Dr Rupy: James, why do you believe we've lost the ability to breathe properly and what are the downstream consequences of that?
James Nestor: I never thought that I would be writing a book about how we were breathing improperly. That was never my intention when I set out to write this book. But it wasn't until I spoke to so many researchers and especially biologists and people that study evolution that I realised that our skulls have fundamentally changed. Our mouths are so small, our teeth don't fit. That's why we have crooked teeth. And with a small mouth, you have a smaller airway. So all of these changes have occurred in the past, depending on where you were, maybe past 400 years or so. So it's not an opinion or a hypothesis, it's a scientific fact that you can trace the exact moment at which we started developing these poor breathing habits. And if you look today at populations around the world, it doesn't matter where you are, you look at the rates of asthma, snoring, sleep apnoea, COPD, on and on and on, most people are suffering from some sort of dysfunctional breathing habit.
Dr Rupy: Yeah. And it goes beyond that, right? So in your book, you talk about not only those obstructive respiratory problems and the way snoring has increased and apnoeas, sleep apnoea, but but weight, ADHD, mental health conditions. Where's the connection there?
James Nestor: Those are the obvious ones I mentioned, right? Asthma, that's obviously has something to do with poor breathing. Pneumonia, emphysema. But people don't realise that how they breathe affects how they sleep and how you sleep affects everything. And also how they breathe during physical exercise affects them later, how apt they're going to be to have respiratory infections. And so you start to look at this pillar of breathing and downstream from it are so many connections to these chronic conditions that we have, even headaches, even diabetes, even heart disease. Who knew that how you breathe could make you more susceptible to all these issues, but this is what the science has clearly shown us over decades and decades.
Dr Rupy: Yeah. I mean, as a as a medic, when I went to medical school over 20 years ago now, I wasn't taught about any of this stuff, right? You know, we're talk about, we're taught the the root causes of type two diabetes, excess sugar. We're not really talked about taught about the impact of sleep, the impact of stress, the impact of and breathing was a real revelation to me. So where do you think that this information has been lost over the the last decades or and hundreds of years? Because in your book, you chronicle how researchers have actually been looking at this.
James Nestor: This is one of the first questions I had, and there's doctors in my family, there's pulmonologists in my family. I came to them and I asked them.
Dr Rupy: Your father-in-law, right?
James Nestor: Yeah, yeah, that's it. He's a pulmonologist. He's a well-known pulmonologist, been doing this for 50 years, right? And I said, what's the proper way to to breathe? Like, what is like the ultimate way? He said, I have no idea. He deals with lung cancer. He deals with catastrophic injuries to the lungs. So he told me that pulmonologists are only concerned that you are breathing. As long as you're breathing, you're good to go. The moment where you physically cannot breathe, you see a pulmonologist and they can fix you up. They can do incredible things. But most of us aren't so far on that one end where we can't breathe. We're just breathing poorly and we're breathing dysfunctionally. And he told me also, he's like, you have to basically be the walking dead before you get treatment. So I think that's what's happened. If pulmonologists, the discipline in medicine that owns the lungs, owns the airways, if they're not teaching this, then nobody is teaching it. And that's what I found. I thought that that was shocking and he was shocked by it as well. He had never learned anything about proper breathing. He learned about lung diseases.
Dr Rupy: Yeah. I think that's a it's a really interesting parallel across all of medicine. We tend to intervene at the very late stages. And at that point, a whole bunch of things have gone wrong to even see someone in that state. So someone who comes in with frequent asthma attacks and we treat them at the acute stage, but then we don't really have those basics of treating and addressing the root cause of the problem and going back upstream. And so this disconnect between medicine, I think is is beyond breathing, it's it's, you know, across all different types of disciplines. Metabolic health is one of them that we have a bias over here in the Doctor's Kitchen. So if pulmonologists and respiratory physicians are intervening too late, where do we need to what are the basics of breathing that we've lost and where should we start?
James Nestor: So I just want to be clear. I think that these pulmonologists, these medical doctors are doing incredible work. You get in a car accident, don't go to a breathwork class, go to the ER and get fixed up with these incredible technologies that can keep you alive. But I think that these milder chronic issues aren't being addressed at all. And that includes nutrition, that includes breathing, that includes sleep. You see online, you know, people think it's cute that their spouse is snoring or that their baby, you know, is kind of choking on himself at night. This is a serious red flag that there is something so wrong going on with the body. If you are stressing yourself out at night when you should be sleeping and restoring your body, everything is going to fall apart. We know that. This is not a controversial thing that I'm saying. We know that now. I think if we trace that back, like where is the first moment where things start to go wrong with our breathing? I think it starts in infancy. That's that's where it really starts. I've gotten a lot of flak for what I'm about to tell you right now. I just want to be be clear. Mothers are amazing. I'm so proud of that mothers are able to live in this modern world and manage kids and manage jobs and all that. I am not shaming anybody by saying this, but we we know this is a scientific fact. If kids are bottle-fed, they are much more apt to have a different shaped mouth than they would otherwise. So it starts with that. Every indigenous culture that's alive today and all of our ancestors from 500 years ago, going back, even sooner than that, going back from to the dawn of humanity, kids were breastfed. And when you are breastfed, it pulls the face out. The palate is able to grow more flat. The mouth expands. So the mouth is naturally larger, which allows teeth to grow in straight. With bottle feeding and with pacifiers, the opposite happens. The mouth tends to cave in like this, which is why these kids have a different facial profile and a different profile in their airways as well. So if you go back to the the origins, it's it really starts with that. And to be clear, you can still have a kid that's bottle-fed and will have a completely normal skeleture and musculature, right? If you start taking preventative measures early on. And that is baby-led weaning. So this is when you take a kid that has been breastfed or even bottle-fed and wean them on to real foods, actual foods. And a lot of parents say, oh my god, that's so dangerous. That's why Gerber's was invented. Well, what did we do before Gerber's? If we didn't if we were fine before Gerber's, which was 100 years old, giving a kid only mashed carrots and everything, that there's there's a way of doing this. So having that early mastication, that chewing, that stress on the face opens up the palate. It opens up all of these different areas and it opens up the airway to allow this kid to breathe better and to become an obligate nasal breather. If you think about a kid breastfeeding, what are they doing for three, four hours a day? Learning to breathe always through their nose and that carries through as they grow older.
Dr Rupy: Yeah, yeah. I I'm I'm glad we're having this conversation. I think we should be able to have a pragmatic conversation without causing offence, particularly when we're discussing something that is scientifically proven to change the nasal shape. And you know, I'm a father to a 15-month-old, so I'm very attuned to the sort of difficulties of weighing up breastfeeding versus bottle feeding. And for me and my wife, it was a hybrid approach. So we used a bit of bottles to give her some respite and also allow her to function in the modern world, go to work and all that kind of stuff, whilst also breastfeeding for the benefits, not only from the facial point of view, but also from the actual nutrition point of view as well. Is there a way to have our cake and eat and and eat it as well? So is there a way to choose certain bottles with certain teats that kind of mimic the the the the sort of breastfeeding action?
James Nestor: Yes, there are and they're getting better and better and better. Looking for ones that have myo or myofunctional therapy or that key phrase. I'm not endorsing any of these bottles, but if you dig around and look that there are some that require more stress, right? And you want that stress. You want that exercise in the jaw and in the mouth. So, yeah, and and I think that that is a a beautiful approach, a hybrid approach. Even if a kid is obligate bottle feeder, that's fine. As long as you acknowledge that and say, hey, after this stage, let's be sure to get them off pacifiers, which are really bad news for mouths. And that's also scientifically proven. It's not going to be good news for a lot of parents, but but the sooner you can get a kid off a pacifier, we know that there are a lot of benefits to be had from that. And then when they're eating, they should be chewing. That's not too far of a leap of logic, right? They should be chewing and the more that they're chewing, the more they're going to develop that proper skeleture and musculature.
Dr Rupy: Totally, yeah. I'm a really big fan of baby-led weaning. We actually started around four to five months, which is relatively early. But he was sat up and he was able to hold his neck, so we we made that pragmatic decision. And the first thing he ate was broccoli. So there was a lot of chewing involved. He only had a couple of teeth at the time. And I remember just thinking, okay, yeah, this is good because he's going to build up the the masseter, which is the strongest muscle per by volume, is that right?
James Nestor: Yes, that's right.
Dr Rupy: Yeah. So all these different things I think are we're thinking of at the moment when it comes to, you know, the development of his airways. So beyond that, so let's say, okay, I can't rewind the time. It's he's like four or I've got a child now that was bottle-fed. What are the other things that sort of the domino effect in terms of the the changing the airway?
James Nestor: Beyond food, which is very important, it's oral posture when you're not eating. And one thing I'm going to add to the eating part, but this still sort of ties into oral posture is the tongue should be on the roof of the mouth when you are swallowing. So so many kids when they swallow, you can see them at four and five years old, they swallow like this. They push their tongue against their front teeth. Guess what's going to happen? They're not only going to develop this bad habit, they're going to throw their teeth out of alignment and their upper palate isn't going to develop properly. I keep mentioning upper palate, upper palate, upper palate. But the wider that is, the wider your airway is, the better the sinus cavities are going to develop, okay? And wider, healthier sinus cavities means easier nasal breathing. So once you develop those skills, right? And these are skills that all animals have, but we've we've lost them because of industrialized foods mostly. Then you can start to train into proper oral posture, which means when you are not eating, the tongue is resting very softly on the upper palate. Upper palate's up here. Not like this. No. You see a lot of kids doing that. But it's resting on the upper palate. Teeth are almost touching, right? And you're breathing in and out through your nose. And this is so important in the day, but it's even more important at night because we grow at night. That's when human growth hormone releases. And if you have this posture at night, like I did all throughout my youth. Guess what's going to happen to your face? It's going to grow narrow. It's going to have this retrognathic growth. And this is also proven, which is why doctors call this adenoid face. When adenoids get inflamed, you default to mouth breathing. So so there's an actual name for it because it's so common. So a lot of kids once they get to be teenagers, do not care about being healthy. They have no interest. You could talk to them about healthy food. They don't care about exercise. And they shouldn't, you know. But show them a picture of a kid with a retrognathic profile with adenoid face and they get so frightened that they're going to look like that. And they will, you know, I was someone who was a mouth breather his whole life. I had crooked teeth, I had extractions. Everyone I knew had this and I wish I had known this, you know, a long time before. So real foods, chewing real foods, oral posture, in and out through the nose. If you can do that, you're about 80% there. Then you work on the rest of the posture for the body and you make sure that a kid isn't allergic, has chronic congestion. But if you develop these two things, a healthy diet and that correct oral posture, especially at night, you're pretty good.
Dr Rupy: Yeah, yeah. You you tell the story through your book, through um the lens of this experiment you did at Stanford, right? Where you purposely blocked your nasal passages and then you you mouth breathed. What was the result of mouth breathing just for 10 days, I believe it was?
James Nestor: So by this time, I had been studying breathing, especially the airway in which the pathway in which we we breathe air, the differences between those two. And it was irrefutable. There's so many studies showing all the damage that will happen breathing through the mouth, even studies going back 120 years. Dennis saying the number one cause of cavities isn't sugar. It's mouth breathing. This makes your mouth more acidic, makes it a breeding ground for bacteria, develops more cavities. Now dentists are saying the exact same thing. So that case was was sealed, right? And not a lot of people would argue that. But I had noticed they had done experiments with animals, these awful experiments, plugging their noses for months or years at a time, looking what happens to their facial structure, looking what happens to their health. But no one had ever done one with with humans. And I went to the chief of rhinology research at Stanford and I said, let's do a study, right? You know, let's get 100 people and we'll have 50 controls and then we'll have 50. And he was just sort of looking at me, entertaining this idea, you know, trying to be respectful. He said, well, that's going to cost, you know, $3 million. And and the most important thing he told me was he believed it would be unethical for him to conduct that. He's a rhinologist. He knows all the wonders of nasal breathing. Because he knew what was going to happen and how damaging this would be for people's health. Gosh. So after several more conversations, I said, I'll volunteer for and I'll get someone else. And it was a maximum two people. And he let us use his lab. We still had to pay for everything else. It was extraordinarily expensive. But the setup of this was 10 days of mouth breathing where our noses were were plugged and then 10 days of nasal breathing and taking data the whole way through. And what happened was exactly what the science told us what was going to happen, except that I guess the big difference was it was so much worse than than I had expected.
Dr Rupy: Wow. And so if you were to give a top line of what happened after mouth breathing for 10 days,
James Nestor: What happened to us was exactly what has been happening to hundreds of millions of people around the world today. Increase in blood pressure, fatigue, chronic fatigue all the time, absolutely terrible sleep, stressed constantly. And going back to that sleep thing, an increase of a significant increase of snoring and sleep apnoea. So we did not feel that we were sort of rigging this in any way. What we were trying to do is put us in the position of so many people on this planet right now who suffer from chronic congestion, who have structural issues in their noses, severely deviated septums, who can't breathe out of their their noses. So they're obligate mouth breathers and they wonder why they have lower back pain. They wonder why they have chronic headaches. They wonder why they can't get their blood pressure down. I'm not saying that this is directly tied to all of those things, but we know it is definitely contributing to it. So, yeah, it was it was really, really bad. The first few days we were kind of laughing, saying, ah, yeah, I feel awful. My sleep is terrible. I went from not snoring to snoring four hours a night within three days. Without any other changes, you know. And by day seven, eight, it was really, really hard. And we couldn't wait for it to be over. We were just counting the minutes.
Dr Rupy: Yeah, yeah, I can imagine. So with mouth breathing, I definitely get how if you're breathing through your mouth more often, you're drying the inside of your mouth, you're changing the the picture of the oral bacteria, you're putting yourself at higher risk of things like cavities. We've had a few functional dentists on talking about this as well. Is it the uh presence of mouth breathing or the absence of nasal breathing that leads to those other downstream effects that you just mentioned?
James Nestor: I think it's both. That's a great question. I think it's both because there are so many benefits to be had with with nasal breathing. This is our filter. It's our first line of defence when we're breathing. It filters out allergens, dust, it helps kill bacteria and viruses. People are like, the nose does that? It does through nitric oxide. And and we know this. And when you breathe through the mouth, you're exposing yourself to everything in the outdoor environment, you know, or the indoor environment even worse. It's almost like your lungs become this external organ. And this is why people who are chronically mouth breathing are so much more susceptible to respiratory infections. So again, all of that is is established. And it's it's the injurious side of mouth breathing and the lack of benefits from nasal breathing that will wear your body down. It will really, I mean, you would be surprised how quickly it happens. I think this is one of the reasons why during allergy season, like snoring and sleep apnoea go through the roof. Do you think there's a connection there? They're like, it's from lack of Claritin. I'm like, no, it's from mouth breathing. You know, that's that's what it is.
Dr Rupy: Yeah, yeah. And nitric oxide comes up quite a bit in in the book. Nasal breathing appears to be a way in which to increase nitric oxide. Where is nitric oxide being produced and and why is it having such a beneficial impact?
James Nestor: Nitric oxide can be produced throughout the body, but we produce a profusion of it in our sinus cavities.
Dr Rupy: Okay, so we've got a little half head here for those of us watching on YouTube. So it's a nice handy structure.
James Nestor: For those who aren't, I am looking at a cross section of a skull right now. So as air goes in through these sinus cavities here, right? It is baffled. It's forced to go through this crazy maze where it passes all of these different tissues. And when you breathe through the nose, you make six times more nitric oxide than you would breathing through the mouth. Because it's forced to go through all of these different areas and all these different areas will vibrate, you know, at certain times and that releases more nitric oxide. That nitric oxide goes down the airway, goes into the lungs. Nitric oxide is this incredible miracle molecule, right? You know, one that the guys who discovered it in '92 won the Nobel Prize for it. It's a big deal. And when you hum, here's what was even crazier. When you hum, you increase it 15-fold.
Dr Rupy: Just humming?
James Nestor: Just humming because that vibration helps to release it. So if you hum and you have nasal congestion, this is a study I have been trying to get on the books somewhere. If there are doctors out there, researchers, come find me. It's an easy thing to set up, but I've heard from so many people with chronic rhinitis and chronic sinusitis that humming for about 10 minutes, three to four times a day, humming any song, it doesn't matter what you're humming, the national anthem, your favourite pop hit, you know, humming sentences to yourself, was able to clear out their noses and effectively remove all the symptoms of rhinitis and sinusitis.
Dr Rupy: Really?
James Nestor: So this is what this is anecdotal. There is one crazy um study that one guy did. It's an N of one, so it doesn't mean that much. But he said this is what I did. This this was the schematic. This is the results of doing that. After a number of days, the nose starts clearing up. And I've heard this anecdotally from so many people. So if anyone wants to put together a study of 20, 30 people, wouldn't be that expensive. And the protocol is very easy. You don't have to get some crazy IRB to do this. You're humming. There are no no negative side effects.
Dr Rupy: I'm going to start doing this myself, particularly around hay fever season as well, you know? And people were given that information around hay fever season when we're constantly, you know, downing antihistamines and doing nasal rinses, which I'm sure that have some benefits for sure. But humming is an extra protocol that is 100% safe. There are no downstream effects or downsides to it. Um I'm definitely going to be trying this, absolutely, because I I suffer from sinusitis during that time as as many people do. For those with deviated septums or they're just like, you know, I just can't nasally breathe. Are there steps to get them to breathe through their nose easier?
James Nestor: It all depends. So everyone's on a spectrum, right, of of breathing health. So I'm one of those people that I broke my nose several times, never got it fixed. I took a scan when I was at Stanford. The rhinologist there was laughing. He's like, you're a complete disaster. He's like, you're a perfect candidate for surgery. I said, well, I want to see what happens if I don't do surgery. I know people that have had severely deviated septums who have had surgery and it was absolutely life-changing. So surgery, if you need it, can change your life. It can allow you to breathe easily through your nose. What I also learned from him, from a guy that he's a surgeon, he does this all day long in one of the top research institutions in the world, he said most of the patients that come to see him and that demand surgery do not need it. They don't need it. So through a neti pot, which is a a sinus rinse, through healthy breathing habits, sometimes putting a low-dose steroid in a neti pot for a couple of weeks, one of the researchers that works with him, she was slated for a very elaborate, intricate sinus surgery. He put her on this protocol. She has never had a problem since and now she works with him because she's so convinced that this word needs to get out. So there is a spectrum of different approaches that you can take depending on what the core issue is, but you have to go back to the core issue. Is it structural? Is it inflammation? Is it tied to me eating too much dairy and I'm allergic to it? And every time I eat some cheese, my nose plugs up. Well, that's a sign that maybe you should remove dairy and see how that works for your nasal breathing. So I'd love to give you a blanket, I won't call it a prescription because I'm not a doctor, but blanket advice, but I can't. You you have to find the core issue. If you are somebody who suffers from very, very serious issues with nasal breathing, it would benefit you to go to an ENT to get your head scanned and to see where the issue is.
Dr Rupy: In addition to shutting our mouths more, trying to prevent ourselves from breathing through our mouth throughout the day and breathing through our noses, exhalation is another feature of your book. We're not exhaling long enough. Am I getting that correct? We're not exhaling at all. At all. Uh most of us use about 10% of the movement of our our diaphragm. So the the capacity of our diaphragm.
James Nestor: 10%.
Dr Rupy: So our diaphragm is this wonderful muscle that sits underneath the lungs. A lot of people think that the lungs are inflating themselves and deflating, you know, as we inhale and exhale. That's not the case. We have this diaphragm and we control our diaphragm, not our lungs. So when we inhale, we push the diaphragm down. This creates a vacuum in the lungs. We take a breath in. The diaphragm relaxes, air naturally comes out. So what I found in a bunch of crazy research from from decades ago is most of us, the diaphragm should be having this big excursion and incursion, right? Real a lot of movement down here. But for most of us, it's just barely moving at all because we've habituated ourselves to breathing through the mouth. You take very shallow breaths into the chest. The majority of those breaths, the majority of that air doesn't enter the lungs. So you're just taking in air into the body and exhaling it without using it. An incredible amount of energy is taken to do this. If you are able to condition your diaphragm to truly descend to the optimum point, and when you exhale, to truly let it go, you can take fewer breaths, much more energy efficient. So Carl Stough, one of these researchers I write about in the book, this crazy story. I was surprised that I'd never heard about it before. But he found that people who suffer from emphysema, it's under the umbrella of COPD now, their diaphragms were literally locked. They they were locked in a position on an inhale, which is why if you see people with emphysema, if you see people with extremely dysfunctional breathing, they can't relax. They can't let that breath out. So it's not a problem with getting the air in, it's a problem with letting it out. And I had heard this, I don't think this has been proven, but in Ayurvedic medicine, they say that areas of the dead space in the lungs that don't participate in gas exchange, those are much more apt to to suffer from pneumonia, right? Those those will atrophy. So you want this constant flow of air in and out of the lungs. This is what they're meant to do. And if your diaphragm is locked down here and you're just forcing air upon air, it's bad news for everything. So the only intervention that he did with these people who were literally left for dead is he taught them how to release their diaphragms. And these people left for dead, walked out of the hospital and lived long, beautiful lives. And I've heard from a few of them. And they're so angry that when Stough left the hospital system, all of his practices, all of his techniques, which were absolutely proven to work, were completely ignored and thrown away. And now we treat emphysemics the same way we were treating them in the 50s and 60s.
Dr Rupy: I've seen plenty. Yeah, I used to one of my first rotations was in respiratory medicine during my general practice training. It was in respiratory medicine. So the the face you just pulled there for for the audio listeners of that stressed sort of wide-eyed, panicked. That was something that has never left me. It was haunting watching some of these patients at the latter stages of their life because it was the shallow breathing and just not being able to and it never occurred to me that breathing exercises could have given some release, not by magically fixing the emphysema, which is something that is incurable. You can't reverse the the damage to the alveoli there. But something to give release, relief because of the ability to exhale and actually took taking a deeper breath in using the diaphragm exercises that you just talked about. I think there is a nugget of how we utilize that in medicine already. So when someone has a damaged rib, either a fracture or a bruised rib, you tend not to be able to take a full breath in because as soon as you take a deep breath in, you get pressure on that area and then oh, it it hurts. So you end up shallow breathing as a result of the pain. And we always remind people in conventional medicine to try and take deep breaths as much as possible because if you don't ventilate that area, you are more likely to have pneumonia. And so that is definitely established fact.
James Nestor: So that's an established thing. I did not know that.
Dr Rupy: Yeah, there's definitely something there for sure. And it makes perfect sense that you should be trying to ventilate as much of your lungs as possible to prevent things like pneumonia.
James Nestor: Yeah, and I'm not going to say like just changing your breathing is going to cure all people. I would never say that, but I think on the other hand, I think it would be really hard to make a lot of progress if someone was dysfunctionally breathing to to such a degree and you didn't fix that foundational element. And just an anecdote, this was not a scientific study, but somebody I knew that that I met at a workshop mentioned that her mother had very, very severe emphysema for 20 years, hadn't been able to walk up a staircase. This is just a story. I want to be want to be clear. Within a half an hour of retraining her with some free, simple methods, her mom got up and walked up the staircase. Placebo effect, maybe? Or or it or it could be that we have been completely neglecting these people with something that is so simple and so foundational. And that's why I continue to do these podcasts because I think people need to hear this. You don't need to get, it would be helpful to get a respiratory therapist to lead you through it, but you don't even need to do that. You need to follow some simple basic steps.
Dr Rupy: So for someone who's listening to this and maybe they don't suffer from an obstructive pulmonary disease, how do we retrain that diaphragm? How do we reconnect with this incredible respiratory muscle that can give us more air in and the ability to exhale properly as well?
James Nestor: The first thing is I would start with the easy part, which would be inhaling. So if you take your hand and place it just below your belly button, as you take a breath in through your nose, you should feel a slight expansion down there, okay? Ultimately, you want that 360 degree expansion. Work on that later. Just focus on the belly right now. So many of us hold so much tension here in our guts that we're embarrassed to take a full breath or our pants are too tight. If it's comfortable for you, just unbutton your pants for for a moment and just take that breath in. If you can't do that, what I found is about 90% of the people cannot do that. They're either uncomfortable or they've lost the muscle coordination to do this. This is foundational. Along with the nasal breathing, you have to be able to do that. Once you've gotten that down, let's say you're one of those 10% of people, you said, no problem, I do my yoga, I do my pranayama. You have to then learn how to take a full exhale, an exhale. And one practice that Carl Stough had his patients do is you'd inhale and you would count from one to 10 as many times as you possibly could, even when you run out of air. One, two, three, four, five, six, seven, eight, nine, 10. One, two, three, four, five. And as you're running out of air, you're still counting. One, two, three, four, five, six, seven, eight, nine, 10. One, two, three, four, five. And then you're just mouthing it. One, two, three, four, five, six, seven, eight, nine, 10. And as you're doing that, by vocalizing this, this nudges the diaphragm up even more, even more. He said it's very important to vocalize it. And so this can jack it way up. Don't push it too hard, okay? Just do it a little bit. And if you practice that for a couple of weeks, it doesn't have to be a few hours, just a few times a day, a couple of weeks, you can probably, still no studies on this, you can probably help expand the incursion and excursion of that diaphragm, right? Because you're waking up this muscle you have not you have not used in a long time. So inhaling is usually easy for people, exhaling is a little more difficult. That's why they're having elite athletes do this. This is the first thing that they're doing now is is breath training before anything else. It's like, if if you aren't able to breathe efficiently, you are wasting energy. You're not going to be able to compete at a top level.
Dr Rupy: Yeah, that's amazing. So I I guess like if people are trying to exhale without doing the vocalization, you have less pressure at the top when you're trying to expel. So when you're vocalizing, maybe that is creating a very mild pressure that's actually like training, physically training the diaphragm. Am I getting that right?
James Nestor: It is. Uh that's what Stough believed, right? That that's what he believed. And the proof of his beliefs like that adds validity to it is these people were able to to walk away from from the hospital. So I hope more people start, I hope somebody that's really qualified hears this and starts adopting this and putting this into basic protocols. One word of warning, if you suffer from extreme emphysema, go very slowly. It's like you wouldn't run a marathon if you've just been sitting on a couch for a couple of years, you know. Go very slowly. Maybe just do that three or four times. One, two, three, four, five, six, seven, eight, nine, 10. One, two, three, four, five, six, seven. Okay, if you feel a lot of stress, then then stop and slow it down. So all these things, when you're waking up a muscle that hasn't been used for a long time, the body doesn't like to be jolted, right? So just go slowly, go go carefully.
Dr Rupy: Yeah. I use the same analogy with fibre. You know, if you're not used to eating that much fibre in your diet, the last thing you want to do is eat a can of beans and, you know, because everyone, you'll know about it, everyone else will know about it. And it's the equivalent of going up to the gym and trying to deadlift your own weight when you've never been to the gym before. So you want to go slow. I appreciate that that caveat there. Um I want to go back to chewing because you did some exercises to improve your facial structure that sounded pretty astounding to me. What were some of the exercises you did to improve your facial structure in the context of of of chewing and expanding the the mouth?
James Nestor: So I had heard this as well. And then I looked at numerous scans from numerous people. And what these scans have said, scans don't have opinions, right? It's only data that that you're looking at. And it's objective. But these scans truly showed that something was going on. We have the suture right up here in our upper palate that the dividing line behind between that upper palate is an opening, right? And that can expand at any time in our lives. So it's very easy to do this when when you're young and developing. That's why that upper palate for an infant is like soft. It's like putty, right? Because everything is expanding. So you can change your facial structure and your airway health at any time of your life. And so after hearing enough of these stories, I'm an investigative journalist. This is what I've been writing about science for 20 years. I said, well, I'm a perfect candidate for this. A kid who had extractions and braces. My mouth was already small and then after all of these procedures, my mouth was so much smaller than it would have been before and my airway was as well. And this is what we're finding. All these practices that I had to suffer through. Hopefully in the next few years, no kid in the future will have to suffer through it. But I wanted to see how much I could do in a year. And so I used this contraption, this retainer I had to wear every night. It was awful. I did not like it. I did not look forward to it. But it had this little dowel at the top of it and it just every few days, I would open it just the tiniest little bit and it would expand the upper palate.
Dr Rupy: Oh, wow.
James Nestor: Yeah.
Dr Rupy: So it's literally like just like widening the
James Nestor: Just widening the upper palate because you have that suture there, right?
Dr Rupy: That sounds very painful.
James Nestor: And so it wasn't because it was so gradual. What a lot of dentists do now is they do it very quickly. So they they put this contraption up there. They actually surgically drill it in and they open it in in a few weeks. It's this rapid expansion. And it just gets that out of the way instead of doing it for a year. So I wore this thing almost every single night. I think there were two or three nights where I was sick or something happened and I didn't wear it, but but almost probably 350, you know, nights out of the year. And I went back and took a scan. So I took a scan before and I took a scan after. And I grew four pennies worth of bone in my face. So a lot of people think, well, weren't you worried there would be like a horn here or there would be like it would grow in the wrong place. But the body is always growing for symmetry, right? The body is going to fill in what it is lacking. The body is very, very smart. So in all these places that were deficient, it was so trippy looking at this scan, this bone was filling in. So this was six years ago, seven years ago I did this. And I still have this retainer. I've been getting a lot of crap from a lot of people. They're like, well, you have to do it again and see if the same thing happens. So I'm going to start again. I don't know if it's going to be for a full year. I really don't want to do it for a full year. Don't make me do it for a full year, please. Uh maybe six months.
Dr Rupy: Six months.
James Nestor: And I'll take some scans and to see if the same thing happens. But we believe that the same thing is happening uh the more that you chew. So and this is another study. I've got a lot of study ideas. No one seems to be interested. That if we go back to chewing the way that we were supposed that we were designed to be chewing, which is, you know, two, three, four hours a day, but even an hour a day of hard stuff, it could be a hard piece of gum or something, that stress, a lot of dentists believe, can help regrow, I won't say regrow, will help build more bone in deficient areas of the face. And again, very easy thing to do. Scan before, chew for three months, scan again, chew for three months. Um we know that chewing has all these other benefits. It helps to tone the airway. Our airways get flabby, makes them more susceptible to So we know all that, but what is it doing for for bone growth? And uh I hope to I have not been chewing as as religiously as I was before when I was doing all this experimentation. I need a little break, you know, I try to eat good food and all that. But I do that is on the bucket list for this coming year is to start developing a little regimen and do my own N1 study taking a scan and then three months later and then three months after that.
Dr Rupy: Why have we lost the ability to chew just naturally through our food? Like what what has happened to food that has meant that you're literally eating gum to sort of mimic the actions of our ancestors?
James Nestor: So we all have the ability, most of us have the ability to chew, right? We we can do it just fine. We live in environments where we aren't given that choice. If you look at how soft food is, so it comes down to chewing. This is why our mouths have not grown to the size that they were 400, 500, 600 years ago and and on back. We don't chew. And you can trace this down to the exact moment when a culture adopted industrialized food, 50% of the population, 5-0% of the population developed crooked teeth in a single generation. So people say, oh, evolution takes a long time, hundreds of No, it doesn't. You could call that evolution or devolution, whatever you want to call it. And then after that, 70% of the population, then after that, 80% of the population, and then here we are, 90% of the population has some sort of crookedness in our teeth, some sort of malocclusion. So we know that. That's that's a fact. There are numerous researchers that have gone around the world and proven this even in animal models over and over and over again.
Dr Rupy: Which generation was this?
James Nestor: This was it it it depends where So Britain was one of the first countries to truly adopt an industrialized diet. Guess what happened to the teeth of people in the Victorian era, you know, and and right before that. And you see these pictures, you know, these cartoons of of British kid with crooked teeth. A few generations ago, this guy would have had perfectly straight teeth. And if you had gone to the country at that time and looked at kids eating a real diet, they would have had perfectly straight teeth, which is the same reason why kids in the city had rickets, then they went out to the country and they're like, why don't any of these kids have rickets out here? Their bones are perfectly straight. It's the same thing. It sounds nuts, but but this is again, it's not a theory, this is this is a proven fact. So that soft diet, even though we've changed the nutrient in our in our diet, well, many of us have. A lot of us still eating ultra-processed foods and all that. The consistency has remained the same. If you think about smoothies, avocados, I love avocados. I eat a lot of avocados. Oatmeal, yogurt. You think about what you ate today, not you, because I'm sure you're eating some super healthy thing that requires a lot of chewing. But what most people ate today, oh, I had a muffin, I had a croissant. How much chewing is involved in your day-to-day life? And the answer for most people is basically none. Chomp, chomp, swallow. Chomp, chomp, swallow. If you think about what is required to eat a carrot that hasn't been boiled, eat celery, eat, you know, raw meat if you were a million years ago. You are grinding away on this stuff. And in some cultures, you know, they chew on sugarcane. Right? On sugarcane. And guess what happens to their mouths? They're enormous and their teeth are perfectly straight. Because that sugar also affects us differently than, you know, you're eating sugar in a packet.
Dr Rupy: Yeah. That's amazing. I mean, speaking honestly, if I think to what I had this morning for breakfast, it was pretty soft. So it's still healthy to your point. It's still nutrient dense.
James Nestor: Absolutely.
Dr Rupy: So I had uh what did I have? Jumbo oats, flaxseed, mixed seeds with with, you know, sesame and some some other flax and sunflower seeds in there. Uh some whole apples that I'd chopped, some raisins for a little bit of natural sweetness, and I might have done a topping of like some some crunchy bits, like some crunchy nuts or whatever. But the nuts were the only hard bit. Everything else is pretty soft. So even though I would regard that macronutriently and from a micronutrient point of view as complete, it's definitely not complete from a chewing perspective. So that's a that's an oversight for me.
James Nestor: Yeah, no shame. I had an avocado, you know, and and a piece of salmon. So zero zero chewing involved in that. But once you be that's why I wish that there was some study, you know, I wish that there even though we know what's going to happen, if there was a study done in modern times in a very controlled condition that wasn't a pig, they've done plenty of them with with pigs that just showed people what a difference this can make to your airway health and even bone density and even your profile. Like I think that people would take it not more seriously because it's already serious enough, but they'd want to incorporate more of this this basic thing that we have been designed to do that we aren't doing. We're exercising every other part of our body. A lot of people aren't, but they're not exercising the airway, which delivers the most energy for you. Like air air over food. You know, it takes six oxygen molecules versus one one glucose. So you need a lot more oxygen and air than than you do foods.
Dr Rupy: I love that. Okay, so for for those of us who don't want to use the retainer that you don't even want to use to sort of improve the the the width of their their upper palate, are there exercises or products that you would say have some reasonable evidence that it's worth trying?
James Nestor: So there there are. For kids, very, I want to start with kids here because it's so much easier to build a good foundation when you're young and then you'll carry that foundation with you the rest of your life.
Dr Rupy: Music to my ears.
James Nestor: For for kids, myofunctional therapy. Um it's absurd that in the modern age, we have to have therapists that retrain kids how to swallow, how to speak, how to hold their tongues and hold and the proper oral posture for their mouths. But we need that. And so many kids benefit from this. So once you do that, then you can start to establish better airway health, better nasal breathing. Myofunctional therapy, terrible name. They need to rebrand that to something easier to remember. If you don't want to go to a myofunctional therapist, you can look up on YouTube or whatever, myofunctional therapy or oropharyngeal exercises. Another terrible name. Oropharyngeal exercises. And all these are are exercises for the tongue, for the mouth. They look really goofy, but they allow this area to develop properly. And kids with speech impediments, kids whose teeth are chronically crooked, who are having a bunch of cavities over and over, kids whose parents are worried about their facial growth and their airway growth, this could really, really benefit you is myofunctional therapy. As adults, once once things are set, it's a lot harder. But that doesn't mean you can't improve it, right? It's a lot harder to move the skeleture and build bone mass and all of that. But you can do these exercises as well. For people who have uh snoring or or mild to even moderate sleep apnoea, there's a few studies that have been shown that doing these exercises can significantly reduce snoring and even sleep apnoea. There's a few official, like very legitimate studies. To me, it makes sense. It's like this area in the back is flabby. It's much more susceptible to flap in the wind as you take an inhale in, then if you could tone that out up and allow that breath to to come in and not be so disturbing, then that could allow you to sleep better. Patrick McKeown, a famous respiratory therapist, to me knows more about breathing than than anyone else in the world. Like he is rehabilitating people with sleep apnoea with only breathing. And he showed me this this trick. So one of the things that he does is he teaches people to breathe much more slowly and breathe much more lightly in the daytime. And he believes that that carries over to their breathing at night. So right now, if you were to breathe through your mouth, a very deep and heavy breath, it's very easy to make a snoring sound. Everyone can do that. Now close your mouth, breathe through your nose very slowly, very lightly and try to make that sound. You have to struggle to make even the slightest slightest sound. So he believes and there's hopefully a lot more research going to be coming out around this too, that establishing those healthy breathing habits, firming up that airway through these oropharyngeal or myofunctional therapy exercises can allow people with these chronic conditions that are really bad news. Like snoring is bad news. People now know that sleep apnoea is bad, but snoring is really, really bad as well. That this can help you and it's free and it's easy and it's available for everybody.
Dr Rupy: Are there uh exercises, I mean, we're inundated with questions about mewing and certain gums and that kind of stuff. Like is that in the realm of potentially, you know, has some benefits or should we really be thinking about these oropharyngeal exercises, the myofunctional therapists first before we even think about those?
James Nestor: Uh I can give you my opinion. I don't know. Um I I think that mewing for instance has been really under-researched. I think that Mike is Mike Mew wants to get it researched. Nobody is taking this up. So I would start with the the first foundational elements like proper oral posture. You could mew for 20 minutes a day, but if you go back to the rest of the time with your mouth, then then who cares? It doesn't matter. Start with the basics, build the good foundation, then explore these other things. The latest thing for for these kids, I don't know if you've seen this, is they're doing this this pulling of the upper part where they get two thumbs. Oh my gosh. And they pull it out. I have no opinions on this. Could be a bad idea. At the same time, I can't believe I'm going to say this. At the same time, the premise kind of makes sense, right? It's a cheap and dirty way of doing something, but you could also be messing yourself up. So I am not condoning any of these practices. I'm telling you what's out there. Be careful, beware, be skeptical. Proceed with caution.
Dr Rupy: These kids can't afford the retainer.
James Nestor: I think they probably can, but you know, it's cooler to sit around in class doing this. To answer your question about the gum thing, this this is something that I actually thought that this study was going to go through and then then it then it fell apart is to give people some very hard gum, sugar-free gum, like very hard gum and have them just chew it for half an hour a day and have another group chew it for an hour a day and then have a control group and to take those scans and look at the airway and look at bone mass in in the face and to see what what changes because for people who can't go out and source their own whole food diet all the time, I travel all the time, you know, the the food in airports is just absolutely garbage. Like you have to, you should see my bag filled with bananas and avocados because I'm flying out today. Like it's it's a disaster. So if there was like some sort of gum that could mimic chewing and then you combine that with proper oral posture, right? And this shows a change in the in the positive direction, then that would be pretty interesting.
Dr Rupy: I feel like we've we've covered some of the basics here in terms of oral posture, chewing, nasal breathing, making sure that you're not breathing through your mouth as often. Um but there's a part of the book where you it's almost like we're manipulating the breath to improve, you know, longevity or like have some um some some benefits, biohacking the breath if you like. Overbreathing. So it seems like, you know, there there are circumstances where we are breathing too quickly already, but there are benefits if you were intentionally overbreathing. Can we talk to that?
James Nestor: Yeah, this is why I put this at the back of the book. So at the beginning is all about developing that foundation. You first need to become a normal breather. So so many of us are breathing in a suboptimal way. We we know this, right? We're breathing dysfunctionally, either through our mouths or or too shallow or whatever. So the first step to all this is to become normal. Once you're normal, we can play around with it and see what else it can do. What frustrates me about breathwork culture right now, which is getting very big, is people who are so far down here, who suffer from chronic respiratory issues are going straight into vigorous hour-long breathwork. I don't think that is healthy. I don't think it's beneficial because they go, they do it for 20 minutes, say, oh my god, I got so high, I feel amazing. Then they go back and snore and choke on themselves all night. So do the boring stuff first. All the stuff we've talked about, it's not really fun, you know. But once you establish it, it becomes your default habit, then you can do the fun stuff because once you're normal and start experimenting with this other breathwork, it will take you so much further to some really, really crazy places. And that's what I tried to, that's why I call it breath plus. So this is this is the plus part, but you have to get the breath part out of the way first. And it it seems contradictory that I'm saying people are overbreathing, they're huffing and puffing through their mouths, and then there are these practices which have you overbreathing and huffing and puffing through your mouth. The big difference is one is done unconsciously. You don't realise you're doing it. The other is done consciously for a purpose for a very short amount of time. So if you are for 8, 10, 12 hours a day, it is awful for you, okay? We we know that. If for 20 minutes a day, for a half an hour, even if you maybe you go on a retreat and you do it for an hour at a time, there are so many benefits to be had by adopting a conscious overbreathing protocol because almost all of those, actually every single one I've ever done and experimented with, they have you overbreathe, hyperventilate, and then they have you hold your breath or breathe extremely slowly. So this puts you in control of your nervous system function. So throughout the day, it empowers you to take control of stress, which is why so many of these different breathing modalities have been proven to be so effective for people with chronic anxiety, even autoimmune issues. That's what Wim Hof method is showing. Sudarshan Kriya, extremely effective. And what is it? They all do the same thing. Overbreathing to to calming down. Parasympathetic to sympathetic, to parasympathetic to sympathetic. Hot sauna to cold bath. Hot sauna to you see what's happening here. And I find them to be extraordinarily beneficial once you've established proper habits.
Dr Rupy: Let's assume we've established these proper habits. We're practicing some of these different overbreathing techniques. When you say you found them beneficial, in what way are they beneficial? How do they give you, I don't know, whether it's calm, whether it's um clarity? What what are those benefits and and what is the potential mechanism behind them as well?
James Nestor: I can talk about what we know from a scientific perspective, then I'll talk about my opinions, which are my opinions much less important than than what has been established. So what the studies have been finding is that the majority, not all of them, the majority of chronic diseases right now are tied to chronic low-grade stress. Stress that just keeps. And so our blood sugar goes up, right? Our cortisol stays up. We can't sleep. And you can get by like this. A lot of people do, especially when you're younger, you can keep cranking it, but your body is going to eventually break down because it's designed to handle stress. It's really good under stress, but it needs that reboot. So this allows you to reduce that chronic low-grade stress. You look at what happens to heart rate variability, very easy measure that you can take before and after these practices and it's extraordinary. And then they've even done studies looking at people with chronic anxiety, even asthma, you know, PTSD, and have found that it has really significant benefits across the board. Sudarshan Kriya has 100 scientific studies on done at Yale. And you know, so it's it's a it's a very real thing. And Wim Hof method as well. That's much more hardcore if you do that. It's it's very strong, very macho. Some people like that. Uh I love it. I think it's very fun to do, but it's not the end all be all. And they're they're finding that that is extremely effective for autoimmune diseases, chronic inflammation. How do I get rid of this inflammation? You stress the body out, give it something to be inflamed about, to be furious about so that the rest of the time when you get out of the ice bath, it's chill. It's a, okay, now I need to prepare for the next emergency which is happening tomorrow at 8:00 a.m. when I have to go into this ice bath. It's extremely stressful for the body. So you're turning on that lever and you're turning it off. So from a personal standpoint, I love, you know, people think I wrote this book about breathing. I'm just hanging out, just breathing, just chilling. I live a completely stressful, chaotic life, right? I use these to keep grounded and at least once a week, I'll do like a big long breathwork session. And personally, uh I've I've found them to be really transformative. That's what convinced me that there was something interesting in this in this subject is someone who had chronic respiratory issues, who was getting pneumonia all the time, who was getting bronchitis all the time, who was told by his doctors that I just need to take more antibiotics and back at the time, 14 years ago, 13 years ago, I believed them and and took antibiotics, but I wasn't getting sick for lack of antibiotics. I can't imagine what I did to my gut microbiome at that time. You know, I I was sick all the time because of my dysfunctional breathing. And it took one of these breathwork classes to completely kick me in the butt. Like it it it slayed me and uh rebooted me in in a way that nothing else has done. And I continue to do that practice. I try to do it every single week and it's a nice reminder of that was back then. I'm still doing it. I still see and feel the benefits.
Dr Rupy: Totally. I I completely get that. And I think a nice parallel to get people to understand why this might have benefits as a stressful activity is um exercise. So when you exercise, if you were to put a blood pressure cuff on, measure your cortisol levels, look at your glucose levels, inflammation levels, everything's going to be sky high, right? And you could conclude this is not a good thing for you to do. Um but when you look at the benefits over time, you can see that it's improving the body's resilience to stress and inflammation. And so that was going to be my next question about these overbreathing techniques. This clearly going to be a dose because in the same way we can over-exercise and overdo it on HIIT training and cardiovascular cardiovascular aerobic exercise, there's probably a dose response for overbreathing techniques or all all these breathing exercises. Um so do we have any idea as to how we titrate the dose of breath exercises for folks?
James Nestor: It depends on who you are, what stage you're in, right? And I heard this from somebody who had been practicing yoga for about 30, 40 years. And he told me this. He's convinced that most of the benefits to be had from exercise, almost the exact same as doing these vigorous breathing techniques. Not not the normal boring stuff we were talking about, but he said if you really look at what happens to blood flow, if you look at what happens to the circulation of the lymph, if you look at what the diaphragm is forced to do, it's going down, taking this huge breath, massaging these organs, creating this movement in your body. If you look at what happens to blood flow in the brain from holding your breath for three minutes and going back to hyperventilating, another study for you to take two groups of people, have them exercise and then just have the others do some vigorous breathwork and see what happens to their blood pressure. See what happens to all the other facets, all the other markers of health, even blood glucose, you know, all these different things, CRP. I think it could be very interesting because the people showing these extraordinary benefits from Wim Hof, they're not out exercising. They're not out walking. They're breathing and they're going in a cold bath and they're sleeping and that's it. So I think if you look at both of those diagrams, I think that there's a lot of crossover. Is it 50%? Is it 70? Is it 90? We don't know. From what I've seen, no one's done that that study. But if you look at the benefits of both of them, they're very similar. Not to bone mass, we we know that just sitting there doing that probably not. But for almost everything else, it seems similar. So for people who are exercise averse, who just don't want to do it, lying down on your couch and doing some of this breathwork for a half an hour in the evening, I think it could be really, really beneficial.
Dr Rupy: Yeah, absolutely. And you know, these benefits seem to extend beyond what we understand to the supernatural, right? So there were some stories in your book about monks that live in the Himalayas and they can do these breath exercises, not even as vigorously as a Wim Hof. It doesn't look like they're doing a breath exercise, but they they do this to keep themselves warm such that there are circles of melted snow around them when they're like sitting in the Himalayas. And then some other stories of people being able to change their heart rate in the flick of an eye. And then obviously, you know, the Wim Hof stuff where he's able to fight off E. coli when he's literally injected into him. And I think that was published in Nature if I'm not mistaken. So how what it just seems weird.
James Nestor: So now we're at the very edge of what is established and what is known and we're talking about data and and then there is this other field that you can go into. I don't get too into that because my personal, what I'm experienced personally should not be of interest to anybody, you know, and I don't want it to be. I hate those books that it's all about someone's personal. That's not helping anyone. But there is so much of that that other field. You could call that field whatever you want. You could call it spiritual, you could call it metaphysical, bioenergetic, whatever. There is something that that happens and I hope that we develop better instruments to start to be able to measure it so people take it more seriously. People that have seen it, that have gone there regularly, know it's there. And what I think is interesting is are these cases, these monks who specifically are are doing something that should not be possible. Any medical textbook says this is impossible. And yet there they are doing it. They've been doing it for thousands of years. They're able to decrease their metabolic rate by 40%, like lower than someone in a coma, and yet increase the heat in their body by 17 degrees Fahrenheit. 17 degrees while decreasing their metabolism. And people say, well, that's impossible except Herbert Benson at Harvard Medical School went out and measured this repeatedly. So we have all the data. Right at that point, I noticed people that don't want to hear those stories, that's fine because what they're tied to is much more their own belief system than it is science. Science should be the exploration of the unknown. Anything that's measurable should be studied. That's what I believe. Even if it's the craziest thing you've ever heard about, well, prove it wrong and measure it. And when people say, oh, you shouldn't be doing that study, you shouldn't be measuring this stuff. Like where would we be if people weren't asking these questions? So, you know, my personal experience is after doing some of these vigorous breathwork techniques that can go on for hours and you're you're it's pedal to the metal the whole time. A whole bunch of weird stuff happens and we can explain some of that through biochemistry. It's like there's a decrease of blood flow to the brain, around 40% decrease of blood flow to the brain. So the brain thinks it's dying. So it defaults and and goes on the fritz in all these crazy ways. You start hallucinating, you start thinking of things you haven't thought about in a while. So that's what we stand, we understand biochemically, right? But the other side is there's still a lot of unanswered questions in there. I love those unanswered questions, you know. Um and to me it makes it exciting to live in this world that there's still so many very large, very significant unanswered questions.
Dr Rupy: Absolutely. I mean, we I love diving into what we know and what is established in the science, but also the lost wisdom of traditional medicine. And we recently had an Ayurvedic doctor on and he has spoken Sanskrit since he was age three. And my impression of Ayurvedic medicine was very much whimsical, sort of old wives' tales, but actually it's a system of codified experiments based on plants and lifestyle practices that have been chronicled for thousands of years. And so it was science before we knew, you know, what evidence-based medicine was or what we believe it to be today. There is something there that is absolutely fascinating and I I want to pull on those threads even more, but to your point, you know, until we have the data, it's very hard to explore them in their entirety. But there is something there that just interests me on a personal, even if there are anecdotes, I just I love that stuff.
James Nestor: Yeah, and I think that with new technologies, we're finding so much of these practices which have been, to me, if they've been around for thousands of years, there's there's probably a reason, right? There's probably maybe they were really good at giving people the conviction that they could heal themselves. So there's there's some fantastic placebo. They're still healing themselves, you know, and and I think traditional Chinese medicine is is the same thing. The more we're starting to find about acupuncture, something that has been dismissed forever by the scientific community. Now we're actually able to measure it and it's throwing our map of biology out the window right now.
Dr Rupy: Yeah, yeah. I mean, you can get acupuncture on the NHS, so there is a um a recognition that acupuncture and acupressure and some of these remedies that, you know, when I was in medical school, it's like, if you even think about reading a book on that, you're a quack. And now it's, yeah.
James Nestor: But this is how it's always been. I mean, we we think that it's so bad now, people are so close-minded. You go back to any time in history and when something was introduced which challenged someone's modality or practices, that person was just thrown out immediately and ridiculed. And then 20 years later, they're like, oh, now it's standard practice. So I prefer to look at a longer arc. What are these practices that people continue to benefit from? What do we know that they were at least from ancient scriptures, they were benefiting in the past because what they have, what they had and what they have now and what we don't is they had time. They had generations to look at, huh, those families over there are all dying really early. These are, you know, these families are doing well. What are they doing differently from this village or this village or this village? And I think that there's real knowledge in these multi-generational, you know, casual studies that these guys were doing. I've seen some things in traditional Chinese medicine which should not be possible. I've seen people do things that are miraculous and yet they're it's just like any other day for them. They're like, this is what I grew up with, this is what I do and we know it works and if you want to continue to deny it, that's cool because we're just going to be over here healing people, you know, doing our own thing.
Dr Rupy: Yeah, yeah. I want to briefly touch on um holding one's breath and the role of carbon dioxide. I've thought, you know, carbon dioxide is something that is a toxic molecule, you know, something that we want to try and reduce um people's exposure to, but there there's clear evidence to the contrary. I wonder if you could talk to us a bit about breath holding and the role of carbon dioxide as it pertains to breathing properly.
James Nestor: So breathing, just like eating, everything else, it's all about a balance. And when I talked about carbon dioxide levels and how many of us would benefit from having higher CO2 levels in our bloodstream, what I was really talking about is we're again down here. It's about getting normal, right? Because when you overbreathe, you are you will exhale more CO2. We know this. This is why if you're hyperventilating, you feel lightness in your head, tingling in your fingers. This is from a lack of CO2 in your bloodstream. So those blood vessels start cramping up, right? Causes this inability for for blood to circulate efficiently. So having more CO2 is beneficial for people who have suboptimal CO2 levels. And one way of training yourself to tolerate more CO2 is to practice these breath holds. For some people, asthmatics, people with anxiety, it's extremely effective to practice short breath holds because it allows them to become more comfortable with breathing more slowly. And so many of these people with asthma and panic, they will exacerbate their attacks by overbreathing, then overbreathing more and overbreathing more when they should be breathing less, doing a small little breath hold, allowing that CO2 to go up to allow that blood to continue to flow. So breath holding is another one of these things that dates back, I found evidence of it, you know, from 4,000 years ago, you know, uh in the books of the Dao, there's 12 books dedicated entirely to breathing. All the awful things that are going to happen if you do it incorrectly and all the health benefits of doing it correctly. And they're always talking about breath holds. Wow. So breath holds as a diagnostic for your breathing health and as a therapy to help allow your body to tolerate more CO2. So when you feel that need to breathe, that's not dictated by oxygen. It's dictated by rising levels of CO2. And once you understand that, I had no idea about any of this until several years ago. I was like, what are you talking about? It's not oxygen. It's rising levels of CO2. If you can tolerate more CO2, you're more comfortable taking these very slow, fluid, deep breaths, which is so beneficial for your health.
Dr Rupy: And I guess if we're able to tolerate more CO2 in our body, in the same way, you know, if you tolerate more lactate as a production of um aerobic respiration, anaerobic respiration, your performance is like to improve as well. Um how what is the the sort of ideal frequency of breath? Like how how does that have an impact on that?
James Nestor: It it depends on who you are. It depends what age you are. You know, young infants, young babies will breathe what twice twice the amount, three times the amount that that an adult will. So the point to having that balance is we need carbon dioxide in order for oxygen to do its job. So we have blood in our veins and that blood is saturated with oxygen, but it is completely useless. That oxygen in our bloodstream doesn't do anything unless it detaches and goes to these hungry cells so it can make energy, it can make ATP, right? And we we know this. So you need the proper amount, a balance of oxygen and CO2. We're always looking at oxygen levels. Of course, oxygen levels are important, but oxygen levels without a balance of CO2, your body is constantly playing catchup. So I think that's that's the fundamental thing. Um as far as there's there's no specific line of advice for people because it depends on what you're suffering from and what you want to do. What we do know is that the longer you can comfortably hold your breath, the more functionally you're breathing, the better your body is working. And the shorter you can hold your breath, that shorter amount of time is usually a big red flag that you're breathing dysfunctionally. You ask an asthmatic or someone with anxiety to hold their breath, you'll get maybe if it's severe, five seconds, six seconds. You ask someone who has been breathing properly, who's focused on their health to hold their breath, you get a minute and a half, you know. You ask a really trained person to do it, you'll get four minutes, five minutes. Rangan was able to hold his breath for for four minutes.
Dr Rupy: Four minutes, really?
James Nestor: Four minutes.
Dr Rupy: I'm going to have to beat him.
James Nestor: It's on. So it's it's that spectrum, right? Not everyone, you don't need to be healthy to hold your breath for four minutes, but I would say on an exhale, if you can comfortably, comfortably, that's very important, hold your breath for 40 seconds, 45 seconds, there is usually a very, very good chance that your breathing is pretty good. Anything below that, you've got some work to do. When I first was starting off doing this stuff, I had about 30 seconds, you know, 30 seconds. And then after some training, especially free diving training, I can do it much longer now.
Dr Rupy: How long can you do it now?
James Nestor: We'll have to, maybe I'll try it and we'll just sit here in silence. It's not going to make for a very interesting podcast, is it? You can put some sort of placard over this and just say, we'll be right back. We'll speed it up. Yeah, there'll be a clock on it.
Dr Rupy: That's amazing. Um James, your book is incredible. Honestly, I've absolutely loved diving into with you in person. I'm so glad we got to do this in person before you go back um home. If there were, if someone's listening to this and they want to get started, right? And they want to they want a quick win, um and then let's make the caveat that they don't have a a severe respiratory issue. What's what is one thing that you think would be a good takeaway to get them on the path of thinking about breath as a means to improve their health and well-being?
James Nestor: The very first thing I would do is to look at your breathing at night. If you're snoring or have sleep apnoea, you have to fix that. If you're breathing through your mouth, it's not a total emergency, but you should fix that. So people think this is so counterintuitive. They're like, give me the the breathing technique, give me the magical thing. No, because you can do that all day long, but if you're breathing through your mouth or breathing dysfunctionally at night. So there are various apps that you can download. I'm not affiliated with any of them. Don't get any money from any of this stuff. Um one's called SnoreLab, the other's called SnoreClock. They all work the same. Place your phone tonight, I challenge you, place your phone on the side of your bed. It can be in airplane mode, so it doesn't have to be on. And these record you throughout the night and they record your breathing. And they'll give you a score in the morning. And you can go back and listen to yourself at any time during the night. If you can hear yourself or if you're snoring or if you're choking on yourself, there are a number of different things, a very long list you can do to help fix that problem. But I would actually start at the nighttime and then work then we'll get into the nasal breathing, then we'll get into the slow breathing, we'll get into the deep breathing. But you you see the what I'm trying to do is start on the very basic thing before you go way up high.
Dr Rupy: Absolutely. I'm 100% going to do that tonight. I've actually started mouth taping um recently. We had Stacy Whitman on and another one of my friends.
James Nestor: She's a good friend of mine.
Dr Rupy: Oh, really?
James Nestor: She didn't tell me that.
Dr Rupy: There you go. We had to do it by Zoom, but when she comes to London later on this year, I'm going to try and get her on again in person. But she's wonderful, as is a good friend of mine, Dr. Victoria Sampson. And uh she got me thinking about mouth taping. So put it on whilst I was cooking, put it on during the day until I was comfortable putting it on at night. And um my sleep scores are really improved. Anecdotally, you know, but it's
James Nestor: It's data now. I mean, there's thousands and tens of thousands of people that are reporting this.
Dr Rupy: And that is another thing, much more fun. People are like, what, I listened to this whole two-hour thing and you're saying to put a phone by by my freaking bed. This is so disappointing.
James Nestor: How about this? We'll edit all that out, right? Go out, get some surgical tape. Surgical tape is meant to be put on skin and taken back off. Get a little piece of that surgical tape. Do not wear it at night. You're going to wear it answering emails for 10 minutes, watching TV for 10 minutes, doing the dishes for 10 minutes. If that is comfortable, you can increase it the next day to 20. If that's comfortable, you continue doing this until you're comfortable enough to have your mouth closed, be breathing in and out of your mouth or in and out of your nose, and then you can experiment with wearing it at night. This little sleep tape thing, it's only a couple paragraphs in the book, but man, it just keeps on giving this gift. All these sleep tape people keep coming after me because it's saved marriages according to them. Um seen incredibly uh beneficial, significant benefits to their sleep. And I'm one of those people. That's the one thing that the Stanford experiment really showed is night and day difference. Full on snoring, mouth breathing, everything gone, wearing this little piece of tape. I still wear it to this day.
Dr Rupy: That's amazing.
James Nestor: By my bed stand at the hotel, a little roll of tape.
Dr Rupy: So start start with that. That's a lot more fun.
James Nestor: Yeah.
Dr Rupy: I love that. I'm definitely going to be humming a lot more and I want to look into some of these practices to help me sort of relax before I do something like a speaking event or a podcast that I'm nervous about or something like that, just to sort of like reset. Um actually me and the team before we do a YouTube video, sometimes we do do breath exercises just even through the nose and out through the mouth. But I'd love to dive into some of these more specific exercises um for for stress relief and and what the data shows uh there. I think there's so much to explore there. So much. James, really, really appreciate your time. I'm going to send you home uh to Heathrow Airport with some lunch, hopefully, that should be delivered in a second. I just want to say absolute pleasure chatting with you and sitting down with you. It's been brilliant.
James Nestor: Thank you very much for having me.
