There is more to VO2 max than performance

VO2max is a popular topic among exercise physiologists and endurance athletes. Exercise physiologists use VO2max to measure the effectiveness of a training protocol. Endurance athletes use VO2max as a marker of fitness and compare values at various times of the season.

But an even better use of your VO2max is the relationship between VO2max and health, as I will explain.  So, even if you are not an athlete wishing to improve performance, your VO2max is an important variable to know. I recommend you get your VO2max measured. Here’s why…

I am often asked, “What does ‘VO2max’ mean?”  First off, the ‘V’ stands for volume, O2 stands for oxygen, and ‘max’ is an abbreviation for maximum.  So, in basic terms, VO2max is the maximum volume of oxygen you consume.   There are a lot of ways to describe VO2max, and the true meaning of VO2max is still hotly debated amongst exercise physiologists.  A simple description is that VO2max is a number that represents the peak amount of oxygen you consume while working up to your maximum workload.  In other words, as you increase exercise intensity, the amount of oxygen you consume will increase accordingly.  At some point, the amount of oxygen you consume will plateau, indicating that your body is not capable of using any more oxygen even if you keep increasing the intensity.  The peak value recorded during this test is your VO2max (or VO2peak).  Folks will have different VO2peak values for different activities. For example, your ‘running VO2peak’ will most likely be different from your ‘bicycling VO2peak’.  If you know your VO2peak values from many different modalities (running, biking, skiing, etc.), then your highest VO2peak is referred to as your VO2max.

So, what is the relationship between VO2max and health?  VO2max is an excellent marker of health, longevity, and risk of disease.  High VO2max values correlate with LESS incidents of heart disease and LESS risk of impending death.  In fact, animal studies have shown that animals with higher VO2max values live longer.  In some cases, up to 40% longer!   So, you want to get your VO2max as high as possible.  Here’s why…

VO2max declines with age.  In fact, a normal person would expect to begin seeing a decline in their VO2max around 30 years of age.  This decline continues for the remainder of life.  Very low VO2max values (below ~20 ml/kg/min) result in frailty, which is defined as the lack of muscle strength and vigor.  Obviously, you don’t want your VO2max to get so low that you become frail.

Think of your VO2max value as a bank account.  The more money you put in your bank account early in life, the more you can withdraw as you age before you run out of money.  Similarly, the higher you can get your VO2max early in life, the greater the cushion you have for the inevitable decline before you reach frailty.  In other words, you won’t reach frailty as quickly as if you had a lower VO2max.  The take home message here is that if you can keep your VO2max high, you have less likelihood of dying, requiring assisted care living, or residing in a nursing home.

The good news is that this decline in VO2max can be blunted by lifestyle choices.  For example, physical activity (exercise) slows this age-related VO2max decline.  Ideally, with an active lifestyle and proper a proper exercise training program, you would experience little to no decrease in VO2max in your 30s and 40s, and a very small (if any) decrease in your 50s and 60s.  This is great news for health and longevity because you are increasing the likelihood of continuing to live with a high quality of life for more years.  So, physical activity, specifically aerobic exercise training, can potentially maintain your VO2max and blunt the age-related decrease in VO2max.  Just like your yearly physical where your cholesterol and blood pressure are measured, performing a VO2max test periodically gives you another valuable marker of your health.  By knowing your VO2max and monitoring it from year to year, you will be better able to determine if your exercise and lifestyle choices are maximizing your health.


NOTE: this concept also applies to bone density and muscular strength. These, like VO2max, reach a peak in life and begin to decline with age. Our goal is to get VO2max, bone density, and muscular strength as high as possible before that age-determined decline takes hold. Another thing to note is that the RATE at which we decline is greatly influenced by lifestyle. Take for example two 50 year old people. One 50 year old has a VO2max of 70 but sits on the couch for the next 20 years. The other 50 year old has a VO2max of 50 but stays active for the next 20 years. Most likely, the person sits on the couch for 20 years will see a greater decline in VO2max than the person that stays active. By the time these two individuals are 70, there’s a good chance the active person will  have a higher VO2max than the first guy.