HRV vs. VO2 max vs. ECG: Which wearable metric ACTUALLY matters? | Prof. Malcolm Findlay

ZOE Science & Nutrition

ZOE

Nutrition, Science, Health & Fitness, Education

4.6 • 5.6K Ratings

🗓️ 2 October 2025

⏱️ 47 minutes

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Summary

Is your smartwatch just a fun gadget, or a serious medical device? In this episode, Jonathan Wolf is joined by Dr. Malcolm Findlay, a leading consultant cardiologist, to explore the powerful health data available on your wrist. They decode the most misunderstood metric, Heart Rate Variability (HRV), and reveal how your wearable can provide clinical-grade insights into your heart's health. Dr. Findlay explains the counter-intuitive science behind HRV — why more ‘wobble’ in your heartbeat is a sign of good health — and breaks down the two opposing nervous systems that control it. He shares the latest on how these devices can accurately detect serious conditions like atrial fibrillation and why he, as a cardiologist, trusts the ECG function on a consumer smartwatch to make diagnoses. For listeners who track their own data, this episode is a practical guide to what your numbers actually mean. Dr. Findlay explains how to interpret your personal HRV trends, what constitutes a significant change, and when you should use the ECG feature. He also debunks common myths about heart rate zones, revealing the level of exercise intensity that truly benefits your long-term health. The episode concludes with an empowering look at how this technology is shifting control into our own hands. Can a simple alert from your watch really help prevent a catastrophic event like a stroke? Discover which metrics matter most and how to use them to guide your wellness journey. 🥑 Make smarter food choices. Become a member at zoe.com Try our new plant based wholefood supplement - Daily 30+ *Naturally high in copper which contributes to normal energy yielding metabolism and the normal function of the immune system. Timecodes 00:06 Quick-fire questions on heart health 01:45 What is heart rate variability (HRV)? 03:05 Is a steady heart rate a healthy sign? 05:15 Atrial fibrillation makes HRV an invalid measure 07:30 What controls our heart rate? 10:00 Your heart is much more than a pump 11:10 Your thoughts can directly affect your heart 13:45 What lifestyle factors influence your HRV score? 15:15 How does stress impact your HRV? 17:15 Your watch's ECG is a clinical-grade tool 20:20 Wearables can help diagnose serious heart conditions 23:45 Are expensive wearables more accurate? 26:20 Does diet impact your HRV score? 29:15 How to track your HRV score correctly 30:00 Don't panic about small HRV fluctuations 32:30 When to use your watch's ECG function 34:10 The truth about heart rate training zones 36:50 The minimum exercise for a healthy heart 37:40 Does sleep consistency matter? 39:50 What is VO2 max and does it matter? 41:10 Stop comparing your health data to others 41:50 Key takeaways from the episode 📚Books by our ZOE Scientists The Food For Life Cookbook Every Body Should Know This by Dr Federica Amati Food For Life by Prof. Tim Spector Ferment by Prof. Tim Spector Free resources from ZOE Live Healthier: Top 10 Tips From ZOE Science & Nutrition Gut Guide - For a Healthier Microbiome in Weeks Better Breakfast Guide Studies referenced for today's episode Heart rate variability: standards of measurement, physiological interpretation and clinical use, 1996, European Heart Journal Diagnostic Accuracy of a Smartwatch App for the Detection of Atrial Fibrillation, 2019, The New England Journal of Medicine The Effects of Alcohol on Heart Rate Variability and Heart Rate, 2017, The American Journal of Cardiology The relationship between mental stress and heart rate variability, 2007, Journal of Psychosomatic Research Have feedback or a topic you'd like us to cover? Let us know here. Episode transcripts are available here.

Transcript

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0:00.0	Welcome to Zoe Science and Nutrition, where world-leading scientists explain how their research can improve your health.
0:11.0	The use of wearable devices that promise to transform our health is booming. But do they work?
0:21.5	These watches and rings provide measurements and feedback
0:24.7	to help you understand your health
0:26.4	and take steps to improve it.
0:29.4	Measurements include sleep quality, step count and others.
0:33.3	But the metric getting a lot of attention right now
0:35.9	is heart rate variability, or HRV.
0:39.3	And it's no wonder, HRV is said to be a good indicator of your stress levels, of your heart health, and your overall well-being.
0:48.3	But is it really all that useful to track HRV? Is there anything else that we'd be better off tracking instead? And how accurate
0:56.7	are these wearable devices anyway? Joining us with answers is Professor Malcolm Finley,
1:06.6	a board-certified cardiologist and electrophysiologist, and an honorary professor of cardiovascular medicine and devices.
1:14.2	A leader in the field of measuring heart health,
1:17.2	he's well positioned to give us the truth.
1:20.4	You'll leave today's episode,
1:22.1	understanding whether a wearable device could help you,
1:24.9	how to get the most out of it if you have one,
1:27.3	and what are the best things
1:28.5	to track to improve your health? Malcolm, thank you so much for joining me today.
1:35.4	Thank you so much. Thanks for hearing me. It's a pleasure. Now, we have a tradition here at Zoe
1:40.3	where we always start with a quick fire round of questions from our listeners. And you can
1:45.4	answer with a yes or a no, or if you have to have one sentence answer. Okay. Can HRV tell you
	...

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