VO2 Max and Life Longevity

I say Vo2 max, what do you think of? Some people may picture athletes on a bicycle or treadmill wearing a mask with doctors taking blood samples, gathering data and looking at charts. Others maybe draw a blank.

Whatever it is you think about, I doubt you put much thought into vo2 max as a biomarker for your health, specifically the single most accurate biomarker for determining life expectancy beyond age 55. That's right, if you were to choose one biomarker to determine the likelihood of you dying over the next 10 years, (assuming you are 55 or older)  your Vo2 max will be the best determining factor for that. 

Take someone in their 50s that has type 2 diabetes; compared to a non diabetic they would have a 40% greater likelihood of death over the next 10 years. This same 40% goes for smokers vs non smokers. 

To give you an idea of the statistical importance of Vo2 max: If we were to do the same comparison on a group of individuals but separate them by their vo2 max scores, it would weigh more than smoking and diabetes combined.

For context, Vo2 will range anywhere from 0-100ml.kg.min. Around 90% of the population falls between 20-55ml.kg.min 

0-20 ml.kg.min think death or very ill

20-30 ml.kg.min is near death / should improve.

30-50 ml.kg.min is below average to really good.

55+ top 5%

75+ less than 1% and usually professional endurance athletes. 

As an example, let's take a group of people and measure their vo2 max. The individuals in the bottom 25%  will represent the “low” group, and the top 25% will represent the “high” group. Statistically the “low” group  would have a 400% greater chance of death over the next 10 years!

  Most importantly vo2 correlates with life expectancy, linearly. This is not a simple point that the least fit people live less than the most fit individuals. Research shows as your vo2 max increases, regardless of other factors (Cholesterol, blood pressure, smoking, diabetes) you live longer on average.

For instance, the second quartile (25-50%) would have a 200% greater chance of death compared to the top 25%. But also a 95% greater chance of living compared to the low group. These are significant figures. And mind you the top 25% are not athletes or “genetic freaks”. In this research (122,007 Americans) the top quartile are numbers everyone with an abled body is capable of. 

Below is a chart to see the raw data from the research and bullet points I made: 

Increased chance of all cause mortality over the next 10 years?

Smoking vs nonsmoking 40% ​

Diabetic 40%​

High blood pressure 20% ​

Vo2 Max: 

Low vs Elite 500% ​

Low vs high 400% ​

Low vs below average 95%​

Below average vs elite 260%​

Below average vs high 200%​

Below vs Above Average 40%​

Above average vs Elite 84%

 

Ok, so Vo2 max is important, but what the heck is it? and how can I improve mine?

Vo2 is made up of two components.

  1. Your body weight

  2. How well does your body take in oxygen and uses it for fuel 

Lets get the easy one out of the way first, weight. The more you weigh, the less your vo2 max will be. This is because Vo2 measures how much oxygen your body can consume in milliliters, per kilogram, per min. If 2 individuals absorbed the same amount of oxygen per minute, one person weighed 50kg and the other 100kg, the individual weighing 50kg will have a significantly higher vo2. This reason plays into vo2 max’s significance as a longevity biomarker. It's directly attached to your weight. That said, if you are fit but overweight, your vo2 will be relatively good because of your fitness. However a sedentary overweight individual will most likely have a very poor vo2. 

It's possible to have two individuals with the same amount of oxygen in their blood but have two completely different oxygen delivery capabilities. This is because, it's not the amount of oxygen our blood can carry, it's how much our body absorbs that matters. And the only way to improve oxygen delivery is by moving!

Second reason: Oxygen!  

Oxygen is what keeps our cells alive. You can live days without water, months without food, but only minutes without oxygen. The better our body can extract oxygen from our blood the healthier our system is. Research even points towards sleep apnea as a risk factor for cancer, as the cells are chronically being deprived of oxygen throughout the night.

Our bodies take oxygen from the air, transfer it to the blood, pump that blood to the tissues, have the tissues extract the oxygen, then circulate the deoxygenated blood back to the lungs to repeat the cycle. Like a well functioning assembly line, all parts need to work for vo2 max to be high. 

Most humans have similar oxygen carrying capacity. What separates individuals with high Vo2 is their ability to extract the oxygen out of the blood and have their cells use this oxygen at higher than average intensities.

So how do I increase deliverability and absorption?? How do I increase my Vo2? 

 Many parts make up this puzzle, but the main “trainable” markers would be: 

  • Mitochondria size and amount

  • Capillaries size and amount

  • Blood volume and red blood cell count

  • Ability to utilize lipids for fuel 

  • Ability to re-use lactate as a fuel 

A healthy cell can use fat and lactate as a fuel source at higher intensities. This is one factor that separates healthy cells from less healthy cells. If you want a lot of oxygen delivered to a cell, the cell needs the proper tools, the right environment to use those tools, and practice at using them. Exercising improves all three! Stop thinking of exercise as a way to burn calories or is only for people who want to look a certain way. Exercise should be thought of as a necessity for life longevity, no different from sleeping or eating. If you want to live a long and independent life, exercise plays the most important role. 

Best 3 types of exercise for all individuals:

  1. Low intensity cardio

  2. Strength train

  3. High intensity cardio