Dedication This book is dedicated to all my students and readers who continue to graciously spread awareness of this work. To my late father, Patrick, who encouraged me to see things differently. And to my mother, Teresa; wife, Sinead; and daughter, Lauren—thank you for your beautiful smiles. Epigraph It isn’t the mountains ahead to climb that wear you out; it’s the pebble in your shoe. —MUHAMMAD ALI Contents Dedication Epigraph Foreword by Dr. Joseph Mercola Introduction: Do More with Less Part I: The Secret of Breath 1. The Oxygen Paradox 2. How Fit Are You Really? The Body Oxygen Level Test (BOLT) 3. Noses Are for Breathing, Mouths Are for Eating 4. Breathe Light to Breathe Right 5. Secrets of Ancient Tribes Part II: The Secret of Fitness 6. Gaining the Edge—Naturally 7. Bring the Mountain to You 8. Finding the Zone Part III: The Secret of Health 9. Rapid Weight Loss Without Dieting 10. Reduce Physical Injury and Fatigue 11. Improve Oxygenation of Your Heart 12. Eliminate Exercise-Induced Asthma 13. Athletic Endeavor—Nature or Nurture? 14. Exercise as if Your Life Depends on It Part IV: Your Oxygen Advantage Program Summary and General Program Based on BOLT Score and Health Quick Reference Summary of the Oxygen Advantage Program Oxygen Advantage Exercise Summary Breathe Light to Breathe Right (Advanced Method) General Program Based on BOLT and Health Program for BOLT Score of Less Than 10 Seconds (or an Unhealthy or Older Person) Program for BOLT Score of 10 to 20 Seconds Program for BOLT Score of 20 to 30 Seconds Program for BOLT Score of 30 Seconds Plus Program for Weight Loss or Obesity (suitable for all BOLT scores) Program for Children and Teenagers Appendix: Upper Limits and Safety of Breath Holding Notes Acknowledgments About OxygenAdvantage.com Index About the Author Also by Patrick McKeown Copyright About the Publisher Some Important Guidelines Before We Begin Although the Oxygen Advantage program is perfectly safe for the vast majority of people, part of the program includes powerful exercises that simulate high- altitude training and would be similar to performing high-intensity exercise. Just as high-intensity exercise is suited only to individuals with reasonably good health and fitness, those with any medical issues should refrain from practicing any of the exercises that simulate high-altitude training. (These exercises include the Nose Unblocking Exercise and any that simulate high-altitude training.) If you are pregnant, this program is not suitable. For those with high blood pressure, cardiovascular disease, type 1 diabetes, kidney disease, depression, or cancer, it is advisable to practice only nasal breathing and the more gentle exercises, including “Breathing Recovery” and “Breathe Light to Breathe Right,” during rest and physical activity until these conditions are resolved. If you have any medical issues then you should follow this program only with the consent of your medical practitioner. For further information, please visit OxygenAdvantage.com. Foreword by Dr. Joseph Mercola It has been well documented that those who live at higher altitudes tend to live longer. The precise mechanism behind this is not known and could be a result of several factors. However, one of the leading candidates for this explanation is a reduced pressure of oxygen at higher altitudes. Research is very clear that calorie restriction extends life span. But another nutrient many of us don’t frequently consider is oxygen. Just as excess calories can cause metabolic damage, excess oxygen can also prematurely damage your tissues through the generation of excess free radicals. These are highly reactive and destructive molecules that cause damage to the fats in your cell membranes, proteins, and DNA. Free radicals are generated by the normal breakdown of oxygen during metabolism. We all create a certain amount of free radicals through the very act of breathing, and incorporating breathing exercises designed to maintain a healthy breathing volume seems to be an effective strategy to keep your oxygen at an optimum level, and thus minimize free radical damage. Additionally, altitude training is a tactic many elite endurance athletes use to gain a competitive edge. One way of tapping into your body’s natural resources is to purposefully expose yourself to reduced oxygen intake for a short period of time. This will improve your blood’s oxygen-carrying capacity and also increases the maximum volume of oxygen that an athlete can use, known as your VO2 max. Of course, most of us live our lives close to sea level and do not achieve this benefit. But there are simple strategies that will allow you to access the benefits of living at a high altitude with reduced oxygen intake: keeping your mouth closed while you are breathing and practicing the various exercises outlined in this book. This is a challenge during intense exercise due to air hunger, but this is when most of the benefit actually occurs. I have personally implemented the information in The Oxygen Advantage during my high-intensity workouts. It took me several weeks to make the transition to breathing through my nose the entire time, but once accomplished, breathing became a far more efficient process for me. Many may know that I am a major fan of using simple, inexpensive lifestyle changes to avoid expensive and dangerous medications and surgery. The strategies in The Oxygen Advantage are tools that I believe should be included in your health habit arsenal. There simply are no downsides that I can identify, and there are massive upsides. I personally use this program and would strongly encourage you to apply it in your life so you can reap the rewards. INTRODUCTION Do More with Less We can live without food for weeks and water for days, but air for just a few brief minutes. While we spend a great deal of time and attention on what we eat and drink, we pay practically no attention to the air we breathe. It is common knowledge that our daily consumption of food and water must be of a certain quality and quantity. Too much or too little spells trouble. We also recognize the importance of breathing good-quality air, but what about the quantity? How much air should we breathe for optimum health? Wouldn’t it be fair to surmise that air, even more important than food or water for human survival, must also meet basic requirements? The quantity of the air you breathe has the potential to transform everything you thought you knew about your body, your health, and your performance, whether you’re a “pre-athlete” just trying to get off the couch, a weekend warrior running an occasional 10K, or a professional athlete in need of a game-changing edge over your competition. You may wonder what I mean by quantity. After all, air isn’t exactly something you can binge on at the kitchen table late at night, or take too many swigs of over the weekend. But what if, in a certain sense, it was? What if healthy breathing habits were just as important as healthy eating habits in fostering maximum fitness—or, in fact, even more so? In this book you will discover the fundamental relationship between oxygen and the body. Improving fitness depends on enhancing the release of oxygen to your muscles, organs, and tissues. Increased oxygenation is not only healthy; it also enables greater exercise intensity with reduced breathlessness. In short, you will be able to discover better health and fitness as well as better performance. If you do compete, you’ll also enjoy your training and competition more than ever, because you’ll be able to achieve more with less effort. Overall fitness and sports performance is usually limited by the lungs—not by the legs, the arms, or even the mind. As anyone who engages in regular exercise knows, the feeling of intense breathlessness during sporting activity dictates exercise intensity far more than muscle fatigue. The foundation of enjoying and improving physical exercise, therefore, is to ensure that breathing is optimally efficient. Chronic Overbreathing Scientific research, as well as the experience of thousands of people I have worked with, has shown me the vital importance of learning how to breathe correctly. The problem is that correct breathing, which should be everyone’s birthright, has become extremely challenging in our modern society. We assume that the body reflexively knows how much air it needs at all times, but unfortunately this is not the case. Over the centuries we have altered our environment so dramatically that many of us have forgotten our innate way of breathing. The process of breathing has been warped by chronic stress, sedentary lifestyles, unhealthy diets, overheated homes, and lack of fitness. All of these contribute to poor breathing habits. These in turn contribute to lethargy, weight gain, sleeping problems, respiratory conditions, and heart disease. Our ancestors lived on a natural diet in a far less competitive environment and physically worked hard, a lifestyle conducive to maintaining an efficient breathing pattern. Compare that to modern-day living, in which we spend hours slouched at a desk on computers and talking on phones, surviving on a rushed lunch of convenience food, trying to manage a seemingly neverending series of tasks and financial obligations. Modern living gradually increases the amount of air we breathe, and while getting more oxygen into our lungs might seem like a good idea, it is in fact light breathing that is a testament to good health and fitness. Think of an overweight tourist and an Olympian both arriving for the Summer Games. As they picked up their luggage and carried it up a flight of stairs, whom would you expect to be huffing and puffing? Certainly not the Olympian. The biggest obstacle to your health and fitness is a rarely identified problem: chronic overbreathing. We can breathe two to three times more air than required without knowing it. To help determine if you are overbreathing, see how many of these questions you answer “yes” to: • Do you sometimes breathe through your mouth as you go about your daily activities? • Do you breathe through your mouth during deep sleep? (If you are not sure, do you wake up with a dry mouth in the morning?) • Do you snore or hold your breath during sleep? • Can you visibly notice your breathing during rest? To find out, take a look at your breathing right now. Spend a minute observing the movements of your chest or abdomen as you take each breath. The more movement you see, the heavier you breathe. • When you observe your breathing, do you see more movements from the chest than from the abdomen? • Do you regularly sigh throughout the day? (While one sigh every now and again is not an issue, regular sighing is enough to maintain chronic overbreathing.) • Do you sometimes hear your breathing during rest? • Do you experience symptoms resulting from habitual overbreathing, such as nasal congestion, tightening of the airways, fatigue, dizziness, or light-headedness? Answering yes to some or all of the questions above suggests a tendency to overbreathe. These traits are typical of what happens when the amount of air we breathe is greater than what we need. Just as we have an optimal quantity of water and food to consume each day, we also have an optimal quantity of air to breathe. And just as eating too much can be damaging to our health, so can overbreathing. The unconscious habit of overbreathing has hit epidemic proportions all across the industrialized world, and it’s highly detrimental to our health. Chronic overbreathing leads to loss of health, poor fitness, and compromised performance and also contributes to many ailments including anxiety, asthma, fatigue, insomnia, heart problems, and even obesity. It may seem strange that such a disparate range of complaints can be caused by or worsened by overbreathing, but the breath of life influences literally every aspect of our health. The purpose of this book is to return you to how you were meant to live and breathe. I will teach you simple methods that will counteract bad breathing habits, unearthing a new well of cardiovascular fitness that will improve your overall health and well-being. Serious athletes will achieve new levels of performance, fitness enthusiasts will unleash untapped potential, and those who are still trying to manage their health will overcome barriers to a more healthful lifestyle. But, as with all conditions, to arrive at the remedy it’s crucial to first understand the ailment. It is how you breathe during your daily life that determines how you breathe during physical exercise. Breathing too much air every minute, every hour, every day translates into excessive breathlessness during exercise. If our breathing is off during rest, it would be unreasonable to expect it to automatically correct itself during physical exercise. The seemingly innocuous tendency to breathe through the mouth during the day or night and breathe noticeably during rest means you will be more breathless during training and often limits your capacity to go faster and farther. These poor breathing habits can be the difference between a healthy and vibrant life and an ill and feeble one. Overbreathing causes the narrowing of airways, limiting your body’s ability to oxygenate, and the constriction of blood vessels, leading to reduced blood flow to the heart and other organs and muscles. These systemic impacts affect your health profoundly, whether you’re a professional athlete or your main exercise is walking up the stairs of your house. Great sports careers can plateau or even be cut short by an athlete’s overbreathing. The lungs let the individual down, and—no matter how strong the rest of the body is—unnecessary, excess breaths take their toll. As most athletes know, our lungs give out long before our arms and legs. It all comes down to our need for that invisible yet vital basis for human life: oxygen. Here’s the paradox: The amount of oxygen your muscles, organs, and tissues are able to use is not entirely dependent on the amount of oxygen in your blood. Our red blood cells are saturated with between 95 and 99 percent oxygen, and that’s plenty for even the most strenuous exercise. (A few of my clients with serious pulmonary disease have a lower oxygen saturation level, but this is very rare.) What determines how much of this oxygen your body can use is actually the amount of carbon dioxide in your blood. You may remember from biology class that we breathe in oxygen and breathe out carbon dioxide, also called CO2. Most people learn that carbon dioxide is just a waste gas that we exhale from our lungs, but it is not a waste gas. It is the key variable that allows the release of oxygen from the red blood cells to be metabolized by the body. This is called the Bohr Effect. Understanding and utilizing this physiological principle will allow you to stop overbreathing. Discovered over a hundred years ago, the Bohr Effect explains the release of oxygen to working muscles and organs. Most people don’t realize that the amount of carbon dioxide present in our blood cells determines how much oxygen we can use. The crux of it is this: How we breathe determines the levels of carbon dioxide present in our blood. When we breathe correctly, we have a sufficient amount of carbon dioxide, and our breathing is quiet, controlled, and rhythmic. If we are overbreathing, our breathing is heavy, more intense, and erratic, and we exhale too much carbon dioxide, leaving our body literally gasping for oxygen. It’s very intuitive: If we breathe better, increasing the amount of carbon dioxide inside us, then we can deliver more oxygen to our muscles and organs, including the heart and brain, and thus heighten our physical capacity. All we’re really doing is assisting the body in working the way it was meant to work in the first place. Bringing the Mountain to You To understand how part two of the Oxygen Advantage works, let’s look at an example most of us are familiar with: high-altitude training, a technique often used by elite athletes to improve their cardiovascular fitness and to improve their endurance. High-altitude training first came to the attention of coaches and athletes during the 1968 Summer Olympics, held in Mexico City at a height of 2,300 meters above sea level. Many competing athletes found that when they returned to sea level, their performance surpassed their previous personal best, prompting coaches to question whether athletes might perform better if they live or train at high altitude. At high altitude the air is thin, which results in reduced atmospheric pressure of oxygen. The body adapts to this environment by increasing the number of red blood cells. Think of red blood cells as your very own Popeye’s spinach, only they come from your body instead of out of a can. Upping the presence of red blood cells translates into improved oxygen delivery to the muscles, a reduction of lactic acid buildup, and stronger overall performance, including longer endurance and a lower risk of inflammation and injury. But of course the catch is that high-altitude training is not available to most of us—which brings me to the goal of this book. You don’t need to go to the mountain. The mountain can come to you. I will show you how to make this happen through simple techniques that in effect take you up a mile high. By learning how to simulate high-altitude training, you will increase the oxygen-carrying capacity of your bloodstream, allowing your red blood cells to fuel new capabilities. Additionally, it will help you to sustain sharper psychological focus during physical activity as you become less conscious of the act of breathing. This will free you to devote more attention to maintaining proper form while exercising or formulating strategy in a competitive sport. If you reduce your breathing and properly regulate the amount of air you take in, you will teach your body to breathe more efficiently, and you will become healthier. No matter what your athletic baseline is to begin with, better breathing will revolutionize your fitness, your endurance, and your performance. I know this for a fact because I have experienced it myself. I was once a chronic overbreather. Back in 1997 I was an executive in the corporate world, but since childhood I had experienced poor health as a result of asthma. My identity was based on everything that I wasn’t. I wasn’t fit, I wasn’t healthy, and I wasn’t confident. I looked desperately for a solution to my health problems. Then I found it. My life changed forever when I discovered the work of the late Dr. Konstantin Buteyko, a brilliant Russian physician who conducted groundbreaking research to determine the optimal breathing for astronauts during the Soviet Space Race. The Cold War had trapped his pioneering methods on the other side of the Iron Curtain, but, starting in the 1990s, they began to be known in the rest of the world. Using breathing exercises based on Buteyko’s teachings, I successfully reversed my own sleep-disordered breathing and chronic asthma, fully recovering from the conditions I had suffered from my