@vo2account

Rebuilding health & wealth with precision. CPET| Remote ECG| Metabolic tracking| Banking intelligence.The future of healthcare & finance is personal.

[@vo2account @vo2account]

Our official statement about the future of personalised banking.

Combining metabolic health with finance.

#banking #finance #health #fintech #healthtech #metabolicfinance

[Tim Noakes @ProfTimNoakes]

Such an important book. @PaulBLaursen

[@vo2account @vo2account]

At some point, he stopped joining in.

Nobody noticed when.

Think Energy.

#heart #energy #fatigue #tired #steps

[Johann Els @Johannels16]

For centuries, humanity has built entire industries around financing structural things.

We insure houses.

We finance cars.

We invest in businesses.

We even insure our pets.

Yet one thing powers all of these:

Human energy.

And strangely, we have never built a financial model around preserving it.

Not disease.

Not hospitals.

Not surgery.

Not disability.

Energy.

Which raises an uncomfortable question.

What happens when someone looks healthy, their scans are normal, their blood tests are normal, but their ability to produce stable energy is quietly deteriorating?

Today, the system waits.

It waits for structural disease.

It waits for heart failure.

It waits for diabetes.

It waits for disability.

Only then does the financing begin.

But by then, damage may already have occurred.

Imagine if the financial world had worked this way with houses.

“We don’t cover maintenance.

Call us when the roof collapses.”

Or with cars.

“We don’t finance servicing.

Call us when the engine fails.”

It sounds absurd.

Yet this is essentially how much of healthcare financing operates.

Perhaps the future of healthcare is not about financing disease.

Perhaps it is about financing the preservation of human energy before structural disease appears.

Not because people are sick.

But because energy is the foundation upon which families, businesses, economies, and societies depend.

Something new is loading.

A disruptive health financing model is loading.

And perhaps one day, people will ask:

“Why did we never think of that?”

Think Energy.

[@vo2account @vo2account]

Something new is loading…

The future of health financing is about to change.

Think Energy.

#health #finance #money #energy #disruptive

[Johann Els @Johannels16]

From a systems-biology perspective, mitochondria sit at the intersection of the immune system, autonomic nervous system, brain, gut microbiome, endocrine system, cardiovascular system, and skeletal muscle metabolism. This means that post-viral syndromes, chronic stress, immune dysregulation, microbiome disturbances, nutritional deficiencies, toxins, or Cell Danger Response pathways could all potentially contribute to a similar energetic phenotype. The most important question may therefore not be “What caused it?” but rather “What is happening to the body’s ability to produce, coordinate, and recover energy?” The emerging V̇O₂ data suggest that loss of metabolic equilibrium and physiological resilience may represent a common downstream pathway linking a wide range of chronic health conditions, making it potentially relevant to healthcare, rehabilitation, workforce health, and actuarial risk assessment.

[@vo2account @vo2account]

Introducing V̇O₂ Human Energy Intelligence: A Superior Physiological Dataset for Actuarial Science

Traditional actuarial models measure disease. V̇O₂ Human Energy Intelligence measures the physiological reserve that precedes disease.

[Johann Els @Johannels16]

V̇O₂ Human Energy Intelligence (implemented by @vo2account) is based on the premise that the most important health and economic risks may begin long before disease becomes visible. The emerging data suggest that some individuals are losing the ability to produce, maintain, and recover from stable energy, reflected by declining FatMax, altered Peak RER responses, blunted lactate responses, and reduced physiological reserve despite often normal structural investigations. This has implications far beyond exercise performance, potentially affecting recovery, productivity, resilience, chronic disease susceptibility, disability risk, and healthcare utilisation. While traditional healthcare, insurance, and economic systems measure disease, claims, and financial outcomes after they occur, V̇O₂ Human Energy Intelligence aims to measure physiological reserve and human energy capacity before those downstream consequences become apparent. It will provide a new framework for understanding health, workforce performance, insurance risk, and economic productivity by quantifying the body’s ability to produce and sustain energy rather than simply detecting disease once it has already developed.

[Johann Els @Johannels16]

V̇O₂ Human Energy Intelligence (implemented by @vo2account) is based on the premise that the most important health and economic risks may begin long before disease becomes visible. The emerging data suggest that some individuals are losing the ability to produce, maintain, and recover from stable energy, reflected by declining FatMax, altered Peak RER responses, blunted lactate responses, and reduced physiological reserve despite often normal structural investigations. This has implications far beyond exercise performance, potentially affecting recovery, productivity, resilience, chronic disease susceptibility, disability risk, and healthcare utilisation. While traditional healthcare, insurance, and economic systems measure disease, claims, and financial outcomes after they occur, V̇O₂ Human Energy Intelligence aims to measure physiological reserve and human energy capacity before those downstream consequences become apparent. It will provide a new framework for understanding health, workforce performance, insurance risk, and economic productivity by quantifying the body’s ability to produce and sustain energy rather than simply detecting disease once it has already developed.

[Johann Els @Johannels16]

The hypothesis is:

Persistent failure of metabolic equilibrium may reduce physiological resilience and contribute to an environment that increases susceptibility to multiple chronic diseases, one of which could be cancer.

I guess time will tell.

[Johann Els @Johannels16]

Reduced metabolic equilibrium
↓
Reduced physiological resilience (current)
↓
Earlier onset of chronic dysfunction
↓
Higher healthcare utilisation
↓
Higher disability burden
↓
Lower workforce productivity
↓
Lower economic growth
↓
Higher insurance and healthcare costs

[Johann Els @Johannels16]

Across multiple cases in South Africa and the USA, we at @vo2account are repeatedly observing young and previously active individuals with Long COVID or post-viral physiology who deteriorate after workloads that should ordinarily be metabolically safe. These episodes are not isolated; they appear to follow a reproducible pattern of delayed symptom amplification after controlled FatMax/VT1 exercise.

The problem may not be exercise intolerance alone. It may be recovery intolerance after apparently low-intensity metabolic stress.

These patients can sometimes complete the session. The collapse comes later.

We may be seeing the early clinical edge of a larger post-viral metabolic-reserve problem in young people. It is not yet fully visible in financial data because insurance claims, disability statistics and healthcare costs are lagging indicators. By the time those numbers rise clearly, the physiological decline may already have been present for years.

[@vo2account @vo2account]

Young. Exhausted. Something isn’t right.

Think Energy.

[@vo2account @vo2account]

RT @Johannels16: Individuals with a chronic disease, interested to gain access to formal
cardiac rehabilitation infrastructure installed at…

[Johann Els @Johannels16]

The patient was discharged from ICU in December 2024. On 28 January 2025 the patient requested assistance to undergo formal cardiopulmonary exercise testing (CPET) with the aim to use the outcomes of the CPET to create a data driven pre-operative cardiac rehabilitation intervention to prepare the patient for the scheduled LVAD surgery. Cardiology informed the patient that his prognosis showed he had a 6 month window period to undergo LVAD surgery to prevent mortality. The patient (who is a business owner) primary objective was to prepare himself for the scheduled surgery. The patient asked cardiology - what is the plan once the LVAD surgery is completed if (1) he did not undergo a formal pre-operative prehabilitation process, (2) a formal return to work protocol was not implemented (based on baseline and follow-up CPET data) to guide clinical decision making. Cardiology informed the patient that no such service was available for cardiac patients.

The primary objective was to prepare the patient for the scheduled surgery. Baseline Peak VO2 was 9 ml/kg/min and peak Cardiac Index was 2.25 L/min/m2 and VE/VCO2 slope was 67.5 . Cardiology was sceptical that cardiac rehabilitation could provide any assistance and informed the patient LVAD surgery was inevitable.

The patient underwent cardiac rehabilitation under clinical supervision for the first 4 months. 3 times a week. Every session started with aggressive breathing exercises and 20 - 30 minutes of cycling set at 5 watts (fatmax threshold). During this initial 4 period the patient was hospitalised twice due to severe oedema in lower legs. He was however stabilised with aggressive medication and strict dietary guidelines (low carb) and after 4 months the patient asked me the following question:

“If the hospitals do not want to implement cardiac rehabilitation, will you be able to provide me with a formal cardiac rehab facility at my home while our remote ECG cardiac rehab software is implemented.

His home cardiac rehabilitation facility was installed in August /September 2025 to continue his cardiac rehab at home. October 2025 a derease in NT - proBNP was observed - 8 months since the cardiac rehab started at 5 watts with aggressive breathing exercise. From October 2025 - June 2026 a sustained decrease in NT - proBNP was recorded.

Data started to show in October 2025 that LVAD surgery could be postponed. In May 2026 cardiology confirmed surgery was not required based on the continual improvement in clinical outcomes.

The patient informed me he wants to use his case as scientific precedent to show that of formal cardiac rehabilitation is implemented, cardiac patients can prevent surgery.

@vo2account is working closely with formal research partner @TheNoakesF to publish this case study in future - however the lack of funding in cardiac rehabilitation is a real world problem to conduct this type of research.

[Stefanus Snyman, MD @StefanusSnyman]

@Johannels16 @Johannels16 @vo2account are doing groundbreaking work. Thank goodness hospitals are not interested - now real innovation can happen and a much-needed service rendered globally
@ProfTimNoakes @SJschmidt963 @MyDocFrank @BenBikmanPhD @nicknorwitz

[@vo2account @vo2account]

RT @Johannels16: Working on this case was (and still is) one of my career highlights. Senior doctors advised severe dilated cardiomyopathy…

[@vo2account @vo2account]

A diagnosis is not destiny.

Think Energy.

#energy #heart #lactate #fat

[Johann Els @Johannels16]

THE FOLLOWING COMMENTARY IS DATA DRIVEN FROM LONGITUDINAL DATA GATHERED OVER YEARS OF CARDIOPULMONARY EXERCISE TESTING DATA OF A COHORT 9 - 94 YEARS OF AGE

THE PHYSIOLOGICAL DATA OBSERVATIONS ARE STARTING TO REFLECT IN FORMAL PUBLICATIONS WITHIN THE FINANCIAL AND INSURANCE SECTOR

The financial & insurance industry is becoming operationally more complex.

Whether the underlying driver is:

• worsening health,
• affordability pressure,
• administrative complexity,
• policy misunderstanding,
• distribution issues,
• or claims disputes,

the financial system is processing:

• more complaints,
• more disputes,
• more claim investigations,
• more appeals,
• more regulatory oversight.

That increases cost throughout the system.

What may be the real actuarial signal?

Looking across:

• @LibertyGroupSA claims growth,
• Momentum critical illness growth,
• disability payouts,
• income protection claims,
• the R38 million sleep-apnoea disability case,
• Ombud complaint growth,

a common theme emerges:

Financial risk is increasingly being driven by loss of functionality rather than death alone.

That is a very important shift.

Historically insurers worried about:

“Will the client die?”

Increasingly they are worrying about:

“Will the client remain economically functional?”

What does this mean for the next 10 years?

If the current industry trends continue, the biggest pressure on insurers may not be:

• mortality,
• funeral claims,
• accidental death.

Instead it may be:

• disability,
• income protection,
• chronic illness,
• long-duration claims,
• rehabilitation,
• complaints management,
• regulatory scrutiny,
• and customer retention.

The future insurer may therefore need to become:

a resilience-management organisation

rather than purely:

a claims-paying organisation.

@Discovery_SA @Momentum_za @sanlam @Profmed_SA @SBGroup @dailymaverick @FNBSA @Absa @CapitecBankSA @SwissRe_CS @vo2account

[Johann Els @Johannels16]

On a daily basis apparently healthy individuals are tested showing evidence of preserved fitness, yet the majority complain of unexplained fatigue.

Specialist doctors confirm the absence of structural disease.

The reason of fatigue is the ability to produce energy during exercise. This is can only be tested through cardiopulmonary exercise testing.

Problem is becoming worse every year and majority of individuals are struggling to perform activities of daily life.

The problem is not a fitness problem but an energy production problem!

[@vo2account @vo2account]

You don’t need more fitness.

You need your life back.

THINK ENERGY

#thinkenergy #energy #fatigue #tired

[Johann Els @Johannels16]

Most people think exercise is about getting fitter.

It isn’t.

Not at first.

If your body struggles to produce energy, exercise should not begin with performance.

It should begin with restoration.

Before you can run faster…

Before you can get stronger…

Before you can lose weight…

Your body must first learn to produce stable energy again.

The goal isn’t becoming an athlete.

The goal is being able to:

• Get through a workday without exhaustion.
• Play with your children.
• Complete household chores.
• Think clearly.
• Recover properly.
• Maintain independence as you age.

Fitness comes later.

Energy comes first.

#thinkenergy