Bryan Johnson on Hyperbaric Oxygen Therapy and India's Air Pollution
Bryan Johnson
In this episode, Bryan Johnson, Blueprint co-founder Kate Tolo, and Johnson's lead physician Dr. Mike Mallin cover two topics that Tolo describes as opposites. The first is hyperbaric oxygen therapy (HBOT), which Johnson tested in a 60-session protocol and now calls possibly the most effective whole-body intervention Blueprint has tried. The second is the air pollution the team encountered on a trip to India, which Johnson says left him physically and emotionally overwhelmed. It became a national talking point after he walked off a podcast recording. The episode ends with practical advice on managing air quality and a broader argument for running health on systems rather than in-the-moment decisions.
Why HBOT made the shortlist
Johnson explains that when Blueprint started, the team tried to set aside popular wellness trends such as cold plunges, NAD drips, and vitamin infusions. Instead, they asked what the scientific literature showed as the most robust ways to move markers that predict longevity. HBOT made that shortlist, but Johnson stresses that the evidence for HBOT as a longevity therapy is "not airtight" and still emerging. He points to a 2020 study out of Israel that brought attention to HBOT through telomere elongation. He adds that, as usual in science, it was not accepted as a panacea, and some researchers questioned whether the study was well done and robust.
So the team decided to test it on Johnson. Mallin designed a protocol using a 2 ATA chamber (two atmospheres absolute). Johnson did 60 sessions over 90 days, each lasting 90 minutes. Within each session, oxygen was delivered in cycles of 20 minutes on and 5 minutes off. Johnson describes the swing from high to low oxygen as what "creates nice signaling mechanisms within the body."
The reported results
Johnson read out the results and said the team was surprised. In his words, they would "probably say it has been the most efficacious therapy we have done since starting Blueprint for the entire body." He reported:
- a 300% increase in VEGF, which he associates with new blood vessel growth;
- hs-CRP, the systemic inflammation marker, falling to undetectable levels;
- microbiome changes, including a 1,000% increase in Akkermansia, a 250% increase in short-chain fatty acids, and a 290% increase in butyrate;
- a 28.6% reduction in a dementia marker;
- improvements in muscle oxygenation.
A second company also analyzed his microbiome. Johnson says it used AI tools to draw on more than 200,000 microbiome papers and found no dysbiosis, meaning no disease signature. He says this put him in the top 10% of microbiomes sampled for that signature, which he called very rare.
On muscle oxygenation, Johnson said he still needs a VO2 max test on a lab-grade system to see what changed. He began to bring up a telomere measurement, then said he would pause and return to it. The episode never came back to it. Tolo's introduction had listed boosted telomeres among the results, but Johnson himself gives no telomere figures in the conversation.
Mallin said the inflammation and microbiome results impressed him most. For the microbiome, he called HBOT "the most impactful intervention I've ever seen." On inflammation, he noted that Johnson started from an already low baseline. Getting lower still in such a short time, with essentially no other intervention, struck him as "pretty insane."
"HBOT skin"
Johnson did not measure skin rejuvenation directly; there was no biopsy. He cited figures from several studies instead: a 12.8% increase in collagen density, a 144% increase in elastic fiber length, and a 41% increase in blood vessel count. Tolo notes that Johnson has started calling the effect "HBOT skin." She recounts meeting Ari Emanuel, CEO of WME, the week before. Johnson recognized "HBOT skin" on him, and Emanuel confirmed he loves HBOT.
Johnson says his son Talmage has also started doing HBOT at the house, and that he can see a signature in skin texture, color, and tone. He noticed it in himself first. Johnson's view is that HBOT is "probably the most significant skin glowup of any therapy out there." He ranks it above lasers or other machines, and above the usual starting points of fillers and Botox. His reasoning is that it works on the whole body rather than just part of the face. He presents this as his opinion, not a measured comparison.
The practical problem: time and access
Tolo asks how people can access HBOT when most cannot own a chamber, noting that LA has many places offering it. Johnson first names time as the obstacle. His protocol meant more than 70 hours in the chamber over 90 days. He says he could not have done it without working at the same time. His chamber lets him sit in a chair at a desk, take meetings, and write.
He explains that his chamber keeps the ambient oxygen at 21%, the normal atmospheric level, while he breathes 100% oxygen through a mask. Filling the chamber itself with 100% oxygen creates fire risk. Keeping the ambient air at 21% is what makes it safe to bring electronics inside. For people going to a facility, he estimates that driving there, doing the session, and returning takes at least two and a half to three hours.
What specs matter, according to Mallin
Mallin says the key variable is pressure: going "deep enough." He explains that the team talks about "diving," because pressure rises the deeper you go. For longevity purposes, he wants to be above 1.5 ATA and ideally at 2.0, the pressure used in the Israeli study. Reaching that requires a hard-shell chamber. He says soft-shell chambers typically top out around 1.3 to 1.5.
The second variable is 100% oxygen, delivered the right way. If high-concentration oxygen fills the ambient air, it exposes the skin and especially the eyes, and Mallin says that can cause cataracts. His preferred setup delivers oxygen through a mask that you also exhale through, so the excess oxygen is vented out of the chamber rather than lingering in the air.
He calls sitting versus lying down a personal preference, though sitting in a slightly larger chamber makes it easier to use a phone or work. On session length, Johnson says 90-minute sessions have advantages over 60-minute ones. He then qualifies this: some indications, such as recovery, respond well to 60 minutes, while the longevity benefits they are pursuing are "really in the 90-minute range." Mallin adds that medical indications for HBOT use different protocols and that their discussion concerns longevity only.
Mallin also describes a likely spectrum of benefit. Johnson started near the high end. Less HBOT probably still helps, and "probably some HBOT is better than no HBOT," but Mallin says the research can't yet quantify where the inflection point of maximum benefit lies. He believes Johnson is likely near maximum benefit now.
How HBOT works, and whether you can overdo it
When Tolo asks whether someone can do too much, Mallin explains the mechanism as he understands it. At high pressure, oxygen dissolves into the serum rather than only binding to red blood cells, delivering what he describes as roughly 15 times the usual oxygen to tissue. High oxygen, he says, is actually damaging, even over short periods. The benefit comes from the body upregulating its own defenses against that damage. Because the exposure is pulsed and brief, the upregulation outlasts the stimulus. This leaves regenerative activity that would not otherwise have happened. He frames this as a hormetic response to something that is, "quote unquote," bad for you.
For the same reason, he says, doing it all the time could theoretically cause too much oxidative damage and leave no room for recovery. That is why the protocol ran about five days a week with two days off. After finishing it, they have scaled back to pulsing sessions occasionally.
Checking what you're actually getting
Tolo raises Johnson's point that some facilities may not deliver the oxygen levels they advertise. Johnson describes their own discovery. Their system originally used an oxygen concentrator, and when they measured its output it was around 89–92% rather than the 100% they expected. They replaced it with medical-grade oxygen cylinders delivered by a local company and fed them through the mask. Johnson acknowledges he doesn't know of evidence comparing 89–92% with 100%, only that they chose 100%.
He then lists the variables to check if you want HBOT to be effective. First is chamber pressure: 1.2–1.4 versus 2.0. Next are oxygen purity and whether it comes through a mask or fills the chamber. He also warns about 100% oxygen in the chamber air. The last variables are session frequency and total number of sessions. He notes that one session a week is not as good as sessions close together. Some indications only need around 20 sessions; they did the full 60. His overall assessment is that their 60-in-90 protocol roughly matched the benefits reported in the literature and "maybe" exceeded them in some areas. Because they had taken baseline measurements against target areas chosen from a literature search, he says they got a "really dramatic before and after snapshot."
Going to India
The conversation then turns to India, which Tolo calls the opposite of HBOT. She says the team went in December and nearly canceled at the last minute because of pollution. She describes some levels as hundreds of times above recommended PM2.5 limits. She also recalls that Johnson and Mallin concluded from the literature that pollution may shorten lives more than cancer in India, so the country might gain more by addressing pollution than by pursuing something like cancer.
Johnson explains that the trip, alongside a stop in China, was meant to seed the "Don't Die" movement in those countries. Until then it had existed mainly among small groups in the US. Friends in India arranged a three-day blitz across two cities. It included about five podcasts, four media interviews, and three or four private events. The original route went through Delhi, but they dropped Delhi at the last minute because its air quality was so bad.
The team wanted to raise a health topic with the country, and air quality was on their radar. In the days before departure, Johnson looked at air-quality data and was so alarmed that he called Tolo to say they should probably cancel. He knew India's air was bad, "but like not to this level." His friend reassured him that the hotel had monitored air purifiers throughout, with readings on screens. On landing, Johnson says, it was "an entirely different world." Seeing numbers on a map was one thing, but he could smell and feel the pollution in his nose, lungs, and throat. And the hotel, it turned out, had no air quality controls or filters.
"Breathing death" and normalization
Johnson explains why PM2.5 matters. These particles are 2.5 micrometers, small enough to get past the nose and throat, deep into the lungs, into the bloodstream, and possibly into the brain. They carry toxins from industrial pollution, vehicle emissions, and smoke, which he lists as nitrogen oxides, sulfur dioxide, and carbon monoxide. He links them to lung disease, cardiovascular damage, and neurodegeneration. He repeats the claim that India would extend lifespan more by addressing air pollution than by solving all cancer.
What struck him most was the normalization. He says many of the people they met were unaware of the problem. They didn't check air quality daily, didn't have purifiers at home, and exercised outdoors. "The more people learn about it the scarier it is," he says, and the issue wasn't being discussed or addressed. He calls it a representation of a more systemic problem in which people are "literally breathing death" and have become so used to it that they no longer see it. Within a couple of days, he says, the topic blew up in India and made the covers of major publications.
Johnson describes the experience as emotionally stressful. He recalls PM2.5 averaging around 75 to 120 depending on the city, which he equates to about three to five cigarettes a day. For someone who tracks every calorie and every movement, he says, imagining himself effectively smoking daily was "incomprehensible" and extremely upsetting.
Walking off the podcast
On day three, the night before flying to China, Johnson left a podcast recording partway through. He says it was not staged. He had reached the end of his rope, and Tolo notes that he was breaking out in rashes and his eyes were affected. She says the whole team was "really feeling it." The setting looked indoor but was effectively outdoors: a marquee-style transparent wall with no real separation from the outside air, at around 125 PM2.5.
Johnson asked to stop early, stepped out, then came back and wrapped the recording so as not to be rude to the host. He assumed they would cut the moment and simply publish a shorter episode. Instead, the footage became what he calls the inflection point that got the whole country talking, and he says the conversation continues today.
America's version: obesity
Johnson and Tolo both stress that the point is not to single out India. Tolo draws the parallel: Indians are breathing death and normalized to it, while Americans are "eating death" and normalized to that. Johnson recounts landing at LAX after two weeks on the road and seeing obesity everywhere. He says the share of obese Americans is shocking, though he doesn't remember the exact figure, and that he is so used to it at home that he no longer notices. "Every country has their own thing," he says.
Tolo adds that in both cases individuals can't easily overcome systemic forces. She points to food deserts across America, poor access to high-quality food, and addictive marketing placed right in front of people.
Mallin's air quality protocol
Asked what listeners can do, Mallin first notes that poor air quality is not unique to India. In the US, wildfires in the West have been the main recent problem. He cites local readings in the 200s and 300s and smoke from California, Oregon, and Washington fires spreading across the northern part of the country. LA also has chronic smog from traffic. He argues that local governments and school systems use criteria that are too lax. Most advise against outdoor exercise only above 150, while Johnson was worried about sitting outside at 125.
His recommendations follow in order:
- Measure. Set up a home monitor such as IQAir, and use IQAir's network of other people's monitors to see outdoor conditions. Also track indoor readings to confirm your filtration is working.
- Fix indoor air first. Use an HVAC filter rated MERV 13 or higher, which catches PM2.5-sized particles. Ideally add carbon filters for the chemicals in smog. Standalone purifiers help too; he names Dyson, IQAir, and Molekule.
- Be selective about going outside. His own threshold is no outdoor exercise above a PM2.5 AQI of 100, while acknowledging that other sources may say differently. He personally rarely exercises outside above about 70, and he wears an N95 above 150.
- Consider supplements with a mechanistic rationale. For people facing a spike in exposure, such as travel or a local fire, he suggests compounds that manage reactive oxygen species, like N-acetylcysteine or glutathione, plus anti-inflammatories. His reasoning is that pollutants entering the lungs and bloodstream drive inflammation and reactive oxygen species. He links these to plaque development, damage to the blood–brain barrier, and brain inflammation.
Running health on systems
Johnson adds a point about avoiding overwhelm. He acknowledges his approach requires investment. His home keeps air quality steady around the clock, with monitoring in every room, IQAir purifiers, and two other purifiers he is currently testing, including a commercial-grade unit. He says MERV 13 is about the cap most home HVAC systems can handle, and many manufacturers recommend 11 or below, so the advice is to use the highest-rated filter your system tolerates. Once monitoring and filtration are in place, he says, "it's running without you thinking about it." He compares it to a fixed bedtime: identify the area, build a system, and put it on autopilot to reduce health stress.
He closes with an assignment for listeners. Write down your plan for the coming days: bedtime, exercise days and what you'll do, and commitments such as no fast food, no junk food, and cutting sugar. His reasoning is that people who decide in the moment are "very likely to cave," while a pre-committed plan gives them more strength when the moment arrives. He describes the episode as part of a new format the team has long wanted to try and asks viewers to say in the comments whether it's working and what they'd change.
At that last day when I walked off that podcast, that was not planned. Yeah, that was not a staged event. So, my team's telling me, you want to like... Yeah, go. Thanks. That was our last podcast I think on day three and we were flying to China the next morning and I had become just overwhelmed with the pollution. Like I just was at the end of my rope.
You were breaking out with rashes, like your eyes. I mean, all of us were dying, like we were really feeling it. It was actually really emotionally stressful because the PM2.5 levels when we were there, I think they averaged around 75 to 120 depending upon the city we were in. And that's equal to around 3 to 5 cigarettes per day.
As we got more and more in the Indian culture and talked about this topic, it just became increasingly clear that it's really a representation of this more systematic problem where they're literally breathing death and everyone is so normalized to it that they couldn't even see it anymore.
All right, you guys, let's get into the topics. This is you, Bryan, on this Monday morning. I'm kind of hoping that one day we can do a podcast episode where you're in HBOT. Wouldn't that be fun? Yeah, that's a good idea. We should put the mic inside the mask or something like the little lav mic.
HBOT's kind of insane. So, you did this really rigorous protocol. I think you did an hour and a half every day for something like 60 days and here are some of the results that you experienced. You wiped out inflammation in your body. You boosted your telomeres, which is an incredible longevity marker. You improved your microbiome. You reduced dementia risk. And you improved your whole body skin dramatically. What is HBOT?
So when we started this project, we were trying to evaluate all the interventions that were in the scientific literature. And what we were basically trying to ask is, you know, you hear a lot of things about what people are doing for health and wellness, popular things like cold plunge and NAD drips and vitamin infusions, and like these are the things that people talk about. And we wanted to go to the scientific literature and say, what does the evidence say are the most robust therapies to actually move markers that predict longevity? And HBOT was on that short list.
But HBOT for longevity is not in this category where the evidence is, you know, airtight. Like you can just say it's tried and true. It's really still emergent. And as recent as a study in 2020 out of Israel where it kind of put this on the map with telomere elongation, but still then people were, you know, as all things in science, it wasn't like it was this panacea. There was still some disagreement on whether or not the study was done well, whether it's robust, etc. So we decided to put hyperbaric oxygen therapy to the test.
And so Mike put together a protocol for this. We got a two atmosphere chamber, so two ATA, and we had a protocol where we did 90 session, I'm sorry, 60 sessions in 90 days. Each session was 90 minutes and it was 20 minutes oxygen on, 5 minutes off. You're going from high oxygen to low oxygen repeatedly. And that increase to decrease creates nice signaling mechanisms within the body.
And I mean, Mike, you chime in here, but I think when we were going over the results, I'll just actually read the results off. I think we were all really surprised and I think we would probably say it has been the most efficacious therapy we have done since starting Blueprint for the entire body.
So let me just read this off. So we had a 300% increase in VEGF, that leads to new blood vessel growth. The measurement for systematic inflammation called hs-CRP was not even detectable in my body. So this test couldn't even find levels of systematic inflammation in my body.
We had dramatic improvements in my microbiome: a 1,000% increase in Akkermansia, 250% increase in short-chain fatty acids, 290% increase in butyrate, so like dramatic improvements. We had a second company do an analysis on my microbiome where they found, looking at over 200,000 papers on the microbiome using AI tools, they couldn't find any dysbiosis. So there was no disease signature in my entire microbiome, which put me in the top 10% of all microbiomes I've ever sampled with that signature. So very, very rare.
It reduced a dementia marker by 28.6%. And then we had other improvements in muscle oxygenation. I need to follow up with a VO2 max test on a lab grade system to see what happened to that. And then we had a telomere measurement. Well, actually I'll pause on telomeres. We'll come back to that. Yeah, like those were the whole body results. I mean, Mike, what's your take on those results?
I mean, the results were pretty impressive. Especially around inflammation and the microbiome. Those two areas for me were beyond, I think, anything. Microbiome for sure, like the most impactful intervention I've ever seen. Inflammation, given that we're starting from someone who is already at a baseline level of inflammation that's quite low and then going to an even lower level, is just pretty insane in such a short period of time with really no other intervention other than HBOT. So yeah, super, super impressed.
Yeah. So the other thing that was interesting is we didn't measure skin rejuvenation. We didn't do a biopsy of the skin, but in several studies this was the data that was seen: 12.8% increase in collagen density, 144% increase in elastic fiber length, and a 41% increase in blood vessel count.
So, which is insane because you've started calling this HBOT skin. By the way, HBOT stands for hyperbaric oxygen therapy for anyone listening at home. So, essentially flooding your body with oxygen. But yeah, you've coined this HBOT skin to the point where last week we were meeting up with Ari Emanuel, the CEO of WME, I believe he started that company. So you saw him and you were like, "That's HBOT skin." And he was like, "Yep, I love HBOT." Isn't that crazy?
Yeah, it's true. And even with Talmage, so my son Talmage started doing HBOT here at the house and I can definitely, there's a signature for it. I can see it in the skin texture and color and tone. And I saw it in mine initially, but I think HBOT is probably the most significant skin glow-up of any therapy out there. Better than any laser, better than any machine.
And like when we started looking at these various skin therapies, people of course start with fillers and look at things like lasers and Botox, etc. But I think HBOT probably is the most efficacious skin remodeling therapy in the world. It's whole body. It's not just part of the face. So, that was really surprising to me. It dramatically improved my skin quality.
It's wild. I know a lot of people do it for fun. Like here in LA, there's plenty of places you can go. When I've heard you talk about it though, it's like actually pretty specific specs that you want to hit. So walk us through what to look for if you want to do HBOT, because you have it at home, but obviously a lot of people can't do that. So, how do they get access to HBOT?
Yeah, this is one of the challenging things about hyperbaric oxygen therapy. One is it's very time consuming. So over a 90-day period you're spending over 70 hours in the hyperbaric oxygen chamber and that's just a lot of time in life. And so if I couldn't pair this up while working, I just couldn't have done it. I don't have that amount of time in the day.
So the fortunate thing is I had a chamber where I could actually sit in a chair and have my desk in front of me and work for the entire time of the therapy. The benefit of that of course is that, like the picture you showed, Kate, I can do meetings and I can write and I could work in other ways.
And also when you're in a chamber, this one maintains an oxygen concentration inside the chamber of 21%. So that's atmospheric levels of oxygen. So you don't have 100% oxygen in the chamber, which creates risk of fire. You're breathing 100% oxygen in the mask, but the chamber itself is 21% oxygen. So in that sense it is safe to have electronics in there and then work.
But I think a lot of people are challenged because, one, you have to go to a place to do this. So by the time you drive there, get there, do it, it's like at least a two and a half, three hour affair. And then Mike, do you want to talk through the difference between most of the soft shell chambers, you know, just like 1.4, 1.2 ATAs, and the 100% oxygen environment they have versus the 100% oxygen we have through the mask?
Yeah. So the important thing here is that you're getting to deep enough levels, which means you're getting high enough pressure. And sometimes we talk about like when you're going into a chamber you're actually diving. That's because the pressure increases as you go further down when you dive. But for the purposes of longevity, we really want to be above 1.5 atm, so 1.5 atmospheric pressure, and ideally at two. That's where the most recent study that Bryan was talking about out of Israel was, at 2.0 atms. So we want to be able to get to two atms.
The challenge is you really need a hard shell chamber to do that. There aren't any soft shell chambers that go that high. The highest soft shells are usually about 1.3 to 1.5. So, it's important that you have a chamber that will take you deep enough and then you also want to make sure that you're getting that 100% oxygen.
Now, the challenge with the oxygen is if you just have that ambient in the air, you're exposing all of your skin and most importantly your eyes to those high levels of oxygen and that actually can cause cataracts. So, what we want to do instead is make sure the oxygen is being delivered through a mask where you can breathe in and actually exhale through the mask. So, that extra oxygen is actually being shot out of the chamber as opposed to staying in the ambient air causing the cataracts.
Does it matter if you're lying down or sitting up or is that just personal preference? Personal preference, but I think if you're sitting up, it's easier to do things as opposed to lying down. So, a slightly larger chamber gives you the opportunity to, you know, do something on your phone or work on your computer in Bryan's case. So sitting is, I think, advantageous as well.
And then it's also the case that 90-minute sessions do have advantages over 60-minute sessions. So if you can do 90, it's better. I mean, I guess let me qualify. If you're looking for recovery, there are certain indications where 60-minute sessions are efficacious, and then 90 there's others, for example. So, we're going after longevity benefits and that's really in the 90-minute range.
And there is some truth to doing it. It's important to remember that there are medical indications for HBOT that are not necessarily the same protocols as what we're talking about here. So, we're talking specifically about longevity.
And I think it's also worth mentioning that there's probably a spectrum. Like Bryan jumped in at a much higher level in the spectrum of doing, you know, 60 total sessions, over 70 hours in HBOT over 3 months, which is a lot, but there is probably some benefit to less. We can't quantify that as well because we don't have the research, but probably some HBOT is better than no HBOT. The question is at what point do you really hit that inflection point where you are getting the maximum benefit? We think we're likely near maximum benefit at this point.
And so yeah, I was gonna say, can you do too much? Like if someone's like, "Hey, I want to go absolutely crazy on HBOT." Is that a problem? Yeah, theoretically you could cause too much oxidative damage. So one, we haven't talked about how HBOT works, which, if you don't mind, I'd like to just go over it real quickly. It's actually causing oxidative damage to your body.
So the high levels of oxygen that get dissolved into your serum, not even attached to your red blood cells, deliver extremely high, like 15x levels of oxygen to your tissue. And high oxygen is actually bad. Even for short periods of time, it can be quote unquote bad. But in this case, what it's doing is it's upregulating your body's natural systems to reduce all the damage that that high oxygen is doing.
And then because we're only doing it for a short period of time, we're pulsing that high oxygen. Now the upregulation lasts longer and you now have this regeneration activity in the body that otherwise wouldn't have been there if you hadn't delivered that stimulus. So it's sort of like a hormetic response to something that is quote unquote bad for you. So in this case it's super interesting.
But you could potentially do too much if you were doing it, say, all of the time. You wouldn't give your body the ample opportunity to sort of recover and have that regenerative process. So that's why we chose a protocol where it was basically around five days a week, two days off, not every day. And then after that length of that protocol, we've sort of backed off and are pulsing it afterwards.
Yeah, that makes a lot of sense. So you can do it too much. You should be careful. And then the other thing I want to mention is, Bryan, I think I've heard you say that it's possible that with these HBOT machines, if you don't know where you're going and you're not going to a reputable place, you're actually not even getting the full advertised oxygen amount potentially. So otherwise people are just wasting their money and time, it sounds like, right? So making sure they go to a reputable place.
Yeah. And one thing we discovered is we had an oxygen concentrator initially with our system and we measured the oxygen concentration and it was around 89 to 92%, I believe, and we expected it to be 100. And so we got rid of the oxygen concentrator and we got medical grade oxygen cylinders. So we found a local company to deliver the cylinder and then we got an attachment to feed it through the mask. So, I'd say, yeah, I'm not quite sure. I don't think there's evidence that compares the various levels of oxygen, you know, from 89 to 92 to 100%. But we did the 100%.
Yeah. Then also, like Mike was saying, be wary of 100% oxygen in the chamber. That has negative effects potentially. And then the frequency: if you do one session per week, it's not as good as if you're doing them in proximity.
So, if you want to achieve the benefits of HBOT, then you'll need to make sure you align whether you're doing a lower atmospheric chamber, you know, 1.2, 1.4 range, versus two, and then 100% oxygen versus some lower grade, and then whether you've got it in a mask or whether you have an environment, and then the protocol, the number of sessions. So, for some indications, you know, 20 sessions are fine. We did the full 60. So all those are variables that you want to contemplate if you want to be efficacious.
The protocol we did, you know, with the 60 sessions in the 90 days, really did achieve it. Basically I think it was about on point with the benefits we've seen in literature and maybe exceeding in some areas. So it was a good outcome in that we did a research search. We tried to assess the areas we thought we'd improve. We did take these baseline measurements to capture the potential benefits and we did see them. So overall I think I'm very happy that we did this test. I'm very happy we were as quantified as we were and we saw a really dramatic before and after snapshot.
Cool. Next topic, which is somewhat related, is the air quality in India. We recently went to India, I think it was in December, and it's the opposite of HBOT because the pollution there was so bad
that we almost canceled the trip last minute. I think sometimes the levels were hundreds of times higher than the recommended PM... PMI, is that what it is? PMI limits? Yeah. PM2.5. PM2.5. Yeah. Which is wild that people are living in this pollution every single day. And I think, Bryan, you said that after you and Mike were doing a look at the literature, it actually potentially is that pollution caused more shortening of life than cancer did. So India might even be better off solving pollution for its country rather than trying to go after something like cancer. So what happened? Why was it so controversial?
Yeah. So we decided to go to India last year. We decided to do India and China because we wanted to seed Don't Die in those countries, and we had up until that point only really been present in small groups of people in the United States. And so I had a few friends in India and we said, let's go, let's do this. And so they lined up this trip for us where in I think three days we did two cities. Initially we were going through Delhi, but we decided not to go through Delhi at the last minute because air quality was so bad, so we skipped Delhi. But yeah, we did three days, and in that time duration I think we did something like five podcasts, four media interviews, three or four private events. It was just an absolute blitz.
And in making the trip, we wanted to have a discussion with the country on a health topic, and so we were evaluating various things which we could talk about, and air quality came up as one that was on our radar. And as we started looking into it, the days before, I looked up a bunch of the air quality data and I got so alarmed. I called my friend, Kate, I called you, and I was like, I think we need to cancel this trip. It is really bad. I mean, I knew that the air quality in India was bad, but not to this level. And so I talked to my friend and he's like, "You know what? It's fine. The hotel we're staying at has air purifiers throughout the hotel. It's all monitored. It's on these screens. You're fine."
And so we went there, and once we landed, it was just an entirely different world. I guess it's one thing to see high levels of toxins on an air quality map, but when you're there and you're breathing it, you can just smell and feel the pollution in your nose and lungs and throat. And it was a shocking arrival. So yeah, we got there, and as we got more and more into the Indian culture and talked about this topic, it just became increasingly clear that it's really a representation of this more systematic problem where they're literally breathing death and everyone is so normalized to it that they couldn't even see it anymore.
And so just for context on this, the PM2.5 is a marker of a health danger. It's 2.5 micrometers, and this particular thing is identified because it's small enough to bypass the nose and the throat and get deeply into the lungs and even the bloodstream and maybe even to the brain. And it carries these toxins, these nitrogen oxides, sulfur dioxides, carbon monoxides that come from industrial pollution, vehicle emissions, smoke, and it causes all kinds of things. It can put you at risk of lung disease, cardiovascular damage, neurodegeneration. And like you're saying, Kate, India would actually do better for their population to address air pollution than solve all cancer. It would actually extend lifespan more. But being there in person, it was actually intense. Much more than I'd imagined.
When you said they're breathing death and they're normalized to it, it makes me think about how in America you're eating death and you're normalized to it. Our culture is just so... So yeah, I guess a note that this really isn't about India's inability to solve pollution. It's about the things that are right in front of our eyes that we can't see, that we learn to live with. So many people we interacted with were just unaware of the situation, and so they weren't checking for the quality every day. They weren't having purifiers in their homes. They were exercising outside. It was just one of those situations where we started poking at something and it was like, oh no, the more people learn about it, the scarier it is. And actually this wasn't being talked about or solved at all. And so I think within that couple of days, it blew up in India. The whole of India was talking about this topic, and from the covers of all the major publications there, it became a really, really big topic.
Yeah. For context on this, this was actually really emotionally stressful because the PM2.5 levels when we were there, I think they averaged around 75 to 120 depending upon the city we were in. And that's equal to around three to five cigarettes per day. So for someone who is monitoring health as meticulously as I am on a daily basis, every single calorie, every single movement, and then to basically imagine myself smoking a day, it was such an incomprehensible concept to me that it was extremely emotionally upsetting. And again, we had imagined that we'd be there in certain environments with air filters, but that just wasn't the case. We arrived and our hotel did not have air quality controls. It did not have filters like we had thought.
So yeah. And so that last day when I walked off that podcast, that was not planned. That was not a staged event. That was our last podcast, I think on day three, and we were flying to China the next morning, and I had become just overwhelmed with the pollution. I was just at the end of my rope. You were breaking out with rashes, your eyes... I mean, all of us were dying. We were really feeling it. And it was basically in an outdoor setting. So they had this outdoor transparent wall, like a marquee, where it looked like it was inside, but actually there was no separation between inside and outside. Yeah. So you're basically just outside in 125 PM2.5, which is multiple cigarettes, and I just couldn't do it. So I asked to end early. I thought they were going to cut it out. I didn't think they would even show me, because we actually wrapped the podcast. I said to him, "Hey, I've got to step out," and then I jumped back in and we actually wrapped the podcast. Yeah. So I didn't want to be rude to my host, and so I thought they were just going to cut that out and just finish the podcast and it'd be a lesser amount of time.
Yeah. But yeah, that turned out to be the inflection point of what really got the whole country to talk about this, and even now it's a continued conversation. So it really started a necessary conversation. And like you were saying, Kate, the last thing I'll say about this is when we came back to the US. So we're traveling back from China, two weeks on the road, and I get to LAX and I see obesity everywhere. It seems like everyone's overweight. And so that's America's equivalent of air pollution. The obesity in the United States, I forget, we looked up the numbers, but it's a shocking percent of Americans that are obese, and I'm so normalized to obesity I just don't see it anymore. So yeah, every country has their own thing. So this is not picking on India. These are just topics of conversation we're normalized to.
Yeah, and I feel like it's a really nice parallel because in both situations it's impossible for the individual to overcome the systematic things. When there are just food deserts all over America, access to high-quality food isn't so impossible, and then also very addictive tactics are placed right in front of you. It's so hard to resist that. Yeah. So, Mike, what would you say for people all over the world that are listening to this? How should they think about being aware of air quality, and what things can they do to improve their health amidst air quality challenges they may face in their region?
Yeah, I mean, so the first thing I wanted to say is that this isn't isolated to India. Air quality is an issue all over the world, and we've actually been having a lot more trouble with it in the States recently, mostly from the wildfires in the West. But LA has had its own challenges with air quality on a chronic basis from traffic and from regular types of smog. But the levels of air quality we're seeing from the wildfires have been pretty insane, levels up in the two to 300s locally, and even traversing across the country in the northern part of the country from the California, Oregon, Washington fires. So it's definitely a concern for sure and something that people should be thinking about.
It's also worth noting that most local governments and school systems don't really have good criteria for when to avoid air quality. Most of them will tell you above 150 you should consider not exercising outside, whereas Bryan's worried about sitting outside at 125, right? So the criteria are probably not quite stringent enough. So the first thing I would recommend is actually measuring and having a way to check on air quality in your local area. So there are two ways you can do that. You can have a monitor that you set up at your house, like an IQAir, or you can find... IQAir has the ability to look at other people's monitors so that you can see what the air quality is outside, but then also tracking where your house is to make sure that your filter is working appropriately. So tracking is the first thing. That's always first.
Right, measurement. But then after that, what can you do to improve air quality? Well, you can improve the air quality in your home, which is probably the most important first step. And the way to do that is to make sure that you have an adequate air filter with your HVAC system, ideally one that is MERV 13 or above, which is just the level of filtration that happens. That means it's going to catch those small particles that get down into your lungs, those 2.5 particles. And then ideally some carbon filters in the house too that can pick up some of the more activated chemicals that can be in the air from smog and things like that. So adequate air purification. You can also add additional air purifiers in your house, like Dyson; IQAir makes one, Molekule makes one. Those are all great.
Then when you're outside, the choice of going outside is something you should be thinking about. So you really shouldn't be exercising outside if the air quality is greater than 100 of PM2.5. That's at least my recommendation. You might get different recommendations from different sources, but I wouldn't do it above 100. In fact, I don't really exercise outside above like 70 generally. And then if it's above 150, I'm usually wearing a mask, and that would be an N95 in order to catch those 2.5 particles. So sort of considering where you're exercising, what you're doing outside when you're going outside, and making sure you have some sort of implement to prevent yourself from breathing in that air.
And then finally, the other thing I would say is there is some mechanistic reason to think about certain supplements if you are exposed to poor air quality. If you're going somewhere where there's going to be poor air quality, or if you live in an area where there's a local fire or something like that, you need to worry about that. Something that picks up reactive oxygen species and manages those, like N-acetylcysteine or glutathione, could be really helpful. And then anti-inflammatories, because really what's happening is these pollutants are getting into your lungs, into your bloodstream. They're causing inflammation and they're causing reactive oxygen species, and that's what's leading to the plaque development and the damage to the blood-brain barrier and the inflammation in your brain. So really we want to reverse those reactive oxygen species with things like glutathione or antioxidants, and we want to reduce inflammation. So obviously we can do that through lots of other lifestyle choices, but as far as supplements go, things that reduce inflammation and manage antioxidants, those are the big ones for me.
Yeah. And also, I think for those of you who are thinking about this, it's really important to talk about systems, because when topics like this come up, it's easy to feel overwhelmed. And so let me just explain really simply how to do this. This does require some investment, so be mindful. So inside my house, basically we maintain perfect air quality 24/7, and so we monitor the air quality in every single room. There are various devices you can use. Mike mentioned one. We have IQAir. We have a few others as well. And then I have the IQAir purifier. I also have two other versions we're trying right now. I have the commercial-grade one. And then we just monitor the air quality with those systems going 24/7.
So once you set this up in your home and you change your filter in your home HVAC system to MERV as high as you can — Mike mentioned 13, which is about the cap of what most HVAC systems can actually accommodate. I think a lot of them will tell you 11 or below. So just take the highest MERV filter you can. And then once you get your air quality monitoring in place and your filters in place, it's running without you thinking about it. So it's not something you have to think about on a regular basis. So this is one way where you want to solve your health with habits and systems. In the same way you want to say you're going to bed at a certain time every single night and never change that, air quality is the same. So if you just identify the area of focus and build systems, then you can just put it on autopilot. And that way you reduce health stress and you run on systems more effectively.
And then a reminder for all of you out there listening: right now, write down your plan for the coming days. Map out what time you're going to go to bed, what days you're going to exercise, what things you're going to do when you exercise, and make some commitments that, for example, you're not going to eat fast food, you're not going to eat junk food, you're going to try to eliminate sugar from your diet. So write these things down. Commit to these behaviors. Don't ever let yourself decide in the moment what you're going to do, because you're very likely to cave to that moment. So make a plan, commit to it, and then when that moment arrives, you're going to have more strength to follow through on being your best self.
So hopefully that's the outcome of this conversation we're having in the podcast. And like previous episodes, let us know in the comments below: is this working? What things do you want us to change? I'm very excited about this. I think we're going to have a good time. We've been wanting to do this for a long time and just trying to find the right format, and I think this has a lot of potential. So let us know what you think. All right, cool. Thanks, guys.
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