What is VO2Max, why it is a key predictor of longevity and how to increase it.

It has been known for decades that breathing and physical exercise are great for your health. Not only they help to lower anxiety and high blood pressure, but also increase health of our cardiovascular system.
Why VO2max is an important indicator of longevity?
Over the last 10 years several scientific studies have shown that an indicator cardio fitness, or VO2Max, is a key predictor of longevity [1], [2]. The higher VO2Max number – the higher our chances to live longer.
One research of Swedish scientists [1] on 792 men started in 1963. They split participants into three groups based on their VO2Max numbers and followed on them over the years. The research has found that each tertile increase (move from lower to high VO2max group) in predicted VO2 max was associated with a 21% lower risk of death over 45 years of follow up. Or rephrasing statistics data: 10% increase in VO2Max can reduce all-cause mortality risk by 15%.
Another research [4] shows that people who are more physically active experience less anxiety and stress and are more resilient to the impacts of stress when it does arise. Also, strong cardiovascular system generally translates into lower blood pressure.
What is VO2max?
With a bit of simplification: Vo2Max shows a maximum amount of oxygen consumption per minute by someone’s body at the peak of aerobic performance. It is usually expressed as a relative rate in millilitres of oxygen per kilogram of body mass per minute ( mL/(kg·min)). It is the generally accepted measure of aerobic fitness and allows to compare aerobic fitness of different people.
The generally accepted test to measure VO2Max is done either while running on a treadmill with gradually increasing speed or while cycling on a stationary bike. A special device compares the composition of the air breathed out and derives VO2Max number. Over the last few years a number of sports smartwatches which can measure speed and heart rate also provide their owners with an estimation of VO2Max. Bases on my own experience with Garmin smartwatches they provide VO2Max estimation with 90% accuracy as compared to a lab test which is sufficient for most people.
It is important to note that the max potential VO2Max number is heavily dependent on our genetics. That’s why some people are born to be better athletes than others, especially in sports which require higher aerobic performance like running, cycling, swimming or cross-country skiing. At the same time VO2Max decreases at a rate of about 10% per decade - that is if we do nothing to keep it higher for longer. Here is the graph from the American College of Sports Medicine which illustrates the point.
