lung size, and a great example of this is just look at free divers.

Dr. Rangan Chatterjee 1:50:43 Yeah.

James Nestor 1:50:43 These are people who focus on their breath all the time. And look at their lung capacity. Herbert Nitsch, a world champion free diver, he's won innumerable, um, uh, awards and competitions. He has a lung capacity of 14 liters. So that's about twice the size of an average adult male, and he didn't get this, uh, when he was born.

Dr. Rangan Chatterjee 1:51:10 Wow.

James Nestor 1:51:10 This is something he did by conscious will, by breathing exercises. So even if we're born with something, and for the vast majority of us, we can change it, and we can improve that. Uh, other organs in the body we can't do much about, our liver, our kidney, right? Uh, but we can influence the size and function of our lungs.

Dr. Rangan Chatterjee 1:51:30 I, I think, James, that's so optimistic for people. We, we, we're seeing that thread at various times through this conversation and our first conversation, that no matter your starting point, no matter where you are right now, there are things that you can do that will start to improve your lung performance, your lung capacity, you know, your, your body's physiology. So I, I really wanna hammer that point home for people that it is worth starting. Even if you've never done anything before, start with something small. You know, maybe try taping your mouth up at night, right? Just, just start to see and feel the benefit. 'Cause once you, once you feel the benefit, you're much more inclined to repeat it and continue doing it.

James Nestor 1:52:14 Yeah. And I, you know, I know that y- you would, uh, I believe you would agree with me here that we're not here to tell anyone to do anything. I'm not here to force feed anyone to, to... or to shame anyone on to eat a certain way or breathe a certain way. The only thing I wanna do is provide people with information, and you can do with this information whatever you choose to do. But just know that the information that we've been talking about in this program so far, this is stuff that has been scientifically validated. And again, there aren't any negative side effects to it. It, it convinces you that there is something really magical going on with our breathing, something that we can harness and better understand to improve various different functions in our body and brain.

Dr. Rangan Chatterjee 1:53:08 Yeah, James, I completely agree. Everyone can make their own choice. I, like you, just wanna share information. In fact, I really feel the only way for people really to make long-term change is when they kind of feel ownership on something and go, "Right, this is now something that I want to take control of." And hopefully there will be a few more on the back of this conversation, but, you know, only time will tell. Um, James, one of the, the many things I love about the book is this idea of breathing plus or breath plus. This, this concept of... I mean, you can probably better explain it than me, but these kind of supercharged breathing practices that aren't kind of the base level ones, but ones that you can tap into if you want. We've mentioned Tummo and Wim Hof breathing already. Um, I did wanna briefly touch, if we could, on holotropic breathwork because I think people are hearing about this. I know you've also spoken in this conversation, and I think in the book, at the point that you bring up Sudarshan Kriya, I think you say that may be your favorite breath practice up to that point in the book thus far. So I wonder if you could explain how you came up with this term of breath plus, what it means, and then dive a bit into holotropic breathing, um, and Sudarshan Kriya.

James Nestor 1:54:27 I just wanted to create an umbrella term that all of these other breathing practices that do require more time. They require more effort, right? But they also can have really profound effects. They can often give you more than just the standard mellower breathing practices. So, you know, the book is set up that at, at the middle of it, it's like here's the stuff that everyone can benefit from. It's like, oh, you want some more? Okay. Well, if you wanna keep pushing this, this is gonna take more time, and some of it may not always be pleasant, right? You, you have to, like, really work through this, but I get interested in that stuff. I said, "Okay, where, where can breathing really take us? What are the absolute limits of where our breath can take us?" And that's where I put all of those methods. And holotropic is certainly within this breathing plus category. And what holotropic breathwork is, is it was developed in the 1970s by Stanislav Grof, who, Grof, he was a psychiatrist- In Czechoslovakia and one of the first test subjects of LSD. So before LSD was illegal, psychiatrists could administer it to their patients, and it did a bunch of amazing things. Grof went to work at Johns Hopkins. He worked at, uh, at various institutions on the East Coast of the US, very respectful and storied institutions, and he was having a lot of success with LSD when it was in a very controlled environment. So when LSD was made illegal, he said, "Oh, no, what am I gonna do? How am I gonna help all these people with schizophrenia and all of these very serious mental conditions?" So he developed a breathing practice that he believed elicited many of the same effects as LSD. [laughs] So that's how holotropic breathwork started out, and what it is, is it involves you sitting in a room with a bunch of other people, lying down on a mat, and listening to extremely loud music, and breathing as hard and as fast as you can for three hours at a time. And if three hours seems like a long amount of time, you're watching a football game, you're like, "Wow, I almost spent three hours in front of the TV. That took a while," try sitting and breathing as hard as you can for three hours and it will feel like an eternity. So I did this. I wanted to try to understand it from the inside. I had an interview with Grof who was, uh, amazing, and I looked at all of the science, which is actually a little flimsy in holotropic breathwork. But it is certainly an experience, and this is what I mean by breathing plus. This is not something you can just casually show up and do. It will kick your ass, and for some people, they've had very profound breakthroughs using holotropic breathwork. Dr. Jimmy Eiermann, who is a psychologist, used this with 11,000 patients over 10 years-

Dr. Rangan Chatterjee 1:57:40 Wow

James Nestor 1:57:40 ... and found it did more than any other therapy for people with addictions or schizophrenia or severe disorders. Um, that's all true according to that study. Uh, I was not the hugest fan of it, um, but that's just my opinion, you know? So other people get incredible benefit from it, and I, I would never take that away from someone. If, if it helps them, then that's great, but just looking at the science and my own experience, it was a lot skinnier than, say, Sudarshan Kriya or the Wim Hof Method on f- as far as the studies are concerned.

Dr. Rangan Chatterjee 1:58:20 There's some new science, I think, coming out soon on holotropic breathing. Is that right?

James Nestor 1:58:25 So ever since the book came out, some of the holotropic people are saying, "Hey, you know, what about us? That's not fair." And I said, "What wasn't fair?" I looked at every single study that had ever been put out on holotropic breathwork, and I honestly told the readers exactly what I had found. I didn't say, "This is a bad thing. You shouldn't do it." I said, "This is what the science says, and this is what happens in your body." So some instructors that I went to said when you breathe this way, you increase oxygenation to the brain, and with that oxygen, your brain is able to process thoughts better. That is 100% BS. What you're doing is denying oxygen to the brain because when you hyperventilate, you cause vasoconstriction, and in states of extreme hyperventilation, you can inhibit up to 40% of your blood flow to your brain, and that's why holotropic breathwork sends people on these very deep hallucinogenic journeys. So ever since the book has come out, I've talked to many amazing holotropic breathwork therapists. Some, you know, thought that I should have looked at the case studies a little more deeply, which I thought I did, but they were very fair about it, and I've gotten to be friends with one of them. And she said, "Hey, I wanna study this further because I know you're absolutely right. The sc- the science is so skinny on this stuff, and before it's accepted very seriously within the medical community, we need some experiments that are conducted at established institutions." I said, "Sign me up. I'm ready to go." So we're working with Johns Hopkins, uh, right now, which in the US is one of the leading medical institutions here, and we will be doing some studies. We're just developing these right now on what we wanna look at. I really wanna do blood work before and after, but that may be too logistically, uh, difficult at this time, so we're definitely looking at brain states-

Dr. Rangan Chatterjee 2:00:28 Yeah

James Nestor 2:00:29 ... and how this affects the brain. And I'm running into a problem that I had before is there's just no money for this stuff. So yeah, we'd love to have 300 people in a very tightly controlled study looking at every imaginable metric. There's zero money, so this will likely be coming out of pocket from, from me and the other people who wanna study this. So if there's any researchers out there who wanna do some research, this stuff is very worthy of study. Again-

Dr. Rangan Chatterjee 2:00:59 Yeah

James Nestor 2:00:59 ... science is the exploration of the unknown. We don't know a lot about what holotropic breathwork does, so what an exciting field to go into right now.

Dr. Rangan Chatterjee 2:01:08 You know, James, I really admire your integrity with this. You, as you've said, you, you just wanna report on what's there. You wanna look at it, you wanna examine it, and share that information with people. Uh, you've been very clear about when you're giving an opinion versus when actually it's backed up by science, which I really, really like, and I think you've really touched on, you know, a potentially, I won't say controversial, but an interesting point about there's no money in this. Um, you know, early on in the conversation you mentioned that study on rheumatoid arthritis patients where people You know, I think did you say cold showers and the sort of the Wim Hof-type hyperventilation methods showing some really promising results? Man, that doesn't... No one can make any money out of that. You know, people hyperventilating, going in a cold shower. You don't even have to heat the water to pay for, you know, to pay for hot water. It's just cold water. And I guess, you know, it really does speak to, I think, the wider problem that, that potentially has been with getting breathwork into medical curriculums because if no one's gonna make money out of the research, who's gonna do the research in the first place? Therefore, you know, I, I, I'll be honest here, I really think, as I said, I, I know medicine can be very helpful for many things, but the more experience I get, the more I reflect on my career, there was a huge pharmaceutical bias to our training, and that may be 'cause there was research there at the time. But because that's what we get taught, that is what many doctors end up using 'cause that's what they're familiar with. Whereas breathwork, for example, is not taught. Even, you know, when I went to med school in 1995, there was research on breathing, but we're not taught that. We're not shown how that could help respiratory conditions and other things. So I think, you know, without getting too political, I, I sort of feel that money component there, I think that's a big one really in terms of getting this out there.

James Nestor 2:03:12 So this is what I've heard from just about every single researcher that I've talked to, um, these are researchers at leading institutions, Stanford, Harvard, Johns Hopkins, is they say if you look at how studies are funded, especially studies in medicine, um, more than 75% come from corporations, and this is why they believe that the results are often skewed towards the results that these corporations, pharmaceutical companies want to get because they have a vested interest in it. There's no controversy about this.

Dr. Rangan Chatterjee 2:03:51 Yeah.

James Nestor 2:03:51 I, I don't think what I'm saying people are gonna be shocked to hear. [laughs]

Dr. Rangan Chatterjee 2:03:54 No, not at all.

James Nestor 2:03:55 Because, because we know that this is, this is how things work right now. We also know that there's really no money to be made in Carl Stough's breathing therapy for emphysemics. If anything, this is gonna cost hospitals so much more money. We also know that not only will researchers not get funded for a lot of these studies, but they could also possibly lose tenure, [laughs] you know, if their names are attached to something that sounds completely crazy. But it's these things that sound completely crazy that to me can help really move the needle forward. Again, why not explore something that hasn't been studied? If your results say, "Oh, this is total BS. This doesn't do anything," that's really important information to have, and it'll really clear up a lot of the muck that's in the air. And if they lead to another answer that, "Oh, it looks like there's a lot of potential here," then what a wonderful thing-

Dr. Rangan Chatterjee 2:05:04 Yeah

James Nestor 2:05:04 ... that there's a new way of exploring a way of treating some certain diseases or allowing people to become more healthy. But it does come down to money.

Dr. Rangan Chatterjee 2:05:16 Yeah.

James Nestor 2:05:16 You know? As, as someone, as a business person told me, he said, "99% of the questions in the world can be answered with money." [laughs]

Dr. Rangan Chatterjee 2:05:28 Yeah.

James Nestor 2:05:28 So, um, and I think that that's true for medicine as it is for anywhere else. So we shouldn't be shocked by this. I wanna be clear, I'm not opposed to pharmaceutical drugs and again, I and my family are doctors, but, but it's allowing yourself to look at the true benefits and look at everything on the table first and then choosing what-

Dr. Rangan Chatterjee 2:05:52 Yeah

James Nestor 2:05:52 ... can work best for you.

Dr. Rangan Chatterjee 2:05:53 Yeah, it's as you were saying, breathing has most of these practices, certainly, you know, if we, if we take Breathing Plus out for a moment, the, the, the simple, um, [lips smack] less, you know, supercharged practices, there's no downside of these things at all. So, you know, primum non nocere, first do no harm, you know, the fundamental tenet of medicine. Kind of breathwork really fits so beautifully into that model. You know, try it, see it, experiment. Um, before we finish, I do

Dr. Rangan Chatterjee 2:06:23 wanna hear about, uh, Sudarshan Kriya because you speak so passionately about it. What is it? What does the research say? And why are you such a big fan?

James Nestor 2:06:35 So Sudarshan Kriya is another variation on that same theme of stressing your body out, holding your breath, breathing slowly, stressing it out again, holding your breath, breathing slowly. So just like Wim Hof method, just like so many other pranayamas, just like some Chinese qigong practices as well. So I think I have such a fondness for this practice because it was the first breathing practice that absolutely blew my mind. I had done other healthy breathing practices. I said, "Oh, I definitely feel better. Oh, I'm sleeping better." But Sudarshan Kriya definitely cracked something in me, and that was very apparent when I had just learned it, and the weekend workshop was, was interesting. I didn't get that much out of it, I'll be honest. But, um, this workshop is based on the teachings of this guy Sri Sri Ravi Shankar, who developed this breathing technique in the 1980s and has developed all these different nonprofits around the world to teach this, this breathing. It's called the Art of Living, um, organization. And y- but even though this, this breathing has been around thousands of years, he was able to, to put it in this very controlled way. And so it wasn't until, uh, uh, several weeks or, or months, this was a long time ago, 10 years ago, that I went for a repeat session of this where I absolutely... I don't know if you would call it a, a breakdown or what, but, but physically I had such a profound response, and nobody could explain what exactly happened. I sweated so profusely my hair was sopping wet, my T-shirt was wet, there were sweat blotches on my jeans, and I was just sitting in a corner of a room of a very cold house here in San Francisco just breathing in this, [laughs] in this calm rhythm, and sweated as though I had just run an ultramarathon. So that got me intrigued in the potential of what breathing could do for us. I also got intrigued where I could not find a real scientific explanation for what had happened to me, and most people said it was a placebo effect, which d- makes absolutely no sense [laughs] that your body can just break down to this extreme sweat. So I've stuck with this breathing. Uh, I love it. It offers me a clarity. It calms me down as well. It's very simple. The one problem is you do have to take a weekend workshop. That costs money, so you can't learn this online. Um, but I, I find the workshop is, is worthwhile because you learn this, this breathing, uh, technique. And I can't get into all the, the minute details of how it works. It's pretty complex. But I will say it is interesting to see there are over 100 independent scientific studies in Sudarshan Kriya done at Harvard, done at Yale, done at top institutions looking at how effective it is for all the things we just talked about, [laughs] panic, anxiety, even asthma, autoimmune problems, diabetes. So it is scientifically validated, and that helps for people who are skeptical.

Dr. Rangan Chatterjee 2:09:57 James, you've been on some journey over the past year since this book came out. Um, lots of people are getting in touch with you. I know you've been doing some work with the UN on trying to educate kids around the world. Tell us a little bit about that, 'cause that sounds incredibly fascinating and has the potential for huge impact.

James Nestor 2:10:16 Yeah, so this is something I got interested in because, again, I'd seen what a tremendous effect healthy breathing habits can have, especially on kids, you know? It's easy- easier to change a habit of, of a kid and have them develop in the right ways. And then once they're developed in the right ways, it'll be easier for them to maintain proper health.

Dr. Rangan Chatterjee 2:10:35 Yeah.

James Nestor 2:10:36 And so many of these chronic conditions that so many of us suffer from, even heart disease, diabetes, and their orig- origins start when we're young. I mean, they really do. And a lot of them I've, I've noticed, um, can be helped or at least, uh, improved in certain ways by improving the breathing, just as we mentioned with ADHD. So I was able to work with this incredible organization called The Global Classroom. They're there in the UK. And they do free all-volunteer-run programs for youth around the world focused on kids in developing nations. These are hour-long video programs that are free to everybody that are piped into schools that teach kids about health, because a lot of these messages, um, don't get filtered out. We tend to get them in, in the West more easily than, than other people in developing countries. So it was an extraordinary experience. Uh, Wim Hof volunteered a, uh, a whole technique and a video program. Jason Mraz, the famous mu- musician, Lindsey Stirling, all of these people dedicated their time to putting together a video program. You know, the video program isn't an end-all be-all, but we look at it as a good introduction to why you should think about your breathing when you're a kid, what you can do to improve it, and how to keep breathing healthy in the future.

Dr. Rangan Chatterjee 2:12:06 Yeah.

James Nestor 2:12:06 So it was such a blast and honor to be able to speak along with this amazing cast of characters and to get that out. So this is available for free for everyone. There are no Pepsi logos on it. There's no Cheeto logos. Uh, this was just something that, uh, everybody came together to, to want to do sans any corporate sponsorship to, to get out into the world.

Dr. Rangan Chatterjee 2:12:31 Yeah, incredible. What's next for you, James? Because, you know, I'm still sensing that passion to learn more. There's research coming up. You wanna go and talk to more people. You know, is there, is there a Breath 2 in the making? Or, you know, what, what's coming next?

James Nestor 2:12:51 Yeah. You know, I'm just gonna do another book that is just gonna be the puffy rice version of everything we just talked about. No, I will not. I will not do that, people. I promise you. I think last time you asked this question I said, "Oh, I'm, I'm planning on sleeping more." Uh, I still haven't done that. So, uh, this has been, you know, combining the, the ongoing book tour with a, with a global pandemic, and, uh, I think I need to reboot.

Dr. Rangan Chatterjee 2:13:15 Yeah.

James Nestor 2:13:15 So I really wanna go somewhere and turn off my phone and computer for, for a month if I can. Um, that might be impossible, but even for a few weeks. But I have a few different projects. Um, a video miniseries, opportunities where, uh, we're hoping to take a lot of the general themes we've talked about during this program and the previous one and put them into- A video program-

Dr. Rangan Chatterjee 2:13:38 Right

James Nestor 2:13:38 ... um, to try to get this out to a whole nother group of people who don't, don't read books. But, um, the most exciting thing I'm working on is another book idea, which I won't bore you with right now. But, um, I am excited after, uh, being able to, having the opportunity to, to talk about this stuff in, in the public, which is great, but I am also excited to go back into my little shed in my backyard and, uh, close off the world and to sink very deeply into another subject, start exploring it.

Dr. Rangan Chatterjee 2:14:09 Yeah.

James Nestor 2:14:09 I really feel that hunger to learn more and do research and go meet some amazing people and interview with them, and I'm so lucky to have a job that allows me to do that.

Dr. Rangan Chatterjee 2:14:19 Well, James, look, uh, as I said just before we started recording, we've had, well, at that time, one conversation, now two lengthy conversations. I've never met you. I feel as though I know you really well from our interactions. I think you're an incredible human being. I think what you have done for this whole field is transformative. I, I genuinely believe that you are changing hundreds of thousands of people's lives across the globe, if not more, based upon writing such a thorough and fabulous

Dr. Rangan Chatterjee 2:14:49 book. So I just wanna appreciate you for that. It really is something special, and I'm delighted to see it do so well. Um, just to finish off today, as I probably said on our first conversation, this is called Feel Better, Live More. When we feel better in ourselves, we get more out of life. When we breathe better, we're gonna get more out of our life. Do you have any final words of wisdom, practical tips, advice for people that go, "Yeah, all right. You've convinced me. I'm in. I wanna get into this breathwork game"? What would Mr. James Nestor say to them?

James Nestor 2:15:23 All I would say is just start with this. Start by breathing through your nose to a count of about five or six, and then start exhaling to that same count. Continue breathing this way for maybe 10 or 20 cycles. And then just check in with yourself and ask yourself how you feel. And I think you'll be surprised that doing something so simple, so basic, can really elicit such a strong response in your body. And if you're intrigued with that, then you can go so much deeper into breathing practices, and these practices, each of them have their own wonderful benefits to offer. But it really just starts with that single breath, and then you can take it from there.

Dr. Rangan Chatterjee 2:16:16 James, it's always a pleasure. I know we're planning to meet up in person at some point as the world opens up. I'm looking forward to that. And in the meantime, take care and get some rest.

James Nestor 2:16:27 Thanks a lot, Rangan. Thanks a lot for having me back.

Dr. Rangan Chatterjee 2:16:29 [upbeat music] Hey, have a think about one thing you can take from that conversation and apply into your own life. And if you want some more inspiration, here is a- another video that I think you are really going to enjoy.

James Nestor 2:16:41 How we breathe absolutely affects us. It even affects the density of our bones. It affects us down to the atomic level.