Beyond Athletic Potential: Why VO2max Matters for Your Healthspan

VO2max for overall health

Calculating VO2max—the gold standard for measuring cardiorespiratory fitness—has been popular amongst endurance athletes seeking to improve their athletic performance. But growing research shows VO2max is important for everyone to monitor—marathon runners and weekend warriors alike.

VO2max is a strong predictor of many health outcomes and healthspan—the duration of life spent in good health without chronic diseases or age-related disorders. In fact, VO2max is a better indicator for cardiovascular health and all-cause mortality than other widely used predictors like smoking, hypertension, high cholesterol, and diabetes status. The American Heart Association even published a seminal scientific statement in 2016 advocating for regular assessment of VO2max’s inclusion as a clinical vital sign. [1]

What is VO2max?

VO2max is a marker that reflects the maximum amount of oxygen your body can consume during aerobic exercise. V is for volume, O2 is for oxygen and max is for maximum.

A higher VO2max means your body delivers oxygen to your muscles more efficiently, which is important, as your muscles need oxygen to fuel chemical reactions that produce energy. The more oxygen you inhale and utilize, the more energy your muscles can use. A higher VO2max is generally better—as having a high VO2max indicates stronger athletic performance, heart health, and overall health. Athletes often have high VO2max levels, enabling sustained energy and power.

Why is VO2max the "engine of healthspan?"

VO2max is also a strong indicator of healthspan, with many studies showing an association between higher VO2max and lower risk of death and disease. [1] This is because a higher VO2max reflects the body’s ability to efficiently transport and utilize oxygen and other nutrients within the blood, which requires the integrated function of numerous body systems, including the heart, lungs, and more.

What is a good VO2max level?

The best VO2max level for you is highly specific to you based on your demographic factors. Researchers have identified VO2max zones for the general population varied by age and sex. The zone for VO2max is higher for males than females and higher for younger individuals than older. Below are charts from the American College of Sports Medicine that reflect typical VO2max by age and sex. [2]

VO2max male chart

VO2max female chart

That said, when it comes to VO2max, the higher the better. Even if your VO2max level is in the optimal zone, improving your VO2max can help boost performance, heart health, and longevity.

How is VO2max measured?

VO2max testing can be completed with a cardiopulmonary exercise test, also referred to as a submaximal test, at your doctor’s office or lab. You will perform cardiovascular exercise, like running on a treadmill or riding a bike, while wearing a mask over your face that connects to a machine capable of analyzing the air you breathe in and out. The test measures how much oxygen you breathe in compared to how much oxygen you breathe out, which reveals how much oxygen your body is using. VO2max is typically measured in milliliters of oxygen consumed in a minute per kilogram of body weight (mL/kg/min).

If you can’t get to a lab, your VO2max can also be estimated with smart devices and fitness trackers like Garmin, Fitbit, or Apple Watch. These devices use your heart rate during walking and running and compare this to your pace as an indication of how hard your body is working and your VO2max. While this method is not as accurate as lab testing, it is readily accessible and can be helpful for monitoring how your VO2max changes. [3]

What happens when you improve your VO2max levels?

Improved heart health

A growing body of research has identified VO2max as a strong predictor of risk for adverse cardiovascular outcomes as well as cardiovascular disease mortality. [1] A meta-analysis that included nearly 103,000 participants reported a 13 percent reduction in cardiovascular disease mortality per 1-MET (a unit of measurement for VO2max) increase in exercise capacity. [4]

Improved endurance

A higher VO2max means more energy to fuel exercise, which can lead to greater athletic endurance. High VO2max scores are commonly associated with endurance sports like cycling or distance running. However, VO2max is just one of many factors that influence endurance, so a higher VO2max does not necessarily equate to better sports performance. [5]

Decreased inflammation (hsCRP) levels

VO2max is related to inflammatory markers, like hsCRP, because consistent exercise reduces the production of pro-inflammatory proteins called cytokines. Several recent studies have observed that CRP and other inflammatory markers are lower among individuals with better cardiorespiratory fitness. [6,7]

Improved triglycerides

A higher VO2max might lead to lower triglyceride levels, as triglycerides can be metabolized and used for fuel during exercise. In a cross-sectional study of overweight and obese healthy males, triglyceride levels were lower and blood lipid profiles were more favorable in males with high VO2max compared to males with low VO2max. [8]

Better blood glucose control

Research has found VO2max to be correlated with blood glucose levels, likely because exercise stimulates glucose uptake by the muscles, lowering blood glucose. [8]

Improved HDL cholesterol levels

Aerobic exercise is known to increase the formation of HDL—the good cholesterol—in the body. As such, increasing your VO2 max is associated with higher HDL levels, an indicator of good cardiovascular health. [8]

How to improve your VO2max levels

Good news—there is a lot you can do to improve your VO2max. From exercise to supplementation, VO2max levels are highly modifiable through lifestyle habits.

Get more aerobic exercise

Consistent aerobic exercise is one of the most effective ways to improve your VO2max. Get at least 150 minutes per week of moderate-intensity activity, such as brisk walk or easy bike ride, to raise your VO2max. If you’re able to do more, studies reveal even greater improvements in VO2max can be achieved with vigorous-intensity exercise, like hiking, running, or swimming laps. For example, findings from a randomized controlled trial that assigned study participants to different exercise intensities revealed VO2max levels increased by 10% in the moderate-intensity group and by 14.3% in the vigorous-intensity group. [9]

Try high intensity interval training (HIIT) workouts

Research shows that completing high intensity interval training (HIIT) workouts—repeated bouts of high intensity effort followed by varied recovery times—at least three times per week can increase VO2max levels by an average of 5 mL/kg/min. In a 2019 meta-analysis of randomized controlled trials, study authors found that even short-intervals (≤30s), low-volume (≤5min) and short-term (≤4 weeks) HIIT exercises significantly improved VO2 max, suggesting HIIT workouts can be an ideal choice for busy individuals. [10]

Participate in yoga

Yoga is not just for stretching and toning muscles. This form of aerobic exercise can help improve breath control and respiratory endurance, thereby contributing to improvements to your overall VO2max. Incorporating yoga sessions at least three times per week can contribute to improving your VO2max. [11,12]

Incorporate strength training

While VO2max is often associated with aerobic endurance, research shows that strength training can also moderately improve your VO2max levels. Findings from a systematic review and meta-analysis reveal a 6.3 percent increase in VO2max with resistance circuit-based training. [13] Add resistance training to your weekly routine to improve your VO2max.

Address low ferritin and low iron levels

Iron is critical for transporting oxygen throughout the body and to your muscles, as it is used to make hemoglobin and myoglobin, proteins that carry oxygen in the blood. As a result, low iron can impact endurance and VO2max. In a systematic review and meta-analysis of women of reproductive age (a common demographic to suffer from low iron stores), iron supplementation was shown to improve VO2max. [14] Another clinical trial in individuals with low ferritin—a protein that stores iron in your cells—reported daily iron supplementation improved ferritin levels and VO2max in study participants. [15] Aim to include iron-rich foods in your diet and be sure to get your iron and ferritin levels checked.

Take an ashwagandha supplement

Studies show that regularly taking ashwagandha can moderately improve VO2max levels. [16,17] Ashwagandha's impact on VO2max may be due to its ability to increase hemoglobin levels, which improves oxygen-carrying capacity. Its adaptogen and antioxidant-like properties may also be responsible for decreasing muscle fatigue during exercise—leading to better performance.

Have caffeine before a workout

Caffeine does more than just give you an energy boost to power through your workouts. Research shows that consuming 5 mg/kg of caffeine, which is equivalent to about three cups of coffee for a 150 lb person, can also improve VO2max. [18,19] For the best VO2max benefits, consume caffeine 60-90 minutes before a workout.

Try sauna bathing post-workout

Regular sauna bathing can help increase your VO2max levels moderately. When exposed to high temperatures in saunas, the body works to cool down by increasing heart rate, blood flow, and blood plasma volume and decreasing blood pressure, resulting in improved VO2max levels. In a multi-arm, randomized controlled trial, sauna use combined with exercise led to greater improvements in VO2 max levels when compared to exercise alone. [20] Aim to use a sauna after an aerobic or strength-based workout.

Next steps to optimize your VO2max

VO2max is not only a key indicator of aerobic fitness, but also serves as a strong predictor of cardiovascular health and ultimately healthspan. Athletes and non-athletes alike can benefit from measuring and improving their VO2max for a healthy, long life.

Now that you know the importance of this marker to your health, let InsideTracker help you learn what your VO2max should be.

This marker, along with personalized recommendations to improve it, is now available in the InsideTracker app. To access this feature, connect a fitness tracker that measures VO2max to the InsideTracker app.

VO2max for optimal health