[Transcript] – Maximize Oxygen Utilization Efficiency, Simulate High Altitude Training, Get The Cardiovascular Capacity of a Navy SEAL & More With “The Oxygen Advantage” Author Patrick McKeown.

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Podcast from:  https://bengreenfieldfitness.com/2017/05/the-oxygen-advantage

[00:00] Introduction/Ample Meal & Organifi

[05:54] About Patrick McKeown

[09:03] Breathing Through The Nose

[14:01] Taking Deep Breaths

[18:59] Processed Foods & Breathing

[25:46] Yandell Henderson's Study

[28:54] BOLT Measurement

[32:00] Why Patrick is Such a Fan of Humming

[33:34] GainsWave/Onnit

[45:54]  How To Breathe Properly Through The Nose

[55:37]  Patrick's Baking Soda Secret

[58:25]  Ensuring Nose Breathing & Longevity

[1:09:33]  End of the Podcast

Ben:  Yo what's up folks?  It's Ben Greenfield.  The time that you're listening to this podcast, I'm over in Bulgaria.  I'm over in Bulgaria, speaking at a conference to teach young men how to be healthy, and wealthy, and full of wisdom.  I'm not wealthy nor am I full of wisdom, so I'm just going to do the first part, the healthy part.  That's my job, but I'm over speaking in Bulgaria, and then for those of you in the California area, I'm going to be flying back over to Monterey to race a Spartan race in the beautiful hillside country of Monterey.  You can go check out any of my journeys or my adventures, you can meet me or we can hang out, we can go race together, it's a lot of fun.  Trust me, when you're crawling underneath barbed wire, covered in mud with your back bleeding, that's a lot of fun.

Just go to bengreenfieldfitness.com/calendar, and you too can join in on any of my crazy adventures that I'm up to.  See where I'm speaking because there's a lot of different places around the globe that I'm going to be speaking at over the next couple of months, really cool conferences.  I only go speak at places that I actually enjoy, that I vouch for, so check it out, bengreenfieldfitness.com/calendar.  I'll be heading to Pennsylvania, North Carolina, all over the place mostly for Spartan races, but I'm also going to be speaking in New York in July at an event over there on a Tuesday night, like a food and a nutrition series over at chap named Chef David Blaze, David Blaze Nutrition Knightly Get Together is what I just named it 'cause I don't remember what it's actually called.  Any ways though, all that's over at bengreenfieldfitness.com/calendar.

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In this episode of The Ben Greenfield Fitness Show:

“Humming will increase nitric oxide production by fifteen fold, so that's why there's some meditation techniques that involves humming.  So there's vibration of the sinuses to produce nitric oxide.”  “The last 75% of it during a sprint in anaerobic, the first 25% is probably going to be aerobic, and the blood oxygen saturation will drop to about 93%, but I wanted to completely disrupt that.”  “So with the upper air winds reduce from chronic mile breathing, it increases the risk of obstructive think math for lifelong.”

Ben:  Hey folks, it's Ben Greenfield, and it's no secret that I'm somewhat obsessed with breathing, not just to stay alive, but to actually make my body a lot better.  The past years, I've written articles on everything from combining ketosis and breath holds and free diving to how to make your own hyperbaric exercise with oxygen therapy device, interviews with guys like Wim Hof or how to use breath for cold thermogenesis, and I've interviewed Laird Hamilton about his underwater breath hold workout.  So I've talked about getting yourself high drug-free with holotropic breath work, I've talked about the use of fancy breath strips and these devices called turbine devices to enhance nasal breathing, plenty and plenty of previous episodes and previous articles that I've written and produced about breathing, and if you go to bengreenfieldfitness.com/oxygenadvantage, bengreenfieldfitness.com/oxygenadvantage, I will link to all that previous content if you just want to geek out on breath and oxygen.

However, there is a guy who I've been wanting to get on the show for a long time because his book is one of the best books on breath work, and I finally managed to wrangle him onto the show.  His name is Patrick McKeown, and he wrote this book called “The Oxygen Advantage”, and the things that he talks about in this book, everything from this test called the BOLT test to why over breathing might be a bigger issue than under breathing to the link between breathing and weight gain to how to mess around with things like pulse oximeters.  He's got all sorts of information that I haven't had a chance to talk about before on the show, believe it or not, and so I've got him here with me, and I'm going to pick his brain about this book “The Oxygen Advantage” because I have plenty of questions that I think you guys are really going to benefit from.

Who is Patrick?  He did his clinical training with something called the Buteyko Breathing Method in Moscow, Russia, and since then he's spent the past fifteen years working with tens and thousands of people around the world on everything from breathing pattern disorders, to sleep disordered breathing, to anxiety, to performance breath work, and he works with some of the top athletes in the world now on their breath, like tennis player, and cyclists, and professional football players, MMA athletes, track and field athletes.  So he's one of the go-to guys in the world when it comes to breath work, and performance, and breath work, and health, and again I'll link to him, all of his books 'cause he actually has eight books about breath work.  Not just one, although the one we're talking about today is called “The Oxygen Advantage”.  So go to bengreenfieldfitness.com/oxygenadvantage to get in on all of that goodness.  Patrick, welcome to the show man.

Patrick:  Thanks so much, Ben.  That's a very great introduction.

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

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

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

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

Ben:  It's called a thoracic breath?

Patrick:  A thoracic breath 'cause you're using the upper part of the thorax, so you're using the upper chest, and it's not a very efficient way of breathing.  And many people have developed that habit because mouth breathing is very, very common, even in children.  Studied children, it show of the 50% of children studied are persistent mouth breathers, and it is a huge knock-on effect on the development of the child which is probably a different topic from what we're talking about.  But when we breathe through the nose, we pick up a gas called nitric oxide that's released from the paranasal sinuses, and we bring that nitric oxide into the lungs, and nitric oxide sterilizes the incoming air.  It opens the airways, so it's a bronchodilator, but it also assists on what's called ventilation perfusion.  As human beings because we're sitting upright or we're standing, most of the concentration of blood in the lungs is in the lower lobes of the lungs, but a lot of us are ventilating.  Our breathing is in the upper lobes, so there's a mismatch there.

So when you breathe through your nose, you'll tend to activate the diaphragm, so you bring the air from the upper part of the lungs to the lower, but when you carry nitric oxide in the incoming air into the lungs, nitric oxide brings the blood from the lower parts of the lobes to the upper.  So ventilation perfusion improves by virtue of nasal breathing, and this is why some theories have suggested that, and I've seen it in a number of papers.  Between 5 and 15% percent improved oxygen uptake in the blood through nose breathing.

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

Patrick:  Yes, most of the people I would have worked with in the first ten years would have been people who would have asthma, people with chronic colds, chest infection, and we've seen quite significant improvements to the instance of colds and chest infections through the breathe.

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

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

Ben:  So you couldn't go from 97 to 98 by doing a whole bunch of like (breathes deeply) deep nasal breaths?

Patrick:  No, I don't believe so.  Because the problem there is by taking the deep breaths or the big breaths, you offload CO2 and carbon dioxide, and it's not just a waste gas.  People often talk about it bringing as much oxygen as possible and get rid of as much CO2.  But the release of oxygen from the red blood cells is dependent on the presence of carbon dioxide.  So if you're breathing hard such as taking big breaths, well you're going to offload CO2.  So the bond between the red blood cells and oxygen is going to strengthen.

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

Patrick:  Exactly, the amount of oxygen delivered to the tissues is reduced when we breathe more than what we should do.  Not only that, but our blood vessels are the smooth muscle embedded in the blood vessels, and carbon dioxide is a relaxant of the smooth muscle.  So if we're breathing hard, again the smooth muscle surrounding in the blood vessels is going to constrict.  So our blood circulation can be impaired by breathing hard.  So when people talk about cold hands, warm heart, it's not correct.  Cold hands, you're breathing too much.  Brain fog even.  Like the amount of oxygen delivery and blood flow to the brain can reduce by between 25 to 50% from taking big breaths.  That's why sometimes people feel dizzy.  If you tell them say 5 or 10 big breaths, they start feeling light-headed.  That's not because of a super oxygenation.  The opposite effect is happening.

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

Patrick:  Yes, correct in the short term.  But in the [16:53] ______ would want to bring the PH back towards 7.365.  So what it does is that the kidneys will dump bicarbonate, and then that instance then, PH will be normal, but you're going to have reduced buffering capacity.  You will have reduced bicarbonate and reduced carbon dioxide, so now you're stuck in a more chronic state of hyperventilation.  So short term over breathing, it wouldn't really cause all that much harm in fairness.  If you're tune in it for one or two minutes, it wouldn't do any harm.  It could stimulate the immune system.

Ben:  You mean if you're doing a Wim Hof style, (deep breathing) if you're doing short periods of that during the day, and Wim showed that one when I interviewed him.  When I've interviewed him, he's talked about the decrease in inflammatory cytokines, the strength in the immune system, the ability to withstand the rigors of cold, etcetera.  But what you're saying is if you're just like this (deep breathing) all day long, you're going to breathe off a bunch of CO2, you're going to become overly alkalinic, and basically you're not going to cause any additional oxygen saturation over and above what you'd normally have?

Patrick:  Exactly, it's very, very common for people to breathe more than what they need.  They're talking… talking increases breathing.  So if you've got somebody who's talking a lot like try today, school teacher, somebody in sales, they'll often feel exhausted at the end of the day, and they're feeling exhausted not because of the mental stimulation or the concentration, but it' jut the very physical act of talking which is increasing ventilation.  Stress, stress increases breathing dramatically.  And so if an individual is subject to stress, breathing gets faster, they sigh more, it's more upper chest.  They mouth breath to take more air in, and they can't think straight, and you can't think straight because the amount of oxygen that's going to be delivered to the brain is going to reduce and brain cells get very excited.  So stress in the long term, is very, very harmful for the human being.  We're not able for it.  Processed foods will also intensify breathing.  Foods that stimulate breathing.

Ben:  Really?

Patrick:  Yes, we would believe so.  In terms that we use the BOLT measurement as you were talking about, and some people from over consumption of processed and acidic foods that will have some impact on their breathing, I think most people can experience that they're feelish.  The foods that will have least impact on breathing are raw foods, especially fruits and vegetables.  Water has no effect on breathing.

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

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

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

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

Ben:  Can I ask you one other question before we talk about the BOLT score?

Patrick:  Sure!

Ben:  Because I do want to ask you about that.  When you've talked about over breathing, obviously you've mentioned before how short periods of time spent over breathing is not an issue, but since reading your book, I'm curious about all those people who are out there, maybe who are exercising, especially endurance athletes for example, sixty to ninety minutes a day, and in many cases breathing hard during those exercise sessions.  Is that too much over breathing because I've thought about this before.

Here's my thought pattern on this.  It's this idea that the heart is a battery.  It has a finite number of beats, and so you got to strike this sweet spot between exercising enough to where you decrease your heart rate the rest of the day, so that the period of time that you spent with your heart beat elevated isn't causing it to have more beats during the day, right?  So if I have a brief period of time of exercise during the day but my heart rate because of that, is lower the rest of my life.  By the end of my life, I've had fewer heart beats because of my exercise habits.  Is there a sweet spot with breathing to where I can breathe hard, and deep, and long, and over breathe during my exercise sessions, but then that's resulting in my breathing less or being better able to control my breath pattern the rest of the day?  Does that make sense?  It there kind of like a time period during which you would over breathe that it does become deleterious like sixty minutes or ninety minutes, or anything like that?

Patrick:  Not so much a time period, but its relative.  You can imagine two people going out for a run, and one person is breathing harder for that same level of physical exercises, and the strength and conditioning coach may say that the person is out of condition, but I work with football teams, and these individuals are training.  They're all training at pretty much the same rate, yet some individuals have poor breathing habits, and that's holding him back.  It's normal for breathing to increase during physical exercise because there's a metabolic demand for oxygen, but also the metabolism is generating more CO2, and the muscles get hotter.  So when the muscles get hotter and just increase carbon dioxide in the blood, and more oxygen is delivered to those tissues because there's a right shift of what's called the oxyhemoglobin dissociation curve.  So it is normal for our breathing to increase during physical exercise, but the real question is how much does your breathing increase by it?  Because you will have individuals who have poor breathing habits during the day, and then that translates when they go into physical exercise, they're breathing in excess of what they should be, and that's actually going to cause less oxygen to be delivered to the tissues.

That's why for recreation athletes, I would encourage them to nose breath, and nose breathing, and you’ve got a better oxygen uptake in the blood.  You've got a better oxygen delivery to the cells, and the amount of oxygen that's taken up by the cells is better.  There's also a better recovery.  There's less stress in the heart because, as you say I would totally agree with you, Ben, there was a very interesting study.  It was conducted in 1908 by Yandell Henderson, and he was a Yale professor of gases.

Ben:  Professor of gases, is that what you said?  That was his thing?

Patrick:  Yeah, that's what he was described at the time.

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

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

Now it comes into my head that taking thirty big breaths in and out, originally that was called the hyperventilation provocation test, but doctors decided not to do it.  The reason being was because it caused Ischemia, the amount of blood flow getting into the heart reduced.  So it's something that will be suitable for a lot of people, but it might not be suitable for everybody.  So we don't do it, we don't do the hyperventilation, but that's the effect.  Over breathing can have quite a profound effect, you know.

Ben:  Interesting.  That would describe me to a T when I used to exercise.  I almost would used breathing to get me tired, to make me feel like I was more tired during exercise even if I could be less tired by just doing deep nasal breathing.  And since I've started to adopt more of the techniques that you discuss in the book like deep nasal breathing during the day, not over breathing, not shallow chest breathing, striking that balance between breathing enough but not taking these enormous nasal breaths throughout the day.  I do the same during exercise, and so it's pretty seldom now during exercise where I open my mouth, right?  Unless I get very anaerobic, I actually take the same breath patterns into my workout now that I use during my day, and so I think that’s a definite advantage when it comes to your exercise sessions, not putting you at risk of being too over breathed if that's a word and I guess to alkalinic coming out of your exercise routine, in which case we all have learned you're going to crave it, burger and coffee.

Ben:  So this BOLT measurement that you talk about, explain to me what it is and why it's such a big part of the book.  What's the bolt measurement?

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

Ben:  Less than twenty seconds, so if I'm just breathing normally.  So I sit for ten minutes, so I'm not gased, and I breathe normally.  I breathe in through my nose, normal breath out through my nose, not like a full force exhalation of air, just a normal breath out, and then I wait, I should be able to wait at least twenty seconds to breath again.

Patrick:  Well it's a minimum that we'd be looking for, but you'd be so surprised.  I've worked with some of the elite athletes in the world, Olympic athletes, and their BOLT score has been as low as ten seconds.  Now what that's telling me is that yes, they're achieving what they achieve, but they're putting their body under a lot of stress to get there.  And because there's no point in doing physical exercise, and you're breathing so hard and so intensely.  Like I had one scientist who had come to me, and he told me that it would take him half an hour to recover after a race.  His breathing would be so intense for half an hour after, and as I listened I said, “that's a stress to the body.”  You know, this is where we want people to be able to recover easy, and a higher BOLT score, you get better oxygen delivery to the tissues, you're better able to sustain it.

It's like economics.  If you've got a car, you've got a car that could be like a Toyota Prius or something that's doing seventy miles to the gallon, it's very economical with its fuel.  Or you've got a big Hummer, and that's doing ten miles to the gallon.  Humans are the same, how economical are you with your oxygen intake?  So can you have light breathing during your physical exercise?  And that's better, and I think that kind of makes sense.  If you see somebody walking down the street, and they're walking down the street, they're really breathless for the amount of exercise that they're doing, well you're going to say at the very least they're on the healthy yard.  They're not fish, so there's improvements to be made there.

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

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

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

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

Ben:  Yeah.

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

Patrick:  Forty.

Ben:  Forty seconds?

Patrick:  Yes, forty seconds.

Ben:  Nobody do this while you're driving by the way.  I don't want you to pass out, so wait until you're sitting somewhere to do the BOLT score.  Patrick how would you get, let's say I was in that forty, forget what I was at, but I was above twenty but I definitely wasn't at forty.  What are some ways that you can actually increase that BOLT score, what's a method one would use to get a higher BOLT score?

Patrick:  Well, the first step is to switch to nose breathing, nose breathing day and night, and that's not going to be enough but it's a good start, and we also practice different exercise.  So these are different breathing exercises, and one exercise, it pretty much involves you tuning into your breath and feeling the cold air coming into your nose and the warm air leaving your nose, and really slowing down your breathing.  So you're concentrating on slowing down your breathing so much that you feel that you're not getting enough air.

Now the feeling that you're not getting enough air is an indicator that carbon dioxide levels have increased in the blood because the primary stimulus to breathe is carbon dioxide.  But you want to subject your body to increase CO2 in the blood, and the increased CO2 will penetrate the blood-brain barrier, and reset the breathing center, so that your breathing can get lighter, and this is something that you do during rest.  By doing it during rest, your breathing becomes more efficient, your BOLT score increases, and when you do physical exercise, you've got lighter breathing as a result of it, and that's one exercise.

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

Patrick:  Yeah, it's not like we have to be careful driving the car, but people are able to do it.

Ben:  But you know, a lot of people listen in while they're driving their car, riding their bicycle, so it' a fact that we have to fix.

Patrick:  It's really about slowing down the brag, so there's a saying.  You'll get in the Eastern world, it was all about subtle breathing and light breathing.  They're saying you should be breathing so soft that the fine hairs within the nostrils do not move.  The cilia does not move.  Lao Tzu was a Chinese philosopher, and he said that the perfect person breathes as if they do not breathe.  So it's really slowing down the breath and slowing down the breath to the point that you feel air hunger, and it's the air hunger that's the key aspect of it.  Like it's amazing what you’ll experience.  Within a few minutes, you'll have increased watery saliva in the mouth, and also about 70 to 80 percent of people will feel warmer.  So because carbon dioxide is opening up the blood circulation.  You know, we have a hundred thousand miles of blood vessels throughout the body, and then we could influence that within three to five minutes through our breath, but here's what's more Ben…

Ben:  Carbon dioxide warms the body.

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

Ben:  So that's one of the reasons that the Wim Hof method for example works is I know with his style of breathing, you're kind of doing a really deep inhale and then a passive exhale.  So by the time you do that thirty time, you've held on to a lot of carbon dioxide, right?  You've loaded yourself with carbon dioxide.  Well if you're not breathing all, if you're exhaling less than you're inhaling, wouldn't you be holding on to more carbon dioxide and warming your body?  Isn't that how the whole cold prep breathing works?

Patrick:  Yeah, do you know it's very interesting on how that's work.  I don't have an answer, I've looked at the studies, and what the study, I think it's by Cocks, the author of it.  He created a hypoxic hypercapnic response there, and because I do breath holding all the time as well, but we create a hypoxic hypercapnic response.  And the difference with our own breath hold technique is that we would breathe in and breathe out and hold because it's only then when you breathe out that you'll actually lower blood oxygen saturation.  But when you breathe out, there's less air remaining in the lungs, so as a result you get a stronger carbon dioxide response, so there's a different effect going on.  So I don't have the full answer.  It could be prior of it is the cold water emersion that's happening with Wim Hof's and passively, it's just really stimulating the immune system, that you're activating a sympathetic response to get the immune system into kind of, if I use the word a protective mechanism that the body then is able to protect itself.

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

Patrick:  Yeah, possibly if people are doing it through the nose, and the other thing is big breaths is all very well, but don't have the idea that it's going to add any more oxygen because it doesn't do that, and don't carry that idea into your normal way of living because if you think about people meditation.  And people meditate to relax and of course it's focusing on the breath and it's taking attention into the inner body, but how does our breath go during meditation?  If you do four, or five, or ten days of meditation will save for pass in the meditation.  The breath on the second, third, and fourth day will almost disappear to nothing, and that's the whole purpose of meditation.

The meditation is designed not to take in bigger breaths, and that's how meditation is helping people to relax and what we're saying is well, really, really work on slowing down your breath.  And there was an interesting study, just come out of Stanford.  It's only come out March of this year, and they looked at it.  You can influence your mental state by slowing down the breath, and that they said there's a pacemaker in the brain.  That when we get anxious, our breathing gets faster, so it's our emotions affect our breathing, but also our breathing affects our emotions.  So see people then who have breathing pattern disorders, who tend to be breathing faster and using upper chest, that's going to stimulate a more stress response in those individuals.

Ben:  Right, 'cause you have like bearer receptors in your chest that can increase the release of cortisol, right?

Patrick:  That could be happening, I'm looking specifically here when they were talking about the study about slow breathing, and they were talking specifically what's happening in the brain, and I think it could be of course, what are things that's going on?  So I think it's really good because modern life is pretty stressful for people, even athletes.  Prior to a game a lot of them would get pre-match anxiety, and what I have them do is I have them do reduced breathing for fifteen minutes the night before a game.

Ben:  With reduced breathing being the one where you breathe in through your nose, out through your mouth, and I think the exercise…

Patrick:  No.  In and out through your nose.

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

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

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

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

Ben:  Below 90?

Patrick:  Yeah, below 90.  So we range to get from 80 to 90%, and we don't encourage athletes, and sometimes there are athletes that do go below 80%.  Sometimes they do go into the 60s.  We don't encourage it because people can get disoriented when oxygen levels drop too much.  But at the same time we want to push them, and the whole purpose of it would be pretty much like intermittent hypoxia training that you're pushing the body into a bout of oxygen deprivation and then normal oxygen, and that's causing then the body to make adaptations.  Probably it's increasing the buffering capacity.  Also you're stimulating anaerobic glycolysis that you can imagine say, a sprinter.  So some of the sprinters that I would have been working for, with track and field in the United States, there were 400 meters, and I was looking at when are these guys going to be the most tired?  Well, it's going to be the last 20 or 30 meters of the race, it's when fatigue sets in.  So some of their sessions, I would have them sprint with their mouth closed which adds an extra load.  It's quite tough, it's adding an extra load onto their exercise, but I would stand at about the 15 or the 20 meter mark from the finish, and when they see me, I would have them breathe out and hold their breath until they pass the line.

Ben:  Okay, so they're running a 400-meter on the track, and you're standing 20 meters from the finish line.  They pass you, they blow everything out, and they just hold that out for those 20 meters until they cross the finish line.

Patrick:  Yes, they'd have a passive exhalation, and they'd hold their breath, and the whole purpose of that was to add an extra load that we wanted to completely disturb the blood acid base because say, during a sprint.  During a normal sprint with normal breathing, you will go anaerobic certainly after about, the last 75% of it during a sprint is anaerobic.  The first 25% is probably going to be aerobic, and the blood oxygen saturation will drop to about 93%, but I wanted to completely disrupt that.  I wanted to bring these guys from 93% say down to 80% or 85%, and it's getting the body to make the adaptations that it would delay the onset of fatigue and possibly also it's training the central governor system, if you believe that there's a central governor in the brain that's setting the limits of exertion.  That when you're pushing the body into a little bit more extreme and not to the point that it's stressful 'cause these athletes are really, really well able for it, and I've looked at studies involving blood gases 'cause as free divers for example, we can take the information from that.  We look at how low did they drop the blood-oxygen saturation in freediving, and we compare what we're doing, so we can make the comparisons.

There's a lot of studies now coming out of Paris, Paris 13 University, and very similar technique to what we've been teaching for fifteen years.  It's the exhale hold technique, and it's showing the benefits in terms of stimulating anaerobic glycolysis, delaying the onset of lactic acid, delaying fatigue.  It's improving time performance, so I think it's something novel that can be introduced at sports.  It's new, it's out of days, but I think it's promising.

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

Patrick:  Yes, that would be one of the ways that we would have worked with them.  We also have exercised them to decongest the nose which is based pretty much on a similar thing.  A lot of athletes get hay fever, and if you've got hay fever, your nose is blocked.  It actually can adversely affect your sleep.  And if your sleep isn't deep, if it's not good, you're more likely then to wake up tired, and it's difficult to perform or to excel at the level that you should be if you've got poor sleep.  You know you can open up your nose by holding your breath as well, and this one is simple.  You could do this sitting in your sitting room.  You take a small breath in through your nose, small breath out through your nose.  You pinch your nose, and you walk around holding your breath, and you continue holding your breath and walking until you feel say a medium to strong air shortage, and then you let go of your nose.  Breath through your nose, and calm your breathing, and wait a minute and repeat it, and do it five or six times, and you'll feel your nose is decongested.

We've had it studied in a hospital here in Ireland, and it reduced rhinitis symptoms by 70%.  And even if you've got a head cold because think of the amount of cyclist who for instance, get cyclist's cough or you overdo it during an endurance run, and your lungs really feel raw and inflamed because if you're taking a large amount of dry and cold air into your mouth, it's basically sucking moisture out of the airways, and it's going to contribute to inflammation.  And it will especially contribute to inflammation with people who are prone to asthma, so that's why we encourage nose breathing because, of course, the nose is going to moisten the incoming air, so that the air is arriving into the lungs in a moistened and warmed state.

Ben:  Why do you have to pinch your nose when you do that?  Why can't you just walk around, holding your breath without pinching your nose?

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

Ben:  And that would clear up congestion?  Like if you have a head cold or something like that or you're congested from swimming or anything like that, you just basically hold your breath.  You exhale through your nose, blow out all the air, pinch and just walk around for a little while.

Patrick:  Yeah, walk around.  The whole objective is that this now is a measurement of your upper tolerance of breathlessness.  So we talked about the BOLT, and then we'll measure your route of breathlessness BOLT during rest and during light physical exercise, and then we use the nose on blocking, the measurement.  So I would like athletes to be able to hold their breath for up to 80 paces.

Ben:  I do that sometimes when I'm walking.  I just count how many paces I can take with my breath held.

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

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

Patrick:  Sure.  A bicarbonate of soda, you can buy it in any supermarket, and it's probably better to get a good quality one, maybe to get one from a natural food store, one that doesn't have aluminum.  But basically, you don't want to take too much of it.  If you take a half a teaspoon to a teaspoon, not a tablespoon but a teaspoon and you could add it to sparkling water, carbonated water, and just drink a glass.  The bicarbonate of soda will increase your breath hold time by about, in studies it shows the increase in breath hold time between 8 and 10%, but it also significantly acts as a buffer to acidity.

So for instance for sports that are involving anaerobic state by taking the bicarbonate of soda, it can delay the onset of lactic acid.  So it's been measured and used or studied in times, in boxers, and boxers efficiency improved, so it is possibly related to the bicarbonate.  Carbon dioxide in the blood will dissociate into a hydrogen ion, a bicarbonate.  So by ingesting bicarbonate, are you possibly increasing the buffering capacity in the blood?  Maybe that's what's happening, so probably something similar to the exercise that we do sometimes in people with asthma.  If I found that their symptoms were a little bit stubborn, and I couldn't really shift it.  I'd have to actually take the bicarbonate of soda, and I'd use that 'cause they'd make quicker recovery.  It was just a little launching pad for them just to start making some progress, and then they'd find the exercises easier to do, and they could stick with them that way.

Ben:  Yeah, you know you could get a little bit of a similar effect with other alkalinic substances like apple cider vinegar or even carbonated water, right?  Just drinking Perrier or Pellegrino water can help with breath hold time a little bit, and with those you have a little bit less risk of blowing out your pants as you do with it.  You got to be careful.  Bicarbonate of soda, most of the research that's done that shows it to be pretty efficacious without gastric distress involves two to three hours leading up to the time when you want to use the baking soda for better acid tolerance or better breath hold time.  You actually take small amounts like a quarter teaspoon every twenty minutes for two or three hours if you don't want to get that stool-loosening effect of baking soda, so you got to be careful.  You don't want to be halfway through your breath holding, have to pull out the dude wipes.

You know another thing that you talk about, Patrick, is a way that you can help yourself to ensure that you actually do this nasal breathing for quite a long period of time, and like I mentioned in the introduction, I've talked about that turbine before, that thing you could put in your nose that a lot of Tour de France cyclists will use to open up their nasal cavity for nasal breathing during exercise.  You can even use one of these Breathe Right strips, but you talk about a different way to use this strip.  You talk about, I believe taping your mouth shut rather than taping your nose open.  Taping your mouth shut, can you go into how one would do that and why?

Patrick:  Sure, primarily during sleep, this is something we've advocated and I practice it myself.  It's a very simple tape.  We usually buy it in a drug store, and we just fold over a tab on each end of it, and we just place it across.  You can do it horizontally or you could do it vertically.  Of course, common sense has to prevail.  Don't do it if you're feeling tummy upset or if there's a risk of vomiting or if you've been drinking alcohol.  Don't use it on young children, but other than that…

Ben:  Don't tape a kid's mouth shut before they go to bed?  That’s good advice.

Patrick:  Well absolutely not, but you'd be surprised to have to kind of emphasize it.  So we use it because it ensures nasal breathing during sleep, and there's no comparison.  The difference between having the mouth open during sleep and having the mouth closed, there's literally no comparison.  Now it's not that everybody would feel really alert when they wake up, but many, many people do.  The risk of sleep disorders are significantly more prevalent.  Including snoring, because snoring through the mouth and vibration of the soft palate, obstructive sleep apnea, when basically you stop breathing during sleep.  That significantly increases when we have the mouth open.

So the quality of a person's sleep is so much better by breathing in through the nose.  Now the other aspect of it, during sports, and I think the turbine is an interesting product.  Caucasians, especially if we've been mouth breathers during childhood, we can tend to have a narrow nasal cavity because this is really so important and a point that I want to stress.  I was a mouth breather for all of my life, and nobody once said Patrick, breathe through your nose, and I'm looking at studies now that 50% of kids are going around with a mouth open.  If the mouth is open, the tongue isn't resting in the roof of the mouth.  And basically it's by having the mouth closed and the tongue resting in the roof of the mouth that shapes the palate.

So the tongue is a U-shape, it's wide.  So by having it fit into the roof of the mouth, it drives the jaws forward, but it also creates a U-shaped profile, so you'll really probably look at this as if the mouth is open, it's almost as if the whole face sinks downwards. So the upper air ways which we'll consider, consists of basically your nose and your throat that the upper airways reduce from chronic mouth breathing.  So if the upper airways reduce from chronic mouth breathing, it increases the risk of obstructive sleep apnea for lifelong.  So as nose breathers and mouth breathers during childhood, studies as well show reduced respite in muscle strength, reduced part of life, and this is so, so well documented.

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

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

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

Patrick:  Yeah, it's because small creatures don't really live that long.  There's a saying from Eastern yoga that your life is not measured by your years, but by the number of your breaths.  A mouse for example breathes very quickly, and they last, especially a rat, say for instance, they might last a couple of years, but there's a rat that's in Africa, and it's called a naked mole rat.  Now it's not the most attractive of all creatures.  But basically it lives underground and it lives in colonies where there's maybe a hundred rats together, and they're in darkness.  The situation is that they're quite far underground.  They can live as much as 8 feet deep, and the amount of oxygen that's in their environment is actually lower than it would be in the atmosphere, but the amount of carbon dioxide is higher.  Scientists are very interested because these rats are exposed to a lot of oxidative stress which should enter you have a negative effect on them, but yet when the scientists injected cancer into the naked mole rat, the rat is able to resist the cancer.  And here are scientists, they are wondering what's exactly going on here?

I don't know what's going on, but most certainly they can live up to thirty years, fifteen times more, longer than their cousins.  They're in a low oxygen, high carbon dioxide environment, and they're exposed to a lot of oxidative stress, and yet they can resist cancer.  So I think there's something in that that may be applicable to human life, and I think the whole thing about lower oxygen and high carbon dioxide.  I think it's interesting because as human beings, we're not doing the same amount of physical exercise that we did by our ancestors.

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

Patrick:  Yeah, and less oxidative stress and maybe less reactive oxygen species.  Who knows?  I remember looking at one study of the Indian army, and they had 20,000 soldiers stationed at high altitude, and this was over a long, long period of time, many, many years, and the soldiers were so bored at high altitude that a lot of them were drinking excessive alcohol, etcetera.  They had nothing to do.

Ben:  Plus it's more fun to drink at altitude.  Everybody knows that.

Patrick:  (laughs) When they compared the health of the soldiers living at high altitude, they had actually better health.  They'd reduced diseases than the guys who were at sea level, so I think there's something in that, and traditionally if people got sick with tuberculosis, they were often sent or even with asthma, they were sent into mountainous regions.  Not necessarily because the air was cleaner but because of the atmospheric concentration of oxygen.

Ben:  Yeah.  See everybody's skinnier and bolder because nobody craves hamburgers 'cause their blood's all, I guess it would be not too alkalinic, right?  They've got that perfect blend of acidity and alkalinity.

This is fascinating.  I think everybody should read this book.  So if you're listening in, first of all I'll link to the book.  I'll link to everything else that Patrick and I talked about.  Just go to bengreenfieldfitness.com/oxygenadvantage.  That's bengreenfieldfitness.com/oxygenadvantage.  I'll also put a link to that talk I was mentioning about longevity and altitude as well that I saw over at the Ancestral Health Symposium.  I'll link to Patrick's book.  I'll even link to some tape you can give your kids to tape their mouth shut during sleep because Patrick said so.  Anyways though, Patrick, thanks for coming on the show and sharing this stuff with us man.  It's a fascinating book, I think everybody who's interested in breathing, or at least as obsessed with breathing as I am, should read it.  Thanks for what you're doing, and I simply love this stuff, so I appreciate your time today.

Patrick:  Great, and thanks very much, Ben.  It was a great chat.

Ben:  Alright, folks.  Well I'm Ben Greenfield along with Patrick McKeown, author of “The Oxygen Advantage”, signing out from bengreenfieldfitness.com/oxygenadvantage.  Have a healthy week.



It's no secret that I'm somewhat obsessed with breathing.

In the past years I've written articles on everything from combining ketosis, breath holds and freediving, to how to make your own hyperbaric “exercise with oxygen therapy” (EWOT) device, to Wim Hof style breathing for cold thermogenesis to underwater workouts with Laird Hamilton to making yourself high with holotropic breathwork to the use of fancy breath strips and “Turbine” devices to enhance nasal breathing during both exercise and sleep…

…and recorded plenty of podcasts with breathing experts too.

Several years ago, Wim Hof appeared on the BenGreenfieldFitness show for one of his first ever podcasts, entitled “Conquer The Cold And Get Quantum Leaps In Performance In This Exclusive Interview With The Amazing Iceman Wim Hof“.

He came back again for “The Iceman Returns: Wim Hof On Climbing Frigid Mountains In Underwear, Eating Only Once A Day, Activating Hormones With Breathing & More.

Then there's my interview with freediving expert Ted Harty “Freediving, Breathholding, Iceman Wim Hof, Tom Cruise’s Mission Impossible Training, How To Use Static Apnea Tables & More!” along with my performance breathing interview with Brian Mackenzie on “How To Hold Your Breath For Four Minutes, Training Mask Myths, Performance Breathing & More“.

Just a few months ago, I interviewed Dr. Belisa Vranich for the episode “Pee Strips, Power Lungs & Pulse Oximeters: How To Flip The Switch On Your Body’s Own Natural Ability To Heal Itself (& Little-Known Ways To Breathe Better).

And then there's this epic XPT performance breathing workshop you can join me at in Kauai, Hawaii Dec 7-10, where guys like me, Brain Mackenzie and Laird Hamilton will teach you every form of breathwork on the face of the planet.

Today's guest is yet another oxygen expert, and the author of The Oxygen Advantage, one of the best breathing books I've read. In The Oxygen Advantage, the man who has trained over 5,000 people—including Olympic and professional athletes—in reduced breathing exercises, shares his scientifically validated techniques to help you breathe more efficiently. His name is Patrick McKeown, and in his book, you learn everything from the fundamental relationship between oxygen and the body, to how to use a Body Oxygen Level Test (BOLT) to determine how efficiently your body uses oxygen to how to increase your BOLT score by using   light breathing exercises and learning how to simulate high altitude training, along with techniques used by Navy SEALs and professional athletes to help increase endurance, weight loss, and vital red blood cells to dramatically improve cardiovascular fitness.

Patrick McKeown completed his clinical training in the Buteyko Breathing Method at the Buteyko Clinic, Moscow, Russia in 2002 and was accredited by the late Professor Konstantin Buteyko. Patrick has spent the last 15 years working with tens of thousands of children and adults worldwide, who experience breathing pattern disorders, sleep disordered breathing and anxiety. To date, he has written eight books on the subject, including Close Your Mouth, Anxiety Free: Stop Worrying and Quieten Your Mind, Asthma Free Naturally, Always Breathe Correctly and Sleep with Buteyko. To date, Patrick has worked with some of the top athletes in the world across a variety of sports including tennis, cycling, American Football, MMA and track and field.

During our discussion, you'll discover:

-Why we have always thought shallow underbreathing was a health problem, but why Patrick says the opposite: that's it's chronic overbreathing that is the issue…[9:18]

-The scientifically proven benefits of nasal breathing…[13:20]

-The fascinating links between acidity, alkalinity, overbreathing and weight gain…[19:30]

-What happens if you're breathing ‘too much' for shorter periods of time, like during exercise…[22:50]

-What the BOLT measurement is and why it's important that you have a long BOLT measurement…[28:56]

-Why Patrick is such a fan of humming…[32:00]

-The best simple exercise you can do to increase breathing efficiency and increase your BOLT score…[37:00]

-The oxygen saturation percentage level you need to get to before you start getting the benefits of holding your breath during exercise…[46:40]

-The sprint and track breathholding workouts Patrick implements with the athletes he coaches…[48:00]

-A quick breathing trick you can use to decongest congestion from a head cold…[51:45]

-A baking soda, apple cider vinegar and carbonated water hack you can use to increase your breathhold time…[55:35]

-Why you may want to consider taping your mouth shut while you sleep…[58:25]

-How the way you breathe actually changes the structure of your face…[60:25]

-Why the naked mole rat lives so long, and what this has to do with breathing…[64:30]

-And much more!

Resources from this episode:

-Patrick's latest book and the topic of our discussion “The Oxygen Advantage

Pulse oximeter

3m micropore tape for taping your mouth shut during sleep

Living High and Healthy: Why Coloradans and Others Who Live at High Altitude Live Longer, and What Flatlanders Can Learn From Them



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