VO2 Max :: What is it and Why is it Important?

Patient Performing VO2 Max Assessment

What if I could tell you there was a single measure that was associated with heart disease risk, all-cause mortality, and even cancer-related deaths? Aerobic fitness, or VO2 max, is one such important measure. It is so important, in fact, that the American Heart Association has recently released a statement calling for it to be included as a “vital sign” in clinical practice (1).

What is VO2 Max?

We know that a stress test is an important way to screen for potential abnormalities in electrical rhythms of the heart during exercise. Here at the Princeton Longevity Center, we will also estimate your VO2 max during this test, something that is not typically assessed at your doctor’s office (although the American Heart Association suggests that it should be incorporated).  VO2 max (a measure of aerobic fitness) is a physiological parameter by which we are able to estimate how much oxygen your body consumes when working at a very high level of exercise. It is a great way to assess overall body function and health, as it measures the integration of multiple body systems.

Research has shown that VO2 max may actually be a stronger predictor of future cardiac events, such as heart attacks, when compared to other established traditional risk factors including smoking, high blood pressure and type 2 diabetes (2).  Therefore, higher levels of aerobic fitness are better! Even after adjusting for other risk factors such as age, family history, and elevations in blood pressure, higher levels of physical fitness still attenuate the overall risk for morbidity and mortality (3). Interestingly, individuals with obesity who have higher levels of fitness have decreased risk for early death when compared to individuals who are normal weight, but have lower levels of fitness (4).  Therefore, even if you are overweight, being more physically fit can help protect you from increased disease risk in the future!

How can I estimate my own VO2 Max?

The best way to assess VO2 max is to undergo a test during which you would be maximally exercising while wearing a mask to collect breath samples that allow a machine to calculate the amount of oxygen that you are consuming. For many people, this type of testing is not typically available; however, there are several other ways to estimate VO2 max. Depending on your age, gender and even body weight, several equations have been developed to help you estimate your aerobic fitness level from a mile walk (5), jog (6) or even a 6-min walk test (7).


What can I do to increase my VO2 Max?

The short answer to this question… more levels of higher intensity movements! The athletes with the highest VO2 max values are usually cross-country skiers, or those individuals engaging in sports or activities that work multiple large muscle groups at higher intensity levels of exercise. It is important to remember that VO2 max is also determined by other factors beyond your control such as age, gender, or even your genetics. But, it is never too late to begin working to improve your aerobic capacity. Previous scientific studies have suggested that high intensity interval training, (exercising at a very hard pace for a certain amount of time, followed by a bout of very low intensity and then repeated), is an excellent way to improve your aerobic fitness (8). However, for those individuals who have never regularly exercised before, do not feel that you must start with high intensity interval training, doing exercise at a moderate intensity will start you on the right path towards improving your cardiorespiratory fitness, as well as your overall health.



  1. https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000461
  2. https://www.nejm.org/doi/full/10.1056/NEJMoa011858
  3. https://www.ncbi.nlm.nih.gov/pubmed/2795824
  4. https://www.ncbi.nlm.nih.gov/pubmed/10546694
  5. https://www.ncbi.nlm.nih.gov/pubmed/7752874
  6. https://www.brianmac.co.uk/vo2mile.htm
  7. https://www.thecardiologyadvisor.com/cardiology/the-6-minute-walk-test/article/584216/
  8. https://www.ncbi.nlm.nih.gov/pubmed/17414804