Every breath you take: Measuring peak VO2


As an endurance athlete, your peak athletic performance is determined by your VO2 max, the maximum amount of oxygen that you can consume per unit of time. You can increase your peak VO2 through training, and it has been shown that high intensity training, or HIT, is the most effective way to do so. While we know that peak VO2 declines with age by as much as 10% per decade, recent studies suggest that this decline can be attenuated through training.

Peak VO2 can be measured objectively and reproducibly in the stress lab with cardiopulmonary exercise testing, or CPET, which employs a mask and a metabolic cart that analyzes gas exchange. We can also identify the ventilatory, or anaerobic, threshold, the point at which CO2 production exceeds O2 consumption.

What is a “normal” value for peak VO2? An elite athlete may have a peak VO2 of 80, a patient with severe congestive heart failure a peak VO2 of 10. Traditionally we have relied on the Wasserman equation which factors in age and weight but was derived from a relatively small number of sedentary adults. The recently published FRIEND registry utilizes data from several thousand subjects and provides percentile rankings for both men and women. For example, a 35 year old woman with a peak VO2 of 36 would be in the fiftieth percentile for her age group (30-39). Importantly, an unexpected decline in peak VO2 can indicate an underlying problem that warrants further investigation.

Photo by Andreas Fidler on Unsplash


  1. Hi , Craig. Is it clear where the decreases in VO2 max are coming from with age? For instance, is the majority of the slowdown from a decrease in max heart rate (and where would that be from?), a metabolic slowdown in the liver, a decrease in lung capacity/function, etc.


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