I was complaining to my brother -in-law last weekend that my newest venture into improving my physical fitness by training to improve my VO2 max was proving to be a painful endeavor. He looked questioningly at me--why would I care what my VO2 max is at the age of 52? I'm not competing in endurance events, and I'm certainly not an elite athlete. So, why do I care about improving this number?
There are a multitude of parameters available to us to assess our overall health and well-being. One metric that I think we should take more note of is our VO2 max. This measurement is not only a gold standard for evaluating cardiorespiratory fitness but also can serve as a tool to provide insight into how what we can expect of our bodies as we age.
What is VO2 Max?
VO2 max is a measurement of the maximum amount (volume) of oxygen your body can take up and use during intense physical activity. It is measured in milliliters of oxygen per kilogram of body weight per minute (ml/kg/min) and is considered one of the most reliable indicators of cardiovascular fitness. This value reflects your body's capacity to assimilate, transport and utilize oxygen, which is essential for aerobic energy production during exercise. Though there is some genetic variability in VO2 max, we can all train to improve this.
Impact on Health
Longevity: VO2 max serves as a critical marker of cardiovascular health and has been found to be directly correlated with lifespan. A study (Mandsager et al., 2018) looking at a large group of middle-aged people's VO2 max found that going from having the lowest VO2 max to having a below average VO2 max translated into a 50% reduction in mortality over a decade. And when comparing the people with the lowest VO2 max to the people with an above average VO2 max, the latter had a 70% mortality reduction over 10 years. To compare this to another risk factor that people are well aware of (smoking), NOT smoking only imparts a 40% reduction in mortality over 10 years. There is NO other intervention that has the impact on lifespan that exercise and cardiovascular fitness does.
Health span: Okay, so we can live longer with better VO2 max, but does that translate into a better life? Many Americans live into their 70s or 80s but are often suffering significantly from serious health conditions in their last decade of life. They might have a decent life span, but very often poor health span. So, if you want to be a reasonably fit 70 or 80 yo (or even just an 80 yo who can live on their own), start paying attention to your VO2 max as early as you can. Our VO2 max drops about 10% per decade. If you're starting your fifth decade of life with a VO2 max in the lowest quartile for your age/gender (so for a 40 yo woman, that'd be <26 ml/kg/min), you may have trouble with maintaining your independence as you age. And, if you want to be able to travel and hoist your own suitcase or (like me) walk 10 miles a day at Disney, you'll need a VO2 max of at least 28 or 30 ml/kg/min. For me, that means I need a VO2 max now in the high 40s or low 50s to maintain enough cardiorespiratory fitness to be able to do those things when I'm in my 80s. Having said that, it's never too late--there are multiple studies in older people that show they can improve their VO2 max in a reasonable period of time and that that improvement lengthens their life and health spans.
Metabolic Health: Finally, research has shown a strong association between VO2 max and metabolic health. A higher VO2 max corresponds to better insulin sensitivity, lower blood pressure, and a healthier lipid profile. This means that individuals with a high VO2 max are more likely to have better control over their blood sugar and cholesterol levels, reducing the risk of type 2 diabetes and obesity-related complications.
Alright, so you're on-board--what does it look like to train to improve your VO2 max? If you think about your fitness in the shape of a pyramid, VO2 max training is at the tip of the pyramid. You'll only need to spend about 20% of your overall exercise time doing VO2 max (sometimes called Zone 5) training. There are several protocols but most of them are something like 4 X 4 intervals. You will go as hard as you can sustain for 4 minutes and then recover for 4 minutes and repeat that a total of 4 times. You can also do 2 min intervals with 2-3 minutes of rest. I like this method--you can see my heart rate graph at the top of this post, where my intervals were about 2 minutes in length. I do my training on a treadmill or running outside, but you can do this kind of training on a bike, on a rowing machine, a stair climber, ski erg, etc. You will see significant gains even only doing this once a week!
Interested in learning more about how to be the best version of yourself? I'd love to tell you more, so to learn about my practice and what I can offer, make a meet 'n greet appointment at renewalhealth.us.
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