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Why You Need a PNOE Breath Analysis Test

The Johnson Center is excited to announce a new service we’re offering to our patients- the PNOE breath analysis. By analyzing your breath, this test will be able to tell you what your body is using for fuel, the health of your respiratory, cardiovascular, and metabolic systems, and how to increase longevity.

In this blog, we’ll explain what a breath analysis is, what it’s analyzing, and why you need one.

What is a breath analysis?

A breath analysis is exactly what it sounds like- a test in which a person’s exhaled gases are analyzed. This specialized test dates back to the early 20th century when scientists were trying to understand how living organisms use and absorb oxygen.

You might also have heard of a breath analysis under its other names- VO2 max testing, Cardiopulmonary exercise testing, cardio-metabolic analysis, and metabolic testing. But regardless of what you call this type of analysis, the breath analysis looks to analyze the elemental mechanisms of oxygen absorption, transfer, and utilization (i.e. your lungs, heart, and cells).

As you inhale and exhale, the breath analysis is measuring oxygen concentration (O2), carbon dioxide concentration (CO2), and free-flow oxygen. Combining these measurements, a breath analysis can give you information on 23 cardio-metabolic biomarkers that evaluate one’s health and performance.

These biomarkers include:

  1. Maximum volume of oxygen consumed

  2. The ratio of oxygen volume consumed over breathing frequency.

  3. The ratio of minute ventilation over carbon dioxide volume produced.

  4. The highest concentration of carbon dioxide achieved during exhalation.

  5. The highest oxygen concentration achieved during inhalation.

  6. The volume of carbon dioxide produced

  7. The maximum volume of air exhaled at rest during the most prolonged exhalation possible.

  8. The ratio of carbon dioxide volume produced over oxygen volume consumed.

  9. The volume of air exhaled in one breath.

  10. The number of breaths completed in one minute.

  11. Average carbon dioxide concentration in one exhalation.

  12. The ratio of mechanical power over calorie burn per second.

  13. The heart rate at which carbohydrate and fat oxidation reach the same level.

  14. Average oxygen concentration in one exhalation.

  15. Number of heartbeats per minute.

  16. The time variability between heartbeats

  17. The volume of air exhaled in one minute.

  18. The ratio of oxygen volume consumed over heart rate.

  19. The number of calories burned per minute.

  20. Grams and calories of fat burned per minute.

  21. Grams and calories of carbohydrates burned per minute.

  22. The heart rate at which fatigue accumulation begins at a sustainable rate for the body.

  23. The heart rate at which fatigue accumulation begins at an unsustainable rate for the body.

These 23 biomarkers will give insight into your heart, lung, cell, and overall systemic health. To make things a little less complicated, these elements have been divided into multiple metrics. We’ll go through them below.

Metabolic rate → How fast or slow your metabolism is

This metric is formulated by assessing the rate at which you burn calories at rest and the rate you burn calories during low exercise intensities. A high Metabolic Rate will keep you from gaining weight as your body will burn more calories throughout the day, allowing you to eat more calories. It also helps with weight loss because burning more calories means that even a small reduction in food consumption results in a significant calorie deficit and weight loss.

Breathing and cognition → How your breathing affects your brain functioning and ability to think

Breathing and cognition are analyzed by assessing your breathing frequency and how much carbon dioxide you exhale per breathing cycle. If you’re breathing too fast and exhaling a lot of carbon dioxide, you enter a state known as hyperventilation. This condition leads to the arteries in the neck narrowing, which will cause less oxygen to enter the brain. Less oxygen in the brain means slowed reaction time and lower cognitive capacity.

Fat burning efficiency → How well your cells can use fat as fuel during exercise

Being able to burn fat for energy is one of the most vital indicators of good cellular health. This is because your cells need oxygen to burn fat, and the more your cells can absorb and use oxygen, the healthier they are. Fat-burning efficiency is a metric that is strongly correlated with longevity and health.

Movement economy → How many calories you burn while exercising

Having a high movement economy is valuable for all sports, but especially for endurance sports. It indicates that your body requires less energy to operate, minimizing fatigue buildup.

Recovery capacity → Your ability to recover from physical exercise

This metric is measured by assessing the rate at which your volume of carbon dioxide exhaled (VCO2) and heart rate drop during the recovery phase of the exercise test. The faster your VCO2 and heart rate drop, the better your cardiovascular and respiratory systems can recover. The higher your recovery capacity, the lower your fatigue.

High-intensity performance → How well your lungs and heart perform in high exercise intensities

Your high-intensity performance is measured by how well your lungs take in oxygen and how well your heart pumps it throughout your body during high-intensity exercise. The higher the volume of oxygen absorbed by the lungs and pumped by the heart, the greater your ability to perform well in high-intensity exercises. When your high-intensity performance is high, your body will remain in an aerobic state while exercising, allowing you to perform at high intensity for longer and burn more calories.

Respiratory capacity and capability → How big your lungs are and how much of your lung volume you can use

These two metrics look at how much air you can take in and how that compares to your lung's overall volume. Being able to take in a lot of air and use most of your lung volume is integral to living a long and healthy life. Limited oxygen intake means less oxygen available to the cells, which leads to chronic fatigue, lower cognitive function, and a reduced ability to exercise.

Aerobic health → Guage of overall health and strongest predictor of how long and how well you will live

Your aerobic health is measured based on the maximum amount of oxygen that your body can absorb. The better your aerobic health, the more oxygen your body is able to absorb, and the healthier your critical organs- namely lungs, heart, cells, and blood. Having low aerobic health has been linked to every significant chronic condition.

Cardiovascular fitness → How well your heart and blood vessels can pump oxygen-rich blood to your body

This metric uses the maximum amount of oxygen your body can absorb and the amount of oxygen your system delivers in a single heartbeat. A high cardiovascular fitness score ensures that your body is able to successfully use that oxygen to break down nutrients and power the movement you’re asking it to do. Low cardiovascular fitness can be a potential risk factor for cardiovascular disease.

What are these results good for?

With the results of your PNEO breath analysis, the team at the Johnson Center will be able to do several different things. Firstly, we can make a nutrition plan that is uniquely tailored to you in the following areas:

  • Energy intake → how many calories you consume per day

  • Macronutrient intake → how many fats, proteins, and carbohydrates you should consume per day

  • Micronutrient intake → which vitamins, minerals, and hormones you should prioritize and consume per day

  • Meal timing → what time of day you should eat to mitigate hunger, maximize fat burn, and get the most out of your workout.

PNOE results will also offer insight into how you should be exercising across the three categories:

  • Cardio training

  • Interval training

  • Resistance training

Each type of training has a widely different impact on your health and performance. The PNOE analysis will tell you exactly where your fitness limitations are and how you can change your routine to remedy them. Moreover, just like every workout has its benefits, it also has its repercussions. Knowing exactly what different workout styles do for your body will help you get the most out of every workout.

To learn more about the PNOE breath analysis or to make an appointment, click here to contact us! If you have any more questions about your path to optimal health, email our office at or call 276-235-3205.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!


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