PUSH-as-Rx ®™ Wellness Exercise & Fitness

Can improving breathing patterns help further fitness and optimize overall health for individuals who walk for exercise?

Improve Breathing and Walking

Exercising is a moment in which breathing can quicken and become labored if not done correctly. There is a proper way to breathe when exercising, especially when walking or speed walking. Breathing incorrectly causes rapid fatigue and exhaustion. Controlling the flow of one's breath improves endurance and cardiovascular health, and it can also amplify metabolism, mood, and energy levels. (Hsiu-Chin Teng et al., 2018) Known as diaphragmatic breathing, it is used for those with reduced lung capacity, like individuals with chronic obstructive pulmonary disease/COPD. The practice improves lung capacity and is a recommended way to help relieve stress.

Physiology

• During exercise, the oxygen inhaled converts the calories consumed into energy that fuels the body. This process is referred to as metabolism.
• When the oxygen supply exceeds the body's oxygen needs, the body is in an aerobic state. This means there is plenty of oxygen to fuel physical activity/exercise as there are calories to burn.
• If the oxygen supply falls short of the body's oxygen needs, the body falls into an anaerobic state.
• Deprived of oxygen, the body turns to stored fuel in the muscles, known as glycogen.
• This delivers a powerful burst of energy, but the fuel is quickly spent and fatigue and exhaustion soon follow.
• Increasing airflow in and out of the lungs can prevent early exhaustion and help the body burn calories more effectively. (Your lungs and exercise. Breathe 2016)

Improved Breathing Benefits

Optimal breathing starts in infancy. When a baby breathes, their belly rises and falls. This facilitates respiration by pushing and pulling the diaphragm - the muscle that separates the lungs and abdominal cavity. When the baby inhales, the belly extends, pulling the diaphragm downward and allowing the lungs to fill with air. When the baby exhales, the belly draws in, pressing the diaphragm upward and forcing air out. As the body ages and the capacity of the lungs increases, individuals shift from belly-breathing to chest-breathing. Chest breathing involves the chest wall muscles with little use of the diaphragm. Chest breathing usually provides enough air for everyday activity but does not fill the lungs.

This is why individuals resort to mouth-breathing or gasping when the oxygen supply is limited. Even those in decent physical shape may be inadvertently undermining efforts by sucking in their stomach to look thinner, depriving themselves of complete inhalations and exhalations. To overcome this, individuals need to re-train their bodies to activate the abdominal muscles when walking. Belly or diaphragmatic breathing can extend the duration of exercise while strengthening the core muscles. (Nelson, Nicole 2012) By increasing core stability, individuals can better support the spine and maintain a healthy posture when walking. This stabilizes the hips, knees, upper back, and shoulders, making the body less prone to strain, instability, and fatigue from unhealthy posture. (Tomas K. Tong et al., 2014)

Breathing Correctly

The inhalation draws the belly out, pulls the diaphragm down, and inflates the lungs. Simultaneously, it extends the ribcage and lengthens the lower spine. This forces the shoulders and collarbone backward, further opening the chest. Exhaling does the reverse.

Walking

Start by inhaling and exhaling through the nose, ensuring that the inhalation duration matches the exhalation duration. When picking up the pace, individuals can resort to mouth-breathing, maintaining the same inhalation/exhalation rhythm. At no time should breathing be held in. Learning diaphragmatic breathing takes time, but the following steps can be a starting point:

• Inhale by inflating the belly fully on a count of five.
• Allow the lungs to fill, drawing the shoulders back as this happens.
• Exhale by pulling the belly button toward the spine on a count of five.
• Use the diaphragm to press the air out of the lungs, keeping the spine erect.
• Repeat.

If unable to maintain a count of five, individuals can shorten the count or slow the pace of the walk. Individuals in good shape can extend the count. Initially, diaphragmatic breathing may not come naturally, but it will become automatic with practice. Stop and place your hands over your head if you are short of breath when walking. Breathe in and out deeply and evenly until breathing returns to normal.

Unlocking Wellness

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Teng, H. C., Yeh, M. L., & Wang, M. H. (2018). Walking with controlled breathing improves exercise tolerance, anxiety, and quality of life in heart failure patients: A randomized controlled trial. European journal of cardiovascular nursing, 17(8), 717–727. https://doi.org/10.1177/1474515118778453

Your lungs and exercise. (2016). Breathe (Sheffield, England), 12(1), 97–100. https://doi.org/10.1183/20734735.ELF121

Tong, T. K., Wu, S., Nie, J., Baker, J. S., & Lin, H. (2014). The occurrence of core muscle fatigue during high-intensity running exercise and its limitation to performance: the role of respiratory work. Journal of sports science & medicine, 13(2), 244–251.

Nelson, Nicole MS, LMT. (2012). Diaphragmatic Breathing: The Foundation of Core Stability. Strength and Conditioning Journal 34(5):p 34-40, October 2012. | DOI: 10.1519/SSC.0b013e31826ddc07

The body's metabolism along with body composition go hand in hand. The higher the metabolism the faster the body burns calories. The slower the metabolism the longer it takes and leads to fat storage as well as other issues, which include:

• Excess gas
• Sugar cravings
• Continued weight gain
• Weight loss difficulties
• Constant Feeling of Bloatedness
• Hypothyroidism
• Easy cellulite development
• High blood sugar

Metabolism is linked with weight gain and loss because it is a biological process involved with energy and calories. The process of the body converting food and drink into energy. The process involves the calories in food and drinks that get combined with oxygen to release energy that the body needs to operate.

Body Composition Linked To Body's Metabolism

Metabolism varies for every individual. Here are two body composition profiles.

Individual A

Individual B

Individual A has a much smaller Basal Metabolic Rate than Individual B. This means individual B needs more calories than individual A to provide the body with the proper energy to function without losing weight. Because the Basal Metabolic Rate is bigger, the metabolism is bigger. The most important factor playing into Basal Metabolic Rate is the amount of Lean Body Mass every individual has.

The more Lean Body Mass the greater the Basal Metabolic Rate will be. Strength training for muscle gain will increase lean body mass and is recommended to increase metabolism. For example: Take a look at Jane and Sarah, two individuals who are similar in age, height, weight, and gender.

Jane

Sarah

Despite being similar in age, height, weight, and gender, these two individuals have very different body compositions, as well as have different Basal Metabolic Rates.

Metabolism and Weight Gain

Take a deeper look at slow metabolism. It is not about being fast or slow but weight gain is almost always the result of caloric imbalance that goes on over a period of time. Two major factors are:

• An individual's energy level and how active they are
• The thermic effect of food or the energy the body uses when digesting food
• These taken together with Basal Metabolic Rate provide Total Daily Energy Expenditure (TDEE). This is the number of calories the body burns in a day.

To take a closer look into the body's metabolism and weight gain, take the two individuals above, Jane and Sarah, and see what could happen in real treatment development that includes diet and exercise. First, the TDEE for Jane and Sarah needs to be estimated, using their BMRs as a guide. Based on their compositions, it's fair to assume that Jane is involved in less physical activity/exercise than Sarah. So an activity level of sedentary for Jane will be assigned and light activity will be assigned for Sarah.

Using these numbers and multiplying them by the appropriate activity factor, Jane’s TDEE can be estimated to be 1573 calories and Sarah’s 1953 calories, a difference of 380 calories. When activity levels are factored in, the difference in actual caloric needs gets magnified. This is an estimate of the calories Jane and Sarah will need to burn in a day. The nutritionist and/or health coach place both of them on a diet of 1,800 calories a day. This is the estimated calorie intake recommended by the USDA for sedentary women between 26-30 years of age.

Let's say they both follow the diet perfectly without any extra, high-calorie snacks/treats. Jane will end each day with a surplus of 227 calories, while Sarah ends each day with a slight calorie deficit of 153 calories a day. When in a calorie surplus taking more calories and living a sedentary lifestyle, weight gain, specifically, fat storage will be experienced. 227 extra calories a day doesn't seem like a lot, but that is a single soda. However, over time, 227 calories a day becomes 1,589 extra calories a week and 7,037 extra calories a month, which is around 2 pounds of fat gain every month.

So despite the same height, gender, similar weight, and similar ages, the difference between Jane and Sarah is their body compositions. Jane will experience weight gain over time while Sarah might experience some weight loss because of the calorie deficit, even though the diets are the same. This is because each individual's caloric needs are different and may seem small at first, but increases to significant differences over time.

Making The Body's Metabolism Work

With the correct exercise and dietary plan, an individual can make their metabolism work for them. Because the body needs more energy to support itself when it has more Lean Body Mass, working to increase Lean Body Mass will increase Basal Metabolic Rate. Avoiding a decrease in metabolism can be done by maintaining the Lean Body Mass that is already present and also means maintaining Skeletal Muscle Mass. Skeletal Muscle Mass is not the same as Lean Body Mass but is the overall largest contributor. It is the muscles that will grow and develop through exercise.

Skeletal Muscle Mass is effectively developed through strength training, resistance exercise, and a healthy diet. This will help maintain Skeletal Muscle Mass. This is especially important as the body ages. Activity levels tend to drop and a healthy diet can become harder to maintain as responsibilities increase. Poor nutrition can lead to loss of Lean Body Mass over time, which leads to a decrease in overall metabolism. Balancing diet and metabolism. The example of Jane shows a well-intentioned dietary plan that does not match the metabolism of the person practicing it.

Even though Jane was told that 1,800 calories are right for her based on age and gender, her metabolism does not require that calorie intake. This will cause weight gain despite any efforts to eat a healthy diet. This is where a health coach and nutritionist come in. The first step is to get the information needed to get the answers by getting an accurate body composition analysis.

InBody Composition

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Westerterp, Klaas R. “Exercise, energy balance, and body composition.” European journal of clinical nutrition vol. 72,9 (2018): 1246-1250. doi:10.1038/s41430-018-0180-4

Mazzoccoli, Gianluigi. “Body composition: Where and when.” European journal of radiology vol. 85,8 (2016): 1456-60. doi:10.1016/j.ejrad.2015.10.020