Dr. Ángel Durántez is one of the world’s leading experts in anti-aging medicine and also a recognized expert in sports medicine. In his professional practice in this last discipline, Durántez has done “hundreds and hundreds, if not thousands” of tests to measure VO2 max. in elite athletes. This metric, known at an epidemiological level in the English-speaking world as cardiorespiratory fitness, refers to the maximum amount of oxygen that the body can absorb, transport and consume in a given time during physical exercise. The higher the VO2 max, the greater the cardiovascular capacity of a person.
“The VO2 max. “It is a metric that has been and is widely used in the field of competitive sports, to obtain data that allows training intensities to be adjusted in a personalized way,” he explains. According to Durántez, the oxygen consumption records are usually in the hands of cross-country skiers (a consumption of around 90 ml/kg/min), “because they move a lot of muscle groups”, followed by great marathoners (80 ml/kg/min). min), cyclists and triathletes (about 70 ml/kg/min). “As we move to less aerobic sports, the numbers go down,” he points out.
A healthy person who does regular non-professional physical exercise moves around 28-40 ml/kg/min. And maintaining these figures is a health challenge, since as explained by Dr. Alejandro Lucía, professor of Exercise Physiology at the Faculty of Health Sciences of the European University of Madrid, VO2 max. It is a “powerful predictor” of the risk of cardiometabolic disease and mortality.
“It is a very important health parameter because it is very integrative, since it reflects the proper functioning of many systems. From, for example, the lung capacity to capture oxygen from the atmosphere; to the functioning of the heart pump pumping oxygenated blood, through the ability of the muscles to consume oxygen,” he points out.
The step of VO2 max. From a sports performance metric to a health indicator, Dr. Lucía places it in an article published at the beginning of the century, in 2002, in the scientific journal The New England Journal of Medicine. Led by Jonathan N. Myers, an affiliate professor of cardiovascular medicine at Stanford University and one of the most prolific researchers in this field, the study concluded that VO2 max, measured in metabolic equivalents (METs)—each MET is approximately equal to 3.5 ml/kg/min—was a more powerful predictor of mortality among men than other established risk factors for cardiovascular disease such as hypertension.
Specifically, those study subjects with an exercise capacity of less than 5 METs (approximately 17.5 ml/kg/min) had a high risk of death, while those with an energy expenditure greater than 8 METs (from 28 ml/kg/min approx.) were considered low risk.
Since then, studies to investigate the potential of VO2 max. They have not stopped happening. Myers himself led another study in 2021 that concluded that maximum oxygen consumption is independently associated with a lower risk of cancer mortality in men with cardiovascular diseases. And the data from the very large cohort of the Cooper Aerobic Longitudinal Study, one of the oldest active longitudinal studies that exist, has made it possible to associate VO2 max. in middle age as a risk marker for dementia, myocardial infarction and hospitalization for heart failure in old age, with the incidence of and survival from lung and colorectal cancer, and with the risk of premature death.
In fact, according to a study led by the Cooper Institute itself that followed 30,077 healthy adults (31% women) with an average age of 49 years for a decade, people with a VO2 max. low were 50% more likely to die during follow-up compared to those who were fit.
“Today there is no doubt about the direct correlation of oxygen consumption with disease, functionality and death. The greater the oxygen consumption, the less illness, better functionality and greater longevity. And vice versa,” says Dr. Durántez.
Calculators circulate on the internet to estimate VO2 max. of a person, as well as formulas to estimate it indirectly by carrying out tests such as the well-known Cooper Test. However, the best way to know with certainty our maximum oxygen consumption is by going to a sports medicine or cardiology consultation.
In fact, the American Heart Association recommends measuring this metric and in an article published in 2021 in the Journal of Clinical Exercise Physiology, Jonathan N. Myers himself stressed that VO2 max. “should be a routine measure in all healthcare settings.”
At this point, the question arises by itself: is it possible to train and improve our VO2 max level? “It is assumed that 50% of a person’s maximum oxygen consumption is genetically determined, but it is a fairly trainable metric at lower levels. That is, it is reasonable to reach 8 METs (28 ml/kg/min), but it is more complicated to go beyond 20 METs (70 28 ml/kg/min). Only people who have a genetic predisposition to be great athletes reach these levels,” answers Alenjandro Lucía.
Regarding exercises to improve VO2 max., the professor at the European University of Madrid points out the fundamental importance of aerobic exercise, but without forgetting strength exercise, “it is important to have good muscles that support us.” “Doing weights also works on oxygen consumption, but not as much as if you go running or cycling,” agrees Dr. Durántez, who points out that there are workouts that are more effective than others to improve maximum oxygen consumption. Among the first, HIT or high-intensity interval training, which the Spanish Federation of Directed Activities and Fitness (FEDA) defines as “repeated periods of high-intensity exercise developed at maximum speed or power interspersed with periods of low-intensity exercise.” intensity or absolute rest.”
This recommendation coincides with scientific evidence. According to it, the fact that exercise intensity is a strong driver of improvements in VO2 max. “It is consistent with studies showing that improvements in maximal oxygen consumption are generally greater in response to high-intensity interval training than to moderate-intensity continuous exercise,” such as walking or jogging.
Notwithstanding the above, Dr. Durántez points out that for people who start from a VO2 max level. low, training in what Dr. Peter Attia, a longevity expert, calls zone 2 can be useful. If zone 1 would be the equivalent of a calm walk and zone 5 sprinting doing your best, zone 2 would involve jogging at an easy to moderate pace; a pace that is easy enough to be able to maintain a conversation, but also fast enough that that conversation is not completely fluid and is difficult to prolong with long sentences.
One way or another, the fundamental thing is to exercise to reach those 8 METs that mark the risk boundary. And if you can go higher, up to 10-12 METs, the better. And Dr. Alejandro Lucía already says it: “Studies show that a difference of just one MET makes an enormous difference in life expectancy.”