There was scepticism surrounding the Tour de France 2023: could Danish cyclist Jonas Vingegaard really be that fast? So much better than the others? If so, how? And because there was no other explanation, some cycling fans focused on one number for a few days to explain his performance: Vingegaard's VO2 max value.
The VO2 max value is one of the most important performance markers in endurance sports. It indicates the maximum amount of oxygen a human body can absorb and utilise under stress. And this has a decisive influence on how much energy an athlete still has available when biking up a steep hill. Or when running the last lap of a race.
In the case of Vingegaard, then 26, this value was supposed to be 97. In other words, Vingegaard's body was supposedly able to process 97 millilitres of oxygen per kilogram of body weight per minute. For men around 30 who are not involved in competitive sports, values above 45 are considered good. Vingegaard's 97 was slightly higher than the highest value ever measured. The speculation surrounding it showed how interesting the figure has become for many.
Born with your values
For a long time, oxygen metabolism was only an issue in competitive sports, but, for some time now, it has also been making a career outside of this. Many fitness watches, so-called wearables, display it to their wearers, and the VO2 max value has also been of interest in medicine for some time. This is because it is not only an indicator of top performance in the Tour de France or the Olympics, but also of life expectancy.
But what exactly does this value mean? And can it be improved?
“Unfortunately, you are born with your values,” says Billy Sperlich. He is a professor of training science at the Würzburg University, a former triathlete and a recognised endurance expert. Sperlich says that three things are relevant for the VO2 max level: how well the body can absorb oxygen, that is how well the lungs work; how much oxygen the body can then send to the muscles, that is how powerful the heart is and how well the blood transports the oxygen; and, finally, how much of it can be utilised there by the mitochondria, the cell's power plants, and converted into energy. Although the term “maximum oxygen uptake” is also used instead of VO2 max, the value integrates more: uptake, transport and utilisation.
Lung intake is rarely a limiting factor, says Sperlich. So most of us can get more than enough oxygen from the air. “It may sometimes feel like our lungs are on fire, but they still provide us with an excellent supply,” he says.
Transport and processing are more likely to cause difficulties. This is why VO2 max is also dependent on certain genetic conditions: the number of blood cells, for example, or the number of capillaries that deliver oxygen to the cells. If you are genetically well positioned, you are potentially also a talented endurance athlete. And vice versa: if you do not have good prerequisites, you cannot train your way to the top. “Someone with an oxygen intake of 40 millilitres is highly unlikely to reach the 80s,” says Sperlich.
But, just as everyone can improve their fitness, everyone can also increase their own oxygen metabolism―regardless of their basic values. And this is not only interesting for ambitious amateur athletes, but for anyone who wants to live healthier for longer.
“The VO2 max value is the most important independent predictor of remaining life expectancy,” says Barbara Prüller-Strasser, a sports and health scientist at the Sigmund Freud Private University in Vienna who specialises in the influence of sport on rehabilitation and prevention.
Prüller-Strasser says that no other single value or risk factor can be used to make statements about mortality risk with such high probability. And this applies to both healthy and chronically ill people. “You cannot extend the genetically determined lifespan by having a particularly good maximum oxygen uptake,” she says. But you can push this range to the limit if you increase your level of fitness.
Live five years longer
Essentially, the higher the VO2 max value, the lower the risk of death. This is shown particularly impressively by long-term studies such as one from Copenhagen, which measured the maximum oxygen uptake of more than 5,000 men with an average age of just under 49 and examined how the value correlated with the later age at death. The result, 46 years after the original VO2 max measurement: the test subjects with exceptionally high VO2 max values lived on average almost five years longer than those with below-average values. And even those with a VO2 max in the lower normal range lived around two years longer than those who were clearly below average.
The results of other studies that investigated a correlation between VO2 max values and mortality in men and women also revealed that there is a connection between maximum oxygen metabolism and life expectancy.
The physiological reasons for this vary, but can be easily broken down: particularly good fitness goes hand-in-hand with a particularly well-functioning cardiovascular system and a good metabolism. And if your cardiovascular system and metabolism function particularly well, you have a lower risk of many diseases. Precisely because the VO2 max value is influenced by different areas of the system―absorption, transport, processing―it is a good indicator of the risk of certain diseases.
“The lower the value, the greater the likelihood that I will develop metabolic diseases, cardiovascular diseases or even some types of cancer,” says Sperlich. And conversely, the rule of thumb is: the higher the fitness level, the better for your health.
Boosting techniques
“Intensive interval training is a particularly effective method,” Sperlich says. In other words: run or cycle for a few minutes close to your maximum performance, then take a short break. If you do this often, you can increase your oxygen intake in a short time, by around half a per cent per week.
Yet Sperlich would necessarily recommend that to everyone. After all, those who are not yet trained to a high level can also increase their fitness―including their maximum oxygen uptake―through plenty of exercise and low-intensity endurance training, that is endurance running. Although your VO2 max does not increase as quickly―or as much as a result―the body becomes more efficient: it needs less oxygen to run at the same pace.
Over time, you can increase your pace to increase your VO2 max even more. From a certain level, an increase becomes more difficult. “To increase the value by more than 10 or 20 per cent, you have to put in a lot of effort,” Sperlich says.
The effects of ageing
The VO2 max value decreases with age, but from a health perspective, a certain level of basic fitness is the most important anyway. Prüller-Strasser says: “The difference between VO2 max values of 35 and 50 is much more relevant than the difference between 50 and 65.” And even higher values have hardly any effect on health, says.
Prüller-Strasser. Even 65 is already extremely high, a value that is usually only achieved by very well-trained endurance athletes. In professional football, for example, many are likely to be below that.
At an older age, 35 to 45 millilitres can also be an exceptionally good value. That figure can be slightly lower for women. For healthy middle-aged people, such a value is average. This is because from around the age of 30, the VO2 max value decreases by around 10 per cent every 10 years.
Yet this shrinking effect can also be slowed through training, Prüller-Strasser says. If you are particularly active, you can still be in the same shape as a 50-year-old at the age of 70. And, she adds, “It is never too late.” Even if people who are already fit before they get old naturally have an advantage, fitness can still be trained up to a certain level in old age. In general, an increase of just 3 to 4 millilitres can be expected to reduce the risk of mortality by 10 to 25 per cent.
Testing VO2 max values
One question remains: determining the exact value still involves money and effort. Smartwatches such as those from Apple or Garmin do display it, but this information is only an estimate based on the heart rate. There can be inaccuracies, Sperlich says, especially in the case of fairly unfit and particularly fit people.
“However, in a range between 40 and 55, where the manufacturers have a lot of data, the estimates are relatively good,” Sperlich says.
If you want to find out your exact value, you should have it tested on a treadmill or ergometer in the laboratory. This can be useful for really ambitious endurance athletes. But if you do not need to be completely precise, you can also try out performance tests that can be used to determine your approximate VO2 max value, says Sperlich: the shuttle run test, for example, which provides comparatively good information, or the Harvard step test.
As far as we know, the record for the highest VO2 max value ever measured is still held by the Norwegian Oskar Svendsen, a former racing cyclist and junior world time trial champion. He achieved a measurement of 96.7.
Vingegaard's score, on the other hand, was not actually 97, but probably in the 80s; this was reported a few days after the initial excitement in 2023. Still, it was enough to win the Tour de France.