Admitting a VO2 max test has been at the top of my bucket list for a while paints a fairly apt picture of the person I am. The keenness doesn’t stem from some nerdy obsession around tracking my fitness levels that Strava can’t log though; my father died from a heart attack at a relatively young age so it’s more aligned with the fear of history repeating itself.
For over 20 years, I've been guilty of that typically male trait of not going for regular check ups with the doctor in case of any faintly bad news – instead preferring to remain fit and healthy through my own means and methods while blocking out any hereditary concerns.
But ahead of turning 40 later in the year, the time has come to bite the bullet and finally tick the VO2 max test off the bucket list. Here’s everything you need to know about arguably the most important health test you should be taking – as well as what my results revealed.
A cardiopulmonary exercise test, otherwise known as a VO2 max test, offers a comprehensive assessment of your overall fitness levels by testing your heart, lungs and muscles to the max. “We use it to assess your current heart health and predict your future health,” says Prof. Michael Papadakis, consultant cardiologist at Lanserhof at The Arts Club.
“The VO2 max refers to the maximum rate at which your muscles can extract oxygen from your blood and put it to use to generate energy,” says Dr Naheem Ali, lead musculoskeletal and sports medicine specialist at Lanserhof. “Your VO2 max is often used as an indicator of overall cardiorespiratory fitness and can serve as a metric for tracking progress. When looking at VO2 max in relation to all-cause mortality, we see a very clear trend, even a small improvement in your VO2 max significantly reduces the risk of mortality,” Dr Ali continues.
For context, by bringing a low VO2 max (let’s say you’re bottom 25th percentile) to a below average VO2 max (25th to 50th percentile) you’re looking at a 50% reduction in all-cause mortality. “The higher your VO2, the lower the chances of heart disease and the more likely you are to live longer,” states Papadakis.
While I booked in for the test at Lanserhof at The Arts Club as part of a wider wellness check up, locking in a VO2 max test is relatively easy as a quick Google shows. They are pretty accessible and, depending on where you book, aren’t expensive. Indeed, you could pay a heavier price from not having one. “I would recommend knowing your VO2 max, just like you would go and see your GP to check your blood pressure or to get a baseline blood test,” adds Dr Ali.
"Knowing one's VO2 max is incredibly important for high level athletes, desk jockeys and everyone in between,” says health and wellbeing specialist Robin Cooke. “It is not only a great way of understanding how fit you are, but also is a good indicator of long-term health and disease prevention. With employee wellbeing becoming of greater significance to companies, with improvements in productivity and workplace satisfaction – as well as all of the other significant mental and physical benefits exercise has, some health insurance providers even have VO2 max testing as part of their yearly assessment, as employers want to know that their staff are firing on all cylinders – and will be for a long time to come."
“The test feels like a real look at your true health. It sees beyond your muscles and your bench PB,” says fitness guru Phil Hilton, who recently took the test to find out what all the fuss is about. “You run, you lift but you always wonder, how fit am I really? This test gives you that visibility. And the score is really motivating when you’re out working on cardio. Having a real target and heart rate zones is so clarifying.”
You might have seen pictures of professional athletes doing one – where they are on a running machine with an oxygen mask over their faces looking pained and out of breath. Once you get past the notion that this is only for pro athletes, the actual test is quite simple. Everybody can do it in some capacity, you don't have to run, so you can cycle on a bike or you can walk on a treadmill on an incline, so it's not limited by any orthopaedic issues.
The treadmill is the most common way of doing the test. You start off by jogging for three minutes at 7km/h pace on the treadmill, then you increase the speed by 1km/h every minute until you can’t continue. My test was terminated due to fatigue but the doctors will be looking for any symptoms of chest pain, breathlessness or dizziness. The result of your VO2 max test means that no matter how much more you could have pushed yourself, your body just can’t absorb oxygen at a faster rate.
After the test, I sat down with Kiran Chopra, lead sport and exercise physiologist at Lanserhof to talk through what the results revealed about my overall fitness, what I can improve on and ultimately how these findings can impact how I work out in the future.
VO2 Max
In terms of my overall VO2 max, my body was able to take in 47ml of oxygen every minute of maximum exertion activity relative to my body weight, which puts me slap bang in the middle of the ‘good’ section – 35-40 being the average for men. My VO2 max was set at around 17.6km/h, which is the point at which my oxygen consumption plateaued. This score is around 42 percent higher than a healthy individual of a similar demographic. That is the biggy to find out but there are other findings that are just as important.
VT1 and VT2
One is your ventilatory threshold (VT1), which is the point during a workout when your breathing increases at a faster rate than your VO2 intake. This threshold reflects the levels of anaerobiosis then the second ventilatory threshold (VT2) is when your body starts to produce lactate acid. It measures when acidity builds up way too quickly to the point your legs start to burn and breathing becomes heavier.
For my VT1, the first turning point happened at around 118 beats per minute, when I was running 10.6km/h at around 64 percent of my overall VO2. This means that I can do long, steady state cardio for significant periods of time. In terms of my second ventilatory threshold, it happened at around 136 beats per minute, or 14.2km/h. That happened at 82 percent of my overall VO2.
Metabolic function
My maximal fat oxidation is 55g/h at heart rate range of 126-127 bpm or an intensity
of approximately 12.2-12.5km/h. This is considered to be excellent and improving this can be done through greater consumption of unsaturated fats and reduced carbohydrate consumption
as well continuing to develop your aerobic capacity.
Recovery heart rate
During the test, my heart rate got up to 162 beats per minute at its peak. And after two minutes of recovery, it dropped by 62 beats per minute, which means I have a strong heart rate recovery. This means I have a strong heart that can push out a lot of blood, helping to pump out the oxygen my body needs to recover.
Oxygen pulse
This is an assessment of how much oxygen we are uptaking relative to our heart rate. So if you were to do an echocardiogram (an ultrasound of the heart), you can physically see how much blood your heart is pushing out per beat. The average is 19ml per beat and my result was 30ml. This means my heart is very strong and definitely not a limiting factor when it comes to running. A plateau in the oxygen pulse at a low value can imply limited cardiac output, either because of a heart abnormality or disorders in the pulmonary circulation.
