My guest today is Panos Papadiamantis, Co-Founder of PNOE, the world’s first portable cardio-metabolic analyzer. If you’re wondering what that is, it’s a mask that you wear during a 10-minute test on a treadmill, and from that you gain incredible insights into your health and fitness.
Panos and I take a deep dive into exactly what cardio-metabolic analysis is, and how PNOE is helping make it available to everyone. We also explore the concept of caloric efficiency, specifically what it means for endurance athletes and people who are trying to lose weight. Additionally, we talk about all the other things cardio-metabolic analysis can do for you beyond determining how many calories you should be consuming each day, including developing your heart rate training zones, testing the efficiency of your breathing, checking for risks of heart disease and even examining the quality of your posture.
We’ve recently made an update to improve how we track calories at WHOOP, and we’re excited to be partnering with PNOE to have the opportunity to provide our members the most accurate data available in the future.
3:56 - What is Cardio-Metabolic Analysis? “A device that analyzes your breath, how much oxygen your body is consuming, how much carbon dioxide it is producing, along with 12 other biomarkers in your breath. Based on that analysis, it scans the 3 most important physiological systems in your body: Your metabolism, your heart function, and your pulmonary function.”
5:08 - Why Isn’t it More Popular? “Until today, they were very expensive, between $40,000-$60,000,” and cardio-metabolic analyzers were so big that you needed a cart to move them around. There was also no support to translate the data. PNOE enables you to do it all yourself.
7:21 - How PNOE Works. “You're basically exercising on a treadmill with a mask connected on your face. We’re analyzing all of the gas exchange that is happening in your body through your mouth and nose … on a breath by breath basis.”
8:23 - The Maximal Test. “Continuing to increase intensity until the person can’t go anymore.”
9:35 - Ramp Tests & Step Tests. “What we basically determined through a ramp are the so called ‘thresholds’ in a person’s physiology, what we use to develop training zones.” A step test measures the fuel consumption and “breakdown between fats and carbohydrates at different intensities.”
11:03 - Mechanical Efficiency. “The ratio between your mechanical power output over your metabolic power output.” Endurance athletes want to be mechanically efficient with how they burn calories, however, that’s not the case for everyone.
14:16 - When is Low Mechanical Efficiency Good? For weight loss. “There are several recent studies that show that mechanical efficiency is one of the biggest reasons why most people can’t lose weight.” Panos references a recent story on their website about The Biggest Loser where “nearly everyone regained the weight after the show.” It begs the question, “Is the type of intervention you're doing leading your body to metabolic adaptations that you don’t want to have?”
20:34 - CrossFit & Calorie Inefficient. “Excessive amounts of very explosive movements and weight lifting will lead someone to be more of a ‘Type 2’ muscle fiber person, and that makes you more [calorie] inefficient.”
21:55 - Adaptive Thermogenesis. “It’s the most fundamental thing. How efficient your body is in transforming energy found in chemical form into mechanical propulsion, which is what we do all day every day.”
22:24 - How to Lose Weight Despite Caloric Efficiency. “What’s going to lead to caloric efficiency is caloric restriction. Also, excessive amounts of cardio training without complementing it with the adequate amount of strength training will also lead you to be more efficient.” So if you only train cardio and are trying to lose weight, it makes sense to try weightlifting. “Every sustainable weight-loss intervention has some type of weightlifting component in it.”
24:51 - All Calories are Equal. “Calories are equal in the sense that if you create a caloric deficit of a specific amount than your body is going to lose pretty much the same amount of weight [no matter what the calories come from]. … When it comes to judging how much weight your are going to lose, it is only a matter of how many calories went in and how many calories went out.”
28:07 - Skeptical of Popular Diets. “At the end of the day, people should know that it has been proven that a low carb diet vs. a low fat diet, provided we are within reasonable boundaries of macronutrients, pretty much will yield the same weight-loss results.”
28:55 - Intermittent Fasting. “It’s more of a psychological strategy.”
31:43 - How PNOE Knows the Number of Calories to Consume. “We measure your basal metabolic rate and your caloric expenditure in different states of activity.”
32:43 - Calibrate a Wearable with PNOE for better calorie tracking. “This is the great window of opportunity for cardio-metabolic analysis to become a truly impactful source of information for the everyday person. The whole idea is that you wear WHOOP when you’re doing the PNOE test ... and by merging the two data streams we’re able to calibrate WHOOP based on your personal cardio-metabolic profile.”
36:24 - Cardiovascular Disease Detection. “It’s the most expensive and the most deadly disease. If you look at the current spectrum of available technologies and methods, they all have significant drawbacks [except for cardio metabolic analysis]. What we’re looking at when we’re screening for ischemic heart disease is basically your VO2 in relationship with work rate, how your oxygen consumption is increasing as your mechanical power output is increasing.” This and other other biomarkers can “detect ischemic heart disease with roughly 90% sensitivity.”
41:59 - Diagnosing Chest Pain. Cardio-metabolic analysis is the gold standard in differentiating between cardiovascular problems and pulmonary problems.
42:50 - A 10-Minute Test is all it takes. “The beauty of this assessment is that you just need 10 minutes on a treadmill to get all the information you need to build a diet plan, to get a workout plan, and to screen for all the conditions that account for roughly 90% of healthcare expenses today.”
43:45 - Posture Assessment. “Breath is actually a very important indicator. Efficient breathing means good bowel control, engagement of your abdomen, and as a result means good posture.”
45:28 - One-Stop Shop for everything. “That’s really the vision of the company, cardio-metabolic analysis is widely accepted as one of the most holistic clinical-grade assessments that a person can do outside of a hospital. It can and should be the health assessment of the future.”
46:42 - Breathing Better. Can you train yourself? PNOE has worked with breath coach Brian McKenzie. “His work has shown there are many different exercises a person can do [to get better at breathing].”
49:24 - Tidal Volume. “How much volume of air we can exchange between our lungs and the environment per breathing cycle.”
52:06 - 3 Gears to Our Body. Lungs, heart and muscles, in that order. “If your body is failing, it could be any combination of the three. … Cardio-metabolic analysis is able to discern what is actually the problem.”
55:46 - VO2 Max. “Extremely overrated, it’s just the tip of the iceberg. VO2 max is your peak oxygen consumption, that’s it. It is great indicator of health. ... It doesn’t give you training zones.”
58:34 - Anaerobic Threshold or VT2. “When your body starts to build fatigue at an unsustainable rate.”
1:00:38 - Where Did PNOE Come From? “The idea started from my cofounder and childhood friend Apostolos.”