Nasal Breathing Improves Health

Health benefits of nasal breathing and the science of breath with James Nestor.

On today’s podcast, I talk to journalist James Nestor about the fascinating science behind breath and the widespread benefits of nasal breathing for improving health, performance, sleep apnea, and even longevity. We also talk about what you can do to improve your own breathing starting now.

In This Episode

Intro … 00:00:45
Background … 00:03:02
Consequences of Snoring … 00:05:10
Breathing and Oral Health … 00:13:57
Increasing Mouth Space … 00:21:04
Improving Facial Appearance … 00:25:56
Skull Examinations & Jaw Exercises … 00:30:07
Mechanical Stress … 00:36:36
Over-Breathing & Exercise … 00:40:40
Lung Capacity and Mortality … 00:47:03
Diaphragmatic Release … 00:51:24
Wearable Technology … 00:57:03
The Breathing Formula … 01:00:03

Nasal Breathing Improves Health - Podcast295 JamesNestor

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Hello everyone. Today I spoke with James Nestor author of the great book Breath, and we build this case regarding how important healthy respiration is. This isn’t an episode on Wim Hof, or some of the more intense practices that you may have heard regarding breath, but rather here we go into the importance of nasal breathing, the importance of lung capacity and how a data set from the Framingham Study found that lung capacity predicted all cause mortality.

We also provide some simple exercises you can do to improve the tonality of the musculature that dictates the potency of your airway, as well as a few other fun musings on diaphragmatic release, how some Indian tribes monitored their infants for proper breathing, and a few other choice select breathing techniques. And we really build upon this case which I hope you’re paying attention to, which is the quality of your breathing is very important. And one flag I’ll throw up for you. If you snore, then this is definitely an issue that you want to look into more, because it’s like driving your car with the e-brake on. It was a great conversation with James. I hope you enjoy it. I also hope you will leave the podcast a review on iTunes. If you’ve been finding the show helpful, it really helps us reach more people with the good work that we’re trying to do. And now we will go to the conversation with James.

➕ Full Podcast Transcript

Intro:

Welcome to Dr. Ruscio radio, providing practical and science-based solutions to feeling your best. To stay up to date on the latest topics as well as all of our prior episodes, make sure to subscribe in your podcast player. For weekly updates visit DrRuscio.com. The following discussion is for educational purposes only and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking with your doctor. Now let’s head to the show.

DrMichaelRuscio:

Hello everyone. Today I spoke with James Nestor author of the great book Breath, and we build this case regarding how important healthy respiration is. This isn’t an episode on Wim Hof, or some of the more intense practices that you may have heard regarding breath, but rather here we go into the importance of nasal breathing, the importance of lung capacity and how a data set from the Framingham Study found that lung capacity predicted all cause mortality. We also provide some simple exercises you can do to improve the tonality of the musculature that dictates the potency of your airway, as well as a few other fun musings on diaphragmatic release, how some Indian tribes monitored their infants for proper breathing, and a few other choice select breathing techniques. And we really build upon this case which I hope you’re paying attention to, which is the quality of your breathing is very important.

DrMR:

And one flag I’ll throw up for you. If you snore, then this is definitely an issue that you want to look into more, because it’s like driving your car with the e-brake on. It was a great conversation with James. I hope you enjoy it. I also hope you will leave the podcast a review on iTunes. If you’ve been finding the show helpful, it really helps us reach more people with the good work that we’re trying to do. And now we will go to the conversation with James. Hey everyone. Welcome back to another episode of Dr. Ruscio radio. We are going to go deeper into breathing and how crucially important healthy breath is with a special guest today. James Nestor, who wrote a book called Breath, which I think is fantastic and I highly recommend. You may have also caught his interview on the Joe Rogan Podcast.

DrMR:

He’s done some really interesting stuff and I’m looking forward to having him expand upon his investigative journalism into breathing, but also some of his personal experiments. So James, welcome to the show. It’s great to have you here because like I was saying before we started the recording, we’ve had on Kevin Boyd, Brian Hockel, Mark Burhenne, but the fact that you’ve gone through some of these treatments firsthand, I think adds another layer of perspective. But I guess before I satisfy my curiosities of picking your brain, can you give people a little bit of your background and kind of the inception of the book Breath?

Background

James Nestor:

Sure. So you know, I’m a science journalist. I’ve been writing for magazines and newspapers for decades. And I had never, ever thought I was going to write a book about breathing. What could be more boring or seemingly banal than that. It wasn’t until I had some breathing difficulties. This was several years ago, where I was eating all the right foods. I was sleeping eight hours a night. I was exercising all the time, but I kept getting bronchitis and mild pneumonia and I was wheezing and I was told that this was all normal for an aging person. I was given a cocktail of antibiotics and shuttled out the door. But I thought that something was a little odd about that.

JN:

So I started exploring, reading a little bit and I attended a class, through The Art of Living that really blew my mind in so many ways. I didn’t know that you could just sit in a corner and breathe in a rhythmic pattern and sweat through all your clothes without moving an inch. That was news to me. As a journalist, I didn’t know what to do with these experiences. I didn’t want to write a memoir. That’s not my thing. Until I met freedivers as part of a reporting assignment with Outside magazine, and I saw where breath could take us, what we could do if we really focused on it. It could allow us to do things that were considered medically, scientifically impossible. So I thought, “Where else can this take us?” Beyond diving down to 300 feet on a single breath or staying underwater for six minutes at a time, can I help heal the body? Can I help heat the body? Where else is the potential of breathing? And that’s really what set me off on this path.

Consequences of Snoring

DrMR:

There’s many ways we can go from here, but I think perhaps one of the most foundational is if you’re snoring, there is a good chance you are killing yourself slowly. Maybe that’s said a little bit pointedly, but it’s meant to kind of spur people to take action. Would you agree with that? Is that too harsh of a statement for me to make?

JN:

I don’t think that’s an exaggeration at all. Especially if you have sleep apnea on top of that, you are killing yourself and along the way to your death, you are going to be experiencing so many chronic illnesses. From neurological problems, metabolic problems on and on and on. With kids, developmental problems, growth problems, you’ll grow shorter, and this isn’t any mystery. This is well-documented in science, just so few people really seem to be talking about it.

DrMR:

And it seems that snoring, it’s almost part of the culture where, if you’re ever going to kind of mock that you were sleeping, what would you do? You’d kind of make the snoring sound. So it seems to be almost a normalcy amongst the culture, but definitely something that indicates there’s something interfering with your breathing. You actually have done, and I really have to commend you because this must have been extremely unpleasant, an experiment where you had your nose plugged. Do you want to tell people a little bit about the experiment, what you noticed from a physiological perspective, from a biomarker perspective? Because this was quite interesting.

JN:

I had been talking with Dr. Jayakar Nayak, who’s the Chief of Rhinology Research down at Stanford; big nose guy. Over several months he was telling me all of the wondrous benefits of nasal breathing, how it filters air, it humidifies it, it moistens it, on and on. And again, no one was refuting that. He was also explaining all the deleterious effects of mouth breathing, how it makes you more apt to have periodontal disease, how it exposes your lungs to everything in the environment. Again, no mystery here. But what people didn’t know was how quickly those problems came on with mouth breathing. No one had really tested it in humans. They tested it in monkeys, some of the most awful studies I read, but no one had looked at it in humans. So we know that about 25 to 50% of the population habitually breathes through its mouth.

JN:

And when we sleep, that number goes up to maybe 60, 70% of the population is mouth breathing. But from what I’ve seen, no one had really measured the difference of sleep quality, of blood pressure, of heart rate variability, breathing through the mouth and breathing through the nose. So we set up this little experiment with me and one other person Anders Olsson, a respiratory therapist from Sweden. We had to pay for the study, which was not cheap at Stanford, but it was set up that for 10 days, we were going to be obligate mouth breathers. We had silicon up our noses. And for the other 10 days, we were going to be breathing through our noses as often as we could. And just comparing datasets from blood work to PFTs to everything, just to see how it affected us.

DrMR:

And you had noticed, I think it was before the first day had even ended, that you were having some deleterious effects when you were only breathing through your mouth, right?

JN:

Yeah. It comes on so quickly. We knew this wasn’t going to be a picnic. We also didn’t view this as some sort of stunt. When you’ve got from 25 to 50% of the population doing something, it’s not like we were being wacky by doing this. We were just lulling ourselves into a position that so many people contend with today. I mean, how many people have chronic sinusitis, 15%? How many people have chronic rhinitis? I mean, it’s just outrageous. We’re just perpetually obstructed. So my blood pressure went through the roof within a couple of hours. We were at Stanford for eight hours, four blood draws, it was a real nightmare of a day. So when I went to bed that night, I went from not snoring at all because we took baseline for two weeks before this, to snoring about an hour and a half.

JN:

And I said, “Wow, that’s weird. Just the pathway through which you breathe, does that affect snoring and sleep apnea?” Maybe I was just super tired or something happened that night. And the next night I snored more. A few days later I was snoring for four hours throughout the night. From zero to four hours, just by switching the pathway through which we breathe. Poor Anders Olsson, he was way worse off than I was. He was snoring through basically the whole night from the time he closed his eyes. We both got sleep apnea as well. We started choking on ourselves and it was getting worse and worse the more this study went on. So really scary stuff.

DrMR:

And this begs a question, should we interpret snoring as someone mouth breathing? I guess we can say that there’s a pretty high probability if someone snores they’re at least partially mouth breathing during the night. Is that a safe assumption?

JN:

No one knows because everybody is slightly different. There’s some obstruction in the nasal pharynx, some obstruction in the oral pharynx. Some people sleep on their sides. But we do know there’s a big body of science and research showing that when allergy season comes on snoring and sleep apnea greatly increase. So we know that there is a correlation between mouth breathing, nasal breathing, and some snoring and some sleep apnea. And looking at this in an opposite way, we also know — there’s been a couple studies, I wish that there were many more. But anecdotally too, my own experience and the experience from hundreds of people who have written me, by becoming an obligate nasal breather, snoring can either be decreased or sometimes disappear completely. This includes some forms of sleep apnea. To be clear, this is not a blanket prescription for everyone. It’s not going to fix all your problems. But I saw it with myself, when we switched over in the Stanford experiment to nasal breathing, my snoring went down to zero. My sleep apnea went to zero. Anders Olsson’s went to zero. Sleep apnea was zero. So, two people, what does that prove? Not much, but you really need to look at the science and how the airways work and also hear from so many other people who’ve had this exact same experience.

DrMR:

It’s an interesting remark that you make in the sense that when people have allergies, they’re more prone to snore, probably because the nasal passageway is somewhat obstructed, so the body’s reverting to the path of least resistance. But if we extrapolate that, and I’m going to speculate here a little bit, but people with these chronic low level inflammatory disorders, IBS, IBD, histamine intolerance, they oftentimes will notice of the litany of symptoms that they’ll have kind of on and off congestion. It makes me wonder how much could there be this, sub-clinical allergy where people just aren’t really healthy digestively and from an immune perspective, so they’re not breathing as clearly as they can. And this is one of the reasons why snoring perhaps is so common.

JN:

I would completely agree with that. When we are obstructed, when our noses become congested, we will be breathing through our nose. If you just look at the physics of it, what happens when you open your mouth up, your tongue gently rocks back into your throat. You’re going to tend to breathe a lot more. So when you breathe a lot more and you breathe more deeply, guess what happens. Try to snore, and while you’re breathing very slowly with that natural resistance of the nose, it’s so much harder. So some of this just comes down to the flow, the physics of it. But you can experience with people. There’s so many different gadgets and wearables people are wearing right now where they can look at their sleep quality throughout the night. When they’re congested, when they’re not congested, and just consistently sleep quality is going to take a huge ding the more congested you are because you’re also losing 40% more water when you’re breathing through your mouth. So you wonder why you wake up super dehydrated with a dry mouth. You wonder why people who are mouth breathers have a much more increased chance of having cavities and periodontal disease. It’s not a coincidence, and it’s not random stuff to me. It makes perfect sense. And yet we’re just not being told this. This is the first time I ever heard about it, once I started really researching it.

Breathing and Oral Health

DrMR:

That was one of the things that I really found insightful about when Mark Burhenne was on the podcast almost three years ago I believe, is that he was looking at things like dry mouth, receding gums, burning tongue, dental, caries and cavities as a sign that there’s a breathing problem. And that was the first time I kind of said, “Oh my goodness, this is something.” When we’re doing our new patient intake at the clinic, we need to be looking at these symptoms as a potential indicator that there’s this sleep disorder and breathing potentially present. That was a real kind of light bulb moment for me.

JN:

Dennis had been saying what Mark has been saying for over a hundred years. There are papers showing very clear links between mouth breathing and the onset of cavities and the onset of periodontal disease. So a lot of dentists were looking at if your lower lip is chapped, if your lips are chapped, if your facial structure is different, if it’s longer, than that suggests at least that you are a mouth breather. So he has been leading this for decades. I know Mark, I’ve talked to him several times and for a lot of that time, people called him a complete quack. Wait, I’m supposed to tape my mouth at night? That sounds dangerous. And it’s so funny to see someone who really went out on a limb, who did the science, who showed up and studied this stuff, and everyone laughed at him. And now, 15, 20 years later, everyone is basically confirming what he was saying to begin with. But that’s usually how science works. It’s just unfortunate for that person to have to weather that for so long.

Oral Pharyngeal Exercises

DrMR:

The martyr, yeah. I just wanna remind our audience of the study we discussed with Dr. Belfor, I believe, how playing a woodwind instrument, the didgeridoo being one example that I’m trying to start using as I look over at it in the corner collecting dust, that was shown through the tongue exercise that one obtains by playing it, to be able to reduce sleep apnea. So it kind of fits in this whole theme of breathing and I guess touches on that tangential theme of the tonality of some of the musculature.

JN:

Yeah, and didgeridoos are great unless you’re a roommate with someone with a didgeridoo, then they’re a little less cool, but you don’t need to play the didgeridoo. You can just practice oral pharyngeal exercises, which have been well-documented to significantly cut down on snoring and sleep apnea. There is a big study in Chest. Chest Journal, a renowned scientific journal, saying just that. So we exercise the rest of our body. We’re exercising our, our pecs, we’re exercising our butts, our legs, whatever, but we don’t exercise our mouth. We don’t exercise our throat because so many of us are eating this soft food all the time, and our tongue needs exercise just like everything else does. So if you build in some exercise for your mouth, for your tongue, you can help tone that airway more, which is exactly what playing the didgeridoo does. It forces air to tone that airway. And you can do that, or you can use inspiratory muscle training which has been shown to be very effective as well. Or you can do these oral pharyngeal exercises.

DrMR:

Now is this the mirroring exercise or mirroring that you talk about in your book?

JN:

That’s a variation of it for sure. That’s gotten the most popular because a lot of people want those hollow, sexy cheekbones. I think it was vanity that really pushed that into the general public. But what that is, it’s just learning how to have correct oral posture. Place the tongue on the roof of the mouth, and then you kind of move the tongue upward, which is exactly what an oral pharyngeal exercises is. So they are variations on the same theme.

DrMR:

I believe you have some exercises on that in your book, but my resolution on your book is fading a little bit since it’s been maybe six months since I read it. But would you point people there or somewhere else if they wanted to start doing some of those exercises?

JN:

Sure. I put some exercises at the end of the book, but my book is not a how to book. There’s a lot of how to books. My book is mostly a why, or what, or where does this come from book, but you will learn how to breathe better by learning why it’s important, because I’ve found that just having instructions, it goes in one ear and out the other. And if you really feel an emotional connection to doing this, it’s going to resonate a lot more. So all people need to do is type in oral pharyngeal exercises, and you can put Chest at the end of that, and that will bring up the free study in Chest Journal. Again, a very legit scientific journal. It will bring you through the steps. You can also search that on YouTube. I would make sure it’s from a qualified person giving you the instructions on that. But this stuff is not complicated. It’s exercises for your mouth, which might sound weird to some people, but to me, it makes perfect sense. If you’re not exercising the mouth, it’s not going to perform properly. You want your throat to be toned. You don’t want a bunch of flabby tissue to go [snoring noise] when you speak or when you sleep.

DrMR:

I have to also credit you with spurring me a little bit further down this path, and to your point of understanding is more important than having the how to, after reading your book, I was just more cognizant of tongue position, and I’ve been noticing all these things are kind of now starting to tie together in the sense that when I’m exercising and when I’m doing some of these tongue exercises, I’m noticing that when I hit correct tongue posture, my tongue wants to proceed past the line of my teeth, which is likely because I wore headgear and my upper arch has been pushed backward and my tongue does not have enough room for it. And so all of these things are starting to connect where now I really have this kind of weird desire to have a larger mouth, but it’s because I’m rediscovering correct tongue posture. And when I do, it’s like I’m in a building and I’m always slouching, and I never hit my head on the ceiling. Now that I’m standing up straight, I’m hitting my head on the ceiling all the time, and it’s making me want a higher roof, so to speak. Your book really helped me kind of connect that.

JN:

Yeah, this was my exact experience. You can also look in the mirror, stick your tongue out, and if there’s teeth indentations on the side of your tongue, that means your tongue is too big for your mouth and your mouth is too big for your tongue. And that’s not a good thing because your tongue will tend to push the teeth out of alignment. Not only that, but having that larger tongue, especially in an airway that’s not toned or properly fit can make you more apt to choke on that tongue in sleep apnea, which is a very slow asphyxiation.

Increasing Mouth Space

DrMR:

You’re several lengths ahead of the road I’m about to embark on, which is having some of my restrictions or constrictions corrected. I’m currently going through some initial phase consultations with Dr. Belfor. You saw him; you talked about this in your book. Do you want to tell us a little bit about what that was like going through it firsthand?

JN:

Yeah, so I had heard about this. The history of my mouth is just like every good American boy. I had extractions, I had braces, I had headgear. I was completely miserable through early high school. It was never a question of if you’re going to get this stuff, it’s just when. Everyone I knew got braces and headgear, and I always thought it was perfectly normal. But then you start to understand. Why is it that humans are the only species that need headgear and braces? Every other animal has perfectly straight teeth. All of our ancestors had perfectly straight teeth. If you don’t believe me, go look at some ancient skulls. I spent months looking at them, all straight. So it’s because our mouths have grown too small for our faces.

JN:

The natural thing to do is to return the mouth to the size it was supposed to have been. There are various products, various ways of doing this. It’s to create more space in that upper palate. By doing so you not only create more space for the teeth to naturally grow in straight, which is what they want to do, you also create a larger airway. So it allows you to breathe better. So there are dozens of these devices. Again, dozens of these procedures. Belfor’s was interesting to me because right when I met him, I was just at the beginning of researching this stuff, and it seemed so weird to me that you would want to expand a mouth. I was like, “this is total quackery.” But he checks out; his research checks out. I looked at his case studies and I thought, hell, I want to see what this does for me.

JN:

You know, I’m an investigative journalist, so I got one of his devices and I took a CT scan the day I got the device, and took a CT scan a year after. Because it’s one thing for me to say, “Hey, I feel better. Yeah, I breathe better. Yeah, you should use this.” It’s another thing to look at data and to look at measurements, and I could send you those CT scans. It is not subtle, what happened. I gained something like 15 to 20% more space in some areas of my airway. My mouth grew larger. I gained more bone in my face as well because bone starts disappearing, starts deteriorating when you’re in middle-age, which I am in. So it was just fascinating to see how the body adapts to this. It was also bizarre to learn that what we’re doing is just trying to make ourselves the way we were before industrialization. That’s what these things are doing, and how sad it is. If we didn’t have all of these new, modern lifestyle problems, we wouldn’t need any of this crap.

DrMR:

I think that’s really important to remind people. We’re not modifying, we’re just trying to return to baseline. Crucially important point.

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Improving Facial Appearance

DrMR:

There’s another aspect of this. I’m curious, this is something that Belfor actually said to me earlier today. He was going through all the various angles and measurements and how, we want you to be at X degrees and you’re at Y degrees, and we can see how it’s influencing your tongue position and how that’s influencing the airway. But then he stopped and he said “Aesthetically, this is going to be great for you,” which is not something I’m after, but hey, I mean, why not? I could get a bonus. But what did you notice in terms of appearance of your face? Were there any changes there?

JN:

Well, this is why I think a lot of people were so attracted to this. So Belfor’s life story is so fascinating. I wasn’t able to fit too much of that in the book. It got cut out, but when he got back from Vietnam, he started expanding mouths of people in the entertainment industry who couldn’t be seen with braces. He noticed that they started singing higher notes. The makeup artists for these people were saying, your face is changing, and it’s been changing over the past month and I don’t know what’s happening. So what he realized is these devices stimulate chewing stress, and with chewing stress, we can grow more bone. We release more STEM cells, more osteoblasts to build more bone in our faces. So it actually will change. Slightly, subtly. It will change the way you look and the body is going to develop you for symmetry.

JN:

And a lot of us are so asymmetrical, myself being included here. So I noticed it within a few weeks. My wife was just like, “Whoa!” I’m not saying if it was good or bad, but it was definitely a change. I was getting more symmetrical. I gained about four pennies worth of new bone in my face after a year. And again, this is all in the CT scans, which were analyzed through the Mayo Clinic. So this is all legit stuff. It’s just the body healing itself; essentially that’s what it’s doing. The body wants to be this way anyway, and these devices just allow you to speed that process up.

DrMR:

This is something that I was first made aware of by Weston A. Price who you also referenced in your book. When he went around the world and documented these indigenous, free living hunter-gatherers, they had wide smiles. It’s important to say that some cultures just have different facial structure than others, so we don’t want to just cherry pick here, but there’s a general trend of wider faces and brighter smiles. That’s really kind of what the Hollywood or Fifth Avenue is stereotyping as attractive. You know, no one ever says, “Oh, she has such a bright, narrow smile.” It’s just a big wide smile with lots of teeth. So we’re just getting back again to that more ancestral template of how we should be.

JN:

But these traits were universal and it didn’t matter if you were looking at the Hazara tribe in Africa, or if you were on the Isles off of Scotland, they all had straight teeth. They all had wide mouths. They all had wide nasal apertures. That’s what’s so crazy. Genetic differences can tie into how wide that smile was, but their faces were, were very well-formed. You can see this in the skeletal record, going back, literally hundreds of thousands of years, Janet Monge at the Morton Collection at the University of Pennsylvania told me she’s seen thousands of skulls. She had never seen a hunter-gatherer with crooked teeth, not one of them ever. So iit’s undeniable, what’s happened to us. People just say, “Oh, it’s evolution. This is the body just changing.” You know, this is dis-evolution. This is evolution that is not benefiting us at all. A lot of people think that evolution is survival of the fittest, but it’s not; it just means change. And we’re changing for the worse.

Skull Examinations

DrMR:

I agree. This is definitely not a health promoting evolution. I would strongly agree with you there. You also kind of found your way into some caves to look at skulls to really affirm that maybe there’s not this canard that’s continually parroted by anthropologists. You actually went and looked at some skulls and some pretty hard to access places.

JN:

Yeah, my day job gets pretty weird, sometimes. This was really at the beginning of my research here. I had heard about this, about how our ancestors all had straight teeth. This is before I went to the University of Penn to see this in labs. I wrote various people and I didn’t hear back from them. I was like, “where can I see a bunch of really old skulls?” So through a friend of a friend who shall remain nameless.

DrMR:

Always a good story. When it starts with a friend of a friend.

JN:

I won’t say it was actually a good friend of mine. So cut that part out. But I got some inside knowledge on how to go down to the Paris quarries, which is different than the catacombs. The catacombs are this prescribed tour that you can go down and look at thousands and thousands of ancient skulls. But that tour is only about, 1 or 2% of the actual quarries, which goes on for like 170 miles below the streets of Paris. So these cataphiles took me. These three French women took me down there, and we just saw hundreds of skulls. I was very much a novice at looking at skulls. I still am, but it was undeniable, looking at the size of their jaws, the breadth of their upper palates. Our ancestors looked drastically different from us, and in many ways they breathed different from the way we are breathing today as well.

Jaw Exercises

DrMR:

One of the things that you also cite in your book is part of the reason we see these differences is due to less chewing stress, mainly because cooking has allowed us to essentially pre-digest food, which may have some pros and cons to it. I’m wondering if you can talk a little bit more about that, and also any devices. I ended up finding these little plastic, almost dice that you chew on. Unfortunately for me, my gut did not like those. I was doing maybe 30 minutes of chewing every morning and I think I was digesting them a little bit. For some reason, my gut didn’t like those, which was sad because I loved the prospect of getting that jaw exercise in. Can you tell us more about that, and if you have any non-plastic versions that you know of that I might be able to try?

JN:

Yeah, we’re always looking for the shortcut, we modern humans. I’m with you on that. Cooking greatly benefited us as a species. The first control use of fire was about a million years old, 800,000 years old. With this fire, we were able to cook more food and release more energy, which helped us grow a larger brain. That larger brain took up some space from the front of our faces. These changes happened over tens of thousands or hundreds of thousands of years, and we adapted to them just fine. Our ancestors were breathing just fine. It’s when we very quickly, immediately, in some cases, changed our diets from an indigenous diet, the same diet we’d been eating for years and years, into a modern industrial diet of processed flour, canned foods, sugary crap and on and on.

JN:

And this really booted up in the industrial revolution. There’s no more chewing involved in these foods. And so we were the first animal in the history of life on earth to just be eating processed food, and look what it did to us. Weston Price documented this. In a single generation, our teeth got crooked. With crooked teeth, we have a smaller airway. With a smaller airway, we have respiratory problems. So again, it sounds nuts, but it’s not, and this has all been documented. So, how do you get around that? If you’re old like me and your youth is decades past, you can make improvements. These palatal expanders can definitely help, but you can just chew real food as well. So there’s Jawsercise, there’s these rubber bits. I’ve heard that some of them can actually cause more damage than benefits because a lot of them have you chew on your front teeth. Named any time that you’re chewing food with your front teeth.

DrMR:

Yes. I saw it when I was searching, and I said, “who is dumb enough to do this device?”

JN:

I mean, it gives you those sculpted cheekbones man. Just ignore the fact that you’re destroying your TMJ and your ears are going to be clicking the rest of your life. The advice here is oral pharyngeal exercises, chewing real food. Eat some raw food, eat a carrot, eat some celery, eat raw unprocessed food. And you’ll get there so much better that way. I should mention it’s harder to make these improvements later on in life, but this is so important in the developing stages. So especially in infancy, we know that kids who are breastfed versus those who are bottle-fed, breastfed kids will have larger airways. There’ll be much less apt to snore and have sleep apnea later on in life. There is some evidence showing that they will look different and they will have straighter teeth, because of course they will.

DrMR:

That’s the suckling, the suckling pressure. It’s harder. Yeah.

JN:

Your face is so malleable and you are drawing your face outward. You’re breastfeeding. It takes an incredible amount of coordination and stress on the face, which is a good thing because it develops it. With bottle-feeding, you don’t get that. Then when you’re younger, eat real food. Don’t eat Flaming Hot Cheetos. Don’t eat apple sauce every day. Eat real food the way our ancestors ate. It’s not that complicated. This stuff just isn’t that complicated, but we always think that there’s a quicker way of fixing it. It’s like, “Oh, I can eat whatever I want. As long as I’m taking Vitamin C and D and K2,” and it doesn’t really work like that. Nature is much more complex.

Mechanical Stress

DrMR:

Yeah, I mean, fantastic point. You’ll definitely have an empathetic audience in our audience, because I know we’re always trying to optimize our diets as best we can. So just one more reason to do that, which is the mechanical stress, which hasn’t been championed enough. I’m not even sure how much Weston A. Price may have mentioned that. I read that book in college, so it’s been quite a while. Does he make that point very clear? I know he harps on the nutrients, but how much does he delineate about the mechanical stress?

JN:

He was too focused on vitamins and minerals and I think that was at his fault. He didn’t know otherwise. His work is extraordinary. A lot of people think that he’s some fringy character, but this is the guy who headed up the research arm of the National Dental Association. So I mean, he was a scientist. Some people have taken what he said and exploited it, and turned it around for their own good. But he was really focused on vitamins and minerals. We know that these traditional diets had from twice as many to 50 times the amount of vitamins and minerals, but he was not looking at mechanical stress. That was a big blind spot of his. Yes, we need that complex array of vitamins and minerals, especially K2, what he called Activator X, but we also need the stress to use those minerals, to use that calcium, to build those bones and integrate a prognathic and wider face.

DrMR:

Is there anyone in particular who is kind of championing that message of the mechanical stress?

JN:

Sim Wallace was talking about this more than a hundred years ago. He was a Scottish doctor, and Robert Corruccini spent over 30 years or 40 years and wrote 200 scientific papers and books. He was very much in the scientific world, and he proved this in experiment after experiment, in study after study. I am shocked by how so few people are looking at his work because this was a university professor. He followed all the rules. He got big funding to do this, and yet here we are still still saying, “We don’t know why people have crooked teeth. Oh, it’s genetic. Anyway, moving on.

DrMR:

Yeah, I had a conversation about 10 years ago with a dentist. I was asking her what she thought about the hypothesis of Price. And she said, “Oh, there’s not a nutritional component to this. It’s just genetic mismatch.” And I thought, “Hmm. You know, that seems a little bit underwhelming,” especially kind of the dismissive way in which she met the comment. But you know, like Franklin said, you have to have an open mind for it to work, just like a parachute.

JN:

But her comment is completely false. Being that 40 to 50% of our face is formed through epigenetics, through environmental inputs. So our phenotype is going to be formed by what we apply to it. Yes, some of it’s genetics, maybe half of it’s genetics, and that will play into this. But with that, even if you’re born with that larger mouth, you can still get a smaller mouth by not having the proper environmental inputs. This has been shown time and time again. Whether or not people want to believe it is another thing. That’s not my job. My job is to present objective information and people can do with that what they want. It’s been quite stunning for me, for someone outside of this field to go into this field and find so many people just refusing to read scientific papers and sticking with their own worldview.

Over-Breathing

DrMR:

Yeah, unfortunately, the more I learned, the more I see that. That’s why we’re doing what we’re doing here to try to shine some light here where it needs to be shown. Coming back to breathing for a second. Another thing from your book that I found quite interesting was this concept of over-breathing, because typically when we say, “Oh, we need to breathe better,” it kind of implies you’re not breathing enough. Take a deep breath, slow down. Some of that’s true, but it’s not quite that simple. Can you expand on that a little bit?

JN:

Well, a lot of us have been taught, present company included here, that the more we breathe, the more oxygen we’re getting into our bodies. I used to be in this boxing class and they’d be like “Breathe, breathe, breathe. More O2.” And in yoga classes, “Take some huge breasts, get that oxygen into your body.” The opposite is happening when you’re over-breathing. Again, this is stuff that we’ve known for over a hundred years. So when we breathe too much, when we over-breathe or hyperventilate, we blow off too much carbon dioxide and we become more alkaline. This actually makes it harder for blood to reach different areas of our body through vasoconstriction. It also makes it harder for oxygen to detach from red blood cells into the hungry cells and to create fuel in our body. And if you don’t believe me, all you have to do is take some heavy breaths.

JN:

You don’t have to super hyperventilate, but maybe take 20 or 30 heavy breaths. You might feel your fingers getting cooler and your toes getting cooler and a little lightness in your head. That is not from an increase of oxygen in those areas, but a decrease of circulation. So if you are chronically breathing too much, and we see this all the time for people with panic or asthma, they’re like, “My hands are always cold. My feet are always cold,” because they are constricting blood from going into these areas and feeding these areas. So what you want to be doing is breathing within your metabolic needs. Easier said than done, right? But just breathing through the nose, you’re about 70 to 80% of your way there, because the nose has all these baffles. It slows down this air so that you can extract more oxygen in each breath. That’s one of the many functions of it. When you breathe through the mouth, you don’t get any of those benefits.

Breath and Exercise

DrMR:

One of the things that’s been helpful for me along these same lines, and I have to credit Mike Nelson with making this recommendation; I believe this originally comes from Brian McKenzie, is to do cardio exercise, even if you’re very high on the intensity scale and nasal-only breathe. That seems to have carry over benefit, at least I believe. Is that something that you’ve forayed much into?

JN:

I talk to Brian all the time. We grew up a few blocks from one another down in the O.C. What he’s found is exactly what Dr. John Douillard found 40 years ago. It’s exactly what so many other fitness trainers have found as well. The reason why people don’t do this is at the beginning it sucks, and your performance goes down, and they think, “Why would I want to do this? I can’t run as fast. I can’t run as long.” But you have to stick with it because the more you become acclimated to breathing through your nose, the fewer breaths you will need to take in order to perform at that same level, which means you can then go beyond that level.

JN:

There was one six month long study of runners by George Dallam. Patrick McKeown was telling me about this a couple of days ago. He found that after six months of nasal breathing, these people were able to perform at the same level with 20% less ventilation. So especially if you’re interested in performance, you want to be running as efficiently as possible. If you think about a car, would you at every stop sign be revving the motor? Would you just be peaking the RPMs wherever you were going, to get where you were going? No, only an idiot would do that. You want to be running efficiently and your lungs are the same thing. Why take more breaths than you need to? Why stress the body out, especially when you’re an athlete.

DrMR:

I’m wondering if you notice the same thing that I did when I started. At first it felt a little bit awkward, but the more I did it, especially when I’d be doing something like a timed row where I’m really pushing myself, I started to notice that it felt like the muscles of my cheeks and around my nose were literally expanding my oral airway, my nasal passages, and really better opening up all that avenue for breathing. I felt like I was really getting this good exercise of some of my facial musculature. Did you notice that same thing? Is there anything that anyone has documented there?

JN:

Isn’t the body an amazing thing? It will change with whatever inputs you bring into it. So for so many people, the more you breathe through your nose, the easier it’s going to be to breathe through your nose. Our noses are covered with these tissues, which can dilate or they can constrict. So the more you train yourself to breathe through your nose, the more these tissues will tend to open to make it easier to do that. I’ve had so many experiences like the ones that you’re explaining after I’ve learned how to do this. So even when I’m working out and I’m really pushing it, be it running or surfing or whatever, I’m breathing through my nose because I know I’m getting more oxygen this way. You can also feel this heat in your body. Whenever I’d be jogging, I’d feel heat on the back of my neck. This is circulation. This is your body saying, “Thank you.” You’re now within this pH range that we can deliver as much oxygenated blood throughout the body to all the places that need it. But again, this really sucks at the beginning. Sometimes it takes people literally months to get over that hump. But once you’re there, you’re going to take off. And Brian McKenzie will tell you, this performance will increase. Recovery times can be cut in half and there’s decades of studies and experiments showing that.

Lung Capacity and Mortality

DrMR:

That’s what happened. One of the things that you also mentioned in your book was a pretty amazing reference. A cohort from the Framingham Study found that lung capacity correlates with all cause mortality.

JN:

Yeah, this was the Framingham Study. It’s like this 70-year long study into cardiovascular health and it’s still going on. This is an incredible amount of data to pull from. This was back in the eighties where they wanted to see the clearest marker of longevity. It turns out it wasn’t genetics; it wasn’t even heart health. It was lung size and respiratory health. According to the data, the larger your lungs were the longer you were going to live, because what happens when we get older is our lung capacity decreases and it decreases precipitously once we reach our fifties, especially for women. But it can also be reversed. You can increase your lung capacity. Guess what yoga does? You stretch, flex those muscles, flex those ribs, so you can breathe more. And I thought that finding was astounding.

JN:

And this was from a speech that the lead researcher made to the US government, to say, “Hey, we really need to look into this.” And all the references are on my website. I think I even have a pullout of that paper because I was like, “What’s, what’s wrong with us? Why didn’t we listen to this?” It’s also interesting that the yogis have been onto this crap for thousands of years. What is yoga but a breathing exercise? That’s what it is. That’s the foundation of it.

DrMR:

Now, one question someone may ask is if lung capacity is just an indirect proxy for people who are exercising and have better lung capacity, have better all cause mortality? Has there been any probing into that?

JN:

Yeah, that’s a good question. We know that even milder exercise can increase lung capacity by about 15%. I don’t know the exact answer to that, and I don’t feel comfortable giving a yay or nay, but they did some further studies Holger Schunemann did this study where he looked at people who had lung transplants. He found that people who had been transplanted lungs that were larger than their original size lived way longer than those who had been transplanted with lungs of the same size or smaller, which to me suggests it is the lungs that are the primary driver. Of course, exercise, especially moderate exercise when you’re older has so many benefits to it. And lung capacity is one of them.

DrMR:

And as a follow-up question then, what are some of the preferred methods of improving one’s lung capacity?

JN:

Breathe through your nose, people. Everyone breathe through your nose. That’s how it starts. It’s so easy. People think it’s not going to do anything. Try it out and tell me how that goes. When we breathe through our nose, we are naturally going to be breathing a little deeper, because that’s just how it works, how it stacks up. When we breathe through our mouth, we’re going to tend to breathe to the top of our chest, those upper lobes. So along with breathing through the nose, you want to engage your diaphragmatic movement. We have this huge muscle that’s shaped like an umbrella underneath our lungs. That’s what allows our lungs to inflate and deflate. When you breathe in, that diaphragm is going to sink down. As it sinks down, it’s going to gently massage your organs and help leach out more lymph fluid.

JN:

As you exhale, you’re going to pump that lymph fluid out with that exhale, with that diaphragm. You’re also going to help your heart by pumping blood this way too. So extending that diaphragmatic movement not only allows you to take these deeper, richer breaths, which allows you to take fewer breaths to get more energy, but it also allows you to purge more toxins out of your body. This is a factoid I just learned from a doctor that I did not know about until a few months ago. So I look forward to exploring that a bit more.

Diaphragmatic Release

DrMR:

Have you ever explored any kind of diaphragmatic release? For our audience, what can that look like? I just had someone perform reflexive performance reset. This is something that Mike Nelson is really big into. You could kind of think of it like hitting certain acupoints or muscle points that help neurologically stimulate muscles and turn on spots that aren’t firing. And I was visiting one of these therapists, and the way to kind of hit the diaphragm is digging your fingers, it’s really pleasant to do, underneath your rib cage. It was interesting though, I was having an issue on my left side and when he dug his fingers in there, it was tender and painful. It seemed like my diaphragm was getting a little stuck or a little inhibited. That was the experience that I had, but James, have you had the pleasure of having a gentleman or a gal shove her fingers underneath your rib cage and try to release your diaphragm?

JN:

I have, and it’s completely trippy because you have to completely submit. If you tense up while they’re doing that, it’s bad news. I’ve had that experience a few years ago. I think it can be massively beneficial. This is a lot of what Carl Stough was doing with people with emphysema, also with the US men’s track team in the sixties. He took emphysemics that were literally left for dead in hospitals, and so many of these people walked out of the hospital and went back to living a semi-normal life after they learned how to engage their diaphragms. So many of us get in these very dysfunctional patterns where we become accustomed to just chest breathing. He called it respiratory fault when it gets really bad, which is why when you see emphysemics, their shoulders or backs and their chests are sticking way out because they’ve lost that diaphragmatic movement and they have to engage other muscles just to breathe 20,000 times a day. What do you think that is going to do to your body? So a lot of us don’t have problems that bad, but we do have some sort of lack of movement in areas that we’ve just gotten used to. But compensation is different than health, and so some of these procedures can help open those areas up. So you can actually engage that diaphragm in a fluid, slow, and easy manner, which will have so many benefits beyond just breathing well.

DrMR:

So lung capacity, nose breathing, activating the diaphragm. One of the things that was also very interesting tying into this kind of ancestral theme from your book was the tribe that used to monitor their infants to make sure they weren’t mouth breathing. And if they were, I believe you said they kind of pinched their lips together to force them to breathe through their nose.

JN:

Yeah, it wasn’t just the man that did this, George Catlin, who went and researched native American tribes in the mid-1800s. He found that all of the tribes shared in nasal breathing as this universally shared thing. They believed breathing was a medicine and mouth breathing was an insult to other people. So you would never do it. They started them off young. When they’re infants, after they were breastfeeding, mothers would gently close their lips. They would stand over them when they were sleeping and gently close their lips, and just try to make this an unconscious habit early on. You see what’s happened to our culture and there’s films on YouTube, there’s videos of cute babies snoring. And you see that and this is a kid who is suffocating, who is struggling to breathe. It’s causing so much damage, but it just shows you how divorced we are from these very simple, simple things.

RuscioResources:

Hi everyone. This is Dr. Ruscio. In case you need help, I wanted to quickly make you aware of what resources are available to you. If you go to drruscio.com/Resources, you will see a few links you can click through for more. Firstly, there is the clinic, which I’m immensely proud of. The fact that we deliver, cost-effective, simple, but highly efficacious, functional medicine. There’s also my book, Healthy Gut, Healthy You, which has been proven to allow those who’ve been unable to improve their health, even after seeing numerous doctors, to be able to help them finally feel better. There’s also our store where there’s a number of products like our Elemental Heal line, our Probiotic line, and other gut supportive and health-supportive supplements. We now offer health coaching. So if you’ve read the book or listened to a podcast like this one, or are reading about a product and you need some help with how or when to use, or how to integrate with diet, we now offer health coaching to help you along your way. And then finally, if you are a clinician, there is our clinicians’ newsletter, the Future of Functional Medicine Review. I’m very proud to say, we’ve now had doctors who’ve read that newsletter, find challenging cases in their practices, apply what we teach in the newsletter and be able to help these patients who were otherwise considered challenging cases. Everything for these resources can be accessed through drruscio.com/Resources. Alrighty, back to the show.

Wearable Technology

DrMR:

In your mind, is there any utility to looking at an Oura Ring and trying to use that loosely, but somewhat diagnostically? If someone’s always having a sleep score, let’s say in the seventies, have you gotten that granular with any of the devices?

JN:

Yeah, I’ve played around with a few of them and I think a few of them are great. There’s interesting data sets there, but I think that a lot of them are pretty myopic too. It’s not just about respiratory rate. It’s also about tidal volume. That’s what healthy breathing is. I know that the sleep data for a lot of those devices is just not very accurate when it comes to REM sleep. There was just an article in the New York times about this six months ago, where they said it was wildly inaccurate. That’s not to say that the data they are providing isn’t going to benefit some people. That’s not to say that some of it isn’t totally legit. I just think it’s a small part of a larger picture that we need to be looking at.

DrMR:

Sure. I agree that the wearables aren’t going to be directly diagnostic. That being said, I know there have been two studies. I think one was looking at a Fitbit and the other was looking at the Oura Ring and correlating them with your traditional gold standard sleep study. And there was agreement, but there was I believe two parameters where the accuracy kind of broke down. So I think important to specify that on the one hand, but then on the other, not to look at that as a stand in for a sleep study and say, “well, my Oura Ring data looks good, so I don’t need to get the sleep study that my doctor is recommending.”

JN:

I don’t want to be little these technologies. It is incredible what we can learn about our bodies right now with these wearables. This is a great sneak peek at what’s going on. I think that they can tell you when things are really bad, and that to me is the most benefit. It gets a little fuzzier going from okay to good, when you start slicing it like that. But I wore a pulse oximeter at night, an attachment for the ring that went onto this watch device, which is just looking at blood SATs. And I found it incredibly interesting. That’s what we wore during the Stanford Study to see how your blood SATs would just like completely crash at night because you’re holding your breath. You’re choking on yourself and see your blood SATs go down into the eighties. And some people go down into the sixties and seventies. I mean, this is so damaging. So these wearables, I think that they have a ways to go to be more accurate, but for what they’re delivering and the price that they’re delivering it for, I think that they can be so useful and it’s a lot cheaper than a full on sleep test for beginning diagnostics. But obviously a sleep test is going to tell you so much more about what’s really going on.

The Breathing Formula

DrMR:

Well, as one of our semi-final points here, you can tell us a little bit about the breathing formula, because there does seem to be this breathing formula that you found or the research has found to be optimal. I have a hard time fully wrapping my mind around this still, because it almost seems like it’s too simple, too good to be true. Can you tell us a little bit more about this? I believe it’s 5.5 in and out.

JN:

Yeah, so some Italian researchers were looking at different prayer cycles, from Catholic prayers to Kundalini prayers, to Buddhist mantras, and they found that they all correlated to this respiratory rate of about five to six breaths per minute, which is about five to six seconds in and five to six seconds out. And when you breathe this way, the heart rate and the respiratory rate, lock in to what’s called a state of coherence. And when this happens, the body is working at peak efficiency. So you get more oxygen to the brain. Your blood pressure will tend to go down. Your baroreceptivity will increase. And it feels great because of course it does. You’re working at peak performance. If people don’t believe this, you can, if you have a heart rate variability monitor, check it out. Breathe in at that rate of about five to six seconds, softly through your nose, don’t push it, five to six seconds out and repeat that over and over.

JN:

And I’ve seen my heart rate variability go from all these jagged disrupted lines to the smoothest sinewaves because your body is so happy breathing at this rate. I’ve gotten so many emails about this, and I put in a little footnote in the new edition of the book. So this is a wonderful exercise to use, but people have written me saying, “I noticed for half an hour today, I wasn’t breathing five breaths in, five seconds out.” This is an exercise. It’s to condition yourself, to acclimate yourself to what the slower breathing feels like. So that slower, healthy breathing becomes an unconscious habit. I don’t know anyone who could breathe this way all day long, but if you breathe this way when you’re stressed or in the morning to set the stage for your breathing, it can have so many benefits. And that’s really what the science has shown us.

DrMR:

Would you say then if someone’s stressed out and they’re looking for an easy way to calm down, just slow down, in through the nose, out through the nose, count five or six, and then just keep going?

JN:

Here’s what I would do. I learned this trick from Dr. Andrew Huberman, a neuroscientists down at Stanford. Inhale twice on top of one another, and then just let it go. For this it’s fine to exhale through your mouth. It’s an exercise. I’m talking about chronic mouth breathing as the problem. Or you can exhale through your nose, whatever is most comfortable. Do that about three times, and you’re going to immediately feel the sense of calm because what you’re doing is you’re activating the subsect of neurons in the brain that are responsible for sighing. If you think about what a lion does or a dog does, or many cats do before they lie down to sleep, they go [sighing.]

JN:

And then they go to sleep. So we can do that at will with this trick. Another thing you can do if ever you want to become more relaxed, extend the exhales. By doing that, you’re going to trigger more of a parasympathetic response. You’re going to relax the body. So a good one to do is count about three to four in and about six out. If that’s too long, if that’s uncomfortable, shorten it. No one’s judging. You do two to three in and then out to about five seconds. And you’re going to notice yourself getting extremely mellow because you’re allowing that rest and relaxation effect to really take over your body doing this.

DrMR:

Awesome. James, I feel like there’s so much we could talk about, but I should probably just ask you in the interest of time so as not to keep you here for three hours, anything else that you think is really important for us to touch on?

JN:

I think that’s the real foundation. A lot of people have said this seems counterintuitive to the Wim Hof Method or Sudarshan Kriya, or Pranayama. There are different breathing methods for different needs. So this sort of forced the hyperventilation of Wim Hof is so therapeutic. Same thing with Sudarshan Kriya, but these are exercises. This is to focus this stressful breathing into one part of the day so you can be chill the rest of the day. So I don’t think these things are at odds with one another. It’s an integrated system of breathing, an integrated system.

DrMR:

Awesome. Yeah, just like people would have different exercises if you want to get faster or more balanced, there’s not just one exercise that’s the best for everything. Awesome. So the book is Breath. Where else would you want to point people if they want to track you down online?

JN:

I convinced the publisher to allow me to print the entire bibliography of the book on my website. So if some of these claims seem just like too insane to be true, you can go check it out. There’s some videos, there’s some interviews with a Harvard professor and a bunch of other people that’s at Mrjamesnestor.com. You can put a backslash breath in there to be taken into that portal. All that stuff is free. I’m trying to get better at this Instagram thing. My handle is MrJamesNestor on that too. I only post things associated with research and breathing. So no puppy pictures on that, unfortunately.

DrMR:

Awesome. Well, James, thank you. It was a great book. I really enjoyed reading it. I think people need to be more aware of this, especially children like we were talking about earlier. So hopefully, for our listeners, you’ll check out his book and plug into some of his work. James, thanks again for taking the time.

JN:

Thanks a lot for having me.

Outro:

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