Once measured only in sports laboratories, VO2max can now be continuously monitored by almost every new smartwatch. Following several scientific studies suggesting a correlation with life expectancy, the longevity community has proclaimed VO2max as a key parameter to maximize for a longer life. But is this true?
VO2max is the key parameter for athletes
VO2max, or maximal oxygen uptake, is the highest rate at which the heart, lungs, and muscles can efficiently use oxygen during exercise. It is commonly used to measure an individual's aerobic capacity and has long been a critical metric for athletes to assess cardiorespiratory fitness. Higher VO2max levels are indicative of superior physical fitness, which may, in turn, enhance the body's ability to cope with physiological stressors, including diseases.
VO2max is today a gold standard for measuring fitness and has been a key parameter for athletes for over 100 years. The higher the VO2max, the better the aerobic performance, although values vary depending on factors such as gender, age, and physical activity level. There is a natural decline in VO2max with age, but regular endurance training can significantly improve this measure—by as much as 15–20%—depending on the intensity and consistency of exercise.
Until recently, VO2max could only be measured in a lab using treadmill or bicycle ergometer tests, typically performed on athletes or individuals with respiratory or cardiovascular conditions. However, the rise of smartwatches and fitness trackers has made this metric widely accessible, allowing for continuous monitoring outside of laboratory settings.
Smartwatch-based VO2max measurements
Smartwatches from brands like Apple, Garmin, Samsung, and Polar now include VO2max estimation as a standard feature. Using heart rate and motion sensors, these devices track various physical activities—such as running, swimming, cycling, and hiking—to estimate VO2max levels.
Since each smartwatch is linked to a user’s account, the device, knowing details such as age and gender, can calculate not only the oxygen uptake capacity but also indicate which fitness range the user falls into. For instance, Garmin smartwatches provide an estimation of biological age based on average VO2max ranges for specific demographics.
But how precise are these measurements?
VO2max monitoring in a smartwatch is not as reliable as results obtained in laboratory conditions. The margin of error varies by manufacturer but typically falls within 3% to 8%. Is it a significant error? A 5% variance means that a VO2max reading of 50 on a smartwatch likely falls within the range of 47 to 52. For the general population, a close estimate is often sufficient for tracking fitness trends and progress over time.
The link between VO2max and longevity
The widespread availability of VO2max data through smartwatches has enabled researchers to investigate its relationship with longevity. In 2018, a study published in JAMA reported that individuals with the lowest VO2max values had a fourfold increased risk of mortality compared to those with the highest values. The researchers suggested that VO2max might be one of the most significant predictors of lifespan.
According to Dr. Peter Attia, a leading longevity guru and author of the best-selling book Outlive: The Science and Art of Longevity, “when looking at VO2 max in relation to all-cause mortality, we see a very clear trend.” Dr Attia claims that “simply bringing your VO2 max from ‘low’ (bottom 25th percentile) to ‘below average’ (25th to 50th percentile) is associated with a 50% reduction in all-cause mortality. When you go from ‘low’ to ‘above average’ (50th to 75th percentile) the risk reduction is closer to 70%.”
Many similar opinions have strengthened the belief that improving VO2max should be a priority for those striving for longevity. And indeed—many papers seem to confirm such assumptions.
A study published in the British Journal of Sports Medicine found that cardiorespiratory fitness, measured through VO2max, was a stronger predictor of cardiovascular health and longevity than body mass index (BMI). The study indicated that individuals with high VO2max values had a lower mortality risk, irrespective of their BMI.
Furthermore, the study Survival of the Fittest: VO2max, a Key Predictor of Longevity?, published in Frontiers of Bioscience, concluded that VO2max serves as a crucial determinant of future life expectancy in both healthy individuals and those with cardiovascular disease. However, other studies have acknowledged that while VO2max is a robust indicator of cardiovascular fitness, it is not necessarily the sole determinant of a long life.
Further research is required
While numerous studies suggest a strong relationship between VO2max and lifespan, conclusive evidence requires extensive long-term research. The integration of VO2max monitoring into consumer wearables has only recently provided researchers with substantial datasets, necessitating further observational studies conducted over extended periods.
One indisputable fact remains: regular physical activity significantly reduces the risk of premature mortality and cardiovascular disease. VO2max is a valuable metric for tracking improvements in fitness and assessing cardiovascular health. Individuals can enhance their VO2max through regular aerobic exercises such as running, swimming, and cycling. However, VO2max should not be the sole focus of a health-conscious lifestyle, as overall well-being also depends on factors such as proper nutrition, quality sleep, stress management, and avoiding harmful habits.
Measuring VO2max provides an insightful metric for assessing cardiorespiratory performance and tracking fitness improvements. To elevate VO2max levels, individuals should gradually increase exercise intensity and incorporate advanced techniques such as interval training. However, given individual differences in age and health status, any significant changes to training regimens should be made under the supervision of a medical professional.
While VO2max is an essential indicator of fitness and longevity potential, well-being requires a comprehensive approach encompassing multiple health and lifestyle aspects. Once again, there is no single golden mean, as health is a complex system of interconnected factors.
