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Cardio Gets A Major Makeover With VO2 Max (& The Benefits Keep Growing)

Ava Durgin
Author:
December 03, 2024
Ava Durgin
mindbodygreen Writer
Image by mbg creative
December 03, 2024
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Cardio is officially getting a makeover, and it's no longer about chasing a calorie burn. Today, it's about cultivating strength, power, and efficiency. The modern approach to cardio prioritizes workouts that deliver real results in less time, helping build resilience, improve endurance, and maximize every minute of movement. 

Central to this transformation is VO2 max, a powerful measure of how well your body uses oxygen, by adding intensity and purpose to cardio beyond traditional methods.

This shift in cardio isn't about weight loss; it's about breaking our own records and building a healthy future. By focusing on VO2 max, we're not just improving endurance; we're redefining what cardio can do for us (and what we can do for ourselves) at every stage of life. This approach challenges us to go beyond the standard cardio mindset and think bigger—about longevity, functional strength, and energy to carry us through every part of our day. Welcome to the future of cardio.

Meet the experts:

Molly Maloof, M.D.

Molly Maloof, M.D., physician, founder of Adamo Bioscience, and pioneering voice in personalized medicine, is on a mission to extend healthspan and unlock human potential through medicine, technology, education, & media.

Kara Fitzgerald, N.D.

Kara Fitzgerald, N.D., is a doctor of naturopathic medicine, author, and leading expert in longevity and epigenetics. Her groundbreaking clinical research reveals the powerful impact of diet and lifestyle interventions on overall health, specifically through DNA methylation.

VO2 max gets the attention it deserves

VO2 max is finally getting its time in the limelight—and it's about so much more than marathon times. Higher VO2 max correlates with a longer lifespan, healthier body composition, and better cardiovascular function. Studies even show it supports brain health1, reduces inflammation, and helps regulate blood glucose2—benefits that extend far beyond the track.

Molly Maloof, M.D., elaborates on a few more benefits, "Prioritizing VO2 max training supports longevity by enhancing cardiovascular health, mitochondrial function, and muscle endurance."

Prioritizing VO2 max training supports longevity by enhancing cardiovascular health, mitochondrial function, and muscle endurance.

Molly Maloof, M.D.

And as VO2 max expert Andy Galpin, Ph.D., previously mentioned on the podcast, "VO2 max would outpredict anything else you could possibly measure. Blood work, blood pressure, scans of any type, nothing will tell you more about your lifespan than VO2 max."

Among the many reasons we love VO2 max? It lends itself to variety, keeping things fun. "Once we get over the initial hurdle of simply moving our bodies, finding a well-designed routine that combines resistance and cardio—and that we genuinely enjoy—will help ensure this powerful longevity practice becomes a lasting part of our healthspan and lifespan," shared Kara Fitzgerald, N.D.

Once we get over the initial hurdle of simply moving our bodies, finding a well-designed routine that combines resistance and cardio—and that we genuinely enjoy—will help ensure this powerful longevity practice becomes a lasting part of our healthspan and lifespan.

Kara Fitzgerald, N.D.

Women's health metrics matter

While improving VO2 max is beneficial for everyone, women need to approach it differently. On average, VO2 max is about 20% less for women than for men. This difference comes down to body composition and oxygen transport capacity: Women tend to have higher body fat and lower blood volume and hemoglobin, which reduces oxygen transport to the muscles. Add the fact that women's muscles may be less efficient at using oxygen with age, and it's clear that VO2 max training calls for a tailored approach.

Fitzgerald explains, "It's essential to respect that we experience unique energy and hormonal shifts, caloric demands, and macronutrient needs that differ from men—and even change over the course of a month. We need to recognize these shifts and trust and respect the information our bodies are giving us."

The good news? Women can absolutely build their VO2 max just as effectively as men, with a few strategic adjustments. Maloof recommends timing VO2 max training within the menstrual cycle. She explains, "During the follicular phase (from menstruation to ovulation), women often experience higher energy levels and better recovery due to rising estrogen, which can support intense training." 

This could include high-intensity interval training (HIIT), cycling, swimming, and sprinting. The key is pushing yourself to 80-85% of your max heart rate in short, challenging bursts. "Shorter is better," Maloof says. Even a once-weekly VO2 max-focused workout can lead to major gains over time. For easy-to-use tips and benchmarks, check out this guide to start measuring and improving your VO2 max today.

It’s essential to respect that we experience unique energy and hormonal shifts, caloric demands, and macronutrient needs that differ from men—and even change over the course of a month. We need to recognize these shifts and trust and respect the information our bodies are giving us.

Kara Fitzgerald, N.D.

The evolution of cardio

In 1986, the U.S. saw a huge uptick in fitness, with 35% more adults engaging in regular exercise than just two years prior and more than 33 million people suddenly jogging. This boom in fitness culture was thanks to Kenneth Cooper, an M.D. who first championed aerobic activity, and it coincided with a 48% drop in heart disease death rates—the first significant decline in history, contributing to a six-year increase in life expectancy. Cooper's vision laid the groundwork for how we approach cardio today: as a cornerstone of longevity.

Cardio has come a long way since the days of prioritizing hours over impact. Today, it's all about efficiency: getting more out of less—and let's face it, that's what we all need. In the era of jam-packed schedules and the growing awareness of joint health, most of us don't have the time (or knees) for a 10-mile run. But with just 10 minutes of sprint intervals once or twice a week, you can gain meaningful cardio benefits without the wear and tear. High-intensity, short-duration workouts not only save time but also yield impressive results, giving you all the benefits of cardio with a fraction of the commitment.

This shift toward shorter, high-intensity workouts has become especially popular as people look to avoid overuse injuries. We're seeing a rise in cross-training and varying types of cardio—rowing today, rucking tomorrow, a HIIT session next week—and VO2 max is the perfect metric to track your progress across these diverse workouts. Fitzgerald emphasizes "the importance of training mindfully and ensuring we're using the right techniques" to reduce the chance of injury and to keep us moving for years to come. Maloof's motto? "Start low, go slow, titrate up."

Start low, go slow, titrate up.

Molly Maloof, M.D.

Another great workout to add to the mix is interval training, alternating between short, high-intensity bursts and slower recovery phases. This form of training doesn't just improve your VO2 max; it enhances speed, endurance, and muscle performance. By increasing your oxygen utilization, you're actually making all your other physical activities easier, whether it's a strength session, a game of tennis, or playing with your kids.

VO2 max training complements your fitness journey rather than monopolizing it. Instead of cardio being the one-size-fits-all solution it was once framed as, today it's an opportunity for each of us to work a little harder, push ourselves a little further, and see how much stronger we can become.

Do the work

There aren't any shortcuts to improving your VO2 max—meaning you can't hack your way to optimal cardiovascular fitness. Real, consistent, hard work is your friend here, but luckily, embracing different activities can keep it exciting, and you can get big payoffs in a short amount of time.

Options like rucking, cycling, air biking, and HIIT deliver major VO2 max benefits. If you love running, by all means, do it, and get those sprints in! It's just nice to know that's not the only way to boost this meaningful metric.

For someone starting out who is currently only walking, you can increase your walking speed and try working on intensity by tackling hills. Whatever level you are at, you want to build on it. Galpin previously shared on the podcast that even 10 minutes a week of these practices can boost VO2 max scores.

Martin Gibala, Ph.D., a professor of kinesiology at McMaster University, supported this during his time on the podcast as well. His research found that just three 20-second bursts of intense exercise can improve VO2 max—just as effectively as traditional, longer workouts.

Your 10-minute VO2 max training cheat sheet:

  1. Warm up for 2-3 minutes
  2. 20-second all-out sprint (run, bike, row, etc.)
  3. Recover for 2 minutes 
  4. Repeat a 20-second sprint 
  5. Recover for 2 more minutes 
  6. Final 20-second sprint 
  7. Cool down 

That's just 1 minute in a high-intensity zone, and 10 minutes of your day, to better total-body health and longevity.

"Nothing is better at improving VO2 max than challenging VO2 max," says Galpin, so remember you are only competing against yourself.

Resistance training is also a fantastic starting point, allowing you to slowly build VO2 max without pounding the pavement. Fitzgerald explains, "Having a body that is capable and resilient is important, and a combination of cardio and resistance training is essential for this."

Beyond exercise

With VO2 max emerging as a crucial marker of longevity, why limit ourselves to workouts? Supporting it through lifestyle choices can give you an extra edge—and some of these may surprise you. From supplementation to breathwork, here are some unexpected ways to boost your VO2 max and elevate your fitness game.

Iron supplementation

Iron is a key player in oxygen transport, especially for women3, who are more likely to have lower iron levels. Without enough iron, proteins like hemoglobin and myoglobin can't carry oxygen efficiently to your muscles, which can take a toll on endurance and tank your VO2 max4. To give your muscles what they need, consider an iron supplement or add iron-rich foods like leafy greens and lean meats to your plate.

Urolithin A

Research shows that supplementation of urolithin A, a postbiotic compound found in the gut, can be beneficial for VO2 max, due to its impact on mitochondrial function and muscle endurance.

Even better, it also reduced markers of inflammation and improved energy production. Although these studies often use higher doses than our bodies naturally produce, they reveal a compelling link between VO2 max and gut health—a promising area for future research.

"It's extraordinary that we can potentially improve VO2 max with a compound that a healthy microbiome naturally produces from certain dietary polyphenols," said Fitzgerald. Research shows that pomegranate peels and their seeds, as well as walnuts and almonds, stand out as rich dietary sources of ellagitannins, which are converted by gut microbes into urolithin A.

Breathwork

Breathwork might sound simple, but it's a VO2 max secret weapon. Focused breathing strengthens your diaphragm and expands lung capacity, making oxygen uptake more efficient. Adding just a few minutes of breathwork daily can enhance your oxygen utilization—consider it an easy, powerful add-on to your fitness routine.

Sauna sessions post-workout

Want an excuse to hit the sauna? Post-workout heat exposure ramps up heart rate, blood flow, and plasma volume, all of which can enhance cardiovascular fitness. Studies have found that adding sauna sessions after exercise significantly boosted VO2 max5 more than exercise alone. It is not only a fantastic recovery tool but also a great way to level up your endurance gains without extra reps.

Incorporating these lifestyle practices alongside exercise can take your VO2 max—and overall fitness—to new heights. Think of them as your ultimate support team, helping you build endurance that powers not only your workouts but every part of your life.

VO2 max metrics to watch

By now you're probably wondering what kinds of numbers you're actually shooting for, so look no further.

VO2 Max Averages for Women

Age20-2930-3940-4950-5960-6970-79
Superior49.647.445.341.137.836.7
Excellent43.942.439.736.73330.9
Good39.537.836.3333028.1
Fair36.134.43330.127.525.9
Poor<36.1<34.4<33<30.1<27.5<25.9

VO2 Max Averages for Men

Age20-2930-3940-4950-5960-6970-79
Superior55.4545248.945.742.1
Excellent51.148.346.443.439.536.7
Good45.44442.439.235.536.7
Fair41.740.538.535.632.329.4
Poor<41.7<40.5<38.5<35.6<32.3<29.4

What's to come

As more people embrace cardio well into their later years, it's becoming clear that VO2 max isn't just a measure of athletic performance but a powerful tool for extending healthspan and promoting lifelong independence. Yet, only about 30% of women over 50 meet recommended aerobic activity levels, underscoring the opportunity to improve health and fitness across all ages. With fitness personalization now in focus, many are redefining how cardio fits into their lifestyles, blending high-efficiency VO2 max workouts with the latest tracking technology to create routines tailored for each stage of life.

In recent years, wearable technology has made it easier to monitor VO2 max outside of lab settings, allowing users to track progress conveniently at home. Once a task confined to clinical settings—with masks and treadmills required—tracking VO2 max can now be done through smart devices like Oura rings, Apple Watches, and other wearable trackers. (You can learn how to estimate yours here.)

Maloof highlights the VO2 Master Analyzer as one product that she is excited about when it comes to accurate VO2 max monitoring. These devices will only become more sophisticated and accessible with time. With the wearable fitness tracker market projected to grow 18.5% through 2033, it's safe to say that personalized cardio metrics are just getting started. 

"It wouldn't surprise me to see VO2 max becoming a key component in research studies focused on favorably reducing the risk of chronic diseases associated with aging and even slowing the aging process itself," predicts Fitzgerald.

It wouldn’t surprise me to see VO2 max becoming a key component in research studies focused on favorably reducing the risk of chronic diseases associated with aging and even slowing the aging process itself.

Kara Fitzgerald, N.D.

Ongoing research is also highlighting new associations between VO2 max and other health factors, from nutrient levels to metabolic and genetic markers. This might even include early detection of conditions like Alzheimer's6, where a VO2 max decline could act as an early indicator. 

With recent research in mind, Maloof believes that "VO2 max training might be 'prescribed' more precisely for specific health outcomes rather than just general fitness benefits." Such advancements are pushing VO2 max beyond a fitness metric, evolving it into a holistic measure of health that may one day be seamlessly integrated with other data for a comprehensive view of full-body health, all easily shareable with doctors. In this way, VO2 max is set to become a core marker of health, guiding us toward a more integrated, proactive approach to wellness and longevity.

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