The Oxygen Advantage: The Simple, Scientifically Proven Breathing Techniques for a Healthier, Slimmer, Faster, and Fitter You

by Patrick McKeown

  58 Scientific findings have shown: Maniscalco M, Sofia M, Pelaia G. Nitric oxide in upper airways inflammatory diseases. Inflamm Res. 2007 Feb;56(2):58–69. Lundberg 1996, 1–27. Lundberg, Weitzberg 1999, 947–52.

  59 “During inspiration through the nose”: Lundberg, Weitzberg 1999, 947–52.

  59 This short-lived gas: Roizen MF, Oz MC. You on a Diet: The Owner’s Manual for Waist Management. Rev. ed. New York: Free Press; 2009.

  59 It helps to prevent high blood pressure: Ignarro, NO More Heart Disease; 2006.

  59 The potency of nitric oxide: Cartledge, Minhas, Eardley 2001, 95–107. Toda, Ayajiki, Okamura 2005 May, 233–66.

  60 In a study of a group of thirty-three: Gunhan K, Zeren F, Uz U, Gumus B, Unlu H. Impact of nasal polyposis on erectile dysfunction. Am J Rhinol Allergy. 2011 Mar–Apr;25(2):112–5.

  60 And women can benefit: Roizen, Oz, You on a Diet, 2009.

  60 In addition to improving your sex: Chang, Nitric Oxide, the Mighty Molecule; 2012.

  60 Most important for athletes: Fried (ed.), Hyperventilation Syndrome, 1987.

  60 They concluded that humming: Weitzberg E, Lundberg JO. Humming greatly increases nasal nitric oxide. Am J Respir Crit Care Med. 2003 Jul 15;166(2):144–5.

  61 The results were an amazing: Three months following the instruction, results as published in the leading European rhinitis journal Clinical Otolaryngology showed a 70 percent reduction of symptoms such as nasal stuffiness, poor sense of smell, snoring, trouble breathing through the nose, trouble sleeping, and having to breathe through the mouth. Adelola OA, Oosthuiven JC, Fenton JE. Role of Buteyko breathing technique in asthmatics with nasal symptoms. Clin Otolaryngol. 2013 Apr;38(2):190–1.

  4. Breathe Light to Breathe Right

  68 “And the third level”: Pei C. Qi Gong for Beginners. DVD. Body Wisdom; 2009.

  68 The traditional Chinese philosophy: Blofeld J. Taoism: The Road to Immortality. Boulder, CO: Shambhala; 1978.

  68 While the kid’s manners: Lavell Crawford kids on fat people. www.youtube.com/all_comments?v=U6rFzngemUE (accessed September 2, 2014).

  68 Authentic professional yoga: Researcher Miharu Miyamura investigated the sensitivity to carbon dioxide during respiration of 1 breath per minute for an hour by a professional Hatha yogi. Results showed that authentic yoga practitioners have reduced sensitivity to carbon dioxide. Miyamura M, Nishimura K, Ishida K, Katayama K, Shimaoka M, Hiruta S. Is man able to breathe once a minute for an hour? The effect of yoga respiration on blood gases. Jpn J Physiol. 2002 Jun;52(3):313–6.

  5. Secrets of Ancient Tribes

  80 Tom theorized that: Tom Piszkin. Personal e-mail to Patrick McKeown, August 2014.

  80 His results showed: Babbitt B. Gun shot at the Oakland Coliseum. Competitor Magazine. 1988. www.ttinet.com/tf/about2.htm (accessed July 1, 2012).

  80 When researchers studied: Douillard J. Perfect Health for Kids: Ten Ayurvedic Health Secrets Every Parent Must Know. Berkeley, CA: North Atlantic Books; 2004.

  81 To date, he: Sebring L. What does it really feel like to be a healthy human? Whole Human (blog). the-whole-human.com/article/lane-sebring-md/what-does-it-really-feel-be-healthy-human (accessed June 10, 2013).

  81 Just like our ancestors: Ibid.

  84 Incorporating this concept: Woorons X, Mollard P, Pichon A, Duvallet A, Richalet JP, Lamberto C. Effects of a 4-week training with voluntary hypoventilation carried out at low pulmonary volumes. Respir Physiol Neurobiol. 2008 Feb 1;160(2):123–30.

  86 The vast majority of sports: LaBella CR, Huxford MR, Grissom J, Kim KY, Peng J, Christoffel KK. Effect of neuromuscular warm-up on injuries in female soccer and basketball athletes in urban public high schools: Cluster randomized controlled trial. Arch Pediatr Adolesc Med. 2011 Nov;165(11):1033–40. Woods K, Bishop P, Jones E. Warm-up and stretching in the prevention of muscular injury. Sports Med. 2007;37(12):1089–99. Shellock FG, Prentice WE. Warming-up and stretching for improved physical performance and prevention of sports-related injuries. Sports Med. 1985 Jul–Aug;2(4):267–78.

  92 Having successfully completed forty: Danny Dreyer, Founder & President. ChiRunning. www.chirunning.com/about/staff-profile/danny-dreyer (accessed September 2, 2014).

  92 A firm exponent of nasal breathing: Dreyer D, Dreyer K. ChiRunning: A Revolutionary Approach to Effortless, Injury-Free Running. Rev. ed. New York: Simon & Schuster; 2009:54.

  6. Gaining the Edge—Naturally

  95 According to the United States: Wilber RL. Application of altitude/hypoxic training by elite athletes. Med Sci Sports Exerc. 2007 Sep;39(9):1610–24.

  96 This addition of blood: Ekblom BT. Blood boosting and sport. Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):89–98.

  96 By the early 1990s: Sawka MN, Joyner MJ, Miles DS, Robertson RJ, Spriet LL, Young AJ. American College of Sports Medicine position stand: The use of blood doping as an ergogenic aid. Med Sci Sports Exerc. 1996 Jun;28(6):i–viii.

  97 Early reports involved: Walsh D. From Lance to Landis: Inside the American Doping Controversy at the Tour de France. New York: Ballantine Books; 2007.

  97 During the race: Fotheringham W. Put Me Back on My Bike: In Search of Tom Simpson. New ed. London: Yellow Jersey Press; 2007. The death of Tom Simpson. BBC World Service. www.bbc.co.uk/programmes/p00hts7t (accessed September 2, 2014).

  97 With a determined effort: Remembering a sensation. BBC. www.bbc.co.uk/insideout/northeast/series6/cycling.shtml (accessed September 2, 2014).

  97 Later, investigators would: Ibid.

  97 “To Lance’s way”: Ungoed-Thomas J. Lance Armstrong “given drugs in lunch bag,” claims teammate Tyler Hamilton. Sunday Times. September 2, 2012.

  98 Summed up in the statement: USADA. Statement from USADA CEO Travis T. Tygart Regarding the U.S. Postal Service Pro Cycling Team Doping Conspiracy. cyclinginvestigation.usada.org (accessed January 14, 2015).

  98 When Winfrey asked: Oprah Winfrey. Interview with Lance Armstrong. www.oprah.com/own/Lance-Armstrong-Confesses-to-Oprah-Video (accessed September 2, 2014).

  98 Looking back, Swart: Pegden E. Swart vindicated by Armstrong report. Waikato Times. October 12, 2012. Available at www.stuff.co.nz/sport/other-sports/7805732/Swart-vindicated-by-Armstrong-report (accessed January 14, 2015).

  99 “I’ve always understood”: Rough Rider. RTE Television. www.rte.ie/tv/programmes/roughrider.html (accessed September 2, 2014).

  100 Levels of hemoglobin: Hemoglobin. MedlinePlus. www.nlm.nih.gov/medlin eplus/ency/article/003645.htm (accessed August 15, 2012).

  100 Hematocrit is usually: Hematocrit. MedlinePlus. www.nlm.nih.gov/medline plus/ency/article/003646.htm (accessed April 20, 2013).

  101 Athletes still use: Levine BD, Stray-Gundersen J. A practical approach to altitude training: Where to live and train for optimal performance enhancement. Int J Sports Med. 1992 Oct;13 Suppl 1:209–12.

  101 To limit the detraining: Levine BD. Intermittent hypoxic training: Fact and fancy. High Alt Med Biol. 2002 Summer;3(2):177–193. Levine BD. Should “artificial” high altitude environments be considered doping? Scand J Med Sci Sports. 2006 Oct;16(5):297–301. Levine BD, Stray-Gundersen J. “Living high-training low”: Effect of moderate-altitude acclimatization with low-altitude training on performance. J Appl Physiol. 1997 Jul;83(1):102–12.

  102 Levine and Stray-Gundersen: Levine, Stray-Gundersen 1997, 102–12.

  102 These improvements were: Ibid.

  102 Furthermore, the increase: Stray-Gundersen J, Chapman RF, Levine BD. “Living high–training low” altitude training improves sea level performance in male and female elite runners. J Appl Physiol. 2001 Sep;91(3):1113–20.

  102 During the 2006 Torino: Wallechinsky D. The Complete Book of the Winter Olympics. Turin 2006 ed. Wilmington, DE: Sport Media Publishing; 2005.

  103 The authors of the study concluded that although: Moderate-intensity aerobic training that improves the maximal aerobic power does not change anaerobic capacity, and adequate high-intensity intermittent training may i
mprove both anaerobic and aerobic energy supplying systems significantly. Tabata I, Nishimura K, Kouzaki M, et al. Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2 max. Med Sci Sports Exerc. 1996 Oct;28(10):1327–30.

  103 Posttrial results: Bailey SJ, Wilkerson DP, Dimenna FJ, Jones AM. Influence of repeated sprint training on pulmonary O2 uptake and muscle deoxygenation kinetics in humans. J Appl Physiol. 2009 Jun;106(6):1875–87.

  103 This means that the athletes: Jones A. Understand the body’s use of oxygen during exercise: Oxygen kinetics—start smart for a mean finish! Sports Performance Bulletin. www.pponline.co.uk/encyc/understand-the-bodys-use-of-oxygen-during-exercise-36326 (accessed April 20, 2013). Hagberg JM, Hickson RC, Ehsani AA, Holloszy JO. Faster adjustment to and recovery from submaximal exercise in the trained state. J Appl Physiol Respir Environ Exerc Physiol. 1980 Feb;48(2):218–24.

  105 For hundreds of thousands of years: Rahn H, Yokoyama T. Physiology of Breath-Hold Diving and the Ama of Japan. Washington, D.C.: National Academy of Sciences–National Research Council; 1965:369.

  105 and some evolutionary theorists: Hardy A. Was man more aquatic in the past? New Scientist. March 17, 1960. Hardy A. Was there a Homo aquaticus? Zenith. 1977;15(1): 4–6.

  106 Generally, most humans: World records. Association Internationale pour le Développement de l’Apnée. www.aidainternational.org/competitive/worlds-records (accessed July 6, 2012).

  106 A number of studies have sought: Isbister JP. Physiology and pathophysiology of blood volume regulation. Transfus Sci. 1997 Sep;18(3):409–23. Koga T. Correlation between sectional area of the spleen by ultrasonic tomography and actual volume of the removed spleen. J Clin Ultrasound. 1979 Apr;7(2):119–20. Erika Schagatay is the director of research at Mid Sweden University. Her interest in physiology began after she met native breath-hold divers from several tribes, including Japanese ama and Indonesian Suku Laut and Bajau, who were able to hold their breath for far longer than medical literature stated was possible. Schagatay has completed a number of studies on the effects of holding the breath on both trained and untrained breath-hold divers. People. Mid Sweden University. www.miun.se/en/Research/Our-Research/Research-groups/epg/About-EPG/People (accessed August 29, 2012).

  One of Schagatay’s studies involved twenty healthy volunteers, including ten who had their spleens removed, to determine the adaptations caused by short-term breath holding. The volunteers performed 5 breath holds of maximum duration (as long as possible for each individual) with a 2-minute rest in between each. The results found that the volunteers with spleens showed a 6.4 percent increase in hematocrit (Hct) and a 3.3 percent increase in hemoglobin concentration (Hb) following the breath holds. This means that after just 5 breath holds, the oxygen-carrying capacity of the blood was significantly improved. However, for the individuals who had their spleens removed, there were no recorded changes to the blood resulting from breath holding. Schagatay E, Andersson JP, Hallén M, Pålsson B. Selected contribution: Role of spleen emptying in prolonging apneas in humans. Journal of Applied Physiology. 2001 Apr;90(4):1623–9.

  During a separate study by Schagatay, seven male volunteers performed 2 sets of 5 breath holds to near maximal duration, one in air and the other with their faces immersed in water. Each breath hold was separated by 2 minutes of rest and each set separated by 20 minutes. Both Hct and Hb concentration increased by approximately 4 percent across both series of breath holds—in air and in water. Schagatay E, Andersson JP, Nielsen B. Hematological response and diving response during apnea and apnea with face immersion. Eur J Appl Physiol. 2007 Sep;101(1):125–32.

  106 The spleen is an organ: Isbister 1997, 409–23.

  106 This means that after as few: Schagatay, Andersson, Nielsen 2007 Sep, 125–32.

  106 breath-hold divers peaked: A study by Bakovic´ et al. from University of Split School of Medicine, Croatia, was conducted to investigate spleen responses resulting from 5 maximal breath holds. Ten trained breath-hold divers, ten untrained volunteers, and seven volunteers who had their spleen removed were recruited. The subjects performed 5 maximum breath holds with their face immersed in cold water, and each breath hold was separated by a 2-minute rest. The duration of the breath holds peaked at the third attempt, with breath-hold divers reaching 143 seconds, untrained divers reaching 127 seconds, and splenectomized persons achieving 74 seconds. Spleen size decreased by a total of 20 percent in both breath-hold divers and the untrained volunteers. Researchers concluded that the results show rapid, probably active contraction of the spleen in response to breath hold in humans. Rapid spleen contraction and its slow recovery may contribute to prolongation of successive, briefly repeated breath-hold attempts. Bakovic´ D, Valic Z, Eterovic´ D, et al. Spleen volume and blood flow response to repeated breath-hold apneas. J Appl Physiol. 2003 Oct;95(4):1460–6.

  106 Not only that but: Ibid.

  107 While these studies generally: In a paper by Dr. Espersen and colleagues from Herlev Hospital, University of Copenhagen, Denmark, splenic contraction was found to take place even with very short breath holds of 30 seconds. However, the strongest contraction of the spleen was as it released blood cells into circulation, occurring when a subject held their breath for as long as possible. Espersen K, Frandsen H, Lorentzen T, Kanstrup IL, Christensen NJ. The human spleen as an erythrocyte reservoir in diving-related interventions. J Appl Physiol. 2002 May;92(5):2071–9.

  107 However, the strongest contractions: Ibid.

  107 Another useful piece of: This study in particular provides pertinent information about the consequence of breath holding: Since there was no visible increase in the results of breath holding with the subjects’ faces immersed in water, the authors concluded that the breath hold, or its consequences, is the major stimulus evoking splenic contraction. Schagatay, Andersson, Nielsen 2007 Sep, 125–32.

  107 Performing just 3 to 5 breaths: Ibid.

  108 While this reduces the: In his doctoral thesis entitled “Haematological changes arising from spleen contraction during breath hold and altitude in humans,” Matt Richardson investigated the role played by higher levels of carbon dioxide.

  Eight non-divers performed 3 sets of breath holds on three separate days under different starting conditions, varying the levels of carbon dioxide available to the subjects before each test. The first test was preceded by the breathing of 5 percent CO2 in oxygen (hypercapnic), the second with pre-breathing of 100 percent oxygen (normocapnic), and the third with hyperventilation of 100 percent oxygen (hypocapnic).

  The duration of each breath hold was kept constant in all 3 sets, and baseline values of Hb and Hct were the same for all conditions. After the 3 breath holds, the increase in Hb in the hypercapnic (higher carbon dioxide) trial was 9.1 percent greater than in the normal carbon dioxide trial (normocapnic) and 71.1 percent greater than in the lower carbon dioxide trial (hypocapnic). Richardson concluded that an increased capnic stimulus during breath hold may elicit a stronger spleen response and subsequent Hb increase than breath hold preceded by hyperventilation. Richardson, MX. Hematological changes arising from spleen contraction during apnea and altitude in humans. Doctoral dissertation. Mid Sweden University; 2008.

  108 Higher levels of carbon dioxide: Ibid.

  108 By exhaling and holding the breath: Dillon WC, Hampl V, Shultz PJ, Rubins JB, Archer SL. Origins of breath nitric oxide in humans. Chest. 1996 Oct;110(4):930–8.

  109 One of the functions of EPO: Joyner MJ. VO2MAX, blood doping, and erythropoietin. Br J Sports Med. 2003 Jun;37(3):190–191. Lemaître F, Joulia F, Chollet D. Apnea: A new training method in sport? Med Hypotheses. 2010 Mar;74(3):413–5.

  109 Breath holding is an effective: Lemaître, Joulia, Chollet 2010 Mar, 413–5.

  109 The concentration of EPO: De Bruijn and colleagues from the department of natural sciences, Mid Sweden University, investigated whether subjecting the body to lower oxygen levels by holding the breath could increase EPO concentration. The study inv
olved ten healthy volunteers performing 3 sets of 5 maximum duration breath holds, with each set separated by 10 minutes of rest. Results showed that EPO concentration increased by 24 percent, peaking three hours after the final breath hold and returning to baseline two hours later. De Bruijn R, Richardson M, Schagatay E. Increased erythropoietin concentration after repeated apneas in humans. Eur J Appl Physiol. 2008 Mar;102(5):609–13.

  109 A clear example: Cahan C, Decker MJ, Arnold JL, Goldwasser E, Strohl KP. Erythropoietin levels with treatment of obstructive sleep apnea. J Appl Physiol. 1995 Oct;79(4):1278–85. A study by Winnicki and colleagues from the Medical University of Gdansk, Poland, tested the hypothesis that the repetitive lowering of oxygen levels from breath holds during sleep apnea increase EPO. The study involved eighteen severe and ten very mild patients. Results showed a 20 percent increase to EPO in patients with severe obstructive sleep apnea, which decreased following elimination of the breath holds by treatment. Winnicki M, Shamsuzzaman A, Lanfranchi P, et al. Erythropoietin and obstructive sleep apnea. Am J Hypertens. 2004 Sep;17(9):783–6.

  111 As U.S. Army general: Patton GS Jr. Third Army, Standard Operating Procedures, 1944. historicaltextarchive.com/sections.php?action=read&artid=384 (accessed September 2, 2014).

  112 Studies with athletes have demonstrated: Lemaître F, Polin D, Joulia F, et al. Physiological responses to repeated apneas in underwater hockey players and controls. Undersea Hyperb Med. 2007 Nov–Dec;34(6):407–14. Woorons X, Bourdillon N, Vandewalle H, et al. Exercise with hypoventilation induces lower muscle oxygenation and higher blood lactate concentration: Role of hypoxia and hypercapnia. Eur J Appl Physiol. 2010 Sep;110(2):367–77.

  114 Dr. Joseph Mercola: Mercola J. Baking soda uses: To remove splinters—and to address many other health needs. Mercola.com. August 27, 2012. articles.mer cola.com/sites/articles/archive/2012/08/27/baking-soda-natural-remedy.aspx (accessed June 10, 2013).

  114 The therapeutic potential: Marty Pagel, PhD, awarded $2 million NIH grant to study impact of baking soda on breast cancer. University of Arizona Cancer Center. March 21, 2012. azcc.arizona.edu/node/4187 (accessed August 10, 2012).