Thanks! As a 70 year old runner and retired statistical researcher, I have questioned the VO2 max results from my Garmin. Thanks for providing a clearer way to view and not view my fitness.
Thanks so much for this helpful and important post, Eric. With Attia having just resigned from NBC News for his connections with Epstein, the snake-oil salesman aspects of his longevity spiel come as no surprise. I have to admit, I fell prey to the VO2 max craze. Although it is not quite the same, it reminds me of the 10,000-step myth, which also lacked a firm scientific basis. My question is whether Attia knew he was pushing what he called 'science' with unfounded claims.
Im a retired 75 yo primary care MD and live at 7000 feet sometimes I still train for skiing climbing backpacking Two days ago I did a freadmill workout this is I carry a 12 lb weight in each hand translated that means I dont hold onto the treadmill I gradually increase the speed to about 3MPH at 12 to 14 degrees incline after about 30 minutes I put the weights down and speed it up to 4.2 MPH at 15 degrees elevation and hang on to the treradmill for a few minutes often this almost stage 4 Bruce protocal dessert allows me to start catching my breath and wind down I never had a VO2 Max Been learning lots of antiaging medicine in my retirement and hopefully will start giving lectures locally
Excellent I prefer to cycle & when the roads are messy I walk/hike with poles (keeps your pace constant, very stable) wearing essentially a miliary flac-vest with steel plates...those who choose to run/jog wearing such a vest are asking for joint problems. All the best & safe hiking!
Good observations. However it would be useful to mention that MET was originally defined as 3.5 ml/kg/min of oxygen. Somewhat arbitrarily. It then make sense that Peter Attia would draw an equivalence between MET and VO2, and consequently between the highest MET and VO2max for the mortality data. But of course he should have attributed that in his graph. Obviously MET defined like that is just a convention, probably not applicable to any individual, and perhaps not even to a population, but there it is.
So many issues with VO2 max. As a former triathlete in my 30s/40s with elite level VO2 max at the time I can attest that not only is Vo2 max obsession not useful it can also be harmful. I ended up with some Afib about 5 years after stopping the tris (left ventricle enlargement in addition to some lifestyle issues for sure). Luckily after a single cardioversion/eliminating alcohol/losing 40 lbs, fixing sleep, lowering stress etc. and some beta blockers it has gone away and I am left with minimal PVCs. Did a stress test in 2023 at age 57 and Mets were still 13.5 with a lot less cardio work, lots of hiking, kayaking and weight training. HIIT twice per week for 15-20 minutes each and good to go. I enjoy the activities, work to overall fitness without obsession and a heck of a lot happier. Thanks Eric (we met years ago when i was running Sg2 and i've followed your work which is really important).
i've also read studies that elite cyclists have a 7 fold higher rate of AFIB then the rest of the population. Oxidative stress? Heart thickening? Ventricular enlargement? Who knows but obsessing on Vo2 max is not useful. Can you walk briskly, can you climb a ten degree hill for a half mile on a hike.. there are other measures that get you there with a smile. Btw- Bill Davis was my cardiologist out there (HLI)
As always, love following along with all your posts! I would think there would be a very high correlation between CRF and VO2 max scores. If you ranked in the top tier of CRF, would you most likely be in the high tier for VO2 max? Is the biggest issue that wearables are not accurate? If they were lab grade results, would that change your view? I get an annual lab test and it is an easy, one number overall assessment of my fitness. Maybe it’s a waste of time 😂.
yes, there's correlation with CRF and V02 max but all the solid data for outcomes are based on CRF, Wearables aren't accurate and can induce unnecessary anxiety. Trying to help folks not waste time or money!
Dr. Topol thank you & once again another excellent distillation of fact vs fiction or maybe conflation.
I am a lifelong cyclist including my ride across Canada, not my boast I just enjoyed the ride. There were companions who had hips & knees replaced, learned to walk again from a horrific car accident...they remain champions.
Never wasted time or money on VO2 max testing, although I have a good value for my max HR from 25 yr's ago...no interest in searching/sweating for it again haha
Those above know you need real food & low cost electrolyte fluids to exercise for hr's.
BTW peanut butter/jam sandwiches, chocolate milk with Carnation Instant pwd fueled my ride 25 yr's ago...today same liquid with Fig Newtons™
As a clinician focusing on metabolic health, I have seen that VO2, exercise metabolic assessment and ventilatory threshold testing is helpful for training guidance for building endurance, aerobic and anaerobic power, movement efficiency, and for sports nutrition education. Of course this would be in the context of high quality metabolic cart equipment and trained physiologists conducting testing, and expert interpretation. Having overseen more than 4000 such tests I certainly see high value. Since baseline and ability to improve are largely genetically determined - there’s a lot of variance and it’s silly to link it to longevity. Cardiac output is of course a major contributor. I don’t fault anyone for wanting to get baseline and sequential testing professionally as part of applying specific training strategies to identify and target their personal strengths and limitations and various cardiopulmonary health and fitness aspects and training goals.
I'm not faulting anyone but trying to set the record straight about the CRF data and problem with wearables. Thanks for your perspective, which is valuable
Thanks! As a 70 year old runner and retired statistical researcher, I have questioned the VO2 max results from my Garmin. Thanks for providing a clearer way to view and not view my fitness.
Glad it was helpful. Thank you.
Thanks so much for this helpful and important post, Eric. With Attia having just resigned from NBC News for his connections with Epstein, the snake-oil salesman aspects of his longevity spiel come as no surprise. I have to admit, I fell prey to the VO2 max craze. Although it is not quite the same, it reminds me of the 10,000-step myth, which also lacked a firm scientific basis. My question is whether Attia knew he was pushing what he called 'science' with unfounded claims.
Exactly. Thanks Naomi
Correction. It is CBS News, not NBC.
Im a retired 75 yo primary care MD and live at 7000 feet sometimes I still train for skiing climbing backpacking Two days ago I did a freadmill workout this is I carry a 12 lb weight in each hand translated that means I dont hold onto the treadmill I gradually increase the speed to about 3MPH at 12 to 14 degrees incline after about 30 minutes I put the weights down and speed it up to 4.2 MPH at 15 degrees elevation and hang on to the treradmill for a few minutes often this almost stage 4 Bruce protocal dessert allows me to start catching my breath and wind down I never had a VO2 Max Been learning lots of antiaging medicine in my retirement and hopefully will start giving lectures locally
Excellent I prefer to cycle & when the roads are messy I walk/hike with poles (keeps your pace constant, very stable) wearing essentially a miliary flac-vest with steel plates...those who choose to run/jog wearing such a vest are asking for joint problems. All the best & safe hiking!
Impressive! thanks
Good observations. However it would be useful to mention that MET was originally defined as 3.5 ml/kg/min of oxygen. Somewhat arbitrarily. It then make sense that Peter Attia would draw an equivalence between MET and VO2, and consequently between the highest MET and VO2max for the mortality data. But of course he should have attributed that in his graph. Obviously MET defined like that is just a convention, probably not applicable to any individual, and perhaps not even to a population, but there it is.
So many issues with VO2 max. As a former triathlete in my 30s/40s with elite level VO2 max at the time I can attest that not only is Vo2 max obsession not useful it can also be harmful. I ended up with some Afib about 5 years after stopping the tris (left ventricle enlargement in addition to some lifestyle issues for sure). Luckily after a single cardioversion/eliminating alcohol/losing 40 lbs, fixing sleep, lowering stress etc. and some beta blockers it has gone away and I am left with minimal PVCs. Did a stress test in 2023 at age 57 and Mets were still 13.5 with a lot less cardio work, lots of hiking, kayaking and weight training. HIIT twice per week for 15-20 minutes each and good to go. I enjoy the activities, work to overall fitness without obsession and a heck of a lot happier. Thanks Eric (we met years ago when i was running Sg2 and i've followed your work which is really important).
i've also read studies that elite cyclists have a 7 fold higher rate of AFIB then the rest of the population. Oxidative stress? Heart thickening? Ventricular enlargement? Who knows but obsessing on Vo2 max is not useful. Can you walk briskly, can you climb a ten degree hill for a half mile on a hike.. there are other measures that get you there with a smile. Btw- Bill Davis was my cardiologist out there (HLI)
As always, love following along with all your posts! I would think there would be a very high correlation between CRF and VO2 max scores. If you ranked in the top tier of CRF, would you most likely be in the high tier for VO2 max? Is the biggest issue that wearables are not accurate? If they were lab grade results, would that change your view? I get an annual lab test and it is an easy, one number overall assessment of my fitness. Maybe it’s a waste of time 😂.
yes, there's correlation with CRF and V02 max but all the solid data for outcomes are based on CRF, Wearables aren't accurate and can induce unnecessary anxiety. Trying to help folks not waste time or money!
Dr. Topol thank you & once again another excellent distillation of fact vs fiction or maybe conflation.
I am a lifelong cyclist including my ride across Canada, not my boast I just enjoyed the ride. There were companions who had hips & knees replaced, learned to walk again from a horrific car accident...they remain champions.
Never wasted time or money on VO2 max testing, although I have a good value for my max HR from 25 yr's ago...no interest in searching/sweating for it again haha
Those above know you need real food & low cost electrolyte fluids to exercise for hr's.
BTW peanut butter/jam sandwiches, chocolate milk with Carnation Instant pwd fueled my ride 25 yr's ago...today same liquid with Fig Newtons™
JJF Phm 🇨🇦
thanks! max HR is such a good metric
As a clinician focusing on metabolic health, I have seen that VO2, exercise metabolic assessment and ventilatory threshold testing is helpful for training guidance for building endurance, aerobic and anaerobic power, movement efficiency, and for sports nutrition education. Of course this would be in the context of high quality metabolic cart equipment and trained physiologists conducting testing, and expert interpretation. Having overseen more than 4000 such tests I certainly see high value. Since baseline and ability to improve are largely genetically determined - there’s a lot of variance and it’s silly to link it to longevity. Cardiac output is of course a major contributor. I don’t fault anyone for wanting to get baseline and sequential testing professionally as part of applying specific training strategies to identify and target their personal strengths and limitations and various cardiopulmonary health and fitness aspects and training goals.
I'm not faulting anyone but trying to set the record straight about the CRF data and problem with wearables. Thanks for your perspective, which is valuable
I did not find tsblrs of figures in this article. Joyce Evans
they are all there, I can assure you
I did not find tables or figures in this article. Joyce Evans