In terms of importance for survival, breathing is
at the top of the list, followed by water , with food in last place. Health
professionals, athletes, and nonathletes alike pay far more attention to their
food tha n their breathing, but what happens if we switch this fo cus around? Improve your BOL T score by 10 seconds and you will find y our appetite
changing. Impro ve your BOL T score to 40 seconds and yo ur life will
change. The loss of appe tite and resultant weight normalization from obtaining a
higher BOL T score may be d ue to a combination of seve ral factors,including one’ s blood pH shifting toward normal, the ef fects of simulated
high-altitude training, or simply an increased feeling of relaxation helping
to reduc e emoti onal eating. In this section we will examine each of these
elements to help explain why Oxygen Advantage exercises help reduce the
appetite. Overweight individuals tend to have poor breathing habits, such as
chronic hyperventilation, frequent sighing, and breathing from the mouth
and upp er chest. Putting on a few extra pounds causes us to b reathe more
heavily , and not just during physical exercise—breathing volume is
increased during rest as well. Based on my observations, there is a clear
relationship between breathing volume and food consumption. The question
is wheth er processed and acid-forming foods lead to the development of
poor breathing habits, or migh t it be that poor breathing habits lead to
cravings for processed and acid- forming foods? In my experience there is a
feedback loop between breathing and weight gain, and this cycle must be
broken if change is to occur . The pH scale measures acidity and alkalinity , ranging from 1 to 14. On
this scale, 1 is the most acidic, 14 the most alkaline, and 7 is neutral. As we
saw in the first chapter , carbon dioxide plays a crucial role in the regulation
of b lood pH. O ur bodies strive to maintain a state of balance known as
homeostasis, which includes normal blood pressure, normal blood sugar ,
and normal blood pH within a n arrow range of 7.35 and 7.45. This balance
of chemicals is kept in check by the lungs and the kidneys. If blood pH
drops be low 7.35 it will become too acidic, causing breathing  volume to
increase as the lungs work to correct pH levels by of floading carbon dioxide
(which i s itself acidic). Over -ac idity of the blood may occur when we eat
processed and acid-forming foods, leading to heavier breathing and
symptoms of bloating, lethar gy , and weight gain. Conversely , an individual who chronically overbreathes will expel too
much carbon dioxide, increasin g blood pH to alkaline levels above 7.45. One hypothesis for the relationship between overbreathing and weight gain
is that the body craves processed and acid-forming foods in an ef fort to
normalize blood  pH. Correct breathing volume and a good diet work
together to keep blood pH at a healthy balance. Throughout evolution humans have adapted very well to coping with
short-term stress. During short periods of stress, breathing volumetemporarily incr eases as the fight-or -flight response is activated. Once the
stress has dissipated, breathing volume will normalize once more, allowing
carbon d ioxide to accumulate and restore normal pH. However , when it
comes to long-term stress, p ersistent overbreathing decreases carbon
dioxide levels for extended peri ods of time, meaning blood pH is not given
the opportunity to normalize. Notable health practitioners around the world advise eating alkaline-
forming foods such as fruit and vegetables and avoiding an excess of acid-
forming foods such as animal protein, grains, and processed foods. And
though the majority of us know what it means to eat he althily , the
temptation of processed and sugary foods can sometimes be impossible to
ignore. A re we just following th e demands of our bodies, or is there a way
to get rid of these ur ges for unhealthy food naturally? T ime an d time again I have wit nessed startling changes to the diets of
my students who learn to practice reduced breathing, often with out the need
for deliberate avoidance or willpower . These individuals, when shown how
to ad dress their poor breathing habits and increase their BOL T  score by at
least 10 seconds, automatically find their diet changing to healthy foods
over pro cessed f oods. It begs th e question: Might breathing be the missing
link in the majority of weight-loss programs? Breaking the vicious cycle of acid-forming foods and increased
breathing volume is certainly  a factor in achieving weight loss and
provoking a reduction in appet ite, but there are other factors to consider
when lo oking at the relationship between breathing and diet, such as the
ef fects of simulated high-altitude training. Since 1957, scientists have identified that animals lose weight when
living at high al titude. Sherpas and others who reside permane ntly at high
altitudes are also generally thin ner than their sea-level counterparts. Based
on th is o bservation, there have been many studies that point to the benefits
of living at high altitude as a way to reduce obesity . The reason for this
sustained weight loss seems to coincide with the lack of appetite
experienced at high altitude due to a reduced saturation of oxygen in the
blood. In te sts w ith mic e it was found that moderate exposure to lower oxygen
saturation can reduce body weight and, just as important, the levels of blood
sugar and blood cholesterol. R esearchers concluded that this was due toincreased synthe sis of EPO by the kidneys. This discovery has a particular
resonance with the Oxygen Ad vantage program, since breath holding has
been shown to increase EPO by up to 24 percent. Of c ourse, living at high altitud e is not feasible or even econo mically
possible for most people, and ironically obesity is also a risk factor for
developing acute mountain sick ness. But you needn’ t climb a mountain to
achieve sustained and ef fective weight loss. Reduced breathing exercises
like thos e practiced in the Oxyg en Advantage program provide a practical
and accessible alternative to high-altitude training. High-altitude training can be simulated by incorporating breath holding
into physical exercise as well a s practicing reduced breathing during rest. For indi viduals with a BOL T score of less than 10 seconds, or those who
have any preexisting health concerns, I would recommend starting by
becoming accustomed to breath ing through the nose night and day . From
there, yo u can practice the Breathe Light to Breathe Right exercise  for 10
minutes, 4 times a day in order to reduce your breathing volume toward
normal and increase your BOL T score. Even a gentle approach like this can
be enou gh to kick-start a reduction in appetite and help toward achieving
healthy weight-loss goals. For those with a BOL T score of more than 20 seconds and who are
relatively health y , in addition to practicing the above exercise you can also
begin to incorporate breath holding into your physical exercise to simulate
high-altitude tra ining, as described in chapter 7. Holding the br eath during
walking, jogging, or running to create a medium to strong hunger for air
decreases the oxygen saturation of the blood to below 94 percent, which can
lead to a suppres sion of appetite. I suggest that you add these exercises into
your current training regimen to make the program easier to sustain over the
long term. Another reason  simulated high-altitude training may contri bute to
weight l oss is that walking or jo gging with nasal breathing allows the body
to work with ox ygen (aerobically), while incorporating breath holds every
minute or so ma kes the body work without oxygen (anaerobically). During
an a naerobic state the body is forced to burn calories from f at stores in
order to produce  ener gy . Incorporating both aerobic and anaerobic workouts
into your training program will lead to increased calorie burn  and weight
loss.Finally , there are emotional a nd psychological factors to take into
account when looking at the rea sons behind increased appetite and weight
gain. The relationship between  stress and increased food int ake is well
documented, with food often providing a distraction or comfort to negate
feelings of anger or loneliness, or financial or relationship issue s. I imagine
that most readers will have experienced, at one point or another , that their
demand for food increases when they are bored, stressed, or feeling low . This is mostly an  unconscious habit, just as smokers will light up  a cigarette
without making  any conscious ef fort to do so. As if on autopi lot, we find
ourselves going to the refrigerator or cupboard to consume wh atever is in
sight, despite having no genuine sensations of hunger . In a study condu cted by the Uni versity of Minnesota, data was c ollected
from more than twelve thousand individuals to determine the relationship
between perceiv ed stress and h ealth behaviors. Results showe d that high
stress for both men and women was associated with smoking, a diet that
was high in fat, and a reduction in exercise. As stress is known to increase
food consumption, anything that helps to reduce the ef fects of stress can be
useful a s an aid to weight loss. Throughout this book I freque ntly discuss
the importance of taking your attention from the mind and dispersing it
throughout the body , focusing on the breath or the present moment. When your attention is focused on the sensations of your inner body and
your breath, it is impossible to maintain anxious, stressful, and distracting
thoughts. These practices of meditation have been employed by human
beings f or thous ands of years, a nd today many studies show the  benefits of
meditation as a means of helping with weight loss. Controllin g stress and
depression can be conducive to maintaining long-term weight loss, and
while it is relatively easy to shed a few pounds with a bu rst of well-
intentioned exer cise and healthy eating, the Holy Grail is to  reach and
maintain your ideal weight—no  one wants to spend their life struggling on
a restrictive diet. The exe rcise Breathe Light to Breathe Right on page 74 has been
specially design ed to help you bring your attention away from the mind and
onto the  breath. This exercise is performed while sitting or lying down, but
a certain amount of focus and concentration is still required to follow the
breath and gently allow it to reduce to create a tolerable a ir shortage. Observing your  breath, slowing it down, and bringing a feeling ofrelaxation throughout the body is in itself a meditation. An additional
benefit of practicing this exercis e and nasal breathing is an improvement in
body oxygenation, thereby reducing brain cell excitability and stress. Meditation does n’ t have to be  about sitting in a corner in a lotus
position saying “om.” At first it will be necessary to find a quiet  place to sit
so that you can focus on observ ing your breath to practice, but in time this
exercise can be b rought into any aspect of your life. As describe d in chapter
8, make your life a meditation b y taking your attention out of your head and
into the current moment. It is i mpossible to experience life when we hide
away fro m it by allowing the m ind to be permanently occupied by worries
and stress. Y ou are not just a head. In fact, imagine you are h eadless. No
matter what activity you partak e in, bring your a ttention out of y our head,
into your body , and on to the a ctivity . Become the activity . And you can
apply this theory to your eating habits too. Eating is a basic function that often receives very little conscious
attention during our busy daily routines. It is common practice to stuf f food
into our  mouths unconsciously ,  not even really tasting anything after the
first bite . The next time you e at, observe how many times y ou actually
noticed the texture, taste, and sm ell of your food. Did you eat m ost of your
meal wi th your attention elsewhere? Or did you experience the sensory
wonders of your food, bite by bite? Forty-one-year -old T essy considers herself a born worrier . As the eldest
child, she often felt an overwh elming sense of responsibility toward her
family and younger siblings; throughout childhood, her parents constantly
reinforced the notion that T essy’ s primary role was to show a go od example
to her younger brother and sister . At school she excelled at both  sports and
academic work and became focused on achieving top marks—anything
other than an A grade was unacceptable. The few times she re ceived a C
grade, sh e and her parents woul d get very upset. On one such o ccasion her
father w ent to the extent of taping her report card to the refriger ator door to
remind everyone in the house that marks like this were not to be tolerated. It so metimes seemed to T essy that her parents were trying to realize
their ow n ambitions through her , but that it was impossible for them to be
fulfilled. Her brother and sister  had far less pressure put upon them, were
required to do l ess homework and fewer household chores, and enjoyed
much more freedom. These ineq ualities became even more apparent duringtheir tee nage ye ars when the yo unger ones were allowed to wa tch hours of
television and go to parties while T essy was expected to concentrate on her
studies. T essy gr ew rese ntful of her par ents. She hated the fact that there was
one set of rules for her and another for her siblings. Through the molding by
her parents, T essy felt that she  always had to be a people pl easer and a
perfectionist, and if she failed to reach her high expectations, she would feel
very low and critical of herself. Things came to a head a year ago when T essy’ s mother came  to visit
and stayed for a whole month. It was then that T essy realized just how
much her mother ’ s high-strung personality made T essy feel stressed. Although she had long been an adult, T essy had never escaped the
attentions of her overbearing mother , who advised her , smothered her , and
always said she knew what wa s best for her . As her mother had grown
older , T e ssy chose to keep the peace and continued to bottle up her feelings
rather than confronting her . Unsurprisingly , T essy’ s mother ’ s visit was very stressful. In a bid to
distract herself from the stress, T essy found herself eating more and more. Whenever she felt that things w ere getting to be too much, she would cook
a meal or head to the local diner to dissipate her feelings. She enjoyed the
pleasure of cooking, tasting, an d eating, and now the food was serving an
additional purpose by helping her to cope. Six wee ks ago, I received a cal l from T essy complaining that she was
feeling increasin gly short of breath. Feelings of dizziness while driving had
made he r feel very anxious ab out her health, suspecting that something
more s erious was going on, and she had begun to suf fer from
breathlessness, u nable to take a satisfying breath. Recognizing the angst in
T essy’ s voice, I asked her to come in to see me the following day . She
explained the situation that led to the changes in her breathing and the use
of food as a crutch. She was co nscious about having a “spare tire” around
her wais t, which  wasn’ t helping with her self-esteem, and she was anxious
about her breathing issues—the time had come to make a change. W e started by measuring T essy’ s BOL T score and found it to be 10
seconds. Although she was predominantly a nasal breather , she used her
upper ch est to breathe and sighed regularly . I explained to her that optimal
breathing should be dif ficult to see and not heard, with gentle movementsfrom below the diaphragm. During stressed-out breathing, however , the
opposite takes place, leading to an unnecessarily lar ge breathing volume
and all its assoc iated problems. T essy needed to learn how to use slow and
gentle breathing to bring her body into relaxation. First, I asked her to place one ha nd on her chest and one hand above her
navel and to bec ome aware of h er breathing, to feel the air as it entered and
left her body . W hen she was c onscious of her breathing, I a sked her to
breathe light and gently soften her breathing in order to create a tolerable
need for air for  a couple of minutes. T essy felt uncomfortab le with the
feeling of air hu nger , so I asked her to reduce the time spent on the exercise
in order to gently condition her body to acclimatize to the sensation. She
repeated 3 sets of 1.5 minutes each, with a small rest of 1 m inute or so
between them, and soon became accustomed to practicing the exercise. T o help quicken her progress, I decided to teach her a walking exercise
with bre ath hold s. This involved walking with her mouth closed  for about 1
minute o r so, followed by gently exhaling through her nose and pinching it
with her fingers to hold her breath for 10 paces. Following each breath hold,
T essy continued  to walk whil e breathing through her nose for 1 or 2
minutes, followed by exhaling through her nose and holding her breath. T essy found this exercise much more comfortable and proceeded to increase
the lengths of h er breath holds to 15 and then 20 paces. Each time she
advanced, I checked to ensure T essy’ s breathing remained un der control,
and soo n she was able to ho ld her breath for 30 paces, even feeling
comfortable with the feeling of air shortage. T essy explained tha t she found
it easier to practice reduced breathing while walking than sitting still, as she
knew that the air hunger was only temporary . T essy made such good prog ress that we decided to mo ve onto
abdominal breathing to change her breathing pattern from the up per chest to
the diaphragm and address her  chronic overbreathing. For this exercise I
asked he r to stand up, as an up right position provides an ideal posture for
abdominal breathing, and gave her the following simple instructions:
•  Breathe in—gently allow your abdomen to move outward. •  Breathe out—gently allow your abdomen to move inward.By f ocusing her attention on her chest and abdomen, T essy was able to
switch f rom upp er -chest to abdominal breathing ef fortlessly . Th e next step
was to gently soften and slow do wn her breathing to produce a comfortable
hunger for air . T essy practiced lightening her breathing for 3  mi nutes be fore
taking a break for 1 minute or so. After 3 sets of this exercise and a short
rest, I measured T essy’ s BOL T score again to find it had increased to 23
seconds. This drastic change to her BOL T score took place in a  single one-
and-a-half-hour session, and T e ssy felt calmer , more alert, and in much
greater control of her breathing. BOL T scores do not usually increase so
quickly , but from time to time it is possible! However , as I e xplained to
T essy , h er sudden high BOL T score would reduce again over the following
few hou rs, but could be regained through the practice of the exe rcises she’d
learned. A few weeks after we met, T essy reported that she had felt extremely
thirsty o n one of the days, almo st as if her body was desperate to rehydrate
itself with plain water after months of relying on fizzy drinks. Exhilarated
by h er p rogress, T essy felt calmer , more ener getic, and no longer turned to
food for comfort, losing ten pounds simply through the practi ce of quiet,
gentle, reduced breathing. By prac ticing O xygen Advantage exercises and making impro vements
to your breathing pattern, you will achieve a higher BOL T score and
experience a reduction of your appetite. Listen to your body and observe
what it is telling  you. Get used to responding only to the feeling  of genuine
hunger r ather tha n eating for bor edom or in response to stress or depression. The next time you feel the ur ge to go to the refrigerator or eat a snack, ask
yourself, “Do I really feel hungry?” By eating only when your body
actually requires  food, you will make the most of your natural suppression
of appetite and f ind losing weight and maintaining a healthy diet achievable
and sim ple. A detailed program  for helping to achieve weight loss can be
found on page 282.CHAPTER 10
R e d u c e  P h y s i c a l  I n j u r y  a n d  F a t i g u e
M y brothe r Lee and his wife, Marie, are in their early thirties and live
with their two children in the town of Navan in Ireland. Thei r work life,
family life, and social life a ll revolve around physical training and
preparation for long-distance events, and every few weeks they  participate
in triathlons, marathons, and even ultramarathons. Most people outside their
sporting circle regard them as exercise nuts, and every now and again, for a
bit of devilment, another of my brothers—Dave, who does no physical
exercise at all—sends Lee the most recent newspaper reports  describing
how too much exercise is bad for your health, increases the risk of
developing dif ferent conditions, or causes premature death. There is nothing
more pleasurabl e to a couch potato, it seems, than to extol the  dangers of
exercise to those who do it. There is  anecdo tal evidence to suggest that athletes may be at risk of
becoming seriously ill early in life or die younger than the rest of the
population, desp ite being in peak physical condition. And while the benefits
of e xercising to maintain goo d health are well accepted by all health
authorities, is there ever a time  when exercise can simply be too much or
too intensive? T o investigate the relationship between longevity and career success,
Professor Richard Epstein and Catherine Epstein from the King horn Cancer
Center in Sydney , Australia, analyzed one thousand New Y ork T imes
obituaries publis hed between 2009 and 2011. Their findings re vealed that
sports players lived on average for 77.4 years, while longer lifespans could
be fo und in the military , busine ss, and politics, where individuals lived for
84.7 yea rs, 83.3  years, and 82.1  years respectively . And while 7 7.4 years isa ripe old age, why should athletes live shorter lives than those who
probably devote less time to their health and fitness? In ad dition to pr ofessional athle tes living shorter than their coun terparts
in the business world, there is much documented evidence that intense
physical exercise increases oxidative stress that may contribute to
premature aging, damage to the heart, and dementia. Given that most health professionals encourage physical exercise for
good health, in what circumstances might exercise be damaging? And,
more im portant, what can we d o to reap the benefits of physical activity
without putting our health at risk? The key to answering these questions
seems to lie in controlling the amount of stress put on the b ody during
exercise—more specifically , oxidative stress, which results from too many
free radicals washing about our system. Free radicals are molecules generated by the breakdown of oxygen
during metabolic activity . W e all create a certain amount of free radicals
through the very act of breathin g, but normal levels do not pose a problem
since the body’ s defense mechan ism is able to neutralize the molecules with
antioxidants such as glutathione, ubiquinone, flavonoids, and vitamins A, E,
and C. But when our antioxida nt defenses are overwhelmed by too many
free radicals, cells can be dama ged and our health adversely af fected. This
is what is known as oxidative stress. Free radicals are highly reactive  and attack other cells, causing damage
to tissues and negatively af fe cting lipids, proteins, and DNA. During
physical exercise we produce more free radicals than usual due to an
increase in breathing and metabolism, which can lead to an imbalance
between the production of free  radicals and the antioxidants required to
detoxify them, resulting in muscle weakness, fatigue, and overtraining. Investigations i nto physical training, regular aerobic exercise , marathon
running, and extreme competitions have consistently found that antioxidant
levels decrease after intense physical activity or extreme competition, while
free radical production increases. In a  paper pub lished in the Journal of the American Col lege of
Nutrition,  Guillaume Machefer and colleagues investigated whether
extreme running decreases blood antioxidant defense capacity . Blood
samples were collected from s ix well-trained athletes participating in an
ultramarathon called the Marathon of Sands. In what is considered to be oneof the toughest foot races on e arth, competitors run the equivalent of six
regular marathons over six days in the Sahara Desert, during which they are
required to carry their own food. Blood samples were taken from runners 72
hours after completion of the r ace, with researchers noting a “significant
alteration of the blood antioxid ant defense capacity” and concluding that
“such extreme competition induced an imbalance between oxidant and
antioxidant protection.”
In a n attempt to deal with this potentially detrimental im balance
between antioxid ants and free radicals, athletes are often encouraged to take
lar ge regular doses of antioxidants. At first glance this might seem like
sound advice, but studies explor ing the use of dietary antioxidan ts to reduce
oxidative stress and exercise-induced muscle injury have met with mixed
results to date. An alternative and totally nat ural method of protecting against the
excessive buildu p of free radicals is to supplement regular ex ercise with
breath holding and to increase your BOL T score. This metho d is cheap,
nontoxic, and less controversial than supplements, providing ef fective
protection against oxidative stress. Breath holding after an exhalation
causes a decrease in oxygen saturation, which triggers an incre ase in lactic
acid. At the sam e time, carbon dioxide levels also increase, leading to a rise
in the concentration of hydrogen ions, which further acidifies the blood. Repeated practi ce of breath-holding exercises of fsets the ef fects of lactic
acid, ind ucing the body to mak e adaptations to delay acidosis (increased
acidity in the b lood) and enabling the athlete to push har der without
experiencing the same level of fatigue. Research has shown that breath-holding exercises can improve an
individual’ s tole rance to hypoxemia (low levels of oxygen in the blood) and
reduce t he acidity of the blood , eliminating oxidative stress and reducing
lactic acid buildup. Athletes with long-term experience of breath-hold
training, such as divers, have demonstrated a marked reduction in blood
acidosis and oxidative stress in studies, suggesting that th e extended
practice of breath-hold exercises can be instrumental in avoiding the
negative ef fects of free radicals produced by exercise. Research spanning thirty years has investigated the mitigating factors in
exercise-induced oxidative stress, taking into consideration dif ferent types
of activi ty , duration, intensity , and the capabilities of the individual. Thecorrect d ose of physical exercis e will of course vary from person to person
according to physical conditio n and training habits, but the  results of
numerous studies show that oxidative stress can best be avoided by
engaging in regular exercise combined with breath-hold training. The body
is very good at adapting to con sistent physical activity but cannot always
react qu ickly en ough to protect itself from a sudden influx of f ree radicals
produced by infrequent high-intensity exercise. Exercising several times a
week at a mod erate, comfortable intensity from which you can recover
easily is the bes t way to increase your body’ s natural antioxida nt defenses
and redu ce oxidative stress. However , if you are a weekend warrior who
does very little or no exercise during the week but engages in intense
training on the weekend, you may be doing more harm than good. More rigorous training regimens can also provide adequate protection
from oxidative stress, so long  as intensity and duration i s increased
gradually; a competitive athlete  preparing for an upcoming event will need
to a llow a suf fi cient period of time to condition his or her body against
oxidative stress. Studies show that well-trained athletes are perfectly able to
cope with the o xidative stress caused by intense training and competition
after the right kind of preparation—in fact, small amounts of oxidative
stress can even prove beneficia l for the body in strengthening  antioxidant
defenses. While breathing naturally increases during physical e xercise,
individuals with  a low BOL T score breathe more heavily th an normal,
creating an even greater quantit y of free radicals relative to their physical
work rat e. A higher BOL T score , on the other hand, corresponds to a lower
breathing volume, producing fewer free radicals and reducing the risk of
muscle damage , injury , fatigue, and premature aging—po ssibly even
extending the length of life. Br eath-holding techniques of fer a simple and
ef fective way to increase antio xidant protection in athletes who exercise
intensely and can easily be incorporated into regular training. Alan is an amateur cyclist in his early twenties living on the west coast
of Ir eland. V ery competitive by nature, Alan has won many races, often
beating riders more seasoned an d experienced than himself. He came to me
for h elp because he found that it sometimes took him a half hou r to recover
his brea thing af ter a race. T aki ng so long to catch his breath—even after
strenuous activity—was a clear indication that Alan was pushing his bodytoo hard during competition. A s I expected, his BOL T score measured 15
seconds, meani ng that his breathing volume was much lar ger than
necessary . The breathlessness he experienced after exercise showed that his
body was struggling to compen sate. I explained to Alan that although he
was clea rly fit and capable of w inning races, he was literally su bjecting his
body to abuse. At the time, he was suf fering from a dry coug h and head
cold as a result of his exercise , but if he continued in the same way , the
ef fects of overbreathing might not always be so mild. My adv ice to Alan was to adapt his cycling to the capabilities of his
body . First, he n eeded to increase his BOL T score to at least 35 seconds to
align his  breathi ng volume with his metabolic needs. I asked Alan to switch
to nasal breathin g during as mu ch of his training as possible, reverting to
mouth breathing only when absolutely necessary . Since the nose of fers a
smaller entry for breathing than  the mouth, nasal breathing se ts a limit to
the volu me of air taken into the lungs. Nasal breathing is a grea t barometer
for training intensity , and my objective was for Alan to match his exercise
to his capabiliti es by not pushi ng himself past the point whe re he could
maintain nasal breathing. This is a safe and easy-to-implement approach,
enabling a gradual but steady increase of BOL T score, which in turn allows
for a sensible increase in intensity and duration. One small land-based mammal has managed to confound the
overwhelming evidence to support the negative ef fects of oxidative stress. For the past few  decades, scientists have studied the naked mole rat—a
bald, blind creature that looks like a hot dog with teeth and lives for up to
twenty-eight years, almost eigh t times longer than any other rodent. The
naked mole rat lives in East Africa, where it is considered a pest by local
farmers as it burrows tunnels underneath fields and eats vegetable crops. The brea thing rate of the naked  mole rat is very low in compa rison to
other ro dents, an d it lives in crowded colonies where there is little oxygen
and high levels of carbon dio xide. As such, the naked mole rat is an
excellent embod iment of the “less is more” theory of breathing. This might
also explain how , despite living  with high oxidative stress from a young
age, the naked mole rat maintai ns good health and longevity , and in all the
years this rather ugly animal has been studied, it has never been known to
develop cancer . Even when scientists have injected the mole rat with
cancer -causing agents, the dise ase was resisted. Exactly why the nakedmole rat  is immune to cancer is  unknown, but some scientists are hopeful
that finding an answer may prov ide the key to unlocking a cure for humans. Living congruently with nature’ s system of checks and balances seems to be
the key to a long and healthy lif e. The naked mole rat does this remarkably
well, given that researchers have discovered that the negative af fects of high
oxidative stress may be of fset by high carbon dioxide levels. Maintaining Y our Fitness During Injury or Rest
The cost of an injury to an ath lete can be devastating. Not on ly does the
athlete have to endure the pain of the injury , but he or she also faces a drop
in m orale and the risk of decreased physical performance due to a lapse in
training. Although a few days’ r est from a regular exercise routine can lead
to improved performance, several studies have shown that a rest period of
around four weeks results in detraining ef fects on the body , including:
•  Increase in body weight
•  Increase in fat mass
•  Increase in waist circumference
•  Decrease of VO 2  peak
When you have worked so hard to increase VO 2  max and maintain your
fitness, the ef fects of detraining can be enormously disappointing,
especially when it becomes a recurrent event. For some, high-intensity
exercise may be the source of a repetitive cycle of injury and  detraining;
when th e body responds to in jury with inflammation, free radicals are
produced, which  may lead to further muscle damage. There is, however , a
way to prevent lapses in your regular routine, as well as maintaining fitness
if yo u suf fer an injury . The Oxygen Advantage program provides a solution
to both the risk o f injury and the  limits an existing injury may place on your
abilities. Practicing the Breathe Light to Breathe Right exercise along with
breath holds can help to increase VO 2  max and the oxygen-carryingcapacity of the b lood while reducing lactic acid and improving  blood flow . This optimal combination mean s that partial fitness can be maintained even
in the case of injury or extended periods of rest. A si gnificant bonus of the Oxygen Advantage program is that it can be
performed durin g rest or during  exercise, and does not require an athlete to
be injury -free. S ome of the ben efits of high-intensity exercise can even be
obtained by adding breath-hold exercises to a gentle walk. Improving the
way you  breathe during rest an d exercise will have positive repercussions
on y our general health as well as your athletic performance, r educing the
risk of injury and enabling you to perform beyond your previous limits.CHAPTER 11
I m p r o v e  O x y g e n a t i o n  o f  Y o u r  H e a r t
O n th e morning o f September 11, 2001, I received a phone call from my
wife, Sinead, telling me to switc h on the news. Listening to the accounts of
what had taken place in New Y ork City and at the Pentagon, I felt a chill go
right thr ough me . The tragedy felt even closer to home as Sinea d and I had
visited that wonderful city just three months prior . On that same day , another tragedy unfolded, although it did not receive
the s ame coverage as the terrorist attacks. In the United States a lone, 3,000
people lo st their lives to heart attack and stroke—two of the top three killers
in the United States. The same tragedy occurred on W ednesday , September
12, and again o n Thursday , September 13, repeating itself eac h and every
day ever since. And while the falling of the T win T owers will ju stifiably be
remembered forever , the victims of cardiovascular disease are only
remembered by  their nearest and dearest. W e cannot predict when a
catastrophic eve nt like 9/11 will  occur , but we can help ourselves to extend
and enri ch the time we have to l ive and enjoy the company of those around
us by taking care of our bodies and especially our hearts. Understanding a simple and scientifically proven way of keeping our
blood vessels healthy is invaluable to living life to the full. In this chapter ,
we explore the role of the gas nitric oxide, along with techniques for
optimal breathing in order to maintain good cardiovascular health. In 1867  the Swedish chemist, inventor , and industrialist Alfred Nobel
invented dynamite by combinin g the chemical nitroglycerine with silica to
form a less vo latile explosive  than nitroglycerine alone. Although his
invention was initially intended to be used for blasting rock for industry , it
later became synonymous with  war and destruction. A few years afterNobel’ s invention, doctors disco vered that this same chemical was ef fective
in helpi ng to reduce high bloo d pressure and treating the cardiovascular
condition known as angina pectoris. In the human body , nitrogly cerine—the
same ma terial used to make explosives—converts to the gas nit ric oxide to
provide amazing benefits for cardiovasular health. In his later years, Nobel
suf fered from heart disease, and when doctors tried to prescribe
nitroglycerine to relieve his condition, he declined it, writing to  his friend:
“Isn’ t it the irony of fate that I  have been prescribed nitroglycerine, to be
taken internally! They call it T rinitrin, so as not to scare the chemist and the
public.” It was u nfortunate that Nobel could not envision how a chemical so
destructive outside the body could actually help it internally . In 1 896 Alfred Nobel suf fere d a stroke and died. In his w ill, the
majority of his wealth was endowed to provide “prizes to those who, during
the preceding year , shall have conferred the greatest benefit to mankind.”
Although the motives of Nobel remain unclear , many commentators,
including Albert Einstein, were of the view that this final act was an attempt
to reliev e his conscience and promote world peace. T o ameliorate the
negative ef fects from the invention of dynamite, Nobel ensured that a
prestigious ceremony would tak e place each year to recognize those who
make the greatest positive contributions to life. In an  iro nic twis t of fate, nearly  one hundred years after Nobel ’ s death,
three do ctors, Robert Furchgott, Louis Ignarro, and Ferid Murad, were
awarded the Nobel Prize in Ph ysiology or Medicine for discovering how
nitric oxide had many important beneficial ef fects for the cardiovascular
system. Had Alfred Nobel conceded to the wishes of his doctors, it is
possible that his life may have been extended. Sometimes referred to as the mi ghty molecule, nitric oxide is produced
within t he 100,000 miles of b lood vessels throughout the human body ,
including the paranasal sinuses surrounding the nasal cavity . Nitric oxide sends a signal for the blood vessels to relax and dilate. If
there is too littl e nitric oxide, blood vessels constrict and the heart has to
raise the  pressu re to send blood  throughout the body . The eas iest way to
understand this is to imagine a  garden hose with a knot in it : The water
cannot flow freely and the pressure must rise if the water has any chance of
flowing from one end to the other . Persistent high blood pressure or
hypertension da mages the arterial blood vessels, causing a buildup ofplaque and cholesterol and also  possibly blood clotting. If the  blood clots
and leads to an obstruction, this may cause the heart or brain to be deprived
of blood and oxygen, resulting in a heart attack or stroke. Nitric o xide plays a monumental role in human health by r educing
cholesterol, rev ersing the buildup of plaque in the blood v essels, and
helping to prevent blood clotting , all of which significantly incre ase the risk
for h eart attack and stroke. Acc ording to Nobel laureate and d istinguished
professor of pharmacology Dr . Louis Ignarro: “[Nitric oxide] is the body’ s
natural defense to prevent all of these things from happening.”
Producing suf ficient nitric oxi de enables blood flow to be directed
ef fortlessly around the body , ensuring that vital or gans receive suf ficient
oxygenation and nutrients. As blood vessels relax, the heart is able to
normalize the pressure required to distribute blood throughou t the body . W ays to increase nitric oxid e include slow nasal breathing, regular
moderate physical exercise, and eating foods that produce nitric oxide. As nitric  oxide is produced inside the paranasal sinuses as well as the
blood vessels, breathing gently and calmly through the nose all ows the gas
to be picked up  and carried to the lungs and blood. According to Jon
Lundber g, professor of nitric oxide pharmacologics at the world-famous
Karolinska Institute in Stockholm, Sweden, lar ge amounts of nitric oxide
are cons tantly r eleased in the n asal airways of humans. As we  breathe in
through the nose, nitric oxide w ill follow the airflow to the lungs, where it
plays a role in increasing the amount of oxygen uptake in the blood. Dr . Dav id Anderson of the Nat ional Institutes of Health in the United
States al so believes that how we  breathe may well hold the key for how the
body regulates blood pressure. It is well known that slow , gentle breathing
from the diaphragm relaxes a nd dilates blood vessels, but the reasons
behind t his lasti ng drop in bloo d pressure is not completely understood. A
plausible explan ation is that the regular practice of relaxed breathing
activates the body’ s relaxation response, resulting in improved  blood gas
regulation and dilation of blood vessels. As we partake in  physical exercise, blood flow increases and stimulates
the inner lining of the blood vessels to produce more nitric oxide. An
interesting study by a team of researchers from Hiroshima University
Graduate Schoo l of Biomedical Sciences compared changes to blood flow
in re sponse to dif ferent intensities of physical exercise. Exercise intensitydescribes the perceived ef fort by  individuals while physically moving their
bodies. For example, most people will agree that walking at a moderate
pace is a low-intensity exercise  because it is easy to sustain a nd involves
light dem ands in terms of brea thlessness and recovery . The study , which
was published in the journal Cir culation,  found that low-intensity exercise
—which expends about the same amount of ener gy as window-shopping—
wasn’ t enough to optimally increase blood flow . Conversely , high-intensity
exercise—which includes vigorous activity at a fast pac e—actually
worsened blood flow . But the middle path—moderate-intensity exercise,
such as a brisk w alk or a light jog or cycle—increased product ion of nitric
oxide and improved blood flow throughout the body . While physical exercise is an excellent way to increase nitric oxide,
diet, die tary supplements, and nasal breathing also play significant roles. In
a r ecent conversation with Irish cross-country running coach Jo hn Downes,
he t old me how  he actively en courages his athletes to drink beet juice,
explaining how he witnessed an increase in performance and reduction of
cramping as a result. Since Joh n isn’ t a man to waste ener gy on unfruitful
training practice s, I decided to find out more. I soon di scovered a study
conducted by the University of Exeter that investigated the ef fects of
increased dietary intake of beet juice, which is rich in the nitrates required
to g enerate nitric oxide. A study group of men aged between n ineteen and
thirty-eight drank about two cups of beet juice every day for a week. This
resulted in a “remarkable reduction” in the amount of oxygen  required to
perform exercise  in comparison with a control group who drank water: The
beet juice drinkers were able to cycle up to 16 percent longer before tiring. Furthermore, blo od pressure within the beet juice drinkers dropped (within
normal levels), even though it wasn’ t high to begin with. In conclusion, the
researchers commented that the reduction of oxygen required for
submaximal exercise following the drinking of beet juice “cannot be
achieved by any other known means, including long-term endurance
exercise training.”
Along w ith beet juice, essential nitric oxide–producing, heart-pr otecting
food sources to include in you r diet include fish, green vege tables, dark
chocolate, red wine (a glass pe r day—not the bottle! ), pomegranate juice,
green or black tea, and oatmeal. Food sources to be limited in your diet
include the usual culprits of meat and processed foods. Along  with eatingthe r ight foods, supplementing your diet with the amino acid L-ar ginine has
been pr oven to increase nitric oxide production, although results vary
depending on age and genetics. These simple changes to y our diet, in
addition to simply breathing ligh tly through your nose, may pro vide the key
to lifelong cardiovascular health. Most of us neve r give a moment’ s thought to our cardiovascula r health,
taking fo r grante d that our hear t will continue to perform its essential task
for s eventy years or more. But  heart-related problems are not limited to
those with a his tory of heart disease; completely avoidable cardiac issues
can be experie nced by young and otherwise healthy individuals, and
prevented simply by increasing nitric oxide levels and by chang ing the way
they breathe. In 1 909, American physiolog ist Dr . Y andell Henderson produced
groundbreaking work on the relationship between breathing and heart rate
that remains relevant today . In a  paper entitled “Acapnia and Shock: Carbon
Dioxide as a Fa ctor in the Regu lation of Heart Rate,” Henderson describes
how he was abl e to regulate th e heart rate of dogs to any rate he desired,
from 40  beats or fewer per minute up to 200 or more, by a ltering their
pulmonary ventilation. Henderson noted that even a “slight reduction of
carbon dioxide of the arterial blood caused a quickening of the heart rate.”
A few years ago, I worked with a thirtysomething woman named Anna
who had been experiencing heart palpitations characterized by a fast
heartbeat. Her resting pulse wa s about 90 beats per minute— the average
heart rat e is between 60 and 80  bpm—leaving her feeling that her “heart
would b eat righ t out of [her] chest.” This feeling was a source of major
distress for Anna and she had c onsulted a number of specialists, but there
didn’ t seem to be anything physically wrong with her . In an ef fort to g et to the bottom of the problem, Anna had under gone a
number of physical examination s and an electrocardiogram. The good news
was that her cardiovascular health was normal. The bad news was that there
was still  no identified reason or solution for her predicament. Following her
diagnosis, she was convinced th at she had a medical condition incurable by
modern science. Unfortunately , A nna is not alone. The late chest physician Dr . Claude
Lum wrote a number of articles illustrating her experience to a tee, based on
patients who presented the very same pattern of symptoms with no physicalanomaly . The one thing all these cases had in common was a tendency for
overbreathing, t he seemingly innocuous habit that is found  to be the
“mystery” cause behind numerous complaints and conditions in every field
of medical practice. Anna and her h usband, having exhausted the traditional rout es for a
solution, somehow came across my work and were relieved to hear that the
ef fects of overbreathing could indeed lead to palpitations characterized by
an abno rmally rapid heartbeat. W ith nothing to lose, they enr olled in my
course. When Anna arrived at the clinic, she appeared to be the picture of
health, i n her early thirties, slim , and of a petite build. For a few moments I
observed her breathing without her noticing. She seemed to be a nose
breather , but the one thing tha t caught my eye was that she would sigh
every fe w minu tes, lifting her shoulders and taking in a lar ge breath. I’d
seen the ef fects of regular sighing many times over the years, often in
individuals pron e to anxiety , and just like mouth breathing, it is a habit that
usually goes unnoticed. I explained to Anna that in order to resolve her
heart sy mptoms, it was very im portant that she retrain herself to stop this
regular sighing. Even th ough a sigh is often involuntary , taking place bef ore the
individual is aware of it, we still have a measure of control to reduce and
eliminate the pattern. I explained to Anna that she should hold h er breath or
swallow any time she felt a sig h coming on. If by chance she missed one,
she sho uld hold her breath for 10 seconds to compensa te for the
overbreathing. I  also provided her with a relaxation exercise and taught her
the Breathe Light to Breathe Right exercise, which she proceeded to
practice diligently for 10 minutes, 6 times per day . In addition, Anna began
to p ay m ore atte ntion to her bre athing throughout the day , ensuring that it
stayed calm and quiet at all times. When h usband and wife returned one week later , Anna explained how
much calmer she felt, and brought the fantastic news that her pulse had
reduced to a per fectly average 60 to 70 beats per minute. Anna’ s case was
one of my first e xperiences of the ef fect of overbreathing on cardiovascular
health, a nd one that I will never for get—a clear demonstrat ion of how
overbreathing c an af fect us in so many dif ferent and potenti ally serious
ways.T o demo nstrate the ef fects of b reathing on heart rate, I often ask my
students to locate their pulse and take six or seven big breaths quickly
through their mouth—within s econds, they are able to feel their pulse
getting quicker . I then ask the students to practice gentle, slow , relaxed
breathing and notice how the pulse slows down. If breathing rate and
volume can have such an immediate and significant ef fect on the heart, we
need to ask what repercussions poor breathing habits might h ave on the
long-term health of our hearts. The heart performs the most important function of the body , and, like all
muscles, it requires suf ficient blood flow and oxygenation in order to work
properly . As Henderson showed , breathing in excess of normal metabolic
requirements causes a reduced concentration of carbon dioxide in the blood. This state of hy pocapnia (which  Henderson called acapnia ) can af fect
cardiac functioning by decreas ing the circulation of blood in the blood
vessels and reducing blood flow  to the heart. Since low levels of carbon
dioxide in the blood lead to a strengthening of the bond betw een the red
blood cells and oxygen, the result is reduced delivery of oxygen to the
heart. O n the other hand, increasing carbon dioxide levels in the blood by
reducing breath ing volume toward normal will result in improved blood
flow and  increas ed available oxygen, providing the heart with a ready and
reliable supply of oxygen. Cardiac Arr est in Athletes: A Missing Link
Each year , fit a nd healthy young athletes die from sudden adult death
syndrome or cardiac arrest. Thes e deaths have a far -reaching ef f ect not only
on family , friends, and classmates but also on entire communities. Cormac McAnallen played Gaelic football for his native County
T yrone, winning  almost every h onor in the game during his career . He was
also a student at  Queen’ s University Belfast and University College Dublin,
and was named Queen’ s University graduate of the year in 2004. On March 2, 2004, at just twenty-four years old, he died sudden ly in his
sleep du e to an undetected heart condition. T ributes to Cormac came from
all s ectors of soc iety , including Irish president Mary McAleese,  who hailed
him as “one of the greatest Gaelic footballers of his time.”While undertaking research for this book, my curiosity was rous ed as to
why healthy athletes might experience cardiac arrest or exhibit
electrocardiogram (ECG) abnormalities with no other apparent risk factors. After all , most athletes are in th e prime of their life, eat a good diet, do not
smoke, have normal cholesterol levels and normal blood pr essure, and
generally care for their health. A side from genetic predisposition, which of
course w e have absolutely no control over , what other factors might
increase the risk of cardiac arrest in athletes? In searc h of the reasons behin d unexplained heart failure in young
athletes, several studies have explored ECG abnormalities in order to find a
connection between the electrical system that controls the heart’ s rhythm
and unexpected cardiac arrest. When the heart beats abnorm ally—either too fast or too s low , or
irregularly—this condition is termed arr hythmia . Ca rdiac arrest happens
when the electrical signals th at control the timing and rhythm of the
heartbeat become completely c haotic. When this happens the heart is no
longer able to ef fectively pump blood around the body , and unless the
condition is treated promptly , death is inevitable. For the best chances of survival, immediate application of
cardiopulmonary resuscitation (CPR) followed by defibrillation is essential. Although cardiac arrest often comes with no warning, clues such as
abnormal heart rate, chest pain, dizziness, fainting, blackouts, and flu-like
symptoms are sometimes presen t. Just prior to the onset of cardiac arrest,
the a thlete may feel dizzy or un well and then collapse, stop bre athing, and
quickly lose consciousness as b lood and oxygen stop flowing to the brain. Unless circulati on is restored within a few minutes, irreve rsible brain
damage and subsequently death will result from sudden heart failure and the
cessation of circulation. An electrocardio gram (ECG) is a test used to interpret the electrical
activity of the h eart, assessing the rate and regularity of the heartbeat as
well as the pres ence of any dam age to the heart muscle. In assessing ECG
abnormalities, doctors examine various indicators that are linked to a
number of life-threatening cardiac conditions. Studies have found that certain ECG changes in young athletes are
common and usually reflect adaptations of the heart as a response to regular
physical training. However , ce rtain abnormal ECG readings, such as T -wave inversion and ST segme nt depression, were found to b e potential
precursors to sudden and unexpected cardiac arrest during sport or exercise. Markedly abnormal ECGs in young and apparently healthy athletes may
also suggest the initial signs of underlying heart disease. ST segment depression is consid ered to be a sign of reduced cir culation
in the blood vessels of the heart, and it has been suggested tha t there is a
link between ST segment depre ssion and the risk of sudden cardiac death. In a study including 1,769 men without evident coronary heart disease, a
total of 72 deaths occurred in th e eighteen years of follow-up—all of whom
showed asympto matic ST segment depression during exercise on their ECG
readings. Earlier on we d iscussed how overbreathing reduces blood fl ow and
oxygen delivery  to the heart. An opportune question at this point is whether
the a mount of air we breathe plays a role in the onset of cardiac arrest. This,
I thi nk, could be  an important f actor in the investigation of sud den cardiac
death in young athletes. A s tudy conducted by researc hers from the University of P atras in
Greece revealed how the amount of air we breathe can produce changes in
electrocardiogram results. During the study a total of 474 healthy volunteers
with no apparent heart disease increased their breathing rate to  more than
30 b reaths per m inute for 5 minu tes to create the ef fects of hyperventilation. ECG readings reported abnormalities in 72 volunteers, including findings of
ST depression and T -wave inv ersion, with 80.5 percent of abnormalities
occurring within the first minute of hyperventilation. Interestingly , the study
found that age, gender , smokin g, and hypertension did not in fluence the
overall incidence of the abnormalities, showing that even perfectly healthy
individuals can be susceptible to the abnormalities caused by
hyperventilation. If increasing the breathing rate to 30 breaths per minute over 5 minutes
can indu ce ECG  abnormalities, what ef fects might strenuous exercise have
on an athlete’ s ri sks of cardiac d isease when you consider that ai r intake can
increase to between 50 and 70 b reaths per minute during moderate- to high-
intensity activity? Should athletes be taught how to ensure healthy
breathing volum e during exercise in order to minimize the ef fects of
hyperventilation on their cardiovascular health?Penny is a cardiac nurse who has worked at a Limerick hospital for the
past thirty years. As a fit and healthy woman of normal build, Penny
became worried when she began to experience symptoms of arrhythmia in
her s ixties. The issue had developed gradually over a few years, and Penny
described the feeling as “a lar ge  butterfly fluttering about in the  left side of
my chest,” which could occur a t any time of the day or night, sometimes
going on for eight hours or more. It all started when Penny’ s job became more demanding and she took on
extra responsibil ities and hours. Ireland has experienced an economic crisis
for several years, leading to many cutbacks in our health service. As a
result, the frontline staf f of nurses has taken much of the brunt in the form
of extra workloads. For Penny ,  the ef fect of these changes was increased
anxiety , which she saw as the main cause of her arrhythmia. As an episode of arrhythmia began, Penny would feel a need for extra
oxygen. T o satisfy this air hunger , her anxiety and breathing would
increase, making  her heart race and further contributing to her complaint. It
was a vicious circle, as her symptoms fed back into the condition. I m et Penny at my clinic in Limerick and observed that she b reathed
through both her nose and mouth. Her breathing was noticeab le, from the
upper chest, and there was no natural pause on the exhalation. Her BOL T
score was 8 se conds, leaving me in no doubt that she was chronically
hyperventilating: the possible source of her cardiac problems. T o begin retraining Penny’ s breathing, I helped her to learn how to
breathe using her diaphragm. I i nstructed her to place one hand on her chest
and one hand just above her navel so that she could easily feel where her
breathing was coming from, a nd begin to direct her breathing into her
abdomen. Breathe in: abdomen out. Breathe out: abdomen in. Penny’ s next
step was  to exert a small amount of pressure against her chest and abdomen
with her  hands so that she felt a  slight resistance to her breathin g. In blocks
of 3 minutes, P enny practiced  calming her breathing, gently slowing it
down an d taking  less air into her body in order to create a slight shortage of
air . I asked Penn y to practice th is exercise for 10 minutes, 5 times per day . The rest of her simple program consisted of breathing through her nose at
all times  and wearing paper tape  across her mouth at night to ma ke sure she
didn’ t breathe through her mouth during sleep.I met Penny several times over the following weeks, and by the third
week her BOL T score had incr eased to 25 seconds. More important, her
symptoms of arrhythmia had reduced significantly . The exercise I gave Penny is very similar to the Papworth method
developed by Dr . Claude Lum. Dr . Lum was well known for his studies of
overbreathing an d was described as an “archetypal caring physician” who
displayed the rare qualities of b oth sympathy and patience, particularly to
those with psychosomatic dis ease. In 1959, at Papworth Hospital in
Cambridgeshire, England, Dr . Lum formed part of a team developing
cardiopulmonary bypass techniques, and during the following decades, his
interest in habitual hyperventilation bur geoned. T ogether with his team of
physiotherapists, he developed the Papworth method in order to address this
common breath ing disorder . Dr . Lum dedicated every ef fort to generate
greater awareness of hyperventilation syndrome through his writings and
lectures, many of which were published in reputable medical journals,
including the  Lancet,  the Journal of the Royal Society of Medicine,  and the
Journal of Psychosomatic Resear ch . He was one of those rare doctors with
the drive and co urage to devote much of his working life to un earthing the
cause of so many common disea ses of civilization that are, at best, only just
managed with medication. Heart Attack: A Missing Link
Myocardial infarction, otherwise known as a heart attack, occurs when
blood flow to the heart is sev erely reduced or cut of f altog ether . This
stoppage of blood results in oxygen starvation and damage or death to part
of the heart muscle. Heart attacks often occur during or following physical exercise or
emotional stress. Both activities increase breathing volume, and when
breathing volume is greater than the body’ s metabolic needs, carbon dioxide
is removed from the lungs and blood, resulting in reduced blood flow and
reduced oxygenation of the heart. Up t o 10 percen t of heart attack patients have symptoms attribu table to
hyperventilation. In one particu lar study , 3 to 6 percent of patie nts showed
normal findings on coronary angiography soon after they experiencedmyocardial infar ction, suggestin g that the infarctions were not in fact due to
any underlying heart disease but could have resulted from hyperventilation. Reduced blood flow to the hea rt muscle due to hyperventilation may
then be partially  or wholly resp onsible for myocardial infarction in some
individuals. It follows, therefore, that the way we breathe, and the resultant
levels o f carbon  dioxide in our  blood, can have significant ef fects on the
health and function of our hearts. In t he following sections we will investigate whether patients with
cardiac problem s, including those who suf fered a heart attack, b reathe more
heavily than normal and wheth er breathing exercises aimed at correcting
breathing volume may reduce the risk of further cardiac problems, and
whether hyperventilation during resuscitation can adversely af fect
outcomes. Heart Disease and Hyperventilation
People with some types of heart disease tend to breathe more heavily and
more intensely than healthier pe ople, but many also experience a reduction
of symp toms when their breathing volume is corrected toward normal. If
these ind ividuals had practiced light breathing in the first instance, would
they have been less at risk of developing heart disease? A study of twenty patients with moderate to severe chronic cardiac
failure showed that these individuals had a breathing volume of between
15.3 to 18.5 lite rs per minute. G iven that normal breathing volume should
be between 4 to 6 liters per minute, each of these patients was breathing a
volume of air that was enough for two or three people. This research, along
with other similar studies, show that patients with chronic heart failure
breathe too intensely . Patients who exhibited heavy breathing  were also
found to  have feelings of breathlessness during physical exercise. This
comes as no surprise when you realize that how we breathe during rest
determines how we breathe during physical exercise. Breathing noticeably
from the upper chest during rest leads to increased breathlessness during
physical exercise and the cycle of overbreathing is destined to continue. It is evid ent from  this research t hat the way we breathe is a contributing
factor in cardiac health, showing a positive correlation between increasedbreathing volume and the severity of chronic heart failure. No t only does
overbreathing reduce the abilit y of the heart to pump blood around the
body , an excessive breathing volume also reduces blood flow to part of the
heart muscle, causing insuf ficien t oxygenation. In a 2004 study published in
the Eur opean Journal of Car diovascular Pr evention and Rehabilitation,
fifty-five men were examined two months after suf fering a heart attack. After following  a program of breathing exercises, the patients’ breathing
volume per minute significantly decreased by approximately 50 percent—
from 18.5 to 9.8 liters. Remembering that normal breathing volume per
minute is 4 to 6 liters, it is evident from this study that patients who suf fered
from a heart atta ck also tend to breathe far in excess of what is r equired, but
that this volume can be reduced much closer to normal simply by
implementing correctional breathing exercises. In additi on, patients who practiced these breathing exercises showed an
increase in the concentration of carbon dioxide in their arterial blood, from
33.2 mmHg to the highest point of the normal range of 44.2 mmHg. Based
on improvements to breathing volume and respiratory function, the authors
of th e study reco mmended that breathing retraining could act a s a valuable
rehabilitation measure after heart attacks. Other studies confirm these benefits, showing how breathing exercises
can hav e lasting ef fects on respiratory function and help to reduce
symptoms of cardiac dysfunction. Hyperventilation During  Cardiopulmonary Resuscitation
(CPR)
W e have  seen clearly how the e f fects of breathing light can im prove blood
flow and oxygenation, and may even be able to help prevent heart attacks in
those w ho breathe excess volumes of air .
_OceanofPDF.com_The_Oxygen_Advantage_-_Patrick_McKeown.txt
Summarize the following text section accurately and concisely. Maintain specific details and numerical information, and use anti-repetition mechanisms:

        In terms of importance for survival, breathing is
at the top of the list, followed by water, with food in last place. Health
professionals, athletes, and nonathletes alike pay far more attention to their
food tha n their breathing, but what happens if we switch this fo cus around. Improve your BOL T score by 10 seconds and you will find y our appetite
changing. Impro ve your BOL T score to 40 seconds and yo ur life will
change. The loss of appe tite and resultant weight normalization from obtaining a
higher BOL T score may be d ue to a combination of seve ral factors,including one’ s blood pH shifting toward normal, the ef fects of simulated
high-altitude training, or simply an increased feeling of relaxation helping
to reduc e emoti onal eating. In this section we will examine each of these
elements to help explain why Oxygen Advantage exercises help reduce the
appetite. Overweight individuals tend to have poor breathing habits, such as
chronic hyperventilation, frequent sighing, and breathing from the mouth
and upp er chest. Putting on a few extra pounds causes us to b reathe more
heavily, and not just during physical exercise—breathing volume is
increased during rest as well. Based on my observations, there is a clear
relationship between breathing volume and food consumption. The question
is wheth er processed and acid-forming foods lead to the development of
poor breathing habits, or migh t it be that poor breathing habits lead to
cravings for processed and acid- forming foods. In my experience there is a
feedback loop between breathing and weight gain, and this cycle must be
broken if change is to occur. The pH scale measures acidity and alkalinity, ranging from 1 to 14. On
this scale, 1 is the most acidic, 14 the most alkaline, and 7 is neutral. As we
saw in the first chapter, carbon dioxide plays a crucial role in the regulation
of b lood pH. O ur bodies strive to maintain a state of balance known as
homeostasis, which includes normal blood pressure, normal blood sugar,
and normal blood pH within a n arrow range of 7. 35 and 7. 45. This balance
of chemicals is kept in check by the lungs and the kidneys. If blood pH
drops be low 7. 35 it will become too acidic, causing breathing  volume to
increase as the lungs work to correct pH levels by of floading carbon dioxide
(which i s itself acidic). Over -ac idity of the blood may occur when we eat
processed and acid-forming foods, leading to heavier breathing and
symptoms of bloating, lethar gy, and weight gain. Conversely, an individual who chronically overbreathes will expel too
much carbon dioxide, increasin g blood pH to alkaline levels above 7.
According to the text, the order of importance for survival is breathing, followed by water, and then food. The text also discusses the relationship between breathing and diet, suggesting that poor breathing habits may lead to cravings for processed and acid-forming foods.
What is the order of importance for survival, and what is the relationship between breathing and diet?
The text suggests that improving the BOL T score by 10 seconds can lead to a change in appetite. However, it does not provide a specific approach to increase the BOL T score. It does mention that some individuals have seen their diet change naturally after improving their BOL T score.
What is the recommended approach to increase the BOL T score, and how does it lead to a reduction in appetite?
Nitric oxide plays a crucial role in the regulation of blood pH. It can be increased through the consumption of certain foods such as fish, green vegetables, and dark chocolate, as well as through the practice of breath-holding exercises.
What is the significance of nitric oxide, and how can it be increased?
The text explains that oxidative stress is caused by an imbalance between the production and elimination of free radicals. It also mentions that some individuals may be producing excessive amounts of free radicals due to chronic overbreathing.
What is the relationship between oxidative stress and free radicals?
The text does not provide a specific approach for athletes to avoid the negative effects of overbreathing. However, it does suggest that athletes should consider incorporating breath-holding exercises into their training regimen to reduce oxidative stress and improve cardiovascular health.
What is the recommended approach for athletes to avoid the negative effects of overbreathing?