At first glance, PNOĒ’s newest device looks like something a comic book villain might carry. The mask, which covers the nose and mouth and fits around the back of the head, bears more than a passing resemblance to the one worn by Bane, Batman’s burly foe. But its purpose is much more benign; It measures how much oxygen you consume and how much carbon dioxide you exhale, then turns that data into advice on how to eat, train and, the company hopes, live longer.
PNOĒ, headquartered in Malden, Massachusetts, with operations in Athens, Greece, is preparing to launch PNOĒ 2.0 on October 1. The big change from its current device is that users can take the test themselves. According to co-founder and CEO Apostolos Atsalakis, someone can walk into a gym, “simply wear the mask, press the button, sit down” and breathe for eight minutes. “That’s it. It’s that easy,” he said recently, speaking to this editor via a Zoom call from the company’s Athens location.
This is important because the current PNOĒ device requires a trained operator, which limits where it can be used. A self-service version could open the door to gyms without dedicated staff and potentially even pharmacies, Atsalakis said.
The science behind PNOĒ is not new. Metabolic testing, which analyzes gases in a person’s breath to measure how their body produces energy, has been around for more than a century. For decades, it has been the gold standard for measuring VO₂max, the maximum amount of oxygen the body can use during exercise and a widely used measure of cardiorespiratory fitness. But testing has traditionally required bulky, expensive equipment found primarily in sports labs and hospitals, which is why it has largely been the province of elite athletes and executive wellness programs.
What 10-year-old PNOĒ promises is the same precision in a portable package, combined with software that translates results into recommendations. “We made it accessible to everyone,” Atsalakis said.
The company says its test captures 23 biomarkers, including (beyond measuring VO₂ max) resting metabolic rate (how many calories the body burns at rest) and metabolic flexibility (how well the body switches between burning fat and carbohydrates). Atsalakis maintains that these metrics answer questions that blood tests cannot, such as how many calories a person needs or how they should train.
It’s a good time for PNOĒ. VO₂ max has become a buzzword among longevity enthusiasts, thanks in part to research linking greater cardiorespiratory fitness with lower mortality. Atsalakis considers VO₂max to be the strongest predictor of human longevity and sees his company’s data as a kind of scorecard for the burgeoning wellness industry.
The new device is smaller and more compact than its predecessor, with fewer parts, which Atsalakis says makes it more reliable. It was designed with Milan-based Design Group Italia on what Atsalakis described as “very, very much a batch of iterations,” as a self-administered metabolic testing device had not been performed before.
It also addresses a question post-pandemic users are likely asking themselves: who used it last? The answer: It doesn’t matter, as the electronics separate from the silicone mask and straps, so multiple people can share the expensive hardware while each user keeps their own mask.
For all his clinical ambitions, PNOĒ is careful about what he claims. The device is not approved by the U.S. Food and Drug Administration, and Atsalakis said “we do not provide medical recommendations.” PNOĒ is rather considered a wellness device. “It’s like a body composition device, like a scale,” he said. “A doctor cannot prescribe medication based on our results.”
That could change in the future. Researchers have long explored whether compounds in human breath can indicate diseases like cancer, and Atsalakis believes the company’s growing trove of data could eventually help it detect health problems. But he acknowledged that a full diagnosis is “definitely a couple of years away,” and that regulatory hurdles will likely stretch that timeline even further. “We’re not there yet,” he said.
PNOĒ has its roots in Atsalakis’s doctoral work in sensing technologies at the University of Cambridge, when wearable devices were taking off and he became fascinated by what breathing could reveal about the body. He co-founded the company with Panos Papadiamantis, a childhood friend who is now the company’s chief product officer.
The startup went through Y Combinator’s winter 2019 batch, when “longevity” was not yet the industry it is today. Since then, it has raised around $22 million, including a recently closed $11 million round, from investors including 50 Years and Google Maps co-founder Lars Rasmussen, who now resides in Athens.
PNOĒ sells only to companies, which then offer the test to their customers. Its customers include Equinox, where it is available in nearly every club, Atsalakis said, as well as Four Seasons hotels, Red Bull, the NBA, Mount Sinai Health System and the Restore Hyper Wellness medical spa chain.
About 85% of its business comes from the United States, which Atsalakis described as “by far the most advanced market globally” in terms of longevity. The company is now expanding in Europe and, through partners, in Latin America and Asia.
Companies pay a subscription ranging from $400 a month to more than $1,000, which covers hardware, software, training and marketing materials, a package Atsalakis calls a “business in a box.” PNOĒ also ties its results to the services a company sells, so a gym or spa can recommend specific offers based on a customer’s test. Many customers use the test during onboarding, Atsalakis said, putting it somewhere between a full clinical study and the estimates people get from their smartwatches.
That middle ground is increasingly crowded. Apple, Garmin, and Whoop estimate VO₂ max from heart rate data, while consumer devices like Lumen analyze breath to measure fat and carbohydrate burning. At the high end, traditional metabolic carts remain the standard in laboratories and hospitals.
PNOĒ, which employs 110 people, says it recently became profitable and is growing more than 100% a year. Atsalakis said the company plans to launch a Series B in the next six to 12 months as it tries to get its skin (Bane comparisons and all) in front of more faces.
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