Loading...
Discover how this powerful biomarker impacts your health and what you can do to improve it.
Scientifically Reviewed by
Dr. Olena Husak, PhD
Explore how your VO₂Max compares to age-based fitness categories and understand its impact on longevity.
Your VO₂Max of 40 ml/kg/min places you in the above Average category. This is associated with a 84% higher risk of all-cause mortality compared to Elite fitness levels (hazard ratio: 1.84). Moving up to High would reduce your mortality risk by 42%.
VO₂Max – or maximal oxygen uptake – is the highest rate at which your body can consume oxygen during intense exercise. It essentially measures how much oxygen your heart, lungs, blood, and muscles can deliver and use when working at maximum capacity. A higher VO₂Max means your cardiorespiratory system (heart and lungs) and muscles are highly efficient at transporting and utilizing oxygen, which is why VO₂Max is considered the gold-standard gauge of cardiorespiratory fitness. This single number reflects the integrated performance of your heart, lungs, circulation, and muscles under stress – in other words, it's a direct measure of your body's ability to generate energy and endure sustained activity.
Because VO₂Max represents peak aerobic capacity, it's strongly linked to your body's resilience. A person with a high VO₂Max can tolerate exercise and physical stress better, and they often recover faster. In fact, superior aerobic fitness provides a buffer or "reserve" capacity that protects against fatigue and frailty. For example, older adults who maintain a high VO₂Max stay well above the threshold of aerobic frailty (around ~17.5 ml/kg/min, the minimum needed for independent living) and thus are far less likely to experience disability.
VO₂Max isn't just a marker of athletic performance—it plays a central role in how well your body supports daily activities. Of note, sitting quietly requires about 3.5 mL/kg/min of oxygen, while light activities like dressing or making tea require about 7–8.75 mL/kg/min. More physically demanding tasks, such as playing football with your grandchildren, call for a VO₂Max of around 25 mL/kg/min. Individuals with a VO₂Max of 30 mL/kg/min or higher are more likely to perform these activities with ease, avoiding fatigue and maintaining independence. In short, VO₂Max isn't just a number for athletes – it's a meaningful indicator of how robust and "young" your cardiovascular and metabolic systems are.
Cardiorespiratory fitness – as captured by VO₂Max – has emerged as one of the strongest predictors of longevity in medical research. Dozens of large studies (in men and women alike) have shown an inverse relationship between VO₂Max and all-cause mortality: the higher your VO₂Max, the lower your risk of dying from any cause. In fact, low fitness is associated with a risk of death on par with or even exceeding traditional risk factors like smoking, diabetes, and hypertension.
A 2018 study of over 120,000 adults found that those with elite cardiorespiratory fitness (top ~2.5% for their age) had an 80% lower risk of mortality than those with very low fitness, meaning elite performers were 5 times less likely to die than the low-fitness group. There appeared to be no upper limit – the fittest individuals enjoyed the greatest survival benefit.
Not only does a high VO₂Max extend lifespan, it also prolongs healthspan – the years of life free from chronic disease. In a landmark 26-year follow-up, middle-aged people with greater fitness were far less likely to develop major chronic diseases (like heart disease, type 2 diabetes, lung or kidney disease) as they aged. Each 1-MET increase in fitness (about 3.5 ml/kg/min VO₂Max) in midlife was associated with a 5–6% lower risk of developing chronic conditions in both men and women. Highly fit individuals not only lived longer, but also delayed the onset of illness, effectively compressing morbidity into a shorter period at the end of life. In practical terms, someone who stays aerobically fit into their 50s and 60s is much more likely to reach older age disease-free compared to a sedentary peer. This strong predictive power is why scientists call VO₂Max a "vital sign" for health – it encapsulates your long-term risk better than almost any other single metric.
Explore how your VO₂Max compares to age-based fitness categories and understand its impact on longevity.
Your VO₂Max of 40 ml/kg/min places you in the above Average category. This is associated with a 84% higher risk of all-cause mortality compared to Elite fitness levels (hazard ratio: 1.84). Moving up to High would reduce your mortality risk by 42%.
Data based on age-adjusted VO₂Max measurements from large population studies. Values shown are for adults aged 30-39 years. Individual results may vary based on factors like training status and genetics.
VO₂Max is measured in milliliters of oxygen per kilogram of body weight per minute (ml/kg/min). Healthy values vary by age and sex, and they decline as we get older. In young adults around 20–29 years old, the average VO₂Max is roughly 45–50 ml/kg/min for men and about 35–40 ml/kg/min for women. This gap is expected – men typically have higher VO₂Max due to larger heart and lung size and higher blood hemoglobin, among other factors. VO₂Max peaks in the 20s and early 30s and then gradually falls by roughly ~10% per decade after age 30.
By the time people reach 70–79 years of age, the median VO₂Max is about ~24 ml/kg/min for men and ~18 ml/kg/min for women. In other words, a typical 75-year-old has about half the aerobic capacity they had in their twenties.
It's important to note there is wide individual variation. An extremely fit 60-year-old endurance athlete might have a VO₂Max comparable to a sedentary 30-year-old. In fact, lifelong athletes can sustain VO₂Max levels 3-fold higher than age-matched sedentary individuals even into their 70s. Men on average start with higher absolute VO₂Max, but women who are very active can outperform inactive men. By very old age (80+), VO₂Max values tend to converge as overall capacity declines.
Maintaining a high VO₂Max "youthfulness" is possible with training – allowing a person to have the aerobic fitness of someone decades younger. Ultimately, healthy VO₂Max is a range: above 40 is excellent for adult women and above 50 is excellent for adult men (younger ages higher, older ages lower). If your VO₂Max is below ~20 (ml/kg/min), daily activities may become challenging – that's a level we strive to stay above to maintain independence.
Gold-standard VO₂Max testing is typically done in a laboratory or clinical exercise lab. You wear a mask over your mouth and nose that analyzes your breath while you perform a graded exercise test – usually running on a treadmill or cycling on a stationary bike. The test starts easy and the intensity gradually increases to push you to your limit. The mask collects the volume of air you inhale and exhale and measures the oxygen and carbon dioxide levels. From this, the equipment determines the exact amount of oxygen your body is consuming each minute. The highest oxygen uptake reached, when you're giving maximal effort and it plateaus despite increasing workload, is your VO₂Max. This method, called cardiopulmonary exercise testing (CPX), is very precise and is considered the best measure of aerobic exercise capacity. It directly assesses how well your heart and lungs can deliver oxygen and how efficiently your muscles use it. Because it requires specialized equipment and trained personnel, VO₂Max testing has traditionally been done in hospitals, sports performance centers, or research labs.
In recent years, at-home and wearable methods for estimating VO₂Max have become widely available. Many smartwatches and fitness trackers (from brands like Garmin, Apple, Polar) now provide a VO₂Max prediction based on your heart rate responses during runs or brisk walks. These devices use algorithms (often based on heart rate, speed, and personal data like age/sex) to estimate VO₂Max without direct gas analysis. Studies have found that modern wearables can estimate VO₂Max within about 5–7% accuracy of lab measurements for most adults. While not as exact as a lab test, they are practical and useful for tracking changes over time.
There are also simple field tests, like the Cooper 12-minute run test or UK step test, which correlate your performance (distance run or heart rate recovery) with VO₂Max via established formulas. These submaximal tests are reasonably accurate for population averages.
In summary, if you want the most accurate VO₂Max, a supervised treadmill test with gas analysis is the gold standard. But if that's not accessible, a smartwatch's VO₂Max feature or a well-validated fitness test can give you a good ballpark figure. These at-home methods are especially good for monitoring progress. For most health-conscious individuals, seeing your estimated VO₂Max improve from, say, 35 to 40 ml/kg/min after a training program is what matters – even if the absolute number has some margin of error. It's now easier than ever to keep an eye on this vital fitness biomarker.
VO₂Max isn't just about performance – it has powerful links to chronic disease risk. Low VO₂Max (poor fitness) is a red flag for future cardiovascular disease. Research consistently shows that individuals with low cardiorespiratory fitness have a much higher likelihood of developing heart attacks, heart failure, or strokes, independent of other risk factors as shown in recent studies. Essentially, a body that struggles to deliver oxygen during exercise is also less resilient to cardiac stressors in life. On the flip side, high fitness exerts a protective effect: it's associated with healthier blood pressure, better cholesterol profiles, and stronger cardiac function. Impressively, high VO₂Max can even offset some of the harm of other risk factors. For instance, in some studies the protective effect of being fit was so strong that a person with obesity or hypertension but high fitness had lower cardiac risk than a lean person with low fitness according to research, with similar findings, and further evidence.
Beyond the heart, VO₂Max is linked to metabolic health. A low VO₂Max often correlates with insulin resistance and a higher risk of developing type 2 diabetes. Years before diabetes is diagnosed, low fitness can be identified as a predictor – likely because regular exercise improves insulin sensitivity. High VO₂Max, reflecting frequent physical activity, helps keep blood sugar and body weight in check, dramatically lowering diabetes risk as demonstrated in studies. Similarly, higher fitness reduces odds of the metabolic syndrome (a cluster of high blood sugar, blood pressure, and cholesterol) according to research, with additional evidence, and further studies.
There's even compelling data connecting VO₂Max to brain health. In a large 24-year cohort study, those with higher midlife VO₂Max had significantly lower risk of developing Alzheimer's disease and other dementias in later life as shown in research. The most fit participants were substantially more likely to stay cognitively intact into their 70s and 80s. Aerobic fitness likely preserves brain circulation and prompts the release of neurotrophic (brain-protective) factors during exercise, which over decades yields a lower dementia incidence according to studies. Additionally, VO₂Max has been linked to lower rates of depression – exercise improves mood and stress resilience, which are reflected in better fitness levels as demonstrated in recent research.
The pattern is clear: low VO₂Max tends to precede the development of chronic diseases, while high VO₂Max is a strong indicator of a body that is resistant to illness. This is why in preventive medicine, cardiorespiratory fitness is sometimes referred to as "the ultimate marker of health." It encapsulates so many aspects of physiology that if your VO₂Max is high, it's highly likely that many pillars of your health (cardiac, metabolic, pulmonary, even mental health) are in good shape. And if it's low, it's a call to action to improve your fitness to ward off disease before it strikes.
Just how much does VO₂Max influence how long you live? The answer, according to extensive research, is profoundly. Scientists often divide people into fitness percentiles or quartiles and examine mortality outcomes. Those analyses show a dramatic gradient: each increment in VO₂Max translates to lower mortality risk as demonstrated in studies. For example, a meta-analysis covering over 100,000 individuals found that for every 1 MET higher VO₂Max (≈3.5 ml/kg/min), all-cause mortality risk dropped by ~13% according to research. So going from a VO₂Max of 30 to 35 ml/kg/min (roughly from "average" to "above average" fitness) might reduce mortality risk on the order of 20–30%. Being in the top fitness quartile for your age is associated with 50% or more reduction in death risk compared to the bottom quartile as shown in studies.
At the extremes, the longevity boost is even more striking. In the study of 122,000 adults undergoing treadmill tests, the least fit group had a risk of death more than 5-fold higher than the fittest group over the years of follow-up according to research. Importantly, this benefit of high VO₂Max persists even into older age. Fit seniors (age 70+) still showed lower mortality than their less fit peers – fitness was protective at every age as demonstrated in studies. High VO₂Max essentially delays the biological aging process, so that a fit 70-year-old might have the mortality risk of an unfit 60-year-old. Moreover, maintaining your VO₂Max as you age helps stave off frailty and dependence. As mentioned earlier, dropping below ~18 ml/kg/min VO₂Max often coincides with losing the ability to live fully independently according to research. Those who preserve a higher VO₂Max later into life have more functional years and delay disability.
It's also worth noting the concept of "compression of morbidity" in the context of VO₂Max. High midlife fitness not only extends lifespan but tends to compress the period of illness and decline into a shorter window. One study found that higher fitness was more strongly associated with delayed onset of chronic disease than with survival itself – meaning fit individuals lived longer and only got illnesses much later in life as shown in research. They essentially enjoy more years of healthy life (and fewer years with disease) thanks to their fitness. All these data underscore that VO₂Max is not just a vanity number for athletes; it's a central biomarker of aging. It influences the two things we care about most: how long we live and how well we live. Even moderate improvements in VO₂Max can significantly shift the odds in favor of a longer, healthier life.
Modern longevity science has given us new tools called epigenetic clocks – these are biological age tests that analyze patterns of DNA methylation (chemical tags on DNA) to estimate the body's "biological age" or the pace at which one is aging. Interestingly, VO₂Max and overall fitness are reflected in many of these aging biomarkers, especially those focused on cardiovascular and metabolic health. For example, the DunedinPACE clock is a cutting-edge measure of the pace of aging developed by following a group of people in Dunedin, New Zealand over decades according to research. This clock wasn't just trained on chronological age – it was trained on how fast individuals were actually aging in real life, based on multiple physiological measures. One of the inputs for DunedinPACE was cardiorespiratory fitness (predicted VO₂Max) measured at several life stages. In other words, as the algorithm learned to predict who ages faster or slower, it incorporated VO₂Max decline as a key signal of aging. People who maintained higher fitness as they got older showed slower biological aging rates, and that is captured in a slower DunedinPACE score (closer to 0.8 or 1.0 rather than >1.0) – essentially indicating they are aging more slowly than average.
Another advanced clock, the OMICm Age algorithm (developed in collaboration with Harvard researchers), takes a multi-omic approach as described by TruDiagnostic. It analyzes not just DNA markers but also dozens of proteins, metabolites, and clinical lab values to estimate biological age. Many of those biomarkers are directly influenced by exercise and VO₂Max – for instance, inflammatory proteins like CRP or metabolic markers like HDL cholesterol and hemoglobin A1c are part of these analyses. High VO₂Max usually comes with lower inflammation, healthier metabolic profiles, and better lipid numbers, all of which would make one's OMICm Age younger according to TruDiagnostic. In essence, if you improve your VO₂Max through training, you're likely improving many of the blood biomarkers that the OMICm Age clock examines, thereby slowing the clock on your biological aging. This clock gives a comprehensive view of aging, and cardiorespiratory fitness is a big part of that picture.
The SYMPHONY Age series of clocks goes one step further – it looks at aging organ by organ. For example, it provides a Heart Age, Lung Age, Liver Age, Brain Age, and so on, by using organ-specific epigenetic signatures as described by TruDiagnostic. VO₂Max is most directly tied to the cardiovascular and pulmonary systems. So if you have a high VO₂Max for your age, you'd expect to see a younger Heart Age and Lung Age on the SYMPHONY report. In fact, the Heart Age algorithm likely captures aspects of cardiovascular youth that VO₂Max epitomizes – things like arterial flexibility, absence of hypertension-related DNA changes, etc. Meanwhile, your Lung Age would benefit from the kind of pulmonary efficiency that comes with high fitness. SYMPHONY Age effectively breaks down your biological age by system, and a high VO₂Max gives you a head start in the organ systems it stresses the most (heart, lungs, circulation, and even musculoskeletal system). These clocks don't explicitly ask for your VO₂Max, but they indirectly reflect it by measuring the downstream effects of VO₂Max on your body's cells and DNA methylation patterns.
In summary, VO₂Max influences biological aging measures in two ways: (1) it was a component used to build some aging algorithms (like DunedinPACE), highlighting that fitness is integral to aging rate; and (2) even where not explicitly included, it alters many metabolic and molecular factors that those clocks read. People who maintain high VO₂Max tend to show younger biological ages and slower aging on these sophisticated tests. This bridges an exciting gap between exercise physiology and epigenetics – affirming that by improving your VO₂Max, you're not just improving performance, you're potentially reprogramming your body's aging trajectory at the molecular level.
The good news is that VO₂Max is highly trainable. You can improve your VO₂Max at any age through targeted exercise, and gains can be seen in a matter of weeks. The most effective approach is a combination of endurance training and high-intensity interval training (HIIT). Endurance training – like sustained running, cycling, or swimming in your aerobic zone (often called "Zone 2" training, around 60-70% of max heart rate) – expands your heart's stroke volume and builds mitochondrial capacity in muscle. HIIT involves short bursts of very intense effort (typically ~30 seconds to a few minutes) alternated with recovery periods. HIIT is especially potent for VO₂Max because repeatedly pushing near your maximum effort stimulates your body to adapt by increasing the speed and volume of oxygen delivery according to research.
Endurance training expands plasma volume and capillary density, while HIIT upregulates mitochondrial enzymes and lactate clearance. Combined, these adaptations optimize oxygen delivery and utilization as shown in research, with additional evidence.
Research has shown that even 12 weeks of training can produce enormous VO₂Max improvements. In one study, older adults (in their 60s and 70s) increased their VO₂Max by about ~30% in just 3 months of endurance exercise – a remarkable boost in aerobic capacity according to research. Intervals tend to drive rapid gains: a seminal 2017 study in Cell Metabolism found that a 12-week HIIT program in older individuals not only improved their VO₂Max (aerobic capacity) but actually reversed certain age-related declines in muscle cells, effectively rejuvenating mitochondrial function as demonstrated in research. HIIT produced more robust fitness gains compared to moderate continuous exercise in that trial, though combined training (mixing aerobic and resistance exercises) was also very beneficial according to the same study. For practical purposes, a weekly routine that includes 2–3 days of interval workouts (e.g., cycling or running intervals where you go hard for 1–4 minutes, recover, and repeat) and 2 days of longer steady-state cardio (45–60 minutes at a moderate pace) is often ideal for maximizing VO₂Max as shown in research.
Crucially, these improvements are not limited to the young. Even sedentary 70-year-olds can dramatically raise VO₂Max with the right exercise plan, as studies have shown. And if you keep training over the years, you can slow down the typical VO₂Max decline with age. Masters athletes are a testament to this – they lose VO₂Max at a much slower rate because they consistently challenge their cardiovascular system. Consistency is key: the body retains adaptations as long as you continue to stimulate it. Taking up exercise early in life is great, but even if you start in midlife, you can catch up. For instance, men and women who maintained intensive endurance training for decades were found to have VO₂Max values in their 70s that were equivalent to or higher than sedentary folks in their 40s according to research. In essence, exercise can rewind your aerobic age by 20–30 years.
HIIT (High-Intensity Interval Training)
Research shows HIIT is one of the most effective methods for improving VO₂Max. Studies indicate it can increase VO₂Max by 8-15% in just 8-12 weeks, with some participants seeing improvements of up to 20% (Gibala et al., 2012).
Zone 2 Endurance Work
Long, steady-state cardio at 60-70% of your maximum heart rate builds your aerobic base. Studies show this type of training increases mitochondrial density and capillary networks, essential for VO₂Max improvements (Holloszy, 1967).
Consistency Over Intensity
Research consistently shows that regular exercise (3-5 times per week) is more effective for VO₂Max improvement than occasional intense workouts. Even moderate exercise can significantly improve VO₂Max in previously sedentary individuals (Mann et al., 2014).
Progressive Overload
Gradually increasing exercise intensity and duration is key. Studies show that progressive overload leads to greater VO₂Max improvements than maintaining the same exercise routine (Foster et al., 2015).
Recovery and Sleep
Adequate recovery between workouts and quality sleep are essential for VO₂Max improvements. Research shows that sleep deprivation can reduce VO₂Max by up to 11% (Oliver et al., 2009).
"The most significant VO₂Max improvements occur in the first 3-6 months of consistent training, with continued but smaller gains possible with long-term dedication."
With dedication, you can usually see VO₂Max improvements in about 4–8 weeks. The first thing many notice is that activities like climbing stairs or running a mile feel easier – that's a sign your aerobic engine is getting stronger. Over months and years, sustaining these habits profoundly impacts your health trajectory. VO₂Max truly embodies the "use it or lose it" principle of aging: challenge your cardio fitness and it will rise or stay high; neglect it and it dwindles. The science is empowering: no matter where you start, you can improve your VO₂Max and reap longevity benefits. Even small VO₂Max gains (5 mL/kg/min or so) can translate into significantly lower health risks as shown in research. It's never too late – or too early – to invest in your VO₂Max through regular exercise, effectively investing in a longer, healthier life.
Take control of your health journey by measuring your VO₂Max and biological age with Liv Longevity Labs. Get personalized insights to optimize your fitness and longevity.
Join thousands of users improving their health with precise biological age tracking