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108: Breathing For Bone Density? YogaU Cannot Be Serious
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In this episode of the Movement Logic Podcast, Dr. Sarah Court and Laurel Beversdorf critically evaluate the claims made by YogaU Online about the connections between breathing practices and bone health during a recent promotional webinar for a new workshop called “Breath As Medicine: Yogic Breathing for Vital Aging.” They meticulously analyze research studies cited by YogaU, debunking pseudoscientific assertions about nitric oxide production, VO2 max, and the impact of breathing on bone density. The hosts highlight the ethical implications of such misleading information and emphasize the importance of evidence-based practices in the fitness and yoga communities. The discussion also touches on marketing tactics that prey on the fears of older women, underscoring the need for transparency and integrity in health advice.
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03:48 Calling Out Pseudoscience
05:19 Yoga U's Dubious Claims
17:47 The Breath as Medicine Workshop
18:39 Debunking the Claims
32:57 Understanding Breathing Pathologies
01:01:56 Lung Function and Bone Mineral Density: A Study Review
01:03:57 Debunking Misleading Claims in Yoga Marketing
01:09:38 Sleep Apnea Studies and Their Misuse
01:17:57 Hypoxia and Bone Health: Misinterpretations
01:23:23 Nitric Oxide and Aging: Separating Fact from Fiction
01:41:02 Cardiovascular Fitness: Misconceptions and Realities
01:50:47 Yoga U's Ethical Dilemma and Call for Accountability
01:59:38 Conclusion and Call to Action
References:
Episode 5 Does Yoga Asana Build Bone Density?
Episode 38 Got Bones? Yoga Asana Isn’t Enough
Episode 79 Make YogaU Make Sense
Episode 92 Make Dr. Loren Fishman Make Sense
Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss
Recognizing and Treating Breathing Disorders: A Multidisciplinary Approach by Leon Chaitow
Breath: The New Science of a Lost Art by James Nestor
Association between lung function and bone mineral density in children and adolescents
Assessment of Bone Mineral Density and Bone Metabolism in Young Men with Obstructive Sleep Apnea
Hypoxia is a Major Stimulator of Osteoclast Formation and Bone Resorption
Molecular Mechanisms Involved in Hypoxia-Induced Alterations in Bone Remodeling
Recommended
Transcript
Introduction and Personal Updates
00:00:00
Speaker
I'm Laurel Biebersdorf, strength and conditioning coach. And I'm Dr. Sarah Court, physical therapist. With over 30 years of combined experience in fitness, movement, and physical therapy, we believe in strong opinions loosely held. Which means we're not here to hype outdated movement concepts. or to gatekeep or fearmonger strength training for women. For too long, women have been sidelined in strength training. Oh, you mean handed pink dumbbells and told to sculpt?
00:00:25
Speaker
Whatever that means, we're here to change that with tools, evidence, and ideas that center women's needs and voices. Let's dive in.
00:00:47
Speaker
Welcome to season seven of the Movement Logic Podcast. I am Dr. Sarah Court. I'm a physical therapist, and I'm here with my co-host, Laurel Beaversdorf. Dorth? Dorthie. Dorthie and the Wizard of Oz.
00:01:01
Speaker
It's like I've never said your name before. I'm here with my co-host, Laurel Beaversdorf, CSCS, strength and conditioning coach, and yoga teacher. Laurel. What is going on? What is going on?
00:01:13
Speaker
My daughter started in the first grade. Amazing. And how's she doing? She loves it. She loves school. Oh, that's pretty. It's pretty sweet. Yeah. She loves school.
00:01:25
Speaker
What else? I am running, but not as much as I did for the marathon, which is nice because then I have time for other things. But you are still potentially going to run the Boston Marathon if you get it. Yes. Oh, yeah. So that's that's something my validated time was accepted.
00:01:45
Speaker
by the Boston Athletics Association or whoever's in charge over there. And so now I just need to apply in the window and hope that there wasn't some huge influx of really strong runners that are in my age group that decided to submit their times
Challenges in Researching Breathing and Bone Health
00:02:01
Speaker
because I think based on where the cutoff was last year, I should be in, but we'll see.
00:02:06
Speaker
ok I also got accepted into the master's program. A&M. So thanks for that stellar letter of recommendation, Dr. Court.
00:02:18
Speaker
Oh, it was absolutely my pleasure. i love writing just glowing reviews of humans. ah So yeah, that's cool. I'm starting classes at the end of this month. Amazing. And the first class is all about research, which is exactly why I'm doing this. So I'm excited. Yeah.
00:02:36
Speaker
Nice. How are you? I'm okay. My sort of biggest banter, honestly, is how long it took me to prep this episode. Yeah. Because yeah last week at some point I texted Laurel and I was like, I don't think this is not going to take that much time. We know what we want to say. We know what the problem is.
Critique of Yoga U's Pseudoscientific Claims
00:02:55
Speaker
We know what our argument is. that- it-da And then I start writing it.
00:02:59
Speaker
And to be perfectly honest, part of why it took so long is while it would be relatively easy to just sit down and say, these people are full of shit.
00:03:12
Speaker
Spoiler. Sorry. Sorry. What I really wanted to do was actually go in really methodically into the evidence, into the scientific clinical terms, into the various pathologies, and really look at the research, really discuss what their claims were and how they were often completely the opposite of what the research is showing.
00:03:41
Speaker
And so that just took a little more time. I learned a lot about different breathing pathologies more than I knew before. So yeah, I mean, that's one of the things as well is like the deep research to me, it's always fun because I think you've said this in the past as well. It's it's really fun to just learn more.
00:03:57
Speaker
Oh yeah. And so I look at it like that, like I'm just getting smarter. yeah Yeah. So you, you spent a lot of time collecting receipts and I mean, i mean i brought um do they have CVS in Alabama? Yeah.
00:04:10
Speaker
Yeah. You know those incredibly long CVS receipts? Have you ever seen those? Yes. There's like coupons and stuff. Yeah. And there I saw a picture one time somebody dressed as a CVS receipt for Halloween.
00:04:22
Speaker
And they just had this giant long piece of paper that trailed off on the ground. They give you the longest receipts. So I have a lot of receipts, basically. I have a CVS level receipt for this whole episode.
00:04:34
Speaker
do. All right. Well, once again, we are calling Yoga U Online to task for some sketchy pseudoscientific claims they used to promote a workshop that is currently on their website with Doug Keller, who, if you are not familiar, is a pretty well-known teacher in the yoga world.
00:04:52
Speaker
Laurel, did you ever take a class or workshop of Keller? I haven't, so I can't speak to anything about his teaching style. No, I don't know anything about him other than the little freebie workshop we took with him. I had heard his name before, so I did know that he had some reputation yeah preceding him. He's well known.
00:05:11
Speaker
Yes. As you may recall... Listeners, we first called out Yoga U around their yoga for osteoporosis claims, a lot of which was based on Dr. Lauren Fishman's infamous study, which we've talked so much about, which tried and failed to show that yoga can increase bone density.
00:05:32
Speaker
We've talked a lot about
Yoga as a Cure-All and Marketing Tactics
00:05:33
Speaker
this study and its impact on the yoga community in episodes 5, 38, 79, and These are all linked in the show notes. Subsequently, we ah got emails from both Eva Norlick-Smith, who is the co-founder of Yoga U, and also from Fishman.
00:05:53
Speaker
Neither were happy with us, but there wasn't much else either of them could do about it. There is a PS to this story, but let's put a pin in that for now, and we're going to come back to it later on.
00:06:05
Speaker
Okay. So then a couple months ago, we heard about a new workshop that Yoga U was promoting called Yoga for Osteoporosis, How Breathing Affects Your Bones, taught by Doug Keller. And there was a free webinar with Keller to learn about what was in the workshop. So we, of course, signed up for the free webinar because we were like, breathing for your bones.
00:06:27
Speaker
And we have an Instagram post that we made of the two of us listening to the webinar and just reacting in disbelief to the crazy things that were said. kind of like this word salad pseudoscience nonsense that both Keller and Norlick Smith said during the webinar. I will say to Norlick Smith's credit, I'm not going to give her a lot of credit, but I will give her credit for this. When we started commenting in the chat during the live webinar and saying things like, this argument makes no sense.
00:06:54
Speaker
She did, in fact, engage with those comments, but mostly, I think, in an attempt to dispel what Laurel in particular was saying, Laurel was the braver one. I kept saying things like, can you please provide the research evidence that backs these claims?
00:07:10
Speaker
And Laurel was like, I find it hard to believe that breathing is going to impact bone density,
00:07:17
Speaker
which is often our m MO. So, but here we are yet again, trying to make yoga do everything for your body. ah yeah yeah In this case, they're trying to make pranayama, which are the breathing practices of yoga, one of the eight limbs of yoga. They're trying to make pranayama impact your bone density.
00:07:34
Speaker
So here we are yet again, trying to force yoga practices to be the be all and end all of what you need to do for your body. And I do just want to say before we get into it, Laurel and I both have great respect for the practices of pranayama and the different techniques that we each learned as yoga teachers and practitioners.
00:07:53
Speaker
And this is in no way us taking issue with those practices themselves. We are questioning whether those practices do anything meaningful to impact bone density and cardiovascular health as was claimed in the webinar.
00:08:08
Speaker
That's it.
00:08:10
Speaker
Laurel, why do you think that so many folks in the yoga community are so apparently desperate to make yoga the one thing that fixes everything? Well, I know why Yoga U is so desperate for it, because they have a bottom line to support, and yoga is their product on offer.
00:08:28
Speaker
But I think in general, the community that is yoga, and I... by no means mean all yoga practitioners or all yoga people when I say this, but I do i do think it's changing for the better.
00:08:43
Speaker
But you know if I kind of let myself go a little bit here, stream of consciousness maybe, but let's be honest, this isn't even that hot of a take because our whole podcast really lives in this territory. But I think there's still this stubborn,
00:08:58
Speaker
belief that yoga can solve every physical problem somehow, right? Some people genuinely think that yoga cures diseases. So it's no shock that they might also think that yoga can meet all of our strength needs or that it builds bone, right? And when you take into account that we are living inside a capitalist system It's the air we breathe, figuratively speaking. Capitalism has these endless tentacles that are able to reach into our brain through clever marketing. And yoga often gets sold to older women as the exercise they should be doing to stay graceful and safe and to make them ageless somehow.
00:09:43
Speaker
And then meanwhile, those same women are told in so many ways through that persuasive marketing that strength training is not for them. It's dangerous. It's for men. It's for younger people.
00:09:56
Speaker
It will make them bulky. It will make them um unfeminine. and And then by society's warp standards, less valuable. strength training in their minds, I think, becomes like, look at all the people who don't look like you, who do this activity.
00:10:13
Speaker
Therefore, it's not for you. You should stick to the thing that people who look like you are doing, and that is yoga. And then there's the narrative that yoga is the antidote to all of what strength training is not sufficient for, right? So yoga is peaceful. Strength training is too aggressive.
00:10:36
Speaker
Yoga is gentle. Strength training is too harsh. Yoga will refill your cup. Strength training is a part of burnout culture. Plus, strength training might make you tight. It might ruin your asana practice. And for a lot of people, it's the asanas that are representative of yoga as a whole, even though they're one small sliver of yoga.
00:10:55
Speaker
It also becomes this us versus them thinking, this tribalism where I've seen it, I've felt it I had these beliefs myself. Yoga folks will often turn their noses up at strength training, at fitness in general, or anything that isn't yoga.
00:11:11
Speaker
The stereotypes kind of write them themselves, like gym bros, meatheads, they're red-faced and they're grunting through their mindless workouts. All they want is bigger muscles and better butts.
00:11:23
Speaker
And then meanwhile, we have the serene yogi, eyes half closed, heart rate 42 beats per minute, wise smile, confident in their more, quote, evolved approach to movement. That's my sentiment, at least, that there is this sort of we are superior to all this mindless fitness nonsense. We are exercising in a far more intelligent and elevated an enlightened way.
00:11:52
Speaker
Now, again, I want to say this is not meant to be a characterization of all people who practice yoga. Not at all. I'm, of course, exaggerating. But I think that conditioning, if you've been in the yoga community for a while, that this type of conditioning runs deeper than people are even aware of. There's a lot of unchecked biases.
00:12:15
Speaker
And here's another thing that happens. Yoga people tend to trust their teacher and what their teacher told them. And so we see this with Eva Norlick-Smith and Doug Keller. She clearly has put enormous trust in Doug Keller, who happens to have a PhD in philosophy, right?
00:12:40
Speaker
to deliver, know, she thinks will be accurate evidence-based information about breathing physiology. Getting basic definitions right, like what is VO2 max?
00:12:52
Speaker
What is the Bohr effect? You know, she assumes that he will make claims about breathing for bone health that are supposedly grounded in solid evidence because, hey, he's a respected yoga teacher who teaches breathing.
00:13:10
Speaker
Right. He's been doing this for so many years. He must know what he's talking about. Right. Right. And yet, as we'll find out, he gets the most basic facts about breathing physiology wrong.
00:13:23
Speaker
And no one bats an eye except Sarah and i Our eyes were batting very hard. My eyes batted so hard they rolled back in my head. My eyelids were fatigued for days.
00:13:35
Speaker
No one questions him, though. And why should they? He's, again, a well-respected yoga teacher. He's a, quote, breathing expert. If he says he can make their bones better with breathing, they believe it.
00:13:48
Speaker
So that's my answer. Yeah. Before we get to Doug Keller and who he is, we need to talk about Eva Norlick-Smith, the co-founder. She's the one who is platforming people like Fishman, but now we're focusing on this workshop from Doug Keller.
00:14:07
Speaker
She's the one platforming these folks. So let's talk about Eva. So from a website called Meditating Entrepreneur, quote, Eva started practicing yoga in 2005. She received her 200-hour certification and shortly after started teaching classes.
00:14:23
Speaker
Soon after entering the yoga teaching world, she realized the education she received from yoga teacher training did not prepare her for the common problems her students were having. This realization sparked her wish to become a more well-rounded and evolved yoga instructor.
00:14:38
Speaker
Eva and her husband, Terry, developed a yoga therapy program to initially improve back problems, which later developed into posture improvement and core strength development called Healthy Back, Healthy Body.
00:14:50
Speaker
Eva saw the need for a platform for continuing education for teachers. Thus, Yoga U Online was born. Yoga U Online grew from 5,000 subscribers in 2013 to over 60,000 subscribers in 2017. All right, so then from the Yoga U website, Eva Norlick-Smith has a background in health psychology and is trained as a yoga therapist.
00:15:12
Speaker
In their yoga teaching, Terry and Eva combine the principles of soft tissue release from the bodywork traditions with the soft tissue transformation fostered by yoga. They believe that we truly hold the power to reshape the soft tissues of the body at our well, they meant will, and that yoga offers a powerful approach to restore strength and balance to the body no matter what our age.
00:15:37
Speaker
Okay. So as an aside, we don't have more recent data on the number of YogaU subscribers since 2017, but I would bet that it's much higher now, in particular due to the pandemic forcing more people to practice yoga online.
00:15:49
Speaker
Yeah, I would agree. Let's talk about Doug Keller and who he is. We got this information from his website. Doug Keller, for those of you listening who may not have heard of him, is a pretty well-known yoga teacher. He studied philosophy at Fordham University, but before he finished his thesis, he became interested in the teachings of Swami Muktananda and in 1986 went to live on Muktananda's ashram in India for seven years.
00:16:18
Speaker
While he was there, he met and became friends with John Friend. He went on to study with and assist him extensively and even to become one of the first Anusara yoga teachers certified by Friend.
00:16:29
Speaker
Okay, so if you don't know who John Friend is, he started a style of yoga called Anusara Yoga in 1997, which grew to be very successful, and it spawned several yoga teacher celebrities like Elena Brower, Darren Rhodes, and more.
00:16:45
Speaker
When I was living in New York and teaching yoga, I took a lot of classes and workshops from Anusara teachers and even from friend. I really appreciated their kind of both very thoughtful but also very lighthearted approach. I really liked it as a style.
00:17:01
Speaker
So then Keller goes on to say that, this is a quote, in addition to teaching the postural practices of Hatha yoga, as well as pranayama and meditation, I have chosen as my focus on sharing insights into what yoga has to offer as wisdom in the face of chronic pain and health issues, which is an evolving field that promises to be a vital part of the future of yoga, unquote.
00:17:25
Speaker
So a quick scan of his schedule on his website shows that he teaches workshops worldwide. And when we looked at the Yoga U online website for courses that he was doing or had done for them, there there are a lot. He has an ongoing relationship with Yoga U. His other Yoga U workshops are things like Yoga for Healthy Hips, the Sensitive Psoas, that old chestnut, Counteracting Forward Head Posture, Yoga for Sciatica and Piriformis Syndrome,
00:17:56
Speaker
So a real greatest hits of yoga workshops. I mean, to be honest, there was a time in my yoga teacher career where I would have taught workshops with names like these. I probably wouldn't have.
00:18:07
Speaker
b
00:18:12
Speaker
Mine would have been called like something about rolling on balls and a play on words with need it in it or something. Yeah. So the first workshop on his Yogi You page is called Breath as Medicine, Yogic Breathing for Vital Aging.
00:18:27
Speaker
And this is the workshop that was being promoted by the free webinar that Sarah and I attended. Now let's talk for a moment about how this free webinar was advertised.
00:18:38
Speaker
The free webinar was being used as a marketing technique to get people to buy the Breath as Medicine workshop. And this, by the way, is a strategy that we use a lot in Movement Logic for our bone density course.
00:18:52
Speaker
We typically offer two free classes in the lead up to a launch of the course. One is a sample weightlifting class. The other is a Q&A. So we have no beef with this strategy. It's under the umbrella of the marketing strategy called give them stuff for free so that they will pay you for stuff later.
00:19:09
Speaker
Yeah. This is pretty standard. So at great expense to my mental health, I have remained on the Yoga U mailing list so that I can continue to see what they're getting up to. So I received their emails promoting the free webinar, which we're going to discuss in a moment.
00:19:26
Speaker
And since we had also done a previous episode about Yoga U, we also heard from several podcast listeners, email subscribers, and others who received these emails and were like, holy shit, do you know about this?
00:19:38
Speaker
So I'm going to read to you from some of the emails that I received that were advertising this free webinar. So this is from the first email, and this is a quote. Namaste, Sarah.
00:19:49
Speaker
Did you know that the way you breathe could be silently eroding the health of your bones? We hear a lot about the importance of strength training to preserve muscle mass and prevent the thinning bones of osteoporosis and osteopenia.
00:20:01
Speaker
However, did you know that there are other important factors that affect our risk of bone mass loss? In this talk, we'll explore the fascinating connection between breath and bone health that most people have never heard about.
00:20:16
Speaker
Recent research has unveiled a crucial link between breathing patterns and bone health. In fact, we now know that poor breathing habits can create biochemical changes that affect bone density over time.
00:20:31
Speaker
Okay, so now I'm breathing wrong and that's going to give me osteoporosis. Great. Laurel, will you read from the second email? Hold on a second. yeah Hold my purse.
00:20:43
Speaker
yeah we yeah we got We got to unpack that first sentence. Yeah. That first sentence. Yeah. Quote, did you know that the way you breathe could be silently eroding the health of your bones?
00:20:56
Speaker
This peak predatory wellness garbage. Yeah. Did you know that the way you breathe could be silently eroding the health of your bones? yeah By design, it it's supposed to make people panic about something so mundane.
00:21:14
Speaker
It's something you've done literally every second of your entire life. It's taking a real serious concern that this community of older women has, which is bone loss, And hijacking it to scare them into signing up for fucking breathing workshop.
00:21:31
Speaker
In her first email to us, the one in response to our social posts about their fucked up blogs that they still had on their website suggesting Mudra's built bone.
00:21:42
Speaker
In her first email to us, she had all kinds of excuses as to why the blogs about yoga for bone building, mudras for bone building, breathing for bone building, nutrition advice that was just wildly wrong about bone building and way out of scope of practice that she then admitted an intern had wrote.
00:22:05
Speaker
She had all kinds of excuses about why that stuff was still up on the site, and a lot of it was her passing the buck. Like she wrote, we have been updating articles for SEO purposes lately, but the person updating the articles failed to check the quality and currency of the content.
00:22:23
Speaker
Okay, here's the second email.
00:22:27
Speaker
Quote, namaste, Sarah. Tomorrow, we will be exploring one of the most overlooked connections in bone health. How the way you breathe could be silently affecting your bones in ways you never imagined. The drama, the sheer drama is just, ugh, gross.
00:22:45
Speaker
It's so gross. In less than 24 hours, Doug Keller will reveal the fascinating science behind how our breathing patterns impact bone metabolism, posture, and fracture risk.
00:22:59
Speaker
This isn't just theory. It's practical knowledge you can start applying immediately. Did you know that clinically significant shallow breathing, as in, for example, COPD, is linked to three times the rate of bone loss and osteoporosis?
00:23:18
Speaker
Sad but true. Recent research shows that a staggering 73% of those with breathing issues develop osteoporosis compared to only 42% of people without breathing complications. I'm sorry. How is, how is, I'm so confused. How 73% three times 42%?
00:23:39
Speaker
It's not even double. Like what? what a quick Google search reveals that higher rates of osteoporosis in COPD patients are due to a blend of things, a blend of things, notably inactivity and steroid therapy. Sarah, what's the relationship between steroids and bone loss?
00:23:59
Speaker
It's a secondary cause of osteoporosis. Additionally, higher rates of osteoporosis can be due to poor lung function, resulting in hypoxia, where the body's tissues do not get enough oxygen.
00:24:11
Speaker
But that is not something you fix with breathing exercises. The email goes on. Why does it matter? This is the email, OK? Why does it matter? Because we all lose breathing capacity over time.
00:24:23
Speaker
By age 65, most people have lost up to 40% of their lung capacity, a decline that leads to shallow breathing. This in turn sets us up for numerous issues, including accelerated bone loss. I'm sorry.
00:24:38
Speaker
No, 40% is disease territory, not normal aging. So stop inflating numbers to make people think they're broken. Okay, the email goes on.
00:24:48
Speaker
This isn't just correlation, it's a direct cause and effect relationship that most of us have never heard about. You haven't heard about it because it's not a direct cause and effect relationship, you yeah fucking numpty. There we go.
00:25:00
Speaker
Curious to learn more about this important component of osteoporosis prevention and how yoga can help? Join renowned yoga therapist Doug Keller for a free talk live online tomorrow.
00:25:13
Speaker
This webinar was included as part of YogaU's ongoing Yoga for Osteoporosis series. Before we dive into the claims about how breathing affects your bones, there were also several claims made in the webinar about breathing and cardiovascular health that were also extremely questionable.
00:25:31
Speaker
So we are going to talk a little bit about that as well, but our main focus is going to be on the supposed breathing to bones connection, as that has been our biggest issue with Yoga U to date, making claims about bone density that don't hold up.
00:25:45
Speaker
We're going to go through the transcript of the free webinar and unpack this pathway of the breathing for bones claim, as well as the research that was provided to support it.
00:25:57
Speaker
And I want to let you know as well that we sometimes use an amazing tool called consensus, which is like chat GPT, but specifically for research. So whenever there's a general claim made, like by age 65, you will lose 40% of your lung capacity. I will punch that claim into consensus.
00:26:14
Speaker
And then it goes through all the available research to see if it's supportive. I mean, it's always still important to then look at the studies themselves and make sure it's picking accurately, but it's an incredible time saver for doing a literature review.
00:26:27
Speaker
Okay, so Norlick Smith starts the webinar by introducing Keller and making the point that both of his parents were scientists, so therefore we're getting it straight from the horse's mouth. That's not how science works.
00:26:39
Speaker
yeah that was an appeal to authority but was a failed one because i'm sorry but scientific knowledge and the ability to speak accurately about scientific topics is not genetically derived Of course, for many yoga practitioners, this fact that his parents were scientists will just be a quaint, fun fact about Keller.
00:26:58
Speaker
I think to many of them, his real expertise on this topic lies solely in the fact that he is a renowned yoga teacher who's taught breathing for many years. Yeah.
00:27:10
Speaker
Okay. Norlick-Smith then goes on to restate the claim from the emails that research shows that by the age of 65, most of us lose up to 40% of our lung capacity.
00:27:21
Speaker
That sounds terrible. Is that true? Guess what? No. While there are age-related declines in pulmonary function, we do not lose 40% of our lung capacity by age 65. It's simply incorrect. And I honestly don't know where they came up with that number.
00:27:40
Speaker
And also, lung capacity is not a scientific term. It doesn't mean anything. Research does show there is loss in aerobic capacity, but it's certainly not 40%.
00:27:51
Speaker
All right, so we are off to a great start. Norlick Smith goes on to ask Keller why a loss of breathing capacity can affect our bones. So I'm going to summarize what he says.
00:28:03
Speaker
But when I do it, this is a summary. We're going to play a little game called unsupported, misleading, exaggerated, or flat out wrong. So the challenge is to determine exactly how Keller is getting this wrong.
00:28:16
Speaker
OK, so here we go. This is just the summary of what he says. The rib cage shape changes with age. Okay, that one's misleading.
00:28:27
Speaker
It doesn't clarify that, yes, the rib cage changes shape with age, but a tiny bit, right? Not a lot. Okay, next thing he says, this rib cage changing shape decreases your lung capacity.
00:28:41
Speaker
I'm going to give this one a misleading. Why is it misleading? While it's true that the rib cage changes shape a little bit, and maybe this affects your lung capacity, this is a gradual decline, and it's not a limiter for healthy adults. So if we're talking about a decrease in lung capacity due to a change in rib cage shape, this would be diseased population, right? Not a healthy adult population.
00:29:04
Speaker
So it's misleading. And so then he goes on. This is the string of logic. This goes along with forward head position. like This is totally unsupported. As we've talked about many times on this podcast, neck posture does not impact breathing mechanics.
00:29:22
Speaker
Okay, he goes on. And then your diaphragm can't function properly. Again, misleading. The only time your diaphragm doesn't function properly is in severe lung disease.
00:29:35
Speaker
And he goes on. And as a result, you breathe more shallowly. This is an exaggeration. Most older adults do not develop clinically significant shallow breathing.
00:29:48
Speaker
And then that leads to chronic hyperventilation. Okay, this is pants on fire level misinformation. It's wrong. Shallow breathing, and we're going to talk about this, is the opposite of hyperventilation.
00:30:04
Speaker
Hyperventilation can be acute or chronic, but it is basically either rapid deep or rapid shallow breathing that decreases CO2 too much.
00:30:18
Speaker
So he's saying that shallow breathing from your misshapen ribcage and your forward head leads to chronic hyperventilation, right?
00:30:30
Speaker
But he just a moment ago said that it causes you to breathe more shallowly. So these are saying two different things. Yeah. Okay. So he goes on.
00:30:41
Speaker
This makes your blood more alkaline. but That's true if you hyperventilate. But the hyperventilation part of this contradicts the shallow breathing part of this. And this whole string of logic began with a ribcage shape change, right? Right.
00:30:56
Speaker
very confused here. And thus, he goes on, and thus leads to the Bohr effect, which is when your red blood cells don't release their oxygen into your body.
00:31:08
Speaker
This is wrong. is an incorrect definition of the Bohr effect. Okay, just really wrong. We'll discuss more. Also, That paragraph of trying to follow that logic, that's why this whole thing took me 15 hours because I was like trying to trying to take that apart and see where is there a kernel of truth?
00:31:29
Speaker
Is there not? what you know All of these things that you're saying, like, is this a stretch or is this just a lie? Like it took a while to get through that. I think we've mentioned this phenomenon before, but it's Brandolini's law.
00:31:42
Speaker
Yeah. The bullshit asymmetry principle. It's on full display right now. This is Brandolini's law. The amount of energy needed to refute bullshit is an order of magnitude larger than it took to produce it.
00:31:54
Speaker
Yep. So Sarah's spent now, you know, once this is edited and up, like upwards of 20 hours. Yeah. Researching, making sense of, trying to make sense of, and then correcting the information shared in this 40 minute webinar.
00:32:10
Speaker
Right. Listen, then it's hard to put the toothpaste back in the tube. It's hard. But we're going to try. But wait, there's more. He goes on to say, when your blood is more alkaline, you hyperventilate more and it becomes a vicious cycle.
00:32:23
Speaker
And then the body tries to correct this by leaching minerals from the bones, including calcium, to try to balance out the pH. And then you lose a lot of that calcium through your urine and your bone density is impacted. And then because calcium is also used in the body for muscle and nerve function,
00:32:40
Speaker
You get issues with smooth muscle functions like digestion and your nerves get more sensitive. right, let's try to unpack this even more. So so we're going to go back to rib cage shape. OK, it is true that throughout your life, from childhood to older age, your rib cage can and likely does change shape.
00:33:01
Speaker
And yes, this change in shape can impact your diaphragm's function, making it maybe a little less efficient. So, okay, that's misleading, as I said, and it's a need of qualification.
00:33:15
Speaker
Otherwise, it sounds really scary. Right? It sounds like your rib cage collapses. Yeah, yeah. older It's a molehill and you are depicting it as a mountain. Yeah. So this change is really small, and its impact on breathing capacity is very gradual, and it doesn't negatively impact most people.
00:33:33
Speaker
Yeah. Okay. But are they going to say that in an advertisement? No. God, no. Like this whole webinar is an advertisement, right? Is that what they're going to say? Yeah. Here's where we need to take a moment before we dive into this claim that Keller is making and really look at the different terminology that is out there to describe the various dysfunctional ways we could be breathing.
00:33:57
Speaker
Because it's important to note that this topic is not set in stone. the way that keller is describing it and that there does not currently appear to be an established medical consensus on how some breathing dysfunctions should be described or categorized there is a review paper from 2016 that proposes a revised definition of dysfunctional breathing terminology but it does not seem like any such consensus has been reached So firstly, there is a condition called hyperventilation syndrome that some describe separately from chronic hyperventilation and some say is the same thing.
00:34:39
Speaker
These are both different from acute hyperventilation. And Laurel is going to discuss this difference in a moment. There is also a condition called shallow breathing that is different from chronic hyperventilation.
00:34:55
Speaker
For our purposes, we're trying to determine the difference between shallow breathing and chronic hyperventilation in terms of the impact on blood pH and which one creates an alkaline blood pH, as this is the crux of Keller's argument. Now, part of the challenge is that Keller uses the terms shallow breathing and chronic hyperventilation interchangeably.
00:35:20
Speaker
but they're not the same. And it's even a bit more complicated than just saying that they're not the same. So I think the simplest way to understand it is that chronic hyperventilation is when you are breathing more than your body's metabolic needs.
00:35:37
Speaker
And shallow breathing is when you are breathing less than your body's metabolic needs. With chronic hyperventilation, you end up exhaling too much carbon dioxide. And as a result, your blood pH will increase and you will have a condition called respiratory alkalosis, meaning that your dysfunctional breathing has caused your blood pH to become too alkaline.
00:36:02
Speaker
With shallow breathing, you are just not breathing enough. So you end up with issues around not taking in enough oxygen, known as hypopnea.
00:36:13
Speaker
Now, there also exists, I told you it's not straightforward, there also exists something called tachypnea, which is rapid, shallow breathing. And this can sometimes lead to respiratory alkalosis, but it can also just be a symptom of a different underlying condition like sepsis or liver disease, where it's the disease state that is actually causing the blood pH to become alkaline, not the type of breathing.
00:36:43
Speaker
So you can see how this is not as simplistic as shallow breathing leads to chronic hyperventilation leads to et cetera, et cetera, as Keller is attempting to make it. The most important factor in this definition is what conditions can cause higher blood pH.
00:36:59
Speaker
And from the research, we can say that yes, chronic hyperventilation can cause blood pH to become more alkaline. But chronic hyperventilation cannot simply be diagnosed by looking at a person and how they are breathing.
00:37:14
Speaker
And it's typically a result of a respiratory disease like asthma or COPD. It is not a condition that affects most people.
00:37:24
Speaker
OK, now here's where we need to talk about the difference between acute hyperventilation and chronic hyperventilation. OK, this is something I didn't know about before getting ready for this episode. I'm glad I know about this now.
00:37:38
Speaker
So when you think about acute hyperventilation, you might visualize someone breathing really quickly, kind of panicky, visibly distressed. And then someone gives them a paper bag to breathe in into, and they are then able to slow their breathing down and return to normal breathing.
00:37:52
Speaker
Sarah, I have never hyperventilated before. Have you? Yes, actually, weirdly. One time, this was probably 20 years ago, 25 years ago on an airplane. I don't know exactly what set it off, but it felt like I was having a panic attack and I couldn't slow my breathing down. It was just happening to me. i had no control. It was really scary. Yeah.
00:38:11
Speaker
But then i grabbed the sick bag. And I breathed into it and it got better. I also, I mean, Santa Monica is renowned for its wooey-wooeyness, but I got sucked into this class in Santa Monica one time.
00:38:25
Speaker
Claimed to be about like accessing your chi or your energy or something. It was basically hyperventilating until you felt buzzing in your hands. which they claimed was you accessing your energy. And I was like, no, this is what happens when you hyperventilate.
00:38:39
Speaker
It's literally a symptom. Yeah. This is not my cheat. This is my body being like, this is wrong. Can we fix this, please? yeah So when you hyperventilate like this, okay, and let's characterize this. This is the acute event, right? It's an attack of hyperventilation.
00:38:55
Speaker
This is not a chronic condition happening all the time. What's happening is that you are taking deep, rapid breaths, and you end up expelling too much carbon dioxide from your body as a result.
00:39:07
Speaker
When you expel too much CO2, carbon dioxide, from your body, your blood pH rises and becomes more alkaline, and you can experience dizziness and lightheadedness, the tingling in hands and feet that Sarah described, and potentially even chest pain.
00:39:23
Speaker
This is a condition called hypocapnia. This is too little CO2 in your blood. Your blood is alkaline. The reason why you breathe into a bag like Sarah did to fix this is that your exhale then contains the carbon dioxide that your body needs So you breathe in this mix from inside the bag that then has more CO2 than regular air levels do, which causes your blood pH to stabilize, and then you can return to normal breathing. Okay?
00:39:58
Speaker
So that is what acute hyperventilation is. It's what we picture when we think of hyperventilation, I think. But there's also something called chronic hyperventilation syndrome, which is characterized by rapid shallow breaths, where acute hyperventilation is characterized by rapid deep breaths.
00:40:16
Speaker
Acute hyperventilation is an event, right? Chronic hyperventilation is a dysfunctional baseline. It's a persistent pattern of breathing too much to relative metabolic needs.
00:40:31
Speaker
rapid shallow breaths. Another more layman's way to say this is over-breathing. Over-breathing, okay? So over-breathing and chronic hyperventilation are the same thing.
00:40:44
Speaker
But then there's something called shallow breathing. This is characterized as a type of hypoventilation, meaning you are not expelling enough CO2, right?
00:40:58
Speaker
versus hyperventilation when you are expelling too much CO2. So Keller's entire claim collapses the second you have an accurate definition of the phenomena he's describing.
00:41:16
Speaker
He has you believe that aging turns us into shallow breathers and that this somehow causes hyperventilation which then supposedly wrecks our blood chemistry and our bones.
00:41:30
Speaker
But here's the thing, okay? Hyperventilation means you're blowing off too much CO2. Hypoventilation, shallow breathing, it means you're just not getting enough air exchange of both your oxygen and your CO2. You're not getting enough gas exchange.
00:41:47
Speaker
Got it. So normal age-related changes in lung function don't produce either one of these issues. right Most healthy 65-year-olds aren't walking around in a state of CO2 crisis.
00:42:01
Speaker
Their lungs still meet their metabolic demands just fine. The only people who actually develop CO2 imbalances are those with medical conditions.
00:42:12
Speaker
Think conditions like COPD, chronic hyperventilation syndrome, which is a functional breathing disorder, And even then, those situations have nothing to do with just simply getting older or forgetting how to breathe.
00:42:28
Speaker
So shallow breathing and chronic hyperventilation are not the same thing. And even though Keller's focus is on chronic hyperventilation, it seems like he's using the terms interchangeably. So that's also concerning right off the bat.
00:42:41
Speaker
And what's extra rich is that Keller describes how you can tell by someone's physical posture and appearance that they are chronically hyperventilating.
00:42:52
Speaker
After all, it's yoga. We got to get that posture part in there, right? And again, i will reiterate, because he also wants to connect forward head posture with shallow breathing.
00:43:04
Speaker
Posture is rarely, if ever, a validated diagnostic marker for anything. Okay? That's what research shows. A lot of research.
00:43:15
Speaker
Mountains of it. Occasionally, posture is a diagnostic marker, correct me if I'm wrong, Sarah, for severe structural conditions, advanced neurological disorders, or acute injury or pain avoidance behaviors. Right, Sarah?
00:43:34
Speaker
Yes, that sounds like a really accurate list. Occasionally, but it most certainly cannot diagnose breathing dysfunction. Research indicates that you actually need to use diagnostic tools like capnography, which is the measurement of CO2 in exhaled breath, to be able to tell if it's chronic hyperventilation or shallow breathing. Also, just as a general FYI, there is actually not a lot of research on this at all.
00:43:59
Speaker
Yeah, really not. The populations that are most likely to be chronically hyperventilating are the following. People with panic and anxiety disorders. you And by the way, this is not the same as being a little stressed out.
00:44:13
Speaker
Okay. And then people with asthma, right? So about 8% of the population has asthma. And then COPD, that's about 5% of the population. By the way, COPD stands for chronic obstructive pulmonary disease.
00:44:29
Speaker
Okay, those are the populations most likely to be affected by chronic hyperventilation. But was this a workshop for people with asthma and COPD, Sarah? It wasn't. But if it was, that would have been wildly out of scope as well.
00:44:43
Speaker
Yeah.
00:44:48
Speaker
All right. oh boy It's also seen more commonly, chronic hyperventilation is seen more commonly in women than men, which may be related to the fact that women report more anxiety disorders than men. yeah So just to reiterate the original claim by Keller, once your rib cage posture changes and your diaphragm is not as efficient as it was, then you start breathing shallowly and that turns into chronic hyperventilation.
00:45:13
Speaker
Here's how we really know that Keller is not a scientist, despite the fact his parents were. No actual scientist would ever claim with a straight face that the shape of your ribs single-handedly caused chronic hyperventilation.
00:45:28
Speaker
Okay. That's not how evidence works. That's not how physiology works. And it's certainly not how science works. Yeah. But it's how many market. And what happens is that they create problems that they can then solve with the solutions that they sell.
00:45:46
Speaker
In yoga specifically, posture is often the problem. And then yoga is the fix. We see that with how Yoga U sells their yoga for osteoporosis workshops.
00:45:59
Speaker
We are going to do yoga to fix our posture and that's going to help your osteoporosis. Creating problems and then selling solutions to them is a hallmark of pseudoscience. And the fact that this is happening under the banner of yoga, that's the antithesis of what yoga is supposed to be. Yeah, I agree.
00:46:19
Speaker
All right. So where did they suddenly get really excited about chronic hyperventilation? This is not something you hear about every day, right? So where did this come from? In 2020, James Nestor published a book called Breath.
00:46:34
Speaker
And of course, the yoga community was all over it. In this book, Nestor puts himself through a variety of breathing experiments and techniques, many of which are extremely uncomfortable, like plugging his nose for a month and only mouth breathing.
00:46:50
Speaker
He then reports on the experiments and his own experiences from learning all these different techniques. Nestor's book got everybody, including me, really suddenly interested in nose breathing versus mouth breathing.
00:47:03
Speaker
And the efficacy of each. And we did two previous episodes about it. That's episode 10 and 19. They'll be linked in the show notes. I will say at this point, listening back to those episodes, I was nowhere near as tough on his claims as I would be nowadays. Yeah.
00:47:19
Speaker
It was a different time. I read his book. I don't know if I read the whole thing. I read i like probably half of his book and I also was not reading it. With a critical eye. Can I just say the book actually inspired me to take Aliana to an ear, nose and throat specialist because she was breathing through her mouth almost exclusively during that time. She had humongous tonsils.
00:47:37
Speaker
Oh, wow. I was concerned that the mouth breathing was going to be like... permanently detrimental to her because I was also hearing things about that, like changing the shape of the child's face and a lot of other things that have since been deemed pseudoscience, right? yeah And scare tactics.
00:47:54
Speaker
And the MD, andm I'm reading into this probably, but I kind of tell she was a little impatient with me. And she was like, she does not, she's fine. Like, yes, her tonsils are swollen, but that's okay. And that's normal like really common with children and she's fine.
00:48:09
Speaker
And I kept like, kind of like, so the mouth breathing, she's basically like, look, like it she's probably in her head. She's like, there's nothing about surgery at this point in the guidelines. Like what? Like, right you know, and I left that and I was like, okay, I'm going to trust the MD. And then like weeks later, basically I realized like I maybe should not base what happens with Eliana's tonsils off a fucking breath by Nestor.
00:48:31
Speaker
Okay. if funny I didn't know that story. Yeah, i know. I know. I just thought of it actually. funny Yeah. i So I read the book again recently.
00:48:42
Speaker
And one of the challenges reading the book critically is that while there is a reference section at the back, it's presented in this weird kind of narrative descriptive style. There's no like citation number in the text that then links to the exact paper or papers he's referencing. It's sort of like a discussion of ideas and like he throws a paper in here or there.
00:49:05
Speaker
So it's not totally devoid of references, but he does not make it easy to trace his claims to specific things. And I would have to believe as well, since a lot of the practices that he tries are under what would be called the alternative health category, there probably isn't much clinical research actually available. And frankly, like we were saying before, I think this is actually appealing to some people. And I think it's really appealing to a lot of people in the yoga world who hold a sort of Western bad Eastern good mentality when it comes to health overall.
00:49:39
Speaker
Yes. Okay. So one of the breathing techniques that Nestor learns is called the Buteyko method. So Konstantin Buteyko was born in 1923 and he went on to become a medical doctor. And according to Nestor,
00:49:54
Speaker
In the Buteyko was doing his rounds in the hospital and noticed that all the patients who were suffering from respiratory illnesses, quote, seemed to breathe too much. So he developed a technique to try and help them.
00:50:07
Speaker
And if we look into Buteyko, it is a group of breathing techniques that are aimed at reducing this kind of chronic hyperventilation by increasing carbon dioxide levels in the body. I accessed a couple of different websites that didn't seem to be one like central website, or at least I couldn't find it.
00:50:24
Speaker
But one of the websites I accessed said it helps people with asthma, panic attacks, sleep apnea. And then they also included things like stress, brain fog, anxiety. The kind of thing that you can just tack on the end of anything and nobody can argue.
00:50:37
Speaker
So the idea as we said before, that chronic hyperventilators are over-breathing and the butyekyo technique focuses on slow, shallow nasal breath, as well as breath holding exercises.
00:50:49
Speaker
And very specifically, the breath holding exercises are holding your breath after you exhale. So holding the breath out. And the method also teaches something called that they call the control pause.
00:51:01
Speaker
as a way of measuring how long you can hold your breath out. Now on the website, it did not say how long you should be able to do this for, but it did mention a goal of 20 seconds. But on this particular website, there was no information available on what that number was based on.
00:51:17
Speaker
So Keller is essentially recycling the buteykio narrative here, which is that because you're exhaling too much carbon dioxide, it's starving your body of oxygen, which that might not make sense, but it actually does physiologically make sense. we'll talk about that more in a second.
00:51:31
Speaker
And according to him, if you can't tolerate, this is something he said in the webinar, if you can't tolerate holding your breath outside the body for more than 10 to 12 seconds, it's an indication that you basically have an intolerance for carbon dioxide.
00:51:45
Speaker
I did not find any reference to this time amount in the book Breath. And additionally, when I looked into the research, it did state that the exhaled breath hold is a way to measure carbon dioxide sensitivity But there's no specific number that they correlate to specific tolerance levels.
00:52:06
Speaker
But, ah the plot thickens. The other book that Keller references is Leon Chaitau's book called Recognizing and Treating Breathing Disorders, a Multidisciplinary Approach.
00:52:19
Speaker
And according to Chaitao, an exhaled breath hold of less than around 15 seconds may reflect low tolerance to carbon dioxide, while a normal exhaled breath hold is around 25 to 30 seconds.
00:52:31
Speaker
And when I tried to figure out where that came from, I got to another Buteykio website. It's another totally different practitioner. And it stated these very specific criteria.
00:52:43
Speaker
like how good you are at holding your breath out and what it means for your tolerance to carbon dioxide. So it says, pour less than 15 seconds. Room for improvement between 15 and 25 seconds. Good above 25 seconds.
00:52:57
Speaker
Great 40 plus seconds. great forty plus second But when I go into the evidence they cite on the other Buteykio website, once again, nothing clinically states that there is a specific time that correlates to specific sensitivity. So these are made up numbers. Yeah.
00:53:16
Speaker
And most of the evidence was related to people with pulmonary diseases like acute asthma or cystic fibrosis. So, yeah. Okay. So here's the thing.
00:53:28
Speaker
Like, even if we grant that Buteyko can be useful for people with asthma or panic disorder, which... is where the bulk of the research is, right? Is on these is disease populations.
00:53:40
Speaker
Yeah. It's a massive leap to go from that to then say to a bunch of random strangers in a free webinar advertisement for your course that breathing the way you're doing it is wrecking your bones.
00:53:55
Speaker
There's zero evidence connecting breath hold times, CO2 sensitivity, or Buteyko training to bone density. Right? Like this isn't science. This is just a story. Yeah. It sounds plausible if you don't look too closely.
00:54:10
Speaker
But unfortunately Keller and Yoga you we like to look closely. It's our favorite thing. Looking closely is our favorite thing. Okay. So then, by the way, at this point, I think we're about three minutes into the webinar.
00:54:24
Speaker
We already had all this information disseminated and I'm just like, oh, my brain hurts. So now, Next, Norlick Smith points out that 70, as she did in that email, right? 75% of people with COPD develop osteoporosis versus 40% of people without COPD.
00:54:42
Speaker
Okay, so COPD, that's chronic obstructive pulmonary disease. It affects about 5% of the population. COPD is a group of lung diseases that cause persistently narrow airways, making it hard to breathe.
00:55:00
Speaker
And it also they also cause inflammation to the airways. And eventually, they it leads to lung damage. It's progressive, and there is no cure. It's often caused by smoking, but air pollution and genetics can contribute.
00:55:14
Speaker
All of this feels like it's that classic, take a chronic condition, claim everyone is at risk for developing the problems that the people with this chronic condition have. and then sell people on the solution to the problem that they don't actually have.
00:55:27
Speaker
Using a treatment that would never be used, or maybe it would be, but like, it would not be the first line of treatment. yeah Okay. every If we keep going past minute three Keller's claims, he talks about your blood pH next.
00:55:45
Speaker
So let's do a quick pH review, shall we? pH h is I'm having flashbacks from chemistry, college chemistry. pH is a scale of acid to alkali, sometimes called base from 0 to 14, with 7 being neutral. Okay. Anything below 7 is acidic.
00:56:06
Speaker
Anything above 7 is alkaline or base. Normal blood pH is 7.4, very slightly alkaline. so very slightly alkaline Keller states that chronic hyperventilation, when you are exhaling too much and you are exhaling too much c o two this makes your blood more alkaline, which means it has a higher pH and thus leads to the Bohr effect, which is when your red blood cells don't release their oxygen into your body.
00:56:41
Speaker
Okay. Yeah, that that doesn't sound right. No. Okay, so we looked up the Bohr effect, and here is the definition. Okay, so hemoglobin is the part of your red blood cells that carries oxygen around your body.
00:56:57
Speaker
The Bohr effect describes how hemoglobin's affinity for oxygen changes based on the pH level of the blood. So hemoglobin will either hang on to oxygen, or it will let it go, depending on your blood pH level.
00:57:16
Speaker
In tissues that are metabolically active, like your muscles, the muscle cells produce more carbon dioxide and hydrogen ions, lowering the pH and making it acidic.
00:57:28
Speaker
So this acidic environment tells the hemoglobin to release oxygen into the muscle tissue that needs it to function. So that's one part of the Bohr effect. It's going on all the time, and it's amped up when you exercise and your muscles are burning through more energy and need more oxygen.
00:57:45
Speaker
Now, over in your lungs, once you have exhaled your carbon dioxide as part of normal breathing, your blood pH is higher. It's more alkaline. In this situation, the hemoglobin's affinity for oxygen increases, so it binds the oxygen more tightly and it doesn't release it.
00:58:04
Speaker
But that is on purpose, because when blood is circulating around the lung tissue, its primary job is to drop off carbon dioxide so you can exhale it.
00:58:15
Speaker
So it makes sense that you would not release as much oxygen at that point. It would be very inefficient. So the bottom line here is that the Bohr effect has two components that are both totally normal background physiological activities and neither of which we need to worry about.
00:58:35
Speaker
The issue with how Keller describes the Bohr effect is that he only talks about what happens when your blood pH is too alkaline and how that inhibits the release of oxygen. And he says this several times.
00:58:47
Speaker
What he is leaving out, as I described, is that the Bohr effect occurs in two different ways, either releasing oxygen or holding onto oxygen, depending if the blood is more alkaline or more acidic.
00:58:59
Speaker
What he's also getting wrong is that the way that the Bohr effect happens in the lungs, where the hemoglobin does not release oxygen, is not what happens in the tissues.
00:59:11
Speaker
If it was happening in the tissues, that would be a problem because metabolically active tissues need oxygen. but it happens in the lungs, what he's describing.
00:59:21
Speaker
And that is where it is supposed to happen. And additionally, just just to note, your blood pH is very tightly controlled by a lot of systems in your body.
00:59:32
Speaker
So suggesting that people's blood pH is wandering into you know dangerous territory when they don't have a respiratory disorder, that's misleading. So yeah, that was incorrect.
00:59:45
Speaker
Moving on. All of this was a lead-up explanation to the idea that your body leaches calcium and other minerals from your bones in an attempt to correct the pH of the blood.
01:00:00
Speaker
And so that that's why we need to change the way we are breathing. Now, talk about creating a problem to sell a solution, Sarah, though, really, like,
01:00:13
Speaker
It's just yeah you're sure's glaring to me. Okay, now there was a document sent out following the webinar with the studies that they used to support this main argument about breathing and bone density.
01:00:26
Speaker
So yeah, let's look at the studies. Let's look at the first one that is about breathing and bone density. Sarah, would you like to tell us about this study? I would love to. I also want to point out that on this one sheet that was sent,
01:00:40
Speaker
The very first reference or the very first link was to a blog post that Norlick Smith wrote about all of this for Yoga U Online. Just to be clear, it's not appropriate to list something you wrote.
01:00:54
Speaker
as evidence to support an argument when the piece you wrote just reiterates what is being claimed and is not itself research. All right. So the first actual research study is called Association Between Lung Function and Bone Mineral Density in Children and Adolescents by Zhao et al. from 2023.
01:01:13
Speaker
Laurel, are you already seeing a problem with this study from the title? I'm just curious. Could it be that this study was done on children and adolescents?
01:01:24
Speaker
Yeah. You cannot extrapolate pediatric data to adult data. That's not how it works. Yeah. But anyway, moving on. This is a single observational study.
01:01:36
Speaker
So it's not a randomized controlled trial. It's not a meta-analysis or systematic review. Hopefully you're learning because we say this a lot. That means it's not great evidence. Yeah. it's maybe somewhere you would start. And the thing is with these so sort of lower quality studies, they're usually used as a stepping stone to then go on and actually try to put together some better research, right? yeah But people love to then just pull this you know type of pilot study basically and say, look, evidence, when it's like, that's not so what it's doing.
01:02:06
Speaker
Right. Okay, and I have to be honest, at this point, as I was preparing this episode, I started to feel really resentful that Yoga You and Doug Keller are making me read a study that has zero relevance to what they're claiming.
01:02:18
Speaker
Yeah. but i But I did read it, and I'm i'm going to pull two quotes because even though you can't extrapolate pediatric data to adult data, the study itself doesn't even prove what Keller and Norlick Smith are saying that it does.
01:02:31
Speaker
Okay, so this is from the introduction to the study, and this is a quote. Several previous studies have investigated the association between lung function and bone metabolism in adults.
01:02:43
Speaker
A study based on the Hertfordshire cohort study investigated the association between lung function and bone mineral density in more than 900 older adults. Still, the association was not statistically significant when adjusted for confounders.
01:03:01
Speaker
So just as a reminder, if it's not statistically significant, we cannot say that it wasn't because of chance. So they're just saying about other studies when they looked at lung function and bone mineral density in adults, even then they could not find statistically significant data.
01:03:18
Speaker
Okay, so they state that in this study, the pediatric study, they found a positive association between bone mineral density of the lumbar spine and lung function, in particular with younger children and lower BMI. So not older adults, just as a reminder,
01:03:36
Speaker
And this is a quote from the discussion. The cross-sectional design, meaning the way this study was designed, precluded the possibility of causal inference.
01:03:49
Speaker
And we were unable to determine a causal association between lung function and bone mineral density in children and adolescents. So this is them acknowledging that the type of study that they were doing was never going to be able to prove causality between lung function and bone mineral density. Just a reminder.
01:04:11
Speaker
One of those marketing emails said that there was a clear cause and effect relationship. yeah this is I'm so, I am so fucking mad right now. There's just absolutely zero integrity going on here.
01:04:24
Speaker
Who, who picked out this study? Did anyone bother to read it? And maybe worse, did they read it and go, sure, this seems fine. And just slap it on the list. You know what? I, I can't stop thinking about it. It's like all the people who are going to come back at us and be like, you're so harsh, you're tearing them down. You've given them the benefit of the doubt. Mean girls. These are people who preying on people's fears and anxieties around their bone health to sell them ah solutions that aren't going to work.
01:04:58
Speaker
Yep. So they're inventing problems. They're creating fear. They're creating anxiety. They're doing it sloppily because they're so confident that no one's actually going to read this research.
01:05:12
Speaker
And I know we're going to have people mad at us for forcefully denouncing this. Yeah. But who are you more interested in protecting?
01:05:24
Speaker
Yoga use bottom line? Yeah. Or all of the people who sign up to learn what they're sharing who are unsuspecting, trusting participants in this this fucking story.
01:05:44
Speaker
yeah I'm interested in putting a stop to this kind of crap In the yoga community, I think it hurts yoga. And then there's going to be people who are mad because we're not yogic enough about it or something, right?
01:06:01
Speaker
But is this yoga? Do you want this kind of stuff to fall under the banner of yoga? That's disastrous for yoga. i agree. i agree.
01:06:12
Speaker
I don't want yoga associated with predatory wellness marketing. And the other thing is, Narlick Smith does kind of position herself as a science expert.
01:06:24
Speaker
Well, she has a PhD in health psychology. But I think that sort of claim goes a long way in instilling this kind of faith that she's not going to lead people astray. She's a science expert. Of course. Right?
01:06:37
Speaker
And it's just so unbelievable to me that... you would try to like crowbar some care research. So yeah careless with people's health, with their psychology.
01:06:49
Speaker
So yeah this this is reminding me of the webinar where Sarah, you repeatedly and politely requested research in the comments. And then there was this barrage of other people in the webinar. By the way, how many people were in this webinar? Was like 200 people?
01:07:04
Speaker
Or attending live? 100? i don't know. Probably about 100, I think. I think it was more than 100. So a ton of people on this webinar chimed in under your comments saying they also wanted to see this research.
01:07:17
Speaker
And that's when even Orlick Smith finally told them that people could get the research in an email if they asked her for it. So yeah I think she's counting on them not asking her for it because the people, they want to know that there's research, but they don't want to read the research. So they're probably not then going to ask her for the research, right? They would have to have crossed over into a level of skepticism that I think many in attendance were had not quite crossed that threshold yet.
01:07:44
Speaker
maybe Maybe they did once we started chiming in, right? yeah If you're yeah a yoga teacher, yoga practitioner, even a yoga therapist, odds are you don't actually like I took classes, a year's worth of classes on reading research.
01:08:02
Speaker
And I didn't enjoy it, especially more of the statistics part than anything else, but learning how to take a critical eye to research is a skill. People are not born with it. And so yeah,
01:08:15
Speaker
I mean, I'm wondering, even just the promise of research might have been enough for people. Yeah, it is. Because they put their faith in them and their trust in Yoga U and even Norlick Smith that they're not going to lead us astray. So this research must prove what they're saying it proves. Right.
01:08:28
Speaker
And just her saying there is research probably delayed anyone who was just having a glimmer of skepticism at that point was like, OK, so this is research based. OK. Based on the the kind of research that they've used in the past that they thought was okay, I think they were just like, this seems fine.
01:08:43
Speaker
And didn't really bother to like try to find anything better. Yeah. Yeah. There isn't anything better. That's the thing. that there's There's some physiological plausibility. Yeah. They make up an entire narrative about it it. They connect all the dots of all of these physiological processes and effects. And then they retroactively go backwards and go, well, now let's find support for this.
01:09:05
Speaker
Which is not science, if you weren't aware. that's no. no we We can't make up how things happen in the body. We really want to understand the body and also want to find the right solutions to the problems. That's a bad idea. Yeah.
01:09:19
Speaker
yeah Okay, so I just want to summarize what we have so far, right? We have a completely unfounded claim that older adults are chronically hyperventilating when in reality, while aging can lead to some gradual reduction in lung function, that does not automatically mean they have or ever will have this clinical condition, okay? Number two,
01:09:39
Speaker
They are also implying that because all older adults are breathing this way, or many older adults are breathing this way, it's very it's very nebulous, right? Yeah. You all in attendance in this webinar, did you know that older adults generally, right, are breathing this way? They're implying that they're breathing this way, that by doing that, they are forcing their bones to give up calcium and other minerals to balance their blood pH.
01:10:02
Speaker
And as a result, their BMD is going down. And then the first piece of evidence we are supplied with... On this topic is a non-causal single cherry-picked study of children.
01:10:16
Speaker
Oh, boy. That's where we are right now. yeah There are two more studies provided as reference for this claim, though. So let's take a look at those. Both of these studies are about sleep apnea.
01:10:28
Speaker
ah Oh, God. I am not kidding. Ugh. Okay, fun fact, sleep apnea is also a condition that Buteyko claims its breathing techniques can help with.
01:10:41
Speaker
So if you're wondering why they picked these studies about sleep apnea, that might be why. A quick definition of sleep apnea, if you are not familiar. Sleep apnea is a condition where breathing is interrupted during sleep.
01:10:55
Speaker
These interruptions can last from a few seconds to a minute and may occur multiple times per hour. The most common type, obstructive sleep apnea, occurs when the airway becomes blocked or collapses during sleep, preventing airflow to the lungs.
01:11:11
Speaker
This blockage can be caused by various factors, such as excess weight, large tonsils, or a narrow airway. 6 to 22% of the population has sleep apnea.
01:11:22
Speaker
Okay, but sure, let's extrapolate that to everyone. Yeah. Here's another issue with using this particular research, okay? Obstructive sleep apnea can lead to hypoxia, okay? We're going to define that.
01:11:38
Speaker
Hypoxia is when you are not able to get enough oxygen into your lungs. Now, this is not actually what Keller and Norlick-Smith are claiming is why you are losing bone mineral density,
01:11:52
Speaker
They are saying that the way you are breathing is causing you to lose too much CO2, and that's why you are pulling calcium out of your bones to balance your blood pH.
01:12:03
Speaker
Losing too much CO2 is not the same thing as not having enough oxygen. They can be related, but they are not the same thing. Yeah. and And they can be related, and we're going to talk about how they can be related later on. But I mean, fuck Laurel. I honestly feel at this point like they're making fun of us. Like, aren't Laurel and i the morons for trying to find honest to God evidence here? Yeah.
01:12:29
Speaker
Yeah.
01:12:34
Speaker
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01:12:51
Speaker
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01:13:05
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01:13:31
Speaker
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01:13:43
Speaker
All right, well, let's let's hear about this sleep apnea. Okay, here we go. The title of the study. Assessment of Bone Mineral Density and Bone Metabolism in Young Men with Obstructive Sleep Apnea, a cross-sectional study by Zhao et from 2022.
01:14:03
Speaker
Okay, so this study was behind a paywall. So unless attendees to this webinar paid to get the full article, they would have only seen the abstract. Now, we have someone who gets papers for us, so we are grateful for Naomi.
01:14:20
Speaker
Yep. Again, this type of study, just like the pediatric one, is unable by design to prove causality. But let's take a look.
01:14:31
Speaker
This was a study of the association of BMD and obstructive sleep apnea in men under 40. Not older men, definitely not older women. Okay, and what they were looking at was the relationship between the hypoxia that happens with sleep apnea and whether it had an association, not cause, just association with BMD loss.
01:14:53
Speaker
So I'm going to read you the limitations of the study that they reported, because what we are trying to establish here are the limits of what this study can show and how Norlick, Smith, and Keller, therefore, should not use it as evidence for their claims. Okay, so here it is. Quote, first, our study was a cross-sectional study and thus could not directly clarify the causal relationship between obstructive sleep apnea and BMD.
01:15:20
Speaker
A long-term follow-up study is needed to assess the effect of intermittent hypoxia on bone metabolism. Second, the sample size of the present study was relatively small, and our result was limited to male patients aged under 40 years.
01:15:37
Speaker
Thus, extrapolation to women and other age groups is not possible. So, says it right there in the study, but, you know, go ahead, Yogi You, and use this as supposed evidence for your claims to sell your workshops.
01:15:56
Speaker
Again, I'm going to have to say it, it's just theater. Yogi You knows that most of their paying customers or future paying customers won't read the papers.
01:16:08
Speaker
So they dangle the offer, and it gives the illusion of credibility. At this point, it feels kind of ridiculous to look at the other study that is also about sleep apnea, but we've come this far, so might as well.
01:16:22
Speaker
All right, so here's the other study. Bone mineral density and changes in bone metabolism in patients with obstructive sleep apnea syndrome by Terzi and Yilmaz from 2015. One of the things that both of these studies point out is that the population that has sleep apnea also often has a lot of other co-conditions like obesity.
01:16:42
Speaker
that also actively impact bone mineral density. So we can't even say for certain that it is the hypoxia that is the only thing negatively impacting these people's bone mineral density.
01:16:54
Speaker
But anyway, the study looked at 30 men around age 50 with obstructive sleep apnea and 20 men around the same age who did not. There was a statistically significant difference in the BMI of these groups with the obstructive sleep apnea group having a much higher BMI than the control And in addition, they did not assess things like physical activity, vitamin D intake, or exposure to sunlight.
01:17:19
Speaker
Just as ah as an aside, you need vitamin D to help your body absorb calcium and nutrition. So there are a lot of confounders here, but here's a little detail that I read in this paper that made me go, are you fucking kidding me?
01:17:34
Speaker
So, and this is a quote, patients with obstructive sleep apnea syndrome also develop acidosis. Studies showed that bone resorption was increased by one fold after every 0.1 decrement decrease in pH value.
01:17:53
Speaker
In addition, acidosis negatively affects bone matrix mineralization. So let's go back to what Norellix Smith and Keller are claiming. They're saying that the issue is that your blood pH goes up, right? You become more alkaline because you exhale too much carbon dioxide.
01:18:12
Speaker
This study is saying that people with obstructive sleep apnea syndrome develop acidosis in which the blood pH goes down. And that for every 0.1 decrease in pH or becoming more acidic, this negatively affects bone matrix mineralization.
01:18:28
Speaker
So not being too alkaline, being too acidic. And we're still looking at a very specific group of people who have obstructive sleep apnea who cannot be generalized to the whole population.
01:18:44
Speaker
Okay, so at this point, they're trying to claim that your supposed chronic hyperventilation is causing you to lose too much CO2, which makes your blood too alkaline. And then you pull calcium from your bones to fix it.
01:18:57
Speaker
And that is the link between breathing and bone mineral density loss. And in attempt to show evidence to back this up, we have a pediatric study that does not prove causality and two studies on sleep apnea, which has a biochemical process where too little oxygen intake leads to bone mineralization decrease, not too much CO2 exhale.
01:19:16
Speaker
And in terms of pH levels is talking about acidosis where your pH is too low, not alkalosis where your pH is too high. And I want to point out as well that while Keller is talking about blood pH becoming too alkaline in this webinar, someone wrote in the chat, and this is a quote, quote, why would the body take calcium and other minerals from the bones if the blood is too alkaline?
01:19:40
Speaker
I understand that if the blood is too acidic, then the body would take minerals from the bones to make the blood more alkaline. Similarly to how stress hormones create an acidic environment in the body.
01:19:53
Speaker
And this person was correct.
01:19:57
Speaker
Now, they also included on the quote research list two studies about hypoxia, which again is when you are not taking in enough oxygen. Now, hypoxia itself can lead to hyperventilation if the person starts feeling panicky about not having enough oxygen in the body. But again, we're talking about a small number of people, certainly not everyone. And most of these people have respiratory diseases.
01:20:22
Speaker
Yep. So we're going talk about these two studies quickly. Here's the first one. This is the title. Hypoxia is a major stimulator of osteoclast formation and bone resorption by Arnett et al. from 2003.
01:20:34
Speaker
This study shows that there is a link between hypoxia and osteoclast formation. And as a reminder, osteoclasts are the type of cells that break bone down. The study was done on mice and rats, FYI. Oh, that's my favorite. The second study, Molecular Mechanisms Involved in Hypoxia-Induced Alterations in Bone Remodeling by Usategui Martin et al.
01:20:57
Speaker
in 2022. Okay. This one looked at both rat studies and human studies, and here's what they found. Rat studies show clear, consistent evidence that hypoxia increases bone resorption by stimulating osteoclast activity and suppressing osteoblast differentiation with tightly controlled experiments revealing specific molecular mechanisms.
01:21:19
Speaker
So rat studies show a strong connection between hypoxia and bone density loss. In contrast, human studies are fewer, less controlled, and show mixed results.
01:21:32
Speaker
often confounded by variables like sleep apnea, altitude exposure, and inflammation. While animal models offer strong mechanistic insight, their direct clinical applicability is limited.
01:21:47
Speaker
Human data are more relevant but inconclusive, making the case that hypoxia can alter bone remodeling, especially in chronic or severe cases,
01:21:58
Speaker
But the strength and direction of that effect remains uncertain in real world populations. Because humans don't spend their lives in cages in a lab.
01:22:11
Speaker
Nope. And they're not rats, right? We are not large rodents. Last I checked. So very much not the thing you don't know about that is giving you osteoporosis.
01:22:24
Speaker
Just a reminder, here's what Eva Norlick-Smith's first email said. Quote, recent research has unveiled a crucial link between breathing patterns and bone health.
01:22:35
Speaker
In fact, we now know that poor breathing habits can create biochemical changes that affect bone density over time. Sometimes when I'm angry, i get really loud and angry.
01:22:50
Speaker
And sometimes when I'm angry, i just get really quiet And the quiet, angry Sarah is a way more dangerous, angry Sarah than the loud, angry Sarah. And yesterday when I was working on this, I was feeling very like, you know, Hulk smash about it. And today I'm just quietly furious, which is, that's the mood I'm in when I feel like I want to slash somebody's tires.
01:23:17
Speaker
All right. Which you should do quietly so you don't care. Yes. I mean, if you're going to slash tires, don't draw attention to yourself. That's number one. Okay. All I just want to keep going back to this claim. So we've established so far that this main claim, right, the the big claim that they're using to promote this workshop has no evidence behind it.
01:23:39
Speaker
Even though they submitted five research papers, none of them prove anything that they're trying to prove. And then just to just to reiterate, the claim was that everyone's rib cage shape changes.
01:23:51
Speaker
They then become chronic hyperventilators, which leads to hypoxia for everyone, which then causes more bone resorption and you get osteoporosis. Did I miss anything?
01:24:02
Speaker
Okay. okay To summarize what we found, your rib cage will likely change shape as you age.
01:24:14
Speaker
Will that automatically lead to chronic hyperventilation? No. That's most likely to occur in certain populations like people with asthma, COPD, or anxiety and panic disorders.
01:24:27
Speaker
Will that also lead to hypoxia? For those populations, perhaps? Is there proof that hypoxia in humans causes bone loss? Not at the moment.
01:24:39
Speaker
It's a house of cards, right? Yeah. You pull one card and the whole thing falls down. Yeah. All right, well, how's everybody doing? How you doing over there, Laurel?
01:24:52
Speaker
So at this point, we've basically established that their main claim is completely unfounded in science. It actually gets a little more fun now, believe it or not, because there were also a lot of other bizarre claims made throughout the webinar.
01:25:05
Speaker
There were so many of them that this podcast episode could be a novel, frankly. yeah But I picked out a few. um Because after a while, it just started to like come at you like you couldn't even absorb the one when the next one was happening. Yeah.
01:25:17
Speaker
Yeah. You start to like dissociate. it was a It was a fire hose of misinformation, basically. It sure was. Yeah. Okay. So now we're going to talk about nitric oxide. All right. So for those of you that didn't read the book, Breath, this part was the big topic that got a lot of people very excited to tape their mouths closed at night.
01:25:36
Speaker
Full disclosure, I did it for a while, but it wasn't because of how I was breathing. It was because i am a nighttime teeth clencher. And i sometimes I would clench so hard that i' would wake up with a headache.
01:25:48
Speaker
And something about taping my mouth closed actually allowed me to relax my jaw muscles. Yeah, that makes sense. for that, it really, really helped. Yeah. Hey, let's link Front Page Fitness's episode on mouth taping for people. Definitely.
Debunking Myths: Mouth Taping and Nitric Oxide Production
01:26:01
Speaker
Yeah. So that's an evidence-based assessment of this thing called mouth taping. And It doesn't live up to its promises. yeah Front Page Fitness, our good friend.
01:26:12
Speaker
I like to call her our good friend. She's not really probably our good friend Barely knows us. The good doctor, ah Lauren Colenzo Semple and Eric Trexler are co-hosts of Front Page Fitness. And they offer their PhDs in science level expertise and research literacy to debunking some of the biggest myths floating around out there in the fitness industry. So they they took on mouth taping.
01:26:36
Speaker
Here's a quick summary of what nitric oxide is, what it does for us, and how we produce it. So nitric oxide is a molecule that we produce by breathing, and it plays a role in several aspects of our breathing quality as well as in other systems in our body.
01:26:52
Speaker
So here's what it does. It's a bronchodilator, which means it expands the airway and allows more airflow into the lungs. It's also a vasodilator, which means it expands the blood vessels in the lungs, and that allows more gas exchange of oxygen and carbon dioxide.
01:27:08
Speaker
It does something called ventilation perfusion matching. Basically, it helps oxygen get to the areas of the lungs where it is most needed. And it also has mild antimicrobial and anti-inflammatory properties.
01:27:23
Speaker
So breathing through the nose is how we produce the most nitric oxide. while breathing through the mouth can still produce nitric oxide, but not as much. So the book Breath made a really big deal about how bad mouth breathing was for you.
01:27:38
Speaker
And he did this experiment to quote unquote, prove it by plugging his nose for a month and recording how all his metrics went into the toilet. But here's the thing, even if you are breathing through your mouth, you are still breathing through your nose as well. It's called oronasal breathing.
01:27:57
Speaker
So it's not this either or good versus bad situation that is presented in the book. And the podcast Yoga Meets Movement Science with Jenny Rawlings and Travis Pollan did an episode called Nasal Versus Mouth Breathing, Does It Matter?
01:28:13
Speaker
that we will link for you. And they examine this argument about the superiority of nasal breathing. And one of the points they make is that the idea that people who have respiratory issues can benefit from nasal breathing is not in question.
01:28:27
Speaker
But the idea that people without respiratory issues need to be doing it so that they don't get respiratory issues is a different, completely unproven argument.
01:28:38
Speaker
All right. So that's why people got into mouth taping at night is so that they could do purely nasal breathing and therefore supposedly improve their nitric oxide production or start to establish themselves as a habit of nose breathers. I don't i don't know.
01:28:56
Speaker
I just used it for my job. All right. So let's see what Keller is claiming goes on with nitric oxide as we age. Are you ready, Laurel? Because this one's a doozy. Let's do it.
01:29:07
Speaker
In the webinar, he states, oh boy, that by the time you reach your 70s, you have lost about 75% of your natural capacity to produce nitric oxide. Oh, shit.
01:29:20
Speaker
That sounds really bad. is it true? 75%. mean, that's almost all of it. Let's do some digging. i asked consensus. Do we lose 75% of our ability to produce nitric oxide by the time we are 70 years old?
01:29:35
Speaker
And consensus, God bless it, looked at 28 studies. After it combed through 1,045 possible studies, it picked out 28 studies to review, and it concluded that while, yes, nitric oxide declined significantly as we age, there is no number associated with that decline.
01:29:55
Speaker
Rat studies showed 50% decline over the rat lifespan, but there is no human study that proves a specific percentage. So yes, we lose a substantial amount, but we can't say that it's 75%.
01:30:07
Speaker
Where the fuck do they keep coming up with these made up percentages out of thin air and zero evidence to back them up? i think I don't know if I'm more horrified by the misinformation itself or how casually it was delivered.
01:30:20
Speaker
Like, here's five explanations of breathing physiology I've got completely backwards. And oh, here's a scary sounding number. I just made up for a good measure. Yeah, seriously.
01:30:32
Speaker
All right. So Keller goes on to say that the practices of pranayama, as he's going to teach them in this workshop, are going to help you with your reduced nitric oxide production as you age. So- Talk about inventing a problem.
01:30:45
Speaker
Seriously, there it is again, right? Yeah. Okay. But but also- hu Also inventing a solution. I was curious about the research and what it showed was the best way to work on improving your nitric oxide production as we age.
01:31:01
Speaker
And you know what it said? Well, Laurel actually does know what it said because i kept texting her just increasingly outraged texts about what I was finding. And I did text her about this one. I'm going to have Laurel tell you what the research says about the best way to improve your nitric oxide production. Dun, dun, dun. It is lifelong or regular exercise. Yay!
01:31:27
Speaker
That is what preserves nitric oxide mediated vascular function and nitric oxide bioavailability in older adults. Older individuals who maintain high fitness levels have nitric oxide functions similar to much younger people, while sedentary older adults show significant declines.
01:31:46
Speaker
Can we just pause for a second? Yeah. I just like it's pause re-heard that somehow. So basically, if you're exercising sufficiently, ye you're not going to see this catastrophic decline in nitric oxide. No, and yeah we would this just kind of tends to be the case with exercising regularly. You don't see as catastrophic of a decline of many things, like muscle mass, like bone density.
01:32:12
Speaker
like VO2 max or cardiorespiratory fitness, right? Yeah. And and now we're learning also nitric oxide. Yeah. And is this a workshop about exercise?
01:32:23
Speaker
I mean, not that I am aware of. No, this is a workshop about pranayama, which is a largely sedentary activity. Yes. All right. So starting an exercise program in later life, it can restore nitric oxide function within months. This is also not surprising to me because it can also restore muscle mass.
01:32:43
Speaker
Yeah. Right. It can also restore cardiorespiratory fitness. Exercise reduces oxidative stress, which otherwise depletes nitric oxide and improves the health of blood vessels and muscles.
01:32:57
Speaker
Okay. In addition, dietary nitrates, which are found in leafy greens, beets, et cetera, all that good stuff, and nitrites can also boost nitric oxide levels by providing an alternative pathway for nitric oxide production. So exercise and diet, there it is again, right? It kind of always comes back to exercise, diet.
01:33:20
Speaker
It's not that you're breathing wrong. It's not that you're breathing wrong. Now, to be fair, this may be, okay, let's strongman their argument here. This may be because of a lack of research around breathing and pranayama practices. This is often what I hear the yoga therapists suggesting, right? It's like, well, there just isn't enough research yet, right? and There's maybe a lack of research around breathing and pranayama practices. Sure.
01:33:50
Speaker
Maybe now when there's, you know, once there's more research, we're going to see that these Practices are really good for improving nitric oxide production. But until that happens, it is irresponsible for Keller and Norlick Smith to claim that they do.
01:34:08
Speaker
Yeah. Right? Yeah. So next up, we have the claim that pranayama is going to change the shape of your upper body by engaging the breathing muscles around the ribs and and it's going to reshape your rib cage so you can breathe better again.
01:34:25
Speaker
He repeatedly stated in the webinar that the rib cage is hard to load with traditional resistance training.
01:34:36
Speaker
oh God. So the clay, so so and another thing I notice happening with Yogi U is that they'll always be like, no, no, no, we're not saying anything bad about resistance training.
01:34:50
Speaker
Right. We're just never mentioning it. And if it does get brought up, we're going to find some reason why it's not ideal. I saw this with Fishman as well, right? Right.
01:35:01
Speaker
No, no. We're not against resistance training. We're not against it. We just never suggest it. So he claimed in the webinar that it's hard to load the rib cage with resistance training as opposed to it being really easy to load it with breathing as if we're not breathing while we're resistance training and as if breathing is like progressively overloaded like it just it makes no sense why do i need to take your breathing workshop i've been breathing since the day i was born
01:35:34
Speaker
But not the right way, Laurel. ah You know, like the claim that the rib cage, let's just go back to this claim that the rib cage is hard to load. This is where I i almost lost it. Yeah. The claim that the rib cage is hard to load with resistance training is absurd. Yeah.
01:35:49
Speaker
There are over 20 pairs of muscles that attach to the rib cage, including some of the biggest and most well-known muscles of the upper extremity in the core.
Criticism of Misleading Health Advice and Misconceptions
01:35:58
Speaker
the pectoralis major, the latissimus dorsi, the serratus anterior, the rectus abdominis, and the external abdominal obliques.
01:36:07
Speaker
So every time you lift a weight and press it, row it, anytime you do a pull-up, anytime you train your abdominals directly, you're loading these muscles.
01:36:20
Speaker
And by extension, the rib cage itself, because remember, the way we load bones with exercise is by targeting the muscles. Right? So far from being hard to load, the rib cage is probably one of the most mechanically engaged regions in strength training.
01:36:35
Speaker
I was genuinely shocked that he said this. He not only mixes up basic breathing terminology and definitions, but he believes the rib cage is somehow hard to load.
01:36:47
Speaker
He seems to believe that only primary and secondary muscles of respiration attached to the ribs. No, the biggest, strongest muscles that move the shoulder joint complex and the spine do too, man.
01:37:00
Speaker
You can't move a barbell, a dumbbell, or even your own body weight without loading the muscles that attach to the ribs. i mean, just period.
01:37:12
Speaker
End of story. like Are we coming down too hard on them? No. This is... Like, this wasn't a second grade book report. This was a webinar to women in their older years designed to sell them a workshop to fix their bone density issues.
01:37:31
Speaker
Yeah. And you said it was absurd, which I agree with. It's either willfully ignorant or I don't even know.
01:37:43
Speaker
I don't even know. yeah The amount of time i spent trying to figure out if these claims were true, is clearly so much more time than they spent trying to figure out if their claims had any basis in evidence. How can you be so careless with people's health? How can you be giving this type of advice, which is positioned as health advice? Use all of this medical sounding, scientific sounding terminology, get it wrong.
01:38:10
Speaker
Why is that okay with you? It's not okay with us. I just want to speak too to some of the criticism we get about calling people out. Like maybe we should just stick to promoting good ideas instead of dismantling bad ones.
01:38:26
Speaker
Or sometimes people are like, just discuss the bad idea, but don't name the people giving the bad idea, which I think actually is not the right strategy. No, because if you have a problem that's going unmet because of bad information, if you're just simply confused about what the best solution is because of bad information,
01:38:49
Speaker
The problem is bad information. The solution is not more right information. The problem is let's call out and correct the bad information.
01:39:02
Speaker
My husband and I someday want to renovate our kitchen. But let's say at the same time our basement is flooding. Until we take care of the flooding basement, we're not going to be able to renovate the kitchen. Yeah. Yeah.
01:39:17
Speaker
And until we identify misinformation, people will have a much harder time finding the correct information, finding the correct people to go to ah solve their problems.
01:39:33
Speaker
One of the arguments that we hear a lot about us dismantling bullshit is that, well, then what's the real answer? people are if that's not the right thing, why aren't you providing us with the, what the right answer is? And I'm like, well, we do actually. mean, we literally have already in this episode, if you missed it, it's called diet and exercise.
01:39:56
Speaker
and Mostly exercise because that's our wheelhouse. That's our scope of practice. exactly But it's also the case that it's way easier to sell someone an overly simplified thing, right? Like breathing for bones, because we talk about this, that's just really easy, right?
01:40:14
Speaker
It seems really easy. Like, why wouldn't I do that? Whereas diet and exercise is like, oh God, where do even start? But breathing for bones is like, oh, well just take this workshop series. Totally easy.
01:40:25
Speaker
You know, easy peasy. All right. So we're going to move on. Because one of the other things that they throw in just for fun, that old stress and cortisol.
01:40:38
Speaker
Oh, we can't have a workshop on breathing geared toward older women without saying cortisol. Yeah. So Keller is saying that by reshaping the rib cage with breathing exercises, it produces less stressful breathing.
01:40:54
Speaker
Sorry, I'm just so ridiculous. And thus, you don't have as much stress. And thus, you won't be overproducing cortisol. They also say that the stress of trying to breathe or get up from the floor raises cortisol.
01:41:09
Speaker
And the danger of all this elevated cortisol is that it impacts your bone mineral density. All right, let's unpack this. So we talk about cortisol a lot in this upcoming season in episodes about menopause myths and also in our interview of Lauren Colenzo-Simple.
01:41:29
Speaker
Just to review, cortisol is a naturally occurring steroid hormone in your body that is involved with a lot of different bodily functions. It has a natural daily rhythm of rising and falling. And yes, it does rise with chronic or acute stress.
01:41:44
Speaker
But can we take a look at what the science defines as chronic stressors? Here we go. Number one, chronic pain. That makes sense. Altered rib cage shape, as far as I know, is not chronic pain.
01:41:58
Speaker
Work and family stress, social adversity and discrimination. Chronic illness like cardiovascular disease, irritable bowel disease, and epilepsy are named as examples, not rib cage shape or diminished aerobic capacity.
01:42:14
Speaker
Major life events, unemployment, parenting a child with a chronic illness, So this claim that cortisol is involved in diminished breathing capacity feels like both a reach and a when in doubt blame cortisol kind of statement. yeah While it is true that elevated cortisol will have an effect on your bone mineral density, it is not true that everyone is walking around with elevated cortisol.
01:42:41
Speaker
Yeah. It's also not true that cortisol is the boogeyman, which I think is why they mention it, right? It's like everyone's ears perk up like, oh no. Oh no.
01:42:51
Speaker
I know that's bad. yeah All right. we're We're going to finish by talking about the cardiovascular claims that were also made in this webinar and they are quite something.
01:43:02
Speaker
First off, Keller defines VO2 max as quote, the amount that your blood is saturated with oxygen. The actual definition of VO2 max is the maximum amount of oxygen your body can utilize during intense exercise.
01:43:21
Speaker
So it's a measure of the volume of oxygen in milliliters consumed per minute relative to your body weight per kilogram. Kaller's definition isn't just wrong.
01:43:33
Speaker
It collapses two completely different concepts into one. So blood oxygen saturation which is what you measure with a pulse oximeter, almost always stays between 95% and 100% in healthy people, even during intense exercise.
01:43:51
Speaker
It only drops significantly with certain medical conditions, severe COVID-19, and other lung diseases. so VO2 max, on the other hand, can vary widely between individuals and can change dramatically with training.
01:44:07
Speaker
It's not about how much oxygen is in your blood, It's about how much oxygen your body can actually use during exercise. In other words, VO2 max measures the combined capacity of your heart, lungs, and circulatory system to deliver oxygen to working muscles, as well as how efficiently your working muscles can then use that oxygen for exercise.
01:44:34
Speaker
A higher VO2 max means you can sustain higher intensity exercise for longer periods.
01:44:42
Speaker
So when someone can't even define ah basic physiological measurement like VO2 max, or if in the moment the definition s slipped their mind and they failed to tell you, you know what, I and don't have the definition on me right now, but I'll look it up.
01:44:58
Speaker
They just kind of came up with something. doesn't inspire confidence in their follow-up claims about aerobic function and how to improve on that. He then also mentioned the, quote, doodads you can use to measure VO2 max, as in wearables, fitness trackers.
01:45:18
Speaker
But just know that the only accurate way to measure VO2 max is using a graded exercise test involving running on a treadmill wearing a mask in a lab. Everything else outside of that uses heart rate as a proxy.
01:45:31
Speaker
Heart rate generally rises in proportion to exercise intensity, so It is a decent proxy for VO2 max, but it's also confounded by all the other things that influence heart rate.
01:45:45
Speaker
it's influenced by far more than fitness levels, right? It's influenced by stress, by caffeine, by cocaine, by lack of sleep, by hydration, by the temperature. Cocaine?
01:45:56
Speaker
Yeah, cocaine, smoking, nicotine, right? Most people are not doing cocaine. What I'm saying is that your heart rate will be influenced by things like drugs.
01:46:07
Speaker
Yes. Temperature, stress levels. So your heart rate is not a accurate, window into your VO2 max. That's the point I'm making. Gotcha. I tell the story a lot about seeing a snake in the woods while I was on a hike and noticing my heart rate was jacked.
01:46:27
Speaker
right If I wanted to go like get my aerobic exercise, should I just go out looking for snakes? Or watch a scary movie? Or open my email inbox? Right? like No. right So heart rate is a poor proxy.
01:46:40
Speaker
right So this is why wrist-worn VO2 max predictions that you get from your Garmin or your Apple Watch, they should be taken with a grain of salt. These doodads, right?
01:46:50
Speaker
Those don't really accurately measure your VO2 max. They're not measuring how much oxygen you're using during intense exercise. They're just guessing based on an indirect marker of your heart rate, which isn't always a reliable marker.
01:47:05
Speaker
Yeah. Okay. So we've made it this far. Let's keep going. This is the description of the workshop on the Yoga U website. And we're talking about cardiovascular activity.
01:47:16
Speaker
and And this was written by Keller. Quote, unfortunately for many people above the age of 50, the typical approaches to building cardiovascular fitness and endurance, like running, jumping, fast-paced biking, may not be available.
01:47:32
Speaker
The good news, research shows that ancient yogic breathing practices can have remarkable effects on our cardiovascular system. Remarkable. So he's promoting yogic breathing as a viable alternative for people over the age of 50 who cannot participate in running, jumping, and fast-paced biking for cardio exercise. By the way, he left out a lot of ways that you could participate cardiovascular exercise.
01:48:01
Speaker
Yeah, seriously. seems like he is just not familiar with the fact that there are a variety of ways to get your cardiovascular exercise, a variety of intensities that confer aerobic benefits.
01:48:16
Speaker
It doesn't have to be high intensity. Maybe he is not up on the zone two lingo. It's like saying some people can't sprint up 10 flights of stairs. So the next best option is breathing. Further down the page, he says this Perhaps most remarkably, studies have found that pranayama can actually increase our body's maximum oxygen uptake, VO2 max, a key indicator of cardiovascular fitness, even more ah effectively than traditional aerobic exercise.
01:48:49
Speaker
oh Wait a minute. So you're saying I can just sit here and breathe it would better than actually doing cardio? Yeah, that is the claim. I mean, sign me up.
01:49:03
Speaker
Okay. So yeah, breathing exercises. It turns out they they can somewhat improve your VO2 max according to some research. But here's the obvious, right? Which is that, of course, aerobic exercise is far better and far more reliable.
01:49:22
Speaker
You know, It's really easy to say some research shows, right? Yeah. I mean, they provided, first of all, no evidence for this claim. Also, I'm so sick of the phrase studies have found.
01:49:36
Speaker
I'm like, you can't just say studies. it's I'm going to say it right now. That's illegal. I'm going to arrest you. It's a citizen's arrest. You can't just say studies and then a not provide any studies, but B, just talk about studies.
01:49:50
Speaker
Like that's not that's not how it works. Yeah.
01:49:54
Speaker
Hulk smash. Okay, go ahead. Wait, but I just want to play a devil's advocate for a minute and maybe we should cut this. But we do say that sometimes we're like so mountains of research. I think what your point is, is that this is a very specific claim saying that aerobic exercise is inferior to pranayama.
01:50:12
Speaker
And then saying studies show. For cardiovascular health. And it's such a bold, yeah specific claim. And then to say some studies show is different than saying mountains of research show that there's no relationship. Yes.
01:50:23
Speaker
And also, you're saying studies have shown, when we went and looked at the studies, none of the studies showed that. Like literally none of them. Consensus is AI. It doesn't have a personality. But as I was typing in the question about is breathing really better than aerobic exercise for improving cardiovascular health, I felt consensus saying to me like, Are you mom?
01:50:48
Speaker
Like, have you never, is this your first day? like what? If it sounds too good to be true people, right? Like it's like yoga builds bone. Breathing is better for your VO2 max than running is.
01:51:04
Speaker
We asked consensus the question, right? Spoiler. Can breathing techniques from yoga increase our VO2 max more efficiently than aerobic exercise? Yeah. And it did a deep search of the literature, came up with 50 papers that were worth including, and then reviewed them and concluded that no, breathing exercises are not more efficient than aerobic exercise and improving VO2 max.
01:51:27
Speaker
Now, this is not to say that if we take, for example, a deconditioned sedentary older person and we start to give them some breathing and yoga movements, that these would have no benefit, right? that That's not what we're saying.
01:51:41
Speaker
There are many recorded benefits of all the practices of yoga, but we have to keep coming back to the fact that if breathing practices were really superior to aerobic exercise for VO2 max, worldwide exercise guidelines would reflect it Guidelines recommend 150 minutes of moderate aerobic activity per week, not 150 minutes of breathing. Yeah.
01:52:10
Speaker
Also, so again, I'm just going to come back to the fact that we breathe like 10,000 times a day or more. And so wouldn't we all just have amazing VO2 max just because this is like literally we spend all day supposedly working on it by breathing?
01:52:27
Speaker
Yeah. I mean, all right. Well, here we are. So there there were more kind of random statements and claims that raised our collective hackle.
01:52:40
Speaker
our Our shared hackle. We share one hackle. But the ones we've discussed today, these were the biggest offenders. Okay. During the webinar, Norlick Smith said, if you want to get the research that this is based on,
01:52:53
Speaker
send us an email and we will send you the research. So I sent an email to the you know info at Yoga you whatever. And she came back personally to our request. And in the email that she wrote to us, she told us, and this is what we were alluding to at the beginning of the episode. She told us that based on our prior evaluation of Fishman's work, they had taken another look at his study and had also concluded that it did not hold up.
01:53:22
Speaker
So they were no longer including that work, that study in their yoga for osteoporosis courses. And we responded by saying that we were glad to hear that they had done this, but in our opinion, they needed to completely divest from their relationship. They have not done this.
01:53:44
Speaker
And instead here's what they have created. And this was another separate promotional email that i received. from Yoga U. And this is a quote. We created our new expanded online course on the new yoga for osteoporosis, the complete fracture prevention blueprint with Ellen Saltenstall, Lynn Cremando, who is another Yoga U teacher,
01:54:11
Speaker
Even Norlick Smith and Dr. Lauren Fishman. This course offers a unique opportunity to study with the leading authorities in developing and researching the applications of yoga for osteoporosis.
01:54:23
Speaker
So this is what this new course that they've created, cause I looked into it a little bit. So it's got three parts. Part one is for just general practitioners, yoga practicers who want to learn more. Part two is for teachers who quote, want to learn the latest research on which yoga poses and movements are best for building stronger bones and and how to incorporate it into your yoga practice for teaching.
01:54:49
Speaker
Part three is if you want to become a certified yoga for osteoporosis teacher who can teach a six-session course on yoga for osteoporosis. So you pick whichever silo that you most fit into, and that's how you take the course.
01:55:07
Speaker
I mean, the thing is we might have to go into this and debunk it as well, but I'm really tired of Yoga U at the moment and I don't have it in me. Here's here's some of what I think about Yoga U. This is the second time, if we're talking about this, this breathing for your bones workshop claim, right?
01:55:30
Speaker
This is the second time we're seeing Yoga U promote a workshop This time it was about how breathing can impact your bones. Last time was about how yoga can impact your bones. Claim that it has a scientific basis and then provide no meaningful research to back it up on top of a ton of misinformation.
01:55:51
Speaker
And that's kind of the part that I find the most egregious. If they didn't try to claim that this was backed by research, if they just said, Hey, let's work on breathing together.
01:56:02
Speaker
Everybody benefits from breathing. Mindfully. Mindful breathing practices, you know, ah meditation type practices. Yeah. Great. I would be all about it if they were like, hey, let's just get together and practice some pranayama together.
01:56:16
Speaker
Fine. But trying to crowbar breathing into the bone density conversation. Why? Because bone density is a hot topic at the moment.
01:56:28
Speaker
And doing it without clear research to back it up, it feels to me like two things. The first is that Norlick Smith continues to try and make yoga practices efficacious for bone density. And the second thing is this kind of like messy, under-researched associations that they have found that no science-based person would ever say backs the argument does feel very on brand for the world of yoga and yoga marketing.
Call for Ethical Standards in Yoga Representation
01:57:00
Speaker
It's assuming your audience will just accept it wholesale. And I mean, I have found in the world of yoga, these types of broad claims are often accepted because of the power dynamics involved in the guru to student relationship.
01:57:19
Speaker
Now, this is not to say that We think yoga teachers are stupid. Sometimes people get mad at us because they're saying, you just think yoga teachers are stupid and they can't discern things. I'm not saying that.
01:57:30
Speaker
I'm saying like the world of being a yoga teacher involves some amount of conditioning to not question what you're being told, but to just accept it. That is the opposite of the scientific approach. Yeah, absolutely.
01:57:45
Speaker
Yeah, I can't overstate how enraging this is. yeah Like, Yoga You is literally telling people that instead of doing actual cardio, one of the most well-researched life-extending disease-preventing forms of exercise, that we can get possibly better benefits from just sitting and breathing.
01:58:10
Speaker
It's wrong. This is misinformation. It's irresponsible. It's harmful. And it's an absolute betrayal of the word yoga.
01:58:23
Speaker
Because if you strip yoga down to what it has always been at its best, which is an ethical practice as well as a practice of awareness, discernment, perhaps between what is and isn't ethical, what is and isn't honest, what is and isn't harmful.
01:58:49
Speaker
This is the exact opposite of that.
01:58:53
Speaker
You don't get to co-opt yoga's name and value to peddle your pseudo-physiology that convinces midlife and older women to skip the very thing that could do the most benefit for their hearts, their lungs, their bones.
01:59:14
Speaker
That's not yoga. That's opportunistic wellness theater. It's dangerous. And I'm furious that that's how they drag yoga's name into this.
01:59:27
Speaker
It doesn't just miseducate people. It actually discredits the entire tradition by turning it into a marketing gimmick.
01:59:36
Speaker
But meanwhile, people get mad at us because sometimes we curse. Yeah. Yoga U... To use a phrase that I thought up a while ago and have been desperate to use, and I think this situation really is appropriate, Yogi U puts the ick in unethical.
01:59:54
Speaker
Nice. All right. Laurel, what do you think Yogi U should or could do to fix this? Can they this? Yeah, they fix this. I mean, everybody makes mistakes. It's true. Right? In the next episode of the season, we talk about... we talk about the mistake we made. We corrected the information. Yes.
02:00:10
Speaker
Right? If you can't admit that you make mistakes, you can never correct the mistakes you make. So the first step is to actually admit that you've made a mistake. Not just in a private email to us, but publicly.
02:00:22
Speaker
Right. Right? You put your reputation on the line. You put your bottom line on the line. And you go, i fucked up. I take responsibility for that. But if you can't admit that you made a mistake, right, that'll never happen.
02:00:38
Speaker
So yeah, they could fix it. And the way they do that is they publicly apologize for spreading misinformation, right? Then they correct the misinformation clearly and transparently.
02:00:51
Speaker
But more than that,
02:00:55
Speaker
ah think we need to back up because I think i think Yoga U has some serious soul searching to do. think they need to sit with themselves and confront how far they've drifted from the evidence, how easily they've misled the very people who've come to trust them and the information they share, and whether or not they're actually living up to the ethical foundations of yoga that they claim to represent.
02:01:21
Speaker
I completely agree. And i predict that we are going to get at least one email from Eva Norlick-Smith about this when it airs.
02:01:33
Speaker
And it will be interesting to see what she says. Okay. Thank you everybody so much for listening. And i hope the majority of our listeners understand that while yes, we curse and yes,
02:01:54
Speaker
Sometimes we poke a little bit of fun or make jokes about things. We are so serious that this company is doing a massive disservice and- They're trying to renovate your kitchen while flooding your basement.
02:02:15
Speaker
and And so i hope I hope that that comes through in what we have said today in this episode. Just because Sarah and I are women doesn't mean we can't speak forcefully, right?
02:02:29
Speaker
We're going to do that. Yeah. but We're going to do that. And we're going to do that in the face of claims like the ones that we saw today.
02:02:40
Speaker
So thank you for listening. As always, You can rate, review, and subscribe. If you have someone who is a big Yoga U super fan, share this episode with them.
02:02:55
Speaker
I mean, it might backfire, but let's we'll see. and You can also sign up for, what are we calling it now? We were calling it our wait list, but we're calling it our interest list. We're calling it our wait list. Interest list is fun to say.
02:03:07
Speaker
Although I do kind of like priority access. That's that know a little bit jargony for me. Yeah. Does that feel like you're getting on an airplane? Priority access sounds like I'm going to get a big seat. Yeah. Nice comfy chair. I get to work first. And a free drink.
02:03:21
Speaker
Yeah, you do. No charge for extra baggage. Okay. Okay. So we have an interest list for people who are interested in our bone density course.
02:03:32
Speaker
So you can sign up for that interest list in the link in the show notes, or if you follow us over on Instagram. And i think that's it. We will see you next week.