Where the Wind Blows

In keeping with this website's "Five Elements of Ayurveda" theme, this is where I talk about Wind. As we're told in Bob Dylan's 1962 song, the answers are blowin' in the wind. I hope this section will provide you with answers to some questions that you never thought to ask, but might wish that you had.

We inhale, and we exhale. We can blow hot or cold with the same breath. We ride in convertibles to enjoy the wind in our hair, but too much wind from a tornado can destroy a house, or an entire town. Sailors can sail their boat upwind, tacking back-and-forth and using their sails as airfoils to provide lift. A ferocious hurricane may be given a woman's name, while demure ladies endeavor to surreptitiously pass wind.

We will first delve into the importance of breathing, and the value of paying closer attention to how we are breathing. Next, we'll explore the many benefits conferred by moderate exercise, such as biking and running. Finally, we'll visit the gassy phenomena that manifest as eructations, borborygmi, and flatus. Don't look those words up now... I'll explain them later.

Sucking Wind

Although it may at first seem like I'm pointing out the obvious, let me call your attention to the vital sign known as breathing, something we check along with an airway and pulse before starting CPR. Inhaling and exhaling is something that we all do, provided we're not in a coma and need mechanical ventilation. Yet, breathing is something that most people take for granted, unless they're holding their breath while diving or having an asthma attack. We typically ignore the breath itself, along with the physical act of breathing, and simply allow the autonomic nervous system's autopilot to take over.

That inattention can create problems, because most people are unaware of the fact that they aren't breathing deeply enough. Except when engaged in strenuous physical activities, experiencing hypoxia at high altitudes, or mindfully practicing yoga or insight meditation, breathing deeply is something that typically just doesn't happen.

We need to distinguish deep breathing from rapid, shallow breathing, known as tachypnea, which can be caused by a variety of medical conditions, such as a pulmonary embolism, pneumonia, or diabetic ketoacidosis. Symptomatically, patients may feel like they are gasping for air. Adults exhibiting respiratory distress will have more than 25 breaths per minute at rest. Treatment often involves taking slow, deep breaths to stop the hyperventilation. Emergency treatment involves the administration of pressurized oxygen with a CPAP machine.

Oxygen, the colorless, odorless gas that makes up a fifth of the earth's atmosphere, is essential for human life. Without oxygen, most people wouldn't live for much more than three minutes. Compared to hypothermia, with an average survival time of three hours, being able to withstand dehydration for three days, starvation for three weeks, and, if you'll permit the hyperbole, live without love for three years, the need for oxygen seems pretty darn important in comparison. It therefore makes sense that we should be getting as much of that life-giving molecule as we can.

While living and practicing medicine in Hawaii for two decades, I often encountered the word, "aloha," used for greetings and farewells, and as an expression of affection. The word means "sharing the breath of life." When the up-tight, pale-skinned, shallow-breathing missionaries showed up in Hawaii, the natives thought they looked and acted like ghosts. They called them "haoles," which literally meant, "without breath." The term is now used derisively by locals to denote a "foreigner" who really doesn't belong there.

I'd like to invite you to give this breathing exercise a try: Sit comfortably and and place both your hands on your abdomen. Relax and drop your shoulders, then begin breathing slowly and deeply. Your abdomen should expand with each inhalation. This is how we should inhale all the time, especially if we don't want to breathe like haoles. Belly-breathing will maximize your intake of oxygen, and your brain will benefit from the experience. So, whenever you can remember to do so throughout the day, check in with your belly and see if you are fully alive and breathing properly.

In the website's next section we will look at paying attention to the breath as a meditative practice. A recent study showed that breathing helps to synchronize neural activity in cognitive areas of the waking brain, while previous studies have found that changes in breathing patterns are related to alterations in attention, arousal, and emotions. Respiration lies at the physiological mind-body intersection. This may explain how breathing exercises, or the conscious awareness of rhythmic breathing during meditation, can modulate cognitive and emotional states.

Cultivating mindfulness through regular meditation can have myriad psychological and physical benefits. However, one need not sit with eyes closed in formal meditation to reap its rewards. When you tune in to your breathing, anytime and anyplace, it helps to focus your attention in the present moment. Instead of being habitually lost in thought, "being here now" can enhance wellbeing and increase one's effectiveness in dealing with life's inevitable challenges.

Pushing Wind

As sparsely-haired, bipedal primates with an exquisite temperature-regulating system, we are literally born to run. Our prehistoric ancestors in Africa perspired easily, enabling them to dissipate body heat far better than the hairy game animals that they hunted. They tracked and pursued their quarry, running after it until the animal overheated and could run no more.

Our heart, lungs and legs are capable of carrying us great distances at a constant pace of about 10 miles an hour. From a health viewpoint, it is unfortunate that so few of us make use of that capability, relying instead upon mechanical forms of transportation. Recent studies have shown the myriad health benefits of moderate-intensity exercises such as jogging and running.

Exercise and Health

While aging is inevitable, atrophy is optional. In addition to a healthy diet, another key to a longer, healthier life is being physically active on a regular basis, investing sufficient time and effort in aerobic activities that will build endurance, and weight-bearing exercises that build strength, muscle mass, and reduce the risk of developing insulin resistance. Be sure to include other activities that can help with balance, coordination and flexibility, such as tai chi and yoga. Although outdoor activities confer additional benefits, low-impact aerobic activities such as pedaling a stationary bicycle and jogging on a treadmill will reduce the impact upon your joints while while exercising at home.

Walking for 30 minutes a day is one of the easiest way to enhance your health. Among its many benefits are greater physical fitness, improved endurance, more flexibility and coordination, better balance, stronger muscles, denser bones, and better cardiovascular health. Regular walking can help with weight management by burning calories, and reduce stress. It can also enhance immune system functioning that helps prevent a variety illnesses, and it has recently been shown to release factors that retard the growth of tumors. In some cases, exercise may play a role in fighting breast cancer.

People who exercise regularly tend to have more energy and increased stamina throughout the day, which reduces fatigue and increases productivity. It also helps to regulate sleep patterns and improve sleep quality. Walking outdoors with others is a great way to safely socialize. Join a local chapter of the Sierra Club and go on their hikes. Your mental health will benefit from those outings, as will the natural environment, especially if you can lower your carbon footprint by walking more and driving less.

Think of being able to engage in physical activity as a sure sign of life. Maintaining physical fitness throughout our lifespan will help us feel better and enjoy life more fully. Frequent physical activities enable us to derive the maximum benefits from the foods that we consume. Exercise may promote the formation of new brain cells and neural connections, and keep the endocrine system working properly.

Seniors take note: Even low-intensity exercises help to promote physical fitness during the aging process. Weight-bearing exercises can reduce your risk of osteoporosis. Strength training and aerobic activities have been associated with lowering the risk of cardiovascular disease, some cancers, and type 2 diabetes. While studies have shown that vigorous daily exercise can reduce all-cause mortality rates by as much as half, even moderate exercise for 15 minutes a day reduces overall mortality from any cause, and light exercise, such as walking as little as 8,000 steps once or twice a week, has been shown to produce significant benefits for all age groups, including people already at risk for cardiovascular disease.

Regular exercise appears to lower the risk of type 2 diabetes, even for those who are genetically susceptible. Research involving 59,325 U.K. Biobank participants, monitored via wrist-worn accelerometers over a period of up to seven years, demonstrated that an hour or more of moderate- to vigorous physical activity daily was linked to a 74 percent reduction in type 2 diabetes risk, compared to less active individuals, irrespective of their genetic risk.

Regular exercise can boost pain tolerance. In a large observational study of more than 10,000 adults, researchers found that those people who consistently engaged in moderate-to-vigorous physical activity over the 7- to 8-year study period reported the highest pain tolerance. The results showed that even light exercise was associated with greater pain tolerance. Exercise is now being prescribed for some people with chronic pain syndromes.

Exercise may also help with depression, according to a meta-analysis of 41 studies involving 2,264 people. It showed that almost any type of exercise substantially reduces depression symptoms. However, some forms of exercise seemed more beneficial than others, such as jogging and aerobic exercise programs. However, the small sample sizes of many of the included trials, as well as the high heterogeneity in study methods, means that further studies are needed before psychiatrists can confidently prescribe exercise as an adjunctive therapy.

Exercise and Weight Loss

To lose extra body fat, maintain a caloric intake that's appropriate for your ideal body weight based upon your size, and then expend an extra 300-500 calories per day in physical activities. Avoid calories that come from fructose, saturated fat, and alcohol, as much as possible. A daily routine that includes exercise and sensible eating can eliminate half of the illnesses typically afflicting people as they get older. Indeed, studies have shown that there is no medicine capable of improving health better than a healthy diet and regular physical activity.

An added benefit of vigorous exercise is that it promotes perspiration, which for most people is the only way for their body to get rid of excess salt. Most processed and packaged foods contain too much salt to begin with, and needing a salt shaker on the dining table practically guarantees you're consuming far too much sodium. Salt has been implicated as a contributor to the development of hypertension, heart disease, and strokes.

A liter of sweat averages about 1.8 grams of salt. People exercising in a hot environment might produce two to three liters of sweat an hour. Compensatory fluid intake should be one and a half to twice the volume of sweat lost. Keep in mind that too much sweating can result in electrolyte depletion, resulting in muscle cramps, nausea, dizziness, and fatigue, while drinking too much plain water can also be dangerous.

A small amount of tomato juice, which contains eight times as much sodium as Gatorade, makes an excellent "sports drink" and is much healthier than sweetened beverages. If you don't work up a sweat exercising, consider taking a sauna, steam bath, or soaking in a hot tub, especially if you, like most people, have been consuming excessive amounts of salt.

Exercise and Cognition

In a retrospective observational study, being physically active over a 30-year span of adulthood was associated with better cognitive function at age 69. The effect sizes were similar across all adult ages and sexes. When comparing those who were moderately active with those who were the most physically active, a strong relationship was found between sustained cumulative physical activity and better later-life cognitive function, in a dose-response manner. In other words, it appears that the more active one is, the greater the cognitive benefits. However, observational studies do not provide strong evidence, compared to interventional studies.

Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized, controlled trials (RCTs) involving sedentary individuals have been limited and their results inconsistent. A meta-analysis of seven RCTs indicated that physical activity might have a general positive effect on cognition. However, a careful independent review of 24 RCTs that reported a positive overall effect of exercise on cognitive function revealed a number of flaws due to low statistical power, selective inclusion, publication bias, and large variations in pre-processing and analytic decisions. The authors of the analysis concluded that claims about the cognitive benefits of physical exercise in a healthy human population must be made cautiously. As is often the case, further RTCs that survive peer review are warranted before reaching any conclusions.

A recent, large-scale, randomized trial found that neither exercise nor mindfulness training improved cognitive function in older adults who reported age-related changes in their memory, but had not received a diagnosis of dementia. The study involved 585 adults aged 65 to 84, who were randomly assigned to four groups: an exercise group, a mindfulness group, a combination of exercise and mindfulness, and a control group that received general health education. After conducting memory tests and brain scans at the start of the study, and again after six and 18 months, the researchers found no significant differences in cognitive performance or brain scans among the four groups.

Another recent study used DNA analysis and the powerful technique of Mendelian randomization, which uses the variation in genes of known function and applies them to epidemiological studies in order to look for potential causal relationships between modifiable exposures and a disease outcomes. This kind of randomization removes the limitations created by confounding variables and reverse causation that weaken observational studies. This particular study identified people who genetically had a greater likelihood of being physically active, and those with a greater likelihood of having better cognition.

Analyzing the genetic data of nearly 350,000 people of all ages, along with objective measurements of physical activity for about 91,000 of them, and collecting cognitive scores for almost 258,000 people, researchers found that those with a genetic predisposition to exercise typically did exercise and scored better on tests of thinking, provided that their exercise was at least of moderate intensity, such as jogging. The relationship between moderate exercise and better cognitive function was statistically strong enough to suggest causation, with the preliminary conclusion that the right kind of exercise could result in having a sharper mind.

The bottom line: While any amount of exercise can bestow myriad benefits upon the body, it is still unclear whether doctors should prescribe moderate to vigorous exercise as a way to ward off dementia. Yet, with all things considered, most humans would be far better off if they would get off the couch, put down the remote, pocket their smartphone, and become a lot more physically active. As always, before making any significant changes in your lifestyle, please check with your healthcare provider to make sure that you can exercise safely. If you can, then just do it!

Breaking Wind

Many of the digestive problems afflicting people in modern societies, such as constipation, irritable bowel syndrome, diverticulosis, and diverticulitis, can be attributed to an inadequate fiber (roughage) intake, as well as a lack of physical activity and poor bowel habits. Fiber plays an important role in keeping people healthy. It is also considered a prebiotic that benefits the gut microbiome, our diverse collection of commensal organisms that play a significant role in maintaining many aspects of our physical and mental health.

Dietary fiber also has a beneficial effect on how the body handles sugars and fats, substances that are implicated in the development of obesity, diabetes, and the metabolic syndrome. Fiber slows down intestinal absorption, giving the liver more time to detoxify fructose and saturated fatty acids. The only downside to increasing the amount of fiber in the diet is that it can cause an increase in flatulence (farting). However you look at it, the choice could eventually come down to whether you'd rather be fat or farty.

There are strategies for reducing the gas-producing effect (such as taking Beano), but it can't be avoided entirely. Most flatus is odorless, but some intestinal gas can include hydrogen sulfide, the rotten smell of which is the result of your intestinal microbes trying to help you digest the indigestible. While flatulence is not a disease, it could be a symptom of a lactose or gluten intolerance, a Giardia infection, or an intestinal disorder. It is perfectly normal for people to break wind 20-40 times a day, depending upon their intestinal flora and fiber intake, but who's counting?

Carbonated beverages and swallowed air also contribute to intestinal gas (flatus), as well as burps, belches (eructations), and abdominal rumblings (borborygmi). Probably the best strategy for dealing with a high-fiber diet is to change your attitude toward intestinal gas. Never mind all those fart jokes, and just break wind like you're proud of being a healthy eater.

The Institute of Medicine and the USDA Dietary Guidelines for Americans recommend that people consume at least 14 grams of fiber for every 1,000 calories of food they eat each day, and preferably more. Some nutritionists suggest that people consume at least 20 grams of insoluble fiber daily, a figure that's far above the amount in the typical American diet.

Although insoluble dietary fiber is a carbohydrate, it is not a significant source of calories. Insoluble fiber, along with adequate fluid intake, helps maintain normal bowel function. Insoluble fiber comes from foods such as whole-wheat flour, wheat bran, nuts, beans, and vegetables, such as cauliflower, green beans, potatoes, leafy vegetables, squashes, cucumbers, and celery.

Soluble fiber, found in fruits, vegetables, legumes and oat bran, reduces the glycemic effects of other foods consumed along with it. Oat bran is a particularly good source of soluble fiber, and your gut microbiome will love it. It has a low glycemic index, and decreases the glycemic response in people with type 2 diabetes. While hot oatmeal made from steel-cut oats is a very healthy way to start the day, most whole-grain breads, cereals, and crackers do not contain enough dietary fiber to justify their glycemic loads.

Dietary fiber should be increased slowly, gradually replacing low-fiber foods. Some medication dosages may have to be adjusted as one's diet is changed. Without a gradual introduction of fiber into the diet, intestinal distress could occur, with bloating, abdominal cramping, and excessive flatulence. However, once your microbiome adapts to your high-fiber diet, you'll wonder how you ever got along without it.