HOW MANY Do you know your body?
Yes, you are intimately familiar with all the unique features and quirks that make your body your—the scar on your shin from the box jump accident at the gym, the hunger pangs you feel before you run, the moment you know you’ll break a sweat during an intense workout. But how much do you know about how your body works? plays—like how well you can use the air you breathe, for example, or how efficiently you convert the food you eat into energy, and how is that energy used in turn to power your body when you run, jump, and lift? Unless you’re a high-level professional athlete with access to a performance lab, the answer is probably very little. At least it was for me.
I take my fitness very seriously – it’s in my job description here at men’s health, after all, and I’m currently training to run the New York Marathon. I can get a good deal of information from the fitness wearables I normally use to track my workouts (most often an Apple Watch, WHOOP strap, and Oura Ring) to see how my fitness training affects my body and performance, but I find myself coming up short, once I need to put that data into practice. I want to improve on my previous marathon time of 3:15:17, which I recorded in 2019 on a wet and miserable race day. But my training intervals have consistently been slower than the 7:27 per mile pace I’ll need to beat my PR even when I push myself really hard; I feel like I am holding back from reaching my athletic potential. Ideally, I’d like my runs to be closer to seven minutes, or even into the high six. 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 can pick up the pace. But how?
The answer comes through a high-tech fitness test that can provide a wealth of data beyond the typical wrist-worn wearable device and a practical plan for putting all that information to work: PNOE. I heard about team protocol from Tailor-made treatmentsNew York City’s premier physical therapy center that also helps provide some of the our best advice from PT.
i hooked up with Cameron Yuen, DPT, CSCSa DPT at Bespoke who guided me through the whole process, which is one of the high-level performance tests offered through practice.
What is PNO?
PNOÉ, named after the ancient Greek word for breath, is a service that provides high-level cardiorespiratory and metabolic analysis through a two-part breath test.
You may be familiar with VO2max, a measurement that can help patients understand their cardiovascular status, essentially how efficiently the body uses oxygen. That’s part of PNOÉ, but this next-level service also provides more data and context than a standard VO2 max test.
“With this test, I can see exactly what your body is using for fuel and where the limitations are in three of your physiological systems: cardiovascular, respiratory and metabolic. [systems]Yuen told me when I met him at the Bespoke office.
The test results would give me insights into biometric data points and details my wearable devices could only dream of, from my aerobic health and cardiovascular fitness levels to a breakdown of how I use fuel during exercise, to the exact point in my workouts. Switching from using fats to carbohydrates. A more complete list of captured biomarkers:
- Resting metabolic rate
- Fat Max Zone
- calorie burning
- VO2max
- fat/carbohydrate burning
- economy of motion
- heart fitness
- lung fitness
- cell fitness
But as my experiences with fitness tracking and context-independent biometric information selection have taught me, I need additional help to really understand what I can do to put all that data to work. The PNOÉ system does not rely solely on cutting-edge AI and context-free reporting to do this; instead, the protocol is specifically designed to be used with a qualified medical provider, such as Yuen, to provide guidance for understanding the results and a performance plan for putting the data into action.
“Understanding your physiology is not something that can be crammed into a faceless mobile app or one-stop-shop process,” says Panos Papadiamantis, co-founder of PNOÉ. He sees his company’s product as a valuable tool for healthcare providers to have in their arsenal to provide patients with better care, whether they are high-level athletes or just ordinary people looking to maximize their quality of life. . Papadiamantis says PNOÉ’s nearly 3,000 clients include many performance coaches and sports physical therapists, but also physicians who focus on weight loss and functional health.
What makes PNOÉ special, according to Papadiamantis, is this combination of portability (similar tests typically only exist in specialized clinical settings, whereas PNOÉ’s small kit of equipment and tablet setup can be performed anywhere there is a tape running 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 provides training and support to its medical clients to help them navigate through the data to determine the best path forward for each patient.
Carrying out the PNOÉ test
PNOÉ’s administration is divided into two very different parts. “A test is the easiest test you’ll ever take,” Yuen told me. “The second test will be the hardest you’ve ever done in your life.” Consider me intimidated.
Resting metabolic rate test
Fortunately, 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, he fitted me with a heart monitor with a chest strap and a face mask, which recorded my breaths and was connected to a small power supply with a cable. After exhaling forcefully into the mask to check that the seal was tight, I lay down on the floor for the resting metabolic rate test.
Resting metabolic rate (RMR) is a measurement used to understand how much energy your body needs to function while at rest, usually calculated manually using a formula or through testing (like I was doing for PNOE ). Yuen told me that we were specifically looking to determine what fuel sources my body uses at rest to determine how healthy my metabolic system is. After being on the ground for 10 minutes, he was relaxed.
VO2 max test
Now the hard part. If you’ve ever watched a sports science special on ESPN, chances are you’ve seen the basics of the VO2 max test I was about to take. The bundle attached to the face mask was placed on a shoulder strap platform and I hopped on the treadmill. Yuen took me through a three-minute walk warm-up to establish a baseline. Easy. But then I had to run. Yuen progressively increased the speed of the machine and I was forced to keep up. The goal was to get my heart rate up to its maximum level after running for 12 to 15 minutes, so that Yuen could use the data collected to understand what limiting factors might be keeping me from reaching peak performance at all points in my training.
I kept up the pace for a few segments, running faster and faster. Breathing the mask didn’t bother me, I I got used to running with things on my face during the peak of the pandemic, but felt pushed to my limits. Shortly after Yuen told me that she had done all the running she absolutely had to do for the test, and that continuing would be reaching my true maximum, I tapped and jumped off the treadmill. He was sweating, breathing heavy and tired. It definitely wasn’t easy.
Results of PNOÉ and a New Training Plan
A few days later, PNOÉ’s software processed the data and returned a couple of very 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 percent fat and 36 percent carbohydrates for energy, which is a pretty healthy ratio.
More pressing, the VO2 max portion of the test yielded unexpected information about my performance. Most of the measurements 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 alarmingly low. This did not mean that my body had any internal problems, Yuen assured me; the problem was how he was using it. Essentially, he found that my maximum lung capacity should be around 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, I would expect an athlete to be able to use about 80 percent of his ability. “What we found was that you actually peak at two liters, so you’re not even using 50 percent of your total lung volume,” she said. What this meant in practice was that I hyperventilated throughout my workouts, using air inefficiently and limiting my potential.
Fortunately, making some improvements would require nothing more than 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 per week following a breathing protocol.
I have been putting them into practice ever since, although the stretches seem simple, I assure you they are not easy or comfortable, and I look forward to seeing the results on my race day later this year. In a few months, I can go back to the Bespoke office to take the test again and find out exactly how much I have improved.
Without the test, I never would have known that I am not reaching my full performance potential. Now, with the data and, more importantly, a training protocol to put it into practice, I feel more empowered to break through my PR marathon.
Brett Williams, fitness editor at Men’s Health, is a NASM-CPT certified trainer and former professional football player and technical reporter who divides his training time between strength and conditioning training, martial arts and running. He can find his work elsewhere on Mashable, Thrillist and other outlets.
