Biomarkers · Functional Fitness
Cardiorespiratory Fitness (VO2 Max)
Higher values go with lower risk of death. Not measured in our NHANES panel. The curve is drawn from the published study (source below).
VO2 Max and risk of death
Published curve higher than the NHANES fitNHANES fit higher
Risk of death relative to the curve's reference value, drawn from the published study (source below).
VO2 Max by age and sex
Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.
The percentiles as a table
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 27.8 | 33.7 | 39.3 | 45.2 | 56.6 | 2,339 | NHANES 1999-2004 |
| All | 40-49 | 25.8 | 32.3 | 37.6 | 44.0 | 56.4 | 908 | NHANES 1999-2004 |
| All | all | 27.0 | 33.3 | 38.7 | 45.0 | 56.6 | 3,247 | NHANES 1999-2004 |
| Men | 20-39 | 32.1 | 38.0 | 42.8 | 47.8 | 59.5 | 1,255 | NHANES 1999-2004 |
| Men | 40-49 | 30.8 | 37.0 | 41.1 | 46.9 | 61.3 | 469 | NHANES 1999-2004 |
| Men | all | 32.0 | 37.6 | 42.5 | 47.3 | 59.7 | 1,724 | NHANES 1999-2004 |
| Women | 20-39 | 25.9 | 30.9 | 35.0 | 40.4 | 51.3 | 1,084 | NHANES 1999-2004 |
| Women | 40-49 | 23.0 | 29.0 | 33.6 | 39.4 | 52.8 | 439 | NHANES 1999-2004 |
| Women | all | 25.2 | 30.5 | 34.4 | 40.0 | 51.3 | 1,523 | NHANES 1999-2004 |
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in VO2 Max, study by study
7 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| exercise | High-intensity interval training (HIIT) or continuous endurance training (>=2 weeks) in healthy adults aged 18-45 | HIIT raised VO2max by 5.5 mL/kg/min (±1.2) and continuous endurance training by 4.9 (±1.4) vs no-exercise controls; HIIT exceeded endurance training by 1.2 (±0.9) | meta-analysis | Milanovic Z, et al. Sports Med. 2015;45:1469-1481. |
| exercise | Polarized endurance training (low-intensity base plus HIIT) | 9 weeks of polarized training raised VO2peak by 6.8 mL/kg/min (11.7%) in well-trained athletes; high-volume training had no further effect | RCT | Stöggl T, et al. Polarized training has greater impact on key endurance… |
| exercise | Supervised aerobic, resistance, combined or high-intensity interval training programmes in adults with overweight or obesity | VO2max increased by 3.82 mL/kg/min (95% CI 3.17-4.48) across all training types | meta-analysis | van Baak MA, Pramono A, Battista F, et al. Effect of different types of regular… |
| exercise | Cardiorespiratory (aerobic) training programmes in ambulatory stroke survivors | VO2 peak increased by 3.40 mL/kg/min (95% CI 2.98-3.83) after cardiorespiratory training (moderate-certainty evidence) | meta-analysis | Saunders DH, Sanderson M, Hayes S, et al. Physical fitness training for stroke… |
| exercise | Short-interval high-intensity interval training (10 x 1 min at 80-100% heart-rate reserve with 1-min recovery), 3 days/week for 12 weeks in people >=6 months post-stroke | VO2 peak rose 3.52 mL/kg/min (95% CI 2.47-4.57) with HIIT vs 1.71 (0.55-2.86) with MICT at 12 weeks (between-group 1.81, 95% CI 0.58-3.04) | RCT | Moncion K, Rodrigues L, De Las Heras B, et al. Cardiorespiratory Fitness… |
| exercise | Supervised moderate-intensity continuous endurance training 5 x 40 min per week for 3 months in sedentary patients with heart failure with preserved ejection fraction | Peak VO2 +1.6 vs -0.6 mL/kg/min with guideline advice at 3 months (difference 2.0, 95% CI 0.9-3.1); HIIT difference 1.5 (0.4-2.7) | RCT | Mueller S, Winzer EB, Duvinage A, et al. Effect of High-Intensity Interval… |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Severe heart failure with reduced ejection fraction | Severe HF transplant candidates had peak VO2 <=14 ml/kg/min; peak VO2 was the best survival predictor (% impairment not reported) | prospective cohort | Mancini DM, et al. Circulation. 1991;83:778-786. |
| lifestyle | Physical inactivity (10 days of bed rest) | 10 days of bed rest lowered maximal aerobic capacity by 12% in healthy older adults (n = 11) | non-randomised trial | Kortebein P, et al. Functional impact of 10 days of bed rest in healthy older… |
Sources
- Risk curve: Mandsager K 2018 (PMID 30646252): all-cause HR 0.2 (0.16-0.24) elite (>=97.7th percentile) vs low (<25th percentile) age- and sex-matched fitness (peak estimated METs). Scaled to US values (NHANES).
- Mandsager K, et al. Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Netw Open. 2018;1(6):e183605.
Map Cardiorespiratory Fitness (VO2 Max) against another biomarker.
Related markers: Chronotropic Index · Daily Movement (Wrist Accelerometer, MIMS) · Daily Step Count · Exercise Capacity (METs) · FEV1/FEV6 Ratio · Forced Expiratory Volume in 1 Second (FEV1) · Forced Vital Capacity (FVC) · Heart Rate Recovery (1 min)