Test. Don't Guess. A Guide to Physiological Testing

My mantra (well one of them), "Test. Don't guess". Powerful if you ask me. However, I have been accumulating feedback the past few years from individuals regarding various types of testing only to have concluded that we are living in the dark ages when it comes to testing. I believe that we are still following the Western Medicine guidelines of having blood work done only when necessary, for life insurance purposes, or once a year as an annual check up. I compare this model to the amount of nutrition education physicians receive in medical school: lacking.

I used subscribe to this same thought process too...albeit, when I was younger (read: bullet proof and NOT the coffee), and only new what university taught me. These days though, the older (read: wiser) me has learned quite a bit about the process of testing, applicability, and more importantly, the "why" behind some of the testing.

So, I thought I would share my thoughts on the way testing should be done, at least through my eyes. Keep in mind that there are SO many different types of tests out there (I am certainly still learning) so I am going to simply review the ones that are in my wheel house since I can speak intelligently about them. I'm going to limit this post to only 5 specific tests so I don't get too far on a rant and end up writing a novel.

Let's get started. First off, remember, there should be a fundamental reason for testing AND a method for using the information you receive. This is a pretty important point to keep in mind. Okay, here we go!

1. Metabolic Efficiency (ME)

Ah, the physiological test I created in the early 2000's. There is quite a bit of confusion not only on the proper protocol for this test but also the purpose of it. Let me make it crystal clear that the ME test is a nutritional assessment test. I guess you can even think of it as a nutritional performance test. However, what it is not is a physical performance test. You can read more about what you receive from the test HERE but this test will provide a "systems check" to see if your current daily nutrition (aka-diet) is meeting your health and performance needs. Quite simply, it looks under the hood to see if your macronutrients that you consume are out of whack or not. The test should progress in 4-5 minute stages, be done in a fasted state, and should last between 15-45 minutes. You should not do this test if you are merely looking to get heart rate, power, or pace training zones. That is physical performance data and there are better tests that will provide this.

The ME test is a sub-maximal. Yes, SUB-maximal, which means you should start at a super easy effort and progress slowly, possibly reaching close to threshold (but often times that is not even necessary)

Listen up because this really happens. An individual says, "I had a metabolic efficiency test last year, I'm fine". Well, um, no you are not. You see, what many do not understand is that your metabolic efficiency is more regulated by your daily nutrition than it is by exercise (more about that HERE). I have personally tested individuals (and myself) showing extremely profound changes in metabolic efficiency in one week. Yes, ONE WEEK! So folks, if you truly want a snapshot of your current nutrition situation, go have a Metabolic Efficiency Test done today. You cannot assume data from a year ago (or even a few months ago) is still valid.

2. Lactate Threshold (what I call, Lactate Clearing Efficiency)

This is the physical performance test that you want to set training zones. It doesn't require fasting and you should be prepared to go HARD on this test. Not like a VO2 but pretty darn close! I won't get into this test too much since I just blogged about it (click HERE to read that post).

In reality, only endurance athletes really need to bother with this type of testing and probably only 2-3 times per year based on their training periodization.

3. Sweat Sodium Concentration (and Rate)

Not many people understand the difference between concentration and rate. Sweat sodium concentration measures the, you guessed it, concentration of your sodium in your body. This is largely influenced by genetics and this testing only needs to be done once (what I term "one and done"). Once you know your sodium concentration, you can then move onto the rate part and get an accurate picture of your fluid and sodium needs during exercise. One thing to note: this type of testing can be done exercising (via patch, sweat bag) but the one we like to use at eNRG Performance is a non-exercise option that induces sweat from your forearm. Super easy and time efficient. In fact, it usually only takes about 30-45 minutes.

Sweat rate is what you need to really keep an eye on throughout the year based on the environmental stress and sport(s) you do. This can change quite a bit and will alter your fluid and electrolyte plan so it is best to do this when the seasons change or per sport (i.e.-if you are a triathlete, you should measure this for swim, bike, and run training). The rate testing is super easy and all that is required is an accurate scale. Simply weigh yourself (preferably nude) pre- and post-workout and record the information. HERE is a sheet detailing this information and how to use it.

4. Blood work

Seriously, this is probably the most important testing EVER, especially as you age or if you have family history of disease states. There are so many options it really isn't funny but suffice to say, I usually recommend a very comprehensive foundational blood work test at the onset of your testing, then follow-up panels based on any deficiencies you have or based on nutritional changes you are making. For example, perhaps you find that your lipids are a bit off (HDL, LDL, particle size, triglycerides) and you work with a Registered Dietitian to make nutritional changes. Your next blood work test can then focus on these specific markers instead of the "whole enchilada" again. Vitamin D or iron low? Work on it. Change your daily nutrition. Supplement if you need to but just be sure to have frequent blood work testing check-ups to ensure what you are doing is actually working. HERE is more information about various tests we do at eNRG Performance.

5. Genomics

This is relatively new and I will point you to the information I wrote for the eNRG Performance website as that is a great summary of what it is and why it is important. Suffice to say, yes it is important and no, it is not ancestry testing. The field is called Nutrigenomics and I remember about 10 years ago when I was reading a nutrition journal introducing this concept/field. I thought it was quite interesting and predicted that it would take off and become wildly popular. Here we are 10 years later and well, it is. This is very much a "one and done" test and is great because you find out which genes (related to nutrition) may have "spelling errors" on them and may not function they way they are supposed to. Perhaps you find out that genes for Vitamin D metabolism are not functioning well. Meet with a Registered Dietitian after the test, and he/she can help you identify work around strategies to help "fix" this problem so you do not risk Vitamin D deficiency. Be careful when you search for genomic testing though. There are quite a few choices, some cheap with not a lot of information and some expensive with too much information. Much like Goldilocks and the Three Bears, you want the one in the middle!

There you have it! Reach out if you have any questions.