Longevity and Vo2max? Does it Actually Matter?

A Mile is a Better Predictor of Longevity than VO2max

If you ever traffic in the health and wellness space, you’ve undoubtedly heard about Vo2max and its impact on longevity. Every single health influencer or podcaster has covered why you need to figure out how to improve your Vo2max!

And for good reason. Let’s look at relatively recent research:

One large study found a 5x lower risk of mortality in the highest versus lowest fitness group. Another found a 4x higher risk in the lowest versus highest fitness.

Great! No wonder health influencers are telling everyone they need to improve their Vo2max.

And yet, and yet.

Many of these folks miss a very important point, one that influences what you should do and what you should pay attention to.

Before we go there, let’s quickly define what Vo2max is: It stands for maximum oxygen consumption. It’s one of the components of aerobic fitness. It’s a test that was pioneered by the father of exercise science, A.V. Hill, over 100 years ago. Nowadays, to figure out your Vo2max, you hop on a treadmill wearing a mask that measures the oxygen and carbon dioxide you breath in and out. In the span of about 10 minutes, the speed or incline of the treadmill is increased every minute or so until you scream STOP, or fall off the treadmill. I’ve myself run in a half dozen of these tests, as well as being the scientist to put dozens of athletes through it. I can tell you firsthand the experience is not fun.

In practical terms, Vo2max is like knowing the size of a car’s engine, which is really important if we want to know about performance. But if we want to know whether that car has a chance to win the Daytona 500, engine size alone won’t tell us. We also need to to know about the size of the fuel tank, about its fuel economy, about how long its tires will hold up, and about all the other small components that translate the power of engine to the speed of the car. It’s the same in humans. Vo2max is one of many components that, taken together, tell us about our holistic aerobic or cardiorespiratory fitness.

It’s why if we took thousands of high-level runners, from current collegiate athletes to the Olympic champions, and provided you with their VO2max, it wouldn’t help you very much in predicting who was best. Everyone has a decent engine at that level. I’ve tested college walk-ons who had VO2max scores that beat Olympic medalists, yet they are running 10 percent slower because their running economy, lactate threshold, critical power, speed reserve, or any of a number of other components aren’t up to par.

Vo2max matters. But it’s just one component of many that make up both performance and aerobic fitness. And that’s important because if we return to the original claims that Vo2max is the key indicator of longevity, we’ll find that the majority of the studies cited did NOT even use Vo2max as the main variable. They used performance! In the majority of research, peak speed and incline during the exhausting test was the main correlate to longevity.

The large study on 750,000 veterans that found a 4-fold higher mortality risk for low versus high fitness used peak speed and incline, not Vo2max. Same with the research on 120,000 individuals finding a 5x difference in the risk of early death.

Research from the Cooper Institute used total time participants stayed on the treadmill until they quit. Same with this study, and this one, that found relationships between fitness and reduced mortality risk.

And as we can see in this meta-analysis looking at mortality and fitness, all but a handful of the included studies used an estimate based on speed or time.

Or we could look at one of my favorite studies that looked at histories first 200 sub-4 minute milers and found that on average they lived 4.7 years longer, and for the earliest ones over 9 years longer.

You get the point.

And this is good news! It means you don’t need to go to a lab and measure your Vo2max. You don’t even need to worry about Vo2max itself (or your watch’s horrible estimation of it). All you need to do is focus on overall aerobic fitness. Which can easily be measured, compared, and improved in a number of ways that are less expensive and more accessible than Vo2max.

Let’s start with measuring fitness so you can compare or track it. If you want an accurate measure, you can go down to the track and run a hard mile, sign up for a 5k fun run, or the equivalent in cycling, swimming, or any other primarily aerobic activity. You can then compare that against others, or more appropriately, against yourself to see if you are maintaining or improving fitness.

But you don’t even have to go that far. Research shows you can use a standardized sub-maximal test and get a pretty dang good idea of where your fitness lies. Basically, do something that is moderately hard, maybe a 6 or 7 out of 10, and that is primarily aerobic. Any test that is more than a couple minutes in length will do. And then you rate how hard it feels at a given heart-rate or wattage and see if your rate of perceived exertion gets lower while performing the same task over time and with training.

As a former competitive runner, this is my tactic: every few months I go run a 5-minute mile. Currently that pace takes a bit of effort but still well within my capacity. If that mile feels harder than the last time, I know my fitness has gotten a bit worse, and I train more. If it feels easier, my fitness is improving.

Once you have a baseline or comparison point, the goal is simple. Aim to get your aerobic fitness a bit better over time. Research tells us that the fitter we are, the better we are, at least in terms of mortality. There’s likely an upper limit, where further gains aren’t meaningful, but in the larger studies the highest of high fitness (top few percent) that had the largest effect was about the equivalent of a 20 minute 5k for a 30-40 year old man, and 22 minutes for women. Quite fast for the average Joe, but nowhere near elite.

The second reason it’s important to note that it’s actually fitness not actual VO2max that correlates to reduced mortality is that overall fitness is easier to improve than Vo2max!

Vo2max has a large genetic component, and if we look at research, most people can get a 15-20% increase in Vo2max with significant training. Some will get a boost well beyond that (30-40%), but generally Vo2max follows a pattern of responding to training for a while and then plateauing. Overall fitness keeps responding to training. It’s why when we look at elite athletes, Vo2max tends to stagnate, even while performance continues to improve.

So the good news is that whenever you hear someone going on and on about Vo2max, realize that it’s general aerobic fitness that matters. When someone says to improve your Vo2max, it really means try to run a mile or 5k or 10k a bit faster, or improve how you feel on your bike route through the park, or your performance on the elliptical or ski-erg or rower in the gym.

Instead of listening to the ​fitness bros​ telling you to do interval workouts that require you to somehow “sprint” for 4 minutes to maximize your Vo2max, you can adopt a well rounded training program that isn’t based on magic workouts that most people cannot sustain without getting injured.

What does a plan to improve aerobic fitness over the long haul look like?

Lots of easy. Some moderate. A bit of hard. Vary it up. And always take the next logical step.

Practically, what this means:

• Train as many days a week as you can, getting 30 minutes or more of exercise that is easy enough where you could have a conversation. Frequency matters more than intensity.

• As you build that foundation, add in one day a week where you do something moderately hard, such as an exercise where you’re able to say a few short sentences. Aim for 10-25 minutes total (i.e., you can split it up, such as 3x5minutes with 2 minutes rest).

• Once you feel like you are mastering that, you can either add a HARD workout or alternate the moderate and HARD workout. The HARD workout should be a mixture of short and medium length intervals that are hard but still controlled. Think of it as being able to have a conversation but with very few words and super short sentences, essentially like you are a teenager responding to your parent asking ,”How was your day at school?”

• Most importantly, the goal of the hard workout isn’t complete exhaustion, it is to accumulate time at a hard stimulus. If you are doing 8 x 30 seconds hard with 1 minute rest, don’t go all out the first 30 seconds and then be jogging by repeat number four. Your goal is to have your last rep about as fast or faster than your first! It’s about pacing.

• Once you reach the point where you are doing some harder workouts, then your best bet is to get a good running, cycling, or conditioning coach, or pick up a book to train for a 5k or time-trial! That will maximize your aerobic fitness better than any social media guru’s advice.
  
  That’s it. Build this up over months, focusing on consistency instead of intensity, and your fitness will flourish.
  
  Also, don’t forget that strength training has an additive effect on health and longevity. Try to strength train every once in a while, starting with simple bodyweight exercises such as push-ups, wall-sits, air squats, and lunges. The current guidelines suggest twice a week, so if you can swing that, you should.
  
  Coming back to where we started: it’s not that Vo2max is bad. It’s just that it’s a single component that is part of a much bigger and important process called aerobic fitness. And if we obsess over that single component, it sends us down a path where we think the key is to run some magical workout to increase Vo2max every week, when it is not.
  
  The goal is to get fit, in whatever way is sustainable and enjoyable for you.

–Steve