Category: Health

Rooted in ancient practices, the modern science of breathwork is revealing how a few minutes spent focusing on your breathing can not only bring an instant dose of stress relief, but also benefit your health in the long term.

Breathing is the first and the last thing we do in life. It’s a largely subconscious activity which our body carries out many times per minute in order to keep us alive and thriving. Yet an emerging realm of science is demonstrating that sometimes our bodies benefit from a little help to do it optimally.

This is the field of breathwork, an ancient art that has been practiced by different cultures for millennia. It ranges from techniques such as Indian pranayama, which looks to connect the mind and body by methods such as breathing through one nostril at a time, to Chinese qigong. 

The overriding theme is that a more mindful approach to breath control, even if carried out for just a few minutes per day, can help calm and relax the body, with both immediate and long-term benefits.

“I like to describe breathwork as an ancient practice that is resurging in the modern day as the new mindfulness hack,” says Abbie Little, a researcher in theoretical psychology and medicine at Griffith University in Australia.

Pregnant women or people with respiratory illnesses such as asthma or chronic obstructive pulmonary disease, should use caution before trying breathwork and consult with a medical professional. Both these groups have been excluded from previous breathwork or breathing exercise trials. However, there are thought to be many people who can potentially benefit.

A few small changes can help lower stress hormones in healthy people, while for those living with chronic health conditions such as inflammatory bowel disease, breathwork can improve symptoms and lower inflammation. For most of us, small tweaks to the rate, rhythm and regularity of breathing can make an immediate difference.

So how can you begin to reap the benefits? The BBC takes a closer look at the fast-developing science of breathwork – and breaks down five different breathwork techniques you can try yourself.

The science of de-stressing

There is a growing body of evidence that breathwork can offer a new way of managing stress. Chronic stress is a pivotal driver of many age-related disorders, along with mental health conditions like anxiety and depression. For people who are already battling illnesses such as breast cancer as well as other cancers, levels of stress hormones such as cortisol can worsen prognosis and accelerate disease progression, while research shows that it can also accelerate the ageing process. 

“We’ve studied cortisol levels in women with advanced breast cancer, and found that abnormal patterns of diurnal cortisol [the daily cycle of cortisol production], can predict how much longer people are going to live,” says David Spiegel, professor and associate chair of psychiatry and behavioural sciences at Stanford University in the US.

But while breathwork has a long and storied past, our modern understanding of the underlying science is only just beginning. One recent paper summarising the available evidence, noted that more than half of all studies on the subject have been published in the last six years, and Little says that researchers are still trying to pin down the precise methods and aspects which are most effective.

However, scientists have already been able to draw a number of conclusions.

Slowing down

To begin with, there is an emerging school of thought that many of us are breathing too quickly. “We all tend to hyperventilate, breathing too fast and not very effectively,” says Spiegel, with hyperventilation typically defined as taking more than 15 breaths per minute. Secondly, some people also predominantly breathe through their mouths, a habit which can begin in children before progressing into adulthood. (Read more about the benefits of nose breathing over mouth breathing.) 

Spiegel says that one of the benefits of breathwork is akin to hypnosis, meditation and other mind-body practices, requiring you to focus inwards and disassociating you from everything else happening in your life. When it comes to hypnosis, he says that the effects of this have even be seen on MRI scans, with one study showing that it tones down neural activity in the brain’s inner alarm system – a region known as the dorsal anterior cingulate cortex – which is activated by stress.

“There are different breathing patterns that are sometimes associated with some of the meditation practices,” he says. “The idea is that you’re being open to your body, you’re not fighting it.”

But breathwork’s secrets are not solely linked to providing our busy brains with a time out. There is also evidence that adapting our breathing, even temporarily, can improve regulation of the nervous system.

Training the nervous system

Back in 2000, a couple of American psychiatrists proposed a new model for the link between the heart, central nervous system and our emotional state. It centred around the autonomic nervous system, a network of nerves including the vagus nerve, which links the major organ systems and handles all unconscious bodily functions, from heart rate to breathing.

The autonomic nervous system has three distinct divisions. The sympathetic nervous system activates the body’s “fight or flight” response in high-arousal or dangerous situations, increasing adrenaline, blood pressure and heart rate. The parasympathetic nervous system triggers so-called “rest and digest” functions, calming the body and focusing on processes such as digestion and waste management. Finally, there is also the enteric nervous system, the several hundred million nerves embedded in the gut wall. 

According to Little, the learnings that have arisen as a result of that original 2000 paper have shown that there is a two-way relationship between breathing and the autonomic nervous system, which explains why shallow mouth breathing is suboptimal for our health.

“If we breathe through our mouths at a quicker, shallower pace, we activate the sympathetic nervous system that tells us we are under stress and there’s danger around,” she says. “Vice versa, if we breathe slowly and deeply through our nose into our belly, we activate the safe, and at-rest, parasympathetic nervous system.”

1. Cyclic sighing

One example of such slower, more intentional nasal breathing is cyclic sighing, which Spiegel describes as the type of breathing we do naturally when singing. In 2023, a randomised controlled trial compared various breathwork exercises to mindfulness meditation, with the results showing that just five minutes per day of cyclic sighing in particular, elicited significant improvements in mood and anxiety over the course of a month.

Spiegel says that one of the likely reasons is because cyclic sighing involves a prolonged exhalation of breath. He points out that the typical advice we give for stress, of taking a deep breath or inhalation, isn’t actually that helpful. “If you’re just inhaling, that’s the wrong thing to do,” he says. “Because when you inhale, you’re reducing blood flow and oxygen, and the heart gets a signal to pump harder. While when you’re doing a nice, long, slow exhale, you’re forcing air out, as well as pushing blood out into the anterior chambers of the heart, and you get a stimulus saying, ‘Slow down.’”

Cyclic sighing begins with two consecutive inhales through your nose. Begin by taking a deep breath in through your nose, and then at the top, take a second, shorter inhale of air to fully expand your lungs. Then, slowly exhale all the air through your mouth over several seconds until your lungs are empty. Spiegel advises repeating this pattern for around five minutes. 

The more you practice cyclic sighing, you will also strengthen your diaphragm. “That allows you to really fill your lungs, and carry out a longer, slow exhale which gives your body that period of more parasympathetic [nervous system] control,” says Spiegel. 

2. Box breathing

Other breathwork techniques attempt to control stress by improving regulation of the autonomic nervous system through the rhythm of your breathing. Box breathing, for example, is about striking a rhythm where you’re inhaling, holding your breath, exhaling and holding your breath again, each for roughly the same amount of time. It’s something which Spiegel says can promote both relaxation and focus ahead of a potentially stressful task. Studies have also suggested that box breathing can help manage chronic pain, while in a trial among women with breast cancer who had undergone mastectomies, it helped manage their stress levels.

Matching the rhythm of your breathing with other bodily functions may also be key to stress reduction. Guy Fincham, who leads a breathwork research lab at Brighton and Sussex Medical School in the UK, says that there’s particularly strong evidence for the benefits of slowing down your breathing to the extent that you’re taking less than 10 breath cycles per minute. “This rhythm of breathing, found widely in traditions such as yoga, qigong, prayer and mantra, is commonly referred to as coherent breathing,” says Fincham. 

The coherent breathing pattern is thought to synchronise breathing with the natural oscillations of the heart and blood pressure, something which is thought to have profound benefits for heart rate variability, the variations in time between each heartbeat. Fincham says that increasing heart rate variability is thought to be indicative of a better stress response and a more flexible nervous system, while it may even help reduce inflammation. (Read more about why you should be paying more attention to your heart rate variability.)

“In general, a higher heart rate variability can be deemed more beneficial, and coherent breathing helps to optimise this,” says Fincham.

A preparatory technique which the Navy Seals practice before going into action, box breathing can both calm the nervous system ahead of a high-pressure situation, and also improve concentration. 

It involves four steps – inhaling, holding your breath, exhaling and then holding again – carrying out each step for four seconds at a time. “It doesn’t particularly trigger comfort,” says Spiegel. “It’s more kind of arousing. You’re preparing your body to go and do something.” 

3. 4-7-8 breathing

This technique, which is used in clinical practice to help alleviate anxiety and support stress management, focuses on a simple pattern of inhaling, holding and then exhaling. Like cyclic sighing, it also emphasises a slow exhalation. 

One study which took people who had undergone bariatric surgery and specifically trained them in the 4-7-8 breathwork technique, found that they had significantly less anxiety compared with those who merely did deep breathing.

It involves initially inhaling for four seconds, then holding your breath for seven seconds, before finally exhaling for eight seconds.

4. Coherent breathing

Because this is a slightly more advanced technique, Fincham recommends beginning by finding a comfortable position, either sitting upright in a chair with your feet flat on the floor or lying down on your back. Rest one hand on your belly, and one on your chest to help you monitor whether you’re breathing more deeply or shallowly.

Then either close your eyes or lower your gaze and take two to three normal breaths to settle in. Start breathing through your nose and consciously direct the breath downwards to engage your diaphragm, so that the hand on your belly rises first, and slightly further than the hand on your chest.

Fincham says it’s important to keep your breathing smooth, resisting the urge to gulp air at the start of the inhale or push air out forcefully at the end of the exhale. “The breath should feel continuous and wave-like, no sharp edges,” he says. “Imagine your breath as a slow tide coming in and going out.”

Then try to establish a rhythm. Fincham suggests using an app or soundtrack to help you inhale slowly for five seconds then exhale for five seconds with no breath holding. This pattern will ensure you’re taking approximately six breath cycles per minute. If this feels too challenging, start by inhaling and exhaling for fewer seconds, and gradually build up to five seconds over several sessions. 

“With increasing familiarity, it will become easier to move towards a more regular rhythm, for example by mentally counting the duration of each inhalation and exhalation,” says Andrea Zaccaro, a psychology and breathwork researcher at the University of Chieti-Pescara in Italy.

5. A52 breath method 

This is similar to coherent breathing, except for a slight tweak. It involves breathing in slowly for five seconds through the nose, deep into the belly, and then immediately exhaling slowly for five seconds. However, at the end of the exhale, you then gently hold your breath for two seconds before going again.

As with coherent breathing, it can take time and practice to get used to. “If you are used to unconsciously breathing quickly, it can be difficult or uncomfortable at first due to the low number of breaths per minute and unfamiliarity,” says Little. “I believe the most important aspect of any breathing technique is the exhale – expel all the air first and this will open you up to be able to take in enough air.” 

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But whatever your breathwork method of choice, the most important thing is simply to do it consistently, even if that’s just for a small amount of time each day, with studies showing that anywhere between three and five minutes can have a measurable benefit.

Even if you’re not attempting to master a particular technique, Little says that we can all improve the regulation of our nervous systems simply by spending a small amount of time focusing on adjusting our everyday breathing. “Breathe gently through your nose and into the belly, it should be quiet and soft and slow,” she says. “This will change your life immediately for the better, and because you breathe so often, it is a practice that will take effect quickly.”

Whether you’re an overthinker, prone to anxious feelings, or simply weighed down by the pressures of work or family, breathwork represents a toolkit which we can all use to handle the stresses of life more acutely.

Sociologist Leah Ruppanner talks to BBC senior health correspondent Melissa Hogenboom about why women are still taking on most of the cognitive burden of running a household, and why understanding the different types of this mental work is key to reducing burnout.

In today’s fast-paced world, many women find themselves grappling with an invisible yet overwhelming burden known as the mental load. This is the often unrecognised mental work required to keep a household and family life functioning – from organising childcare and planning healthy meals to researching fun activities. 

Leah Ruppanner, a professor of sociology at the University of Melbourne in Australia, and author of the book Drained, explains that there’s not one form of mental load, however, but eight different types. From “magic making” to “meta-care”, she says many of these are “boundaryless” and enduring. While men are taking on more at home, women are still overwhelmingly burdened by this hidden work, which can often result in burnout.

But it doesn’t have to be this way. When we recognise that sharing this mental work benefits our health, wellbeing and relationships, it could also help encourage more couples to advocate for a more balanced relationship.

In the interview below, she speaks to BBC senior health correspondent Melissa Hogenboom about how societal expectations and norms contribute to the mental load. 

First of all, Leah – there’s now a lot more awareness of the mental load, so how do you define it?

It’s when your thinking has this emotional layer, that’s why it’s so draining. It can sometimes bring you positive emotions when things go well, but the mental load can be the opposite – it can be emotional thinking work where you’re constantly ruminating and it doesn’t have an end. You don’t take your washing with you on the walk around the neighbourhood, but you’re taking that mental load with you.

You’ve now done hundreds of interviews to identify eight different types of mental load, what are they?

What kept showing up was that women would describe their load as invisible, boundaryless and enduring and it was burning them out. I felt like we needed to get a handle on what it was so that we could help people start to lighten it, so here are the eight categories I came up with:

1. Life organisation

This is probably the most traditional understanding of the mental load, which simply refers to staying on top of planning tasks – all that invisible work needed to ensure the home is running smoothly.

2. Emotional support

This is when you’re doing emotional thinking to make sure you’re checking in on family, friends or co-workers. It also involves noticing others’ moods and providing emotional support during big or small moments.

3. Relationship hygiene

Maintaining strong social connections with your children, friends, partner and extended family. At work you might refer to it as networking – but mostly it’s the work of making sure everyone feels connected and loved. 

4. Magic-making

The emotional thinking about carrying on traditions and creating special life moments. Think about who creates the “magical moments” at Christmas and who does all the work to make that happen.

5. Dream-building

This relates to the work required to make sure everyone close to us is finding the right opportunities to fulfil their passions and ambitions. This might involve signing your children up to their ideal hobbies or ensuring your partner gets time to play golf or devote long hours to his career. 

6. Individual upkeep

Think self-care but more – this load is about whether you are keeping fit and healthy to maintain or promote optimal physical and mental health – as well as presenting that image to others.

7. Safety

This involves thinking about whether your loved ones and community are safe in real and hypothetical ways. It’s also worth recognising that certain parents carry heavier mental loads related to safety – people of colour and families in the disabled community for instance. This can involve a constant worry about their own and their families’ safety.

8. Meta-care

This is a little bit more abstract but relates to thinking about whether you’re working on creating the world in which you want to live in or whether you need to do something different. This involves thinking about your responsibilities within that domain and requires big-picture thinking to make sure we are living our lives in ways that align with our values. It’s parenting in the way we want to parent, for instance.

Why is this such an important area of study?

I started studying the mental load in part because I felt like there was this thing that we weren’t capturing. So I’ve studied gender, work, family, housework and domestic divisions for decades. And even though we kept seeing that men were doing more at home – we kept seeing this movement towards progress – there was this thing that just wasn’t working, this thing that we weren’t capturing, that we weren’t measuring. That thing is the mental load. What I was determined to do was give us a clear understanding of what it is.

Just how drained were the women you spoke to?

I developed a mental load burnout scale where I actually asked women, do you find it difficult to access energy to respond to life’s emergencies? Do you find your mental load “spending” makes you tired at the end of the day? Do you find you’re overtaxed? 

One of the things that came through was that fathers had capacity and weren’t running a deficit but almost every single mother I talked to was. They were holding enough energy in their “mental load account” to respond to an emergency if something went wrong but when I asked: “do you have enough energy to respond to an opportunity in your life” they said no. 

And how can we reduce this mental overwhelm?

For starters, we need to recognise that it’s very valuable to feel your feelings, but you’re not responsible for everyone else’s feelings or for creating a perfect family. You are not responsible for creating a perfect world. I think getting very clear on the idea that many of us women have been socialised from birth to be kind, polite, caring, deferential and giving to others at the expense of yourself. Also, let’s stop putting the ice on men’s feelings. Let’s stop telling women that they have to be responsible for everyone else’s feelings at the detriment of themselves.

When we think about empowering women, it isn’t just for their benefit, but for all of us

Let’s make sure that we’re identifying when we’re doing too much. When do you really need to step in and give emotional support and when you don’t. If we can get a little clearer that we don’t act on default or the way we’re told we should act, but actually be a bit more strategic. For instance, I always say to my daughter: “You can make the choice right now whether you’re going to actually increase your energy or increase your emotion, but is it worth it?”

What should we take away from your research?

First, stop feeling so guilty and responsible for everything. I ran this pilot study where I gave women money to reduce their mental load and I found that it was so hard for many of those women to spend that money on themselves. What they wanted to do was give that money to the family to make everyone else’s life better. They felt so guilty about taking it for themselves.

So, we have basically socialised women to feel like they should be at the bottom of the list and then any investment in themselves once they become mothers is at the expense of their children. What a ridiculous lie we’ve been told.

More like this:

• How ‘thinking of everything’ holds mums back

• Why women are doing a hidden form of work

• The myth that women are more naturally empathetic than men

After a while though – and after spending the money, their mental load stress lessened. Did it solve all of their problems? Of course not! But it did lighten their loads a bit, and more importantly, they each experienced a valuable mindset shift and realised the importance of prioritising themselves.

One woman I gave money to, Katrina, spent it on a weekend away – and by being absent she wasn’t thinking about the household. She told me that the money helped her live in the moment rather than fixating on additional expenses. When she returned home her partner had made sure the house was cleaned, the fridge stocked and laundry put away.

Once we get clear on our mental load spending [where we spend mental energy on], we can use our mental load strategically. Sometimes we need to outsource help to get there. Sometimes we need selfcare, sometimes both. 

And actually, what the research shows is that the more empowered women are and the more educated they are – this gives them more access to the labour market and then in turn, they have more equal divisions of housework. Their relationships are better and men do better.

So when we think about empowering women, it isn’t just for their benefit, but for all of us.

* Melissa Hogenboom is a senior health correspondent at the BBC and author of Breadwinners (2025) and The Motherhood Complex.

The outbreak of Ebola in the Democratic Republic of Congo is concerning.

It has been spreading for weeks undetected in a part of the world where civil war makes getting on top of the virus difficult, and the species of Ebola involved is rare, so there are fewer tools to stop a virus that kills around a third of people infected.

This is a critical moment in an outbreak where there is uncertainty about how far it has spread, but there are already almost 250 suspected cases and 80 deaths.

Most Ebola outbreaks tend to be small, but specialists are haunted by the 2014-16 outbreak. Then, 28,600 people in West Africa were infected in the largest ever outbreak of the disease.

The declaration of a public health emergency of international concern by the World Health Organization (WHO) does not mean we are in the early stages of a Covid-style pandemic.

The risk Ebola poses to the whole world remains tiny.Even in the 2014-16 outbreak, there were only three cases in the UK and all were healthcare workers who had volunteered to help.

“But it does reflect that the situation is complex enough to require international coordination,” says Dr Amanda Rojek, from the Pandemic Sciences Institute at the University of Oxford.

After all, there is still a significant threat to neighbouring countries like Uganda, South Sudan and Rwanda, considered high risk because of close trade and travel links.

Two people have already been confirmed to have the virus in Uganda, of whom one has died.

WHO declares Ebola outbreak in DR Congo an international emergency

Ebola is a severe and deadly disease, although it is thankfully rare. Ebola viruses naturally infect animals – mainly fruit bats – but people can become infected if they come into close contact.

This outbreak is being caused by the Bundibugyo species of Ebola – it is one of three species known to cause outbreaks but is relatively unfamiliar.

Bundibugyo has caused only two outbreaks before – in 2007 and 2012 – where it killed around 30% of people infected.

Bundibugyo poses a series of challenges. There are no approved vaccines or drug treatments for Bundibugyo, although there are some experimental ones, unlike other species of Ebola virus.

And tests to determine whether somebody has the infection do not appear to work well. Initial results in the outbreak were negative for Ebola virus, and more sophisticated laboratory tools were required to confirm Bundibugyo was involved.

Dealing with Bundibugyo is “one of the most significant concerns” in this outbreak, says Prof Trudie Lang from the University of Oxford.

Symptoms are thought to appear between two and 21 days after somebody is infected.

Initially they are like developing the flu – fever, headache and tiredness. But as Ebola progresses, it leads to vomiting, diarrhoea, and the body’s organs not working. Some patients develop internal and external bleeding.

With no approved drugs designed to target Bundibugyo virus, treatment relies on “optimised supportive care” including managing pain, other infections, fluids and nutrition. Early care improves the odds of surviving.

Ebola spreads through infected bodily fluids such as blood and vomit, although this does not normally occur until symptoms have appeared.

The first known case was a nurse who developed symptoms on April 24. It has since taken three weeks to confirm an outbreak is happening.

“Ongoing transmission has occurred for several weeks, and the outbreak has been detected very late, which is concerning,” said Dr Anne Cori from Imperial College London.

It means health officials are behind where they would like to be in stopping the outbreak, which the WHO says points towards a “potentially much larger outbreak than what is currently being detected and reported”.

The main method will be rapidly identifying who is infected, and to whom they may have passed the virus.

There will also be efforts to prevent Ebola spreading through hospitals and other treatment centres, which will be dealing with patients when they are most infectious. And to ensure anyone who dies and whose body remains infectious has a safe burial.

This will be a challenge due to the number already infected, and made worse as it is taking place in a conflict-torn part of DR Congo that has more than 250,000 people displaced from their homes.

“Many of the affected areas are mining towns with highly mobile and transient populations. This mobility increases risk as people move between communities and across borders,” says Lang.

However, DR Congo does have extensive experience in dealing with Ebola outbreaks and the response is “significantly stronger today than it was a decade ago”, says Dr Daniela Manno from the London School of Hygiene & Tropical Medicine.

Whether this outbreak can be quickly contained or spirals into a repeat of what happened just over a decade ago will be determined by the response now.

Small increases in physical activity as part of our daily lives can bring long-term benefits to our health.

Some mornings, I really struggle to go out for a jog, but I force myself because I know it will be good for me. The protective effect that exercise can have not only the body, but our brain, memory and general wellbeing is something I’ve spoken to researchers a lot about recently.

But what has also become clear is that we don’t need to be doing intense workouts to see benefits.

New research shows that even small increases in activity can have a powerful impact on health and longevity. Just five minutes of moderate activity each day – such as brisk walking, cycling or climbing stairs – could prevent around one in ten premature deaths, which could help millions of individuals live longer.

While this doesn’t mean that just doing five minutes of exercise is enough to ensure you stay healthy, it is an indication that compared to doing nothing, this small increase in physical activity can bring improvements to overall health. For those who are already pretty active or relatively fit, doing five minutes more exercise will have a smaller effect.

But it shows the power of doing even just some very basic forms of exercise.

“Physical activity is something that is really beneficial for preventing high stress rates and high burnout rates,” says Nicole Logan, an assistant professor of kinesiology from the University of Rhode Island in the US. “We know that physical function, muscle strength, muscle quality, bone strength, these are really good predictors of later life mortality. So living longer and living healthier for longer.”

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Increasing lifespan

The new research involved a large-scale analysis of data from 150,000 adults in the UK, US and Scandinavia.

“It was surprising that very small changes in physical activity of five minutes per day have such a large impact on reducing the risk for premature mortality,” says Ulf Ekelund, lead author of the research and a professor of physical activity and health at the Norwegian School of Sport. The findings reveal the health benefits of doing five minutes of exercise across the whole population rather than on an individual level, he says.  

Adults should still strive for the World Health Organization’s recommendation of 150 minutes of moderate-intensity exercise a week, Ekelund says. But the study shows that those who might struggle to go to the gym or join a sports club, can still benefit from adding more movement into their lives.

Reducing inactivity was also found to be beneficial. Cutting daily sitting time by 30 minutes was linked to a 7% reduction of early death across the population. This is especially important because physical inactivity is a leading cause of chronic disease and an earlier death.

Ekelund says that consistency is key. “Start slow and gradually build up the amount,” he says. The activity should be tailored to the individual’s preferences and ability.”

Exercise snacking

The study builds on many others that show how long-term health benefits from exercise do not require us to radically change our lifestyle. Simply adding movement into our daily life can have an outsized effect.

Muscle strengthening activities have also been shown to be beneficial. One US study found that individuals in their 60s and 70s who combined aerobic exercise with muscle-strengthening activities lived longer and had a lower risk of dying compared to those who did no exercise.

Other recent work shows that “exercise snacking” – which consists of short bursts of activity spread throughout the day – can improve heart health. A large authoritative analysis of existing research found that among older adults, it also helped with muscular endurance. Uptake was high too, with over 82% of participants continuing to take part, most likely because exercise snacking is easy to “integrate into daily routines”, the authors note. (Read more about how short bursts of activity can help you live for longer.)

Unlike a gym session, these “snacks” can be spread throughout the day as part of your normal routine. This can include anything that gets your heart rate up – be it vigorous hoovering, dancing to a song in your kitchen or running up and down your stairs faster than normal.

As Marie Murphy, professor of exercise and health at Ulster University in the UK, told the BBC’s Just One Thing podcast, smaller chunks of exercise increase how often we are stimulating our metabolism. “When we stop exercising, our metabolism keeps going a little bit quicker while we recover,” she said. “You still have that metabolic mill turning.”

Benefits of habit

Research shows that people respond positively when they are made more aware of the health benefits of exercise snacking, and that it could help address barriers to exercise.

Simple prompts can make a difference. Signs encouraging people to take the stairs instead of the lift or escalator, for example, can lead to more of them to do so.

According to Amanda Daley, professor of behavioural medicine at Loughborough University in the UK, it’s these small shifts that build meaningful change over time. “We just have these unconscious ways of doing things that mean that we’re more likely to do it,” she says. “You take the stairs because that’s you’ve learned. It’s a habit.”

Similarly, Daley suggests that a simple way to decrease sedentary behaviour is to park the car at least five minutes from your destination. She calls this type of approach “snacktivity” and in a small study, she and colleagues found that participants were receptive to the idea, finding it easier to implement than longer bouts of exercise.

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Or take walking. We can benefit from fewer steps in a day than is commonly believed, as the BBC has previously reported. One step-count study found that taking 2,517-2,735 steps per day reduces cardiovascular risk by 11% compared to taking only 2,000 steps.

When it comes to how you exercise, there are numerous options. You could go rock climbing, join a dance class or try some something a little more vigorous like high-intensity interval training, which can improve blood sugar control and blood pressure, as well as reducing body fat. 

I’ve certainly had sore arms when carrying food shopping home instead of taking the car. But it seems that discomfort can be worth it.

So next time you’re waiting for your pasta to boil or watching TV, perhaps include a set of squats, leg kicks or press ups. These little “exercise snacks” all add up. They are certainly “snacks” you won’t ever need to feel guilty about.

While it’s widely known that chewing more improves digestion, research suggests it can also boost our brains and even help fend off Alzheimer’s.

For once chewing a shallot 722 times before swallowing it, Horace Fletcher was dubbed “The Great Masticator”. The American self-taught nutritionist believed food should be chewed “until it is completely liquefied” and it “practically swallows itself”. Fletcher even estimated that vigorous chewing could have saved the US economy of the early 20th Century more than half a million dollars a day (roughly $19.5m in today’s money), because the average person would have ingested half a pound (227g) less food daily.

Fletcher’s doctrine may have been a little extreme, “but in some aspects, he was actually right”, says Mats Trulsson, professor in the department of dental health at the Karolinska Institutet in Sweden.

Chewing more can provide a wide range of health benefits, from improving digestion and helping people consume fewer calories to alleviating stress and anxiety and improving cognition by solidifying memory skills and boosting attention span. As there is a correlation between tooth health and Alzheimer’s disease and dementia, some experts argue that improving patients’ dental health could even help reverse mental ageing.

The prehistory of chewing   

Like most animals, humans have “had teeth and jaws for millions of years,” says evolutionary and ecological biochemist Adam van Casteren at the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany. But they’ve gone through many changes throughout prehistory.      

The earliest hominins, who lived roughly six to seven million years ago, had teeth similar to those of apes today; especially helpful for eating “lots of large, fleshy fruit” abundant in the forest habitats that our early ancestors lived in, says Van Casteren. But as rainforests gave way to more woodlands, open habitats and even savannah-like ecologies, hominins had to contend with “more mechanically challenging foods”, says Van Casteren, such as seeds, nuts, and tubers. So they evolved to favour an increase in molar size, with bigger jaws and faces to house all those teeth, alongside the larger muscles needed to power them.

The theory is that chewing works like a pump, pumping blood to the brain – Mats Trulsson

With the development of tools, food processing, and agriculture, as well as fire to cook food, we also stopped needing such lengthy bouts of mastication, explains Van Casteren. Today, humans spend roughly 35 minutes chewing every day, compared to 4.5 hours for our closest ape relatives, chimpanzees and bonobos and 6.6 hours for gorillas and orangutans.

Despite these evolutionary changes, the purpose of chewing remains the same. “We mammals are such complicated chewers because we want to get as much energy out of our food to power our warm-blooded metabolisms,” says Van Casteren.

An important first step

At the most basic level, chewing breaks food down into small particles and moistens them with saliva so that they can be easily swallowed. “It’s the first phase of digestion,” says Andries van der Bilt, a pioneer in the field of oral physiology and chewing, who worked as a researcher at the University Medical Center Utrecht in the Netherlands for over three decades.

Not only does chewing increase saliva production and the amount of digestive enzymes like amylase that help break down food, it also triggers the gut and pancreas to secrete juices that will help process food further, too. “If you don’t chew, the gut is not prepared to handle food,” says Trulsson.

The act of breaking food particles into smaller pieces also increases their surface area, which means digestive juices can act on them more efficiently, says orofacial neuroscientist Abhishek Kumar, who works with Trulsson at the Karolinska Institutet. This is important for gut health. Bigger particles tend to linger in the gut longer, giving microorganisms more time to ferment them. This causes “feelings of bloatedness, fullness, constipation, and other symptoms”, Kumar says.

Improving absorption and feelings of fullness

The act of chewing helps release nutrients in food, allowing our bodies to absorb them more effectively. In a 2009 study, for instance, 13 healthy adults were asked to chew a small handful of almonds 10, 25, or 40 times. When researchers collected samples of participants’ poo, they discovered that the more people chewed, the less fat they excreted, suggesting that the absorption of energy from the nuts was up to a third higher. (In the early 1900s, in fact, Fletcher believed chewing more helps produce poo of superior quality – “quite dry” and smelling of a “hot biscuit”.)

What’s more, chewing 40 times left participants feeling fuller for longer. A separate 2013 study echoed this satiety link: when 21 participants chewed a chicken-nugget sized slice of pizza either 15 or 40 times before swallowing, those in the latter group experienced a significant reduction in hunger. They also had higher levels of CCK and GIP, two hormones that coordinate digestion in the gut, alongside suppressed levels of the “hunger hormone” ghrelin.

Fletcherism

So-called “Fletcherism” became a curious diet fad that swept through parts of Europe and the US in the 1900s and was practised by many notable figures. Some Asian cultures also espouse good chewing, including traditional Chinese medicine. Japan’s health authorities once even introduced a Kamingu 30 campaign, encouraging citizens to chew every bite 30 times before swallowing.

Chewing more means you’re also likely to consume less food, according to two separate meta-analyses that reviewed nearly 50 studies.

That’s because it takes around 20 minutes for the body to adjust its production of hunger-related hormones and send signals to the brain that you’re full – and chewing buys you more time. It’s one reason why so many dieticians and doctors advocate slow and mindful eating over wolfing down a meal, especially if you’re trying to shed some pounds. A survey of 92 children in Brazil found that those who were obese “performed fewer mastication sequences and ate faster” compared to children of normal weight. 

One good way of slowing down your eating rate, in fact, is to eat more textured foods. Many studies recommend choosing solids over liquids (think oranges rather than orange juice), and high-viscosity foods over low-viscosity ones (oatmeal and flaxseeds instead of white rice or pasta).     

“The texture of food can affect how full we feel, and therefore potentially help those struggling with obesity to lose weight by reducing their food intake,” says Kumar.

A boost for brain health

Nutrition and digestion aside, researchers are increasingly uncovering that chewing plays an important role in other aspects of our wellbeing – especially brain health – as we get older. “There is growing interest in the ‘bite–brain axis,’ which proposes that mastication is directly linked to brain health,” says Kumar. Tooth loss, for instance, has also been linked with a higher risk of Alzheimer’s disease and dementia. 

Wouldn’t it be really cool if you can rehabilitate the brain by rehabilitating the dentition? – Mats Trulsson

Memory is affected, too. In a survey involving more than 28,500 people older than 50 across 14 European countries, participants with good chewing ability or those without dentures performed better on a battery of cognitive tests. They demonstrated significantly better word recall, verbal fluency, and numeracy skills than those with chewing problems. In one study of 273 healthy people between the ages of 55 and 80, scientists found that those who retained a greater number of their natural teeth had better semantic memory (linked to knowledge and facts of the world) and long-term memory. 

But why does chomping ability have anything to do with memory? Some researchers point to the multiple neural circuits connecting our chewing apparatus to the hippocampus – the region of the brain responsible for spatial learning and making new memories, which is one of the first to be damaged by Alzheimer’s. Others suggest that chewing, especially moderately hard substances, may increase blood flow to the brain, as Japanese researchers demonstrated in experiments with gum chewers. “The theory is that chewing works like a pump, pumping blood to the brain,” explains Trulsson. This keeps the brain sharp and working well, he says. 

To determine whether poor chewing ability can actually cause cognitive decline, and whether rehabilitation is possible, Trulsson’s team is currently running an experiment replacing patients’ missing teeth with implants and then studying their brain function before and up to a year after the procedure. MRI brain scans will also be used to examine if white matter lesions, a marker of poor brain vascular health, shrink with treatment.

“Wouldn’t it be really cool if you can rehabilitate the brain by rehabilitating the dentition?” says Trulsson, who has recruited over 80 patients for his trial so far.

Heightening alertness

In some instances, chewing has also been found to improve concentration in the general population. One meta-analysis, comprising 21 studies, detected a weak but statistically significant improvement in attention levels of gum-chewing participants compared to non-chewers during some cognitively demanding tasks. (This research was funded by gum manufacturer Mars Wrigley, suggesting a potential conflict of interest.)

In an unrelated study of 80 participants, chewing improved alertness levels by 10% during a series of cognitive tasks. Gum-chewers also performed better on an intelligence test.

Scientists “don’t really know exactly how it works,” but the link between chewing and heightened attention is fairly strong, says Trulsson. There’s a caveat, though: “The effect will probably not last for more than 15 to 20 minutes“, although researchers aren’t sure why.

Another experiment – in young adults who were asked to perform four computerised tasks simultaneously – also found significantly better alertness (nearly 20% higher) in gum chewers. Interestingly, this was accompanied by reductions in self-reported anxiety, stress and salivary cortisol levels (a common biomarker of stress).

Lowering stress

Outside the lab, chewing is a good stress-reliever too. When a group of Turkish researchers studied 100 nursing students preparing for mid-term exams, they found that students who chewed gum for at least 30 minutes daily experienced lower levels of stress, anxiety and depression. This was regardless of whether they began chewing gum 15 days or two days before their exams.

For two separate groups of women undergoing elective gynaecological surgery in Korea, chewing on gum helped alleviate their pre-operative anxiety. It also had this effect on 73 Turkish children who were having an intravenous cannula inserted.

Chewing seems to be a natural reflex in stressful times, says Jianshe Chen, an oral processing researcher at Singapore’s Agency for Science, Technology and Research. “When some people are stressed, they start to chew unconsciously.” Teeth grinding or bruxism, which uses the same jaw muscles as chewing and affects roughly one in 10 adults, is commonly triggered by stress and anxiety.

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But the scientific data here is more contentious. Chen, for instance, says the evidence linking chewing to a calmer state of mind is “scattered”. We’re “still short of systematic studies” that confidently point to a strong association, he says. Another study, led by the same Korean researcher above, for instance, found that gum-chewing did little to alleviate the anxiety pregnant women felt as they were wheeled into the operating theatre for an elective caesarean section. It also failed to dent the stress levels of those working on an insolvable word puzzle.

One thing’s for sure, though – eating often elevates our mood. And chewing, a crucial part of this process, releases flavours in food, and combined with texture and aroma, makes “your eating experience much richer and more pleasant,” says Chen, who also studies the sensory perception of food. So, according to this logic, chewing your food better could boost your mental health, too. But rather than choosing sugary gum, you might want to consider chewing a healthy, textured snack before a stressful task.

Don’t overdo it, though. Unlike Fletcher, most experts don’t think there is a magic number for chewing. “Chew in a normal way until you feel it’s okay to swallow, which will be different for different people,” says Van der Bilt. “Just enjoy your food.”

Can the right foods really improve your chances of having a baby? Here are the facts.

Visit any online fertility chat room, and one of the main topics of debate will probably be what to eat to maximise your chances of conceiving. In addition to the wealth of supplements promoted as being fertility-boosting, there is also an array of foods that are supposed to help achieve a healthy pregnancy.

Amid all the myths and marketing, what is the actual evidence for using certain foods to enhance male and female fertility, and support the developing fetus?

For a start, when it comes to supporting a healthy pregnancy and fetus, certain nutrients really can make a difference – such as folic acid. When taken before and during pregnancy, it has been shown to help prevent both anencephaly, a birth defect of the baby’s brain, and spina bifida, which affects the baby’s spine.

Because these defects develop very early in the pregnancy, often before a woman knows she is pregnant, the US Centers for Disease Control and Prevention recommend that all women of reproductive age take 400 micrograms (mcg) of folic acid each day. Fortifying staple foods such as cereals with folic acid may offer even more powerful protection, because many pregnancies are unplanned. It is estimated that, in 2019, effective fortification programmes prevented 22% of potential cases of folic-acid-preventable spina bifida and anencephaly, worldwide.

Folic acid may have an additional benefit: when taken as a supplement by women trying to conceive, it may increase the chance of getting pregnant, though there is a need for further trials to confirm this.

What about other foods and supplements? Is there such a thing as a “fertility diet” that will maximise your chances of conceiving?

A study of couples undergoing IVF found that men’s meat consumption, and especially the type of meat they ate, affected the outcome

To answer that question, it helps to break down the main reasons for infertility. In the United States, after one year of having unprotected sex, 15% of couples are unable to conceive. There are many potential causes. On the female side, the ovaries may be unable to produce healthy eggs, or the egg may not be able to move from the ovaries to the womb – for example, due to blocked fallopian tubes. Even if the egg makes that journey successfully, it may then not attach to the lining of the womb, or not survive once it has attached.

On the male side, the quality of sperm cells is crucial for fertility. This includes their ability to move efficiently (motility), their shape and size (morphology), and how many there are in a given quantity of semen (sperm count). A range of factors can threaten sperm quality, including environmental problems such as pollution (read BBC Future’s report on the global decline in sperm quality). Even after tests, the cause of infertility may not always be clear: about 15% of infertility cases remain unexplained.

While no individual food or supplement will be a quick fix for any of these potential issues, experts say diet can play a beneficial role throughout the process of trying to conceive and beyond.

Most obviously, being well-nourished is crucial. The consequences of malnutrition can be devastating for prenatal health.

Arguably the best-known findings in this area come from a study of babies conceived during the so-called “Dutch Hunger Winter” of 1944; an eight-month famine that occurred when the Nazis cut off food supplies into the Netherlands at the end of World War II. The mothers-to-be were surviving on only 400 calories a day, a fraction of the intake necessary for a healthy pregnancy. The babies conceived during that time faced a range of adverse health consequences, including being shorter and thinner than those born before or after them, and having smaller heads. As adults, they had higher rates of obesity, diabetes and schizophrenia, and tended to die younger.

For those who do have access to sufficient food, it is still important to obtain the right mix of nutrients. While discussions around beneficial foods often focus on female fertility, there has been a growing awareness of how diet can also affect male fertility.

A 2015 study of couples undergoing IVF found that men’s meat consumption, and especially the type of meat they ate, affected the outcome, as measured by fertilization rates. Eating more poultry had a positive impact on fertilisation rates, whereas eating processed meat (such as bacon and sausages) had a negative impact. Men who ate the least processed meats, averaging fewer than 1.5 servings a week, had an 82% chance of achieving pregnancy with their partner – while men who ate the most processed meats, with an average of 4.3 servings a week, had just a 54% chance.

5:05What external factors affect male fertility and why.

Even after conception, the father’s diet may indirectly affect the unborn child.

A study led by researchers at The University of Queensland in Australia has shown that what fathers eat has a lasting effect on the future health of their unborn children. The team analysed dietary data from almost 200 couples receiving antenatal care at Australia’s largest maternity hospital, the Mater Mothers’ Hospital in Brisbane. The study found that the men’s dietary intake strongly influenced that of the women, and that in turn impacted the developing baby. Other studies suggest that a father’s weight can have an intergenerational effect, influencing the weight of the child.

“Men’s health and nutrition for fertility is overlooked, but it is so important,” says Shelley Wilkinson, a dietician who was one of the authors of the University of Queensland study and now works at Lifestyle Maternity, a private clinic in Australia that specialises in fertility support. “It can actually impact their grandchildren’s health.”

Wilkinson also highlights the importance of tackling any changes as a couple. “If one person is meeting the dietary guidelines, the other person is more likely to be as well,” she says. “We should be focusing on supporting women as well as men to make healthy changes. Otherwise, we’re losing half the battle.”

One beneficial change can be to increase the amount of fat in the couple’s diet – as long as it’s the right kind of fat. Healthy fats are found in nuts, seeds, salmon, avocado and olive oil. However, trans fatty acids – which can come from natural or industrial sources, and are for example found in margarine, doughnuts, fried food and other processed food – are associated with a higher risk of infertility.

A diet rich in plants may also be beneficial. Researchers at Harvard School of Public Health assessed the diets of a group of 18,555 women over eight years, as they attempted a pregnancy or became pregnant. Consuming plant-based protein like legumes, instead of animal-based proteins like red meat, was associated with a more than 50% lower risk of ovulatory infertility, they found.

We need to support women as well as men to make healthy changes. Otherwise, we’re losing half the battle – Shelley Wilkinson

The authors of a 2021 review of research on the possible link between diet and female fertility concluded that, while their recommendations focused on women, “diet and nutritional patterns are undoubtedly significant for both male and female fertility”.

The researchers gave a detailed overview of the effects of individual nutrients and the foods that contain them. They also emphasised the importance of involving a clinical dietician in the care of couples planning a pregnancy. Broadly speaking, their summary recommended foods such as vegetables, fruit, whole-grain pasta and whole-grain bread (for carbohydrates); sources of healthy fat such as oily fish; and legumes, eggs and lean meat for protein. They also pointed out the important role of certain nutrients that may sometimes be overlooked: these include iodine, which helps the proper development of the fetus and the expectant mother’s thyroid function.

For alcohol, the advice is clear and consistent across the research. The CDC states: “there is no known safe amount of alcohol use during pregnancy or while trying to get pregnant.” This goes for all types of alcohol, including all wines and beer. The advice is to avoid it altogether.

If you have any concerns or questions about your diet and how it might affect your fertility, the best step is to consult your healthcare provider. And while certain foods do appear to play a positive role in fertility, it’s important not to overstate their power. Infertility is complex, as are its cause. Worrying over one’s diet can cause unnecessary stress as well as feelings of guilt and shame. Those struggling to conceive can rest assured that the problem is unlikely to be rooted in one specific thing they did or did not eat.

Wilkinson says that people with fertility issues are often searching for a single fertility-promoting food – but it is better to aim for an overall healthy eating pattern. “In the fertility chat rooms, there’s a lot of talk about pineapple being some kind of magic fertility food for if you’re trying to fall pregnant. However, there is no single food or supplement that works like that.”

* All content within this article is provided for general information only, and should not be treated as a substitute for the medical advice of health care professionals.

Disclaimer: The BBC is not responsible or liable for any diagnosis or actions taken by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you’re in any way concerned about your health or the health of your child.

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