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VO₂max: The Fifth Vital Sign

Everything you ever wanted to know about our ability to take in and use oxygen — and why it's so important to our overall health and fitness.

VO₂max is the most important metric of your overall cardiorespiratory fitness. It’s a measure of the maximal ability of your body to take in and use oxygen. But what does the number actually mean for your health and longevity? Why is it important to know your VO₂max? What’s the most effective way to improve your VO₂max, whether you’re an athlete or just someone seeking to improve your health? And what does this all have to do with beer-league hockey, and everybody’s favourite Sudbury Blueberry Bulldog, Shoresy?

In this episode, Stuart Phillips asks Martin Gibala to break down VO₂max in plain English: what it is, why it matters, and how it shapes everything from your risk of dying to how fast you can run a 10K. And just to get the kin grad students among us even more excited, this episode namedrops the Hickson Protocol, plus legends of kinesiology like Robert Ross, Ulrik Wisløff and Carsten Lundby. Pitter patter, let’s get at ‘er!

Have a listener question or an idea for an episode? Email us at realexercisescience@gmail.com

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EPISODE LINKS

A Case for Fitness as a Clinical Vital Sign: The academic paper Marty references, that argues that MDs should assess VO₂max during each patient visit.

Biology of VO2 max: looking under the physiology lamp by Carsten Lundby and Mike Joyner. Here’s the 2015 review by Lundby that references a top VO₂max reading of 90.6. And then here’s a 2019 case study from Lundby and Joyner that references the physiological profile of Norwegian cyclist Oskar Svendsen, who recorded a staggering 96.7 mL/kg/min in a laboratory.

The Hickson protocol is described here, featuring six sessions per week, including three sessions of continuous vigorous in which the athletes ran as far as they could in 40 minutes, interspersed with three interval training bouts per week. The interval training amounted to six sessions of five-minute-long intervals during which the athletes tried to achieve VO₂max in each interval, interspersed with two minutes of easier cycling. Pretty intense!

Protocols to test VO₂max by proxy: YMCA fitness test is described in this academic paper. Plus here’s a better description of the 3-min step test.

A survey-based non-exercise predictor of VO₂max is found at worldfitnesslevel.org.

VO₂max test footage from McMaster University

Wisløff Hunt Study one high-intensity bout of week v. cardiac risk

Wisløff 2001 out of Norwegian University of Science and Technology with elite male junior soccer players, 2x a week for eight weeks boosted VO₂max by 11%.

Wisløff 2008 with sedentary middle-aged men and women with metabolic syndrome, 3x a week for 16 weeks, improved VO₂max by 35%, more than twice as much as a control that performed continuous moderate exercise.

Martin Gibala contributed to Wisløff’s 2013 paper, showing most of the benefits from an interval workout come from the first sprint.

SHOW LINKS

Exercise Science is everywhere @realexercisescience: Substack. YouTube. TikTok. Instagram. Apple Podcasts. Spotify. On X you can find us @realexscience.

Stu is everywhere, too, but mostly on Instagram and X. Follow him on TikTok to make him feel nice!

Marty just started his own Instagram. Give him a follow! He’s also on X!

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DISCUSSION POINTS

00:00 Cardio v. Strength

02:08 VO₂max explained

06:08 Heart’s role

08:41 Clinical vital sign

10:36 Benefits of boosting VO₂max

12:11 Assessing VO₂max

13:51 Ulrik Wisløff

15:15 Beer league hockey

17:07 VO₂max ranges

20:59 More boosting benefits

24:16 VO₂max trainability

27:00 Highest recorded values

29:30 How to improve VO₂max

31:27 Hickson protocol

33:38 Fastest way to boost

DISCLAIMER

The Exercise Science podcast is for educational and entertainment purposes only and is not a substitute for professional medical advice. Strength training and fitness carry inherent risks. Always consult with a physician or qualified healthcare provider before starting any new exercise program or making changes to your diet. The hosts, producers, sponsors and guests of this podcast disclaim any liability for any injuries or losses connected with the information discussed in this show.

The science of strength and fitness is continually evolving. While we strive to provide accurate, evidence-based information, we make no representations or warranties regarding the completeness, accuracy, or timeliness of the information discussed.

Martin Gibala is an advisor to and holds equity in Longevity League Ltd., a US-based company whose services in part relate to exercise.

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