I tried the PNOE metabolic analysis service to test and review

HOW MUCH TO DO do you know your body?

Yes, you know intimately all the unique characteristics and quirks that make your body you-the scar on your shin from the box jump accident in the gym, the feeling of hunger you feel before a race, the moment you know you’re going to sweat during a hard workout. But what do you know of the way your body works– as in, how well you are able to use the air you breathe, for example, or how efficiently you convert the food you eat into energy, and how that energy is in turn used to fuel your body when you run, jump, and lift? Unless you are a top professional athlete with access to a performance lab, the answer is probably very little. At least it was for me.

I take my fitness seriously – it’s in my job description here at men’s health, after all, and I’m currently training to run the New York City Marathon. I can glean a fair amount of information from the fitness wearables I typically use to track my workouts (most often an Apple Watch, WHOOP bracelet, and Oura ring) to find out how my fitness training affects my body and my performance, but I find myself coming short once I need to put this data into practice. I want to beat my previous 3:15:17 marathon, which I recorded in 2019 on a wet and miserable running day. But my training splits have always been slower than the 7:27 per mile pace I’ll need to beat my PR even when pushing hard; I feel like I’m holding myself back from reaching my athletic potential. Ideally, I’d like my runs to be closer to seven minutes flat, or even in the high sixes. I’ve run faster than this before (my half marathon PR is 1:29:55, just over 6:51 per mile) so I know I have the ability in me to speed up the rhythm. But how?

The answer comes through a high-tech fitness test that can provide tons of data beyond the typical wrist-bound wearable and an action plan to put all that information to work: PNOE. I heard about the protocol from the team at Tailor-made treatmentsNYC’s premier performance physical therapy center that also helps provide some of the our best PT tips.

I connected with Cameron Yuen, DPT, CSCSa DPT at Bespoke who guided me through the process, which is one of the high-level benchmarks offered by practice.

What is PNOE?

PNOÉ, whose name comes from the ancient Greek meaning breath, is a service that provides high-level cardiorespiratory and metabolic analysis via a two-part breath test.

You may know VO2 max, a measurement that can help patients understand their cardiovascular fitness, essentially how efficiently the body uses oxygen. It’s part of PNOÉ, but this higher-level service also provides more data and context than a standard VO2 max test.

“Through this test, I can see exactly what your body uses for fuel and where the limits are for three of your physiological systems: your cardiovascular system, your respiratory system, and your metabolic system. [systems]“, Yuen told me when I met him at the Bespoke office.

The test results would provide my information on biometric data points and details my wearable devices could only dream of, from my aerobic health and cardiovascular fitness levels to the breakdown of how I use fuel during the exercise, to the exact point in my workouts I switch from fats to carbs. A more complete list of captured biomarkers:

  • Resting Metabolic Rate
  • Fat Max Zone
  • calorie burn
  • VO2max
  • Fat/carb burn
  • Economy of movement
  • heart shape
  • Lung form
  • Cellular fitness

But as my experiences with fitness tracking and reviewing context-free biometric information have taught me, I need some extra help to really understand what I can do to put all this data into practice. . The PNOÉ system doesn’t just rely on state-of-the-art AI and context-free reporting to do this; instead, the protocol is designed specifically for use with a qualified medical provider, like Yuen, to provide guidance to understand the results and a performance plan to put the data into action.


“Understanding your physiology is not something that can be contained in a faceless mobile app or a one-stop-shop process,” says Panos Papadiamantis, co-founder of PNOÉ. He sees his company’s product as a valuable tool that healthcare providers should have in their arsenal to deliver better care to patients, whether they are top athletes or just normal people looking to maximize their quality. of life. Papadiamantis says that among PNOÉ’s nearly 3,000 clients are many performance trainers and sports physiotherapists, but also physicians who focus on weight loss and functional health.

According to Papadiamantis, what makes PNOÉ special is this combination of portability – similar tests typically only exist in specialized clinical settings, while PNOÉ’s small case of equipment and tablet setup can be undertaken anywhere. where there is a treadmill or a stationary bike – and a dedicated service. Once the breath test data is recorded, PNOÉ’s software generates a detailed report, which the healthcare professional interprets for the patient, as Yuen would for me. PNOÉ also offers training and support to its medical clients to help them navigate the data to determine the best course of action for each patient.

Pass the PNOÉ test

The administration of PNOÉ is divided into two very different parts. “A test is the easiest test you will ever do in your life,” Yuen told me. “The second test will be the most difficult test you have ever taken in your life.” Consider me intimidated.

Resting metabolic rate test

Luckily, the first part of the test was there to make the process easier for me. I showed up at Bespoke on an empty stomach; Yuen told me not to eat anything on the day of the test. Once everything was set up, he fitted me with a chest strap heart monitor and face mask, which recorded my breathing and was attached to a small power supply by a lanyard. After exhaling hard into the mask to check that the seal was tight, I lay down on the floor for the resting metabolic rate test.


men’s health

Resting Metabolic Rate (RMR) is a measurement used to understand how much energy your body needs to function at rest, usually calculated manually using a formula or through testing (as I did for PNOE). Yuen told me that we were specifically looking at what fuel sources my body uses at rest to determine the health of my metabolic system. After being on the ground for 10 minutes, I was relaxed.

VO2 Max test

Now the hardest part. If you’ve ever seen a sports science special on ESPN, you’ve probably seen the basics of the VO2 max test I was about to take. The bag attached to the face mask went on a shoulder strap platform and I rode the treadmill. Yuen made me do a three-minute walking warm-up to establish a baseline. Easy. But then I had to run. Yuen gradually increased the speed of the machine, and I was forced to follow. The goal was to increase my heart rate to its maximum level after running for 12-15 minutes, so Yuen could use the data collected to understand what limiting factors might be preventing me from achieving peak performance at all stages. of my training.


men’s health

I kept up the pace for a few segments, running faster and faster. Breathing in the mask did not bother me – I I got used to running with stuff on my face during the peak of the pandemic, but I felt pushed to my limits. Shortly after Yuen told me that I had done all the running I absolutely had to do for the test, and that continuing would be to reach my true maximum, I tapped and jumped off the treadmill. I was sweating, breathing hard and I was tired. It certainly wasn’t easy.

The results of the PNOÉ and a new training plan

A few days later, PNOÉ’s software had analyzed the data and returned a pair of super detailed reports based on the tests, which Yuen then shared with me. I learned from the RMR report that my metabolism uses an energy mix of 64% fat and 36% carbs to produce energy, which is a pretty healthy ratio.



More pressing, the VO2 max portion of the tests revealed some unexpected information about my performance. Most of the metrics were high, which I expected as someone who trains five to six days a week. I discovered my biological age (three years younger than my real age), the exact heart rate training zone ranges for me, and more.

But some of my marks related to my breathing were alarming. That didn’t mean anything was wrong with my body, Yuen assured me; the problem was in the way i used it. Basically, he found that my maximum lung capacity should be about five liters of oxygen. But when I was running on the treadmill during the test, I wasn’t even close to using all the air that should have been available to me. Typically, he would expect an athlete to be able to use around 80% of their capacity. “What we found is that you actually peak at two liters, so you’re not even using 50% of your total lung volume,” he said. In practice, this meant I hyperventilated during my workouts, using air inefficiently and limiting my potential.

Luckily, making improvements wouldn’t take anything but good old-fashioned hard work. Yuen gave me a simple plan to follow, consisting of two stretches to help me breathe better and two 45-minute runs following a breathing protocol per week.

I’ve been practicing them since then – although the stretches seem simple, let me assure you they’re neither easy nor comfortable – and I can’t wait to see the results on my race day later this year . In a few months, I can go back to the Bespoke office to retest to find out exactly how much I’ve improved.

Without the test, I never would have known that I wasn’t living up to my full performance potential. Now, with the data — and more importantly, a training protocol to put it into practice — I feel more empowered to go break my PR marathon.

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