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Track your Vo2 Max! Lifestyle medicine's most important longevity vital sign

Updated: May 30, 2023

Getting old may not be optional, but for many of us (most of us) becoming frail is. Today I want to share some information about the importance of keeping our heart function high.


When it comes to avoiding trouble or dealing with it, preparation is key. As the old saying goes: “I’m a great believer in luck, the harder I work, the more luck I seem to have.” This is a key concept to our health for sure. Keeping our fitness as high as possible makes us more resilient. This is especially true as it relates to the function of our heart!


Frequently when we talk about the heart, we are talking about heart attacks and blocked up blood

vessels, but today I want us to think about the heart as a muscle. The heart is the most complicated muscle ever created! But under all its complexity, it’s a muscle like any other.

As we age, unless we exercise, we tend to lose muscular strength and mass. This is sarcopenia and we’ve touched on it before. Some studies suggest after the age of 30 we lose 3-5% of our muscle mass per decade, and the average man will lose 30% of their muscle mass as they age.

You can imagine how the loss of that muscle mass and strength starts to limit our ability to work and play!

Well, what about the heart muscle? What happens to it as we age? No surprise, as we age our heart function (as measured by VO2max) drops by 1% per year starting at age 30. By the time we are getting into our 40’s and 50’s many of us just can’t keep up the way we could when we were spry 30-year-olds. We say, we are getting old, but the truth is, our hearts are becoming deconditioned due to lack of maintenance. That decline in cardiac endurance doesn’t just impact our ability to play tennis, chase grand kids or dig fence posts. People with the lowest cardiac endurance have much higher rates of dementia, osteoporosis (weak bones), cancer (and risk of dying of cancer), heart attacks and early mortality. Those with the lowest cardiac endurance have five times the risk of passing away from any cause than those with the best. In fact: Compared with traditional risk factors like hypertension, cholesterol problems, smoking, physical inactivity, obesity, and diabetes status, cardiac endurance (as measured by VO2max) is a more powerful predictor of risk for poor health and longevity. That really puts it in perspective for me. Those things are being screened and treated by our doctors all the time. But have you ever had your doctor talk to you about cardiac endurance or VO2max testing?


What is VO2 max testing anyway? If you have seen athletes doing exercise testing like running or biking with a mask over their nose and mouth attached by a tube to a computer, that’s a VO2max test. This test measures how much oxygen your heart can consume as you are doing

progressively more exercise. Oxygen is fuel for our heart ? the better our heart is at gobbling up that fuel and turning it into work, the more endurance we have.VO2 max testing is important to us for two very different reasons. First, it tells us where we are with our cardiac endurance- are we ok? Are we way below where we should be? Secondly, and probably most importantly, it lets us monitor improvements or declines. Track you Vo2 Max! Lifestyle medicine's most important vital sign.


Cardiac endurance is trainable. Just like starting a strength training program, we can build our cardiac endurance with exercises to get it to a safe level and to keep it there for our lifetime. What if you haven’t been very active during your younger years? What if you are seventy-eight years old and wondering if it’s too late to build up some vitality? Studies looking at eight-week training programs showed an improvement in VO2max of 9-13%. There was no difference in the amount of improvement between those people in their 20’s and those in their70’s! So no, it is NEVER too late to gain vitality! Don’t let anyone convince you otherwise.



Hopefully, by now I have you intrigued. What could you do with all of this? Well first, you need to talk with a doctor to be sure you are suitable for doing exercise testing. If you are having active chest pain or pressure when you do activity that needs to be looked at first. Second, starting in your forties, you should have a VO2max test done yearly. We need to set some base

line function and set some goals. Third is the exercises: This consists of two types of activity; Zone 2 training and HITT. Zone 2 training is low level cardio activity keeping your heart rate up at 70% of your maximum for your age for 30-40 minutes three times per week. An example would be walking briskly on a treadmill at a level that makes you just a little short winded. This will build a great base of cardiac endurance. To get our VO2 max higher, we need to challenge our heart once per week. This involves “high intensity interval training” or (HIIT). This type of exercise involves us cranking up the work of the heart to max (for you) for four minutes and then resting for four minutes. We would repeat that four times and then be glad we were done for the week! HIIT training is challenging, but it is that challenge that pushes our VO2 max up-

which is just what we want.


For those looking at that routine thinking, “I can’t do that”, remember it isn’t about “all or none”. All

effort is beneficial. Start with what you can do and build from there. It is about progress not perfection. I hope this has given you some ideas on how to build up your health span and keep you functioning at the level that brings joy to you and your family!


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