Advanced Metabolic Testing


Frequently Asked Questions

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What is Advanced Metabolic and Cardiopulmonary Stress Testing (CPX)?

Advanced Metabolic & Cardiopulmonary Stress Testing is used to evaluate how well your heart and lungs are working during exercise. It also provides a clear picture of your individual metabolism and how your body utilizes food for fuel. The testing measures the amount of oxygen being consumed and how much of that oxygen is actually going to the working muscles. An individual’s ability to consume and utilize oxygen is directly related to their risk of developing cardiovascular disease.

Why are Advanced Metabolic & Cardiopulmonary Stress Tests performed?

Advanced Metabolic & Cardiopulmonary Stress Testing can be done for many reasons. Some of these reasons include:

  • Shortness of breath
  • Evaluate/detect heart failure
  • Evaluate lung function
  • Understanding how your body utilizes fat and carbohydrate
  • Identify resting metabolic rate
  • Address weight loss, gain, or maintenance
  • Overall evaluation of cardiopulmonary health

What is a Pulmonary Function Test?

We will also be looking at how well your lungs are working by administering Pulmonary Function Tests (PFTs) also known as spirometry. These tests will
determine how effective your lungs are at bringing oxygen to your entire body. PFTs are performed for the following reasons:

  • If you have any symptoms of lung issues
  • To measure the effectiveness of bronchodilators
  • During a routine physical
  • Determine how well your lungs are working before a surgical procedure
  • To determine if an already diagnosed lung condition is progressing

PFTs can also help diagnosis the following:

  • Asthma
  • Chronic bronchitis
  • Allergies
  • Lung Fibrosis
  • Respiratory infections
  • Pulmonary tumors
  • COPD, which is chronic obstructive pulmonary disease also known as emphysema
  • Bronchiectasis, a condition where the airways widen and stretch
  • Asbestosis, a condition caused by exposure to asbestos
  • Scleroderma, a disease affecting your connective tissues

How are the tests performed and how long does the testing take?

The Resting Metabolic Assessment and lung function testing are both performed sitting in comfortable chair. The exercise component is performed on a stationary bicycle. Total time for the test will be 1 hour, including time for warm-up, the testing assessments, and an overview of the results.

How do I prepare for testing?

  • Do not exercise the day of your test. Any exercise done the day before should be a very easy effort (conversational pace), and no more than one hour long.
  • Do not consume nicotine 3 hours before the test.
  • No thermogenic aids (weight loss products/metabolic enhancers) 24 hours prior to the test.
  • Do not consume alcohol 24 hours before the test.
  • Do not eat 3 hours prior to the test. You may drink water in that 3-hour time period, just no tea, soda, coffee, or juice.
  • Do not use lotions on chest area and make sure chest is shaved for ECG electrode placement
  • You should not stop any medications without contacting your prescribing doctor.

What do I wear and bring to testing?

  • Comfortable workout clothing such as shorts and shirt/sports top.
  • Your completed Customer Information Packet
  • Water bottle
  • Hand towel
  • Hair pulled back if it is long
  • Medications (i.e. inhalers)
  • Closed-toe shoes

What exactly will happen during the test?

During the Resting Metabolic Test you will relax in a chair while a comfortable mask is placed over your mouth and nose in order to collect your expired gases. The mask will not restrict breathing and will provide you with air in the environment. It is very important to remain as relaxed as possible to get the most accurate results. The test will take 15-20 minutes. The spirometry test is also performed sitting straight up in a comfortable chair with your feet flat on the floor. The testing administrator will place a clip on your nose to keep both nostrils closed. You will be asked to create a tight seal with your lips around the plastic filter. You will be instructed to take a deep breath in and forcefully blow all of the air out of your lungs. You will repeat this same process 3 times. If you currently take a bronchodilator then the testing administrator will have you take your bronchodilator then repeat the test to measure the effectiveness of the medication. The spirometry test will take 7-10 minutes.

For the Exercise Test, a 12-lead EKG, blood pressure cuff, and pulse oximeter are connected. Then a comfortable mask is placed over the mouth and nose to collect expired gases and obtain information regarding respiratory rate. The test will begin with a warm-up on the stationary bike. Once the warm-up is complete, there will be a stage of collecting preliminary data before the intensity gradually begins to increase. During this time the rate at which your body consumes oxygen, gives off
carbon dioxide, blood pressure, pulse ox, heart rhythms, and rate of perceived exertion (RPE) are monitored. The level of oxygen consumed will increase as the exercise intensity increases. The test will end when you can no longer continue to exercise or when the testing administrator has collected all the measurements necessary. The test will also be terminated if any ill effects occur during exercise.

After the testing is complete there will be a two-minute cool-down period to assess how quickly the cardiovascular system recovers. The total time for the exercise component will be 8-12 minutes. At the end of the tests, your results will be reviewed and an exercise Rx will be provided and explained. Your results will also be reviewed by our Registered Dietitian who will provide you with a nutrition Rx in conjunction with the exercise Rx you received.

What are the benefits of testing?

  • Understanding how your body utilizes fat and carbohydrates
  • Identifying your personalized optimal fat burning zone
  • Addressing weight loss, gain, or maintenance
  • Exercise & Nutrition Prescriptions created for your unique physiology
  • Identifying Resting Metabolic Rate (the amount of calories needed daily for survival)
  • Evaluating the health of your lungs and respiratory system
  • Understanding how to utilize breathing techniques to reduce stress and anxiety
  • Implementing strategies to improve overall health and well being

What are the benefits of the exercise and nutrition prescription?

  • Increased weight loss
  • Improved weight management
  • Improved fasting insulin levels
  • Improved concentration and focus
  • Decreased body fat
  • Increased fasting blood sugar levels
  • Improved HbA1c levels
  • Reduced hunger & food cravings
  • Improved sleep & recovery
  • Increased sustainable energy
  • Improved blood lipid profile
  • Improved sleep
  • Increased energy levels
  • Improved quality of life