Understand how these important measures influence and complement each other to provide energy and stamina.

Legendary cyclist Lance Armstrong has won countless races, broken records, and received accolades. Unless you're a superfan, however, you probably don't know that his reported VO2 max rate of about 85 is one of the highest in the world. What does this mysterious number mean, and why does it matter to you? 

VO2 max is shorthand to express the maximum amount of oxygen available for your body to use when you exercise, work out, or simply perform activities of daily living like gardening and climbing stairs. The V stands for volume and the O stands for oxygen, meaning the max volume of oxygen your lungs use during exercise. Most sources report VO2 max in liters of oxygen per minute processed by the lungs per minute. Other terms for VO2 max include maximal aerobic capacity, maximal oxygen uptake, and peak oxygen uptake.

Maybe you're a fitness enthusiast and VO2 max gets thrown around a lot by your running group, or maybe this is the first time you've heard about VO2 max,  but even less-active individuals can benefit from knowing this number and understanding its meaning. While you don't hear this acronym as often as others like BMI, people at all fitness levels can benefit from testing VO2 max and applying the findings to their wellness routines.

Fun fact: According to a 2019 article published in the magazine Outside Online, Norwegian cyclist Oskar Svendsen achieved the highest scientifically recorded VO2 max in 2012 with a reading of 96.7. The athlete, then age 18, was an Alpine skier throughout childhood and started biking during the off-season. His VO2 max scores were validated by a research team from the Innland University of Applied Sciences in Norway.

What is VO2 max?

According to a 2014 study published in the Journal of Clinical & Diagnostic Research, VO2 max provides the most accurate indicator of someone's cardiovascular endurance during physical activity. Each person's VO2 max varies based on their overall fitness level, age, gender, and geographic elevation.

The higher your VO2 max, the more energy your lungs can produce during physical activity in the form of ATP (adenosine triphosphate). This compound drives the delivery of oxygen to the cells and facilitates the removal of carbon dioxide as you recover to take the next breath. Boosting VO2 max allows your body to take in more oxygen and use it more effectively, enhancing ATP production and, in turn, your stamina. 

Enhanced energy production translates to better athletic performance, particularly when you engage in aerobic exercise like cardio, running, or swimming. That doesn't mean this measure is only for elite athletes, though. Those who don't participate in sports and rigorous workouts also benefit from increasing their VO2 max. When you improve this fitness metric, you'll probably notice you have more stamina when you play with your kids, do chores, and take walks.

Enhanced energy production translates to better athletic performance, particularly when you engage in aerobic exercise like cardio, running, or swimming. That doesn't mean this measure is only for elite athletes, though. Those who don't participate in sports and rigorous workouts also benefit from increasing their VO2 max. When you improve this fitness metric, you'll probably notice you have more stamina when you play with your kids, do chores, and take walks.

Better VO2 max may also translate to better health outcomes and even improved longevity. A 2018 study published in the peer-reviewed journal Frontiers in Bioscience associated higher VO2 max levels with improved oxygen delivery to tissues and organs. Researchers postulated that this effect could prevent disease and help us stay healthier as we age, even lowering the risk of stroke, heart attack, diabetes, and cancer. Higher VO2 max has been correlated with improved immunity and lower stress, two factors that also help prevent chronic illness and enhance quality of life. 

In fact, VO2 max has been designated as a clinical vital sign to assess cardiorespiratory fitness by the American Heart Association. The organization's scientific panel recommends regular testing of VO2 max because low cardiorespiratory fitness can result in higher mortality rates from all health-related causes, particularly heart disease and cancer. The AHA says that the use of this metric can improve patient health and disease management and guide prescribed exercise programs for individuals who have a high risk for chronic disease based on physical fitness. 

Generally, people with higher body fat percentages have lower physical stamina, reflected by a relatively low VO2 max level. Tracking VO2 max along with your body composition can illustrate progress toward your fitness and wellness goals. 

If you have a sedentary lifestyle and don't exercise very often, you will likely notice an improvement in your VO2 max in four to six weeks. If you already have a solid workout routine, it will take longer for your maximum lung capacity to improve. A research meta-analysis published in the PLOS One multidisciplinary peer-reviewed journal by the Public Library of Science found the most impressive VO2 max increases in those who completed six weekly high-intensity running or cycling workouts lasting 30 to 40 minutes for at least 10 weeks.

What really works to improve VO2 max?

While some factors that affect your VO2 max can't be changed, like age and gender, you can make healthy lifestyle changes that improve your lungs’ ability to use oxygen during exercise. In general, making changes that balance your body composition by gaining lean muscle or losing fat helps your body use oxygen more effectively, boosting VO2 max. Here's what you should know about what actually works—and what doesn't—to help you meet these goals based on scientific research. 

Fun fact: When your VO2 max level improves, it means your muscles can take in and use more oxygen, your heart can pump more blood, or both!

Diet and nutrition

Athletes rely on superfoods packed with healthy antioxidants and nutrients to support oxygen intake and delivery. Consider chia seeds, which are full of protein, iron, antioxidants, and fiber—nutrients that help regulate the body's energy use. Oatmeal is another smart choice that's rich in complex carbohydrates, soluble fiber, and protein to facilitate the steady transfer of energy from the bloodstream to the organs and tissues.

While these foods contain vitamins and minerals that boost endurance and improve the body's oxygen use, the Office of Dietary Supplements at the National Institutes of Health says that research conflicts about whether supplements can effectively increase VO2 max. However, iron supplements can improve athletic performance and endurance in individuals with low iron levels because iron produces proteins that deliver oxygen to muscles (myoglobin) and transport oxygen from the lungs throughout the organs and tissues (myoglobin). 

Fun fact: Research has not associated quantity or quality of sleep with changes in VO2 max levels. 

Physical activity

Experts stress the importance of high-intensity workouts to increase VO2 max. Ideally, you should reach 90 to 95 percent of your maximum heart rate to maximize lung endurance. Not sure of your max heart rate? Get an easy estimate by subtracting your age from 220. For example, a 40-year-old would have an average maximum heart rate of 180. A VO2 max test gives you a more accurate measure of your maximum heart rate as well as your heart rate for target fitness zones such as your anaerobic and aerobic thresholds. 

Alternating different types of cardio activities also has benefits. If you don't like running, opt for cycling, rowing, dancing, or any other vigorous movement that pushes your heart rate to the limit. 

Start slow and push your endurance by setting incremental goals, especially if you're new to high-intensity exercise. According to a 2016 study published in the International Journal of Exercise Science, occasional intense activity can have a beneficial effect on VO2 max as part of an ongoing exercise program. While this research focused on young adults, the results suggest that training can improve the body's oxygen intake and use.

Many runners train with this simple high-intensity workout that you can adapt to your own needs:

• While using a fitness tracker or pedometer to measure distance, run as fast as you can for 5 minutes.

• Note your performance, then rest for 5 minutes.

• For the second interval, reduce the distance you traveled in the first interval by 20 percent. For example, if you traveled 0.5 miles in the first 5 minutes, you will aim to run 0.4 miles in the next 5-minute interval. 

Fun fact: According to Active magazine, a high VO2 max has the greatest impact on runners who compete in “middle-distance” events from the 800 to 3,000 meters. 

Body Composition

Just as improving your VO2 max affects your body composition by building lean mass and reducing fat, improving your body composition increases its ability to use oxygen effectively. As your body fat percentage goes down, your VO2 max will rise. 

Your VO2 also affects your physical makeup, including the percentage of fat mass compared to lean muscle mass. While it logically follows that a 100 lbs person needs only half the oxygen delivery as someone who weighs 200 lbs., muscle and fat transport and utilize oxygen using different mechanisms. As a result, if you have low body fat and high muscle mass, you may have a lower VO2 max rate than a person who weighs less but has more body fat and less lean muscle.

What is a good VO2 max? 

The PLOS One study referenced above provided these estimated average VO2 max ranges based on gender and activity level for adults ages 18 to 45:

• Highly active woman: ≤ 77 mL/kg/min

• Highly active man: ≤ 85 mL/kg/min

• Active woman: 33.0–36.9 mL/kg/min

• Active man: 42.5–46.4 mL/kg/min

• Inactive woman: 27–30 mL/kg/min

• Inactive man: 35–40 mL/kg/min

As you can see from these numbers, a "good" VO2 max varies significantly depending on individual characteristics. Obtaining a baseline VO2 max measurement allows you to set goals for improvement. 

What methods are used to calculate VO2 max?

Fitness specialists and health care providers conduct several different tests to determine VO2 max. These tests involve obtaining VO2 measurements during exercise and at rest. If you do not engage in regular physical activity, the test provider may ask you to run or walk on a treadmill. For example, the 12-minute run test introduced by the Cooper Institute in 1970 requires you to run your maximum possible distance in 12 minutes. 

While VO2 max tests given by certified fitness instructors and personal trainers may be less accurate than those conducted by a medical professional in a lab, they still provide the necessary information to guide your fitness objectives including target heart rates and heart rate recovery (HRR).

In addition to learning your VO2 max, knowing your body composition can provide a more complete picture of your health and wellness. The DEXA scan offers detailed information about your distribution of fat and lean mass so you can set body composition goals. Losing fat and building mass support oxygen delivery, which can help you improve VO2 max.

 In turn, a higher VO2 max level improves your endurance and stamina, which allows you to shatter your  fitness goals and set bigger and better wellness objectives. You can continue to track your improving body composition with periodic DEXA scans.

Fitnescity provides both DEXA scans and VO2 max testing for fitness and health benchmarking and progress tracking. Find a FItnescity location in your area to start your wellness journey today. 

References:

https://pubmed.ncbi.nlm.nih.gov/29293447/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316241/ 

https://www.runnersworld.com/health-injuries/a20817982/is-vo2max-proportional-to-weight/ 

https://www.active.com/running/Articles/The-Science-of-VO2-Max-and-Its-Impact-on-Running-Performance.htm 

https://www.healthline.com/health/vo2-max 

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0073182

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836566/ 

https://www.active.com/nutrition/articles/10-superfoods-for-endurance-athletes 

https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-HealthProfessional/ 

https://www.cooperinstitute.org/2018/06/08/50-years-of-the-cooper-12-minute-run