• Introduction
  • The basics of maximal oxygen uptake
  • Physiological determinants of VO₂max
  • How to measure VO₂max
  • How to improve VO₂max
  • Final thoughts
  • Adenosine triphosphate: ATP is the energy currency of the body. It provides energy to drive several processes in living cells (muscle contractions, nerve impulse propagation, condensate dissolution, chemical synthesis, etc.)
  • Aerobic exercise: Also known as cardiovascular endurance. Exercise of low to moderate intensity that  relies primarily on the aerobic energy-generating process.
  • Aerobic respiration: the process in which ATP is produced with the presence of oxygen.
  • Lactate threshold: the level of intensity that causes lactate to accumulate in the blood at a faster rate than it can be removed.

Introduction

VO₂max describes the maximum rate of oxygen consumption during exercise. Oxygen is a crucial component in aerobic respiration – the process in which the oxygen you breathe in can be used to produce adenosine triphosphate (ATP).

ATP is known as the energy currency in your body. It fuels your cells during exercise as well as maintains regular bodily functions while at rest. A higher VO₂max is directly related better cardiovascular endurance and lowered risk of several chronic illnesses.

This post explains the basics of VO₂max, and why it is considered such an important measuring tool of endurance performance and overall health. We have also added ways to assess and improve your own aerobic capacity.

The basics of maximal oxygen uptake

Maximal oxygen uptake (maximal aerobic capacity) refers to the maximum amount of oxygen consumed during intense or maximal exercise. VO₂max depends on oxygen delivery (air exchange in the lungs, pumping power of the heart, blood flow to the muscles) and the oxygen demand of the tissues (especially the mitochondria). The name itself is derived from three abbreviations: maximal (max) volume (V) and oxygen (O₂).

VO₂max measurement is regarded as the gold standard of cardiovascular fitness and aerobic endurance. The reason for this is twofold. First, the muscles need oxygen for prolonged aerobic exercise. Second, the heart must pump enough oxygen-filled blood through the circulatory system to meet the demands of the activity. Thus, the more oxygen you can use during strenuous exercise, the more energy you can ultimately produce.

Although VO₂max sets the theoretical upper limit for your ability to sustain prolonged endurance exercise, even the most elite endurance athletes can exercise at their VO₂max for only a few minutes. Maximal aerobic capacity has long been used as an indicator of endurance performance. Yet, it seems to have a relatively low correlation to athletic success. After all, it does not measure sustained performance. It also negates other important factors like lactate threshold, movement economy, motivation, training, etc.

VO₂max can be expressed in two ways; the absolute rate of oxygen per minute (l/min), or as a relative rate. One example of this is milliliters of oxygen per a kilogram of body mass per minute (ml/(kg·min). The latter is usually used for measuring endurance performance. Elite endurance athletes (marathon runners, cross-country skiers, cyclists, etc.) usually reach a VO₂max of approximately 75 ml/(kg·min).

Aerobic capacity measurements are not just for athletes. In fact, it is also one of the best predictors of chronic illnesses such as cardiovascular disease, type 2 diabetes, and certain types of cancers. 

Share this post

Maximal Oxygen Uptake (VO₂max)

The maximum amount of oxygen your body can use during exerciseThe most accurate measurement of cardiovascular fitnessUsed as an indicator of endurance performanceCan be used to track progress in endurance performance

Physiological determinants of VO₂max

There are several factors that affect your aerobic capacity. Most notably your genetics, gender, age, body composition, and training history. Even certain lifestyle choices such as diet and smoking can have big impact on VO₂max.

Variable

Effect

Genetics

Some differences in VO₂max can be explained via genetics (height, weight, body composition muscle mass, and lung capacity). The trainability of VO₂max seems to be highly hereditary.

Gender

Males tend to have higher maximal oxygen uptake than females. This is largely due to their larger physical size and greater muscle mass, resulting in increased oxygen need.

Age

VO₂max peaks around your 20s. After the age of 30 your maximal oxygen uptake tends to decline around 5-10% per decade.

Training history

Previous training history (especially endurance training) has a significant impact on VO₂max. It can be improved by 5-30% with consistent training, although it differs greatly between individuals.

Body composition

Lower body mass index (BMI) has a direct correlation to higher VO₂max. This is because the more mass you move, the more oxygen is required.

Lifestyle choices

Unhealthy diet, alcohol consumption, smoking, and sedentary lifestyle are strongly connected to diabetes, high BMI, and heart disease. All of which are connected to low VO₂max.

How to measure VO₂max

Maximal oxygen uptake tests are designed achieve full exhaustion to accurately measure oxygen consumption. In a clinical setting, this is done by putting on a mouthpiece that measures ventilation and oxygen/carbon dioxide concentration of the inhaled and exhaled air during increasingly strenuous exercise. The most common tests involve a treadmill or a cycle ergometer (stationary bike). This test also provides an accurate measurement of your maximal heart rate. Along with resting heart rate, this gives an accurate representation of your heart rate range.

Maximum oxygen uptake is reached when oxygen consumption remains constant despite the increase in workload. VO₂max can then be calculated using the Fick principle: VO2 = (CO × Ca) – (CO × Cv).

However, you do not need to exert maximum effort in order to calculate maximum oxygen uptake. There are several submaximal tests being used today. These include:

  • Astrand treadmill test
  • Cooper test
  • Heart rate method
  • Multi-stage fitness test
  • Rockport walking test
  • Wingate Test

Submaximal tests utilize their own equations to estimate VO₂max. They are also safer options for people with compromised cardiovascular or respiratory systems. 

Maximal oxygen uptake measures how much the body can consume oxygen during exercise.

How to improve VO₂max

Maximal oxygen uptake can be improved in two ways: with continuous aerobic training or high-intensity interval training. Multiple studies have shown that interval exercise increases VO₂max significantly more than prolonged exercises performed at a moderate heart rate. This is because high-intensity exercises increase oxygen demand and elevate your heart rate much more than less intense workouts.

Continuous aerobic exercises may be a better fit for older adults and beginners who are just starting out their fitness journey. Running, swimming, cycling, rowing, and cross-country skiing are all good examples of effective endurance exercises that can be done at a moderate heart rate. 

High-intensity interval training can be roughly divided into two categories: aerobic and sprint training. Previous studies indicate that aerobic interval exercises improve VO₂max mainly through improved cardiac function. Sprint interval training improves maximal oxygen uptake by increasing the oxidative capacity of peripheral muscles. Some of the best methods to increase VO₂max include:

Whether you enjoy longer workouts or more time-efficient intervals, the most important aspect of training is consistency. Only then will you be able to improve both your health and your performance. 

Final thoughts

Good aerobic fitness is associated with a wide range of health benefits. Better quality of life, longer lifespan, reduced risk of heart disease, stroke, diabetes, and cancer are all strongly related to higher maximal oxygen uptake. It even has beneficial effects on your mental health.

To maintain or improve your maximal oxygen uptake, you should perform cardiovascular endurance exercises three times a week. This can be anything from a short jog in your neighborhood to commuting to work by bike.

VO₂max is also often used to measure the potential for better endurance performance. However, individual differences in lactate threshold, biomechanics, technique, motivation and training have shown that VO₂max is only one part of the equation of better performance.

Did you learn anything new about maximal oxygen uptake? Let us know in the comments.

Sources

  • Bacon AP, Carter RE, Ogle EA, Joyner MJ. VO2max trainability and high intensity interval training in humans: a meta-analysis. PLoS One. 2013 Sep 16;8(9):e73182. doi: 10.1371/journal.pone.0073182. PMID: 24066036; PMCID: PMC3774727.
  • Bernaards CM, Twisk JW, Van Mechelen W, Snel J, Kemper HC. A longitudinal study on smoking in relationship to fitness and heart rate response. Med Sci Sports Exerc. 2003 May;35(5):793-800. doi: 10.1249/01.MSS.0000064955.31005.E0. PMID: 12750589.
  • Betik AC, Hepple RT. Determinants of VO2 max decline with aging: an integrated perspective. Appl Physiol Nutr Metab. 2008 Feb;33(1):130-40. doi: 10.1139/H07-174. PMID: 18347663.
  • Bouchard C, An P, Rice T, Skinner JS, Wilmore JH, Gagnon J, Pérusse L, Leon AS, Rao DC. Familial aggregation of VO(2max) response to exercise training: results from the HERITAGE Family Study. J Appl Physiol (1985). 1999 Sep;87(3):1003-8. doi: 10.1152/jappl.1999.87.3.1003. PMID: 10484570.
  • Diaz-Canestro, C., Montero, D. Sex Dimorphism of VO2max Trainability: A Systematic Review and Meta-analysis. Sports Med 49, 1949–1956 (2019). https://doi.org/10.1007/s40279-019-01180-z
  • Green JS, Crouse SF. The effects of endurance training on functional capacity in the elderly: a meta-analysis. Medicine and Science in Sports and Exercise. 1995 Jun;27(6):920-926. PMID: 7658956
  • Huang G, Gibson CA, Tran ZV, et al. Controlled endurance exercise training and VO2max changes in older adults: a meta-analysis. 2005. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995.
  • Kenny WL, Wilmore JH, and Costill DL, (2015). Physiology of Sports and Exercise (5th). Champaign, IL. Human Kinetics.
  • Kim CH, Wheatley CM, Behnia M, Johnson BD. The Effect of Aging on Relationships between Lean Body Mass and VO2max in Rowers. PLoS One. 2016 Aug 1;11(8):e0160275. doi: 10.1371/journal.pone.0160275. PMID: 27479009; PMCID: PMC4968829.
  • Levine BD. .VO2max: what do we know, and what do we still need to know? J Physiol. 2008 Jan 1;586(1):25-34. doi: 10.1113/jphysiol.2007.147629. Epub 2007 Nov 15. PMID: 18006574; PMCID: PMC2375567.
  • Lundby C, Montero D, Joyner M. Biology of VO2 max: looking under the physiology lamp. Acta Physiol (Oxf). 2017 Jun;220(2):218-228. doi: 10.1111/apha.12827. Epub 2016 Nov 25. PMID: 27888580.
  • Mann TN, Lamberts RP, Lambert MI. High responders and low responders: factors associated with individual variation in response to standardized training. Sports Med. 2014 Aug;44(8):1113-24. doi: 10.1007/s40279-014-0197-3. PMID: 24807838.
  • Matsuo T, Saotome K, Seino S, Shimojo N, Matsushita A, Iemitsu M, Ohshima H, Tanaka K, Mukai C. Effects of a low-volume aerobic-type interval exercise on VO2max and cardiac mass. Med Sci Sports Exerc. 2014 Jan;46(1):42-50. doi: 10.1249/MSS.0b013e3182a38da8. PMID: 23846165.
  • Milanović Z, Sporiš G, Weston M. Effectiveness of High-Intensity Interval Training (HIT) and Continuous Endurance Training for VO2max Improvements: A Systematic Review and Meta-Analysis of Controlled Trials. Sports Med. 2015 Oct;45(10):1469-81. doi: 10.1007/s40279-015-0365-0. PMID: 26243014.
  • Støren Ø, Helgerud J, Sæbø M, Støa EM, Bratland-Sanda S, Unhjem RJ, Hoff J, Wang E. The Effect of Age on the V˙O2max Response to High-Intensity Interval Training. Med Sci Sports Exerc. 2017 Jan;49(1):78-85. doi: 10.1249/MSS.0000000000001070. PMID: 27501361.
  • Rogers MA, Hagberg JM, Martin WH 3rd, Ehsani AA, Holloszy JO. Decline in VO2max with aging in master athletes and sedentary men. J Appl Physiol (1985). 1990 May;68(5):2195-9. doi: 10.1152/jappl.1990.68.5.2195. PMID: 2361923.
  • Rankinen, T., Bouchard, C. Genetic Predictors of Exercise Training Response. Curr Cardiovasc Risk Rep5, 368–372 (2011). https://doi.org/10.1007/s12170-011-0179-z
  • Schwartz, W. & Reibold, R.C. Aerobic fitness norms for males and females: a review. Aviat Space Environ Med 61, 3-11.
  • Scribbans TD, Vecsey S, Hankinson PB, Foster WS, Gurd BJ. The Effect of Training Intensity on VO2max in Young Healthy Adults: A Meta-Regression and Meta-Analysis. Int J Exerc Sci. 2016 Apr 1;9(2):230-247. PMID: 27182424; PMCID: PMC4836566.
  • Støren Ø, Helgerud J, Sæbø M, Støa EM, Bratland-Sanda S, Unhjem RJ, Hoff J, Wang E. The Effect of Age on the V˙O2max Response to High-Intensity Interval Training. Med Sci Sports Exerc. 2017 Jan;49(1):78-85. doi: 10.1249/MSS.0000000000001070. PMID: 27501361.
  • Vollaard NBJ, Metcalfe RS, Williams S. Effect of Number of Sprints in an SIT Session on Change in V˙O2max: A Meta-analysis. Med Sci Sports Exerc. 2017 Jun;49(6):1147-1156. doi: 10.1249/MSS.0000000000001204. PMID: 28079707.
  • Williams, C.J., Williams, M.G., Eynon, N. et al. Genes to predict VO2max trainability: a systematic review. BMC Genomics 18, 831 (2017). https://doi.org/10.1186/s12864-017-4192-6
  • Wilson MG, Ellison GM, Cable NT. Basic science behind the cardiovascular benefits of exercise. Br J Sports Med. 2016 Jan;50(2):93-9. doi: 10.1136/bjsports-2014-306596rep. PMID: 26729891.

Join our growing list of subscribers!

Stay informed about the latest in sports science and physical performance. Subscribe to our mailing list for the latest updates, posts, products and much more.

    Cardiovascular Endurance Endurance Maximal Oxygen Uptake Speed Endurance