Dmitri Konash
Want to live longer? Run faster!
What is VO2Max, why it is a key predictor of longevity and how to increase it.

It has been known for decades that breathing and physical exercise are great for your health. Not only they help to lower anxiety and high blood pressure but also increase health of our cardiovascular system. Over the last 5-7 years several scientific studies have shown that one particular indicator, called VO2Max, is a key predictor of longevity (1), (2). The higher VO2Max number – the higher our chances to live longer. One research of Swedish scientists (1) on 792 men started in 1963. They split participants into three groups based on their VO2Max numbers and followed on them over the years. The research has found that each tertile increase (move from lower to high VO2max group) in predicted VO2 max was associated with a 21% lower risk of death over 45 years of follow up. Or rephrasing statistics data: 10% increase in VO2Max can reduce all-cause mortality risk by 15%. Another research (4) shows that people who are more physically active experience less anxiety and stress and are more resilient to the impacts of stress when it does arise. Also, strong cardiovascular system generally translates into lower blood pressure.
"10% increase in VO2Max can reduce all-cause mortality risk by 15%. "
So, what is Vo2max? With a bit of simplification: Vo2Max shows a maximum amount of oxygen consumption per minute by someone’s body at the peak of aerobic performance. It is usually expressed as a relative rate in milliliters of oxygen per kilogram of body mass per minute ( mL/(kg·min)). It is the generally accepted measure of aerobic fitness and allows to compare aerobic fitness of different people. The generally accepted test to measure VO2Max is done either while running on a treadmill with gradually increasing speed or while cycling on a stationary bike. A special device compares the composition of the air breathed out and derives VO2Max number. Over the last few years a number of sports smartwatches which can measure speed and heart rate also provide their owners with an estimation of VO2Max. Bases on my own experience with Garmin smartwatches they provide VO2Max estimation with 90% accuracy as compared to a lab test which is sufficient for most people.
It is important to note that the max potential VO2Max number is heavily dependent on our genetics. That’s why some people are born to be better athletes than others, especially in sports which require higher aerobic performance like running, cycling, swimming or cross-country skiing. At the same time VO2Max decreases at a rate of about 10% per decade - that is if we do nothing to keep it higher for longer. Here is the table from the American College of Sports Medicine which illustrates the point.

People with long exercise history, i.e. lifelong endurance athletes, have higher VO2Max numbers as compared to sedentary subjects (see graph below) (1). Upper dashed line corresponds to men, lower dashed line – to women.

The next big question is what is the exercise routine which is required to grow your VO2Max up to your potential max value? Obviously, it is somehow related to aerobic exercise? Definitely. However, I have to disappoint those hoping to get away with just walking or slow jogging. These exercises are great for losing weight, lower anxiety and high blood pressure. In order to grow VO2Max, however, one needs to exercise hard: run, cycle or swim for a period of time at the maximum of your capacity. Then give yourself plenty of time to recover (5). In sports language it is called interval training. Detailed procedures of interval training are beyond the scope of this article. The best clear and simple description of these procedures I found in the book by Joe Friel (3).
Finally, some readers may ask: It may all be great, but can I grow VO2Max if I turned 50? There is scarce research on this topic so I will refer to my own experience. I decided to invest time and effort and grow my cycling VO2Max early in 2020 when I turned 56. I started an interval exercise program in January which involved cycling on a stationary bike between January and April and cycling outside in May-June. On average it included 1.5 hours of cycling intervals per week. As you could see from the graph below this program increased my VO2Max from 45 in January to 52 in June (15% increase). If we compared this number to the average VO2Max number from the top table above, you could see that it corresponds to the “Good” level of an average 25 year old person. By the way, I do not fit in the category of “Lifelong endurance athletes” as I was quite a weak kid and started exercising seriously only at the age of 48.
"I increased my VO2Max from 45 in January to 52 in June (15% increase)"

Finally, the study from American College of Sports Medicine shows that people with higher aerobic fitness experience not only lower rates of cardiovascular and coronary artery disease, but also colon cancer and type-2 diabetes. Many studies have also linked higher VO2max numbers with reduced risk of developing both dementia and Alzheimer disease
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References:
3. Joe Friel, Fast after 50: How to race strong for the rest of your life.