When we think about the predictors of longevity, we often think of genetics, diet, and lifestyle factors. In the pursuit of a long and healthy life, understanding the factors that influence our physiological capacity becomes crucial.
One such key indicator is VO2 max—a measure of the body’s ability to transport and utilize oxygen during intense exercise. It is widely regarded as one of the most reliable indicators of cardiovascular fitness and endurance, but recent research suggests that it is also a powerful predictor of overall longevity.
Understanding VO2 Max
VO2 max, also known as maximal oxygen uptake or maximal oxygen consumption, refers to the highest capacity of your body to utilize the oxygen you inhale for energy production. It is expressed in millilitres of oxygen used in one minute per kilogram of body weight (ml/kg/min). VO2 max is a vital indicator of cardiovascular fitness and aerobic endurance. Simply put, the higher the VO2 max, the more oxygen a person can consume, and consequently, the longer and harder they can perform physical tasks. Athletes, especially endurance ones, often have high VO2 max values, indicating their exceptional ability to supply oxygen to their muscles during high-intensity workouts.
VO2 max is essentially a measure of the body’s ability to use oxygen effectively. Why is this so crucial to longevity? At a cellular level, oxygen is vital for producing energy. Mitochondria, the powerhouses of our cells, utilize oxygen to convert glucose and fats into adenosine triphosphate (ATP), the main energy currency of the body. Therefore, having a high VO2 max means you have an efficient system of delivering and using oxygen, which results in better cellular health and functioning.
VO2 Max and Longevity
The concept of VO2 max was first introduced by A. V. Hill and H. Lupton in 1923, and ever since, it has been a golden standard in the domain of sports science. But VO2 max is not merely a performance metric.
There is now a solid body of evidence connecting VO2 max to longevity. Multiple longitudinal studies have indicated a robust link between higher VO2 max values and reduced risk of mortality from all causes, not just those related to cardiovascular diseases.(1) In fact, it has proven to be a more reliable indicator of early mortality compared to other commonly measured factors such as high blood pressure, obesity, cholesterol levels, triglycerides, and overall metabolic health. Surprisingly, it even surpasses the detrimental effects of smoking. While it is essential to consider and address these other health markers, the existing research consistently demonstrates that VO2 max stands out as the most significant biomarker when it comes to predicting longevity.
A seminal study published in the Journal of the American Medical Association in 2018 examined the relationship between VO2 max and mortality among 122,007 participants. (2) The study revealed that higher cardiorespiratory fitness, indicated by higher VO2 max, was directly linked to lower all-cause mortality. This pattern held true irrespective of age, sex, and health history, underscoring the profound impact of cardiorespiratory fitness on our lifespan.
The potential reasons behind this link are multifold. A higher VO2 max suggests a more efficient cardiovascular system, healthier lung function, and better metabolic health, all of which contribute to longevity. High VO2 max levels are also often associated with a healthier lifestyle, including regular physical activity and a balanced diet, further enhancing lifespan.
Assessing VO2 Max
Dr. Andy Galpin is a prominent figure in the field of human performance and exercise physiology. He is a professor at California State University, Fullerton, where he teaches and conducts research on the topics of muscle physiology, exercise science, and strength and conditioning. He is widely recognized for his expertise in understanding and improving human performance, particularly in the areas of exercise metabolism, muscle fiber types, and athletic training. Dr.Galpin believes VO2 max should be a minimum of 35 ml/kg/min for males (ideally over 55 ml/kg/min), and a minimum of 30 ml/kg/min for females (ideally over 50 ml/kg/min) as benchmarks for optimal cardiovascular fitness. (3)
A laboratory test, generally a treadmill or stationary bicycle test, is the most accurate way to measure VO2 max. It involves progressively increasing the intensity of exercise until exhaustion, while breath-by-breath measurements are taken to calculate oxygen consumption. You can do an internet search for a facility in your area that will test your VO2 max, however these lab tests may not be not easily accessible, and do come at a cost. Luckily, there are alternatives. Here are a couple well- validated techniques for estimating VO2 max yourself:
Rockport Walk Test—f you have difficulty running, use the Rockport Walk Test. Walk 1 mile, as fast as you can but avoid jogging, and record the time in decimals (minutes + seconds/60) and your heart rate when finished. Enter this and your weight and age in decimals (years + months/12) in an online calculator, or use the formula: 132.853 – (0.0769 x weight in lbs) – (0.3877 x age) + (6.315 if male or 0 if female) – 3.2648 x time) – (0.1565 x heart rate) (4)
Cooper 12-minute Run Test—Just as it sounds, you run as far as you can in 12 minutes. This is likely to be between 1 and 2 miles unless you are very well trained. Enter the distance you cover into an online calculator or use the formula: (35.97 x miles) – 11.29 or (22.351 x kilometres) – 11.288 (5)
Garmin Running Watch—Several models of Garmin watches have VO2 max assessment capabilities built in. Fenix watches, the Forerunner Series (245, 745 , 945), Venu, and Vivosmart 3 all have this ability. To ensure the most accurate VO2 max estimate, it is important to have updated and precise personal information in your Garmin profile. https://www.garmin.com/en-CA/These devices utilize proprietary Firstbeat algorithms, which can estimate VO2 max with accuracy comparable to laboratory tests in most normal conditions. However, it’s important to remember that these are still estimates and may not replace laboratory-based tests for clinical or high-performance purposes.
If you are interested in a more in depth test, find a gym or facility in your area that offers VO2 Max testing for a more accurate assessment. These facilities often offer the use of more advanced equipment, such as metabolic carts or portable gas analyzers, which provide real-time data during the test. These devices accurately measure oxygen consumption and help professionals determine the exact point at which you reach your maximal effort. Additionally, the equipment may offer additional insights into breathing patterns, heart rate response, and other physiological variables, enhancing the overall assessment.
Get In The Zone
Before diving into strategies to increase VO2 max, it is essential to establish a solid aerobic foundation. This foundation is built through consistent training at lower intensities, typically referred to as Zone 2 training. Zone 2 cardio encompasses various activities such as brisk walking, cycling, swimming, or rowing. The key factor is to elevate your heart rate to around 60% to 70% of your maximum heart rate, which can be estimated by subtracting your age from 220 beats per minute.
If you don’t have a device to monitor your heart rate, you can employ the talk test. During Zone 2 exercise, you should be able to speak, but not engage in a full-fledged conversation. Sustaining this level of intensity for an extended period without reaching exhaustion is a good indicator that you are in the appropriate zone.
Zone 2 training focuses on developing the aerobic energy system, which relies primarily on oxygen as the primary fuel source to generate energy. By training at this moderate intensity, the body becomes more efficient at utilizing oxygen, enhancing the delivery of oxygen to the working muscles and increasing the body’s capacity to produce energy aerobically.
Engaging in Zone 2 training builds cardiovascular strength, improves blood circulation, and enhances endurance. It strengthens the heart, allowing it to pump more blood, oxygen, and nutrients to muscles efficiently. Zone 2 training also increases the number and size of mitochondria, and improves fat metabolism, enabling the body to use fat as a fuel source during low to moderate-intensity exercise. This helps sustain longer durations of exercise without depleting glycogen stores needed for high-intensity efforts.
VO2 max is an advancement beyond Zone 2 cardio and presents a slightly greater challenge since it necessitates exerting more effort in less time.
Dr. Peter Attia, a well-known medical doctor, author, and expert in the fields of longevity and human performance, recommends starting with two 30-minute sessions of Zone 2 cardio per week if you’re just starting out. Once you become accustomed to this routine, you can gradually increase your training volume to a total of three hours (180 minutes) of Zone 2 activity per week. It is recommended to maintain this Zone 2 training regimen for approximately five to six months or until you no longer find it tiring.(6)
Increasing VO2 max and aerobic capacity is a gradual process requiring patience and consistency. With proper training, the body becomes more efficient at utilizing oxygen, resulting in increased VO2 max and overall aerobic capacity.
Boosting VO2 Max for a Healthier Life
Given the importance of VO2 max for both performance and longevity, it’s worth exploring ways to increase it. Once you’ve established a solid Zone 2 training baseline, you can now start to increase your VO2 max. Here are some strategies:
High-Intensity Interval Training (HIIT)—HIIT involves short, intense bouts of exercise followed by recovery periods. These high-intensity periods push your heart rate close to its maximum, stimulating adaptations in your cardiovascular system and improving VO2 max.
Long, Slow Distance Training (LSD)—Long, slow workouts at a steady pace can improve cardiovascular function and increase VO2 max over time. These sessions should be performed at a relatively comfortable intensity, making them more sustainable and less likely to lead to overtraining.
Fartlek Training—This Swedish word means “speed play” and refers to a training style that blends continuous training with interval training. Fartlek training might involve a long run interspersed with periods of faster running, but unlike traditional interval training, these periods are not set in time.
Diet and Hydration—A balanced diet and proper hydration are essential for optimal cardiovascular function and fitness. Nutrients like omega-3 fatty acids, antioxidants, and beetroot (rich in nitrates) are particularly beneficial for cardiovascular health.
Adequate Rest and Recovery—Overtraining can lead to diminished performance and health. It’s essential to balance training with adequate rest and recovery to allow the body to repair and adapt to the increased demands placed upon it.
Altitude Training—Some athletes train at high altitudes to boost their VO2 max. This is because the lower oxygen concentration at high altitudes forces the body to produce more red blood cells and enhances the body’s oxygen-carrying capacity. However, the benefits of altitude training are still a topic of ongoing research, and this method might not be practical or beneficial for everyone. There are altitude simulation training masks available if a trip to the mountains just isn’t feasible. These masks restrict the flow of oxygen during exercise, making the body work harder. There are differences of opinion in the athletic world if these devices are actually of any benefit however, and they should not be used by anyone with respiratory or cardiovascular issues.
VO2 max is not just a measure of your cardiovascular fitness; it’s a reflection of your overall health and a powerful predictor of longevity. By incorporating regular, intense physical activity into your lifestyle, you can increase your VO2 max, improve your health, and maybe even add years to your life.
Remember, everyone’s fitness journey is unique. Don’t focus on the numbers, but rather on consistently striving for better health, day after day.
In-text References
- Kodama, S., Saito, K., Tanaka, S., Maki, M., Yachi, Y., Asumi, M., Sugawara, A., Totsuka, K., Shimano, H., Ohashi, Y., Yamada, N., Sone, H. (2009). Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA, 301(19), 2024–2035.
- Mandsager K, Harb S, Cremer P, Phelan D, Nissen SE, Jaber W. Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing. JAMA Netw Open. 2018 Oct 5;1(6):e183605. doi: 10.1001/jamanetworkopen.2018.3605. PMID: 30646252; PMCID: PMC6324439.
- Dr. Andy Galpin: How to Assess & Improve All Aspects of Your Fitness | Huberman Lab Guest Series [Video]. YouTube. Retrieved from [https://www.youtube.com/watch?v=zEYE-vcVKy8]
- Kline, G.M., Porcari, J.P., Hintermeister, R., et al. (1987). Estimation of VO2 Max from a one mile track walk, gender, age, and body weight. Medicine and Science in Sports and Exercise, 19(3), 253-259.
- Cooper, K. H. (1968). A means of assessing maximal oxygen intake. JAMA, 203(3), 201. https://doi.org/10.1001/jama.1968.03140030033008
- YouTube. (2022, March 28). 201 – deep dive back into zone 2 training | iñigo san-millán, Ph.D. & Peter Attia, M.D. YouTube. https://www.youtube.com/watch?v=-6PDBVRkCKc