Cardio-respiratory fitness/VO2 max.

Cardio-respiratory fitness/VO2 max.

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Would you like to know how efficiently your body works? How long and well you can live?

There is an answer: VO2 max reflects “the size of your engine”.

VO₂ max is the maximum (max) rate (V) of oxygen (O₂) your body is able to use during exercise.

VO2 max is often used as an indicator of overall cardio-respiratory fitness (CRF) and can serve as a metric for tracking progress.

High VO₂ max can be a good predictor of your athletic performance and is independent of motivation.

Simply said, VO2 max tells you how quickly you can take oxygen from the air into your lungs, get it into your blood, pump it to your muscles, and then have your muscles use it in the metabolic processes that will provide energy to move you.
The benefits are simple:

The greater your VO₂ max, the more oxygen your body can consume, and the more effectively your body can use that oxygen to generate the maximum amount of ATP energy.

Oxygen is the molecule of life. It’s involved in every reaction in our body, necessary to sustain life and movement. It’s also the foundational element for long and high-quality life.

Without oxygen, death is inevitable. Luckily, our body houses a unique computer system that allows us to breathe without thinking about inhaling and exhaling. Our brain and neurons ensure that oxygen exchange and transport of oxygenated blood across every cell in our body happens seamlessly in the background.
Most debilitating chronic disease, namely heart disease, lung disease, cancer, and diabetes, are typically caused by lifestyle factors such as poor nutrition, lack of exercise, or tobacco use and inflict an ongoing reduction in quality and duration of life.

The American Heart Association in a 2016 statement concluded that cardio-respiratory fitness, AKA VO2 max or peak oxygen consumption, is the strongest predictor of how well and long someone will live.

It is a potentially stronger predictor of mortality (risk of dying) than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus:

  • If you compare someone of low fitness to elite, it is a fivefold difference in mortality over a decade. To compare with:
    • Smoking is a 41% increase
    • Coronary artery disease is a 29% increase
    • Diabetes is a 40% increase
    • High blood pressure is a 21% increase
    • End-stage renal disease is about a 180% increase in mortality

Addition of CRF/VO2 max to traditional risk factors significantly improves the reclassification of risk for adverse outcomes.

Although a low VO2 max can’t reveal the exact sub-system (e.g., heart, lungs, or cells) causing its deterioration, it can certainly indicate that at least the person is facing an underlying problem and is thus it’s a strong indicator of chronic disease onset. This immediately translates into a reduction in expected lifespan and quality of life. 

The impact of VO2 max as a biomarker is valuable not only to determine a person’s risk for future adverse clinical outcomes, but also to optimize treatment strategies.

 Determining CRF on a serial basis is valuable in gauging the effectiveness of treatment strategies, including recommendations for participation in physical activity.  Individuals whose CRF increases between examinations have a lower risk of adverse health and clinical outcomes than those whose CRF decreases.

Higher levels of VO2 max are associated with a reduced risk of developing diabetes, metabolic syndrome, lung, breast, and colorectal cancers, dementia and Alzheimer disease, as well as drop in stress level, boost in immune system and decrease in disability.[1]

The goal is to improve and move from the bottom 25th percentile to being in the 50th to 75th percentile. Each time you move from one of these groups to the next, you get a statistically significant benefit.

How to increase your fitness and VO2 max:

  • physical activities of moderate intensities of ≤50% CRF, performing Moderate Intensity Continuous Training (MICT), endurance or low-level aerobic type exercises over a period of 6 months.
  • the higher the baseline CRF, the more vigorous the intensity needed to produce a clinically significant increase in VO2 max.
  • High Intensity Interval Training (HIIT) and Sprint Interval Training (SIT) regimens induce greater increases in CRF than MICT, especially when total amounts of energy expended in the different regimens are similar.
  • frequency: ≥5 d/week of MICT, or ≥3 d/week of vigorous-intensity exercise, or a combination of moderate and vigorous exercise on 3–5 d/week.
  • 30–60 min/d (150 min/week) of MICT, or 20–60 min/d (75 min/week) of vigorous exercise, or a combination of moderate and vigorous exercise per day for most adults; <20 but ≥10 min/d (<150 min/week) of exercise can be beneficial, especially in previously inactive people. Sessions should be at least 10 min.

Analyzing the oxygen chain through breath analysis provides a unique tool that identifies the nutrition and training you need to achieve your fitness and overall health goals.

Testing can evaluate how the heart, lungs, blood circulation, and cells work individually, but also in unison. After identifying the limiting factor, a trained provider has the information needed to structure a unique program for you to overcome it.

Testing offers to us the opportunity to evaluate your metabolic health and determine how fat and carbohydrates contribute to metabolic activity of your body. 

We can determine the best level of exercise and diet composition to improve your VO2 max and maintain healthy weight and metabolism.


For more information on Cardio-respiratory/VO2 max testing please contact Dr. Koganski at NIM Longevity by calling: 1-215-750-7000, or online:


[1] Ross R, Blair SN, Arena R, Church TS, Després J-P, Franklin BA, Haskell WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis R, Sawada SS, Sui X, Wisløff U; on behalf of the American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council on Cardiovascular and Stroke Nursing; Council on Functional Genomics and Translational Biology; and Stroke Council. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association. Circulation. 2016;134: e653–e699. doi: 10.1161/CIR.0000000000000461.