Your VO2 Max score can be an indicator for long life
Wearable tech means more of us have access to our VO2 Max scores. Here’s what it means for your fitness, but also for healthy ageing.
For too long, the “gold standard” measure of fitness, VO2 Max, was something confined to the lab. But with the rise of sophisticated wearable tech, more of us can now peek behind the curtain and truly understand our fitness levels. As a sports cardiologist, I can tell you it’s a vital metric for healthy ageing, and its high time we paid more attention.
What exactly is VO2 Max?
Simply put, VO2 Max is the maximum volume of oxygen your body can use during intense exercise. Think of it as your body’s engine efficiency – the more oxygen your body can consume, the more energy it can produce, leading to better physical performance. It’s measured in millilitres of oxygen per kilogram of body weight per minute (ml/kg/min). An average person might use around 3.5ml per minute per kilogram of oxygen. When you’re stressed, that increases, and with exercise, it rises rapidly until you hit a ceiling – that’s your VO2 Max. For a very fit person, that value will be high; for someone unfit, it will be low.
To give you some perspective, a Tour de France cyclist might register a VO2 Max of 80-90, while for someone largely sedentary, it could be as low as 10 to 15. That’s a staggering difference – up to 900 per cent!
How do you accurately measure VO2 Max in a clinical setting?
In our clinic, we get individuals onto a treadmill or bike, fitted with a metabolic mask. We progressively increase the intensity of their workout. Our machines precisely measure the oxygen content in the air they exhale compared to what they inhale. At a certain point, even if the athlete or individual is pushing harder, we observe a plateau – they simply cannot use any more oxygen. That peak point is their true VO2 Max.
Can I get a reliable VO2 Max reading outside of a lab, say, with my smartwatch?
While your Garmin or Apple Watch doesn’t directly measure oxygen intake and output like our lab equipment, they’re surprisingly good at providing a decent estimate. These devices leverage data from millions of users and understand your heart rate response to various activities. So, if you’re running a 3.5-minute kilometre pace with a heart rate of 160bpm, your watch can estimate your VO2 Max to be somewhere in the 50-55 range. It’s not perfect, but it offers a valuable starting point and a benchmark for improvement.
How critical is VO2 Max for healthy ageing?
VO2 Max is, without doubt, one of the strongest, if not the strongest, prognostic factors for longevity. Every major population-level study that has looked at the relationship between lifespan and fitness consistently shows that VO2 Max outperforms almost every other health measure. Studies have even demonstrated that a small incremental increase in VO2 fitness – say, from 35 to 36 – can equate to an 8 per cent increase in longevity for women and around 4 per cent for men. Every single increase translates to a measurable improvement in health outcomes. Understanding and optimising this metric is about extending not just life, but the quality of life well into your later years.
What’s the most effective way to improve my VO2 Max fitness?
The evidence suggests a smart mix of high-intensity and lower-intensity exercise. This means incorporating some short, sharp bursts of activity that really stress your oxygen system to its max, alongside periods of lower-zone exercise. If you’re out cycling with friends, for instance, you’d want some easy riding interspersed with short, intense efforts. Crucially, less time should be spent in that “middle zone” where you’re working moderately but not pushing your limits or truly recovering. Hours and hours of middling-pace exercise can be time-consuming and less efficient for boosting your VO2 Max.
Is it inevitable to lose VO2 fitness as we age, and what can we do about it?
Unfortunately, everyone starts to lose VO2 fitness from about the age of 30 – roughly one millilitre per minute per kilogram each year. If you don’t actively maintain it, it becomes significantly harder to regain as you age. Think of it like superannuation: the earlier you start contributing, the greater the benefit later on. You really need to start working on this in your middle age. If you’re still healthy at 50 and continue to focus on your fitness, you’re setting yourself up for a long, healthy life. While it’s not impossible to get fitter after 50, you do lose fitness very quickly, and it’s much more challenging to build it back. One study showed that if you have a low level of fitness in your 60s and 70s, it’s almost unachievable to get back to even average fitness levels.
My message is simple: prioritise maintaining your fitness. As we live longer, it’s not just about how long we live, but how well we live. Taking control of your VO2 Max is key to ensuring those extended years are lived with vitality and independence.
Professor Andre La Gerche is a world-leading sports cardiologist and head of the HEART Lab, supported by the Victor Chang Cardiac Research Institute and St Vincent’s Medical Research Institute.
This column is published for information purposes only. It is not intended to be used as medical advice and should not be relied on as a substitute for independent professional advice about your personal health or a medical condition from your doctor or other qualified health professional.
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