1: “Let’s say you are a fifty-year-old woman, and you enjoy hiking in the mountains,” Peter Attia MD writes in Outlive: The Science and Art of Longevity..
“That’s how you want to spend your retirement.”
Yesterday, we examined the correlation between longevity and our VO2 max, the maximum rate at which our bodies can utilize oxygen.
VO2 max “turns out to be highly correlated with longevity,” Peter explains. “A 2018 study in JAMA that followed more than 120,000 people found that higher VO2 max (measured via a treadmill test) was associated with lower mortality across the board. The fittest people had the lowest mortality rates—by a surprising margin.”
To hike in the mountains requires a VO2 max of about 30. Let’s assume the woman mentioned above is in the 50th percentile for her age, which puts her at about 32 ml/kg/min.
She can go for a hike now. Which seems like good news.
Wrong. “It’s really bad news,” Peter notes. “Studies suggest that your VO2 max will decline by roughly 10 percent per decade—and up to 15 percent per decade after the age of fifty.
“So simply having average or even above-average VO2 max now just won’t cut it,” he notes. “If we are only starting at 32 ml/kg/min now, at fifty, we can expect to be closer to 21 ml/kg/min at age eighty.”
Here’s the thing: These are not just abstract metrics.
“They represent a profound decline in function,” Peter observes. “It’s the difference between walking easily up a flight of stairs versus struggling to even walk on an inclined surface.”
If our fifty-year-old woman wants to be able to hike in the mountains in her eighties, she would need a VO2 max of about 45 to 49 right now.
Which brings us to Peter’s bigger point: “The more active we want or plan to be as we age, the more we need to train for it now.”
2: So, how trainable is VO2 max?
“The beauty of this is that VO2 max can always be improved by training, no matter how old we are,” Peter writes.
Literally. As in “the amazing Frenchman named Robert Marchand, who set an age-group world record in 2012 by cycling 24.25 kilometers in an hour, at the age of 101,” Peter writes.
“Apparently, he wasn’t satisfied with that performance, so he decided he needed to train harder. Following a strict program designed by top coaches and physiologists, he managed to boost his VO2 max from an already-impressive 31 ml/kg/min up to 35 ml/kg/min, which would put him in the elite 2.5 percent of men in their eighties.
“Two years later, now 103, he came back and broke his own record, riding almost twenty-seven kilometers in an hour. That’s impressive, and it shows that it’s never too late to improve your VO2 max.”
3: To train VO2 max typically requires one workout per week. We “don’t need to spend very much time in the pain cave,” Peter notes.
“Where HIIT intervals are very short, typically measured in seconds, VO2 max intervals are a bit longer, ranging from three to eight minutes—and a notch-less intense,” he explains. “I do these workouts on my road bike, mounted to a stationary trainer, or on a rowing machine, but running on a treadmill (or a track) could also work.
“The tried-and-true formula for these intervals is to go four minutes at the maximum pace you can sustain for this amount of time—not an all-out sprint, but still a very hard effort.
“Then ride or jog four minutes easy, which should be enough time for your heart rate to come back down to below about one hundred beats per minute. . . We want to make sure that we get as close to fully recovered as possible before beginning the next set.
“If we fail to recover sufficiently between sets, we will not be able to reach our peak effort in the working sets, and we’ll consequently miss the desired adaptation.
“Repeat this four to six times and cool down.”
Take note, however. While only one workout per week will suffice, it is still a long-term game. Results take time, however. “I tell my patients that this is not a two-month project; it’s a two-year project,” Peter notes.
There are other benefits to VO2 max training as well. Peter writes: “Keep in mind, increasing our VO2 max by any amount is going to improve our lives, not only in terms of how long we live but also how well we live, today and in the future.
“Improving our VO2 max from the very bottom quartile to the quartile above (i.e., below average) is associated with almost a 50 percent reduction in all-cause mortality, as we saw earlier.”
Onward and more tomorrow!
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Reflection: Have I ever measured my VO2 max? How’s my overall level of fitness?
Action: Discuss with a friend or colleague.
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