Author: Patrick McKeown

Topics: Breathing

All information is attributed to the author. Except in the case where we may have misunderstood a concept and summarized incorrectly. These notes are only for reference and we always suggest reading from the original source.

Forward: Dr. Joseph Mercola

Those that live at higher altitudes live longer. Reduced caloric intake and reduced pressure of oxygen are two candidates for why this is the case. Too much oxygen can prematurely damage your cells by the production of excess free radicals during the metabolic process. They damage lipids in your cell membranes, protein, and DNA. By exposing yourself to high altitude training, you are reducing oxygen intake and forcing your body to increase your blood’s oxygen carrying capacity and maximum volume of O2 you can use (VO2 max). Nasal breathing is a technique you can use, while training, to achieve a similar effect (possibly due to increased pressure, NO production increasing affinity for O2, etc.).

Introduction: Do More with Less

Chronic stress, sedentary lifestyles, unhealthy diets, overheated homes, and a lack of fitness have all contributed to poor breathing habits. Leading to lethargy, weight gain, sleeping problems, respiratory conditions, and heart disease. The biggest obstacle to your health and fitness is over-breathing.

• Do you sometimes breathe through your mouth as you go about daily activities?
• Do you mouth breathe in your sleep (dry mouth in the morning)?
• Do you snore or hold your breath in your sleep?
• Can you visibly notice your breathing during rest?
• Do you notice more movement from your chest than your abdomen?
• Do you regularly sigh throughout the day?
• Do you sometimes hear your breath during rest?
• Do you experience symptoms resulting from habitual over-breathing, such as nasal congestion, tightening of the airways, fatigue, dizziness, or light-headedness?

Over-breathing can lead to loss of health, poor fitness, anxiety, asthma, fatigue, insomnia, heart problems, and even obesity.

The amount of oxygen your muscles, organs, and tissues can use is not entirely limited to oxygen saturation. Our red blood cells (RBC) are usually between 95-99% saturated. What determines how much oxygen we can use is the CO2 levels (Bohr Effect). If we breathe better, increasing the amount of carbon dioxide (CO2) inside us, we can deliver more oxygen to our muscles and organs, including the heart and brain, and thus heighten our physical capacity.

Upping the RBC number (altitude training) can improve oxygen delivery, a reduction of lactic acid buildup, and stronger overall performance, including greater endurance and lower inflammation and injury risk.

Programs in this book help to lower energy expenditure whilst running and to increase your VO2 max. It can also help with weight loss, by modifying your consumption-to-burning ratio. Allowing our bodies to operate more efficiently and prevent cravings for high caloric food. Instead of calorie counting, you can start eating when hungry and stopping when satiated.

Part I: The Secret of Breath

1. The Oxygen Paradox

Oxygen saturation (SpO2) is the percentage of oxygen-carrying RBC (hemoglobin molecules) containing oxygen within the blood. During rest, the standard breathing volume is 4-6 liters of air per minute. Because oxygen is continually diffusing from blood to the cells, 100% saturation is not always possible. The human body actually carries excess oxygen in the blood. 75% is exhaled during rest and as much as 25% is exhaled during exercise. So, increasing saturation doesn’t do much.

In conventional medicine, the accepted breaths per minute is 10-12, with each breath drawing in a volume of 500ml of air. More breaths and more volume per breath can both lead to over-breathing. Receptors in the brain measure CO2 levels, along with pH levels in the blood. When CO2 increases, the receptors detect this and and stimulate breathing to get rid of it.

CO2 is a byproduct of breaking down fats and carbohydrates. CO2 has a certain quotient that is maintained in the body, as it is the doorway that allows oxygen to reach our muscles. If we breathe too much over an extended period of time, the result is an increased sensitivity or lower tolerance to CO2. With a lower set point, breathing remains above normal as the receptors in the brain continuously stimulate breathing to get rid of CO2.

It is not the oxygen saturation in the blood that is the problem, it is the oxygen not being released from the blood that is leading to lethargy (too much CO2 released).

CO2 does the following:

• Offloading of O2 from the blood to be used by the cells.
• The dilation of the smooth muscle in the walls of the airways and blood vessels.
• The regulation of blood pH.

Hemoglobin releases oxygen when in the presence of CO2. When we over-breathe, too much CO2 is washed from the lungs, blood, tissues, and cells (hypocapnia), causing the hemoglobin to hold onto the oxygen instead of delivering it. John West, author of Respiratory Physiology says, “an exercising muscle is hot and generates carbon dioxide, and it benefits from increased unloading of O2 [oxygen] from its capillaries.”

Breathing too much can reduce blood flow. 2 minutes of heavy breathing is enough to reduce blood circulation throughout the body, including the brain, which can cause dizziness and light-headedness. Dr. Daniel M. Gibbs, assessed excessive breathing and found in some cases a 50% decrease in blood vessel diameter. Depending on genetic predisposition to asthma, the loss of CO2 can cause the smooth muscles in the airway to constrict, resulting in wheezing and breathlessness. If the pH is too acidic (consuming too much acidic food) breathing increases in order to offload CO2 as acid.

2. How Fit Are You Really? The Body Oxygen Level Test (BOLT)

With a greater CO2 tolerance you can reduce breathlessness and allow more effective delivery of oxygen to muscles during exercise. Efficient breathing means fewer free radicals are produced, reducing the risk of inflammation, tissue damage, and injury. Free radicals are typically only a problem when there is an imbalance between oxidants and antioxidants, leading to oxidative stress (free radicals attacking cells, inflammation, muscular fatigue, overtraining).

Intense physical training can help condition the body to higher CO2 levels, but instead of thrashing your body like an elite athlete, you could try the breathing exercises. Breath-hold training can improve running economy. Training helps but we often breathe inefficiently, and heavily from the chest, when exhausted.

Vo2 max: The maximum capacity of your body’s ability to transport and utilize oxygen in 1 minute during maximal or exhaustive exercise. The ability to tolerate higher concentrations of CO2 in the blood means a higher VO2 max can be achieved.

The Blood Oxygen Level Test (BOLT): The length of a comfortable breath hold.

• Take a normal breath in through your nose and allow a normal breath out through your nose.
• Hold your nose with your fingers to prevent air entering your lungs.
• Time the number of seconds until you feel the first definite desire to breathe, or the first stresses of your body urging you to breathe. This could be the need to swallow or a constriction in the airways. It is not a test for total breath time, but a test on how long until the body asks for air.
• Release your nose, stop the timer, and breathe in through your nose. Your inhalation at the end of the breath hold should be calm.
• Resume normal breathing.

Be aware of the following:

• The breath is taken after a gentle exhalation.
• The breath is held until the breathing muscles first begin to move.
• If you do not feel the first involuntary movements of your breathing muscles, then release your nose when you feel the first definite urge or first distinct stress to breathe.
• The BOLT is not an exercise to correct breathing.
• If you need a big breath afterwards, you’ve held it too long.

When your BOLT score is low, it indicates a greater sensitivity to CO2, and your breathing volume will be greater. Just remember, even elite athletes can have a low BOLT score. A common score for somebody who exercises regularly is approximately 20s. If it is low, depending on your genetic predisposition, you will find you experience a blocked nose, coughing, wheezing, disrupted sleep. snoring, fatigue, and excessive breathlessness during physical exercise. The goal of the Oxygen Advantage program is to increase it to 40s. The closer to 40s you can get, the better the match between breathing volume and metabolic requirements. Once your score is above 20s, you should be able to partake in physical exercise without too much exertion.

Three steps to increasing the BOLT score:

1: Stop Losses of Carbon Dioxide

• Breathe through your nose, day and night.
• Stop sighing; instead, swallow or suppress the sigh. One sigh every few minutes is enough to maintain chronic over breathing, so it is necessary to counteract the sigh by swallowing or holding the breath. If you only notice them after they have taken place, hold your breath for 10-15s to help compensate for the loss of CO2.
• Avoid taking big breaths when yawing or talking. Slow down speaking, use shorter sentences, take a gentle breath through your nose between each sentence.
• Observe your breathing throughout the day. Good breathing should not be seen or heard.

2: Improve Tolerance of Carbon Dioxide

• Exercises that reduce your breathing volume, that create a sustained need for air over 10-12 minutes, reset the receptors in the brain to tolerate higher concentrations of CO2.

3: Simulate High-Altitude Training

• Creating a strong air shortage with the breathing exercises.

Over the first 2-3 weeks, your score will increase 3-4s. When it reaches 20s, the progression tends to slow. If it gets stuck, it helps to incorporate exercise while using the exercises. Slow progress is usually due to lifestyle factors, such as stress and excessive talking, and sickness. The best/most accurate score is taken upon waking. The objective is to maintain a score of 40s for 6 months.

Exercises for scores under 10s:

• Breathing Recovery Exercise to unblock the nose.
• Nose breathe at all times. Mouth tape at night.
• Avoiding sighing and taking big breaths.
• Breathe Light to Breathe Right during rest.
• Breathing Recovery Exercise.

BOLT score of 10-20s:

• Nose unblocking exercise.
• Nose-breathe at all times.
• Avoiding sighing and taking big breaths.
• Breathe Light to Breathe Right during rest and physical exercise.

BOLT score of 20-30s:

• Nose unblocking.
• Nose breathe.
• BL to BR during rest and exercise.
• Simulate High Altitude Training during a fast walk or jog.

BOLT of 30s and over:

• Nose unblocking.
• BL to BR during rest and physical exercise.
• Simulate High-Altitude Training (HAT) during jogging or running.
• Advanced simulation of HAT.

If you have a BOLT under 10s, don’t attempt breath holds involving a strong need for air, which might aggravate your condition. Don’t attempt nose unblocking or simulating HAT unless you are over 10s. Also, at least 20s before breath holding during jogging or running.

If your score starts low, you may experience a “detoxification.” Symptoms may include:

• Increased demand for water.
• Loss of appetite.
• Bad taste in the mouth.
• Increased moodiness.
• Short-term headaches.
• Increased secretions of mucus from the lungs by people with asthma.
• Head cold with runny nose, especially during physical exercise.
• Diarrhea.

To reduce the severity, only eat when hungry and drink warm water regularly.

3. Noses Are for Breathing, Mouths Are for Eating

Mouth breathing is synonymous with emergency, stress, and chest breathing. It is also the cause of narrow jaws, crooked teeth, sunken cheekbones, and smaller nasal cavities. Western Price found connections between children becoming mouth breathers after changing from traditional diets to a modernized diet of white flour products, canned vegetables, sweets, and confectionary. Processed foods are mucus and acid forming. Throughout evolution, our diets consisted of 95% alkaline-forming foods. Now the reverse is true. Acid-forming = processed products, dairy, meat, bread, sugar, coffee, and tea. These stimulate increased breathing and opening the mouth to breathe is a potential solution. Over time, this becomes a habit. You don’t need to become a vegetarian, just get rid of the crap foods and eat more veggies.

Nasal breathing allows the following:

• Approximately 50% more resistance to the airstream in normal individuals, resulting in 10-20% more O2 uptake.
• Warms and humidifies incoming air (air coming in at 42.8F/6C will be warmed to 86F/30C by the time it reaches the back of the throat, and 98.6F/37C when it is in the lungs).
• Removes a significant amount of germs and bacteria from the air.
• During physical exercise, allows for a work intensity great enough to produce an aerobic training effect as based on heart rate and % of VO2 max.
• A reservoir for nitric oxide.

Mouth breathing:

• Greater risk of developing forward head posture, and reduced respiratory strength.
• Dehydration.
• Dry mouths increase acidification of the mouth and results in more dental cavities and gum disease.
• Bad breath (bacterial flora change).
• Increased snoring and obstructive sleep apnea.

Nitric oxide is produced in the nasal cavity and the lining of the blood vessels in the body. It starts in the nasal airways and transfers to the lower airway and lungs. It then dilates the air passage and blood vessels. Nitric oxide plays a part in vasoregulation, homeostasis, neurotransmission, immune defense, and respiration. It also helps to reduce high blood pressure and lower cholesterol levels, keeping arteries young and flexible.

As we age, blood vessels lose flexibility and reduce blood circulation (ED is a result for men and lower libido in women).

Humming can improve NO production fifteenfold compared with a quiet exhalation.

Breathing through the mouth causes nose blood vessels to enlarge and become inflamed. Increased secretion of mucus also helps to create the feeling of nasal stuffiness. Making nasal breathing even harder. Breathing exercises lead to a 70% reduction in nasal swelling and stuffiness. This is the Nasal Breathing exercise (do not practice after eating):

• Take a small, silent breath in through the nose and a small, silent breath out through your nose.
• Pinch your nose with your fingers to hold your breath.
• Walk as many paces as possible with your breath held. Try to build up a medium to strong air shortage, without overdoing it.
• When you resume breathing, do so through your nose. Try to calm your breathing immediately.
• After resuming your breathing, your first breath will probably be bigger than usual. Make sure that you calm your breathing as soon as possible by suppressing the second and third breaths.
• You should be able to recover normal breathing within 2-3. If your breathing is erratic or heavy, you held it too long.
• Wait 1-2 minutes before repeating the breath hold.
• Go easy for the first few repetitions, increasing your pace each time.
• Repeat 6 times, creating a fairly strong need for air.

The nose will congest again, but once you’ve worked your tolerance up to about 80 steps it should remain decongested. An increase of ten paces a week is achievable. Holding the breath should greatly increase NO in the nasal cavity, resulting in greater dilation.

Mouth taping at night (dry the mouth and place horizontally with folded edges for easy removal), or a snoring strap, to keep the lower jaw from dropping, as an alternative. You should sleep longer, quicker, have better quality sleep, and wake up more energized.

4. Breathe Light to Breathe Right

Yoga, tai chi, and qigong all express the importance of quiet, gentle, and light breathing. Taoism describes ideal breathing as “so smooth that the fine hairs within the nostrils remain motionless.”

Chest breathing limits total oxygen transfer and initiates the fight or flight response, which raises stress and heavy breathing. Abdominal/diaphragmatic breathing assists with lymphatic drainage by sucking it through the bloodstream, neutralizing and destroying dead cells, reducing fluid retention, and improving detoxification. The lymphatic system requires muscle movement to push it along.

Breathe Light to Breathe Right:

• Sit up straight. Allow the shoulders to relax. Imagine a piece of string gently holding you up from the top of the back of your head. Feel the space between your ribs gradually widening.
• Place one hand on your chest and one hand above your navel.
• Feel your abdomen gently moving outward as you inhale and gently moving inward as you exhale.
• As you breathe, exert gentle pressure with your hands against your abdomen and chest. This should create resistance to your breathing.
• Breathe against your hands, concentrating on making the size of each breath smaller.
• With each breath, take in less air than you would like to. Make the in-breath smaller or shorter.
• Gently slow down and reduce your breathing movements until you feel a tolerable hunger for air.
• Breathe out with a relaxed exhalation. Allow the natural elasticity of your lungs and diaphragm to play their role in each exhalation. Imagine a balloon slowly and gently deflating of its own accord.
• When the in-breath becomes smaller and the out-breath is relaxed, visible breathing movements will be reduced. You may be able to notice this in a mirror.

This exercise should reduce breathing movements by 20-30%. If the stomach muscles start to contract, are tense, or breathing rhythm is disrupted, the air shortage is too intense. Rest for 15s, or when the shortage has disappeared, and resume. The result of these exercises may provide an increased warmth from blood vessel dilation, a red color in the face, and increased saliva production (PNS activation). Don’t worry about breathing counts.

5. Secrets of Ancient Tribes

Nasal breathing during exercise:

• Filters, warms, and humidifies air before being drawn into the lungs.
• Reduces the heart rate.
• Brings NO into the lungs to open airways and blood vessels.
• Better oxygen delivery throughout the body.
• Reduced lactic acid as more oxygen is delivered to working muscles.

Bigger nostrils will experience less resistance to breathing, enabling higher intensity with the mouth closed. Here is a general guideline to ability, with the mouth closed, based on the BOLT score:

• 5s – walking is hampered.
• 10s – you can walk slowly.
• 20s – walk quickly or jog lightly.
• 30s – jog at a medium to fast pace.
• 40s – run quickly.

To reduce air intake during exercise:

• Relax your body and take less air into your lungs.
• Increase exercise intensity while nasal breathing.
• Practice breath holding during exercise.

Warming up before exercise and nasal breathing allows the following:

• More CO2, improving the release of O2 from blood to tissues and organs, increasing VO2 max, improving endurance, and reducing the risk of injury.
• The opening of blood vessels and airways, allowing for better blood flow and easy breathing.

Oxygen Advantage Warm up (accumulates CO2):

• Begin walking at a pace that is comfortable to you.
• During your warm up, try to breathe regularly and calmly through your nose, using your diaphragm to maintain a gently and relaxed breathing technique.
• Feel your abdomen gently moving outward as you inhale and gently moving inward as you exhale.
• As you walk, allow a feeling of relaxation to spread throughout your body. Silently encourage the area around your chest and abdomen to relax. Feel your body relax and become soft. Body relaxation during physical exercise helps to ensure steady, calm, and regular breathing.
• After 1 minute or so of walking at a fairly good pace, exhale normally through your nose and pinch your nose with your fingers to hold the breath.
• While holding your breath, walk for 10-30 paces, or until you feel a moderate need to breathe. When you feel this hunger for air, let go and resume breathing through your nose.
• Continue walking for 10 minutes, performing a breath hold every minute or so.

To avoid exercise-induced asthma:

• Attain a high BOLT score.
• Nasal breathe.
• Warm up.

Cool down by walking 3-5 minutes, while doing the following:

• Small breath in.
• Small breath out.
• Hold breath for 2-5s.
• Breathe normally for 10-15s.
• Continue until calm.

Follow these steps to track progress:

• Measure your BOLT before training.
• Perform your physical exercise.
• Measure BOLT one hour after training.
• If it is higher than before, your breathing is efficient during exercise.
• If it is lower, it is inefficient. Safer to slow down and ensure breathing is controlled during exercise.

Part II: The Secret of Fitness

6. Gaining the Edge—Naturally

EPO is a naturally occurring hormone, produced by the kidneys, that stimulate bone marrow to release more RBC into circulation. A higher concentration of RBC does the following:

• Improves the oxygen carrying capacity of your blood.
• Increases VO2 max.
• Extends your endurance potential.

Normal hemoglobin levels are:

• Male: 13.8 to 17.2gm/dL
• Female: 12.1 to 15.1gm/dL
• (gm/dL = grams per deciliter)

Hematocrit refers to the percentage of RBC in the blood. Usually around 40.7-50.3% in males and 36.1-44.3% in females.

Using high altitude training, it is best to live high and train low, to prevent the limit to work rate when training high.

High intensity training provides improvements in aerobic and anaerobic capacity.

• Improved anaerobic and aerobic energy supplying systems, allowing for greater endurance, strength, speed, and power.
• Faster VO2 kinetics, allowing the blood to carry more oxygen to the muscles.
• Increased tolerance to high-intensity exercise.
• Decreased recovery time from less than maximum exercise.
• Reduced lactic acid buildup.
• Improved oxygenation of active muscles, allowing you to exercise harder and longer.

Breath holding techniques can simulate many of the positive effects of high-altitude and high intensity training, including:

• The release of RBC from the spleen, improving aerobic performance.
• The production of natural EPO.
• A higher tolerance to CO2.
• Reduced stress and fatigue of working muscles.
• Improved psychological preparedness.
• Improved recovery time.
• Reduced lactic acid.
• Improved swimming technique.
• The ability to maintain fitness during rest or injury.
• Maintenance of these benefits without the need to travel to high altitudes.

A breath hold after exhalation simulates the effects of high altitude training, and has the greatest change to oxygen saturation. After 4-5 days training, most people can achieve a level below 94%. Increasing CO2 and therefore improving hemoglobin concentration by 10%. High CO2 creates even greater contractions of the spleen, resulting in an increase in the release of RBC. By holding the breath, nitric oxide (NO) can pool in the nasal cavity, ready to travel to the lungs.

Working a muscle without sufficient fuel generates lactic acid. A small amount can be used as fuel, but a build up can cause cramping and halting of the exercise.

The ingestion of bicarbonate of soda prior to breath holding has been shown to increase it by 8.6%. Neutralizing acid build up in the blood. Improving endurance, max breath hold, reducing breathlessness, and higher average power output.

7. Bring the Mountain to You

Walk and hold: After a minute of continuous walking, gently exhale and pinch your nose to hold your breath. When you feel a medium-strong level air hunger, release your nose, inhale through it, and minimize your breathing for about 15s. Then allow breathing to return to normal. After 30s, repeat 8-10 times. Approximately 12 minutes to complete.

Count the paces so you can measure improvement. To improve the times you should relax the body. If you can’t recover after 3-4 normal breaths you’ve held too long.

While jogging or running: 10-15 minutes into your run, gently exhale and hold your breath until you feel the medium-high strength air hunger. Typically ranges between 10-40 paces. Return to normal nasal breathing for a minute and repeat 8-10 times.

You can also do these exercise while cycling and swimming.

Advanced High Altitude Simulation: Lowering oxygen saturation below 90% for a duration of 1-2 minutes can increase production of EPO significantly. To carry out the following exercise you should be in good health and have a BOLT score of at least 30s.

• Practice on an empty stomach and record if possible with an oximeter. Don’t go below 80% saturation.
• Exhale and hold the breath for about 40-60 paces or until the med-high urge.
• After the first hold, subsequent holds are performed every 5-10 paces.
• After each hold, either exhale through your nose or take a sip of air through your nose before the next hold. To relieve tension rather than take in air.
• Diaphragm contractions will strengthen over time. Try to relax the muscles. O2 saturation will be decreasing.
• If the shortage is too great, take a slightly larger breath and continue to relax.
• Perform for 1-2 minutes.

An example of a cyclist’s program is:

• BL to BR for 15min.
• Simulate HAT while walking, with breath holds for 60-80 paces.
• Rest for 3-4 minutes.
• Do 1 set of Advanced Simulation HAT to reduce arterial blood O2 saturation to around 81-84%.

VO2 max improved, lactate buffering, and reduced heart rate at rest.

Long term effects are higher resting hemoglobin mass, stronger spleen contractions in response to breath holding, improved O2 delivery, higher CO2 tolerance.

8. Finding the Zone

A still mind can be acquired via lowering the BOLT score, meditation, and developing awareness of the mind. This helps concentration and improving the odds of the flow state. It also reduces stress, improves sleep, and reduces normal heart rate recovery time.

People who meditate apparently increase brain efficiency in the orbitofrontal cortex and the hippocampus. Which play a role in holding attention, cultivating positive emotions, and retaining emotional stability.

Learn to identify practical thoughts and distracting ones. This helps to avoid energy draining thoughts that provide no service.

Observe the mind, quieten your thoughts, don’t judge yourself, try to avoid reflexive responses. Every moment is a chance to meditate and bring about awareness. Scan the body and merge with your movement.

Before an event or physical activity, improve brain oxygenation by a small breath in, out, hold for 2-5s, breathe normally for 10-15s, repeat for about 10-15 minutes, then continue until calm.

Hyperventilation and anxiety symptoms are similar. Lower CO2 levels and faster respiration frequency.

Quality Sleep for Performance: A BOLT score less than 20s may lead to the following:

• Snoring
• Sleep apnea
• Disrupted sleep
• Insomnia
• A racing mind
• Nightmares
• Sweating
• Frequent bathroom visits
• A dry mouth
• Brain fog
• Fatigue
• Poor concentration
• Upper or lower respiratory complaints

Mouth breathing during sleep creates a considerable loss of CO2 while also bypassing the benefits of NO, resulting in an even lower BOLT score. The solution is BL to BR during the day and before bed. Also:

• Avoid eating 2 hours before sleep, digestion increases breathing.
• Keep your bedroom cool and airy (but not cold). A hot and stuffy room will increase breathing.
• Sleep on your front or left side; sleeping on your back is by far the worst position, as there is no restriction to your breathing.
• Mouth tape.
• BL to BR 15-20 minutes before sleep to calm the mind and discourage heavy breathing.

Part III: The Secret of Health

9. Rapid Weight Loss Without Dieting

Weight loss, stress, high blood pressure, diabetes (reduced need for food and alcohol with lower stress).

• 10 minutes of BL to BR, 4 times a day, with 1 session before bed and one after waking.
• Stop and observe the breath for 1-2 minutes at various times of the day to reduce overthinking.
• Tape the mouth before sleep.
• Practice the Breathing Recovery Exercise whenever anxious or stressed.
• Walk with the mouth closed for 30 minutes daily.
• Pay attention to the appetite and eat only when hungry.

Reduce alcohol consumption to no more than 2 servings each night for the first week. From week 2, reduce drinking to every other night.

Weight and appetite loss may be due to shifting the blood pH, simulating high altitude training, or an increased feeling of relaxation, reducing emotional eating. Eating acid forming foods leads to over-breathing (to clear CO2), bloating, lethargy, and weight gain. There is a hypothesis that craving acid forming foods is an attempt to rebalance pH when O2 is too high from over breathing. Break the acid forming food craving cycle by breathing correctly and natural urges should change.

Animals at higher altitudes typically carry less weight. Reduced saturation of oxygen in the blood. High altitude simulation can replicate the effects.

Walking or jogging while holding the breath restricts oxygen supply and the body must become anaerobic and burn fat stores.

High stress levels lead to increased food intake for comfort or distraction.

10. Reduce Physical Injury and Fatigue

Professional athletes sometimes live shorter lives due to increased oxidative stress contributing to premature aging, heart damage, and dementia. Free radicals are usually countered by glutathione, ubiquinone, flavonoids, and vitamins A, E, and C. Increased breathing and exercise can lead to an excess of free radicals, which damage lipids, protein, and DNA. Breath holding after an exhalation causes a decrease in oxygen saturation, triggering an increase in lactic acid, CO2 increases, H+ increases, further acidifying the blood. The body adapts to the exposure by offsetting the effects of lactic acid so the athlete can work harder for longer. Meaning, breath holding is good for tolerating hypoxemia, reducing alkalinity of the blood, eliminating oxidative stress, and reducing lactic acid buildup.

Exercising several times a week at a moderate, comfortable intensity from which your body can recover easily is the best way to reduce oxidative stress (+ breath holding).

BL to BR for injured athletes to improve VO2 max and oxygen carrying capacity of the blood while reducing lactic acid and improving blood flow.

11. Improve Oxygenation of Your Heart

Persistent high blood pressure damages the arterial walls, causing a buildup of plaque and cholesterol and also possibly blood clotting. Nitric oxide reduces cholesterol blockage by relaxing blood vessels. Slow nasal breathing (paranasal sinus release), regular moderate physical exercise, and eating NO producing foods (beet juice, fish, green vegetables, pomegranate juice, green and black tea, and oatmeal).

High pulse can be reduced through BL to BR. Lowering anxiety and arrhythmia too. Abnormal T-wave (reduced circulation in blood vessels of the heart) inversion and ST segment depression ECG readings were found to be potential precursors to sudden and unexpected cardiac arrest during sport or exercise. Seems to be a result of hyperventilation.

Hyperventilation symptoms were found in up to 10% of heart attack patients. Between 3-6% of patients in one study seemed to arise from hyperventilation. Patients with heart disease or chronic heart failure breathe too heavily (a study showed 15.3-18.5 liters minute). Excessive breathing volume reduces the ability of the heart to pump blood around the body, and decreases blood flow to the heart itself. Breathing exercises after heart attacks can raise CO2 levels and decrease total breath volume dramatically.

12. Eliminate Exercise-Induced Asthma

Common theories about the cause of asthma include the hygiene hypothesis and an increase in pollution. Habitually breathing too much is probably the greater cause. The prevalence of asthma increases relative to wealth. Food becomes more processed, competitive stress increases, houses become more airtight, we perform less physical exercise, and the majority of our jobs are sedentary. Adults with asthma have shown resting breathing volumes of 10-15 liters per minute.

Influences of modern life -> Increased breathing volume -> Loss of CO2, drying of airways, cooling of airways -> Airway hyper-sensitivity -> Coughing, wheezing, breathlessness -> Increased breathing volume…

Triggers such as animal dander, dust mites, exercise, pollution, excessive hygiene, and changes to the weather are often cited to be the cause of asthma symptoms, but by learning to breathe lightly these triggers have less of an effect.

Mouth breathing influences asthma the following ways:

• Air is not filtered of airborne particles, including germs and bacteria.
• The mouth is less effective at conditioning air to the correct temperature and humidity prior to entering the lungs.
• Because the mouth is a larger space, breathing volume is higher, causing too much CO2 to be exhaled. CO2 opens the smooth muscle in the airways. Losing it narrows the airways even more.
• Mouth breathing restricts nasal NO, which supports the lung’s defensive capabilities.

A study from the book mentions narrowing the airways affected 55% of football athletes, 50% of basketball players, but 0% of water polo players. The water polo players have a higher tolerance to CO2, increased NO and reduced breathing volume. Asthma tendencies don’t tend to appear with a more normal breathing volume. Although, chlorine can damage lung tissue.

As you work towards a greater BOLT score, you may continue to experience symptoms, depending on your medical history and triggers. Your ability to stop asthma symptoms with this exercise will depend on your resting BOLT score and how you react when symptoms appear. If you ignore them, coughing and wheezing will get worse. After a BOLT of 20s, extreme symptoms usually disappear. Over 40s, symptoms from a trigger disappear. If severe, take the medication. Always ask doctor, and take meds after 10min of symptoms not going away. Do these to prevent asthma symptoms before they arrive. Warm up with walking at least 10 minutes first.

• Take a small, silent breath in and out through your nose.
• Hold your breath and walk for 10-15 paces.
• Stop walking, release your nose, and resume gentle breathing in and out of your nose.
• Wait for 30-60s and repeat.
• If symptoms are mild, you may be able to hold your breath longer.
• Do this exercise for at least 10 minutes.

13. Athletic Endeavor—Nature or Nurture?

Mouth breathers grow narrow face structures and undeveloped jaws. Atrophying the palate and throat muscles and also crowding the teeth. They are often misdiagnosed with ADD and hyperactivity.

Functional orthodontists believe mouth breathing and thumb sucking are the cause of a small jaw and tooth overcrowding. They gently expand the jaw and guide them forward to make room for teeth.

Traditional orthodontists remove teeth and close up excess space. This usually results in a caved in face and a prominent nose and chin. Along with restricted airways.

95% of head circumference growth happens before the age of 9. Butekyo + Dr. Mew can help.

14. Exercise as if Your Life Depends on It

Only at a BOLT score of 40s is breathing at a normal volume.

Part IV: Your Oxygen Advantage Program

Quick Reference Summary of the Oxygen Advantage Program

Habitual over breathing involves breathing more air than your body requires during rest and exercise. Over breathing leads to:

• A reduction of CO2 in the blood.
• Mouth breathing and underutilization of the gas NO.
• Impaired release of Oxygen from red blood cells (Bohr Effect).
• Constriction of the smooth muscle in the blood vessels and airways.
• Adverse effects on blood pH.
• Reduced oxygenation of working muscles and organs, including the heart and brain.
• Increased acidity and fatigue during exercise.
• Limited sports performance.
• Negative effects to overall health.

Benefits of practicing the Oxygen Advantage program include:

• Improved sleep and energy.
• Easier breathing with reduced breathlessness during exercise.
• Naturally increasing the production of EPO and red blood cells.
• Improving oxygenation of working muscles and organs.
• Reduction of lactic acid buildup and fatigue.
• Improved running economy and VO2 max.
• Improved aerobic performance.
• Improved anaerobic performance.

Oxygen Advantage Exercise Summary

• Nose Unblocking Exercise
• Breathe Light to Breathe Right
• Breathe Light to Breathe Right – Jogging, running, or any other activity
• Breathing Recovery, Improved Concentration
• Simulate High-Altitude Training – Walking
• Simulate High-Altitude Training – Running, cycling, swimming
• Advanced Simulation of High-Altitude Training

BOLT Test:

• Take a small, silent breath in through your nose, and allow a small, silent breath out through your nose.
• Hold your nose with your fingers to prevent air from entering your lungs.
• Count the number of seconds until you feel the first definite desire to breathe.
• At the first definite desire to breathe, you may feel the first involuntary movements of your breathing muscles.
• Release your nose and breathe in through it.
• Your inhalation should be calm.

To increase the BOLT score:

• Nose breathe at all times.
• Avoid taking large breaths while sighing, yawning, and talking.
• Practice Oxygen Advantage exercises appropriate to your health and fitness.

It should increase 3-4s the first week and slow down afterwards. Integrate it into exercise to increase it. It can take 6 months to reach 40s.

Nose Unblocking Exercise (Don’t do if BOLT is under 10s, high BP, CV issues, diabetes, or pregnant).

• Take a small, silent breath in and a small, silent breath out through your nose.
• Pinch your nose with your fingers to hold your breath.
• Walk as many paces as possible with your breath held. Try to bring up a strong air shortage, without overdoing it.
• When you resume breathing, do so only through your nose; your breathing must be calmed immediately.
• After resuming your breathing, your first breath will usually be bigger than normal. Make sure you calm it as soon as possible by suppressing your second and third breaths.
• You should be able to recover your breath. If you cannot, you held your breath too long.
• Repeat 5-6 times, or until decongested.

Breathe Light to Breathe Right

• One hand on the chest and the other above the naval to help follow your breathing.
• Breathe in and gently guide the abdomen outward.
• Breathe out and gently guide the abdomen inward.
• Observe your breathing pattern, noting the size and depth of each breath.
• Apply gentle pressure with your hands to slightly reduce your breathing movements. It should feel as if you are breathing against your hands.
• Encourage the depth of each breath to reduce.
• Take in a smaller or shorter breath than you would like.
• Allow a relaxed breath out, exhaling gently, slowly, and easily.
• Bring a feeling of relaxation to your breathing.
• Do not tense your body, hold your breath, or pause your breathing. Continue to breathe smoothly but take in less air than before.
• The objective is to create a tolerable air hunger. Try to sustain this for 3-5 minutes at a time. If your breathing rhythm becomes chaotic or if your breathing muscles contract, then the air shortage is too much. If this happens, stop and return when breathing is back to normal.

Breathe Light to Breathe Right – Jogging, running, or other activities

• Repeat the previous, but while exercising lightly.
• Focus on relaxing the body and being aware of your movements and bodily sensations.

Breathing Recovery, Improved Concentration

• Exhale as normal through the nose.
• Pinch your nose with your fingers to hold the breath for 2-5s.
• Breathe normally through the nose for 10s.
• Repeat.

Simulate High-Altitude Training – Walking (only if over BOLT 20s and not at risk)

• Walk for 1 minute or so while breathing through the nose.
• Gently exhale and hold your breath until a medium-strong hunger for air, followed by minimal breathing for 15s.
• Breathe normally for 30s then gently exhale and hold the breath again.
• Repeat breath holds 8-10 times.
• A typical pace increase may look like this: 20, 20, 30, 35, 42, 47, 53, 60, 60, 55.

Simulate High-Altitude Training – Running, cycling, swimming

• 10-15min into the run, gently exhale and hold your breath until a strong air shortage is reached. The length may range from 10-40 paces and will depend on your running speed and BOLT score.
• Following the breath hold, continue to jog with nose breathing for about 1 minute, until your breathing has partially recovered.
• Repeat the breath hold 8-10 times for the duration of your run. It should be a challenge, but breathing should be able to recover to normal within a couple a breaths.
• Same for cycling and swimming.

Advanced Simulation of High-Altitude Training

• Blood oxygen saturation must be monitored and kept above 80%.
• Walk for a minute or so. Exhale and hold your breath for approximately 40 paces, then take a sip of air into the lungs. Hold the breath for a further 10 paces.
• Now take a sip of air in or out. Hold for 10 paces.
• Continue taking sips of air and repeating short breath holds until you feel a fairly strong air shortage.
• If it is too strong, reduce the hold to 5 paces. With each hold, oxygen saturation will decrease.
• Challenge but don’t stress yourself.
• Perform for 1-2 minutes.

Breathe Light to Breathe Right (Advanced Method)

Stage 1: Relaxing and Activating the Diaphragm

• Sit up straight, not forced upright as this will add to tension. Try to lengthen the distance between your navel and sternum. Imagine a piece of string gently lifting you from the back of your head, making the space between your ribs feel wider.
• Place one hand on your chest and one hand above your navel.
• Gently guide your lower hand outwards by pushing your abdomen outward, just enough to feel the movement. No need to change your breathing yet.
• Now draw in your abdomen, paying attention to the hand moving inward.
• Perform this exercise for a few minutes to activate a “stiff” diaphragm.
• Alternatively, you can perform this while lying on your back with your knees bent and feet flat on the floor.

Stage 2: Merging Abdominal Movements with Breathing

• Sit up straight.
• Place on hand on the chest and the other on the abdomen.
• Gently encourage chest movements to reduce as you breathe, using the guidance of your mind and your hand.
• Try to coordinate your abdominal movements with your breathing.
• As you breathe in, gently guide your abdomen outward. As you breathe out, guide it inward. Keeping breathing silent and calm.

Stage 3: Reducing Breathing Volume Using Abdominal Breathing

• Sit up straight (imagine string guiding the back of your head upward and rib space widening) and place hands on chest and abdomen.
• Breathe in, gently guiding the abdomen out, with small chest movements. Breathe out, gently guiding the abdomen in. Always remembering to breathe through the nose.
• Pay attention to the size and frequency of each breath.
• Exert gentle pressure with your hands against your abdomen and chest to create extra resistance.
• With each breath, take in less air than you would like. Make the in-breath smaller or shorter.
• Breathe out with a relaxed exhalation. Allow the natural elasticity of your lungs and diaphragm to play their role. Imagine a balloon inflating and gently deflating of its own accord.
• Breathing movements should be reduced once the in-breath movements are smaller and the out-breath is more relaxed.
• If you find your breathing is becoming erratic, or you are tensing your chest or abdomen muscles, take a 15s break and try again once you are relaxed.
• Aim to maintain an air hunger for 3-5 minutes at a time. 2 sets of 5 minutes is enough to help to reset your breathing center and improve your body’s CO2 tolerance. Most of the exercises require 10 minutes of practice at a time. Can be broken up or done straight if well practiced.

General Program Based on BOLT and Health

Bolt under 10s (asthmatics)

• Measure your BOLT score each morning after waking.
• Breathe through the nose day and night (mouth tape).
• Practice the Breathing Recovery Exercise throughout the day, ideally spending 10 minutes, 6 times per day doing small breath holds of between 2-5s.
• Another option is to exhale through the nose, pinch the nose, walk while holding the breath for 5-10 paces, rest for 1 minute, and repeat 10 times.
• 10-15 minutes of slow walking each day with the mouth closed. If you need to breathe through the mouth, stop walking to recover.
• If below 15s, don’t try BL to BR because the air hunger may destabilize your breathing. If you do breath holds you will be limited to 10s. When your BOLT is above 15s, you will find it easier to bring relaxation to your body with Breathe Light to Breathe Right. The minimum time for practicing BL to BR is 1 hour total (6 sets of 10 minutes).
• As your score increases, it will be easier to engage in physical exercise. Your expected progress is 25s within 6-8 weeks.

BOLT of 10-20s (usually high stress)

• Measure every morning after waking.
• Breathe through the nose at all times.
• Regularly observe your breathing throughout the day to ensure it stays calm and soft. Swallow or hold your breath if you feel a sigh coming. If you miss a sigh, gently hold your breath for 5-10s to compensate.
• Practice BL to BR or BR for 10 minutes, 3 times a day. Once in the morning, once in the afternoon, and once before bed.
• Practice BL to BR – Walking for between 30-60 minutes per day. You can slow jog if your BOLT is greater than 15s.

BOLT of 20-30s (maybe frequent exerciser who mouth breaths and gets fatigued)

• Measure BOLT every morning.
• Breathe through the nose.
• Reduce breathing by BL to BR for 10 minutes, 3 times per day, morning, afternoon, and night.
• Warm up for 10 minutes by walking and performing a breath hold to achieve a medium to strong air hunger every minute or so to Simulate High-Altitude Training.
• BL to BR during a fast walk or jog for 30-60 minutes daily with a relaxed body abdominal breathing, and nasal breathing to create an air shortage.
• Simulate High-Altitude Training during walking or jogging by practicing 8-10 breath holds.
• After physical exercise, practice the Breathing Recovery Exercise.

BOLT of 30s+

• Measure every morning after waking.
• Breathe through the nose.
• Warm up for 10 minutes by walking and performing a breath hold every minute or so to Simulate High-Altitude Training.
• BL to BR during the run by increasing the intensity of the exercise while maintaining nasal breathing to develop a reasonably strong air shortage.
• Continue with running and nasal breathing for 20 minutes to 1 hour.
• Midway through the run, practice breath holds to Simulate High-Altitude Training. Exhale and hold the breath for 10-40 steps while running at a good pace.
• After the breath hold, resume nasal breathing while simultaneously relaxing the body. Continue to intersperse breath holds every few minutes throughout the run.
• After physical exercise, practice the Breathing Recovery Exercise.
• Practice one session of Advanced Simulation of High Altitude every other day.
• Reduce breathing using the BL to BR exercise for 15 minutes last thing before sleep.

Program for Weight Loss or Obesity (suitable for all BOLT scores)

• Nasal breathe.
• Wear tape across mouth at night.
• Become conscious of breathing during everyday tasks, allowing it to become calm, relaxed, and quiet.
• Practice BL to BR for 10-15 minutes, 5 times a day.
  • 10 minutes before work.
  • 10 minutes during lunch.
  • 10 minutes after work.
  • 10 minutes while watching TV in the evening.
  • 15 minutes before bed.
• BL to BR during walking for 30-60 minutes per day.
• For those with a BOLT over 20s, and who are suited to performing breath holds, Simulate High-Altitude Training by incorporating 8-10 breath holds to achieve a medium air hunger throughout the walk.
• Pay attention to hunger sensations, asking yourself whether you really need to eat at that time and stopping when satisfied.

Program for Children and Teenagers

• Nose Unblocking Exercise (quick, easy, and measurable). 12 x per day, divided into 2 sets of 6 reps. Paces should increase by 10 every week.
• Nasal breathing.

Appendix: Upper Limits and Safety of Breath Holding

Breaking point for O2 saturation is 62mmHg and CO2 is 54mmHg. People with high BP, diabetics, cardiac conditions, pregnancy, etc. should not hold the breath.

Air shortage descriptions:

• Easy air shortage: non sensation to breathe.
• Moderate air shortage: from the first involuntary contraction of the breathing muscles until contractions become frequent.
• Strong air shortage: urge to breathe is strong, leading to termination of the breath hold.

Factors that may influence breath-hold time:

• Distraction.
• Whether breath-hold follows inhalation or exhalation.
• Whether the athlete hyperventilates beforehand.