Such an instruction
is comm only given by stress counselors, yoga practitioners,  and sports
coaches, resultin g in the student taking a big breath of fresh air into the
lungs, b ut often  this is done through an open mouth while activating the
upper ch est. Such breathing is both big and shallow , but not dee p. This type
of b reathing is entirely the wron g thing to do if your objective is to deliver
more oxygen throughout the body . If we use the de finition of “extending far from the top” in the context of
deep breathing, the “top” will refer to the top of the lungs or the upper
chest. A deep breath, therefore, means to breathe down into the full depth of
the l ungs. It also means using the main breathing muscle, the  diaphragm,
which separates  the chest from the abdomen. During rest, heal thy animals
and bab ies naturally take deep, silent breaths. W ith each inhalation and
exhalation the abdomen gently  expands and contracts. There is no ef fort
involved; the breath is silent, regular , and, more important, through the
nose. If you want to learn what constitutes good breathing, observe the
breathing of a b aby or a healthy  pet, whose breathing has not been altered
by the ef fects of modern lifestyles.Bell jar experiment showing “how we br eathe”
The bell jar di agram above illustrates the relationship betw een the
movement of the diaphragm and movement of the abdome n. As you
breathe, your abdomen moves in  the opposite direction. The rea son why the
abdomen moves outward with the in-breath is because the diaphragm
pushes downwa rd, exerting gentle force on the abdomen. As you exhale,
the d iaphragm moves upward, ta king pressure of f the abdomen and moving
the abdomen inward. T o bring air do wn into the depths of the lungs, it is not actually
necessary to take a big breath, a s even the quietest of breaths will activate
the diaphragm. When you are practicing abdominal nasal breathing, you
should n ot be able to see or hear your breath during rest. In contrast,
overbreathing through the mouth, in an attempt to take a “deep” breath, will
be clearly audible and cause the chest to rise and fall, but will still not
manage to draw the breath deeply into the lungs. The DiaphragmThe diaphragm is a dome-shaped sheet of muscle that separate s the thorax
(which houses the heart and lu ngs) from the abdomen (which houses the
intestines, stoma ch, liver , and kidneys). The diaphragm serves as our main
breathing muscle and, if used correctly , it provides deep and ef ficient
breathing. Poor breathing habits do not take full advantage of the
diaphragm and instead encourage inef ficient overbreathing from the upper
chest. T o  determ ine where your diaphragm is located, place your hands just
at the base of your rib cage and follow your ribs from the front of your body
to the sides. A good rule of thu mb is that the diaphragm is located about
four buttons down on your shirt. Breathing in (inhaling)—abdomen gently moves outwardBreathing out (exhaling)—abdomen gently moves inward
Abdominal breathing is more ef ficient simply because of the shape of
the lung s. Since they are narrow at the top and wider at the bottom, the
amount of blood flow in the low er lobes of the lungs is greater than in the
upper lobes. The fast upper -chest breathing of people who chronically
hyperventilate does not take advantage of the lower parts of  the lungs,
limiting the amount of oxygen  that can be transferred to the blood and
resulting in a gr eater loss of CO 2 . No t on ly this, but upper -chest breathing
activates the fight-or -flight response, which raises stress levels and
produces even heavier breathing. Observe your own breathing when you are stressed, or watch the
breathing of anxious relatives, f riends, or colleagues—you will see that this
type of breathin g is generally located in the upper chest and go es at a rate
that is faster tha n normal. When we are stressed we tend to overbreathe and
resort to breathing through the  mouth. Stressed breathing is faster than
normal, audible, produces visible movements, and often involves sighs. Many people habitually breathe in this manner every minute of every hour
of every  day , holding them in  a perpetual state of fight-or -flight with
adrenaline leve ls high. The work of even the best stress counselors,
psychologists, or psychotherapists will be limited unless they fir st help their
patients to address their dysfunc tional breathing. When oxygen delivery tothe brain is reduced, no amount of talking and reasoning is goin g to correct
this deficiency . Stressed and an xious patients can only make t he progress
they really need when their bad breathing habits are addressed. On the other ha nd, healthy individuals who are relaxed and relatively
free from stress will exhibit brea thing that is abdominal: slow , g entle, calm,
regular , relatively unnoticeable, silent, and through the nose. T o achieve this
type of breathing and reduce the negative ef fects of stressed overbreathing,
it is important to activate the body’ s parasympathetic nervous system to
elicit the relaxation response. T o do this, you will need to adjust your
breathing habits in order to properly use your diaphragm. A void sighing,
panting, and breathing through t he mouth, and become accustomed to slow ,
gentle, relaxed, calm, and quiet breathing through the nose. This is how we
should b reathe d uring rest every minute of every hour of every day . W ithin
a v ery short tim e you will find that you feel calmer and more en er getic and
are able to slee p better . The po sitive ef fects of abdominal breathing will
continue to transform every as pect of your health, including your sports
performance. Another advantage of abdominal breathing is that it assists with
lymphatic drainage. The lymphatic system is ef fectively the body’ s
sewerage system, draining awa y waste materials and excess fluid. As the
lymphatic system  does not have  a heart to pump the waste thr oughout the
body , it is reliant on the motions of the muscles, including the diaphragm. During abdominal breathing, lymph is sucked through the bloodstream,
neutralizing and destroying dead cells, reducing fluid retention, and
improving detoxification of the body . By utili zing the natural benefits of abdominal breathing you will
improve the quality of your blood flow , increase delivery of oxygen to
working muscle s, and reduce the symptoms of anxiety associated with
overbreathing. Returning your breathing habits to the natural and ef ficient
methods you were born with wi ll also allow you to enjoy better health and
maximize the potential of your sports or exercise performance. Use the
following exerci se to encourage abdominal breathing during rest and sports
until it again becomes second  nature. As the objective of the Oxygen
Advantage program is to restore light, abdominal breathing with a high
BOL T score, the exercise below forms the foundation upon which
remaining exercises are practiced.Br eathe Light to Br eathe Right
( A mor e advance d version of th is exer cise can be found in Part IV : Y our
Oxygen Advantage Pr ogram under Br eathe Light to Br eathe Right
(Advanced Method) . ) During the process of breathing, oxygen is drawn into the lungs and
excess carbon dioxide is exhaled . The respiratory center located in the brain
continuously m onitors blood pH, carbon dioxide, and to a l esser extent
oxygen. When the level of carbon dioxide in the blood increases above
programmed levels, the respiratory center transmits impulses that tell the
respiratory muscles to breathe in order to remove the excess gas. When we
breathe too much over a period of hours to days, as in the case  of chronic
stress, the respiratory center adjusts to a lower tolerance of carbon dioxide. Having a lower than normal tolerance to carbon dioxide results in the
respiratory cente r increasing the rate of impulses to the respirato ry muscles. The result is habitual overbreathing and excess breathlessness during
physical exercise. Y ou are  practicing this exercise correctly when you slow down and
reduce y our breathing suf ficien tly to create a tolerable need for air . The
need for  air signifies an accumulation of arterial carbon dioxide , the goal of
which is to reset  the respiratory center ’ s tolerance to this gas. T o assist with
this, it is very helpful to exert gentle pressure against your chest and
abdomen with your hands. T ry to maintain the need for air for the duration
of 4 to 5 minutes. T o p ractice this exercise, it can b e very helpful to sit in front of a mirror
to observe and follow your breathing movements. •   Sit up straigh t. Allow your sh oulders to relax. Imagine a pie ce
of string  gently holding you up from the top of the back of your
head. At the sa me time, feel the space between your ribs
gradually widening. •   Place one hand on your chest and one hand just above your
navel.•   Feel you r abdomen gently moving outward as you inhale and
gently moving inward as you exhale. •   A s yo u breathe, exert gentle pressure with your hands against
your abdomen and chest. This s hould create resistance to your
breathing. •  Breathe against your hands, concentrating on making the size of
each breath smaller . •   W ith e ach bre ath, take in less air than you would like to. Mak e
the in-breath smaller or shorter . •   G ently slow d own and reduce your breathing movements un til
you feel a tolerable hunger for air . •   Brea the out  with a relaxed exhalation. Allow the natur al
elasticity of your lungs and diap hragm to play their role in each
exhalation. Imagine a balloon slowly and gently deflating of its
own accord. •   Whe n the in-breath becomes smaller and the out-breath is
relaxed, visible breathing movements will be reduced. Y ou may
be able to notice this in a mirror . By using a simple exercise like this, you can reduce your breathing
movements by 20 to 30 percent. If your stomach muscles start to contract orjerk or feel tense, or if your breathing rhythm becomes disrupted or out of
control, then the air shortage is too intense. In this situation, a bandon the
exercise for 15 seconds or so and return to it when the air s hortage has
disappeared. At fi rst, you may only be able to  maintain an air shortage for 20 seconds
before the ur ge to breathe is too  strong. W ith practice, you will be able to
maintain an air shortage for longer periods. Remember , you a re trying to
create an air shortage that is tolerable but not stressful. Aim to m aintain this
tolerable “air hunger” for 3 to 5 minutes at a time. Practicing 2 sets of 5-
minute exercise s is enough to help you reset your breathing center and
improve your body’ s tolerance for carbon dioxide. When you practice Breathing Light, the accumulation of carbon dioxide
in th e bl ood wil l result in certai n physiological changes in the body . These
include:
•   A  fee ling of increased warm th resulting from the dilation of
blood vessels
•  A rosy red color coming into the face
•   Increa sed prod uction of watery saliva in the mouth, which is an
indication that your body is going into relaxation mode and
activating the parasympathetic nervous system
All of these ch anges are normal and should not cause dis comfort. However , if you experience dizziness or anxiety while practicing an
Oxygen Advantage exercise, th en it is better to refrain from doing this
exercise and contact an Oxygen  Advantage practitioner who can establish
that you  are doing the exercise correctly . For a list of practitio ners, please
visit OxygenAdvantage.com. T iming Y our Br eathing: A Fundamental Err or
Y ou ma y have noticed that while we attempt to reset breathing volume
toward n ormal, there is no sug gestion of changing the number of breathsper minu te, or to time the lengt h of each breath. This is deliberate—using
time to measure  the size of a breath is a fundamental error . Modern W estern
society s eeks to quantify everything in terms of measurement, including our
breathing, but when it comes to retraining poor breathing habits, it is not the
timing that needs to be focused on. Altering the number of breaths per
minute or counting the size of  each breath in seconds has taken root in
many br eathing techniques but actually has little or no ef fect in addressing
poor breathing habits. For exam ple, te lling someone to inhale for 2 seconds and exhale for 3
seconds does not provide guida nce on whether they should tak e in a very
gentle breath or a huge inhalation of air . The volume of a gentle breath
would be far less than the volume of a lar ge breath, and si nce we are
concerned mainly with volume and reducing it toward normal, counting the
length of a brea th using seconds does not work. The following illustration
shows two dif ferent breaths, each with an inhalation length of 2 seconds
and an exhalation of 3 seconds . Note the dif ference in the amount of air
taken into the lungs by each breath, despite them being the same length:Similarly , is it n ot possible to ad dress poor breathing habits by c hanging
the number of b reaths per minute. T ake, for example, an indi vidual who
breathes 20 breaths per minute, with each breath consisting of 500ml of air . This bre athing p attern provides a total volume of 10 liters per m inute. And,
since 10 liters of air per minute is too much, the individual may be
mistakenly instr ucted to remedy this by reducing the number of breaths per
minute from 20 to 10. However ,  changing the number of breaths  in this way
will sim ply resu lt in each brea th doubling in size to compen sate for the
reduction of breathing rate. There will be no change to breathing volume
and the individual’ s symptoms will persist. There is  only one way to chang e your breathing volume and r ate, and
that is by slowin g down and dim inishing the size of each breath  in order to
create a shortage of air . In time, as breathing volume chan ges toward
normal, you will obtain a higher BOL T measurement and the  number of
breaths you take per minute w ill automatically reduce. T o reiterate, it is
impossible to change breathing  volume by altering breathing r ate, but thebest way  to naturally alter your breathing rate is to reduce you r breathing
volume. As your BOL T increa ses, not only will the size of each breath
decrease, but so too will the number of breaths taken per minute. Learning and applying the above exercise to your daily breathing will
provide an excellent foundation on which to build a more ef ficient
breathing technique during sports. Just as if you were building the house of
your dreams, the most crucial aspect is the foundation. There is no point
building a beautiful structure on  top of a weak foundation. T o d o so would
be futile , as the building would t opple soon after it was built. The same rule
applies w ith addressing your breathing volume. Breathing Ligh t to Breathe
Right is the fou ndation on top of which we simulate high-altit ude training
during many sports activities, as you will see in the followin g chapters. T ake yo ur time to become fa miliar with the techniques of abdominal
breathing and reduced breathing before you move on.CHAPTER 5
S e c r e t s  o f  A n c i e n t  T r i b e s
I n 1974, twenty-o ne-year -old T om Piszkin was attending the University of
California at Berkeley . He was a runner and worked part-time in the
sporting goods department at Montgomery W ard in Oakland. On October
24 h e finished his shift and made his way to a bus stop near the Oakland
Coliseum, know n as one of the tougher parts of town. Soon afte r , T om was
confronted by four young men who demanded he give them everything he
had. Th ree of the four youths drew handguns and pressed them against
T om’ s head, chest, and leg. In s hock, when T om stood up to take his wallet
from his pocket, he was shot po int-blank in the middle of the chest by a .38
special. The bullet bore through T om’ s sternum and entered h is left lung. T om recalls that, surprisingly , the shot didn’ t cause him a lot of pain. Following an operation to remove the lead fragments, T om was
dischar ged from the hospital and resumed running within a month, but
recovering from such a traumatic experience was slow and arduous. T om’ s
journey to restore his lung capa city took over a decade as he continued to
fall short of his expectations, despite working hard at his fitness routine. Above a ll else, T om wanted to r egain the level of athletic fitness he enjoyed
before h e was shot and was determined to figure out a way to lim it his heart
rate duri ng his workout sessions . Intuitively , he figured that by reducing the
stress on his body during exercise, he would be able to improve his overall
fitness a nd endurance. T om theorized that it would help to restrict his
breathing in order to maintain a  steady and manageable exercise intensity
—“like a governor on a lawn mower engine”—a solution th at was also
much cheaper than buying a heart rate monitor .T om soon realized that if he co uldn’ t sustain his pace while b reathing
exclusively through his nose during training, then he was worki ng too hard
and goin g too fast. At first, he  found breathing through his nose during
physical training a little challenging, but soon discovered  that nasal
breathing could more easily be maintained by placing tape ove r his mouth. Not only did T om  tape his mout h during training, he also did it during sleep
to en sure that he  continued nasal breathing during the night. One year after
beginning his reduced breathing training, T om went for a lung c apacity test. His results showed that he was at 130 percent capacity for his weight and
age. T om has since dedicated his life to his two passions of spo rts and
inventing. He is currently a triathlon coach at the University of C alifornia at
San Die go and creator of T itan Flex bikes. He is also certified  as a USA
Olympic T riathlon coach. After  thirteen years of serving at the leadership
level in the T riathlon Club of San Diego, he was inducted into their hall of
fame. Switching to nasal breathing after spending years mouth breathing
requires courage  and commitment. Sometimes it is necessary to take one
step back to m ove two forward if you want to truly im prove your
performance. If you observe y our teammates or competitors during physical e xercise,
you will  no doubt notice that m ost will be breathing through th eir mouths. A qu estion I ofte n hear is: “If nasal breathing is so good, then why do most
elite athletes breathe through their mouths and not their noses?” A simple
answer i s that W estern breathin g habits have become so far removed from
what they should be that mouth breathing has become the norm. Our ance stors used their noses to breathe during physical exercis e, as do
present-day indigenous tribes, including the T arahumara, the famed running
tribe of Northern Mexico. When researchers studied the nasal-breathing
T arahumara trib e over the cours e of a 26-mile run, they were a stounded to
find that their average heart rate was a surprisingly low 130 beats per
minute. Compa re this with the normal average heart rate of a W estern
marathon runner , which lies between 160 and 180 beats per minute, and you
can see how nasal breathing a llows for a calm and sustaine d breathing
pattern e ven when engaging in intense physical exercise (more on this in
chapter 11). Breathing through the mouth is a relatively modernphenomenon and does nothing to improve performance—in fact, it impedes
it. Harvard-educated anthropologist W ade Davis has devoted much of his
life’ s work to t he study of indigenous cultures, especially in North and
South A merica. T o date, he has lived with fifteen groups of indigenous
people, includin g tribal hunters of the Amazon whose senses are so attuned
that they  can smell the urine of  an animal from forty paces and determine
whether it is from a male or female. While st aying w ith the tribe, Da vis, who is also a triathlete, was allowed
to ac company them on hunting expeditions. Hunts began in the  morning at
a pa ce a lternating between a jog and a run. As soon as they pi cked up the
trail of an anim al, the hunters switched to running in order to catch up. When th e anima l became aware of the hunters, it would speed away , but
they would continue to follow in  close pursuit. The hunters wer e persistent,
increasing their pace so as to give their prey little time to rest, and each time
they lost sight of it they would continue on doggedly until they tracked it
down again. This pattern could  continue over many hours, po ssibly even
days, but the h unters’ tenacity would eventually pay of f and  the animal
would c ollapse from exhaustion, enabling them to capture it at close range. While Davis had a hard time ke eping up with the hunters’ pace, what was
most im pressive to him was that  they never opened their mouths  to breathe. Just like  our ancestors, present -day indigenous tribes are able to run at a
high intensity with their mouth s closed over a relatively long duration of
time, a feat that civilized man seems to have for gotten. It is time to go back
to basics. Initially , breathi ng through the n ose might feel strange during e xercise,
especially if you are used to breathing through your mouth. Bu t remember
that the nose is made for breathing, and nasal breathing ensures a number of
benefits that are essential not only for good health but for impr oved sports
performance, including:
•   Filteri ng, war ming, and humidifying air before it is drawn in to
the lungs
•  Reducing the heart rate
•   Bringing nitric oxide into the lungs to open airways and blood
vessels•  Better oxygen delivery throughout the body
•   Redu ced lact ic acid as more oxygen is delivered to workin g
muscles
The pace at whic h you are able to exercise during a half hour of  training
while br eathing through your nose will depend on your BOL T score. Below
are s ome guidelines that are influenced by your nostril and airway size. For
example, an athlete with lar ge nostrils will experience less resistance to
breathing, enabling exercise at a higher intensity with his or  her mouth
closed. Here is a general guideline of exercise ability (with  the mouth
closed) according to BOL T score:
•   If yo ur BOL T score is 5 seconds, your ability to walk is
seriously hampered. Climbing one flight of stairs will be
challenging, req uiring you to sto p every 3 or 4 steps in order to
take a rest. •   If your BOL T  score is 10 seconds, you will be able to walk
slowly . •   If your BOL T  score is 20 seconds, you will be able to walk
quickly or jog lightly . •   If your BOL T score is 30 seconds, you will be able to jog at a
medium to fast pace. •   If  your BOL T score is 40 seconds, you will be able to ru n
quickly . By increasing your BOL T score, no matter the size of your airways, you
will exp erience lighter breathin g and be able to train at a higher pace, for
longer d istances, while breathin g through the nose. Y our fitness levels will
soon increase well beyond what  they were before, and nasal breathing will
become much easier during exercise. W ithin 6 to 8 weeks your BOL T
measurement sh ould increase by 10 to 15 seconds, resulting in a  significant
improvement to your fitness.Dr . Bill  Hang is an orthodont ist from California. For the past few
decades he has e xamined the mouths and airways of thousands  of patients. What di f ferentiates Dr . Hang from many traditional orthodon tists is that
when he considers the alignmen t of the teeth, he also gives atte ntion to the
resultant ef fect on the jaws, the  width of the face, and size of airways. In
fact, I have yet to meet an individual with such a fascination for airway
size. While we need to be ef ficient with our use of oxygen, it is also
imperative that the size of our airways enables air to flow freely to and from
the lungs. If children or teenage rs spend five or ten years with their mouths
hanging open, their faces will become narrow , their jaws will not develop
correctly , and their airway sizes will be reduced. Nasal breathin g during the
formative years is absolutely es sential to help ensure correct development
of th e face, jaws, and airways. In chapter 13, we will look mor e closely at
the role breathin g plays in the development of the face and the need for
orthodontic treatment. I first met Dr . H ang in 2009, when we were both scheduled t o give a
talk to a study group of myofunctional therapists. As it turned out, we had
the s ame aim in  mind: to explor e how breathing and resting ton gue posture
af fects sleep, sports, and health. I spoke about the benefits of nasal
breathing, while  Dr . Hang spoke about airway size and the benefits of
having a good fa cial structure for sports performance. When the  airways are
too narr ow , our ability to perfo rm physical exercise is hampered. Imagine
completing a marathon while b reathing through airways the size of a very
narrow straw— no matter how well trained you are, how fit, how
determined, if your airways are  constricted you will not be able to take in
enough air to properly oxygenate your body . That day Dr . Ha ng told me that he had been running for forty-tw o years
and had  completed nineteen marathons with his “mouth open like a dog.”
Following our meeting, he cha nged to breathing through his nose during
training and taped his mouth closed every night to ensure nasal breathing
while he  slept. Initially he found that his nose would run consta ntly during
exercise, requiring him to blow his nose every few hundred yards. This is a
common experi ence for most people adjusting to nasal breathing as the
airways clear and breathing volume increases, but it is a minorinconvenience that will clear up within a few weeks. Like any or gan or
muscle, the nose needs to get used to being used more during sports. Six months later , Bill completed the Pasadena Marathon and finished
second i n his age group. Not on ly this, but he kept his lips tog ether every
step of the way  except during a  couple of long hills when he allowed his
mouth to  drop open occasionall y . No mean feat for a sixty-year -old! Now ,
each Sun day , he  completes a two -hour run and continues to nasa l breathe in
order to maintain and ideally improve his fitness. T wenty minu tes into his
run, when he is good and warm, he is able to get up to a good speed while
retaining a slow , regular breathing pattern—much improved from his
previous method of panting through the mouth, expending maximum
ener gy as he ran. T rain Y our Body to Do Mor e with Less
T o r eap the most benefit from your physical training, you need t o train your
body to do mor e with less. T o  do this, you will need to reduce your air
intake. Incorpor ating this concept into your training will result in improved
breathing econo my and an increase in your athletic performance, along with
reduced breathlessness and lactic acid during competition. More important,
you will not nee d to push your body beyond its limits, reducing your risk of
injury , cardiovascular and respiratory problems, and other health concerns. Nasal breathing during physical training ensures that you do not push
yourself beyond what your body is capable of doing. During physical exercise, there are three ways to reduce air intake:
1. Relax your body and take less air into your lungs. 2. Increase exercise intensity while nasal breathing. 3. Practice breath holding during exercise. When yo u first switch to nasal b reathing you may find that you r ability
to train at maximum pace is imp eded. Breathing through the nostrils creates
resistance and adds an extra load  that is likely to slow your performance for
the first  few weeks. However , with continued practice and by increasingyour BO L T score you will so on find that your performance surpasses
previous levels. Competitive athletes who regularly take part in high-intensity training
will need to alte rnate nasal breathing with mouth breathing fo r an overall
improvement to breathing patterns. High-intensity training helps to prevent
muscle decondi tioning and will require an athlete to periodic ally breathe
through his or h er mouth. This is to be expected and can be combined with
nasal br eathing to attain the best results. For less-than-maximum intensity
training, and at all other times,  nasal breathing should be employed. For
example, compe titive athletes may spend 70 percent of their tr aining with
the mou th close d, harnessing the benefits of nasal breathing and adding an
extra loa d to their training to increase BOL T score. They may a lso devote a
smaller portion of training to wo rking at an all-out pace in order to maintain
muscle conditio n, for which brief periods of mouth breathing will be
required. During c ompetition there is no n eed to intentionally take bigger breaths,
nor is there a requirement to breathe less. Instead, bring a feeling of
relaxation to your body and breathe as you feel necessary . However , breath-
holding exercise s during your warm-up can be very advantageous, as can
practicing breathing recovery during your cooldown. Competition isn’ t the
ideal tim e to focus on how wel l or how poorly you are breathing, as your
full conc entration should be devoted to the game or race. The best way to
improve breathing for competition is to improve your everyday breathing,
and the key to this is obtaining a higher BOL T score. Recreational athletes who are not taking part in competition or high-
intensity exercis e, however , are far better of f maintaining nasal breathing at
all times. While reducing your breathing during physical exercise, try not to
overdo i t. If you find that your n eed for air is so great that you need to open
your mo uth, simply slow down and allow your breathing to calm once
more. Unveiling the W arm-Up
The vast majority of sports coaches are in agreement that w arming up
before exercise is vitally impo rtant. During physical exercis e the bodyrequires greater blood flow to tissues and muscles than durin g rest. The
objective of a warm-up is to increase blood flow and prepare t he body for
more intense physical exercise, thus reducing the incidence of sports-related
injuries and improving overall performance. It takes time for the body to w arm up, but when it does, your body is
able to function  more ef fectively during exercise. When your body is
warmed up prior to exercise, the following benefits can be maximized:
•   The productio n of more carbo n dioxide—improving the release
of oxygen from the blood to tissues and or gans—increasing
VO 2  max, improving endurance, and reducing the risk of
injury
•   The o pening o f blood vessels and airways—allowing for bett er
blood flow and easy breathing
In practice, however , many athletes do not warm up suf ficiently . Many
spend, at most, 2 to 3 minutes  warming up by doing a light jog before
intensifying their exercise. This is simply a case of going too fast, too soon. Aisling plays soccer for one of the better amateur football teams in
Ireland. She has reached a high  level of fitness and is a newc omer to the
Oxygen Advantage exercises. D espite her excellent fitness, she often finds
that she feels qu ite breathless during the first 10 to 20 minutes of a game,
while at the end of the game she feels as if she could go on playing forever . This is a common complaint within the world of sport, and usually comes
down to  a lack of warm-up. T he best way to avoid early breathlessness
during e xercise is to increase your BOL T score and spend more time
warming up with nasal breathing. For people like Aisling, who find it hard to get going when they
exercise, at least 10 minutes sh ould be spent warming up befo re physical
activity , especially during cold weather , as it can take the body up to 30
minutes to function at its best. In  order to devote all your ener gy to a game,
your bod y should reach peak form early on rather than somewhere during
the second half. By skipping an adequate warm-up—either through
impatience or because you believe it’ s not necessary—you are cheating
yourself out of performing at your full capability .T o maxi mize the benefits of your warm-up, combine movement with
relaxation techniques and breath holds, as described below . Oxygen Advantage W arm-Up
•  Begin walking at a pace that is comfortable for you. •   Durin g your  warm-up, try to breathe regularly and calm ly
through your nose, using your d iaphragm to maintain a gentle
and relaxed breathing technique. •   F eel y our abdomen gently m oving outward as you inhale an d
gently moving inward as you exhale. •   As you walk, allow a feeling of relaxation to spread throughout
your bod y . Silen tly encourage the area around your chest and
abdomen to relax (you will f ind that any tension can be
released by silently telling that area of the body to relax). Feel
your body relax and become soft. Body relaxation during
physical exercise helps to ensure steady , calm, and regular
breathing. •   After 1 minu te or so of walking at a fairly good pace, exhale
normally throug h your nose an d pinch your nose with your
fingers t o hold the breath. (If y ou are in a public place, you
might prefer to hold the breath without holding your nose.) •   While  holding your breath, walk for 10 to 30 paces, or until yo u
feel a moderate need to breathe. When you feel this hunger for
air , let go of your nose and resume breathing through your
nose. •   Conti nue wa lking for 10 minutes, performing a breath ho ld
every minute or so. Creating an air shortage by holding the breath during your warm-up is
vitally im portant to cause an accumulation of carbon dioxide i n the bloodbefore physical exercise commences. Y our breathing will naturally increase when you exercise more
intensely , but without a corresponding increase in the production of CO 2,
the r esult will be  a net loss of carbon dioxide. This loss can lead to reduced
oxygen delivery  to working muscles and the constriction of a irways and
blood vessels. Not surprisingly , most asthma attacks and breathing
dif ficulties occur during the first 10 minutes of physical exercise. In orde r to avoid exercise-induced asthma, there are three simple
guidelines:
1. Attain a high BOL T score
2. Nasal breathe
3. W arm up
Br eathe Ligh t to Br eathe Right—Jogging, Running , or Any
Other Activity
After a 10-minu te warm-up of walking using relaxation and breath holds,
you can  increase your pace to a jog or run. Start of f easy and follow your
breathing, conti nuing to breathe through the nose. While jogging or
running, it is necessary to keep your breathing regular and under control. If
you find  it too d if ficult to run with your mouth closed, it simply  means that
your pac e is too fast at that mom ent. Slow down or even walk a little until
you reco ver , always breathing in and out through the nose, especially if
your BOL T score is less than 20 seconds. Y ou can  check whether you are pushing yourself too hard during
physical exercise by exhaling normally and holding your breath for 5
seconds. When you resume breathing through the nose, your breathing
should remain controlled. If you find that you lose contr ol of your
breathing, you are pushing yourself too hard. No m atter what type of exercise you prefer , make sure that yo u watch
your bre ath and become aware of your inner body . Silently repeat the word
r elax  to help release the tension aro und your abdomen. Bring your entire
attention from your mind into your body . Become one with your run or
exercise, mer ging body , mind, and activity together . Move with every cellof your body , from the top of your head to the tips of your toes. Doing so
will give your tr aining, your sport, and your competition the attention they
deserve. When engaged in an activity , there is no point to just going through
the motions. One needs to become the activity . As you run, fe el each gentle connection between your feet and the
ground as you p ropel yourself forward. A void pounding the pavement as
this will lead to sore hips, sore j oints, and possible injuries. Instead, bring a
feeling of lightness to your body , and visualize yourself barely t ouching the
ground as your run. Imagine yourself running over thin twigs, treading so
softly th at they do not break, emulating the words of Chinese philosopher
Lao Tzu : “A good runner leaves no tracks.” Remember: light foot strikes, a
relaxed body , and regular , steady breathing. T en or fifteen minutes into your run or other workout, you will probably
experience an endorphin high fr om your exercise. Allow your body to find
its p erfect work rate by breathing through your nose in a steady  and regular
fashion. There is no need whatsoever for a heart rate monitor to provide
feedback on training intensity . Instead, let your nose, your breathing
rhythm, and how you feel dictate your training intensity . Continue to
increase your pace to the point that you can maintain steady and regular
breathing throug h the nose. If your breathing rhythm becomes chaotic or it
is neces sary to open your mouth to breathe, your exercise intensity is toomuch. If this happens, slow your pace to a walk for 2 to 3 minutes to allow
your bre athing to recover . When you are able to breathe calmly through
your nose once more, you can resume your physical exercise. As y ou continue your physica l exercise, the increased generation of
carbon dioxide and heat will enhance the delivery of oxygen from the blood
to w orking muscles, as well as f acilitating the dilation of airways and blood
vessels. Y our body will be warm and sweating, your breathing will be faster
than normal but steady , and your head will be clear . If you keep your mouth
closed throughout your exercise, your breathing will recover quickly . Br eathing Recovery Exer cise
Following physical exercise, cool down by walking for 3 to  5 minutes,
performing the following small breath holds:
•  Exhale as normal through the nose. •   Pinch  your nose with your fingers to hold the breath for 2 to 5
seconds. •  Breathe normally through the nose for 10 seconds.•  Repeat the first 3 steps throughout your cooldown. •  Resume regular breathing. How to Determine Whether Y ou Have Exer cised Corr ectly
In ad dition to us ing breath holds to determine your training limits, you can
also use your BOL T score to see how ef ficient your breathin g is during
physical exercise. Follow these steps to track your progress using your
BOL T score:
•  Measure your BOL T score before training. •  Perform your physical exercise. •  Measure your BOL T score one hour after you finish training. •   If your BOL T score is higher after exercise than before, your
breathing is ef ficient during exercise. •   If  you r BOL T  score is lower  after exercise than before, yo ur
breathing is inef ficient during exercise. In this situation, it is
safer to slow down and ensure your breathing remains
controlled throughout exercise. In 19 99 Danny D reyer and his w ife, Katherine, introduced Chi-R unning
to the athletic world, a fusion of running, walking, and the subtle inner
focus of tai chi. Having successfully completed forty ultramara thons since
1995, Danny has finished within the top three of his age group in all but one
competition. A firm exponent o f nasal breathing, Danny advises the use of
nose breathing as a self-regulati ng mechanism, “because you won’ t be able
to do  it if you ar e either running too fast, not relaxed enough, or inef ficient
in y our movement.” Similar to  the experience of most season ed runners,
when Danny first began nose breathing he could only go for a minute or so
before h e had to breathe through his mouth. However , as he be came more
ef ficient and his breathing rela xed into his running form, he was able to
breathe through his nose for longer periods of time. Another  reason forbreathing throug h the nose, acc ording to Danny , is that it allows air more
fully to be brought into the deep er parts of the lungs, enabling a better gas
exchange to take place. See for yourself. Switch to breathing through your nose and you will
notice the benefits within a short space of time.P A R T  I I
T h e  S e c r e t  o f  F i t n e s sCHAPTER 6
G a i n i n g  t h e  E d g e — N a t u r a l l y
A ccording to the United States  Olympic T raining Center , there is a
dif ference of less than 0.5 perce nt in the performance of Olym pic athletes. W ith such a na rrow mar gin for success, it is essential for a thletes and
coaches to look for new ways to  attain a competitive edge. Since oxygen is
the fuel for wo rking muscles, anything that increases body o xygenation
above no rmal le vels will be of great benefit to an athlete’ s performance, and
because oxygen is a natural and limitless resource, it is the id eal tool for
boosting performance legally . One way of tapp ing into your o wn natural resources is to purp osefully
subject the body to reduced oxy gen intake for a short period of time. When
the human body is exposed to situations in which there are reduced oxygen
levels—such as high altitude, or by holding the breath—adaptations take
place that force the body to increase oxygenation of the blood. Even if you
are n ot a  compe titive athlete, using these techniques will allow  you to get
the most out of your workout and accelerate whatever fitness program you
undertake. Who doesn’ t want to do more with less ef fort? While st riving for improved performance, however , there will always be
athletes who choose to participa te in illegal methods of blood doping, either
through blood transfusion or by taking a banned substance such as
erythropoietin (EPO), testosterone, or human growth hormone. Blood tr ansfusions are a testament to the drastic and illegal measures
that some athletes go to in order to gain the edge over their competitors. A
few wee ks before competition, blood is extracted from the athlete’ s body
and stored in a freezer or refrigerator . The body , sensing that blood levels
are l ower than n ormal, will produce additional red blood cells to bridge thegap. Closer to the endurance ev ent, typically between one and seven days,
the stored blood is reinfused into the body of the athlete. This addition of
blood increases quantities of red  blood cells above normal leve ls, which in
turn increases VO 2  max and enhances physical performance. By the early 19 90s EPO had become the banned substance of choice
amongst athletes  seeking to increase their endurance performanc e. EPO is a
naturally occurr ing hormone produced in the kidneys that stimulates the
bone marrow to release more re d blood cells into circulation. Because red
blood ce lls carr y oxygen from the lungs to the muscles, having a higher
concentration in the circulation can greatly improve an athlete’ s aerobic
capacity . EPO that is produced in a lab is almost identical to t he naturally
occurring hormone that is produced in the body . For medical purposes, EPO
is prescr ibed to people with chro nic kidney disease–induced anemia as their
condition result s in a decreas e in the amount of red blood cells in
circulation. How ever , soon after its inception, some members of the athletic
community reali zed that taking an artificial version of EPO impr oved sports
performance by increasing the oxygen-carrying capacity of the body . The mos t notori ous endurance event on earth for blood doping has to be
the T our  de France. Regarded a s the most prestigious of all cycle races in
the world, and with places limited to around two hundred athletes,
participation in the T our de France is the dream of any budding amateur or
professional cyclist. Not for the fainthearted, the event consists of a
grueling 2,200-mile cycle over twenty-two days, with some mountain
climbs lasting for twenty miles or more. Ever since its inception in 1903,
there have been allegations of cyclists resorting to various illegal techniques
to help them complete the event or improve their performance. Early
reports i nvolved cyclists fueling  their bodies with alcohol, stopping of f at
various stages to load their pouches with wine, beer , or whatever else they
could ge t their hands on, more so to numb the pain to help finish the race
rather th an improve athletic performance. However , in more recent decades,
competitors took greater risks to gain an edge. A granit e memorial to the renow ned British cyclist T om Simpson stands
on the spot whe re he collapsed and died during the 1967 T our de France. The epitaph reads: OL YMPIC MEDALIST , WORLD CHAM PION, BRITISH SPOR TING
AMBASSADOR . At twe nty-nine, Simpson was regarded as one of the all-timebest Brit ish cycl ists. During the race, as the route made its way through the
Alps, Simpson fell ill with diarrhea and stomach pains. In the searing heat, close to the summit of Mont V entoux, Simpson fell. W ith a determin ed ef fort to cont inue, he ordered onlookers to “p ut me back
on my bike,” a nd continued to ride 500 yards farther before  collapsing
again. Despite ef forts by a nurse to resuscitate him, he was pronounced
dead af ter being airlifted by helicopter to the hospital. Simpson’ s
postmortem revealed amphetamines in his system. Later , i nvestigators
would discover more evidence of the drugs in his hotel room and the
pockets of his jersey . In la ter years, methods of doping became more sophisticated. T yler
Hamilton, who was the now-disgraced former champion Lance Armstrong’ s
teammate, descr ibed how he got goose bumps as blood, fresh from the
refrigerator , entered his veins. In his book, The Secr et Race,  Hamilton
claims that Armstrong also h ad a blood transfusion to i mprove his
performance, and that during the 1998 T our de France the riders were
followed on a m otorbike by an a ccomplice carrying fresh vials of EPO. “T o
Lance’ s way of thinking, doping is a fact of life, like oxygen or gravity ,”
Hamilton wrote. Lance Armstron g’ s fall from gra ce came on October 10, 2010, when the
U.S. Anti-Doping Agency (USADA) released a statement concluding that
the “evidence shows beyond a ny doubt that the U.S. Postal Service Pro
Cycling T eam [Lance Armstrong’ s team] ran the most sophisticated,
professionalized, and successful doping program that sport ha s ever seen.”
Summed up in the statement was the courage of eleven of A rmstrong’ s
former t eammates who participated in the doping conspiracy but assisted
the agency in its investigation in order to “help young athletes have hope
that they are not put in the position they were.”
In January 2013, in a no-holds -barred interview with Oprah W infrey ,
Armstrong adm itted to taking banned substances, including EPO,
testosterone, human growth hormone, and cortisone, and confess ed to blood
doping a nd bloo d transfusions to enhance his cycling performance. When
W infrey asked if he had used il legal substances or doping methods during
all seven of his T our de France victories, the crushing answer was “yes.”
Preparation to compete in the T our de France often takes place at a
young a ge. From their early tee ns, cyclists sacrifice their social lives andspare time to cyc ling and training to build strength, stamina, and endurance. I would like you to put yourself in this situation for a moment. Imagine that
for years you have devoted every waking hour to training, living, and
dreaming cycling. After a roller -coaster few years, you are finally good
enough t o take part in your greatest aspiration: the T our de France. But soon
within y our first season, your colleagues present you with two options:
Either blood dope and have some chance of competing on a level playing
field, or  choose  not to blood dope and return home, leaving your dreams
behind. This is likely the scenar io that faced many cycling great s, including
T yler Ha milton, Floyd Landis, Bjarne Riis, and Marco Pantani, who wanted
nothing more than to compete in the sport they loved . While many cyclists
reluctantly gave  into the temptation, others chose to abandon their chance at
the T our de France. Stephen Swart grew up on New Zealand’ s North Island,
and in his junior racing days both he and his brother were very  successful
cyclists. Swart cycled alongside Lance Armstrong in 1994 and 1995, but at
age thirty he walked away from cycling completely and was later vilified by
his fellow cyclists for “spitting in the soup” after he broke the code of
silence about doping within the sport. Looking back, Swart said he felt
cheated in a way , wishing he had never been put i n th e positio n to dope. His
natural ability was undermined by the doping culture that surrounded him. For man y years, winning the T o ur de France seemed to be as much about
whose doctor prescribed the be st cocktail of banned substances than the
athletic prowess of the competitors. Since the sporting world has come under increased attention from
investigative jou rnalists—including David W alsh, chief sports writer with
the London  Sunday T imes , and Paul Kimmage, former professional cyclist
and award-winning sports journalist—dealing with cheating has now risen
to th e to p of the agenda for man y sporting authorities. Kimmage , who spent
the past  few decades exposing the doping culture in the T our de France,
commented: “I’ ve always understood the pressure to dope. I’ve always
understood the temptation to dope, and I understand because I’ve been
there. Th e perce ption of the T our de France now from the publi c is that it’ s
rotten, they all dope, and tha t saddens me because it sho uldn’ t have
happened.”
Fortunately for the future of sports, the culture is slowly changing, and
the majo rity of athletes do not partake in the unethical practice of blooddoping. Instead,  they choose naturally beneficial activities such as high-
altitude training  or other techniques designed to increase the bo dy’ s ability
to carry more oxygen. The main purpose of altitude training and the Oxygen Advantage
techniques outlined in this book is to increase red blood cell count. By
practicing the breath-hold exercises outlined in this book, the kidneys
increase product ion of EPO and  the spleen releases red blood cells into the
blood circulation. Both of these ef fects increase the oxygen-carrying
capacity of the b lood above normal levels, giving an athlete a competitive
edge without the risks and e thical issues of illegal doping. A higher
concentration of red blood cells can benefit your sporting performance in
several ways, including:
•  Improving the oxygen-carrying capacity of your blood
•  Increasing your VO 2  max
•  Extending your endurance potential
Maximal oxygen uptake, or VO 2  max , re fers to the maximum capacity
of an individual’ s body to transport and utilize oxygen during 1 minute of
exhaustive exercise. The V refers to volume, the O 2  to  oxygen, and max to
the max imum c apacity of your body . Y our VO 2  m ax is measur ed by the
amount of oxygen that is used d uring 1 minute of exercise per kilogram of
body weight. VO 2  max is a factor that can determine an athlete’ s capacity
to sustai n physi cal exercise, and is considered to be the best indicator of
cardiorespiratory endurance and aerobic fitness. In sports that require
exceptional endurance, such as cycling, rowing, swimming, and running,
world-class athletes typically have a high VO 2  ma x. The goa l of most
endurance progr ams is to increase an individual’ s VO 2  m ax, and this ca n be
achieved by improving the oxygen-carrying capacity of the blood. The rest of this  chapter explores several dif ferent training r egimens
along with their ef fects on VO 2  m ax and the ox ygen-carrying capacity of
the blood. In order to understand how and why these techniques work, it is
useful to know the following b asic information about the composition of
your blood and some common terms that we will be referring to regularly .Blood is made u p of three parts: oxygen-carrying red cells, whi te blood
cells, an d plasm a. Hemoglobin  is a protein fou nd within the re d cells. One
of the functions  of hemoglobin is to carry oxygen from the lungs to the
cells, tissues, and or gans of the body , where it is released in order to burn
nutrients for the production of e ner gy . Once oxygen has been r eleased, the
resultant carbon dioxide is collected by hemoglobin and returned to the
lungs, which exhale the excess. Levels of hemoglobin will vary from person to person, but the
following figures provide a general guide for normal results:
Male: 13.8 to 17.2 gm/dL
Female: 12.1 to 15.1 gm/dL
(gm/dL = grams per deciliter)
Hematocrit  refers to the percentage of red blood cells in the blood. Under normal conditions, hemat ocrit will relate closely to the concentration
of hemoglobin in the blood. Hematocrit is usually found to  be 40.7 to 50.3
percent for males and 36.1 to 44.3 percent for females. Another measurement relevant to Oxygen Advantage techniques is the
oxygen saturation percentage of hemoglobin. Hemoglobin has a maximum
oxygen-carrying capacity , and oxygen saturation simply means how much
of that capacity is filled with ox ygen. Normal arterial oxygen saturation is
between 95 and 99 percent. In the following sections w e look at research that investigates
supplementary training programs, including high-altitude training, high-
intensity exercise, and simulation of high altitude by breath holding, and
compare how these techniques can improve oxygen-carrying capacity and
athletic performance naturally . The Merits of High-Altitude T raining
T raditional altitude training methods involve living and training at a high
altitude, forcing  the body to adapt to exercising with less oxygen and
therefore increasing the blood’ s oxygen-carrying capacity . Athletes still use
this technique today , particularl y those who live at high altitudes such as
Kenyan and Ethiopian runners. However , there is a significant drawback to
training at high altitude, since e xercising in such an atmosphere increasesresistance, which can prevent an athlete from achieving his or her
maximum work  rate. This reduction in exercise intensity can result in
muscle deconditioning. T o limit  the detraining ef fects of working at high altitude while still
maintaining the benefits, Dr . Benjamin Levine and Dr . James Stray-
Gundersen from the University of T exas in Dallas developed th e “live high
and train low” m odel in the 199 0s. This model requires an athlete to live at
a moder ate altit ude of 2,500 meters but to train at an altitude lower than
1,500 m eters. T he premise of t he method is to enable athlete s to benefit
from the  positive physiological  changes associated with living at a high
altitude while enabling them to train at their maximum work rate. Levine a nd Stra y-Gundersen co nducted a study of thirty-nine m ale and
female collegiate distance runners who were evenly matched in fitness
level. Each runner was assigned to one of three groups:
1. Live low (150 meters) and train low (150 meters)
2. Live high (2,500 meters) and train low (1,250 meters)
3. Live high (2,500 meters) and train high (2,500 meters)
Results for the second group, “live high and train low ,” showed a 9
percent i mprovement in red blood cell volume and a 5 percent im provement
in maximal oxygen uptake (VO 2  max). The improvement in maximal
oxygen uptake was in direct pro portion to increased red cell m ass volume. This tran slated to an impressive performance improvement of 13.4 seconds
in a 5,000-meter run. After returning to sea level, the “live high and train low” group  was the
only one to demonstrate significant improvements in both VO 2  max and
5,000-meter run  time. These im provements were attributed to the athletes’
acclimatization to altitude while  maintaining the velocity of their sea-level
training, most likely also accounting for the increase in their VO 2  max. Another study replicated these results using national team distance
runners. Following 27 days of training at an altitude of 2,500 meters,
participants achieved an improv ement of 1.1 percent in a 3,000-meter time
trial. Alt hough a 1.1 percent improvement in performance may not seem to
be a lar ge ef fect, at an elite level, races are won or lost by small fractions ofa percent. Furthermore, the increase in running performance was
accompanied by a 3 percent improvement in maximal oxygen uptake. The United States national team  for long track speed skating utilized the
“live hig h, train  low” model to  prepare for the 2002 W inter Olympics in
Salt Lak e City . That year they  enjoyed unprecedented success, with six
athletes winning eight medals (three of which were gold) and two world
records broken. During the 2006 T orino Olympics, the U.S. long track
speed skaters who continued to employ the “live high, tra in low”  model
brought home three gold, three silver , and one bronze medal. The Merits of High-Intensity T raining
Another training method that receives considerable attention from athletes
and coaches is h igh-intensity training. The fundamental princi ple of high-
intensity training is to exercise in short, intense bursts, performing at
maximum work  rate—a technique that is certainly not for the fainthearted. Numerous studie s have investigated the dif ferent responses from training at
dif ferent intensities, and in comparison to moderate exercise, high-intensity
training provides greater improvements to both aerobic and anaerobic
capacity . Aerobic exercise is related to endurance and ensures th at the body
is suppli ed with enough oxygen to continue to perform. Anaerobic exercise
means “ without oxygen” and is more concerned with speed, power , and
strength, leading to improved performance in a shorter space of time. Japanese scienti st Izumi T abata and colleagues at the National Institute
of F itness and Sports in Jap an conducted a study of two training
experiments to compare moderate- to high-intensity training. The high-
intensity group participated in the method known as T abata training, in
which athletes give their full ef f ort at an exhausting work rate for periods of
just 20 seconds at a time. The authors of the study concluded that although
moderate-intensity aerobic training improved aerobic power , hi gh-intensity
intermittent training improved both anaerobic and aerobic performance. In anoth er study , Stephen Bailey and colleagues from the University of
Exeter in the U K compared a high-intensity sprint training program with
low-intensity endurance training, measuring VO 2  u ptake  and muscle
deoxygenation. Posttrial results showed that the high-inten sity groupexperienced faster VO 2  kin etics and an increased to lerance of high-
intensity exercis e. This means that the athletes experienced fa ster oxygen
uptake when transitioning between rest and exercise, allowing them to
perform at a hi gher standard more easily . This improved oxygenation of
active muscles also contributes to decreased recovery time following
exercise and a reduction in the production of lactic acid. It seems clear , therefore, that high-intensity training of fers several
positive benefits to athletes, including:
•   Improved anaerobic and aerobic ener gy supplying systems,
allowing for greater endurance, strength, speed, and power
•   Faster  VO 2  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 ox ygenation of active muscles, allowing you to
exercise harder and longer
In t he next sec tion we will examine how to produce the be neficial
ef fects of high-altitude and high-intensity training to increase exercise
performance. The Science of Simulating High-Altitude and High -Intensity
Exer cise
High-altitude training in real conditions is obviously more feasible for
athletes living in countries such as Kenya than those of us liv ing in, say ,
Ireland, where the low-lying terrain reaches no higher than 1,000 meters. Similarly , high-i ntensity training  may not be practical for some people, as itinvolves maximum physical ef fort and respiration until exhaustion. Some
people will find high-intensity exercise extremely uncomfortable or find
that they lose control of their breathing, which can lead to health concerns. A practi cal alternative available to all athletes regardless of location and
fitness i s to supplement regular training with breath-hold training. In the
following sections we will learn how breath-holding techniques allow us to
simulate many of the positive benefits of high-altitude and hi gh-intensity
training, including:
•   The release of red blood c ells from the spleen, improving
aerobic performance
•  The production of natural EPO
•  A higher tolerance to carbon dioxide
•  Reduced stress and fatigue of working muscles
•  Improved psychological preparedness
•  Improved recovery time
•  Reduced lactic acid
•  Improved swimming technique (as discussed later)
•  The ability to maintain fitness during rest or injury
•   Maintenance of these benefits without the need to travel to high
altitudes
For hundreds of thousands of years, breath holding was practiced
extensively by our ancestors for  the purposes of foraging for food by diving
in a deep-water environment, an d some evolutionary theorists even suggest
that it might have been responsible for a number of unique human features. T o t his day , pre dominantly female Japanese pearl divers kno wn as amacontinue with the tradition of b reath-hold diving—a practice th ought to be
over two thousand years old. The bes t-equipped natural dive r is likely the W eddell seal, which can
remain submer g ed in water for up to two hours at a time. Although humans
do not have the same adaptive physiological response of the seal, we are
able to exhibit certain coping mechanisms in order to deal with a relative
lack of oxygen. Generally , most humans can hold their breath after an
inhalation for a maximum of up to about 50 seconds, with elite divers
achieving a static breath hold of between 8 minutes 23 seconds and 11
minutes 35 seconds. A nu mber of stu dies have sought to understand the significant role that
breath holding can play in adapt ing the body for increased oxyg en delivery ,
with res earchers investigating the ef fects of breath-hold divin g in native
divers, professional divers, and untrained divers. The spleen is an  or gan that acts as a blood bank; when the body  signals
an incre ased demand for oxygen, the spleen releases stores of red blood
cells. It therefore plays a very important role in regulating blood  hematocrit
(the percentage of red blood cells in the blood), as well as hemoglobin
concentration. Provoking the body to release additional red blood cells and increase the
concentration of hemoglobin in the blood improves the body’ s ability to
deliver oxygen to working muscles during exercise. Breath-holding studies
involving volun teers whose spleens had been removed for med ical reasons
demonstrate just  how vital this or gan is in changing the composition of the
blood. After a s eries of short breath-holding exercises, those with spleens
intact sh owed a n increase in he matocrit and hemoglobin conc entration of
6.4 perc ent and 3.3 percent respectively , while those without spleens
showed no alterations in blood composition at all. This means that after as
few as 5 breath holds, the oxygen-carrying capacity of the blood can be
significantly improved with the help of the spleen. This or g an also influences how long a person can hold their br eath for . In o ne s tudy , pa rticipants were able to achieve their longest breath hold on
their thi rd attempt. T rained breath-hold divers peaked at a total of 143
seconds, untrained divers at 127 seconds, and splenectomized volunteers—
those wh o had previously had their spleens removed—achieved 74 seconds. Not only  that but spleen size decreased by a total of 20 percent in bothbreath-hold divers and the untrained volunteers, demonstrating a rapid
contraction of the spleen in resp onse to the reduction of oxygen. What this
means is  that breath-holding ability improves with repetition as the spleen
contracts, releasing additional red blood cells into circulation and
improving the oxygen-carrying capacity of the body . While these studies
generally include subjects hold ing their breath for as long as possible,
significant splen ic contraction has been found to take place with even very
short bre ath hold s of 30 seconds . However , the strongest contractions of the
spleen, and therefore the greatest changes to blood composition, are shown
following maximum breath holds. Another useful piece of information gleaned from these studies is that it
is not necessary  to be immerse d in water to benefit from the ef fects of
breath-hold diving. There seems  to be no discernible dif ference between the
increase of hematocrit and hemoglobin concentration in volunteers
practicing breath holds in and out of water . Since there is no visible increase
in the results of breath holding with the face immersed in water , it can be
concluded that it is the breath hold itself that stimulates splenic contraction. In o ther words, it is not being underwater that causes the splee n to release
red bloo d cells into the circulation but the simple drop of oxyg en pressure
in th e bl ood resu lting from holding of the breath. Therefore, the benefits of
breath h olding a re not limited to  divers and swimmers.
_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:

        Such an instruction
is comm only given by stress counselors, yoga practitioners,  and sports
coaches, resultin g in the student taking a big breath of fresh air into the
lungs, b ut often  this is done through an open mouth while activating the
upper ch est. Such breathing is both big and shallow, but not dee p. This type
of b reathing is entirely the wron g thing to do if your objective is to deliver
more oxygen throughout the body. If we use the de finition of “extending far from the top” in the context of
deep breathing, the “top” will refer to the top of the lungs or the upper
chest. A deep breath, therefore, means to breathe down into the full depth of
the l ungs. It also means using the main breathing muscle, the  diaphragm,
which separates  the chest from the abdomen. During rest, heal thy animals
and bab ies naturally take deep, silent breaths. W ith each inhalation and
exhalation the abdomen gently  expands and contracts. There is no ef fort
involved; the breath is silent, regular, and, more important, through the
nose. If you want to learn what constitutes good breathing, observe the
breathing of a b aby or a healthy  pet, whose breathing has not been altered
by the ef fects of modern lifestyles. Bell jar experiment showing “how we br eathe”
The bell jar di agram above illustrates the relationship betw een the
movement of the diaphragm and movement of the abdome n. As you
breathe, your abdomen moves in  the opposite direction. The rea son why the
abdomen moves outward with the in-breath is because the diaphragm
pushes downwa rd, exerting gentle force on the abdomen. As you exhale,
the d iaphragm moves upward, ta king pressure of f the abdomen and moving
the abdomen inward. T o bring air do wn into the depths of the lungs, it is not actually
necessary to take a big breath, a s even the quietest of breaths will activate
the diaphragm. When you are practicing abdominal nasal breathing, you
should n ot be able to see or hear your breath during rest. In contrast,
overbreathing through the mouth, in an attempt to take a “deep” breath, will
be clearly audible and cause the chest to rise and fall, but will still not
manage to draw the breath deeply into the lungs. The DiaphragmThe diaphragm is a dome-shaped sheet of muscle that separate s the thorax
(which houses the heart and lu ngs) from the abdomen (which houses the
intestines, stoma ch, liver, and kidneys). The diaphragm serves as our main
breathing muscle and, if used correctly, it provides deep and ef ficient
breathing. Poor breathing habits do not take full advantage of the
diaphragm and instead encourage inef ficient overbreathing from the upper
chest. T o  determ ine where your diaphragm is located, place your hands just
at the base of your rib cage and follow your ribs from the front of your body
to the sides. A good rule of thu mb is that the diaphragm is located about
four buttons down on your shirt. Breathing in (inhaling)—abdomen gently moves outwardBreathing out (exhaling)—abdomen gently moves inward
Abdominal breathing is more ef ficient simply because of the shape of
the lung s. Since they are narrow at the top and wider at the bottom, the
amount of blood flow in the low er lobes of the lungs is greater than in the
upper lobes. The fast upper -chest breathing of people who chronically
hyperventilate does not take advantage of the lower parts of  the lungs,
limiting the amount of oxygen  that can be transferred to the blood and
resulting in a gr eater loss of CO 2. No t on ly this, but upper -chest breathing
activates the fight-or -flight response, which raises stress levels and
produces even heavier breathing. Observe your own breathing when you are stressed, or watch the
breathing of anxious relatives, f riends, or colleagues—you will see that this
type of breathin g is generally located in the upper chest and go es at a rate
that is faster tha n normal. When we are stressed we tend to overbreathe and
resort to breathing through the  mouth. Stressed breathing is faster than
normal, audible, produces visible movements, and often involves sighs. Many people habitually breathe in this manner every minute of every hour
of every  day, holding them in  a perpetual state of fight-or -flight with
adrenaline leve ls high. The work of even the best stress counselors,
psychologists, or psychotherapists will be limited unless they fir st help their
patients to address their dysfunc tional breathing. When oxygen delivery tothe brain is reduced, no amount of talking and reasoning is goin g to correct
this deficiency. Stressed and an xious patients can only make t he progress
they really need when their bad breathing habits are addressed. On the other ha nd, healthy individuals who are relaxed and relatively
free from stress will exhibit brea thing that is abdominal: slow, g entle, calm,
regular, relatively unnoticeable, silent, and through the nose. T o achieve this
type of breathing and reduce the negative ef fects of stressed overbreathing,
it is important to activate the body’ s parasympathetic nervous system to
elicit the relaxation response. T o do this, you will need to adjust your
breathing habits in order to properly use your diaphragm. A void sighing,
panting, and breathing through t he mouth, and become accustomed to slow,
gentle, relaxed, calm, and quiet breathing through the nose. This is how we
should b reathe d uring rest every minute of every hour of every day. W ithin
a v ery short tim e you will find that you feel calmer and more en er getic and
are able to slee p better. The po sitive ef fects of abdominal breathing will
continue to transform every as pect of your health, including your sports
performance. Another advantage of abdominal breathing is that it assists with
lymphatic drainage. The lymphatic system is ef fectively the body’ s
sewerage system, draining awa y waste materials and excess fluid. As the
lymphatic system  does not have  a heart to pump the waste thr oughout the
body, it is reliant on the motions of the muscles, including the diaphragm. During abdominal breathing, lymph is sucked through the bloodstream,
neutralizing and destroying dead cells, reducing fluid retention, and
improving detoxification of the body. By utili zing the natural benefits of abdominal breathing you will
improve the quality of your blood flow, increase delivery of oxygen to
working muscle s, and reduce the symptoms of anxiety associated with
overbreathing. Returning your breathing habits to the natural and ef ficient
methods you were born with wi ll also allow you to enjoy better health and
maximize the potential of your sports or exercise performance. Use the
following exerci se to encourage abdominal breathing during rest and sports
until it again becomes second  nature. As the objective of the Oxygen
Advantage program is to restore light, abdominal breathing with a high
BOL T score, the exercise below forms the foundation upon which
remaining exercises are practiced. Br eathe Light to Br eathe Right
( A mor e advance d version of th is exer cise can be found in Part IV : Y our
Oxygen Advantage Pr ogram under Br eathe Light to Br eathe Right
(Advanced Method). ) During the process of breathing, oxygen is drawn into the lungs and
excess carbon dioxide is exhaled. The respiratory center located in the brain
continuously m onitors blood pH, carbon dioxide, and to a l esser extent
oxygen. When the level of carbon dioxide in the blood increases above
programmed levels, the respiratory center transmits impulses that tell the
respiratory muscles to breathe in order to remove the excess gas. When we
breathe too much over a period of hours to days, as in the case  of chronic
stress, the respiratory center adjusts to a lower tolerance of carbon dioxide. Having a lower than normal tolerance to carbon dioxide results in the
respiratory cente r increasing the rate of impulses to the respirato ry muscles. The result is habitual overbreathing and excess breathlessness during
physical exercise. Y ou are  practicing this exercise correctly when you slow down and
reduce y our breathing suf ficien tly to create a tolerable need for air. The
need for  air signifies an accumulation of arterial carbon dioxide, the goal of
which is to reset  the respiratory center ’ s tolerance to this gas. T o assist with
this, it is very helpful to exert gentle pressure against your chest and
abdomen with your hands. T ry to maintain the need for air for the duration
of 4 to 5 minutes. T o p ractice this exercise, it can b e very helpful to sit in front of a mirror
to observe and follow your breathing movements. •   Sit up straigh t. Allow your sh oulders to relax. Imagine a pie ce
of string  gently holding you up from the top of the back of your
head. At the sa me time, feel the space between your ribs
gradually widening. •   Place one hand on your chest and one hand just above your
navel. •   Feel you r abdomen gently moving outward as you inhale and
gently moving inward as you exhale. •   A s yo u breathe, exert gentle pressure with your hands against
your abdomen and chest. This s hould create resistance to your
breathing. •  Breathe against your hands, concentrating on making the size of
each breath smaller. •   W ith e ach bre ath, take in less air than you would like to. Mak e
the in-breath smaller or shorter. •   G ently slow d own and reduce your breathing movements un til
you feel a tolerable hunger for air. •   Brea the out  with a relaxed exhalation. Allow the natur al
elasticity of your lungs and diap hragm to play their role in each
exhalation. Imagine a balloon slowly and gently deflating of its
own accord. •   Whe n the in-breath becomes smaller and the out-breath is
relaxed, visible breathing movements will be reduced. Y ou may
be able to notice this in a mirror. By using a simple exercise like this, you can reduce your breathing
movements by 20 to 30 percent. If your stomach muscles start to contract orjerk or feel tense, or if your breathing rhythm becomes disrupted or out of
control, then the air shortage is too intense. In this situation, a bandon the
exercise for 15 seconds or so and return to it when the air s hortage has
disappeared. At fi rst, you may only be able to  maintain an air shortage for 20 seconds
before the ur ge to breathe is too  strong. W ith practice, you will be able to
maintain an air shortage for longer periods. Remember, you a re trying to
create an air shortage that is tolerable but not stressful. Aim to m aintain this
tolerable “air hunger” for 3 to 5 minutes at a time. Practicing 2 sets of 5-
minute exercise s is enough to help you reset your breathing center and
improve your body’ s tolerance for carbon dioxide. When you practice Breathing Light, the accumulation of carbon dioxide
in th e bl ood wil l result in certai n physiological changes in the body. These
include:
•   A  fee ling of increased warm th resulting from the dilation of
blood vessels
•  A rosy red color coming into the face
•   Increa sed prod uction of watery saliva in the mouth, which is an
indication that your body is going into relaxation mode and
activating the parasympathetic nervous system
All of these ch anges are normal and should not cause dis comfort. However, if you experience dizziness or anxiety while practicing an
Oxygen Advantage exercise, th en it is better to refrain from doing this
exercise and contact an Oxygen  Advantage practitioner who can establish
that you  are doing the exercise correctly. For a list of practitio ners, please
visit OxygenAdvantage. com. T iming Y our Br eathing: A Fundamental Err or
Y ou ma y have noticed that while we attempt to reset breathing volume
toward n ormal, there is no sug gestion of changing the number of breathsper minu te, or to time the lengt h of each breath. This is deliberate—using
time to measure  the size of a breath is a fundamental error. Modern W estern
society s eeks to quantify everything in terms of measurement, including our
breathing, but when it comes to retraining poor breathing habits, it is not the
timing that needs to be focused on. Altering the number of breaths per
minute or counting the size of  each breath in seconds has taken root in
many br eathing techniques but actually has little or no ef fect in addressing
poor breathing habits. For exam ple, te lling someone to inhale for 2 seconds and exhale for 3
seconds does not provide guida nce on whether they should tak e in a very
gentle breath or a huge inhalation of air. The volume of a gentle breath
would be far less than the volume of a lar ge breath, and si nce we are
concerned mainly with volume and reducing it toward normal, counting the
length of a brea th using seconds does not work. The following illustration
shows two dif ferent breaths, each with an inhalation length of 2 seconds
and an exhalation of 3 seconds. Note the dif ference in the amount of air
taken into the lungs by each breath, despite them being the same length:Similarly, is it n ot possible to ad dress poor breathing habits by c hanging
the number of b reaths per minute. T ake, for example, an indi vidual who
breathes 20 breaths per minute, with each breath consisting of 500ml of air. This bre athing p attern provides a total volume of 10 liters per m inute. And,
since 10 liters of air per minute is too much, the individual may be
mistakenly instr ucted to remedy this by reducing the number of breaths per
minute from 20 to 10. However,  changing the number of breaths  in this way
will sim ply resu lt in each brea th doubling in size to compen sate for the
reduction of breathing rate. There will be no change to breathing volume
and the individual’ s symptoms will persist. There is  only one way to chang e your breathing volume and r ate, and
that is by slowin g down and dim inishing the size of each breath  in order to
create a shortage of air. In time, as breathing volume chan ges toward
normal, you will obtain a higher BOL T measurement and the  number of
breaths you take per minute w ill automatically reduce. T o reiterate, it is
impossible to change breathing  volume by altering breathing r ate, but thebest way  to naturally alter your breathing rate is to reduce you r breathing
volume. As your BOL T increa ses, not only will the size of each breath
decrease, but so too will the number of breaths taken per minute. Learning and applying the above exercise to your daily breathing will
provide an excellent foundation on which to build a more ef ficient
breathing technique during sports. Just as if you were building the house of
your dreams, the most crucial aspect is the foundation. There is no point
building a beautiful structure on  top of a weak foundation. T o d o so would
be futile, as the building would t opple soon after it was built. The same rule
applies w ith addressing your breathing volume. Breathing Ligh t to Breathe
Right is the fou ndation on top of which we simulate high-altit ude training
during many sports activities, as you will see in the followin g chapters. T ake yo ur time to become fa miliar with the techniques of abdominal
breathing and reduced breathing before you move on. CHAPTER 5
S e c r e t s  o f  A n c i e n t  T r i b e s
I n 1974, twenty-o ne-year -old T om Piszkin was attending the University of
California at Berkeley. He was a runner and worked part-time in the
sporting goods department at Montgomery W ard in Oakland. On October
24 h e finished his shift and made his way to a bus stop near the Oakland
Coliseum, know n as one of the tougher parts of town. Soon afte r, T om was
confronted by four young men who demanded he give them everything he
had. Th ree of the four youths drew handguns and pressed them against
T om’ s head, chest, and leg. In s hock, when T om stood up to take his wallet
from his pocket, he was shot po int-blank in the middle of the chest by a. 38
special. The bullet bore through T om’ s sternum and entered h is left lung. T om recalls that, surprisingly, the shot didn’ t cause him a lot of pain. Following an operation to remove the lead fragments, T om was
dischar ged from the hospital and resumed running within a month, but
recovering from such a traumatic experience was slow and arduous. T om’ s
journey to restore his lung capa city took over a decade as he continued to
fall short of his expectations, despite working hard at his fitness routine. Above a ll else, T om wanted to r egain the level of athletic fitness he enjoyed
before h e was shot and was determined to figure out a way to lim it his heart
rate duri ng his workout sessions. Intuitively, he figured that by reducing the
stress on his body during exercise, he would be able to improve his overall
fitness a nd endurance. T om theorized that it would help to restrict his
breathing in order to maintain a  steady and manageable exercise intensity
—“like a governor on a lawn mower engine”—a solution th at was also
much cheaper than buying a heart rate monitor. T om soon realized that if he co uldn’ t sustain his pace while b reathing
exclusively through his nose during training, then he was worki ng too hard
and goin g too fast. At first, he  found breathing through his nose during
physical training a little challenging, but soon discovered  that nasal
breathing could more easily be maintained by placing tape ove r his mouth. Not only did T om  tape his mout h during training, he also did it during sleep
to en sure that he  continued nasal breathing during the night. One year after
beginning his reduced breathing training, T om went for a lung c apacity test. His results showed that he was at 130 percent capacity for his weight and
age. T om has since dedicated his life to his two passions of spo rts and
inventing. He is currently a triathlon coach at the University of C alifornia at
San Die go and creator of T itan Flex bikes. He is also certified  as a USA
Olympic T riathlon coach. After  thirteen years of serving at the leadership
level in the T riathlon Club of San Diego, he was inducted into their hall of
fame. Switching to nasal breathing after spending years mouth breathing
requires courage  and commitment. Sometimes it is necessary to take one
step back to m ove two forward if you want to truly im prove your
performance. If you observe y our teammates or competitors during physical e xercise,
you will  no doubt notice that m ost will be breathing through th eir mouths. A qu estion I ofte n hear is: “If nasal breathing is so good, then why do most
elite athletes breathe through their mouths and not their noses. ” A simple
answer i s that W estern breathin g habits have become so far removed from
what they should be that mouth breathing has become the norm. Our ance stors used their noses to breathe during physical exercis e, as do
present-day indigenous tribes, including the T arahumara, the famed running
tribe of Northern Mexico. When researchers studied the nasal-breathing
T arahumara trib e over the cours e of a 26-mile run, they were a stounded to
find that their average heart rate was a surprisingly low 130 beats per
minute. Compa re this with the normal average heart rate of a W estern
marathon runner, which lies between 160 and 180 beats per minute, and you
can see how nasal breathing a llows for a calm and sustaine d breathing
pattern e ven when engaging in intense physical exercise (more on this in
chapter 11). Breathing through the mouth is a relatively modernphenomenon and does nothing to improve performance—in fact, it impedes
it. Harvard-educated anthropologist W ade Davis has devoted much of his
life’ s work to t he study of indigenous cultures, especially in North and
South A merica. T o date, he has lived with fifteen groups of indigenous
people, includin g tribal hunters of the Amazon whose senses are so attuned
that they  can smell the urine of  an animal from forty paces and determine
whether it is from a male or female. While st aying w ith the tribe, Da vis, who is also a triathlete, was allowed
to ac company them on hunting expeditions. Hunts began in the  morning at
a pa ce a lternating between a jog and a run. As soon as they pi cked up the
trail of an anim al, the hunters switched to running in order to catch up. When th e anima l became aware of the hunters, it would speed away, but
they would continue to follow in  close pursuit. The hunters wer e persistent,
increasing their pace so as to give their prey little time to rest, and each time
they lost sight of it they would continue on doggedly until they tracked it
down again. This pattern could  continue over many hours, po ssibly even
days, but the h unters’ tenacity would eventually pay of f and  the animal
would c ollapse from exhaustion, enabling them to capture it at close range. While Davis had a hard time ke eping up with the hunters’ pace, what was
most im pressive to him was that  they never opened their mouths  to breathe. Just like  our ancestors, present -day indigenous tribes are able to run at a
high intensity with their mouth s closed over a relatively long duration of
time, a feat that civilized man seems to have for gotten. It is time to go back
to basics. Initially, breathi ng through the n ose might feel strange during e xercise,
especially if you are used to breathing through your mouth. Bu t remember
that the nose is made for breathing, and nasal breathing ensures a number of
benefits that are essential not only for good health but for impr oved sports
performance, including:
•   Filteri ng, war ming, and humidifying air before it is drawn in to
the lungs
•  Reducing the heart rate
•   Bringing nitric oxide into the lungs to open airways and blood
vessels•  Better oxygen delivery throughout the body
•   Redu ced lact ic acid as more oxygen is delivered to workin g
muscles
The pace at whic h you are able to exercise during a half hour of  training
while br eathing through your nose will depend on your BOL T score. Below
are s ome guidelines that are influenced by your nostril and airway size. For
example, an athlete with lar ge nostrils will experience less resistance to
breathing, enabling exercise at a higher intensity with his or  her mouth
closed. Here is a general guideline of exercise ability (with  the mouth
closed) according to BOL T score:
•   If yo ur BOL T score is 5 seconds, your ability to walk is
seriously hampered. Climbing one flight of stairs will be
challenging, req uiring you to sto p every 3 or 4 steps in order to
take a rest. •   If your BOL T  score is 10 seconds, you will be able to walk
slowly. •   If your BOL T  score is 20 seconds, you will be able to walk
quickly or jog lightly. •   If your BOL T score is 30 seconds, you will be able to jog at a
medium to fast pace. •   If  your BOL T score is 40 seconds, you will be able to ru n
quickly. By increasing your BOL T score, no matter the size of your airways, you
will exp erience lighter breathin g and be able to train at a higher pace, for
longer d istances, while breathin g through the nose. Y our fitness levels will
soon increase well beyond what  they were before, and nasal breathing will
become much easier during exercise. W ithin 6 to 8 weeks your BOL T
measurement sh ould increase by 10 to 15 seconds, resulting in a  significant
improvement to your fitness. Dr. Bill  Hang is an orthodont ist from California. For the past few
decades he has e xamined the mouths and airways of thousands  of patients. What di f ferentiates Dr. Hang from many traditional orthodon tists is that
when he considers the alignmen t of the teeth, he also gives atte ntion to the
resultant ef fect on the jaws, the  width of the face, and size of airways. In
fact, I have yet to meet an individual with such a fascination for airway
size. While we need to be ef ficient with our use of oxygen, it is also
imperative that the size of our airways enables air to flow freely to and from
the lungs. If children or teenage rs spend five or ten years with their mouths
hanging open, their faces will become narrow, their jaws will not develop
correctly, and their airway sizes will be reduced. Nasal breathin g during the
formative years is absolutely es sential to help ensure correct development
of th e face, jaws, and airways. In chapter 13, we will look mor e closely at
the role breathin g plays in the development of the face and the need for
orthodontic treatment. I first met Dr. H ang in 2009, when we were both scheduled t o give a
talk to a study group of myofunctional therapists. As it turned out, we had
the s ame aim in  mind: to explor e how breathing and resting ton gue posture
af fects sleep, sports, and health. I spoke about the benefits of nasal
breathing, while  Dr. Hang spoke about airway size and the benefits of
having a good fa cial structure for sports performance. When the  airways are
too narr ow, our ability to perfo rm physical exercise is hampered. Imagine
completing a marathon while b reathing through airways the size of a very
narrow straw— no matter how well trained you are, how fit, how
determined, if your airways are  constricted you will not be able to take in
enough air to properly oxygenate your body. That day Dr. Ha ng told me that he had been running for forty-tw o years
and had  completed nineteen marathons with his “mouth open like a dog. ”
Following our meeting, he cha nged to breathing through his nose during
training and taped his mouth closed every night to ensure nasal breathing
while he  slept. Initially he found that his nose would run consta ntly during
exercise, requiring him to blow his nose every few hundred yards. This is a
common experi ence for most people adjusting to nasal breathing as the
airways clear and breathing volume increases, but it is a minorinconvenience that will clear up within a few weeks. Like any or gan or
muscle, the nose needs to get used to being used more during sports. Six months later, Bill completed the Pasadena Marathon and finished
second i n his age group. Not on ly this, but he kept his lips tog ether every
step of the way  except during a  couple of long hills when he allowed his
mouth to  drop open occasionall y. No mean feat for a sixty-year -old. Now,
each Sun day, he  completes a two -hour run and continues to nasa l breathe in
order to maintain and ideally improve his fitness. T wenty minu tes into his
run, when he is good and warm, he is able to get up to a good speed while
retaining a slow, regular breathing pattern—much improved from his
previous method of panting through the mouth, expending maximum
ener gy as he ran. T rain Y our Body to Do Mor e with Less
T o r eap the most benefit from your physical training, you need t o train your
body to do mor e with less. T o  do this, you will need to reduce your air
intake. Incorpor ating this concept into your training will result in improved
breathing econo my and an increase in your athletic performance, along with
reduced breathlessness and lactic acid during competition. More important,
you will not nee d to push your body beyond its limits, reducing your risk of
injury, cardiovascular and respiratory problems, and other health concerns. Nasal breathing during physical training ensures that you do not push
yourself beyond what your body is capable of doing. During physical exercise, there are three ways to reduce air intake:
1. Relax your body and take less air into your lungs. 2. Increase exercise intensity while nasal breathing. 3. Practice breath holding during exercise. When yo u first switch to nasal b reathing you may find that you r ability
to train at maximum pace is imp eded. Breathing through the nostrils creates
resistance and adds an extra load  that is likely to slow your performance for
the first  few weeks. However, with continued practice and by increasingyour BO L T score you will so on find that your performance surpasses
previous levels. Competitive athletes who regularly take part in high-intensity training
will need to alte rnate nasal breathing with mouth breathing fo r an overall
improvement to breathing patterns. High-intensity training helps to prevent
muscle decondi tioning and will require an athlete to periodic ally breathe
through his or h er mouth. This is to be expected and can be combined with
nasal br eathing to attain the best results. For less-than-maximum intensity
training, and at all other times,  nasal breathing should be employed. For
example, compe titive athletes may spend 70 percent of their tr aining with
the mou th close d, harnessing the benefits of nasal breathing and adding an
extra loa d to their training to increase BOL T score. They may a lso devote a
smaller portion of training to wo rking at an all-out pace in order to maintain
muscle conditio n, for which brief periods of mouth breathing will be
required. During c ompetition there is no n eed to intentionally take bigger breaths,
nor is there a requirement to breathe less. Instead, bring a feeling of
relaxation to your body and breathe as you feel necessary. However, breath-
holding exercise s during your warm-up can be very advantageous, as can
practicing breathing recovery during your cooldown. Competition isn’ t the
ideal tim e to focus on how wel l or how poorly you are breathing, as your
full conc entration should be devoted to the game or race. The best way to
improve breathing for competition is to improve your everyday breathing,
and the key to this is obtaining a higher BOL T score. Recreational athletes who are not taking part in competition or high-
intensity exercis e, however, are far better of f maintaining nasal breathing at
all times. While reducing your breathing during physical exercise, try not to
overdo i t. If you find that your n eed for air is so great that you need to open
your mo uth, simply slow down and allow your breathing to calm once
more. Unveiling the W arm-Up
The vast majority of sports coaches are in agreement that w arming up
before exercise is vitally impo rtant. During physical exercis e the bodyrequires greater blood flow to tissues and muscles than durin g rest. The
objective of a warm-up is to increase blood flow and prepare t he body for
more intense physical exercise, thus reducing the incidence of sports-related
injuries and improving overall performance. It takes time for the body to w arm up, but when it does, your body is
able to function  more ef fectively during exercise. When your body is
warmed up prior to exercise, the following benefits can be maximized:
•   The productio n of more carbo n dioxide—improving the release
of oxygen from the blood to tissues and or gans—increasing
VO 2  max, improving endurance, and reducing the risk of
injury
•   The o pening o f blood vessels and airways—allowing for bett er
blood flow and easy breathing
In practice, however, many athletes do not warm up suf ficiently. Many
spend, at most, 2 to 3 minutes  warming up by doing a light jog before
intensifying their exercise. This is simply a case of going too fast, too soon. Aisling plays soccer for one of the better amateur football teams in
Ireland. She has reached a high  level of fitness and is a newc omer to the
Oxygen Advantage exercises. D espite her excellent fitness, she often finds
that she feels qu ite breathless during the first 10 to 20 minutes of a game,
while at the end of the game she feels as if she could go on playing forever. This is a common complaint within the world of sport, and usually comes
down to  a lack of warm-up. T he best way to avoid early breathlessness
during e xercise is to increase your BOL T score and spend more time
warming up with nasal breathing. For people like Aisling, who find it hard to get going when they
exercise, at least 10 minutes sh ould be spent warming up befo re physical
activity, especially during cold weather, as it can take the body up to 30
minutes to function at its best. In  order to devote all your ener gy to a game,
your bod y should reach peak form early on rather than somewhere during
the second half. By skipping an adequate warm-up—either through
impatience or because you believe it’ s not necessary—you are cheating
yourself out of performing at your full capability. T o maxi mize the benefits of your warm-up, combine movement with
relaxation techniques and breath holds, as described below. Oxygen Advantage W arm-Up
•  Begin walking at a pace that is comfortable for you. •   Durin g your  warm-up, try to breathe regularly and calm ly
through your nose, using your d iaphragm to maintain a gentle
and relaxed breathing technique. •   F eel y our abdomen gently m oving outward as you inhale an d
gently moving inward as you exhale. •   As you walk, allow a feeling of relaxation to spread throughout
your bod y. Silen tly encourage the area around your chest and
abdomen to relax (you will f ind that any tension can be
released by silently telling that area of the body to relax). Feel
your body relax and become soft. Body relaxation during
physical exercise helps to ensure steady, calm, and regular
breathing. •   After 1 minu te or so of walking at a fairly good pace, exhale
normally throug h your nose an d pinch your nose with your
fingers t o hold the breath. (If y ou are in a public place, you
might prefer to hold the breath without holding your nose. ) •   While  holding your breath, walk for 10 to 30 paces, or until yo u
feel a moderate need to breathe. When you feel this hunger for
air, let go of your nose and resume breathing through your
nose. •   Conti nue wa lking for 10 minutes, performing a breath ho ld
every minute or so. Creating an air shortage by holding the breath during your warm-up is
vitally im portant to cause an accumulation of carbon dioxide i n the bloodbefore physical exercise commences. Y our breathing will naturally increase when you exercise more
intensely, but without a corresponding increase in the production of CO 2,
the r esult will be  a net loss of carbon dioxide. This loss can lead to reduced
oxygen delivery  to working muscles and the constriction of a irways and
blood vessels. Not surprisingly, most asthma attacks and breathing
dif ficulties occur during the first 10 minutes of physical exercise. In orde r to avoid exercise-induced asthma, there are three simple
guidelines:
1. Attain a high BOL T score
2. Nasal breathe
3. W arm up
Br eathe Ligh t to Br eathe Right—Jogging, Running, or Any
Other Activity
After a 10-minu te warm-up of walking using relaxation and breath holds,
you can  increase your pace to a jog or run. Start of f easy and follow your
breathing, conti nuing to breathe through the nose. While jogging or
running, it is necessary to keep your breathing regular and under control. If
you find  it too d if ficult to run with your mouth closed, it simply  means that
your pac e is too fast at that mom ent. Slow down or even walk a little until
you reco ver, always breathing in and out through the nose, especially if
your BOL T score is less than 20 seconds. Y ou can  check whether you are pushing yourself too hard during
physical exercise by exhaling normally and holding your breath for 5
seconds. When you resume breathing through the nose, your breathing
should remain controlled. If you find that you lose contr ol of your
breathing, you are pushing yourself too hard. No m atter what type of exercise you prefer, make sure that yo u watch
your bre ath and become aware of your inner body. Silently repeat the word
r elax  to help release the tension aro und your abdomen. Bring your entire
attention from your mind into your body. Become one with your run or
exercise, mer ging body, mind, and activity together. Move with every cellof your body, from the top of your head to the tips of your toes. Doing so
will give your tr aining, your sport, and your competition the attention they
deserve. When engaged in an activity, there is no point to just going through
the motions. One needs to become the activity. As you run, fe el each gentle connection between your feet and the
ground as you p ropel yourself forward. A void pounding the pavement as
this will lead to sore hips, sore j oints, and possible injuries. Instead, bring a
feeling of lightness to your body, and visualize yourself barely t ouching the
ground as your run. Imagine yourself running over thin twigs, treading so
softly th at they do not break, emulating the words of Chinese philosopher
Lao Tzu : “A good runner leaves no tracks. ” Remember: light foot strikes, a
relaxed body, and regular, steady breathing. T en or fifteen minutes into your run or other workout, you will probably
experience an endorphin high fr om your exercise. Allow your body to find
its p erfect work rate by breathing through your nose in a steady  and regular
fashion. There is no need whatsoever for a heart rate monitor to provide
feedback on training intensity. Instead, let your nose, your breathing
rhythm, and how you feel dictate your training intensity. Continue to
increase your pace to the point that you can maintain steady and regular
breathing throug h the nose. If your breathing rhythm becomes chaotic or it
is neces sary to open your mouth to breathe, your exercise intensity is toomuch. If this happens, slow your pace to a walk for 2 to 3 minutes to allow
your bre athing to recover. When you are able to breathe calmly through
your nose once more, you can resume your physical exercise. As y ou continue your physica l exercise, the increased generation of
carbon dioxide and heat will enhance the delivery of oxygen from the blood
to w orking muscles, as well as f acilitating the dilation of airways and blood
vessels. Y our body will be warm and sweating, your breathing will be faster
than normal but steady, and your head will be clear. If you keep your mouth
closed throughout your exercise, your breathing will recover quickly. Br eathing Recovery Exer cise
Following physical exercise, cool down by walking for 3 to  5 minutes,
performing the following small breath holds:
•  Exhale as normal through the nose. •   Pinch  your nose with your fingers to hold the breath for 2 to 5
seconds. •  Breathe normally through the nose for 10 seconds. •  Repeat the first 3 steps throughout your cooldown. •  Resume regular breathing. How to Determine Whether Y ou Have Exer cised Corr ectly
In ad dition to us ing breath holds to determine your training limits, you can
also use your BOL T score to see how ef ficient your breathin g is during
physical exercise. Follow these steps to track your progress using your
BOL T score:
•  Measure your BOL T score before training. •  Perform your physical exercise. •  Measure your BOL T score one hour after you finish training. •   If your BOL T score is higher after exercise than before, your
breathing is ef ficient during exercise. •   If  you r BOL T  score is lower  after exercise than before, yo ur
breathing is inef ficient during exercise. In this situation, it is
safer to slow down and ensure your breathing remains
controlled throughout exercise. In 19 99 Danny D reyer and his w ife, Katherine, introduced Chi-R unning
to the athletic world, a fusion of running, walking, and the subtle inner
focus of tai chi. Having successfully completed forty ultramara thons since
1995, Danny has finished within the top three of his age group in all but one
competition. A firm exponent o f nasal breathing, Danny advises the use of
nose breathing as a self-regulati ng mechanism, “because you won’ t be able
to do  it if you ar e either running too fast, not relaxed enough, or inef ficient
in y our movement. ” Similar to  the experience of most season ed runners,
when Danny first began nose breathing he could only go for a minute or so
before h e had to breathe through his mouth. However, as he be came more
ef ficient and his breathing rela xed into his running form, he was able to
breathe through his nose for longer periods of time. Another  reason forbreathing throug h the nose, acc ording to Danny, is that it allows air more
fully to be brought into the deep er parts of the lungs, enabling a better gas
exchange to take place. See for yourself. Switch to breathing through your nose and you will
notice the benefits within a short space of time. P A R T  I I
T h e  S e c r e t  o f  F i t n e s sCHAPTER 6
G a i n i n g  t h e  E d g e — N a t u r a l l y
A ccording to the United States  Olympic T raining Center, there is a
dif ference of less than 0. 5 perce nt in the performance of Olym pic athletes. W ith such a na rrow mar gin for success, it is essential for a thletes and
coaches to look for new ways to  attain a competitive edge. Since oxygen is
the fuel for wo rking muscles, anything that increases body o xygenation
above no rmal le vels will be of great benefit to an athlete’ s performance, and
because oxygen is a natural and limitless resource, it is the id eal tool for
boosting performance legally. One way of tapp ing into your o wn natural resources is to purp osefully
subject the body to reduced oxy gen intake for a short period of time. When
the human body is exposed to situations in which there are reduced oxygen
levels—such as high altitude, or by holding the breath—adaptations take
place that force the body to increase oxygenation of the blood. Even if you
are n ot a  compe titive athlete, using these techniques will allow  you to get
the most out of your workout and accelerate whatever fitness program you
undertake. Who doesn’ t want to do more with less ef fort. While st riving for improved performance, however, there will always be
athletes who choose to participa te in illegal methods of blood doping, either
through blood transfusion or by taking a banned substance such as
erythropoietin (EPO), testosterone, or human growth hormone. Blood tr ansfusions are a testament to the drastic and illegal measures
that some athletes go to in order to gain the edge over their competitors. A
few wee ks before competition, blood is extracted from the athlete’ s body
and stored in a freezer or refrigerator. The body, sensing that blood levels
are l ower than n ormal, will produce additional red blood cells to bridge thegap. Closer to the endurance ev ent, typically between one and seven days,
the stored blood is reinfused into the body of the athlete. This addition of
blood increases quantities of red  blood cells above normal leve ls, which in
turn increases VO 2  max and enhances physical performance. By the early 19 90s EPO had become the banned substance of choice
amongst athletes  seeking to increase their endurance performanc e. EPO is a
naturally occurr ing hormone produced in the kidneys that stimulates the
bone marrow to release more re d blood cells into circulation. Because red
blood ce lls carr y oxygen from the lungs to the muscles, having a higher
concentration in the circulation can greatly improve an athlete’ s aerobic
capacity. EPO that is produced in a lab is almost identical to t he naturally
occurring hormone that is produced in the body. For medical purposes, EPO
is prescr ibed to people with chro nic kidney disease–induced anemia as their
condition result s in a decreas e in the amount of red blood cells in
circulation. How ever, soon after its inception, some members of the athletic
community reali zed that taking an artificial version of EPO impr oved sports
performance by increasing the oxygen-carrying capacity of the body. The mos t notori ous endurance event on earth for blood doping has to be
the T our  de France. Regarded a s the most prestigious of all cycle races in
the world, and with places limited to around two hundred athletes,
participation in the T our de France is the dream of any budding amateur or
professional cyclist. Not for the fainthearted, the event consists of a
grueling 2,200-mile cycle over twenty-two days, with some mountain
climbs lasting for twenty miles or more. Ever since its inception in 1903,
there have been allegations of cyclists resorting to various illegal techniques
to help them complete the event or improve their performance. Early
reports i nvolved cyclists fueling  their bodies with alcohol, stopping of f at
various stages to load their pouches with wine, beer, or whatever else they
could ge t their hands on, more so to numb the pain to help finish the race
rather th an improve athletic performance. However, in more recent decades,
competitors took greater risks to gain an edge. A granit e memorial to the renow ned British cyclist T om Simpson stands
on the spot whe re he collapsed and died during the 1967 T our de France. The epitaph reads: OL YMPIC MEDALIST, WORLD CHAM PION, BRITISH SPOR TING
AMBASSADOR. At twe nty-nine, Simpson was regarded as one of the all-timebest Brit ish cycl ists. During the race, as the route made its way through the
Alps, Simpson fell ill with diarrhea and stomach pains. In the searing heat, close to the summit of Mont V entoux, Simpson fell. W ith a determin ed ef fort to cont inue, he ordered onlookers to “p ut me back
on my bike,” a nd continued to ride 500 yards farther before  collapsing
again. Despite ef forts by a nurse to resuscitate him, he was pronounced
dead af ter being airlifted by helicopter to the hospital. Simpson’ s
postmortem revealed amphetamines in his system. Later, i nvestigators
would discover more evidence of the drugs in his hotel room and the
pockets of his jersey. In la ter years, methods of doping became more sophisticated. T yler
Hamilton, who was the now-disgraced former champion Lance Armstrong’ s
teammate, descr ibed how he got goose bumps as blood, fresh from the
refrigerator, entered his veins. In his book, The Secr et Race,  Hamilton
claims that Armstrong also h ad a blood transfusion to i mprove his
performance, and that during the 1998 T our de France the riders were
followed on a m otorbike by an a ccomplice carrying fresh vials of EPO. “T o
Lance’ s way of thinking, doping is a fact of life, like oxygen or gravity,”
Hamilton wrote. Lance Armstron g’ s fall from gra ce came on October 10, 2010, when the
U. S. Anti-Doping Agency (USADA) released a statement concluding that
the “evidence shows beyond a ny doubt that the U.
Stress counselors, yoga practitioners, and sports coaches.
Who typically gives the instruction to take a big breath?
Breathe deeply by activating the diaphragm and using the nose, not the mouth.
What is the correct way to breathe to deliver oxygen to the body?
Stressed individuals breathe faster, more shallowly, and through the mouth, whereas healthy individuals breathe calmly, slowly, and through the nose.
What is the main difference between healthy and stressed individuals' breathing patterns?
To improve athletic performance by increasing oxygen delivery to the muscles, reducing stress, and enhancing overall health.
What is the purpose of the Oxygen Advantage program?
Nasal breathing and increasing oxygen delivery to the muscles.
What is the key to improving sports performance, according to Dr. Hang?