Lexicon
VO2 Max
Also known as Maximal oxygen uptake, VO2max
Definition
Maximum oxygen uptake (VO2max), measured during large muscle mass exercise such as cycling or running, is widely considered to be the gold standard measurement of integrated cardiopulmonary-muscle oxidative function. [1] Cardiorespiratory fitness, as measured by VO2max, is related to functional capacity and human performance and has been shown to be a strong and independent predictor of all-cause and disease-specific mortality. [2]
How it works
In the exercising human, VO2max is limited by the ability of the cardiorespiratory system to deliver oxygen to the exercising muscles, so oxygen delivery, not skeletal muscle oxygen extraction, is viewed as the primary limiting factor. [3] The increase in VO2max with training results primarily from an increase in maximal cardiac output rather than from an increase in the arteriovenous oxygen difference. [3] The consumption of oxygen and production of carbon dioxide in muscle cells are dynamically linked to oxygen uptake and carbon dioxide output at the lung by integrated functions of the cardiovascular, pulmonary, hematologic, and neurohumoral systems. [4] Aging lowers VO2 max in parallel with impaired Mitochondrial Function, and skeletal-muscle expression of the mitochondrial biogenesis factor TFAM shows a strong relationship with VO2 max, tying aerobic capacity to mitochondrial health [5]
Connected concepts
How it's measured
Cardiopulmonary exercise testing (CPET) provides a noninvasive and integrated assessment of the response of the respiratory, cardiovascular, and musculoskeletal systems to exercise, and is the gold standard test for cardiorespiratory fitness quantification and exercise prescription. [6] A standardised incremental CPET protocol supports a resting phase lasting at least 3 minutes, a 3-minute unloaded phase, and an 8- to 12-minute incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2 to 3 minutes. [7] With modern ramp testing protocols a plateau in oxygen uptake is not an obligatory outcome, which has led investigators to rely on secondary criteria such as respiratory exchange ratio, maximal heart rate, and maximal blood lactate concentration whose acceptable values may be selected arbitrarily and can result in inaccurate VO2max estimation. [1]
What it means for longevity
In a meta-analysis of 33 cohort studies covering 102 980 participants and 6910 deaths, each 1-MET higher level of maximal aerobic capacity was associated with a pooled risk ratio for all-cause mortality of 0.87 (95% CI 0.84-0.90). [8] In the same analysis, compared with participants with high cardiorespiratory fitness, those with low fitness had a risk ratio for all-cause mortality of 1.70 (95% CI 1.51-1.92) and for combined coronary heart disease and cardiovascular events of 1.56 (95% CI 1.39-1.75).
Community knowledge
## Training To Raise VO2 Max
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- 1.Poole DC, Jones AM. Measurement of the maximum oxygen uptake V̇o2max: V̇o2peak is no longer acceptable. J Appl Physiol (1985) · 2017
- 2.Strasser B, Burtscher M. Survival of the fittest: VO2max, a key predictor of longevity? Front Biosci (Landmark Ed) · 2018
- 3.Bassett DR, Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc · 2000
- 4.Sietsema KE, Rossiter HB. Exercise Physiology and Cardiopulmonary Exercise Testing. Semin Respir Crit Care Med · 2023
- 5.Bori Z, Zhao Z, Koltai E, Fatouros IG, Jamurtas AZ, Douroudos II, Terzis G, Chatzinikolaou A, Sovatzidis A, Draganidis D, Boldogh I, Radak Z. The effects of aging, physical training, and a single bout of exercise on mitochondrial protein expression in human skeletal muscle. Exp Gerontol · 2012
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