I’m running on a treadmill. A face mask is tightly strapped over my mouth and nose. A series of tubes runs from the mask to a small backpack pinned across my shoulder blades. There is a loud beeping sound and the treadmill speeds up, taking me from a brisk jog into a light sprint.

“When you feel like you can’t run any more, we want you to push for another five or 10 seconds,” yells a trainer from the sidelines. He’s holding an iPad. A number of graphs and stats are blinking on the screen. “Keep going.” The treadmill picks up again and I get a little faster. Trying to keep pace just after the 12-minute mark, sweat drips from my brow and my breathing is heavy.

I look like a super villain. I feel like a lab rat. This is a VO2 max test. Previously, these tests were exclusive to research labs and elite athletic facilities, helping endurance athletes and elite level performers create a competitive edge during a match or race. Now they’ve gained traction among the general public: Influencers such as YouTuber Peter Attia, author of Outlive: The Science and Art of Longevity, have referred to V02 max as the “the greatest predictor of lifespan.”

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VO2 max tests used to be exclusive to research labs and elite athletes. Now, they’ve gained traction among the general public.

Medical doctors have said it is one of the best indicators of overall health. A meta analysis published in the Journal of Translational Sports Medicine called VO2 max “the gold standard measure of cardiorespiratory fitness.” Cardiorespiratory fitness is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes, according to a statement from the American Heart Association.

“I think VO2 max is the most critical measure of overall fitness and overall health,” said Dr. Martin Gibala, a professor of kinesiology at McMaster University, whose lab conducts applied research examining the impact of training and nutrition on health and performance.

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While the test itself can feel intimidating – not everyone likes to push themselves to their physical limit on a treadmill – Gibala believes that it may be more useful information than other common evaluations at the doctor’s office.

Below we walk through what the test is, how you can improve your score, and whether or not it’s worth paying for.

The test evaluates the maximum amount of oxygen the body uses during intense physical exercise.

VO2 max stands for maximum volume of oxygen. It’s also referred to as “maximal oxygen uptake” and “maximal aerobic capacity.” Your VO2 max score indicates the integrated capacity of your heart, your lungs, your blood vessels, and your muscles’ ability to use oxygen. Muscles rely on oxygen for fuel. The more intense the activity, the more oxygen they need. So a higher VO2 max, the better capacity you have for intense physical exercise.

The test itself takes place on an exercise bike or treadmill, wearing a face mask that measures your oxygen consumption and carbon dioxide production. The intensity of the exercise incrementally increases until you’re working at your maximum capacity. Tests normally take about 10 to 15 minutes.

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Many wellness centres have started offering VO2 max tests, with an average cost between $120 and $300. Alternatively, a number of fitness trackers give users an estimate of their VO2 max score. Popular brands such as Whoop and Oura Ring give users a VO2 max score, while Apple Watch labels the data as “Cardio Fitness.”

The accuracy of this data can vary widely depending on the equipment used for the test and/or who is overseeing the experiment. For the gold standard in VO2 max accuracy, it’s best to head to a research clinic. But even a ballpark estimate of your VO2 max numbers can be useful, according to some experts.

A handful of factors contribute to your VO2 max: Weight, age, biological sex, and genetics all play a part. So does your fitness level and training regime. It’s measured in millilitres of oxygen used for each kilogram of body weight per minute. An athletic man will have a VO2 max of around 50-60 (ml/kg/min) while the average guy will be close to 40 (ml/kg/min). For women, those numbers are about 10 to 15 per cent lower, based on physiological differences.

If you’re looking to improve your VO2 max score, fitness programming largely depends on where your starting point is. According to Gibala, anyone in the lowest category should see improvement by getting the recommended minimums for exercise suggested by Canada’s physical activity guidelines. That’s 150 minutes of moderate to vigorous physical activity.

For anyone with an average VO2 trying to up their game, both high intensity cardio training and more moderate exercise can be impactful. Losing weight can also help though the relationship between weight and V02 max has proved controversial.

Athletes looking to improve their performance and people concerned with longevity might want to pay for the test. Everyone else? It largely comes down to your interest level. While the data points associated with your VO2 max can be a great indicator of your overall health, the changes you can make to improve your score – spend more time exercising, lose some weight – are advised for most people looking to get in better shape.


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