What is ‘breathwork’? And do I need to do it?
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From “breathwork recipes” to breathing techniques, many social media and health websites are recommending breathwork to reduce stress.
But breathwork is not new. Rather it is the latest in a long history of breathing techniques such as Pranayama from India and qigong from China. Such practices have been used for thousands of years to promote a healthy mind and body.
The benefits can be immediate and obvious. Try taking a deep breath in through your nose and exhaling slowly. Do you feel a little calmer?
So, what’s the difference between the breathing we do to keep us alive and breathwork?
Breathwork is about control
Breathwork is not the same as other mindfulness practices. While the latter focus on observing the breath, breathwork is about controlling inhalation and exhalation.
Normally, breathing happens automatically via messages from the brain, outside our conscious control. But we can control our breath, by directing the movement of our diaphragm and mouth.
The diaphragm is a large muscle that separates our thoracic (chest) and abdominal (belly) cavities. When the diaphragm contracts, it expands the thoracic cavity and pulls air into the lungs.
Controlling how deep, how often, how fast and through what (nose or mouth) we inhale is the crux of breathwork, from fire breathing to the humming bee breath.
Breathwork can calm or excite
Even small bits of breathwork can have physical and mental health benefits and complete the stress cycle to avoid burnout.
Calming breathwork includes diaphragmatic (belly) breathing, slow breathing, pausing between breaths, and specifically slowing down the exhale.
In diaphragmatic breathing, you consciously contract your diaphragm down into your abdomen to inhale. This pushes your belly outwards and makes your breathing deeper and slower.
You can also slow the breath by doing:
- box breathing (count to four for each of four steps: breathe in, hold, breathe out, hold), or
- coherent breathing (controlled slow breathing of five or six breaths per minute), or
- alternate nostril breathing (close the left nostril and breathe in slowly through the right nostril, then close the right nostril and breathe out slowly through the left nostril, then repeat the opposite way).
You can slow down the exhalation specifically by counting, humming or pursing your lips as you breathe out.
In contrast to these calming breathing practices, energising fast-paced breathwork increases arousal. For example, fire breathing (breathe in and out quickly, but not deeply, through your nose in a consistent rhythm) and Lion’s breath (breathe out through your mouth, stick your tongue out and make a strong “haa” sound).
What is happening in the body?
Deep and slow breathing, especially with a long exhale, is the best way to stimulate the vagus nerves. The vagus nerves pass through the diaphragm and are the main nerves of the parasympathetic nervous system.
Simulating the vagus nerves calms our sympathetic nervous system (fight or flight) stress response. This improves mood, lowers the stress hormone cortisol and helps to regulate emotions and responses. It also promotes more coordinated brain activity, improves immune function and reduces inflammation.
Taking deep, diaphragmatic breaths also has physical benefits. This improves blood flow, lung function and exercise performance, increases oxygen in the body, and strengthens the diaphragm.
Slow breathing reduces heart rate and blood pressure and increases heart rate variability (normal variation in time between heart beats). These are linked to better heart health.
Taking shallow, quick, rhythmic breaths in and out through your nose stimulates the sympathetic nervous system. Short-term, controlled activation of the stress response is healthy and develops resilience to stress.
Breathing in through the nose
We are designed to inhale through our nose, not our mouth. Inside our nose are lots of blood vessels, mucous glands and tiny hairs called cilia. These warm and humidify the air we breathe and filter out germs and toxins.
We want the air that reaches our airways and lungs to be clean and moist. Cold and dry air is irritating to our nose and throat, and we don’t want germs to get into the body.
Nasal breathing increases parasympathetic activity and releases nitric oxide, which improves airway dilation and lowers blood pressure.
Consistently breathing through our mouth is not healthy. It can lead to pollutants and infections reaching the lungs, snoring, sleep apnoea, and dental issues including cavities and jaw joint problems.
A free workout
Slow breathing – even short sessions at home – can reduce stress, anxiety and depression in the general population and among those with clinical depression or anxiety. Research on breathwork in helping post-traumatic stress disorder (PTSD) is also promising.
Diaphragmatic breathing to improve lung function and strengthen the diaphragm can improve breathing and exercise intolerance in chronic heart failure, chronic obstructive pulmonary disease and asthma. It can also improve exercise performance and reduce oxidative stress (an imbalance of more free radicals and/or less antioxidants, which can damage cells) after exercise.
A mind-body connection you can access any time
If you feel stressed or anxious, you might subconsciously take shallow, quick breaths, but this can make you feel more anxious. Deep diaphragmatic breaths through your nose and focusing on strong exhalations can help break this cycle and bring calm and mental clarity.
Just a few minutes a day of breathwork can improve your physical and mental health and wellbeing. Daily deep breathing exercises in the workplace reduce blood pressure and stress, which is important since burnout rates are high.
Bottom line: any conscious control of your breath throughout the day is positive.
So, next time you are waiting in a line, at traffic lights or for the kettle to boil, take a moment to focus on your breath. Breathe deeply into your belly through your nose, exhale slowly, and enjoy the benefits.
Theresa Larkin, Associate professor of Medical Sciences, University of Wollongong and Judy Pickard, Senior Lecturer, Clinical Psychology, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Complete Guide To Fasting – By Dr. Jason Fung
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When it comes to intermittent fasting, the plethora of options can be daunting at first, as can such questions as what fluids are ok to take vs what will break the fast, what to expect in terms of your first fasting experience, and how not to accidentally self-sabotage.
Practised well, intermittent fasting can be a very freeing experience, and not at all uncomfortable. Practised badly, it can be absolutely miserable, and this is one of those things where knowledge makes the difference.
Dr. Fung (yes, the same Dr. Fung we’ve featured before as an expert on metabolic health) shares this knowledge over the course of 304 pages, with lots of scientific information and insider tips. He covers the different kinds of fasting, how each of them work and what they do for the body and brain, hunger/satiety hacks, lots of “frequently asked questions”, and even a range of recipes to help smooth your journey along its way.
The style is very well-written pop-science; it’s engaging and straightforward without skimping on science at all.
Bottom line: if you’re thinking of trying intermittent fasting but aren’t sure where/how to best get started, this book can set you off on the right foot and keep you on the right track thereafter.
Click here to check out The Complete Guide to Fasting, and enjoy the process as well as the results!
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Yoga for Better Sleep – by Mark Stephens
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The book has, as you might expect:
- postural exercises
- breathing exercises
- meditation exercises
Instructions given in all of the above categories are clear and easy to follow, and there are photographic illustrations too where appropriate.
What sets it apart from many books of this kind is that it also has chapters dedicated to various specific circumstances; the many actual reasons people seriously struggle to sleep; not just “screentime too late”, but for example deprepression, sleep apnea, hyperarousal, or even just aging.
As well as the comprehensive exercises, there are also many tips, tricks, hacks, and workarounds—it’s a practical guidebook with practical advice.
While the book is about yogic practices, the author also does tackle this holistically, acknowledging that there are many factors going on, and that yogic practices should be one more string to our sleep-improving bow—as we continue with other general good advice for good sleep too, have medical tests if it seems appropriate, that kind of thing. Basically, to have one’s assorted approaches work together with synergistic effect.
Bottom line: this book will quite possibly put you to sleep! But only in the best possible way.
Click here to check out Yoga for Better Sleep, and get those valuable Zs in, healthily!
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How To Leverage Placebo Effect For Yourself
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Placebo Effect: Making Things Work Since… Well, A Very Long Time Ago
The placebo effect is a well-known, well-evidenced factor that is very relevant when it comes to the testing and implementation of medical treatments:
NIH | National Center for Biotechnology Information | Placebo Effect
Some things that make placebo effect stronger include:
- Larger pills instead of small ones: because there’s got to be more going on in there, right?
- Thematically-colored pills: e.g. red for stimulant effects, blue for relaxing effects
- Things that seem expensive: e.g. a well-made large heavy machine, over a cheap-looking flimsy plastic device. Similarly, medication from a small glass jar with a childproof lock, rather than popped out from a cheap blister-pack.
- Things that seem rational: if there’s an explanation for how it works that you understand and find rational, or at least you believe you understand and find rational ← this works in advertising, too; if there’s a “because”, it lands better almost regardless of what follows the word “because”
- Things delivered confidently by a professional: this is similar to the “argument from authority” fallacy (whereby a proposed authority will be more likely trusted, even if this is not their area of expertise at all, e.g. celebrity endorsements), but in the case of placebo trials, this often looks like a well-dressed middle-aged or older man with an expensive haircut calling for a young confident-looking aide in a lab coat to administer the medicine, and is received better than a slightly frazzled academic saying “and, uh, this one’s yours” while handing you a pill.
- Things with ritual attached: this can be related to the above (the more pomp and circumstance is given to the administration of the treatment, the better), but it can also be as simple as an instruction on an at-home-trial medication saying “take 20 minutes before bed”. Because, if it weren’t important, they wouldn’t bother to specify that, right? So it must be important!
And now for a quick personality test
Did you see the above as a list of dastardly tricks to watch out for, or did you see the above as a list of things that can make your actual medication more effective?
It’s arguably both, of course, but the latter more optimistic view is a lot more useful than the former more pessimistic one.
Since placebo effect works at least somewhat even when you know about it, there is nothing to stop you from leveraging it for your own benefit when taking medication or doing health-related things.
Next time you take your meds or supplements or similar, pause for a moment for each one to remember what it is and what it will be doing for you. This is a lot like the principles (which are physiological as well as psychological) of mindful eating, by the way:
How To Get More Nutrition From The Same Food
Placebo makes some surprising things evidence-based
We’ve addressed placebo effect sometimes as part of an assessment of a given alternative therapy, often in our “Mythbusting Friday” edition of 10almonds.
- In some cases, placebo is adjuvant to the therapy, i.e. it is one of multiple mechanisms of action (example: chiropractic or acupuncture)
- In some cases, placebo is the only known mechanism of action (example: homeopathy)
- In some cases, even placebo can’t help (example: ear candling)
One other fascinating and far-reaching (in a potentially good way) thing that placebo makes evidence-based is: prayer
…which is particularly interesting for something that is fundamentally faith-based, i.e. the opposite of evidence-based.
Now, we’re a health science publication, not a theological publication, so we’ll consider actual divine intervention to be beyond the scope of mechanisms of action we can examine, but there’s been a lot of research done into the extent to which prayer is beneficial as a therapy, what things it may be beneficial for, and what factors affect whether it helps:
Prayer and healing: A medical and scientific perspective on randomized controlled trials
👆 full paper here, and it is very worthwhile reading if you have time, whether or not you are religious personally
Placebo works best when there’s a clear possibility for psychosomatic effect
We’ve mentioned before, and we’ll mention again:
- psychosomatic effect does not mean: “imagining it”
- psychosomatic effect means: “your brain regulates almost everything else in your body, directly or indirectly, including your autonomic functions, and especially notably when it comes to illness, your immune responses”
So, a placebo might well heal your rash or even shrink a tumor, but it probably won’t regrow a missing limb, for instance.
And, this is important: it’s not about how credible/miraculous the outcome will be!
Rather, it is because we have existing pre-programmed internal bodily processes for healing rashes and shrinking tumors, that just need to be activated—whereas we don’t have existing pre-programmed internal bodily processes for regrowing a missing limb, so that’s not something our brain can just tell our body to do.
So for this reason, in terms of what placebo can and can’t do:
- Get rid of cancer? Yes, sometimes—because the body has a process for doing that; enjoy your remission
- Fix a broken nail? No—because the body has no process for doing that; you’ll just have to cut it and wait for it to grow again
With that in mind, what will you use the not-so-mystical powers of placebo for? What ever you go for… Enjoy, and take care!
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Things Many People Forget When It Comes To Hydration
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Good hydration is about more than just “drink lots of water”, and in fact it’s quite possible for a person to drink too much water, and at the same time, be dehydrated. Here’s how and why and what to do about it:
Water, water, everywhere
Factors that people forget:
- Electrolyte balance: without it, we can technically have lots of water while either retaining it (in the case of too high salt levels) or peeing it out (in the case of too low salt levels), neither of which are as helpful as getting it right and actually being able to use the water.
- Gastrointestinal health: conditions like IBS, Crohn’s, or celiac disease can impair water and nutrient absorption, affecting hydration
- Genetic factors: some people simply have a predisposition to need more or less water for proper hydration
- Dietary factors: high salt, caffeine, and alcohol intake (amongst other diuretics) can increase water loss, while water-rich foods (assuming they aren’t also diuretics) increase hydration.
Strategies to do better:
- Drink small amounts of water consistently throughout the day rather than large quantities at once—healthy kidneys can process about 1 liter (about 1 quart) of water per hour, so drinking more than that will not help, no matter how dehydrated you are when you start. If your kidneys aren’t in peak health, the amount processable per hour will be lower for you.
- Increase fiber intake (e.g., fruit and vegetables) to retain water in the intestines and improve hydration
- Consume water-rich foods (e.g., watermelon, cucumbers, grapes) to enhance overall hydration and support cellular function (the body can use this a lot more efficiently than if you just drink water).
- Counteract the diuretic effects of caffeine and alcohol by drinking an additional 12 oz of water for every 8 oz of these beverages. Best yet, don’t drink alcohol and keep caffeine to a low level (or quit entirely, if you prefer, but for most people that’s not necessary).
- If you are sweating (be it because of weather, exercise, or any other reasons), include electrolyte fluids to improve cellular hydration, as they contain essential minerals like magnesium, potassium, and in moderation yes even sodium which you will have lost in your sweat too, supporting fluid regulation.
For more details on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Water’s Counterintuitive Properties
- Hydration Mythbusting
- When To Take Electrolytes (And When We Shouldn’t!)
- Keeping Your Kidneys Healthy (Especially After 60)
Take care!
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Can you die from long COVID? The answer is not so simple
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Nearly five years into the pandemic, COVID is feeling less central to our daily lives.
But the virus, SARS-CoV-2, is still around, and for many people the effects of an infection can be long-lasting. When symptoms persist for more than three months after the initial COVID infection, this is generally referred to as long COVID.
In September, Grammy-winning Brazilian musician Sérgio Mendes died aged 83 after reportedly having long COVID.
Australian data show 196 deaths were due to the long-term effects of COVID from the beginning of the pandemic up to the end of July 2023.
In the United States, the Centers for Disease Control and Prevention reported 3,544 long-COVID-related deaths from the start of the pandemic up to the end of June 2022.
The symptoms of long COVID – such as fatigue, shortness of breath and “brain fog” – can be debilitating. But can you die from long COVID? The answer is not so simple.
Jan Krava/Shutterstock How could long COVID lead to death?
There’s still a lot we don’t understand about what causes long COVID. A popular theory is that “zombie” virus fragments may linger in the body and cause inflammation even after the virus has gone, resulting in long-term health problems. Recent research suggests a reservoir of SARS-CoV-2 proteins in the blood might explain why some people experience ongoing symptoms.
We know a serious COVID infection can damage multiple organs. For example, severe COVID can lead to permanent lung dysfunction, persistent heart inflammation, neurological damage and long-term kidney disease.
These issues can in some cases lead to death, either immediately or months or years down the track. But is death beyond the acute phase of infection from one of these causes the direct result of COVID, long COVID, or something else? Whether long COVID can directly cause death continues to be a topic of debate.
Of the 3,544 deaths related to long COVID in the US up to June 2022, the most commonly recorded underlying cause was COVID itself (67.5%). This could mean they died as a result of one of the long-term effects of a COVID infection, such as those mentioned above.
COVID infection was followed by heart disease (8.6%), cancer (2.9%), Alzheimer’s disease (2.7%), lung disease (2.5%), diabetes (2%) and stroke (1.8%). Adults aged 75–84 had the highest rate of death related to long COVID (28.8%).
These findings suggest many of these people died “with” long COVID, rather than from the condition. In other words, long COVID may not be a direct driver of death, but rather a contributor, likely exacerbating existing conditions.
The symptoms of long COVID can be debilitating. Lysenko Andrii/Shutterstock ‘Cause of death’ is difficult to define
Long COVID is a relatively recent phenomenon, so mortality data for people with this condition are limited.
However, we can draw some insights from the experiences of people with post-viral conditions that have been studied for longer, such as myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS).
Like long COVID, ME/CFS is a complex condition which can have significant and varied effects on a person’s physical fitness, nutritional status, social engagement, mental health and quality of life.
Some research indicates people with ME/CFS are at increased risk of dying from causes including heart conditions, infections and suicide, that may be triggered or compounded by the debilitating nature of the syndrome.
So what is the emerging data on long COVID telling us about the potential increased risk of death?
Research from 2023 has suggested adults in the US with long COVID were at greater risk of developing heart disease, stroke, lung disease and asthma.
Research has also found long COVID is associated with a higher risk of suicidal ideation (thinking about or planning suicide). This may reflect common symptoms and consequences of long COVID such as sleep problems, fatigue, chronic pain and emotional distress.
But long COVID is more likely to occur in people who have existing health conditions. This makes it challenging to accurately determine how much long COVID contributes to a person’s death.
Research has long revealed reliability issues in cause-of-death reporting, particularly for people with chronic illness.
Determining the exact cause of someone’s death is not always easy. Pixabay/Pexels So what can we conclude?
Ultimately, long COVID is a chronic condition that can significantly affect quality of life, mental wellbeing and overall health.
While long COVID is not usually immediately or directly life-threatening, it’s possible it could exacerbate existing conditions, and play a role in a person’s death in this way.
Importantly, many people with long COVID around the world lack access to appropriate support. We need to develop models of care for the optimal management of people with long COVID with a focus on multidisciplinary care.
Dr Natalie Jovanovski, Vice Chancellor’s Senior Research Fellow in the School of Health and Biomedical Sciences at RMIT University, contributed to this article.
Rose (Shiqi) Luo, Postdoctoral Research Fellow, School of Health and Biomedical Sciences, RMIT University; Catherine Itsiopoulos, Professor and Dean, School of Health and Biomedical Sciences, RMIT University; Kate Anderson, Vice Chancellor’s Senior Research Fellow, RMIT University; Magdalena Plebanski, Professor of Immunology, RMIT University, and Zhen Zheng, Associate Professor, STEM | Health and Biomedical Sciences, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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An Accessible New Development Against Alzheimer’s
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Dopamine vs Alzheimer’s
One of the key hallmarks of Alzheimer’s disease is the formation of hardened beta-amyloid plaques around neurons. The beta-amyloid peptides themselves are supposed to be in the brain, but the hardened pieces of them that form the plaques are not.
While the full nature of the relationship between those plaques and Alzheimer’s disease is not known for sure (there are likely other factors involved, and “the amyloid hypothesis” is at this stage nominally just that, a hypothesis), one thing that has been observed is that increasing or reducing the plaques increases or reduces (respectively) Alzheimer’s symptoms such as memory loss.
Neprilysin
There is an enzyme, neprilysin, that can break down those plaques.
Neprilysin is made naturally in the brain, and/but we cannot take it as a supplement or medication, because it’s too big to pass through the blood-brain barrier.
A team of researchers led by Dr. Takaomi Saido genetically manipulated mice to produce more neprilysin, and those mice resultantly experienced fewer beta-amyloid plaques and better memory in their old age.
However wonderful for the mice (and a great proof of principle) the above approach is not useful as a treatment for humans whose genomes weren’t modified at our conception in a lab.
Since (as mentioned before) we also can’t take it as a medication/supplement, that leaves one remaining option: find a way to make our already-existing brains produce more of it.
The team’s previous research allowed them to narrow this down to “there is probably a hormone made in the hypothalamus that modulates this”, so they began experimenting with making the mice produce more hormones there.
The DREADD switch
DREADDs, or Designer Receptors Exclusively Activated by Designer Drugs, were the next tool in the toolbox. The scientists attached these designer receptors to dopamine-producing neurons in the mice, so that they could be activated by the appropriate designer drugs—basically, allowing for a “make more dopamine” button, without having to literally wire up the brains with electrodes. The “button” gets triggered instead by a chemical trigger, the designer drug. You can read more about them here:
DREADDs for Neuroscientists: A Primer
The result was positive; when the mice made more dopamine, the result was that they also made more neprilysin. So far, the hypothesis is that the presence of dopamine upregulates the production of neprilysin. In other words, the increased neprilysin levels were caused by the increased dopamine levels (the alternatives would have been: they were both caused by the same thing—in this case that’d be the DREADD activation—or the increase was caused by something else entirely that hadn’t been controlled for).
As to how the causal relationship was determined…
“But I don’t have (or want) a DREADD switch in my head”
Happily for us (and probably happily for the mice too, because dopamine causes feelings of happiness), the experiments continued.
This time, instead of using the DREADD system, they tried simply supplementing the mouse food with l-dopa, a dopamine precursor. L-dopa is often used in the treatment of Parkinson’s disease, because the molecules are small enough to pass through the blood-brain barrier, and can be converted to full dopamine inside the brain itself. So, taking l-dopa normally raises dopamine levels.
The results? The mice who were given l-dopa enjoyed:
- higher dopamine levels
- higher neprilysin levels
- lower beta-amyloid plaque levels
- better memory in tests
The next step for the researchers is to investigate how exactly dopamine regulates neprilysin in the brain, but for now, the relationship between l-dopa consumption and the reduction of Alzheimer’s symptoms seems clear.
You can read about the study here:
The dopaminergic system promotes neprilysin-mediated degradation of amyloid-β in the brain
Is there a catch?
L-dopa has common side effects that are not pleasant; the list begins with nausea and vomiting, and continues with things that one might expect from having “too much of a good thing” when it comes to dopamine, such as dyskinesia (extra movements) and hallucinations.
You can read about it more here at the Parkinson’s Foundation:
Parkinson’s Foundation | Levodopa
However! All is not lost. Rather than reaching for the heavy guns by taking l-dopa unnecessarily, there are other dopamine precursors that don’t have those side effects (and are consequently less restricted, to the point they can be purchased as supplements, or indeed, enjoyed where they occur naturally in some foods).
Top of the list of such safe* and readily-available dopamine precursors is…
N-Acetyl L-Tyrosine (NALT): The Dopamine Precursor & More
If you’d like to try that, here’s an example product on Amazon… Or you could eat fish, white beans, tofu, natto, or pumpkin seeds 😉
*Quick note on safety: “safe” is a relative term and may vary from person to person. Please speak with your own doctor to be sure, check with your pharmacist in case of any meds interactions, and be especially careful taking anything that increases dopamine levels if you have bipolar disorder or are otherwise prone to psychosis of any kind. For most people, this shouldn’t be an issue as our brains have a built-in mechanism for scrubbing excess dopamine and ensuring we don’t end up with too much, but for some people whose dopamine regulation is not so good in that regard, it can cause problems. So again, speak with your doctor to be sure, because we are not doctors, let alone your doctor.
Lastly…
If you’d like an entirely drug-free approach, that’s skipping even the “nutraceuticals”, you might enjoy:
Short On Dopamine? Science Has The Answer
Take care!
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