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Is VO2Max the best predictor of lifespan?

Old 05-07-24, 09:08 AM
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Is VO2Max the best predictor of lifespan?

Peter Attia has been saying this, and now a new GCN video repeats it.

This is not a criticism of the main point, which is that cardiorespiratory fitness is a good thing to have. That seems unassailable. The question I'm raising is whether VO2Max measurements, especially using the current generation of wearables (like Whoop, or Apple watches, or Garmin watches, or the Oura ring), or VO2Max estimates from running or cycling or rowing tests are accurate, precise, or, in fact, necessary.

Much of the long-term evidence that cardiorespiratory fitness matters for longevity comes from the Copenhagen study, which has tracked adult men since 1970, so more than 50 years. In the Copenhagen study, the original cohort were middle-aged men who were given an ergometer test to estimate their VO2Max and asked some questions about their lifestyle and then-current disease status. Then these men were followed up for nearly 50 years, to look at mortality from any cause. It turns out that their VO2Max scores back at the time of enrollment did a good job of predicting lifespan.

But we know that other measures of cardiorespiratory fitness are highly correlated with VO2Max -- a rising tide lifts all boats. If you have a power meter (and I know most people don't) and you track FTP, or CP, or some other similar measure, my guess is that these are just as good and (if you already have a power meter and I know most people don't) more convenient and cheaper to do. In addition, there appears to be a lot of variance in VO2Max estimates made by Apple watches, Whoop bracelets, and power meters (they do seem to move together, but the actual raw numbers appear to vary a lot).

Bottom line, I think cardiorespiratory fitness is important--I'm just not sure that it's worth it to go out and do a specific test to estimate VO2Max, or to buy an Apple or Garmin watch to get their VO2Max estimates. Because of the variance in VO2Max estimates, I'd also be pretty wary of looking at those VO2Max tables and saying either "Oh No!" or "Woohoo!" because of your score.
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Old 05-07-24, 11:16 AM
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"Really high VO2, but he got hit by a distracted driver."
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Old 05-07-24, 12:02 PM
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I thought it was grip strength




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Old 05-07-24, 12:08 PM
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I guess I will be checking out soon....
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Old 05-07-24, 04:15 PM
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Best idea: don't ever look at that stuff. Bad for your heart.

That said, my numbers have always been crappy and my guess is that I will not be long-lived. But I've had and am having a helluva good time.
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Old 05-07-24, 06:26 PM
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I just make sure that I include enough intensity in my training to maintain my VO2 max, regardless of how accurate the measurement is. The various devices I have that estimate VO2 max all appear to suggest Im hovering around 50 and it hasnt dropped over the last 5 years, which is quite encouraging. My FTP has also been pretty consistent over that period.

From what I recall of Peter Attias book, the link with longevity appears to revolve around the idea of maintaining our basic mobility in old age, which requires a minimum VO2 max. Once we drop below that minimum value (18 seems to ring a bell) our days are numbered. So having a much higher VO2 max in midlife gives us a larger buffer before we reach that critical level and therefore we should survive longer.
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Old 05-07-24, 06:32 PM
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If VO2max is all that, why do women outlive men?

Seriously, though, its clearly a marker of something important and presumably correlates with a whole batch of other health parameters, but Im not
sure that maximal oxygen uptake per se is keeping anyone alive unless theyre trying to cross a busy street. The point about estimation is also well taken.

Last edited by MoAlpha; 05-07-24 at 07:17 PM.
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Old 05-08-24, 04:03 AM
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I think the number simply paints an overall picture of health. And I imagine there is a point of diminished returns.

And the extremes on either side of the scale probably skew the numbers.
-Example - fire drill at work last week. As a floor fire captain(yes, I'm a dork) - I have to wait until the floor/stairwell is cleared. We had three employees at their limits walking DOWN the stairs. VO2 max levels were probably less than 10, maybe 5.

I do think cycling VO2 max estimates paint a decent picture but doesn't tell the entire story.

Assuming the same power output - an 80kg rider like myself with lean with upper body muscle will have a lower cycling VO2 max than a 60kg cyclist that's built like a T-Rex. Almost 15 points lower. They will climb faster - but are they really healthier/will they live longer in general? And is their true VO2 max actually 15 points higher?

Rowing/cross country skiing would probably lead to more accurate results.
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Old 05-08-24, 07:55 AM
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Originally Posted by Jughed
I imagine there is a point of diminished returns.
From what I remember, no one has actually found one, which is one reason people are so excited about it.
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Old 05-08-24, 08:57 AM
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Originally Posted by MoAlpha
From what I remember, no one has actually found one, which is one reason people are so excited about it.
I was thinking of the extreme levels a pro athlete/cyclist has to go through in order to get a VO2 80++. Or to maintain a super high level throughout life.

You need to be extremely skinny/lean - possibly lean past the point of being truly healthy. You need to do fairly extreme levels of intense exercise - 15-20-25+ hours per week, with large amounts of threshold, VO2 and beyond levels of intensity. Then you need to consume mass amounts of extra fuel, which can be taxing to every system in the body.

Similar to how one can have too much muscle mass and all that's required to gain/maintain that mass.
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Old 05-08-24, 09:55 AM
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Originally Posted by Jughed;23234680[b
]I was thinking of the extreme levels a pro athlete/cyclist has to go through in order to get a VO2 80++[/b].
No matter how long they may live, the few among us who are that elite achieve some form of immortality.
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Old 05-08-24, 11:23 AM
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I like GCN and Dan in particular. It is unfortunate that they are dissolving. VO2max, as measured in the lab, may be an important metric for getting a pro contract in an endurance sport or getting on a development team. For juniors interested in getting on Team USA sprint development team, USAC requires a 5 second max power effort on the Wattbike. If one doe not generate enough watts...no good. But I digress.

My new Garmin Connect Home Screen proudly displays my VO2max. Garmin must think that 1) they have a solid way of determining VO2, 2) think I am impressed with the number or 3) put up a number so their device is competitive with other independent of the accuracy. I give the Garmin VO2 a meh.

My own theory of aging is that strength is determinate. Strength is an enabler that allows one to pursue activities such as cycling, hiking, skiing, stair climbing, running and etc. With strength, one can develop one's mitochondria through training and increase the ability to generate more ATP and increase/maintain VO2.

The more that strong muscles are utilized, such as in cross country skiing, the more opportunity to increase oxygen utilization and increase VO2.

I have been consistently strength training since 1974 and I went through a phase where I concentrated on getting to muscle failure in the gym. Then I fell into a maintenance mode that lasted years. I am back into the get to failure mode with the most effort in a short period of time trying to maximize eccentric contraction along with concentric. I have been using fancy weight machines with computer screens that show a band of green and I have to keep the line in the band over the duration of the effort. These gyms are popping up where I live.

The machine can deliver increased eccentric load such that the "negative" feels really heavy compared to the concentric motion but yet I can stay in the green and get to failure. The theory is that the higher levels of force increase / maintain bone density as well as strength. I am doing one session per week with the fancy machines to failure and using conventional strength training to get in another full body session to failure.

IMO, with a strong muscular and bone base, one can overlay any aerobic modality that suits one fancy including cycling and have a reasonable shot at higher quality of life.

Having said that, only aerobic zone 2 with no intensity will make Jack a dull boy. IMO, at least one intensity session per week that goes to failure running, cycling, swimming, skiing and etc is required. That conclusion goes back to the video that increased VO2 is important. Zone 2 creates the opportunity to increase VO2 and intensity seals the deal.
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Old 05-08-24, 02:20 PM
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Originally Posted by Jughed
I was thinking of the extreme levels a pro athlete/cyclist has to go through in order to get a VO2 80++. Or to maintain a super high level throughout life.

You need to be extremely skinny/lean - possibly lean past the point of being truly healthy. You need to do fairly extreme levels of intense exercise - 15-20-25+ hours per week, with large amounts of threshold, VO2 and beyond levels of intensity. Then you need to consume mass amounts of extra fuel, which can be taxing to every system in the body.

Similar to how one can have too much muscle mass and all that's required to gain/maintain that mass.
Does the association with mortality take body mass into account? My recollection is that its just absolute VO2 max.
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Old 05-08-24, 03:22 PM
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Originally Posted by MoAlpha
Does the association with mortality take body mass into account? My recollection is that its just absolute VO2 max.
Which study do you have in mind? The Copenhagen study used mlO2/kg/min.
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Old 05-08-24, 03:59 PM
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Originally Posted by Jughed
60kg cyclist that's built like a T-Rex.
complete with the road cyclist vestigial fore-arms?
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Old 05-08-24, 06:15 PM
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Originally Posted by RChung
Which study do you have in mind? The Copenhagen study used mlO2/kg/min.
I think thats the one, mis-remembered.
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Old 05-08-24, 06:17 PM
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Originally Posted by Jughed
Assuming the same power output - an 80kg rider like myself with lean with upper body muscle will have a lower cycling VO2 max than a 60kg cyclist that's built like a T-Rex. Almost 15 points lower. They will climb faster - but are they really healthier/will they live longer in general? And is their true VO2 max actually 15 points higher?
As a 60.5kg cyclist, I take offense to that comparison.

I am not built like a T-Rex. I'm built like a spider monkey.

Minus the tail.

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Old 05-08-24, 08:13 PM
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I think long life is based on how big an a hole you are...they seem to live forever...i'm 689 years old by the way...
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Old 05-09-24, 04:45 AM
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Originally Posted by Hermes
I like GCN and Dan in particular. It is unfortunate that they are dissolving. VO2max, as measured in the lab, may be an important metric for getting a pro contract in an endurance sport or getting on a development team. For juniors interested in getting on Team USA sprint development team, USAC requires a 5 second max power effort on the Wattbike. If one doe not generate enough watts...no good. But I digress.

My new Garmin Connect Home Screen proudly displays my VO2max. Garmin must think that 1) they have a solid way of determining VO2, 2) think I am impressed with the number or 3) put up a number so their device is competitive with other independent of the accuracy. I give the Garmin VO2 a meh.

My own theory of aging is that strength is determinate. Strength is an enabler that allows one to pursue activities such as cycling, hiking, skiing, stair climbing, running and etc. With strength, one can develop one's mitochondria through training and increase the ability to generate more ATP and increase/maintain VO2.

The more that strong muscles are utilized, such as in cross country skiing, the more opportunity to increase oxygen utilization and increase VO2.

I have been consistently strength training since 1974 and I went through a phase where I concentrated on getting to muscle failure in the gym. Then I fell into a maintenance mode that lasted years. I am back into the get to failure mode with the most effort in a short period of time trying to maximize eccentric contraction along with concentric. I have been using fancy weight machines with computer screens that show a band of green and I have to keep the line in the band over the duration of the effort. These gyms are popping up where I live.

The machine can deliver increased eccentric load such that the "negative" feels really heavy compared to the concentric motion but yet I can stay in the green and get to failure. The theory is that the higher levels of force increase / maintain bone density as well as strength. I am doing one session per week with the fancy machines to failure and using conventional strength training to get in another full body session to failure.

IMO, with a strong muscular and bone base, one can overlay any aerobic modality that suits one fancy including cycling and have a reasonable shot at higher quality of life.

Having said that, only aerobic zone 2 with no intensity will make Jack a dull boy. IMO, at least one intensity session per week that goes to failure running, cycling, swimming, skiing and etc is required. That conclusion goes back to the video that increased VO2 is important. Zone 2 creates the opportunity to increase VO2 and intensity seals the deal.
GCN dissolving? I know they are a bit campy - but I do enjoy watching their stuff.

The weight lifting aspect is interesting. If I started lifting again, and lifting to failure - I would quickly build up to 200#+. When I rode back in my 20's, heavy road riding, mountain biking, BMX, and lifted at the same time I weighed in at 220#++, and I wasn't fat.

My weight would go up faster than my VO2 max. And it would go up faster than my w/KG at FTP.
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Old 05-14-24, 08:01 PM
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As the 'Best ' predictor of lifespan? for whom? at which point in their lifespan? ongoing?
VO2 Max prolly is a great indicator of overall 'condition' of the organism, very tied to fitness. Then there's genetics... which can be :Go To Jail' Card or 'Pass Go & collect $200'...
When I have comprehensive physical - the results I see make no mention of VO2 max...
I know all the hot new metric devices can give you 'VO2 max' and a bunch of other guesses, like calories expended, etc... Personally, I don;t put much into the value of those numbers...
So, it really has no value for the average person, since it's so difficult to get any population studies (The Copenhagen and Finnish studies as only a few).
And then there's the gender divide... how much does 'gender' play in the population validity?
I do think it can be a 'Feel Good' number, and thereby also a 'Feel Bad' number...
Been quite some years since I had the snorkel on... And how that goes can also be greatly affected by personal, psychological, and short term physical things; to cause significant variation.
Trying to make 'connections', I did a quick 'google' of - does muscle mass have an impact on VO2 max - try it...
very interesting variety of reading...
in that I found " VO2 Max is a vital sign - How to Measure It" interesting...
which covered some methods used for measuring VO2 Max. Of course the snorkel is the gold std...
I do remember my numbers from the early 80's, and a comparison seems 'ludicrous', but maybe fun.
So I did the Norwegian calculation - surprised, a Feel Good number. But really close to reality? I very highly doubt it... But still was Fun.
We all have so many numbers going thru our heads, available from so many sources , HR, PWR, STRESS, - if we pick any combination to use, it's still guessing, until we see some direct impact on our wanted 'results'...
Even thought the Norwegian estimate number feels good, it will have no impact on how I manage the remainder of my days.
Without some direct 'Tie' into what we want, VO2 Max is just another number.
Don't get me wrong - we should still move forward strongly on science and learning/discovering more. It's all 'minor' or maybe greater 'Gains', which have helped us make better decisions on living our lives.
Ride On
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Old 05-15-24, 06:30 AM
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Originally Posted by cyclezen
As the 'Best ' predictor of lifespan? for whom? at which point in their lifespan? ongoing?
VO2 Max prolly is a great indicator of overall 'condition' of the organism, very tied to fitness. Then there's genetics... which can be :Go To Jail' Card or 'Pass Go & collect $200'...
When I have comprehensive physical - the results I see make no mention of VO2 max...
I know all the hot new metric devices can give you 'VO2 max' and a bunch of other guesses, like calories expended, etc... Personally, I don;t put much into the value of those numbers...
So, it really has no value for the average person, since it's so difficult to get any population studies (The Copenhagen and Finnish studies as only a few).
And then there's the gender divide... how much does 'gender' play in the population validity?
I do think it can be a 'Feel Good' number, and thereby also a 'Feel Bad' number...
Been quite some years since I had the snorkel on... And how that goes can also be greatly affected by personal, psychological, and short term physical things; to cause significant variation.
Trying to make 'connections', I did a quick 'google' of - does muscle mass have an impact on VO2 max - try it...
very interesting variety of reading...
in that I found " VO2 Max is a vital sign - How to Measure It" interesting...
which covered some methods used for measuring VO2 Max. Of course the snorkel is the gold std...
I do remember my numbers from the early 80's, and a comparison seems 'ludicrous', but maybe fun.
So I did the Norwegian calculation - surprised, a Feel Good number. But really close to reality? I very highly doubt it... But still was Fun.
We all have so many numbers going thru our heads, available from so many sources , HR, PWR, STRESS, - if we pick any combination to use, it's still guessing, until we see some direct impact on our wanted 'results'...
Even thought the Norwegian estimate number feels good, it will have no impact on how I manage the remainder of my days.
Without some direct 'Tie' into what we want, VO2 Max is just another number.
Don't get me wrong - we should still move forward strongly on science and learning/discovering more. It's all 'minor' or maybe greater 'Gains', which have helped us make better decisions on living our lives.
Ride On
Yuri
As I understand this, its not so much your VO2 Max today that matters, but how that value extrapolates forward to old age and ultimately death. Once your VO2 Max drops below a certain minimum then you effectively lose mobility, whither and die! So the higher your VO2 Max today, the more buffer you have available to maintain adequate mobility in old age. Dr Peter Attia talks about this at some length in his book, but I cant remember the details. Obviously there are many other factors that might influence our demise, but aerobic fitness (VO2 Max) appears to correlate pretty well with longevity.
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Old 05-15-24, 09:28 AM
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Originally Posted by PeteHski
Obviously there are many other factors that might influence our demise, but aerobic fitness (VO2 Max) appears to correlate pretty well with longevity.
On the other hand.


Increasing disparity in trend of expectation of life at birth between US and other high-income countries

In 1980, the US's expectation of life at birth both for men and for women, was smack dab in the middle of the other high-income countries. Today, among high-income countries, it's last.
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Old 05-15-24, 09:41 AM
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Originally Posted by Jughed
GCN dissolving? I know they are a bit campy - but I do enjoy watching their stuff.

The weight lifting aspect is interesting. If I started lifting again, and lifting to failure - I would quickly build up to 200#+. When I rode back in my 20's, heavy road riding, mountain biking, BMX, and lifted at the same time I weighed in at 220#++, and I wasn't fat.

My weight would go up faster than my VO2 max. And it would go up faster than my w/KG at FTP.
Lifting doesn't make you gain weight. Eating more sure does though. The weight one puts on is real physical mass. It's not magic. And that extra mass is all made from stuff you ate. There's no other explanation. I've been lifting to exhaustion for . . . well, my wife and I joined our first gym in 1979. I'm 10 lbs. over my ideal weight right now, but I'm finally back on the bike and the trail and it's starting to go away. I'm still lifting.
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Old 05-15-24, 09:54 AM
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For sure, top pros do seem to be long-lived. The object of the game in the US is to have enough money not to be a part of the declining red line. It's not magic, it's diet, medical care, and housing. The US is structurally failing its population in all three aspects.
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Old 05-15-24, 10:32 AM
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Originally Posted by Carbonfiberboy
The object of the game in the US is to have enough money not to be a part of the declining red line.
Alas, we've also looked at trends in life expectancy by income levels. Males have to be in the top 10% of income in the US to have the same life expectancy as the *average* in the UK: the other 90% of income levels in the US are worse than that. It's worse when compared with Japan or France. There's wide variation across states, too. Having an average income in some states is (in terms of life expectancy) about like some Second World Countries.

It's not magic, it's diet, medical care, and housing. The US is structurally failing its population in all three aspects.
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