Track Vo2 Max

Vo2 Max Overview

Vo2 max refers to the maximum volume of oxygen that your body can consume during intense exercise.
Because Vo2 max improves with exercise, it is a great indicator of your endurance exercise capacity and overall fitness level.
Think of Vo2 max as an objective assessment (a number) for what is otherwise subjective (how “fit” do you feel”).
Once you have a Vo2 max number, it’s far easier to track changes to your fitness level overtime.
The benefits of knowing your Vo2 max do not stop there.
Vo2 Max has also been repeatedly demonstrated to predict risk of death as well, or better, than any other health metric. Individuals with the lowest Vo2 Max 20% of the population have a greater risk of death than shown for smoking, diabetes, high blood pressure, and coronary artery disease. According to certain criteria, a low Vo2 Max confers a greater risk of death even than kidney failure.
Some refer to Vo2 Max, with justification, as the most important health metric known today. If you had to predict risk of death for any individual using one health metric, there is nothing more telling than Vo2 Max. While the concept of Vo2 max originated in 1922, it continues to suffer from a lack of awareness among patients and clinicians alike, but it’s absolutely worthy of greater attention.
Direct measurements of Vo2 Max provide the best accuracy and generate additional valuable information (such as lactate changes during exercise and anaerobic threshold), but measuring Vo2 max directly is expensive ($200 to $300).
Several methods of estimating Vo2 max have been studied and demonstrated to be >=90% accurate compared to direct measurement. These methods can be performed for free and with minimal equipment.
This site allows you to estimate your Vo2 max via two methods: the Cooper Run-Walk test and the Silva Stationary Bike test.
The Cooper Run-Walk test is slightly less accurate than the Silva Stationary Bike test (93 to 95% accuracy), but is still about 90% accurate relative to direct Vo2 max measurement.
For the following situations, the Cooper Run-Walk test is more appropriate: (a) you do not have access to a stationary bike that measures watts, and/or (b) you spend more time walking/running than cycling

References:

Souza e Silva CG, Araújo CG. Sex-Specific Equations to Estimate Maximum Oxygen Uptake in Cycle Ergometry. Arq Bras Cardiol. 2015
Cooper KH. A Means of Assessing Maximal Oxygen Intake: Correlation Between Field and Treadmill Testing. JAMA. 1968

Protein Consumption Overview

Most people are not consuming enough protein. Even being a doctor, I wasn’t aware of how to determine an optimal amount of protein for myself until a few years ago. It never up came during medical school, residency, or fellowship. In fact, I suspect the average body builder knows much more about optimal protein intake than the average doctor.
Previously, I would use protein shakes only after workouts; however, numerous studies suggest this approach is suboptimal. The body needs a certain amount of protein each day to provide maximal benefit, and it’s much more than most people and doctors suspect or consume on a regular basis.
If someone does a strength training workout on Sunday, that individual’s muscles are still in a state of recovery and repair on Tuesday and perhaps into Wednesday. So, by only using protein shakes on work out days, and assuming I was below typically below an optimal protein consumption on most days, I was leaving my muscles “hungry” for protein in the days after each work out, which impaired increases in muscle mass that would have occurred at more optimal protein intakes.
The primary reason that most people underestimate how much protein they need stems from the Recommended Dietary Allowance (RDA) for protein. The studies used to determine the RDA focused on the minimal amount of protein per day to prevent nitrogen imbalance. The RDA for protein was set at 0.8 grams of protein per kilogram of total body weight per day (g/kg/d), or 0.36 grams of protein per pound of body weight per day. The protein amount displayed on food labels stems from the RDA amount and assumes consumption of 2000 calories per day.
So, what is the optimal amount of protein for an individual to consume per day?

Two meta-analyses were performed to answer this question and focused on individuals who performed strength training with some regularity. A meta-analysis is a study of studies performed on a similar topic. The advantage of a meta-analysis is that it allows for inclusion of many more individuals typically found in a single study. The disadvantage is that it loses some granularity, such as the nature of the strength training routines and frequency.
The first meta-analysis (Morton et al., 2018) found that muscle mass increased with greater protein consumption up to 1.62 g/kg/d.
The second meta-analysis (Tagawa et al., 2022) found that strength increased with greater protein consumption up to 1.5 g/kg/d.
For both of these studies, consuming more than those amounts of protein did not lead to further increases in muscle mass or strength.
However, we can’t say with confidence that more protein than those amounts would not provide further benefit. In fact, given certain conditions, more protein has been shown to provide greater muscle mass benefit. See Blog Post on Protein for more information.

Click here to receive personalized guidance on how much protein you should aim to consume on a daily basis.

The Vo2 max estimation via the Silva Stationary Bike Test is ~93% to 95% accurate in women and ~95% accurate in men when compared with direct Vo2 max measurement.

- Reference: Silva CG de S e, Araújo CGS. Sex-Specific Equations to Estimate Maximum Oxygen Uptake in Cycle Ergometry. Arq Bras Cardiol. 2015;105(4):381-389. doi:10.5935/abc.20150089

The Vo2 max estimation via Cooper Run Walk test is 90% accurate when compared with direct Vo2 max measurement and is gender agnostic

Reference: Cooper KH. A Means of Assessing Maximal Oxygen Intake: Correlation Between Field and Treadmill Testing. JAMA. 1968;203(3):201.
doi:10.1001/
jama.1968.03140030033008

Why You Should Care About Vo2 Max

Adjusted Hazard Ratio (HR) for Cardiorespiratory Fitness According to Performance Group

Strategy on Improving your Cardiorespiratory fitness

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The Importance of VO2 Max in Reducing Mortality Risk

VO2 Max, a measure of cardiorespiratory fitness, plays a crucial role in determining overall health and longevity. Individuals with higher VO2 Max levels have significantly lower risks of death compared to those with lower levels. The data shows that even a small improvement in VO2 Max can lead to substantial reductions in mortality risk, making it a vital metric for health and fitness. Prioritizing aerobic exercise and striving to reach higher fitness categories can help mitigate the risks associated with conditions like heart disease, hypertension, and kidney failure.

About the site creator

Dr. Eugene Lucas is a physician with board-certifications in Internal Medicine (2016), Clinical Informatics (2019), and Obesity Medicine (2020). He has been working at Weill Cornell Medicine as an Obesity Medicine specialist for several years and continues to provide care for about 1,000 patients.

Dr. Lucas became interested in Obesity Medicine before the “age of Ozempic.” His interest in this field of medicine developed from realizing that achieving optimal body weight leads to total health improvements. For example, through weight loss a patient who previously had obesity can better control diabetes, hypertension, and osteoarthritis, while reducing their risk of heart attacks, strokes, and cancer. Weight loss for individuals with excess weight can therefore reduce the number of medications needed to combat/control various disease states. Dr. Lucas felt that this area of focus, through attention to each patient’s dietary and exercise habits, also oriented him towards understanding his patients as people first.

As Dr. Lucas saw how effective GLP-1 medications were for facilitating weight loss, he developed a strong and ongoing interest to educate himself on strategies to help patients make health improvements beyond weight loss alone. As Dr. Lucas tells his patients, people are so much than a number on a scale, and their plan to optimize their health should reflect that. Dr. Lucas’s depth of knowledge soon grew (and continues to grow), and he started covering a broader range of topics with his patients. The more he learned, the more he felt compelled to share with his patients. In doing so, Dr. Lucas frequently found the information overload from social media led many patients to feel overwhelmed or to draw in-accurate conclusions about various health improvement strategies. This website serves as an opportunity to share more of the existing evidence with a greater number of people, and to help individuals understand the difference between signal (evidence-based and important strategies) and noise (exaggerated, misleading, clickbait, etc ). Dr. Lucas hopes you find at least some of this information to be as important and as exciting as he does.

Dr. Lucas is active as @elucasmd on twitter/X and tiktok.

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