Exploring the Science of Breath: An Interview with Author James Nestor

by Ryan Kennedy, CCN, CFMP, CTN | Steven Schindler / March 29, 2022

We were fortunate to have the opportunity to conduct two fascinating and extremely informative interviews with James Nestor on the subject of his New York Times bestseller Breath: The New Science of a Lost Art. Here is a compilation of these interviews, one conducted by Functional Medicine Practitioner and breath coach Ryan Kennedy and the other by our executive director, Steven Schindler.

● ● ●

Price-Pottenger: Why do you consider breathing to be a lost art?

James Nestor: Our ancestors understood that how we breathe can be used as a medicine. It is a very powerful tool in healing, and can also be used in spiritual practices to attain altered states of consciousness. Ancient cultures, from the Greeks and Chinese to the Hindus and Native Americans, appreciated that breathing is as significant to our health and well-being as what we eat or how much we exercise.

Look at the few hunter-gatherer tribes that are still around today, and you will see that they don’t have all the chronic diseases that we suffer from. The Hazda in Tasmania don’t have hypertension, diabetes, COPD, or asthma. Then look at all the chronic respiratory issues that are afflicting us here. Nearly 8% of Americans have asthma, 15% have chronic sinusitis, and 45% snore. We tend to think it’s normal, but it’s not. We are struggling to breathe, and this is something that we do over 20,000 times a day. Something has gone terribly wrong.

The fact is, as we have moved farther away from nature, we have gotten sicker – and the more we try to adapt the human body to industrialization, the sicker we’re going to get. We have all these chronic diseases because we aren’t moving, eating, or breathing the way we used to. A lot of people today realize that eating well and exercising are essential to health, but the breathing component has not been appreciated as much as it should be.

We’re so divorced from our natural environment that we need to be retaught how to breathe‚ just as we’ve had to reteach ourselves how to eat, sleep, and exercise. We wouldn’t need to do any of this if we lived in an environment that was conducive to our health. But we live in the modern world, and so we’ve had to relearn all these things. Luckily, relearning breathing is very easy and essentially free.

Price-Pottenger: Would you tell us more about why proper breathing is so important to our health, both physical and psychological?

James Nestor: Many studies show that how we breathe can directly impact asthma, emphysema, COPD, anxiety disorders, posture, and more. This sounds crazy until you look at the science, and then you see that it can actually affect all of these things. I’m not saying that breathing correctly is going to resolve all of everyone’s problems. It’s not a cure-all. However, you can only benefit from it – maybe a little or maybe a lot. Sometimes it may transform your life.

Breathing impacts every cell of our bodies. We have 30 trillion cells in our bodies, and our cells can run anaerobically – but not very efficiently and not for very long. What they really want is oxygen. If we are breathing in a dysfunctional way, we are affecting our ability to get that oxygen and maintain proper energy levels. That doesn’t just impact us physically, because the brain and the body aren’t two separate things. We’re one united organism, and what happens on a physical level also impacts us on a mental level. For example, we know that overbreathing inhibits blood flow and oxygenation of the brain, and that’s why people who chronically hyperventilate have problems focusing, can’t get to sleep, and experience anxiety.

Another thing is that 80% of the messages between the brain and the body come from the body. So, if our bodies are hunched over or if we’re breathing in a dysfunctional way, we’re sending little alarm signals to the brain that something is wrong, and the brain responds by activating our fight-or-flight response. This is one of the reasons why some very intense breathing practices can be so effective; they purposely put you into a state of stress so that you learn to control your stress response.

Anxiety and panic can have a close connection to breathing. For a long time, people thought that they were solely neurological issues – just something wrong in the brain – but researchers are finding that’s not the case. They are quite often tied to breathing.

Price-Pottenger: What role does carbon dioxide play in maintaining our health?

James Nestor: I had always been taught that CO2 was a toxic gas that we needed to get out of our bodies. It was a waste product. But when I dove into the science, I learned that CO2 is as essential to our bodies as is oxygen, and we need a balance of the two in order for oxygen to fuel us. Here’s a great example of this: If you hyperventilate – just take 30 or 40 big breaths – you will notice a lightness in your head and some tingling in your fingers. That’s not from an increase of oxygen; it’s from a decrease.

When we are constantly breathing too much, which so many of us do because we are mouth breathers, we tend to offload too much CO2, and this can cause a lot of downstream problems. People with fear-based disorders – anorexia, agoraphobia, panic disorders – and asthmatics tend to have much lower CO2 levels than healthy people because they’re constantly overbreathing. For a long time, researchers thought that was just a side effect of these chronic conditions. But what we’re learning now is that, for many people, overbreathing can be the cause of the ailment. In order to fix the core problem, you have to address breathing. I was just talking to Dr. Belisa Vranich, a psychologist who is an expert in breathing. She said that you cannot ever hope to cure or reduce anxiety and panic if you don’t first control breathing, and I tend to agree with her.

However, I’m not here to tell people what to do. I’m a journalist, and what I want to do is present objective and clear information to give people a choice. Although what I’ve learned about breathing has changed my life, my job is to go out and just report on what I find.

Price-Pottenger: You mentioned that overbreathing inhibits oxygenation of the brain. How can slowing the respiration rate increase oxygenation?

James Nestor: When we breathe through the mouth, as 25 to 50% of the population habitually does, there’s no resistance. There’s much more resistance when we breathe through the nose. The air is forced to slow down and become more pressurized. In that process of pressurizing that air, the lungs absorb a lot more oxygen.

A lot of people think that air you breathe in through your nose is the same as air you breathe in through your mouth, but that is false. The air that enters your lungs through each of these channels is very different. Our noses are our first line of defense, helping to filter out bacteria, viruses, dust, allergens, pollution, and more. That’s why it takes a little while longer to breathe through your nose than it does to breathe through your mouth. That extra time is good, because as the air is pushing through the many different structures within and behind the nose – almost like a labyrinth of cartilage, bone, and tissue – it’s being cleansed, heated, moistened, and conditioned. By the time that air reaches your lungs, you can get about 20% more oxygen from it than you could from equivalent breaths through the mouth. That’s going to make an enormous difference to your immune system, mental health, athletic ability, and more.

In fact, the very first thing that top athletic trainers do with a new client is assess and correct the athlete’s breathing. According to Brian MacKenzie, Patrick McKeown, and other leading people in this field, among all the athletes who have come to them, they have not seen one who has been breathing in an optimal way, and they have helped them transform their performance by focusing on their breathing.

Of course, learning to breathe through the nose affects different people in different ways. You can try it at any time and see how it affects you. It’s important to mention that, if you are a habitual mouth breather, switching to nasal breathing while exercising can make you feel miserable for weeks or months until you get used to it. A lot of people give up after a few days, most likely because they think they are not getting enough air. But if you stick with it, you will benefit.

Price-Pottenger: How does the action of the diaphragm affect our ability to breathe optimally?

James Nestor: The simplest way of thinking about the diaphragm is this: It’s essential to breathing. The lungs can’t inflate or deflate on their own, and the diaphragm, the muscle that sits below them, enables them to do that. But it’s also like the body’s piston, pumping blood and lymphatic fluid and helping to massage our internal organs so that they can expel lymph. It keeps the fluids moving in our bodies, and we need to have the fluids moving in order to be healthy. We don’t want things to coagulate, which is what happens when we breathe very high into our chests.

I spoke with one doctor who mentioned that in people who breathe very shallowly, lymph fluid can accumulate in the abdomen and start to harden. She sees this in many of her patients because they can’t – or don’t know how to – take deep and enriching breaths. The diaphragm needs to descend a certain amount in order for things to work efficiently, just as a piston in a car needs to have the right timing for it to run efficiently. Otherwise, it can still run – but not very well.

Typically, some people engage as little as 10% of the diaphragm’s range of movement when they breathe, and this can overburden the heart, elevate blood pressure, and cause circulatory problems. Although the diaphragm is generally considered an involuntary muscle, breathing techniques have been developed that strengthen the diaphragm and enable it to descend further and lift higher. Learning to use 50 to 70% of the diaphragm’s range can ease cardiovascular stress and allow the body to work more efficiently.

There’s a whole science pertaining to the diaphragm, and researchers are currently learning more and more about it. This is a topic I’m going to be including in the paperback edition of Breath when it comes out.

Price-Pottenger: Would you talk about the historical connection between breathing, dental problems, and diet, starting with the rise of agriculture 12,000 years ago?

James Nestor: The very first communities of people to have widespread malocclusion – crooked teeth and deformation of the jaw and mouth – arose in the first farming cultures, in Southwest Asia and the Eastern Mediterranean. But this occurred only in a few communities, as we can see from the skeletal record. I heard from one researcher that she had never seen a hunter- gatherer with crooked teeth, and she’d looked at thousands of human skulls dating from 50,000 to 500 years ago.

There really wasn’t much of a problem with our teeth until the industrialization of food about 300 years ago. Then much of the world’s population suddenly began to suffer from crooked teeth and all the breathing problems that accompany them. How quickly and completely various cultures pivoted to industrialized foods determined the straightness of their teeth and the extent of their airway issues.

As we switched to an industrial diet, our faces became flatter and our mouths shrank. Our teeth grew in crooked because our mouths were now too small to accommodate them. In addition, our upper palates began to push into our sinuses, making it harder for us to breathe through the nose. We became obligate mouth breathers because that was the only way we could easily get air in and out of our bodies. The main cause of all this was our diet.

This is where a lot of the work of Dr. Weston A. Price fits in. The founder of the National Dental Association, he was a researcher who was rooted very firmly within the scientific community. For a decade, starting in the 1930s, he examined the diets, teeth, and general health of various indigenous communities around the world. Wherever he went, he found that those people who replaced their traditional diets with modern, processed foods had more cavities, crooked teeth, and overall poorer health. This he attributed to deficiencies in essential nutrients.

Price’s work with vitamins and minerals was extraordinary. However, when I started digging deeper into the body of research on mouth size and facial change, I learned that nutrients such as vitamin K2 and vitamin D play only a part. The main driver is a lack of chewing. That is one thing that I think Price, had he been around for a little longer, would have seen and documented. The process of chewing not only helps the mouth grow wider when we’re in early stages of development, but it also tones the airway – both when we’re young and later on in life. It also helps drain the sinuses, drains fluid from the Eustachian tubes, and pulls more blood into the brain.

Our ancestors ate hard foods that required them to chew for hours every day, and this caused their mouths and faces to become wide and strong. In comparison, most of the modern diet is soft. Think about what you have eaten in the last few days and how little of that food you have actually had to chew. Even most foods that are generally considered healthy today, such as smoothies, nut butters, and avocadoes, are soft. Nothing is better than chewing hard, natural food, such as carrots, celery, and even really tough meat. But in the typical American diet, we hardly chew at all.

Price-Pottenger: Do you feel that chewing was a significant factor in the wide palates and straight teeth Dr. Price found in the remote indigenous communities he visited, including those in Alaska?

James Nestor: If you’re looking at Alaska Natives, you have to consider how long the children were breastfed – at least two years, and probably a lot longer. Breastfeeding requires an enormous amount of coordination and chewing and sucking stress, which exercises the masseter and other facial muscles. I believe that one of the primary drivers of healthy oral and facial structure is breastfeeding early on and for a long amount of time. In all of the populations that Price visited, that was just part of their culture. There were no bottles or formula. Children were simply breastfed.

In the Alaska Native communities he went to, what was the diet after weaning? Mostly, seal meat, fish, and lichen, and this diet continued to provide some chewing stress. Similarly, Price found that the Maasai of East Africa, known to drink cow’s blood as a dietary staple, also ate meat and some grain, resulting in a diet that required chewing. Their children were breastfed for three to four years.

Although chewing in early development is the main driver, there are also other factors that help determine the epigenetic potential of our mouths and faces. One of these is oral posture. How do you hold your mouth? Have you been a mouth breather your whole life? Do you breathe through your mouth when sleeping? I can guarantee you the people in these cultures were not doing that. Had they been, they would not have had such excellent facial structure.

Price-Pottenger: In addition to eating more foods that require chewing, what are some simple techniques we can use to boost our epigenetic potential and improve our breathing?

James Nestor: Breathe through your nose as often as you can. That doesn’t mean you won’t breathe through your mouth on occasion, such as when you laugh or sing. But for the vast majority of your breaths, and for all your breaths at night, breathe through your nose.

That’s easier said than done for a lot of people, because many of us suffer from chronic congestion. About 15% of us have chronic sinusitis, and around 50% have inflamed nasal turbinates. The more we breathe through our noses, the more they adapt and start to open up. But what I have seen personally – and this is just anecdotal – is that even when people adopt healthy breathing habits during the day, they still often breathe through their mouths at night while sleeping. In fact, about 60% of the population engages in mouth breathing at night. You have to find a way of breathing through your nose while you sleep.

Of all the little breathing hacks that I’ve adopted over the years, one of the most effective has been to use a small piece of tape on my lips to keep my mouth shut at night, thus making myself into an obligate nasal breather. This has resulted in a dramatic increase in the quality of my sleep and transformed me in so many ways. Since the book has come out, I have heard from many people who tried this technique and said that it decreased or completely alleviated their snoring and even mild or moderate sleep apnea. I have also received hundreds – perhaps even thousands – of letters from people saying they had kids who had been on a cocktail of different drugs for years, with problems such as bedwetting, ADHD, and deteriorating health for which no one could find a cause. They finally trained their kids to close their mouths, and the vast majority of their symptoms disappeared.

Historically, in every Native American culture that the adventurer and painter George Catlin visited in the 1830s, the mothers would bring their babies’ lips together if they found them sleeping with their mouths open. When he was in his fifties, Catlin went down to South America and found that every single culture he visited there carried the same beliefs about the importance of oral posture and the medicinal qualities of breathing. It was a medicine for them.

Price-Pottenger: What advice would you give mothers who want to stimulate optimal facial development and breathing in their infants?

James Nestor: Follow nature. That may seem a little wishy washy, but it’s really not. We evolved a certain way in a certain environment, and we are now divorced from that environment. We are suffering from dysevolution, which is why so many of us are becoming sick. What did we do 400 or 500 years ago? Children were breastfed for two or three years, and sometimes up to four years. Then they were weaned onto hard foods. They were not weaned onto baby food – applesauce or soft carrots. They chewed actual food. That chewing stress early in life helps build bones and proper musculature and widens the mouth. As children grow, continuing to feed them hard, natural foods in their original form is essential.

We know that the mother’s nutrient levels during gestation can have a huge effect on the infant’s vitamin D, K2, and stress levels. There are also links between maternal sleep apnea and fetal growth issues. When you’re repeatedly starving the fetus of oxygen at night, that’s going to impact its development. In addition, studies have shown that children who were breastfed have lower incidences of sleep apnea and breathing issues later in life than those who were bottle-fed.

Price-Pottenger: Have you found that dentistry can correct our jaw alignment and improve our breathing?

James Nestor: This is an extremely controversial area right now, but dentistry can help an enormous amount- depending on what kind you are getting. Imagine that you have a mouth that’s too small for your face, so the teeth are growing in crooked. What is going to happen when you remove teeth from that mouth, cram the remaining teeth closer together, and use headgear to push them further back into the mouth? You are going to have a smaller mouth than you began with.

Many dentists say that one of the main reasons why a lot of us are suffering from breathing disorders could be tied to the use of braces, headgear, and extractions early in life that changed the shape of our mouths and faces. I find it fascinating that more than 100 years ago the standard practice to straighten teeth was by expanding the mouth. If a mouth is too small, it makes sense to expand it to make room for the teeth to naturally grow in straight. Today, expansion is finally coming back into dentistry.

This is important because when you expand the mouth, you also expand the airway, which makes it easier to breathe. That’s why many people who have had expansion procedures done – people who had severe problems with sleep apnea, allergies, or chronic sinusitis – no longer have any of these issues. There’s room in the back of their mouths and in their noses to breathe more freely.

I’m not saying that expansion is going to work for everyone. Procedures that can be done in the nose may have a more beneficial effect, depending on where your problems are. Sleep apnea, for example, can be caused by a structural problem in the nasal pharynx (the back section of the nasal cavity) or can involve the tongue being too large and falling against the back of the throat. It can sometimes involve the hypopharynx (the bottom part of the throat). Obstruction can occur throughout the airway, and the solution depends on what the problem is.

Price-Pottenger: Would you tell us how your explorations in breathing improved your health?

James Nestor: I try not to get into my personal story too much in my writing, because I want my books to be about the reader. I didn’t write about what specifically breathing had done for me, because I didn’t want to say, “Hey, it worked for me; it’s going to work for you.” But with that major caveat, I will say that the knowledge and practice of breathing completely transformed my health.

A number of years ago, I was getting mild pneumonia at least once a year, and I was coming down with bronchitis all the time. I was eating all the right foods, sleeping eight hours a night, and exercising regularly. I was doing martial arts, surfing, and jogging. Despite this, I kept contracting respiratory infections. Every doctor I went to told me that it was perfectly normal to take antibiotics to fight these off at least once a year and to use a bronchodilator when I had trouble breathing. However, in the back of my mind, I thought there must be a better way.

It wasn’t until years later, when I began interviewing respiratory therapists, doctors, dentists, and even nonprofessionals who were exploring breathing – pulmonauts, I call them – that I started adopting these breathing habits into my own life. You can’t see people be transformed by something so simple and not want to do it yourself. So, I did it – and it massively changed my athletic performance and my sleep quality. I have not had pneumonia, bronchitis, or any other respiratory issues since. I haven’t even had a stuffy nose. To be very clear, I’m not saying my experience is going to be your experience. Results are going to vary for each person, but it completely changed my life in that regard.

Price-Pottenger: One of the pulmonauts in your book is Anders Olsson, who was your partner in a number of breathing studies. What was his motivation to explore the science of breathing?

James Nestor: Anders is a very interesting character in that he doesn’t come from a medical background. He was thrown into discovering what breathing could do by necessity. This is what I have found with many people who are passionate about breathing: It’s not something they chose, it’s something that chose them – because of a health problem they or someone in their family suffered from.

Anders had been a very successful businessman in Sweden, with a big house and nice cars, but he began to feel that something was missing from his life. Then, when his child became extremely sick, he started to question the way his child was being treated for that sickness. He saw a similar pattern when his dad, who had severe breathing difficulties late in life, was given various drugs but no instruction on how to breathe. So, he came to this field and began to do his own research just to help himself and his family. After many years of work, he developed a protocol that he thought could help a lot of people, and it turns out that it does.

That protocol, called Conscious Breathing, is similar in many ways to various other breathing techniques or protocols. They all share the same tenets: close your mouth, breathe through your nose, breathe slowly, breathe easy.

So, Anders is an example of a freelance pulmonaut. He’s passionate about this field, and it shows – and he’s helped tens of thousands of people.

Price-Pottenger: Would you tell us about some of the most surprising things you learned in your study of breathing?

James Nestor: I think the most surprising thing was learning that evolution does not progress in a straight line. Life forms can change over time for better or for worse, and humans, over the last 100 years especially, have been adopting characteristics that are in no way advantageous for our long-term survival.

This was all news to me. In college, I was taught that evolution is survival of the fittest, and that’s still what we’re being told today. However, the concept that we’re getting stronger and better with every generation is completely false. To me, realizing that and understanding the core reasons why we have changed for the worse are essential steps to developing ways to reverse some of this damage and return ourselves to our natural state.

Another thing that surprised me is that our lifespan – which is different than life expectancy calculations – really hasn’t changed in the past 2000 or 3000 years. Our ability to live to a ripe old age, into our 90s, is about the same as it was two millennia ago. I was reading up on the classical philosophers, and I learned that so many of them lived into their 70s and 80s. I had been told that most people only lived into their 30s, but this is not true.

I think that the modern world has done many incredible things for us, but they have come at a price. I hope that in the future we’ll be able to utilize modern technologies without forgetting where we came from. A natural path is often the best way to maintain health and to help get it back if we happen to lose it.

Price-Pottenger: What do you consider the most important basic steps that people can take today to improve their health through breathing?

James Nestor: Nature is very simple, and the simplest things I found are the most effective. You should be taking in most of your breaths through your nose, and breathing slowly, rhythmically, and deeply. Just doing that can have a transformative effect on your health. For example, I’ve heard from many breathing therapists that sleep apnea can be reduced or sometimes completely cured by learning to breathe better in the daytime. When you breathe more softly and fluidly during the day, you can carry that ability into the night.

In addition, the science is very clear that by breathing in this way, you can bolster your immune function and influence your autonomic nervous system in order to calm yourself down. You can reduce your blood pressure and heart rate, increase your focus, and more. To see this for yourself, all you have to do is to connect yourself to any one of a number of wearables that measure your heart rate, blood pressure, and heart rate variability (HRV). See what happens after just a few minutes of breathing in this very light, smooth, rhythmic way. Then you can just imagine what will happen after a few days, or weeks, or months, or years of breathing this way.