Athletes, especially those who engage in endurance activities are typically familiar with VO2max because it’s a useful predictor of their performance in races. As we age, VO2max is also a good predictor of what physical activities we will be able to engage in, so I think it’s useful for everyone to be aware of.

What is VO2max?

VO2max is a measurement of a person’s ability to take in and use oxygen.  It is impacted by how effective their lungs are to transfer O2 from the air to blood, how effective the heart is to deliver the blood to muscles  (volume per beat and maximum heart rate are the keys), and the muscles ability to utilize the oxygen. It’s worth noting that often VO2max is described as milliliters of oxygen per minute per kilogram of body weight so losing weight will often raise someone’s VO2max.

How to Measure VO2max

The gold standard is performed in a sports performance laboratory by measuring oxygen consumption via Indirect Calorimetry. This involves wearing a mask which measure the O2 you breath in, and the CO2 that you exhale while running on a treadmill or riding a bicycle as quickly as you are able. This test typically costs >$200 and has to be done in a lab. In the Bay Area DexaFit has an office in San Carlos, Silicon Valley Sports Medicine in Campbell,  and the UCSF Human Performance Center do VO2max tests.

There are a number of methods which are pretty accurate that don’t require the expensive laboratory equipment.  A number of methods and the accuracy are described in the show notes from podcast #223 Peter Attia AMA #39 VO2 max and more. A few methods I would recommend considering

What is a “Normal” VO2max

I think it’s useful to know what “normal” island to see how it changes generally in people. I think we should select a target based on the activities we want to be able to engage in rather than settling for “average”.

Humans who have been training throughout their lives tend to have their VO2max peak when they are around 30 years old. After 30, VO2max has a tendency to drop. The individuals health and training determine how quickly VO2max drops. For people who have not trained before they were 30, it is possible to increase VO2max beyond what they achieved at 30. Once an individual is trained, their VO2max will drop over time.

  • 10% / decade after someone is 30 is the common figure if an individual is not training
  • 5% / decade is what is often cited for people maintaining training. 
  • Recorded data from training individuals suggests that well trained individuals lose around 5% / tens years between ages 30-60, after 60 even with continued training people loss 8-10% / decade. 

How to Increase VO2Max

A meta analysis of training to increase VO2max found the biggest gains over multiple months were several intervals of 3-5 minutes with an active rest in-between.   The protocol discussion on Attia’s AMA suggested 4 cycles of 4 minutes exercise at VO2max followed by 4 minutes of active rest.

FirstBeat has a list of issues which might be preventing you from increasing your vo2max.

For cyclists, using power is the easiest way to plan workouts.  See an introduction to training with power  by Dr. Andrew Coggan, one of the experts in this field.

I have been starting to look into how training your breathing could significantly improve VO2max and endurance. There are several devices such as the o2trainer might be useful as well as breathing training.

There is some evidence that suggests that rowing might be the best way exercise to maintain VO2max in the later years.  I suspect this is because it provides a more complete (full body) workout when compared to a number of endurance activities while being low impact and having a very low incidences of accidents which might require someone to stop training for a period of time.

Setting a VO2max Goal

Peter Attia encourages most people to train for  the centenarian olympics. In AMA 39  he discussed  how VO2max is often something that limits what people are able to do as they age. 

So lets say someone wants to be able to climb stairs and speed walk when they hit 100 which would require a VO2max of 32.  Assuming they regularly train the following is what  their VO2max needs to be in the proceeding decades.

AgeVO2maxPossible Activities
3058Run 10mph
6050jog 6mph up a hill
7045run 8mph on level ground, carry heavy objects up stairs
9036Run 6mph
10032briskly climb stairs, walk 3mph up steep hill

Other References

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