When it comes to heart health and longevity, traditional markers like LDL cholesterol and blood pressure provide insight into baseline cardiovascular disease risk, but they don't capture how your system performs under demand. If there were a single metric that reflects how efficiently your heart, lungs, and muscles work together to transport and use oxygen, VO2 max would be a strong contender.
VO2 max measures how efficiently your body uses oxygen during exercise and is one of the strongest indicators of cardiorespiratory fitness. It’s closely linked to longevity, energy, and resilience. At Biograph, VO2 max is measured as part of a 30+ marker assessment to provide early insight across key health systems, not as a standalone number.
VO2 max represents your body’s upper limit for aerobic metabolism. It reflects the maximum rate at which your system can supply oxygen to power energy production, serving as a powerful predictor of both physical capacity and long-term health.
VO2max has transitioned from a specialized lab measurement used by pro athletes to a standard feature on most modern fitness trackers. But while these apps make the data accessible, they don't always provide the context needed to turn a raw score into a meaningful health insight.
What is less widely understood is how strongly VO2 max is connected to your overall health. It’s without a doubt one of the most powerful indicators of cardiorespiratory fitness, a physiological system that is not just foundational to your athletic performance, but also how you age. Research consistently shows that higher VO2 max levels are associated with lower risk of cardiovascular disease and all-cause mortality [1].
But VO2 max is not a standalone metric. A single score, especially one derived from a wearable, does not fully explain what is driving your fitness or how it connects to your broader health. Its value becomes clearer when it’s interpreted alongside other markers, including metabolic health, body composition, and recovery capacity.
At Biograph, VO2 max is not treated as a performance stat in isolation. It is integrated into a 30+ marker comprehensive assessment designed to identify early risk patterns and guide targeted interventions across four key pillars of chronic disease and quality of life.
To understand how to use VO2 max effectively, you first have to learn what it measures.
What is VO2 Max?
VO2 max refers to the maximum amount of oxygen your body can use during intense exercise [2]. More specifically, it reflects how efficiently three systems work together:
The lungs (oxygen intake)
The heart and blood vessels (oxygen delivery)
The muscles (oxygen utilization)
VO2 max is typically measured during a graded exercise test, where the intensity gradually increases on a treadmill or stationary bike until you reach near-maximal effort. This approach allows clinicians to assess how your body responds as demand rises, rather than relying on a short, all-out burst.
Your reading is expressed as milliliters of oxygen per kilogram of body weight per minute (mL/kg/min).
In other words, your VO2 max reflects how efficiently your heart, lungs, and muscles work together to transport and utilize oxygen when your system is pushed to its limit.
Why VO2 Max Matters Beyond Fitness
VO2 max is often linked to endurance athletes, but you don’t have to be a marathon runner to get value out of this metric. Emerging research suggests it’s one of the strongest measurable indicators of [3] [4]:
Cardiovascular health
Metabolic efficiency
Longevity and disease risk
Higher levels of cardiorespiratory fitness are consistently associated with:
Lower risk of heart disease
Improved insulin sensitivity
Reduced risk of premature death
Your VO2 max may also give you insight into your functional fitness, or how comfortably you can perform everyday activities such as climbing stairs, maintaining independence as you age, and how well you recover after exercise or other forms of physical stress.
What’s a “Good” VO2 Max? (And How to Interpret Yours)
The answer depends on several factors:
Age
Sex
Training status
Genetics
Health conditions
It’s important to note that VO2 max naturally declines with age, even in healthy, active people. Men also tend to have higher average values than women due to physiological differences in body composition and hemoglobin levels [5].
Instead of focusing on a single number, consider:
Comparing your VO2 max to age- and sex-based norms
Tracking trends over time
Interpreting it within the context of your overall health
Keep in mind that you don’t need to strive to have the same VO2 max score as an elite endurance athlete to be in good health. The “average” range for your age may indicate that your heart health is just fine, depending on your baseline and goals.
Average VO2 Max Values by Age and Sex
What counts as a “good” VO2 max depends on age and sex. Reference ranges, such as those from the FRIEND registry below, help contextualize your score by showing how it compares to population-based percentiles [6].
Men
Women
A declining VO2 max may signal changes in fitness and recovery. Making subtle adjustments, such as introducing high-intensity interval training (HIIT) workouts into your routine, can help increase your score over time [7].
How to Improve VO2 Max
VO2max values may be improved with specific training. How much it improves depends on several factors, including your baseline fitness, genetics, age, training history, and the consistency of your current training.
But for most people, VO2 max can improve meaningfully with the right combination of intensity, structure, and consistency.
The most effective way to improve VO2 max is typically through a combination of training intensities, each targeting a different physiologic adaptation. The most evidence-backed approaches include:
Short bursts of high physical effort followed by a brief recovery. This promotes improvements in oxygen uptake and utilization.
Sustained, moderate-intensity exercise that builds metabolic efficiency and endurance.
Gradually increasing workout intensity or duration to continue challenging the body and improving cardiovascular capacity.
Regular training matters more than occasional high-effort sessions.
Everyone’s body is different, but the findings from one systematic review suggest that four to 12 weeks of consistent training can lead to measurable improvements in your VO2 max [8], especially if you’re new to exercise.
More substantial gains tend to take place over months. Don’t be discouraged if your progress slows as your fitness improves—that’s completely normal.
Why VO2 Max Should Be Part of a Comprehensive Assessment
VO2 max is a powerful metric, but like most standalone figures, it doesn’t capture the full picture. It tells you something important about your cardiorespiratory fitness, but not necessarily what’s driving that score behind the scenes.
For example, VO2 max alone cannot fully account for:
Why your fitness is improving or declining
How your metabolic health is evolving
Whether inflammation or recovery is limiting your athletic performance
How your body composition affects your efficiency
This is where triangulation becomes essential. VO2 max is most useful when interpreted alongside other markers, including cardiometabolic health, body composition, and inflammatory markers, as well as data around recovery and sleep.
For a relatively active person who recently took time off from consistent training, a declining VO2 max may just indicate deconditioning. But for others, a low score could also point to underlying metabolic dysfunction.
On the other hand, a relatively high VO2 max paired with poor recovery markers may suggest that someone is training hard but not adapting well. Even changes over time become more significant or relevant when you have a better understanding of what else is going on in your body [9].
Without that context, VO2 max may as well just be a number. That context is what gives that score meaning.
How Biograph Uses VO2 Max Inside Our 30+ Marker Assessment
At Biograph, VO2 max is measured as part of a 30+ marker comprehensive assessment designed to evaluate early risk and performance across five key areas: cardiovascular health, metabolic health, brain health, cancer risk, and quality of life. That broader framework allows VO2 max to be interpreted within the full context of your unique physiology rather than treated as an isolated fitness score.
Remember: the goal is to understand what’s driving your score and identify any constraints or risks that may be negatively affecting it so you can make necessary lifestyle adjustments.
Common Questions About VO2 Max
What is VO2 max?
VO2 max is the maximum amount of oxygen your body can use during intense exercise. It reflects how efficiently your lungs, heart, blood vessels, and muscles work together to deliver and use oxygen.
How does VO2 max relate to longevity?
Higher VO2 max levels are associated with lower risk of cardiovascular disease and all-cause mortality, making it a strong predictor of long-term health.
Do genetics affect your VO2 max?
Genetics can play a role in your VO2 max, affecting both your baseline level and how strongly you respond to training. Some people naturally start with a higher VO2 max, while others may see faster gains once they begin a structured exercise program.
Why is VO2 max important?
VO2 max is one of the strongest indicators of cardiorespiratory fitness. Higher VO2 max levels are associated with better endurance, better metabolic health, and lower risk of cardiovascular disease and all-cause mortality.
What is a good VO2 max?
A good VO2 max depends on your age, sex, training history, genetics, and health status. Rather than aiming for an elite athlete score, it is more useful to compare your VO2 max with age- and sex-based norms and track how it changes over time.
What is the average VO2 max by age?
Average VO2 max declines with age, even in healthy adults. Population-based reference ranges, such as those from the FRIEND registry, can help show how your score compares with others in your age and sex group.
Is VO2 max different for women and men?
Yes. Men typically have higher average VO2 max values than women because of differences in body composition and hemoglobin levels. But VO2 max is valuable for both women and men and should always be interpreted using sex-specific reference ranges.
How is VO2 max tested?
VO2 max is usually measured during a graded exercise test on a treadmill or stationary bike. Exercise intensity increases gradually while oxygen use is measured to determine your maximum aerobic capacity.
Can wearables accurately measure VO2 max?
Wearables can estimate VO2 max, but they do not measure it directly as in laboratory-based exercise testing. These estimates may be useful for trend tracking, but accuracy and clinical interpretation are stronger when VO2 max is measured in a structured test and viewed alongside other health markers.
How can you improve your VO2 max?
VO2 max can often improve with consistent aerobic training, especially high-intensity interval training, Zone 2 training, progressive overload, and regular exercise over time. At Biograph, we personalize each program by tailoring training intensity, volume, and progression to the member’s unique physiology, goals, schedule, and lifestyle.
About the Author
Dr. Michael Doney is Biograph’s Executive Medical Director, with over 20 years of experience leading clinical care and advancing a more proactive, data-driven approach to medicine.
Clinical References
Wang Y, Xu T, Xia C, et al. Association of cardiorespiratory fitness with adverse outcomes in patients with and without atrial fibrillation: a prospective cohort study. International journal of medical sciences. 2025;22(11):2830-2838. doi:10.7150/ijms.110802
Srivastava S, Tamrakar S, Nallathambi N, Vrindavanam SA, Prasad R, Kothari R. Assessment of Maximal Oxygen Uptake (VO2 Max) in Athletes and Nonathletes Assessed in Sports Physiology Laboratory. Cureus. 2024;16(5). doi:10.7759/cureus.61124
Kodama S. Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women. JAMA. 2009;301(19):2024. doi:10.1001/jama.2009.681
Sawyer BJ, Blessinger JR, Irving BA, Weltman A, Patrie JT, Gaesser GA. Walking and running economy: inverse association with peak oxygen uptake. Medicine and Science in Sports and Exercise. 2010;42(11):2122-2127. doi:10.1249/MSS.0b013e3181de2da7
Santisteban KJ, Lovering AT, Halliwill JR, Minson CT. Sex Differences in VO2max and the Impact on Endurance-Exercise Performance. International Journal of Environmental Research and Public Health. 2022;19(9):4946. doi:10.3390/ijerph19094946
Kaminsky LA, Arena R, Myers J. Reference Standards for Cardiorespiratory Fitness Measured With Cardiopulmonary Exercise Testing. Mayo Clinic Proceedings. 2015;90(11):1515-1523. doi:10.1016/j.mayocp.2015.07.026
Laury D, Tehrany A. VO2 Max Improvement of 96% in a Non-Elite Recreational Athlete over 24 Months. The Surgery Journal. 2019;05(01):e25-e27. doi:10.1055/s-0039-1688438
Wen D, Utesch T, Wu J, et al. Effects of different protocols of high intensity interval training for VO2max improvements in adults: A meta-analysis of randomised controlled trials. Journal of Science and Medicine in Sport. 2019;22(8). doi:10.1016/j.jsams.2019.01.013
Muñoz-Hernandez L, Rivera AL, Soto-Mota A, et al. Insulin resistance and metabolic health predict cardiorespiratory fitness: cohort study. European Heart Journal Open. 2026;6(2). doi:10.1093/ehjopen/oeag029
