Diving into the "mother of all biomarkers": Heart rate variability.
HRV is an accurate, non-invasive measure of the autonomic nervous system – which responds to nearly everything: how you exercise, recover, eat, sleep, and perceive stress. Unlike basic heart rate, which counts the number of heartbeats per minute, HRV counts the exact time intervals between successive heartbeats (inter-beat intervals, RR intervals, NN intervals, etc). Jason Moore, CEO of EliteHRV, joins the podcast to discuss the basics and nuances of HRV and how it ties into optimal performance and health.
Enter code "hvmn" at checkout and get 10% off EliteHRV's heart rate variability sensor: CorSense.
Hey, welcome to this week's episode of the HVMN Podcast. This is your host, Geoffrey Woo and this is going to be a really fun one because in a lot of our conversations over with previous guests, we touched upon the topic of heart rate variability, HRV, and it's becoming a biometric that's been getting a lot of attention and traction as being important for so many different endpoints of measurement. I'm excited to be talking with Jason Moore, who's the founder of Elite HRV, probably one of the most premier software applications out there to track and monitor HRV. Welcome to the program.
I appreciate it. Yeah, thanks for having me. I'm excited to be here and I love the work that you all are doing as well and I know folks are familiar with that so I don't have to talk it up but I think you're doing great things over there, so happy to be able to contribute.
Hey, appreciate it, appreciate it. I mean, I think there's more and more entrepreneurs and thinkers and operators who are looking at humans as a platform for innovation, so I see us very much as similar kindred spirits who are hopefully making humans a little bit better. Let's just dive into it, so HRV, heart rate variability, let's start from the basics. What is it? How does one measure it? How about we start from there?
Yeah, and , feel free to curtail me a little bit because I teach a whole course on this and things so I can talk hours on the subject, but heart rate variability in a nutshell is kind of looking at these tiny, almost imperceptible changes that occur in your heart rate between each and every single beat. It's not just that you have a higher heart rate when you're exercising and lower when you're not exercising. Of course, people understand that, but each and every beat is actually different than the one before it, and certain patterns within those changes between heartbeats actually reflect activity from different systems within the body, such as the nervous system, the autonomic nervous system specifically is one that we're really interested in. By measuring these tiny little millisecond changes between heartbeats, this heart rate variability, we can run certain algorithms to detect activity from the nervous system, see how the body is responding to stress, whether that's from physical exercise or from the environment, from nutrition, from psychological stress, and then also how the body's actually recovering from and adapting to that stress, which is super interesting as well, us being adaptive organisms and that's how we improve over time or not improve is that we're looking at the body's recovery responses and things to those different stressors as well, which actually produce different patterns in those heart rate variability changes. All around, it's helpful information to know for your performance, health, and well-being.
Yeah, so the way I like to think about it is that the heartbeat itself is an obvious metric that everyone sort of talks about, because it's easy to measure, but the heart rate variability, which is harder to measure, it's the time in between each heartbeat and the variability between each of those variances so it's kind of like a second order of measure. It requires more sensitive equipment, so it's perhaps less talked about. I think one question that I had when I was first looking at the heart rate variability space was that's kind of counterintuitive that more variability is a marker for more recovered or a state that you want to be in or less variability or more steady of a heartbeat is actually a sign of not being as an optimal state. It's kind of counterintuitive, right? Can you walk us through why that happens physiologically?
Yeah, and it's important because a quick frame of reference for that is that optimal and suboptimal is contextual and relative, so if you exercise, you want your heart rate to go up. Otherwise, you won't be able to be very effective at exercising. Similarly, when you're resting, you want your heart rate to go back down because you don't want to waste a ton of energy from like an evolutionary perspective and energy efficiency perspective alone. That would be pretty suboptimal, but similarly, this heart rate variability concept, when you're exercising, and I just like to use exercise because that's an easy example that people can understand of stressing their body out and it's inherently neutral stress in the sense that it's positive or negative, depending on what you're up to.
Your body needs to deliver resources to the right place at the right time very efficiently when you're stressing it out, so your body takes tight control over your heartbeat.
It makes it very consistent as well as elevating it and so you're shuttling glucose and hormonal signaling around to the bloodstream and all this stuff and it needs to, oxygen and everything needs to happen at the right place at the right time very efficiently for you to respond to that stress so it becomes more consistent versus when you're kind of relaxed and this is kind of like a bigger picture overview, analogous way of looking at it is things can become a little bit more flexible. Your recovery systems kind of kick back in and slow things down, and then you've got this push and pull between recovery and performance going on a little bit more and things become a little bit more variable and flexible and it's less important that your heart rate is 55 beats versus 56 beats or something like that at any given moment. It doesn't really matter. That's just kind of some kind of bigger picture generalistic ways of describing it and how it can give signs that you have a healthy heart. There's a lot more to the mechanisms, there's exceptions and things as well but that's kind of how you can think of it.
Right. Okay, that makes sense. If you're just more relaxed, it doesn't matter as much to be out of rhythm of exactly, I guess one second between a heartbeat or something, right?
Yeah, and so, coming back to what you were saying about optimal and suboptimal is that when you're exercising and you're going hard, you actually don't necessarily want a high degree of variability. In HRV, a higher HRV is normally seen as better but it's not necessarily always the case depending on what you're doing. There's a lot of interest between HRV in exercise and HRV at rest and other various activities, so optimal depends on the context of when you're measuring the values as well.
Yeah, I think it's like a good segue to actually talk about why people should care about HRV. I think in a lot of our conversations with previous guests, it's interesting from a training athletic performance perspective, there's more data suggesting that's interesting from an emotional mood state perspective. Can you help break it down? Why do people, why is there so much excitement about HRV as a marker to track? Do you want to increase HRV or decrease? Can you categorize a couple of the key areas that people are coalescing around?
Sure, definitely. Heart rate variability, it goes way back actually in history, pulse rate variation generally was detected like a century ago, but about 50 years ago, they started being able to actually quantify that with things like formal ECG machines, but it takes a high degree of accuracy to measure. Up until recently, technology wasn't available to capture daily HRV very easily. It took really expensive equipment, tens of thousands of dollars, and usually a team of scientists to cipher through all the data to figure out what was going on, and now we're able to automate a lot of that and make it accessible and so, the use cases for it have also increased over time and the interest of it has really exploded recently now that it's become so accessible. Originally, it was used only in kind of behind the scenes for Olympic training and things like that, or some of the top high budget sports teams as well as in a hospital setting where you have EKG is all over the place and those things are pretty prevalent for measuring heart rate variability after like heart attacks, myocardial infarctions and fetal heart rate variability situations, looking for really acute situations and now that you can measure HRV in as little as 60 seconds anytime anywhere and basically all you need is a phone and a fairly affordable device to accurately capture the data, people are using it for definitely for tailoring training from avoiding overtraining, avoiding under training, kind of trying to find that sweet spot for training and then as well as optimizing sleep, optimizing their nutrition plans, understanding how inflammation in the body works because inflammation and heart rate variability have a strong correlation and then managing chronic health conditions as well.
Coaches are now starting to integrate it in many more different types of models outside of just elite sports. You have people integrating it into gyms, integrating it into health coaching scenarios where people are trying to manipulate many different variables, and that kind of brings us back to some of what your original question was is why do we care about HRV specifically, right? HRV is kind of a very systemic marker, so it reflects activity from the autonomic nervous system. The autonomic nervous system is like the body's central kind of control center for most of the response to stress and recovery from stress and it's involved in almost every automatic process in the body, from controlling your blood pressure, controlling your blood sugar, pupil dilation, sweating, sexual function, digestion, all of these things are impacted by autonomic nervous system.
I think the old name for it was like a vegetative nervous system, right? It's like your reptilian or your primal instinctual interactions are guided by the autonomic nervous system, right?
Yeah, exactly. Yeah, and the more they learned about it, then they came up with better names for it too. Yeah, so basically, yeah, it integrates very tightly into the big picture of things, and so it makes it a very powerful marker to say, okay, I'm going to manipulate this variable. How's that impacting me overall? Whether you're tweaking training or whether you're tweaking recovery, sleep, nutrition, psychological health, mindfulness practices, meditation, all these things that people talk about that can help you or to what degree you don't know, this kind of gives you a nice marker to say, okay, I'm actually making progress here. I'm moving the needle in a positive direction or a negative direction as I make changes in all of these things.
Yeah, I think that's like an astute point where I think again, I think why there's a lot of interest is that it's such a primal biomarker that seems to be implicated in so many downstream systems, that it is like relatively easy now to access a biomarker that's important to test different interventions, like ostensibly, if your meditation practice helps you be more relaxed, be more mindful and you have lower cortisol, that ostensibly might show up in having a higher risk of HRV, right?
Right, and there's a lot of individuality to it too, and so we're often told that X, Y or Z practice will help us but our individual situations are so unique that yes, it's true most of the time following addressing nutrition or sleep or something like that could be a good thing to do, but maybe that's not the thing for you. That's the worst act or that you'll get the best bang for your buck out of changing, right, so also about efficiency of time. We have busy lives and things like that and we don't want to just be guessing about what we should be doing. This helps us kind of decrease the feedback loop on knowing whether or not what we're doing is actually working.
I'm curious to hear about your personal trajectory and story about why you got so deep into HRV. Where does that start?
Yeah, aside from it just being a really interesting subject, so my background is designing data analysis to some systems in oil and gas industry and so, by education and by original career path, I was basically working in an environment where we were putting sensors out on these really expensive equipment out on the field, collecting a lot of complex data from that equipment and then manipulating that data so that people who are actually maintaining the equipment or decision makers could use that data and make effective decisions. Millions of dollars were on the line for a lot of this equipment, and you really don't want to mess it up. Similarly, I would kind of translate that to us in saying that one of the most important pieces of equipment we have is our body and someday, maybe-
The most important, I think it's clinically the most important.
[[Jason M.]] Exactly, exactly, priceless in fact, and until we can download our conscious into a brain or to a jar or something, but so on the side though, almost every chronic health condition in the books is in my family and based on family history, I'm predisposed to just about everything and I also am very interested in human performance from a personal perspective. I competed in sports and then eventually became a coach, and on the side of doing all this data analysis work, I was always hands on in sports and coaching and health team and things like that. I was a coach for a number of years and I was looking for ways to basically simplify the quantification of progress for myself, my clients, people near and dear to me and things like that and discovered heart rate variability a number of years ago, started and just the nature of how I operate is I really like personal interaction. I immediately try to go straight to the experts, so people who are on the front lines doing the innovative research and kind of networking with innovative coaches and doctors in different fields and doing what I do, which is just pulling data together and making it easier for these people who decided, hey, I think there's a lot of promise with this heart rate variability thing, but the systems that are available to track it are just not really that accessible to most people or understandable, and I think we can do better.
I decided to form a team and put that together, and that's where Elite HRV was born and pretty rapidly spread around the world. Basically, every country that has a smartphone has Elite HRV users, and we had people medaling in the Olympics after a short period of time, monitoring their HRV on our platform and and then all the way to measuring child psychology cases, reintroducing children in troubled homes back into their home and using HRV as a way to show parents that there's a physiological effect of confrontation with your child, and just because they're being quiet and there doesn't appear to be any effect, there actually is. There's a full spectrum of use cases there, even with animals. That was an interesting use case that we can talk about if we have extra time at the end.
That will be interesting. I want to touch upon that but I think before talking about like the animal use case, I'm sure there's interesting animal studies going around all the time, you must have seen the evolution of the sensors and technology. I think you touched upon it a little bit in the introduction about how this used to be done only in the clinic, only in the hospital, only for like super expensive really elite teams can afford this kind of equipment. I remember this probably like four or five years ago using like a Polar heart rate monitor and then linking it up to the Elite HRV, the heart rate variability data and I was recently playing with it and it sounds like, there's like things like Oura Ring, which is a sleep tracker that also has the capability for HRV measurements. How have you seen the sensor technology shift over the time? Perhaps, where do you see sensor technology developing moving into the future?
Right, yeah, definitely. As you mentioned, even still to today, the Polar type chest strap is one of the most accessible and accurate ways to capture HRV data and stream that to like a smartphone app like ours, like Elite HRV, and that's been a recent years evolution where the chest straps were able to get accurate enough to start calculating that data, and then the processing power became powerful enough on smartphones to do signal filtering and things like that to clean up the data to make it accurate enough for HRV, so really rapidly after that happened, people started saying, okay well, now I can measure this regularly. Now I want it to be more convenient, right? That's where a lot of interest has come into wrist wearables, the Oura Ring. There's been ear clips and finger clips and things like that, that are all trying to figure out how to incorporate HRV, and it's really challenging because heart rate variability again does require a high degree of accuracy.
Anytime you're measuring HRV below or off the chest, essentially, if you're using a multi lead chest electric, passive electric sensor like a chest strap, it's very forgiving when you're moving around, right for signal noise, as long as you're not doing a lot of torso rotation that will cause friction under the strap or something like that, but as soon as you start measuring on more convenient places, like the wrist or the hand of the finger, arm, things like that, as soon as you move that limb, it introduces a huge amount of noise into the signal. That's the big challenge that's kind of come up for people who are trying to measure HRV continuously over 24 hours, for example. A lot of the wrist wearables like Apple watches are now including an HRV value in Apple HealthKit. They are just using it for guided breathing for the most part right now, because you don't need extreme accuracy to help guide someone's breathing, but if you're trying to report statistical values that are meaningful from an autonomic nervous system balance point of view and things like that, it's still not quite there yet from an accuracy point of view, and that's where specialty devices are kind of coming in.
In general, the wearable market is doing this interesting trend where from a health perspective, everyone wants to be the health wearable of choice but things like Apple Watch, they're trying to compete more for style, more for emojis and tweets than they are for like accurate physical, physiological data, right? Of course, Apple may be the company that ends up bridging both gaps, but things like the Oura Ring have taken things a step further. Moving to the fingers is definitely an upgrade from the wrist.
There's so many challenges to measuring HRV accurately at the wrist that is just almost insurmountable task from a cost-benefit perspective.
Just physiology, right, like I think we actually had the Oura Ring founder on our podcast and he's describing that there's so much bone on the top of our wrist to have such like a powerful lasers engine, it'd be like penetrating the bone is challenging, so other locations seem to be smarter in terms but perhaps less stylish but like, literally smarter in terms of like the amount of data and versus power you need.
Exactly. Yeah, and so then the other question too comes in, and this kind of comes from my background of doing the data analysis in oil and gas is, the more data you collect, the more data you have to analyze, right? More data isn't always better, and so that's kind of what set us apart early on was we're trying to say like a lot of people started going from the chest strap to like adhesive patches, and you may have seen like AmpStrip try to come out, which was a huge crowdfunding campaign that raised several million dollars and then just collapsed because they were trying to basically have a chest patch that you could stick on your chest and then wear for continuously and that would capture accurate HRV data theoretically over time, but the problem is, what are you going to do with all of that data? How do we make it clear to the user what it means to have high HRV or low HRV?
How much like, megabytes, gigabytes are we talking about? I'm just actually curious from an engineering perspective.
Yeah, that's a good question. I would say, so let's see, I'm trying to do some quick math in my head. We're talking about yeah, I mean, any one person, if you're actually capturing all our intervals, you could be capturing several megabytes of data per day. It's not really that huge from an enrolled perspective. If you're looking at full pulse wave form throughout the day, that could be a lot more. You could be talking gigabytes a day per person potentially, depending on the resolution of that data, but I think storage is probably not the issue.
It's a signal processing, it's the signal processing that's difficult, okay.
Exactly. Yeah, it's the processing, the signal processing, and then also the interpretation. Here's the thing. In acute situation like exercise, let's say you exercise really hard. Well, if you're measuring during that time, you can see that you exercise really hard. Then you keep measuring for the next couple days or whatever, and then you find out like, okay well, interestingly, when I exercise really hard, I actually automatically, my body is very smart and adaptive, I automatically ate more, I automatically slept more. By the following morning, I had actually already compensated enough on the recovery side to make up for that additional exercise load. That's not always the case, depends on volume, depends on load, depends on your training experience and things like that, but the body is adaptive.
What we've done is we've kind of reduce the amount of measurement time that you need down to just a couple minutes a day and to be able to derive 90 plus percent of the value out of that by saying, okay, if you exercise hard yesterday, and it shows up the following morning, then you know that there's something that has made significant and lasting change in your body that you might want to address, right? You don't have all the signal noise to analyze or interpret it. You just have one number from one reading and only took two minutes to do and exercise, whether it's exercise, sleep, nutrition, all these other things. It's kind of about distilling it down to how often are you actually going to be making decisions and what data do you need? What's the minimum amount of data you need to effectively make that decision.
Just to round out your question though from earlier as how I see it evolving is eventually, computing capacity and processing power will be so robust that you may just have like a tattoo or an implantable, and at any moment you'll or even like I say a joke, like a micro hover drone. That's just like there all the time watching you, and you'll get a little bit more real time feedback to say, like, hey, I noticed you just picked up a donut. Maybe today is not the best day. You should put that down, something like that. You might get a little bit more real time feedback, but in the meantime, it's about how often you're going to actually make decisions, and we even tell people sometimes you don't need to monitor every day. It depends what your goals are and where you're at, measuring a couple times a week or even measuring once a month or something like that may be enough and it just depends.
Yeah, yeah, I think would it be accurate to say you guys probably have the most HRV data across the population in the world? The highest capability for HRV analysis?
Yeah, I don't have access to all the databases in the world, but definitely.
One of the larger ones would be safe to say.
Definitely, one of the larger yeah, one of the largest for the way that we do it, which is we're capturing lots of baseline HRV data on like a longitudinal basis. Millions of readings and hundreds of thousands of people across many different backgrounds, and one of the things too that we have, which is kind of nice is a lot of contextual data as well, comparing different things like sleep, exercise, alcohol consumption, different nutritional habits, shift work, all this stuff to HRV data.
I want to take that context in a couple directions. One, I mean, what's like the best setup or an optimal setup that you could recommend? I mean, you're talking a little bit about the trade offs between like an Apple Watch or a wrist device versus a chest strap, and obviously, like a chest strap. I know from personal experience is more cumbersome, quite a bit cumbersome. You got to take out your shirt, you got to put it on and make sure it sticks right and make sure it's like a little bit of wetness, so that you can actually pick up the electric signal versus like an Oura Ring. What's your personal setup? What are popular setups that your customers or your users use?
Yeah, and so kind of coming back to the accuracy is super important to us. We've never given, so to speak on that piece, and so most of our users still today use chest straps, but the number one feedback we get is we love the data but we hate putting this wet strap around our chest first thing in the morning, and so totally understandable. Basically, we almost were forced by our users to get into hardware, and so we are coming out with the device that is going to be a specialty HRV device, which captures accurate from the fingertip, and it is targeting our specific use cases of short, again capturing the minimum data you need to make the most effective decisions and it's called CorSense and that'll be out in just a few weeks actually.
Yeah, yeah, it's very exciting and so we're very low key about the stuff. We're not pushy on devices and things because if you already have a chest strap, then just use that because it works, but if you're ready to take it kind of to the next level where you can get a little bit more convenience, you can capture for a few different other use cases. You can do group readings.
Is that like a pulse oximeter, so it just kind of clips on?
Yeah, so for people on the video, you can see I just picked one up off the desk. It's very much like a pulse oximeter. You just stick your finger in and go, and what people do a lot of cases is they'll just leave it on their bedside table and just wake up, pop it on your finger for two minutes, pop it off, you're done. That's all the data you need for the entire day, and then our algorithms, which we could talk about more in a bit, do the rest of the work, but it's also nice because if people do want to do live biofeedback, you can stream the data in real time and get visual feedback and you can practice different meditations, guided breathing patterns. Just pop this on your finger whether you're at work or anywhere and get that live biofeedback. Yeah, this will be out in a couple of weeks, it's going to retail at $145. We've got some special deals for the podcast listeners here that we can chat about.
At the end, so that when the true supporters can stick out to that. They need to learn more about it before they get the special access, but I think that's exciting. I mean I think knowing a little bit about the hardware business. It's not easy to build a piece of hardware. Can you talk about the trials and tribulations going from a software signals processing company that's processing one of the most, largest data sets of HRV to now building hardware that is essentially a new heart monitor? How was that transition? Any learning stumbling blocks or smooth sailing because you guys are just really good operators? Tell me about that story.
Smooth is always relative, right? It's gone very well, I'll say that and we are very detail oriented people. We come from a high risk industry in oil and gas. If you mess things up, people die, and millions of dollars are lost. We do have a lot of background in high dollar, high risk projects like that, but going from software to hardware has definitely been an adventure. It's been actually an advantage, we think, in the sense that we've spent so much time getting to know people on the data analysis side and how they're actually using this data out in the real world and all the signal processing and things like that, optimizing the algorithms. Our app is like the most downloaded app for sure and the highest rated as well. That combo is kind of hard to achieve but basically, it's because we interact so heavily with people, so doing all that has really helped us understand people before we had to do all this investment of getting into hardware right and so rather than guessing what people need, we pretty much knew from the beginning because they were asking us for it.
That really helped us design the hardware in such a way that people we know, we've already pre sold a large share of the units that we're producing, so we're going to have to be upping that production very soon, but the main learning I would say, from a business perspective, going from software to hardware is the timelines are much longer, so anytime you make a tiny little change and we're very detail oriented people, so there's been a lot of little changes along the way. It adds lots of cycles and so, but it's been great and honestly, the technology, the sensor technology has evolved so much in the recent years, even the past couple of years that when we started down this road actually a couple years ago now in the initial research and design and engineering phase of this hardware is it's become much more accessible and we've been able to price it now in such a way where it's very accessible to a lot of people.
Yeah, no, I mean, the price point's very competitive and it sounds like I mean, just knowing very little about like the feature set here, we can talk a little bit more about the feature set but I mean, it sounds like it's like a perfect use case where it's like it's easy to use, it's not invasive, and it's like, it sounds like it streams directly the HRV so it's like a very easy real time sensor that's not like you got to put on some strap or wear something continuous all the time because it does get just a little bit cumbersome to have to charge devices all the time, but it sounds like this is just like as you need and the software takes care of the rest, so very cool.
Yeah, and from that perspective too, that introduces so many pros to doing the hardware this way, so the battery lasts like six months. Yeah, so it's I mean, virtually have to just try not to lose the charger because you're never going to use it almost and then the package this way being a specialty HRV device, we have three different wavelength emitters, so green, red and infrared covering the full spectrum of skin colors and skin thicknesses and things like that, top and bottom LEDs, so it's transmitting not only light through your finger, but reflecting off your finger and having centers on both sides. The sampling rate is 500 hertz, so that's 500 samples per second, which is basically ECG grade sampling rate, getting it 99% comparable to an ECG for heart rate and 98% for heart rate variability.
What's that comp to for people that have no idea, I mean what does an Apple Watch pull at? What does an Oura Ring pull at? Do you have a sense?
Yeah, I don't know specifically what the Oura Ring pulls at. I think it's probably 200, something like that. There's a lot of power, power and sampling trade offs to make there. The Apple Watch, I think is like 125 or something like that when it's pulling, right? Those devices aren't pulling 24/7. They're, depending on the device, it's pulling at certain times. Yeah, we kind of were able to take it up to this 500 hertz range, which is actually double the gold standard for heart rate variability now. If people are kind of used to the old research on heart rate variability, they'll go, oh no, it has to be 1,000 hertz or something like that, but that was before the software became a lot more powerful. Now that we have software that's much more powerful, you can actually drill or dial down the sampling rate and still have effective measurements, but we like to, again keep the data quality as high as possible. 500 hertz is over double the gold standard right now for HRV rested measurements, and it's over double most of the other devices on the market for the sampling rate.
Yeah, very cool. I mean, I can't wait to play with it. I mean, I know that we have a lot of amateur and some more than others at the company that are more than amateur athletes, so it will be interesting to sort of see this on a regular basis, comparing HRVs and all that. One thing I wanted to move back towards was given that you have one of the largest data sets on HRV data, what are some interesting patterns or anecdotes or stories that you can tell from this interesting data set?
Yeah, there's so many anecdotes. It's incredible and that's been part of our learning process over the years is we've had tons of people now report things like I woke up, I took a morning reading and it told me that I was in the red and that I should be aware of something, but I felt fine. I wasn't sure. Then at lunch, I went home sick throwing up, right?
The algorithm already is starting to predict or at least show early warning signs for things like sickness and things like that before any symptoms or any change in perception of your condition occurs.
Then definitely from a training perspective, I mean, this is being being mapped out for almost every sport now. we're getting to the point where we're working with a lot of the top experts in different fields to create kind of AI training templates, essentially where it's like, wake up, take this two minute reading, adjust training like this, go and it's going to be very hand holding to that extent. Right now, it's a little bit more like takes a slight bit more of interpretation from the coach or the user but that's getting refined over time. Then we've had things like a user had the chest strap on taking a reading and had taken readings before. Notice that the patterns were way off. There was something really wrong and then started realizing they were kind of having like a panic attack and then started getting pain in their arm, things like this. They called emergency services, ambulance came.
He was about to have a heart attack.
Yeah, about to have a heart attack and the app was detecting and he kept the chest strap on measuring all the way through on the ambulance all the way to the hospital. The doctors in the ambulance and at the hospital were like, what app is this? You should keep using this app, and we're saying like okay, well right now it's not intended for heart attack prevention but it's really interesting to see that data and obviously, we got a really nice message from that person potentially saved their life making this entire journey worth it alone.
Yeah, part of our goal is to make this accessible. That's why the app's free. That's why we work with, even though we're coming out with our own hardware, we're still going to work with chest straps, right? This person is on disability and low income and they couldn't afford to purchase any type of fancy expensive wearable but their friend gave them a chest strap and our app is free. They literally spend zero dollars to monitor this and then it saved their life and that to me makes this all worth it. If we can reach people in that way, the money will come so yeah.
Absolutely, I think that's almost the epitome of where I think people should aspire to with their craft, right? Like, create a meaning with their craft and then if you're creating value for the world, money's going to come and I think a lot of people are chasing the opposite where it's like make money, make money and then kind of find meaning when they go on like long vacations or go to meditation retreat, right? They get to spend their money to find meaning, but what if you actually just solve the core root problem, which is like just do something meaningful and then you don't have to, like mortgage your life to do a crappy job to then go find meaning on a vacation to Africa or something. I think one point I thought was interesting to just highlight was that I think when people talk about biohackers or human performance, they always focus on elite athletes and physical activity. I think with anecdotes that you're telling and I think this is something that we really understanding and sort of want to educate to the world at HVMN is that it's really two sides of the same coin in terms of human performance at the elite level, and helping sick people or deficient people turn into healthy individuals. It's just the notion that you have some measure of baseline and work on interventions and prove that baseline. That baseline could be from you're a super elite athlete trying to go for a gold medal or you have cardiovascular disease risk, and you want to prevent that.
I think in some sense, the money, at least the sophistication starts at the elite level, but hopefully, it's something you have similar goals that like everyone should be incorporating some of these tools.
Exactly. Yeah, and it's just like you said. I mean, the people at the top are very motivated, so these are the types of people often if they're into cycling, they're buying like a $16,000 bicycle. Those people, they'll pay for the premium services, they'll pay for the nice to haves and things like that, which is great because it's going to actually make small percentages gains for them, which is what they need. For the rest of us, a 1% change in your health, if you're just a normal person is pretty probably unnoticeable but you can make some more broad brush changes, and use the same or similar technology to see if you're making bigger changes in your overall health status.
Let us move to some of these audience questions. We touched upon some of this but might be better just to directly answer them. Megan Robbins writes in to our email firstname.lastname@example.org, what success stories have you seen with people using HRV for athletic performance?
Yeah, I mean Olympic medalists so that's, we have tons of anecdotes now that say, from a heart rate variability perspective before they were measuring it, it's all about consistency, because now you have such a large population. You're going to get these epic performances. If people are doing all the wrong things, you'll still get somebody performing well, but it's about consistency.
People who have implemented HRV on a team scale have been able to reduce injuries across the team, as well as increase overall performance of the team.
Decreasing the variation between the top performers and the bottom performers, bringing more people up to that top performing tier and then from a personal perspective, is you have a lot of case studies showing athletes that are operating at one level and then implement monitoring where they're now training load and recovery status based on data and kicking them up from just being a competitor in like an age group competitive bracket or something like that to being a podium finisher, pretty much every competition and so we've seen these things, again just tracking the data doesn't automatically guarantee that by any means. You have to actually do things differently right, make changes based off of it but tons and tons of use cases like that.
Yeah and I think just given my experience working with some of top S&C coaches, strength and conditioning coaches, I think one point you mentioned, injury prevention. I think that's like the most underrated part of something like HRV. S&C coaches in some sense are paid the big bucks to prevent their million dollar salary football players or basketball players from being on the bench recovering from injury. I mean, that's millions of dollars that the management has to, they can't utilize their their investment to their player. I think you talked about performance. I think injury prevention seems to be probably a bigger use case if not.
Yeah. Like you said, there's a lot of money on the line with injuries, right? Oh, another one real quick before I dive into injuries is we have a sports scientist who works with the national and world champion wrestling teams for collegiate level age group and things like that, and they're able to almost predict the point differential in the wrestling match based on pre match HRV scores. From a gambling perspective too, that's very interesting.
You guys should shop this to race horses.
Yes, that's an anecdote that I have actually.
We had a question, I'll keep this story really short. We had a question about many users sharing one phone and I was like trying to figure out what this person or why don't they just use their own phone or something like that. Like, what's the use case here and then it turns out that these users were horses. They're monitoring to the Elite HRV app with a Polar strap that's designed for horses. Those actually exist, and so we've had a couple interesting cases like that. Yeah, so to come back to your point about injuries, that's a huge thing. I have a personal anecdote for this. I'm always pushing my limits. I'm always trying to.
What are you training for?
It's just training for life.
I mean yeah, like what events? Are you running? Are you swimming? Are you cycling?
We're all fighting for life. Life's hard.
Life's hard, and so I subscribe to a bit of an anti fragile approach to my training in the sense that I try to train for scenarios that are unforeseeable in the sense that I like to change it up a lot. I'll do CrossFit type workouts for a period of time, I'll do more endurance type focus exercise for periods of time. I've had a really big deficiency in upper body, body weight strength, because I grew up playing soccer. I've been getting into gymnastics and things like that to kind of round out some of that. Last year I injured my neck unfortunately, and HRV definitely picked that up and tracked with my recovery, which I've used with my physical therapist and chiropractor and other things, but every single time that I've injured myself in the past several years has been on days when my HRV told me in advance.
You shouldn't got at it hard.
Yeah, I should be aware. I'm human, just like the rest of us.
I hope so.
I do have a plate in my ankle so I'm semi bionic. I've injured myself pushing my own limits and HRV has helped me in the recovery process. I'm also learning to pay attention to it on those days.
That actually segues into another question. How does HRV correlate with other biological variables? You mentioned inflammation, cortisol, any other obvious interesting biomarkers that there's associations that have been, I guess, discovered or hypothesized?
Yeah. Typically, as blood pressure increases, heart rate variability decreases and speaking of cortisol and C reactive protein, as cortisol increases, typically HRV will decrease and C reactive proteins and other measures sort of are inflammatory load, right. This is kind of a nice non invasive way of measuring inflammation without having to do blood draws and things like that to get that CRP value and just overall things, blood glucose, as that increases typically HRV decreases. We're actually working with some pretty innovative people doing research on the relationship between blood glucose and HRV and coming up with somewhat of an index between those and seeing how those two markers combined can give us like an overall inflammatory load score basically, that's more specific.
I mean, we got to do a collaboration on Ketone Ester and how it affects HRV. I mean, that's an obvious one.
Yeah, definitely. For sure, I mean, ketones and inflammation are also very closely tied.
Exactly and so there's, speaking of without going too far down that rabbit hole when you're talking about performance in different fuel sources, using glucose as a fuel source versus ketones as a fuel source and fat, it's not only about how much energy output you're able to produce. It's also about inflammatory load and cascading effects from that as well and recovery from all that training. That's where something like HRV and ketones versus glucose as a fuel source, kind of is really interesting, right?
Yeah, lots of markers. I mean, we've even had people do weight loss challenges where they're tracking scale weight and HRV, and the people who increased their HRV the most in 30 days, also lost the most weight. Really interesting data there. We've had rehab clinics. Speaking of injuries, again, work related injury, people in this clinic, the clinicians are now predicting almost if somebody's going to recover from the injury 12 months in advance based on their first couple weeks of HRV readings. They can kind of pay closer attention to the people who are showing warning signs of 12 months going by before there before they know okay, well, I guess treatment didn't work, right? If you could figure that out in six weeks instead of 12 months, you'd be saving everyone a lot of time.
Yeah, there's a good audience question here that maybe is a little bit of devil's advocate on how useful HRV can be. Gavin Allston on Twitter asks, I've heard that you can manipulate your score before taking a measurement by doing breathing exercises. Is this true? I guess, going to the devil's advocate perspective, oh can I just sort of hack my HRV and does that make the long term predictions inaccurate?
If you're really trying hard to game it, you can, and so that's just how it is.
You can game anything I guess.
Exactly yeah, yeah. You can game anything. You can take a shot of Kool Aid before you go to your diabetes test.
You're going to look like you're type two diabetic.
Exactly. Yeah. If you're really wanting an insulin subscription, you can get one, but yes. The thing is though, is people ask this question a lot. They find that they may, kind of once they learn about breathing patterns that influence, they're like, oh now I can't help it. I kind of subconsciously breathe this way or something like that. The interesting thing is, is yes, in the acute situation, that will change the absolute value of the HRV score, but for relative changes over time, that actually can wash out if you do it correctly. If you're isolating variables, like taking the reading first thing in the morning, same time each day, multiple readings over time and then you just use the same breathing pattern, then that variable is becoming a constant. Then the changes in your HRV actually are reflecting other things besides that breathing pattern. We don't typically recommend that.
We prefer a natural breathing pattern because respiratory rate is a response to stress and it's a recovery tactic that your body uses but if it's something you're worried about, you can control for that.
Then what we do to mitigate that is we recommend that you don't lie down and take the reading and do this deep kind of meditative breathing because the combination of all that can kind of be so relaxing that it masks your body's expression of stress, so to speak. We'll recommend sitting up or standing up if you're going to follow some type of guided breathing pattern but then that's how you eliminate that variable if you want.
I mean, the reason that if you're just meditating all the time, and you want to like hack HRV, but you just meditate all the time, you probably will just feel better, right? By hacking it, you're actually doing like that mindfulness exercise and like the stress relaxation techniques, actually probably to the end outcome that you actually want to do, which is probably fine. It's like exercise. You're going to like exercise a lot more. You have more variability. Is that a hack or is that just like, hey, we helped you have a new habit.
Yeah, exactly. It all comes back to like you're saying, what's your goal of the measurement, right? If your goal is to just learn what your baseline is, just sit down, relax, don't try to hack it. If you know that you're kind of subconsciously hacking it, let's control for that. Otherwise, yeah, definitely. There is a powerful use case for using HRV as a biofeedback tool, breathing meditation, those types of things. It can show you immediate physiological effects of those that we've used that with everyone from police, fire, military to golfers with their golf swing, and NBA players for their free throws to kind of control the physiology, the balance of their nervous system in those key moments where they need to make critical decisions and perform?
If you want to compete and not risk injuring yourself, you've got to be measuring something, right? Unless you're fine with just competing at the lowest levels, which is okay, and there's exceptions to that. Like I said, there's always going to be that person that eats donuts and somehow makes it to the Olympics, but 99.9% of people are not that person. Then on the flip side of things, being healthy in the modern world is really challenging because everything's working against you. We've got bright lights all night long. We've got stimulating things. We feel like we got to check our phone every five minutes. We've got all the stimulation, demands from work, stress life. The food is not as nutritious as it used to be. We don't get as much sunlight as we need to. Unless you have all the time and money in the day to sit around and lead a natural kind of hunter gatherer lifestyle, you've got to be able to pick and choose what to focus on to get the most bang for your buck.
Doing a little bit of measurement allows you to do that. I can choose to say, okay, now I know for sure that when I drink alcohol, it has lasting effects for at least three days on me, right? I have data and my HRV to show that and so knowing that, I can either choose to when I drink alcohol, or not at all, depending on the person or I can take strategies like perhaps using human ketones or something like that, some type of nutritional strategy to mitigate that damage and reset and then I won't be operating at a lower level for three straight days following.
Absolutely. I think that seems to be where the more sensible people that I talk to I think sort of land, like there's no magic formula that you just check the box off and you're like Superman. I think in elite competition, there's an animal sort of instinctual part that's like hard to measure. Perhaps it is measurable at some point but it's hard to measure given our limited technology but if you want to really be thoughtful and deliberate about your protocol, your routine where you spend time, you have to measure it, right? That's the engineering sort of reality. If you don't measure, how can you optimize? How can you know what you're doing is right or wrong.
Right. It's about time, efficiency and risk. If you're not measuring, you're introducing the risk that you're either wasting time, you're going to injure yourself or one of those two things basically, and so we don't, none of us want to waste our time. None of us want to get injured so we want to be able to compete or just perform in life and be healthy and a little bit of measurement goes a long way in that.
100%, so Elite HRV, really interesting measurement software suite and now a new device. Tell us about that. I know you have a special offer for our listeners.
Yeah, no, I appreciate that. Elite HRV is a free app, so Android, iOS, you can go get that. If you already have a Polar chest strap or something like that, you can start taking readings right this moment and good to go. If you're interested in adding convenience and a little bit of extra horsepower to your readings, then we have CorSense coming out, but you can just see it at elitehrv.com. For those on video, you can see a sneak preview of it right here. We've been playing with these at conferences for a couple of months, and people have been really excited taking readings on those.
We have a discount for HVMN podcast listeners, and that's HVMN. Just enter that at the checkout and you get 10% off there. It's already 10% off right now for pre orders so you can stack that over the next couple of weeks and yeah, that's a nice deal. We also have educational courses actually. I mentioned at the very beginning kind of offhandedly. We work basically with the people whose names you see in the research studies. We work directly with those people to compile all the latest information on how heart rate variability is used and we teach courses online about how to do that. There's educational courses out there at hrvcourse.com and the same coupon will work there, HVMN will work there as well, 10% off on all those courses. Courses, CorSense, apps, HVMN is the coupon code and you can find it all at elitehrv.com.
That is super awesome. I know for myself I'm excited to play with CorSense and really start learning about HRV. Appreciate the time, appreciate the expertise and thanks for the offer for our listeners. Thanks so much Jason, talk to you soon.
Thank you. I much appreciate it and I love what you all are doing as well so the honor is mine, thank you.
All right, cheers.
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