VO2 Max is a key measure of cardiorespiratory fitness, reflecting the maximum amount of oxygen your body can utilize during intense exercise. It serves as a powerful indicator of overall health and longevity, with higher values strongly correlating to increased life expectancy.
👉 key take aways:
- Maintaining high VO2 Max values can add 2-5 years to life expectancy
- Check your VO2 Max every 4-6 weeks during intensive training, or every 3-6 months for maintenance
- Target top 5% values for your age/sex group: 60+ ml/kg/min (men 20-29) to 30+ ml/kg/min (women 70+)
- Regular endurance training can halve the natural age-related decline from 12% to 5.5% per decade
- Consider CPOmax as alternative metric: more accurate for obese individuals and better predictor of heart health
1. VO2 Max and Longevity
Life Expectancy Impact
- Individuals in the top 5% of VO2 Max live an average of 4.9 years longer than those in the lowest 5%
- High VO2 Max values significantly reduce cardiovascular mortality risk
- Regular endurance exercise helps maintain high VO2 Max levels throughout life
Age-Related Changes
- Natural decline occurs at approximately 12% per decade in sedentary individuals
- Well-trained athletes experience only 5.5% decline per decade
- Structured endurance training can increase VO2 Max by 16.3% even in older adults
2. Monitoring and Improvement
Change Rate
- Short-term HIIT programs can increase VO2 Max by 4-7% within 4 weeks
- Moderate-intensity exercise shows measurable improvements within 6 weeks
- Detraining can decrease VO2 Max by up to 20% within 12 weeks of inactivity
Recommended Check Intervals
- Intensive training programs: Every 4-6 weeks
- Long-term endurance training: Every 10-12 weeks
- Maintenance phase: Every 3-6 months
3. Target Values by Age and Sex
Men (ml/kg/min)
| Age | VO2Max |
|---|---|
| 20-29 | 60+ |
| 30-39 | 56+ |
| 40-49 | 52+ |
| 50-59 | 48+ |
| 60-69 | 44+ |
| 70+ | 40+ |
Women (ml/kg/min)
| Age | VO2Max |
|---|---|
| 20-29 | 50+ |
| 30-39 | 46+ |
| 40-49 | 42+ |
| 50-59 | 38+ |
| 60-69 | 34+ |
| 70+ | 30+ |
4. Measurement Considerations
VO2 Max Formula
\[ \text{VO2Max} = \frac{\text{Maximum Oxygen Uptake (mL/min)}}{\text{Body Weight (kg)}} \]- Calculated as maximum oxygen uptake (mL/min) divided by body weight (kg)
- Similar to BMI, the formula has inherent biases due to total body weight usage
- More accurate when normalized to lean body mass rather than total weight
Measurement Accuracy
- Total body weight in the denominator may underestimate fitness in individuals with higher fat mass
- Lean body mass is the primary determinant of oxygen uptake during exercise
- Consider absolute VO2 Max (mL/min) or lean mass-adjusted values for more accurate assessment
Alternative Measurements
- Peak cardiac power output (CPOmax) provides a more reliable indicator for obese individuals
- Obese individuals often show normal or above-average cardiac output despite lower VO2 Max/kg values
- Regression-based adjustments can provide more accurate fitness assessments than simple weight normalization
- Body surface area and fat-free mass scaling offer alternative normalization methods
5. Cardiac Power Output (CPOmax)
CPOmax directly measures the heart’s ability to pump blood and generate power during maximal effort, making it a more precise indicator of cardiac function than VO2 Max. It’s particularly valuable for individuals with atypical body composition (e.g., athletes, obese) and provides superior prognostic information for cardiovascular health. Unlike VO2 Max, CPOmax isn’t biased by body weight and better reflects the heart’s actual mechanical performance.
CPOmax Formula
\[ \text{CPOmax} = \frac{\text{Qmax} \times \text{MAP}}{451} \]Where:
- Qmax: Maximum cardiac output (in L/min)
- MAP: Mean arterial pressure (in mmHg)
- 451: Conversion factor to convert to watts (W)
Target Values by Age and Sex
Men
| Age Group | CPOmax (W) |
|---|---|
| 20-30 | 5.5-7.0 |
| 40-60 | 4.5-5.5 |
| 60+ | 3.5-4.5 |
Women
| Age Group | CPOmax (W) |
|---|---|
| 20-30 | 4.5-6.0 |
| 40-60 | 4.0-4.5 |
| 60+ | 3.0-4.0 |
Age and Sex Differences
- Men experience a 20-25% decrease in CPOmax with aging
- Women show better preservation of CPOmax values over time
- Men’s higher values attributed to larger left ventricular mass and stroke volume
- Active men show 17-36% higher CPOmax compared to sedentary peers
- Women’s exercise response is less pronounced but more stable over time
Sex and Age Considerations
- Women typically show lower VO2 Max values due to differences in lean body mass and hemoglobin levels
- Age-related decreases partly reflect changes in lean body mass
- Measuring per kilogram of lean mass provides better insights into aging effects
References
- Clausen et al., 2018 : Midlife Cardiorespiratory Fitness and the Long-Term Risk of Mortality: 46 Years of Follow-Up
- Valenzuela et al., 2019 : Lifelong Endurance Exercise as a Countermeasure Against Age‐Related VO2Max
- Rogers et al., 1990 : Decline in VO2max with aging in master athletes and sedentary men
- Huang et al., 2005 : Controlled endurance exercise training and VO2max changes in older adults: a meta-analysis
- Burtscher et al., 2022 : The Impact of Training on the Loss of Cardiorespiratory Fitness in Aging Masters Endurance Athletes
- Rusip & SriMukti, 2019 : Impact of 12-week moderate intensity exercise on cardiorespiratory changes in MMP-9 and VO2max in elderly women
- Gordon et al., 2019 : Four Weeks of Low Volume High-Intensity Interval Training Has No Effect On VO2max
- Lewis et al., 2010 : VO2max/kg is unreliable as an indicator of cardiac function in obese patients
- Savonen et al., 2012 : The current standard measure of cardiorespiratory fitness introduces confounding by body mass: the DR’s EXTRA study
- Patkar & Joshi, 2011 : Comparison of VO2max in obese and non-obese young Indian population
- Goldspink et al., 2009 : A study of presbycardia, with gender differences favoring ageing women
- Clements, 2005 : The effects of ageing, endurance exercise and heart failure on cardiac power output