One measurement of how much oxygen your body can use predicts your lifespan better than cholesterol, blood pressure or smoking. It can be improved at any age.
In 2018 a study of more than 120,000 patients who had done a treadmill test found something that surprised even the cardiologists who ran it: the fitter people were, the longer they lived, with no upper limit. Moving from the least fit fifth of the population to the next fifth reduced the risk of death more than quitting smoking, and the extremely fit did better still. The measurement behind it was cardiorespiratory fitness, best expressed as VO2max.
What it measures
VO2max is the maximum volume of oxygen your body can take in, transport and use per minute, per kilogram of body weight. It integrates the lungs, the heart, the blood and the mitochondria in the muscles, which is why it says so much: a high value means every link in the chain works. A sedentary sixty-year-old might have a VO2max of 25; a fit one, 40; an elite endurance athlete, over 70. Values decline with age by roughly ten percent a decade, unless you train.
How it is tested
The gold standard is a graded exercise test on a treadmill or bike with a mask measuring gases, offered by sports clinics and the better longevity clinics. It takes fifteen minutes and is unpleasant for the last three. Estimates from watches and submaximal tests are rough but track changes over time. Whatever the method, the point is to know your starting line and re-test a year later.
How to raise it
Two ingredients. The first is a large volume of easy zone 2 work, which builds the aerobic base. The second is a smaller dose of hard intervals: four minutes hard, three minutes easy, repeated four times, once or twice a week, is the protocol with the best evidence. Hill walking, uphill cycling, rowing and swimming all work. Beginners gain fast; even people in their seventies improve by ten to twenty percent within months.
Where the mountains help
Altitude is a natural training aid and a natural interval session. A week in the Engadin or the Dolomites pushes the heart every morning. The Vitality Score asks how often you get out of breath; if the honest answer is rarely, this is the number to change first.
Try it
Vitality ScoreSleep, steps, strength, plants, alcohol, friends, purpose, stress, daylight and breath.Walk the WorldEnter your daily steps and height, and the tool converts a year of walking into kilometres and into a journey between the fifteen destinations on this site.Frequently asked questions
What is a good VO2max for my age?
It depends on sex and age. As a rough guide, above 40 for men and 35 for women in their fifties is good; above 45 and 40 is excellent. What matters most is the direction over time.
Can I measure VO2max with a smartwatch?
Watches estimate it from heart rate and pace. The absolute number can be off by several points, but the trend over months is useful.
