Imagine that VO2max is the limit on your credit card. The higher it is, the more your body can “buy” – more recovery, more resilience, more energy without falling into debt. When that limit is low, every greater effort or bout of stress becomes an obligation the body struggles to repay. A high VO2max means cells are permanently “solvent” and have the resources to repair damage as it happens.
In this article we show what VO2max actually is, why it is so strongly linked to longevity, how it changes with age and – most importantly – how it can be raised, no matter where you are starting from.
This article expands on our Longevity Alphabet series, in which we define the most important concepts in longevity medicine. Discover what our Speaker says about VO2max. Watch the video, and follow Elevate on Instagram for more content like this:
What VO2max Is
VO2max describes the maximum rate at which the body can use oxygen during exercise. It is the combined result of several systems at once: the heart has to pump enough blood, the lungs to deliver oxygen, the blood to carry it, and the muscles and their mitochondria to use it efficiently. That is why VO2max is such a good “summary” of overall fitness: it shows how well that whole chain works.
It is precisely this comprehensiveness that leads experts to propose treating cardiorespiratory fitness as a vital sign – as important as blood pressure or cholesterol. The American Heart Association has explicitly called for cardiorespiratory fitness to be assessed as a “clinical vital sign”, because it carries an exceptional amount of information about health.
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Read moreWhy the Level of VO2max Translates into Longevity
The evidence here is surprisingly consistent and strong. Numerous studies show that higher cardiorespiratory fitness is associated with a markedly lower risk of death and of cardiovascular events. The most recent reviews on the subject confirm this link and show that VO2max is one of the strongest predictors of mortality – often stronger than the classic risk factors.
Particularly telling is a study of more than 120,000 people, in which higher fitness was associated with lower mortality without any clear “upper limit”. Those with the highest fitness fared best, while very low fitness carried a risk comparable to serious disease. In other words: among the things we can influence, few offer as much protection against premature death as improving aerobic capacity.
VO2max and Age
VO2max naturally declines with age – that is part of the physiology of aging. Crucially, though, the rate of that decline is not predetermined. Active people maintain clearly higher fitness than sedentary peers, and the difference can correspond to many years of a “younger” body. In fairness it should be added that genetics plays a part. Both the baseline level of VO2max and how strongly it rises in response to training differ between individuals.
How to Increase VO2max
The good news is that VO2max responds superbly to training – at any age. Almost anyone can improve their fitness relative to their own starting point. The greatest health benefits go to those who move from a very low level to even a moderate one. The most effective approach combines two elements. The first is an aerobic base: regular, moderate endurance exercise (easy running, brisk walking, cycling, swimming) that builds capacity without excessive strain. The second is higher-intensity interval training, which stimulates a rise in VO2max particularly strongly.
The key is regularity and a gradual increase in load, not isolated exhausting sessions. For people starting from a low level, even a small improvement brings a clear health gain – because it is precisely the move out of the lowest fitness band that lowers risk the most. It is also worth consulting a doctor or specialist about your plan, especially if you have a medical condition or are returning after a long break.
Want to know how to improve this parameter effectively and check the norms for your age? Read our full article with commentary from Professor Łukasz Małek.
Conclusions
VO2max is the hard currency of health – the best single measure of the body’s capacity and one of the strongest, best documented predictors of a long and high-quality life. High fitness means greater reserves for recovery, resilience and coping with stress, while low fitness is an objective risk factor, comparable to serious disease.
Sources
1. Kodama S, Saito K, Tanaka S, et al. Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women: https://doi.org/10.1001/jama.2009.681
2. Mandsager K, Harb S, Cremer P, et al. Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing: https://doi.org/10.1001/jamanetworkopen.2018.3605
3. Ross R, Blair SN, Arena R, et al. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign (American Heart Association): https://doi.org/10.1161/CIR.0000000000000461
4. Harber MP, Kaminsky LA, Arena R, et al. Impact of Cardiorespiratory Fitness on All-Cause and Disease-Specific Mortality: Advances Since 2009: https://doi.org/10.1016/j.pcad.2017.03.001
