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  • Writer's pictureMeta Boliqa

Breath Analysis – An Overview

Breath analysis is a test during which a person’s exhaled gases are analyzed. Its origins date back to the early 20th century when scientists looked to analyze and understand the most fundamental mechanism of all living organisms on our planet, the absorption, and utilization of oxygen.

Since its inception, breath analysis has been given many names, including metabolic testing, VO2max testing, Cardiopulmonary exercise testing, and cardio-metabolic analysis. These names are derived from their ability to analyze the three elemental mechanisms that participate in oxygen absorption, transfer, and utilization, namely, our lungs, heart, and cells.

In this article, we dive into the biomarkers breath analysis analyses and how they are translated into actionable evaluators of our health and performance.

The elemental metrics:

The gold standard for analyzing human breath includes the measurement of oxygen concentration (O2), carbon dioxide concentration (CO2), and flow volume in real-time during inhalation and exhalation. The graph below shows how these three metrics evolve during inhalation and exhalation.

To better understand the sinus-like waveform of these signals, one needs to consider our body’s primary function, which is the absorption of air with high O2 content followed by exhalation of air with lower O2 content and higher CO2 generated by metabolic processes. The longer air stays within the lungs, the more O2 it transfers and the more CO2 it receives from the bloodstream. As a result, the deeper the inhaled air goes into the lungs, the more O2-CO2 exchange it experiences, leading to lower O2 and higher CO2 concentrations. This process is reflected in the signals picked up by the CO2 and O2 sensors. When the subject exhales, O2 concentration drops and CO2 concentration increases as air from the deeper parts of the lungs make it back to the mouth and nose during exhalation. When exhalation is followed by inhalation, the CO2 and O2 concentrations immediately revert back to concentrations the atmosphere around us contains, which are generally 20.9% for O2 and 0.05% for CO2.

Flow volume represents the rate at which air passes through your mouth and nose. During inhalation, air moves from the atmosphere and into your lungs. During exhalation, air moves in the exact opposite direction. This is reflected in the “flipping” of the curve above and below the x-axis.

Cardio-metabolic variables:

Combining the O2 and CO2 concentration signals with flow volume breath analysis of twenty-three cardio-metabolic biomarkers that evaluate one’s health and performance.

These include:

1. VO2peak: Maximum volume of oxygen consumed

2. VCO2: Volume of carbon dioxide produced

3. Respiratory Exchange Ratio (RER): Ratio of carbon dioxide volume produced over oxygen volume consumed.

4. Tidal Volume (VT): Volume of air exhaled in one breath.

5. Breathing Frequency (BF): Number of breaths completed in one minute.

6. Minute Ventilation (VE): The volume of air exhaled in one minute.

7. VE/VCO2: Ratio of minute ventilation over carbon dioxide volume produced.

8. O2pulse: Ratio of oxygen volume consumed over heart rate.

9. VO2/BF: Ration of oxygen volume consumed over breathing frequency.

10. End-tidal CO2 (FetCO2): The highest concentration of carbon dioxide achieved during exhalation.

11. End-tidal O2 (FetO2): The highest oxygen concentration achieved during inhalation.

12. Fraction of expired CO2 (FeCO2): Average carbon dioxide concentration in one exhalation.

13. Fraction of expired O2 (FeO2): Average oxygen concentration in one exhalation.

14. Heart rate: Number of heart beats per minute.

15. Heart Rate Variability (HRV): The time variability between heartbeats

16. Forced Expired Volume (FVC): The maximum volume of air exhaled at rest during the most prolonged exhalation possible.

17. Caloric burn: Number of calories burned per minute.

18. Fat oxidation: Grams and calories of fat burned per minute.

19. Carbohydrate oxidation: Grams and calories of carbohydrate burned per minute.

20. Mechanical Efficiency: Ratio of mechanical power over calorie burn per second.

21. Crossover point: The heart rate at which carbohydrate and fat oxidation reach the same level.

22. Aerobic Threshold or First Ventilatory Threshold (VT1): The heart rate at which fatigue accumulation begins at a sustainable rate for the body.

23. Anaerobic Threshold of Second Ventilatory Threshold (VT2): The heart rate at which fatigue accumulation begins at an unsustainable rate for the body.

Source: PNOE

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