Cardiorespiratory Fitness: What Is the VO2 Max Parameter and What Does It Have to Do with Longevity?

Article by SoLongevity Research
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A 24-year study confirmed the inverse correlation between VO2 max and the risk of death from cardiovascular disease, cancer and other causes

What this article is about

  • Cardiorespiratory fitness, assessed by measuring maximum oxygen consumption (VO2 max), reflects the maximum amount of oxygen an individual can use during intense physical exercise
  • Good cardiorespiratory capacity is associated with lower mortality
  • Regular aerobic exercise is an excellent ally for improving VO2 max

Numerous scientific studies have highlighted the fact that the maximum amount of oxygen an individual can use during intense physical exercise — a parameter called VO2 max — is inversely correlated with mortality. In essence, this means that good cardiorespiratory capacity is associated with a lower risk of death. And the results of a study published in the Journal of the American College of Cardiology, which involved more than 4,000 participants followed for an average of as many as 24 years, seem to confirm this inverse correlation.

How to measure cardiorespiratory fitness: VO2 max and the CPET (or CPX) test

One of the parameters used to assess cardiorespiratory capacity, as anticipated, is the VO2 max (in milliliters per kilogram of body weight) reachable during an activity at the maximum possible intensity. A high value generally indicates good cardiorespiratory fitness, understood as the ability of the cardiovascular and respiratory systems to supply oxygen to the muscles during prolonged, high-intensity physical activity, and the ability of the muscles to use oxygen to produce energy.

The most precise way to measure VO2 max is through the so-called “cardiopulmonary exercise test” (CPET) — in English cardiopulmonary exercise or CPX — used by the authors of the study. This consists of physical exercise of increasing intensity, during which various physiological and metabolic parameters are measured, including oxygen consumption and the emission of carbon dioxide through breathing.

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The study

A total of 4,137 adults who declared themselves healthy took part in the research, of whom 2,326 men and 1,811 women, with an average age of just under 43. At the start of the study all participants underwent the CPX test. Each participant was then followed up to the age of 49 (or until death, if it occurred earlier). As anticipated, poor cardiorespiratory capacity was found to be associated with a higher risk of mortality from all causes (assessed together) and also, specifically, from cardiovascular disease and cancer. In addition, an increase in cardiorespiratory fitness was found to be associated with a reduction of 11.6%, 16% and 14% in mortality from all causes, cardiovascular disease and cancer respectively.

How to improve VO2 max

As we have seen, VO2 max reflects cardiorespiratory capacity, which in turn is also an important measure of overall health. But how can we act on this factor to keep fit and promote our health? “Regular aerobic exercise is certainly a good ally on this front — explains Alberto Cerasari, Sports Medicine Specialist, Medical Director and Longevity Doctor of SoLongevity — Physical activity can improve the number and above all the efficiency with which our mitochondria produce energy. A type of aerobic training that is particularly effective in this sense is ‘zone 2’ training, which consists of exercising while keeping the heart rate between 60 and 75% of the theoretical maximum for age, corresponding to an activity that still allows nasal breathing without the need to breathe through the mouth. This practice can then be alternated with higher-intensity activities close to the maximum. One of the practices also used by those who have little time available — the expert concludes — is so-called high-intensity interval training (HIIT), which includes high-load phases and lower-intensity recovery periods”.

The cardiopulmonary exercise test to measure VO2 max is among the tests performed at the SoLongevity Clinic and in particular in the check-ups of the Sport Longevity Hub.

Bibliography

Mary T. Imboden, Matthew P. Harber, Mitchell H. Whaley, W. Holmes Finch, Derron L. Bishop, Leonard A. Kaminsky,
Cardiorespiratory Fitness and Mortality in Healthy Men and Women, Journal of the American College of Cardiology (2018)

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