Ep. 208 – The Underestimated Power of Breathing with James Nestor

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I have the honor of connecting with James Nestor today! James is a science journalist and author of the book Breath. Breath was one of my favorite books to read in 2021! It was awarded the prize for Best General Nonfiction Book of 2020 by the American Society of Journalists and Authors and shortlisted for the Royal Society Best Science book of 2020. It explores the million-year-long history of how humans have lost the ability to breathe properly and why we suffer from issues like snoring, sleep apnea, asthma, autoimmune disease, and allergies.

James traveled the world in his effort to figure out what went wrong and how to fix our ability to breathe properly. He did not discover the answers in pulmonology labs but in the muddy digs of ancient burial sites, secret Soviet facilities, New Jersey choir schools, and the smoggy streets of Sao Paulo.

In this episode, James and I dive into how humans have become poor breathers and how crooked teeth contribute to poor breathing. We discuss the nasal anatomy and the impact it has on poor breathing. We talk about alternate nostril breathing, the vagus nerve, the anatomical changes that occur with aging, how overeaters become over-breathers, chewing, and how our palates and facial bones have evolved and changed. We also get into James’s experience in the Paris catacombs and the impact of breathwork on the autonomic nervous system.

I hope you enjoy listening to this conversation as much as I did recording it! Stay tuned for more!


  • How have the structural changes in our bodies impacted our quality of breathing?
  • The importance of having a proper deep sleep.
  • The association between obligate mouth breathing and getting up at night to urinate.
  • James talks about nasal erections and the effects of alternate nostril breathing on the body.
  • James talks about the vagus nerve and explains the concept of vagal tone.
  • Why do overeaters tend to become over-breathers?
  • Poor breathing can lead to poor sleep quality, which can cause metabolic imbalance.
  • What can you do to proactively impact the stimulation of facial bone remodeling if your mouth is too small or you have crooked teeth?
  • James talks about his experience of crawling around in the Paris catacombs.
  • What has been driving the changes in the anatomy of our faces?
  • The importance of chewing stress.
  • Chewing can play a role in how we look, how we breathe, and how our brain functions.
  • James explains the significance of the empty nose syndrome.
  • How proper breathing impacts the body and the benefits of breathing techniques.
  • James talks about carbon dioxide therapy.

Connect with Cynthia Thurlow

Connect with James Nestor 

Books mentioned: 

Breath: The New Science of a Lost Art by James Nestor

Connect with Cynthia Thurlow

“Having proper deep sleep is essential to health, and you will never be healthy unless you are able to hit all those stages of sleep.”

– James Nestor


Cynthia: Welcome to Everyday Wellness Podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent are to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.


Today, I had the distinct honor of connecting with James Nestor, who is a science journalist and author of the book, Breath. It was absolutely one of my favorite books I read in 2021 and in preparation for this podcast together, I read it a second time and got even more out of it. We dove deep into how humans have become such poor breathers, and the role of crooked teeth and how it has to do with poor breathing. We discussed the nasal anatomy and its impact on breathing, the role of alternate nostril breathing, as well as the vagus nerve, anatomical changes that occur with aging, how overeaters become over breathers, and we dove deep into the role of chewing, and how our palates and our facial bones have actually changed evolutionary wise. We discussed his experiences in the Paris Catacombs and lastly, we dove into breathwork and how that actually impacts the autonomic nervous system. I really hope you will enjoy this conversation as much as I did recording it.


Well, James, welcome. It’s really a pleasure to connect with you. As I was telling you, before we started recording, I’ve now read your book twice and recommend it to my lay public friends, as well as my clinician friends, because I got so much out of it. I would really love to start the conversation today talking about some of the things that have changed structurally in our face and our nose. Because this is information that just incredibly blew my mind. I literally was at a loss for words how to explain how surprising all this information was. And largely, because for many of us, myself included, when I think about all the dental extractions I had for braces in the 1980s and I’m realizing this cumulative domino effect of how the structural changes in our bodies have really impacted our quality of breathing.


James: Well, when I was first starting off really seriously researching the subject, I remember talking to a few dentists and it was these dentists who told me, they said, “Well, the reason why some people are breathing so poorly now is because their mouths are too small.” I was like, “What are you talking about? Mouths just don’t randomly grow too small.” He’s like, “Yeah, why do we have crooked teeth?” I thought, “Well, because the teeth are growing in crooked.” They said, “No, it’s because your mouth is too small for your face. And so, teeth grow in crooked. When you have a small mouth, you have a smaller airway, which can lead to all of these different breathing problems.” This sounded completely nuts to me and I told them so. And they said, “Well, why don’t you go look at ancient skulls, and compare them to modern skulls, and see the difference for yourself.” So, I did. I went to the University of Pennsylvania to the Morton collection, which is one of the largest assemblages of ancient skulls in the world. It was extremely spooky to walk into this place and see these shells, just lined with skulls from Asia, Africa, Europe, North America, South America, Poland, wherever, and they all had perfectly straight teeth. Every single one of them in these huge prognathic faces and had wide airways that come with that. 


If you look at a modern skull, about 90% of us have some sort of dysfunction in our mouths. Malocclusion leads to crooked teeth, overbites, underbites, all of that. With that smaller mouth, that can lead to so many chronic respiratory problems. This was the first time I’d ever heard of this and it was something I was pretty shocked to learn about because I’ve learned that evolution meant progress that we were supposed to be getting stronger and better that regeneration, which is total BS. All you have to do is look at your own face, and look at your ancestors faces, then you can see that for yourself.


Cynthia: Yeah, absolutely. Well, it really gave me pause as I thought about my own dental history and had eight teeth pulled out of my mouth when I got braces. Back in the 1980s, that’s just what they did. Thankfully, my children didn’t require. They had minimal orthodontic care, but they didn’t require any teeth being pulled out of their mouths, which I have to give credit to my husband, who never had braces. They inherited his genetics and not mine. But what I found really interesting was, when I reflect on all the patients I’ve taken care of over the years, how many of them were obligate mouth breathers and we didn’t really think much of that. We just, “Oh, they’re an obligate mouth breather and because of that they have these physiologic changes to their mouth and they have to work a whole lot harder at breathing.”


What was interesting to me when I was reading your book is that in the book, you talk about 90% of us are breathing incorrectly. Most, if not all of us, 40% of us suffer from chronic nasal obstruction and then 50% of us are obligate mouth breathers. And although, I think I’m very cognizant of the fact that I don’t breathe through my mouth, even when I’m outside walking or exercising, now, I make a really big effort to keep my mouth closed.


James: Well, that’s wise. I had always thought that that was just an insult, because of the way it makes you look, because that was always associated, at least when I was growing up with someone who looks silly mouth breather. I had no idea that the pathway through which we breathe air can make such an enormous impact on our health, wellbeing, our sleep quality, or anxiety, panic levels, asthma, I could go on and on. But the science has been there and it’s been there for decades. And then if you go back even further hundreds and hundreds of years ago, researchers were finding from indigenous cultures that they celebrated nasal breathing for all the same reasons we celebrate it today. They didn’t have the scientific measurements that we do, but they noticed that people who are breathing through their noses were much better off. 


This is something that’s so simple people think, “Oh, it’s not going to make a big difference to me. Try it.” And then after you try it, look at the science. You see that this is a chronic, widespread problem. Few people are talking about it and it’s one of the easiest fixes you can do. I want to be very clear that some people are mouth breathers, because they have structural problems in their noses and polyps, severely deviated septums, they’ve broken their nose. For those people, they need more serious interventions and that’s where a responsible ENT can help out. But for the vast majority of us, a nose is a use it or lose it organ. The less we use it, the less we’re going to be able to use it, we become mouth breathers, which is bad for all the reasons we were just talking about.


Cynthia: Yeah. No, and I think for so many people, we just assume breathing is effortless and breathing is easy. One of the things that I found interesting when I was reading the book was talking about the net impact of obligate mouth breathing, what that does to our hydration status, how that impacts our deep sleep. I’m a huge proponent of high-quality sleep, and probably, I feel it’s foundational to our lives, and it’s not celebrated enough. But I found it really interesting that there’s this correlation with not enough deep sleep, and the thirst, and the need to urinate at night, how many people don’t recognize that nocturia is not normal. There’s this association with the obligate mouth breathers and this net impact on getting up at night to urinate, can you talk a little bit about that?


James: Yeah, you’re right about deep sleep. If we’re not able to get that big chunk of deep sleep, and that deep sleep comes earlier on in our sleep cycle, then our body’s unable to function properly. Our brains aren’t able to reset, our brains flush out during deep sleep and remove metabolites and allow us to start a new in the morning. But also, if you’re looking at the stress response and if you’re looking at different hormones that have to be stimulated in deep sleep, that can actually help us comfortably hold our water instead of the need to release it. All of this is essential to entering into that proper deep sleep cycle earlier on in our sleep.


I always wondered this. I have a dog and after she eats dinner at around five, she can sit down. She won’t go outside until the morning. I’m like, “Wow, what a bladder that dog might have.” But no, we’re all built to do this. We’re built so that we don’t have to wake up three times. I’m not saying that that’s the only reason why people urinate at night that could be you’re drinking way too much water. There could be problems, other problems with your kidney, I don’t know. But I do know that having proper deep sleep is essential to health and you will never ever really be healthy unless you’re able to hit all those stages of sleep. And I also know that a lot of people aren’t talking about the links between how you’re breathing and your sleep quality and how you’re breathing can have a huge impact on your snoring and even some levels of sleep apnea.


Cynthia: I think it’s really important, because on so many levels, you touched on the physiologic things that can be at risk or put people at risk for developing problems with mouth breathing. But one thing that I found interesting and I just wrote down a lot of statistics as I was reading your book, because of course, I was nerding out on all the details, and one of the statistics was that 90% of kids have a deformity in the nose and mouth, that’s 90% and 45% of adults snore occasionally. I’m not talking light snoring, like, maybe our dogs do, but actual snoring. I know when I worked in cardiology as an NP, we would send people off for these polysomnography tests, which of course they hated and trying to explain to patients that the net impact on not getting high-quality sleep had profound downward effects, like, thinking about the role of the glymphatic system and how it’s this waste and recycling process that goes on in the brain that goes on in deep sleep. If you miss out on that, it has a lot of negative net impact on your day-to-day life because your body doesn’t get that restful sleep. 


I’m curious, when you were doing a lot of the research for the book, I’m sure you probably felt you fell down a rabbit hole. When we’re talking about the anatomy of the nose and the actual breathing and I’ve never thought thoughtfully about it as I did when I was reading your book. Let’s talk about nasal erections. This is a concept I’d never heard about. I thought it was fascinating. What is this about and why would this be of interest to listeners?


James: I’m not sure why it would be of interest to listeners. I’ll tell you why it was of interest to me is because I learned from Dr. Jayakar Nayak, who’s the Chief of Rhinology Research down at Stanford that our noses are covered with erectile tissue. It’s the same erectile tissue that’s you know where, in our genitals and it operates in the same way. It becomes engorged with blood or it will clog up our noses and then it becomes flaccid where we’ll be able to clearly breathe through our noses. Each side of your nostrils actually fluctuate throughout the day. After about 30 minutes to three to four hours, the right side or the left side of your nostril will tend to become engorged with blood and will gently plug up. It doesn’t mean completely plug up, but it will mean the other nostril is dominant. This just happened back and forth all day long. I remember asking some rhinologists, “Well, the body wouldn’t do this randomly, why does it do that?” 


We don’t know exactly why but there’s a lot of really strong theories right now. Basically, we know why, but no one’s really willing to put up the flag. And why, because that air that we breathe through our nostrils will affect our body and will affect our brain in different ways. Yogi’s have known this for thousands of years, which is why they’ve developed alternate nostril breathing, which allows you to hack into these different functions, but our bodies do this naturally and so it’s another reason. If you’re a mouth breather, you are not getting these functions, all of this additional balancing that is coming from your nasal passages cycling from one side to the other in those nasal erections.


Cynthia: It’s really interesting because I have been an avid yoga enthusiast for the past 10 years and never really took the alternate nasal breathing very seriously, but when I read this and the acknowledgement that depending on which nostril you’re depressing, you could be supporting the parasympathetic or the sympathetic nervous system. When I really reflect on how sympathetic dominant most individuals are and past two years haven’t exactly helped everyone. I think that this is a very easy way to support your body and to try to support having a little bit more parasympathetic tone, a little more rest and repose as opposed to the sympathetic dominant, where we feel we’re being chased by a rabid animal on a daily basis.


James: Yeah. There’re a few dozen studies into this as well. You can take your own measurements, you can look at EEG readings, you can look at your heart rate, you can look at your blood pressure. The data proves that this is definitely doing something. What it’s doing is if you’re breathing in through your right nostril, that tends to activate the body that sympathetic response, where blood pressure will go up, more “heat” will develop in the body, your heart rate will go up. Left nostril, in and out will have that opposite effect, where it will calm you. A lot of alternate nostril breathing just has you try to rebalance that system. The body is perfect in its natural place. Everyone thinks the body is faulty and that’s why we’re diseased, no. The body is fantastic and perfect. This is just balancing the body back to its place where it can function properly. Throughout the days, we’re stressing our bodies in so many different ways that it’s not able to do what it’s naturally designed to do and that’s why we get sick.


Cynthia: Right. I think it’s important just acknowledging the role of homeostasis that our body desperately wants to find balance all on its own. Now, when we talk about the role of the vagus nerve, we talked about nitric oxide. I found this really interesting and how there’s all this interrelationship with the anatomy of the nose. I promise our whole discussion will not be about this, but this really was new information for me. It was really profound. As my listeners know, I’m super curious and so, the vagus nerve is considered to be the wanderer, it’s one of the cranial nerves. How does that impact nasal anatomy?


James: The vagus nerve? Sorry.


Cynthia: Sorry. I meant the role of the vagus nerve when it comes to our nose and the role of nitric oxide.


James: Okay. There are various ways of stimulating a vagal response and stimulating vagal tone. You want vagal tone, because what vagal tone is, is that that vagus nerve being able to have access to all of the organs it’s connected to. When we are stressed out, the vagus nerve stops those connections, so the body can focus on fighting or running away. When we’re focused on just fighting and running away, that’s what’s allowed us to live modern humans. That’s why we’re here is having that ability, but we’re not meant to be in that state all the time. So many of us are spending most of our time in that state, where that vagus nerve isn’t able to connect with all those organs, which means they are essentially turned off, functionally turned off from doing what they’re designed to do. 


By breathing, breathing is a wonderful way of establishing more vagal tone of calming your body down, of allowing that vagus nerve to come back online. Because when you breathe in this very calm way, you’re sending your brain messages that the body is safe. If the vagus nerve and if your brain knows the body is safe, it will start functioning normally again. This is also one of the reasons that there is often humming involved with so many different practices and religions from yoga to qi gong, “Mmm.” You’re breathing in humming, oming, and all of that, because it so happens to be that the vagus nerve comes right down along the throat. When you hum at these lower frequencies, it sends the vagus nerve a massage to allow the nerve to come back online again and relax the body. So, all these things have been around for thousands of years before people had ever heard or wondered what a vagus nerve was. It’s fascinating to me to find that now we have measurements and we can look and find the real mechanisms behind so many of these breathing techniques. 


Cynthia: I think it’s really important and certainly very relevant, I know that I have a whole process I go through when I do public speaking, because I get so excited. Like that my heart rate pick up, and I have all this adrenaline coursing through my veins, and so, part of my calming down is, if I’m not humming to myself and looking like a crazy person, it’s just box breathing, because that will stimulate my vagus nerve. I’m trying to explain to people that has been my strategy. My methodology for a long time, having that whole cardiology background was certainly very beneficial. The vagus nerve can be stimulated in negative ways, but this was certainly a beneficial way. 


Now, when we’re reflecting on some of the changes that have occurred with modern society, one of the things I found interesting was overeaters become over breathers. Can we talk about some of the things that have changed as we have become a more metabolically unhealthy, less metabolically flexible, obese and overweight population? How has that impacted breathing? We just talked about ways that we can support breathing beneficially, but how has that impacted our breathing in negative ways?


James: I would think that the first thing it would impact is our ability just to get air easily in and out of our bodies. Because the larger your neck is, the more difficulty you’re going to have. Men who have a neck size of over 17.5 inches will have an increased risk of suffering from sleep apnea and other breathing dysfunctions. The reason is it doesn’t matter what– This is fascinating. If it’s muscle, or if it’s fat, or if it’s whatever, because it will just tend to crowd the airways, which is why so many weightlifters, you look at these people and they’ve got .2% body fat, they’re all muscle, but they suffer from terrible sleep apnea and chronic breathing problems. Because they haven’t been working out their throats, they haven’t been working out their airways. They’re working out their pecs and their biceps, but they’re not working out the most important channel through which we get energy and that’s our airways. Even more than our stomachs, more than we eat, we get most energy from the air we breathe. I think that that’s one of the issues. 


Another problem with so much of the population becoming obese and how weight affects breathing is having too much weight, too much fat specifically around the chest area, around the abdomen can actually impede your ability to take a free and easy breath in and out. It’s no coincidence that Yogi’s, what is yoga? But a technology of breathing and stretching and those two things complement one another. There is no yoga without breathing. The reason you stretch is to allow you to breathe more easily. When you have a corset around you that does not allow you to do that, even if you want to breathe in a healthy way, you can’t. You tend to breathe up into the chest through the mouth too much, which can actually make it harder for you to lose weight. So, it’s this very evil, little perfect storm of problems that happens when your body gets way out of balance and it makes it harder for you to get back into balance.


Cynthia: Well, it’s interesting. There was a cardiologist I worked with when I was a new Nurse Practitioner many years ago. That was a standard refrain. He would walk in to do a consult and if he perceived someone’s neck size was at least 17 inches, he would say, “What shirt size do you wear?” And of course, this patient would never have any idea that there was any correlation. The next thing he would be doing would be ordering a polysomnography test because he said, “You probably have sleep apnea.” Says that, “17 inches, it is not as benign as people like to think it is.” I think on a lot of levels, we’ve gotten conditioned as a society that we don’t breathe very deeply. Whether or not, it’s through restriction from corsetry, or clothing, or visceral fat from being overfed. We definitely put ourselves in a position. I say, we as a society, not we as in you and I, but we as a society have really detrimentally impacted our ability to breathe properly. And like I said earlier, so many of us, we take breathing for granted until we have a problem.


James: Yeah. And if you look at, if we flip this a little bit and you look at– so what are the causes of so much of the population becoming overweight, well, it’s the food we eat. Obviously, it’s all the stuff we’re drinking. Obviously, it’s sedentary lifestyles that ties into it as well. But it’s interesting when you start looking into sleep medicine and the people who study this that the way you breathe at night, your sleep quality can significantly affect your weight. If you are struggling to sleep and you have sleep apnea that will increase your risk of having adult-onset diabetes. It will also increase your risk of having insulin resistance, which is it becomes adult-onset diabetes, but it also spikes your blood sugar. All of these things just make you metabolically imbalanced and you can survive this way for a long time. But that doesn’t mean you’re healthy. You look at this vicious cycle of poor breathing, how it can lead to weight problems, then how weight problems can lead to poor breathing. It’s so hard to get out of that trap. The very first step is to diagnose these issues and provide people with some information on what it is and what they can do to improve their breathing.


Cynthia: Absolutely. One the things I found really interesting was talking about and you mentioned earlier that you went to this very specialized museum in Philadelphia. I know that museum because my mom was at University of Pennsylvania for a long period of time. There are a lot of very interesting museums in Philadelphia. And looking at bones, looking at facial structure, what are some of the changes that have occurred? You had mentioned, you alluded to mouths being smaller, there’s some of the cranial facial changes that have occurred. But the net impact of mouths being smaller, facial bones being stunted, crooked teeth, what is the significance of all this, in terms of what are the things people can do? If someone’s listening and certainly, I’m a good example of this. Actually, I’ve started thinking thoughtfully about some of these things myself, because I’ve always been told, I have a small mouth, I have big teeth, I had teeth extracted. The net impact of what we can do proactively if we know that we already have this bone physiology, this bone structure, most of us can’t change it unless you do something surgically. But what can people do? I found some of the things that you did in terms of chewing that can impact the stimulation of bone remodeling, which I found fascinating.


James: I think the first thing you need to do is to look at what are the problems associated with having a mouth, it’s too small for your face. Okay, so, we know it’s crooked teeth. A lot of people say, “I don’t care if my airway and my mouth is too small, because I want to breathe through my nose.” Well, if only it were that simple. What happens when your mouth is too small is that upper palate tends to grow up instead of out. You want that upper palate to grow laterally, which is why if you look at an ancient skull, they have these gorgeous upper palates that are perfectly balanced, aligned, and they’re flat, and they’re extremely wide. If you look at a modern palate, I’m a great example. That palette tends to go up. When that palette tends to go up, it can impede the airflow in your nose. What happens, then? It’s harder to breathe through your nose. What do you do, then? You breathe through your mouth. 


Okay. Well, now, because your mouth is so small that airway is compromised in your mouth, so, what do you have? Extreme breathing dysfunction, and the sleep disordered breathing, and all of that laundry list of problems that comes with that. I want to be very clear to everybody. This is not my hypothesis, this is not my theory. I’m not paid to write theories. I go out in the field and report on things from experts in the field. This is an established scientific fact, and we’ve known it forever, and no one wants to talk about it, which I think is absolutely bizarre because my understanding is, you want to start with a core issue and then work up from there. What’s my core problem? I’m going to fix that core problem, then all the other symptoms tend to go away.


That leads us to the next part here is, “Well, what do you do?” You can’t go back in time. If you’ve had teeth extracted like I have, like you have, like most people have, if you’ve had braces, and headgear, and retainers, I had all that stuff as well. What do you do? I think that it’s much easier when you’re younger, because when you’re younger, forming and creating change in building that better foundation is so much easier because you’re more malleable. When you’re older, what do you do? You’re middle aged, you’re like, “My mouth is too small, I’m having breathing problems.” I’m not here to provide a blanket prescription for everyone because there is no such thing. Everyone is suffering from a slightly different, not everyone, most people are suffering from a slightly different breathing dysfunction. What you can do is look at the foundation of– What you need to do is to diagnose where the problem is. For me, my airway is too small, my mouth is too small, I had trouble breathing through my nose, it was nothing structural. I just forced myself to breathe through my nose mark. Guess what happens? Those erectile tissues open up. You can breathe through the nose much easier. 


If you’re talking about chewing stress and trying to expand your mouth, you can do that surgically, which has been shown to be incredibly effective for sleep apnea, for other breathing issues, and it also changes the way your face looks. Some people show some benefit of chewing hard foods. When you’re chewing, you tend to tone your airway. By toning your airway, you allow it to become more fit, so that air can more easily enter and exit your body instead of going, “orgh-mmrgh.” Every time you breathe, it will sound like this. If you’re hearing nothing, that’s because my airway is more fit than it was before. So, that’s a very convoluted answer to a very simple question, but I can’t offer one answer to that, because there’s so many variables.


Cynthia: Well, and I think that here in the United States, there’s been such a focus on aesthetics. Aesthetics before really looking at root cause. I 100% am aligned with what you’re saying. I think know better, do better. But what I find most interesting is that when I brought this discussion up with my dentist, “I now, I’m in a new city, new dentist.” He looked at me like I potentially might have been a little bit crazy. I said, “I would hope you would be open minded enough,” because for me, never having heard this information before, it really resonated. I think that’s the traditional challenge with a more traditional allopathic role model is we treat symptoms. Symptoms are overcrowding, overbite, the solution for most of that methodology is that we then go on to straighten teeth, pull teeth, put headgear on, and yes, I suffered with headgear, but I didn’t even have the one that went behind my neck. I had the one that went on my head, because I had an overbite.


But realizing that there’s so much more to it, and I always think about Weston A. Price and when I did a functional nutrition program, he talked about all these indigenous cultures, and how beautiful their teeth were, and how it wasn’t until we got to a point where we were eating highly processed hyperpalatable food that that was what created all the dental caries, and so that was a lot of the focus of his work. But really, what I’m hearing is that over time this has become much more of an issue and I would imagine for most people listening that some of this is genetics, but it’s also our choice in the types of foods that we eat, because we are definitely not going to be building those masseter muscles if we are eating essentially baby food. If we’re eating applesauce and soft foods, you actually have to eat crunchy natural foods. I’m not talking about eating chips, but eating foods in a more natural state that are going to stimulate the improvement in that muscle. And maybe we can talk about the masseter muscle, because some people may not be familiar with what that muscle actually does, but it’s a very important one.


James: First, starting off with your dentist’s looking at you like you were crazy, this is exactly what I heard years and years ago, when I started asking some dentists about this. It just reminded me of any doctor 20 years ago, if you would have said, “I think the problem with so many people becoming obese might be actually tied to this low-fat food. So, I’m going to eat more fats right now because I think if I eat more fats, my body is going to lose weight.” Any doc, not any the vast majority of doctors you would talk to would say, “You are absolutely insane. You need to stay on this extremely high-carb, high-sugar diet of processed foods that has no salt in it, because this is how you lose weight and this is heart healthy.” We know now that that is complete and utter garbage. There are a zillion books to prove it and there are whole conferences. I go to these conferences with leaders in the field from Harvard, from Boston, I mean, all over the place are speaking at this, knowing it’s garbage.


I think you have to, first of all, accept that science is not a closed book. It is constantly changing. Anyone who is still adhering to a doctrine that was laid out 50 years ago when they were in school and hasn’t changed their mind any little bit is not looking at what real science is and after that, do your own research. We’re lucky enough to live in an era where there are different ways of getting information. You can go and look at medical studies, you can go to a library, you can listen to podcast by doctors, and then people who really know what they’re talking about, and learn this stuff. That’s a long way of saying things are constantly changing. The news about airway health and dentistry is actually that news is very old news. Everything I’m telling you was talked about 125 years ago and we’re just relearning it right now and readopting what we learned so long ago. I think the more that we do that, the more we’re able to balance our bodies and get ourselves back to breathing right, which is so important.


Cynthia: Yeah, it’s interesting. My standard mantra is, I was raised this way. I went to a school that encouraged this was that we should question everything. We should be intellectually curious. I remember saying to colleagues of mine, probably, 10 years ago, it all starts with food. And everything I had been telling patients in the early 2000s, I look at now and I cringe, I always say, “Know better, do better.” But we should be evolving, we should be changing our opinions, we should be evolving as a clinician or an individual, and so we should be questioning things. I think that that’s really important, although there’s a degree of cognitive dissonance. I’m not necessarily with my field, but with a lot of individuals these days that sometimes makes it challenging, but I remind people that we really shouldn’t be questioning dogma, we shouldn’t remain dogmatic and rigid that we should acknowledge that. Over time, we may change our opinions and that is completely okay. Certainly, the nutritional paradigms and looking at the health of our patients over the last 20 years it’s not getting better. It’s certainly heading in the wrong direction. We need to adopt different principles and philosophies.


Now, one of the things that as someone who is incredibly– I’m definitely one of those individuals that struggles with being in a closed space, your whole discussion about the Paris Catacombs, I found both interesting and horrifyingly terrifying. I would love for you to touch on that whole process of crawling around the Catacombs. For anyone that’s been to Paris, this is one of those kinds of probably less well-known activities that you can do, but I would imagine that you found it fascinating, but by the same token, as I was listening or reading rather your book, imagining what it must have been like to be crawling around in such narrow places. I really have to give it to you for being in a position, where you felt comfortable doing that and doing it for the benefit of your science readers.


James: First of all, I wish I had gone to the schools you went to because I was told a question nothing. And everything that I learned including growing up, “Question nothing, this is the doctrine, this is the word. Now, go on on your way and continue repeating this word.” I think it’s later on in life, you start questioning things. I think a lot of people are questioning a lot of things right now, which I think is healthy. If you look at the founding of the Royal Society in England, their motto is “Take nobody’s word for it.” Isaac Newton was saying that, “Where would we be in science if everyone was accepting what someone else had said? The only way to progress is to challenge, and to test things, and not to throw things out all the time. Just to really test them, and measure them, and see what holds up, and see what doesn’t.” Science isn’t supposed to be about opinions. It’s supposed to be about looking at data. Okay, I’ll hop off my soapbox and tell you about the Paris catacombs.


Before I was able to get to the University of Pennsylvania to the Morton collection, I could not get access to human skulls. I called up some different museums, nobody wanted to talk to me, and this is usually the plight of many reporters. They’re like, “Wait, you want to look at ancient skulls because you’re interested in breathing? Now, not going to work here.” I was in Paris and through a friend of a friend, who shall remain anonymous, I was able to connect with these people, who have been able to over the past several years to get access to about 170 miles of these underground catacombs that are beneath the streets of Paris. A lot of people know the catacombs from the sanction tour, where they take you down this tour, and you see these goals, and you go back up. No, no, no, the real catacombs are quarries are all of these unsanctioned areas, which are also illegal to be trampling in. That’s where there are over 6 million human skulls dating back thousands and thousands of years. I didn’t know if I was going to get access to museum and I wanted to see the difference in our faces. You can see it online. That’s cool, but I’m a reporter. I need to go out in the field and do this. 


I was given the opportunity to do this. I had no idea what I was getting into. I thought it was going to be half-an-hour-long stroll with these people. I knew something was terribly off when they showed up with rainboots up to their knees, and overalls, and headlamps. I was sitting there in a sport coat and sneakers. It was very dirty, but it allowed me to– I got what I was looking for which I could see skulls dating back hundreds of years. And even though, I’m so far from being an expert on skulls, you don’t need to be an expert to see. It’s so dramatic what has happened to us. In just a few hundred years of industrialization, our faces have changed, our teeth have changed, our breathing has changed. When you see it right there, when you’re 60 feet below the streets of Paris, it sticks with you and I can’t wait to go back there if they’ll invite me again.


Cynthia: What an incredible experience. I would imagine your curiosity must have really been piqued, not just with the differences in how you were dressed compared to your colleagues that you [giggles] were in the catacombs with. But I’m curious, when you think about or you reflect on the differences that you saw when you were in the catacombs or when you were in Philadelphia, you’re working hypothesis of what has contributed to the changes in the anatomy of our faces is a lot of it driven by the dietary changes or the fact that we’re now consuming more highly processed foods. I’m just out of curiosity. I’m just asking what is driving most of those changes? Is it imagining that it’s the palates are getting and our faces are just getting smaller and smaller over time?


James: Yeah. Well, so, it’s not my hypothesis and it’s not even a theory. This is a fact. It’s a fact that we’ve known for just about hundred years now starting with the work of Weston Price, who spent 10 years studying this stuff and found in a single generation of converting from a traditional diet to a diet of industrialized foods about 50% of the population is going to get crooked teeth and they’re going to have respiratory issues that come with that. After that next generation, I think it’s about 70, the next generation, it’s about 80, 85, the generation after that, look around, that’s us. It’s upwards of 90. Robert Corruccini, who I was lucky enough to talk to and I’ll be with him at a conference coming up here, picked up all of this research from Price. Because Price released this 500-page book, it is really hard to read. Some people loved it, other people hated it, they said he was too opinionated. Whatever, data is data and I think you can very clearly see what has happened. Robert Corruccini, who was a professor in Chicago picked this up in the 70s and found exactly what Price had found. 


More specifically, the mechanism by which we became such widespread crooked teeth is chewing stress that masticatory stress. This is what Daniel Lieberman had found at Harvard and this is what Corruccini had found as well. The food being nutritionally deficient, obviously, it wasn’t going to help us. That played a part, but it was a smaller part than chewing stress. When we’re young and developing, we need that constant chewing stress, which is why kids, who have spent two plus years being breastfed will have a different mouth than kids who have been bottle fed. I’m not pointing fingers at anyone. I’ve had something to be very clear I’m providing you with information. I have no opinions about this. I’ve gotten lectured many times. That is a scientific fact. If kids eat very soft food when they’re growing up, soft processed foods, they don’t get that chewing stress they need to build the proper skeleture and musculature of their faces. They’re just as beautiful as anyone’s kids. Another thing, I’m not going to get into this argument. I’m providing you with information that researchers have accumulated over decades as to why our teeth have grown crooked and why we suffer from breathing problems because of that.


Cynthia: It’s really fascinating because one of the things in your book that I made sure I wrote down was that engaging those muscles, the masseter muscles actually increases stem cell activity, which then further potentiates, has that net impact on not only the facial muscles, but bone changes, which I found really, really interesting? I certainly trained in Inner City, Baltimore and I was exposed to a very different environment than I had as a suburban individual and I remember saying to my clinical faculty that the amount of processed foods that kids were growing up with because we would sometimes be in doing home visits, and it was just absolutely heartbreaking. When we’re in an environment where our kids from a very young age are eating just processed foods, they’re never going to develop the musculature in their mouths and the bone structure that they’re going to need to avoid as you mentioned, the aforementioned crooked teeth, smaller mouths, etc., I find it absolutely fascinating. What is the significance of the empty nose syndrome?


James: Oh, I’m going to just go back to a few things that you mentioned. Not only are the benefits of chewing tied to allowing you to grow to your epigenetic potential, to allow you to build more bone, more musculature to have a more toned airway, but you also increase blood flow to the brain. When you chew, you enter into a parasympathetic state, which is why you salivate. Salivation comes with being in a parasympathetic state, which is why it’s really hard to digest food if you’re completely stressed out. In that parasympathetic state, that’s when the body is able to build bone. This is one of the reasons why it’s so harmful to people to have sleep disordered breathing, especially for kids or to be gnashing your teeth, because there’s a difference of the chewing and the stress you do. When you clench your jaw, both sides of your molars are clenched down. That is sympathetic stress which is why you do that when you’re boxing or you’re stressed out. When people grind their teeth all night, some dentists and some researchers have said that’s eliciting a sympathetic response, which makes it hard to grow more bone. Those osteoblasts need a parasympathetic response. Chewing, if you think about chewing a carrot right now, you go from one side to the other. That elicits that parasympathetic response, that relaxation response. Not clenching your jaw down. I know that your listeners are more scientific. But that to me, I think is so fascinating, and how chewing can play a role, and how you look, how you breathe, how your brain functions, and more. Our ancestors used to chew for about three hours a day. How often do we chew today? Not at all. Most of us don’t chew much at all, because all the food is so soft. 


Next, empty nose syndrome. A lot of people have structural issues in their noses and because of that they elect to have surgery, which can be absolutely life changing. A bunch of wonderful ways for so many– I’ve talked with dozens and dozens of people who said, “Oh, my God, I can breathe out of my nose now. It’s the most amazing day. My sleeps better, athletic performance is better, stress is down.” That’s all great. But with anything else, sometimes, surgeons can be a little too overzealous and they can tend to take out too many of the structures of the nose. When you do this, breathing becomes much worse and it becomes so bad that it affects your mental health, it affects your physical health, it affects your sleep quality, and more. 


The message behind all of this is just like anything else, go in conservatively, try to find other therapies, other ways to clear your nose first. I’ve found from many very responsible ENTs. They said, “Not everyone needs surgery.” In fact, a lot of people can benefit much more from not having surgery. If you do do surgery, make sure the ENT you’re working with knows that. Taking out less is oftentimes much more beneficial to you. I have talked to so many people with this empty nose syndrome. You do not want to have this. They can’t breathe, they have no sensation of breathing, they’re constantly out of breath. So, when you talk to them, they go, [huffing noises]. They can’t sleep and everyone thinks they’re crazy. They’re not. This has been proven by looking at CAT scans and airflow.


Cynthia: It really must be incredibly unfortunate and I would imagine that would be absolutely miserable. I do want to come back to the concept of digestion starts in the brain why that’s so important. I talk a lot about that, but I remind individuals that when we’re in this sympathetic dominant state, we can’t properly set our bodies up for success. With digestion, we can’t detoxify, we can’t secrete adequate amounts of bile to break down and emulsify fats. That dovetails nicely into that discussion. So, thank you for that. The empty nose syndrome to me almost sounds as if patients are suffocating, because they never feel they have enough air. They never feel they have enough oxygen and how miserable that must be. I’m really grateful that you brought that up because I without question had patients that had had multiple sinus surgeries, had multiple rhinoplasties, all with the intent of being able to improve their breathing, but ultimately, ending up in a situation that likely was not correctable that they were just going to have to live out the rest of their lives really feeling like they were coming from a place of suffering and it was incredibly unfortunate.


James: Dr. Jayakar Nayak is one of the world leaders in helping people with empty nose syndrome down at Stanford. People fly in from every imaginable country because they were told, “What you have more space in your nose? You should be happy. You should be thanking me.” I can’t sleep because those nerve endings that tell your brain that you’re breathing some of them are in the nose and without that pressure in the nose, you don’t get the signals that you’re breathing. At night, they keep waking up suffocating over and over and over. It’s truly awful. Here is just the most crazy thing is that Nayak is the specialist in restoring the nose the way it was supposed to be before that extremely invasive surgery occurred. He also helps clear up the nose in a very responsible way. Same thing with Noah Siegel at Harvard. But it’s ironic that we’re now using pig tissue to try to recreate the natural structures of the nose, so we can breathe normally. But that’s modern life here everybody. [crosstalk] Surgery to remove it and then a surgery to put it back in. There you go. 


Cynthia: Well, and I think it really speaks to the fact that surgery should be the end result. When everything else has failed and that’s certainly a message that I know you and I are very aligned on, the last thing you should do is surgery. It should be everything else has not worked, or has been ineffective, or has not met your needs. And then you consider surgery, and then you actually go to people, this is what they do. You’ve mentioned two clinicians, you’ve wrote about them both in the book, who sound incredibly talented and are able to do very delicate surgeries, because I know that if I were ever to need nasal surgery, I would want to be going to someone who just works on noses. Not just from a cosmetic perspective, but someone who works on the physiology within the nose to make it anatomically conducive to being able to breathe better.


James: Yeah. At Ohio State now they’re developed aerodynamic models, so they can see how much they would have to clear out. I think that that’s going to be the future is to take a CAT scan, look at where the problem is, say, “Okay, if I snip this, this, and this, this will create the natural airflow to the rest of your airway,” which I mean, otherwise you’re going in blind and just drilling stuff out. It just doesn’t seem like a good idea. I just want to be very clear again. Surgery is fantastic. What an amazing thing that if you have polyps or a severely deviated septum, you can fix it. So, surgery is great. It just has to be done responsibly and when you really need it.


Cynthia: Absolutely. Now, I would love to end our conversation today really talking about breathing, because for me when I was reading the book and considering something that I took for granted all the time, you brought up different types of breathing. [unintelligible [00:50:17] and I may be mispronouncing that. I thought it was very interesting and very telling that there’s more to breathing than just breathing in and out that you can impact your heart rate as we’ve alluded to if we stimulate the vagus nerve, but it also impacts immune function, and temperature regulation, as well as stimulation and secretion of specific neurotransmitters. I always think about Wim Hof who I’ve had the honor of being able to connect with, but I know that some of his work is reflective of this technique.


James: If you get a book on pranayama, or qi gong, or whatever, you can find these books filled with hundreds and hundreds of different breathing techniques. The first question you ask is, “Well, what do I do? Where do I start?” Often times, the descriptions are really confusing. They’re extremely detailed. Instead of focusing just on a few specific techniques, what I tried to do is put these all in certain groups, because so many of these techniques are doing the exact same thing. They’re either making you breathe too much to elicit a stress response and to have hormetic response in your body, which is very acute stress, which can be so beneficial or they’re having you breathe very slowly to slow yourself down, and then hold your breath, and then breathe very slowly again. You can call these techniques whatever you want but they all fall into about three or four different categories.


What’s fascinating to me, at least, was that by really focusing on these breathing techniques and controlling them, you can do things that are supposed to be impossible. You can take control of your autonomic nervous system supposed to be impossible, it’s called autonomic, which means automatic, which means beyond our control. Wrong. You can take control of it, you can influence your immune function. Wim Hof has certainly shown that. You can heat your body up on command and you can use breathing to help heal yourself with several chronic conditions. Sounds crazy until you look at the science until you try it yourself. 


I think that people don’t have to be obsessed with, “Oh, I only do this school of breathing. Oh, I only want to do this school of breathing.” A lot of schools, much to their detriment, I think is they say, “This is the best thing. You can only breath this way. Buteyko, you just breathe very little bit and this is the only thing we’re focusing on CO2. There are benefits to all different kinds of breathing. It depends on what you want and what you’re looking for. And then luckily, so many of these different breathing techniques you can just learn for free. They’re available to everyone, everywhere. No one’s found a way to really effectively market these things yet. I’m sure that’s coming. So, it’s accessible, and open to everyone, and you can see what works for you.


Cynthia: I think that’s really key is finding what makes the most sense. I read with great interest about carbon dioxide therapies, which I thought was really interesting, because coming from a more traditional allopathic background, we always worried about CO2 poisoning or carbon monoxide poisoning would come into the emergency room. But I found carbon dioxide therapies to be really, really interesting and I’m sure that must have been for you, as you were guinea pigging yourself through this entire process, it must have been really, I guess, the best way I would say is, in the name of science, putting yourself in a position where you’re uncomfortable, there were definitely a lot of trials of trying different therapies. Certainly, when you’re out with your friend in California, and you were having your nose obstructed for two weeks, and watching the net impact on your metabolic health, and sleep quality, etc., I think in the name of science it’s really fascinating.


James: Yeah. If you look at CO2 and carbon monoxide, these are extremely dangerous gases in high quantity. Don’t ever think they aren’t. Keep that monitor up in your house. Like carbon monoxide is especially extremely damaging and carbon dioxide in high levels is very, very bad for you as well. But we tend to want to categorize things as good or bad and we tend to want to look at things in this very binary way. But that’s not how our bodies work. Just like we say, stress is bad. Why do I want to stress. Short-term stress is really, really good for you. Now, that is starting to come out. It’s the same thing with diet. All of the things that were supposed to be bad, actually in small quantities, it can be really good for us. Carbon monoxide is another thing. No, any amount of carbon monoxide is bad news. But carbon dioxide, we need a balance of CO2 in our bodies for oxygen to do its thing. Any pulmonologist, any cardiologist, any doctor knows this. But we have vilified carbon dioxide because we associate it with climate change which is really bad. There is too much CO2 in the atmosphere but in our bodies, we need a balance. 


Most of us, I don’t know, if I’ll say most of us, a large population of us, how’s that for being a little more diplomatic, is CO2 deficient. They will actually benefit from breathing slower to build up a little more CO2. Because with a little more CO2, you calm your body down. It’s a very powerful vasodilator that allows for more circulation. You’ll notice when you breathe more slowly that you feel your toes or fingers will start warming up. That’s from an increase of circulation. Some very industrious researchers found, “Well, if CO2, if a little is good for us, maybe a lot is going to be really good for us.” Some of that was shown to be false, but in some cases, for people with severe mental problems, it was found to be extremely effective. And who led this charge was Yandell Henderson at Yale, spent decades studying the effects of CO2 and it was absolutely bizarre to me that this science was not unproven. It just was forgotten about. It’s exciting to see so much of this science starting to come back. CO2 therapies for asthma, CO2 therapies for panic, anxiety, they were even using it for schizophrenia, which they found to be extremely effective in some studies. What can we do now? We can study it again and we can measure it. It’s a very cheap therapy, which I think is probably one of the problems, why it won’t be studied. You can’t patent CO2. Why would you want to give money to explore that further? But that’s just me being crass. I hope that some people take this up and look into it a little further.


Cynthia: Absolutely, and I’m so very grateful for you bringing this information not only to the masses, but to clinicians to bring up that there are modalities that are far more simple. As you mentioned, not being able to market something, not being able to put it in a pill form and have big pharma form it out to the masses. What are your new projects? Are you working on any new books? Are there any new areas of interest that you’re working on right now?


James: Well, since the book has come out, I’ve been lucky enough to now be in touch with dozens and dozens of doctors, and cardiologist, and pulmonologist, and all the rest. It’s fascinating. They’re conducting some new studies. I’m trying to help out when I can. It’s wonderful just to be within this community listening more. I’m not working on a Breath 2. People keep asking me, “When his Breath 2 coming out? Maybe if I was a smarter businessman that would happen but it’s not. I’m just still fascinated with the subject and I want to get the word out. I want people to have a choice. You can’t force people to do anything, but you can offer is for people who want to help themselves, you can give them a choice. I don’t feel that choice with breathing and breathing therapies has been as widespread as it could be. So, I’m going to help trumpet that about. But mostly, I’m just resetting right now. I’ve been on a very extended book tour for about 20 months. I am going to come back and hibernate here in my outdoor office here and get started with a bunch of new research. Got some film projects coming up. I got another European tour and a Japanese tour coming up. So, still in the world, but no Breath 2 book. I’m sorry to say.


Cynthia: No. Great. Well, please let my listeners know how to connect with you. I think one of the things I found humorous was that when I was doing my research for the book was that when you went to, I guess, find an Instagram handle that someone had taken your name, so which I thought was probably both frustrating for you and humorous at the same time. How can people connect with you on social media or on your website?


James: Yeah. I think the same jerk took the URL. That’s why I had to put a MR, a Mr. James Nestor. People thought I was doing that for some formality. It was that or the real James Nestor. You can take your pick. it’s mrjamesnestor,com. That’s N-E-S-T-O-R dotcom. And that will give you a site that has about 400, 500 different scientific references. There are also interviews I’ve done with leaders in the field of breathing, of the biochemistry of breathing, biomechanics of breathing. There’re Harvard professors on there talking about breathing in infants. There are also various breathing techniques. Everything is free. There’s no paywall. It’s available for everyone. There’re some videos and datasheets for this stuff that really sounds like it is impossible. You can’t heat your body up with breathing. Check out the studies done at Harvard in the 1980s of monks doing just that. All of that’s on the site. I’m also on this thing called Instagram, wild, and weird, and pretty annoying world, but my handle is @mrjamesnestor. I’m trying to post more per my publisher’s request, but a little busy. So, I’ll get to it when I can.


Cynthia: Oh, thank you. It’s been such a joy to connect with you today. Thank you for your time.


James: Thanks a lot for having me.


Cynthia: If you love this podcast episode, please leave a rating, and review, subscribe, and tell a friend.