Hate that they just put “track and field running,” since that one category by itself almost spans the rest of the range here. I’m guessing there’s a large difference between the 100 and 200 m specialists vs the 10K guys.
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My VO2 max has a life of its own. Goes up and down (maybe within margin of error on Apple Watch) without any clear correlation to other activity. I do Norwegian HIITs 3 times a week, zone 2 cardio etc etc
Same with HRV. Very variable.
Im with Inside Tracker and their ‘pro tip’ today was to reduce creatine to increase VO2 max. Hadnt heard that. Have been taking 5g of Creatine for years.
Anyone noticed blunting of VO2 due to creatine?
I thought you liked working out.
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Hahaha - noooo! I do not like working out. The best part of the workout is the final set. And, knowing I do not have to go back for a whole day. Seriously!
That said - I do like the way I look, the anti-aging benefits and general strength and feeling healthy - so not going to the gym is really not an option. I also think the TRT definitely makes it easier.
I go religiously, 1 hour and 15 minutes - non-stop. But, I have been waiting for the day it kicks in that I look forward to it. Now going on 8 straight years of every other day not thinking that will happen.
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LOL, that me! I actually dislike exercising, but do it religiously, because I know it has health benefits. I always look forward to my days off from exercise, as it is only then that I feel fully alive - Wednesday, Saturday, Sunday, even though the off days are not 100% off, since I still do 45 minutes of brisk walking on those days.
And the best part of exercising is when it’s over, and I can take a shower. Too bad I don’t believe there’s ever going to be a pill that duplicates the effect of exercise 100%, because I’d be the biggest customer.
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The inestimable Dr. Greger comes through again, slashing away at sacred cows with no regard for the sanity of exercise worshippers like Peter Attia. Very hard to argue against the, at this point self-evident, conclusion that it’s the genes uber alles. And a good antidote to all the exercise fanatics of “the more the better”. My own view is that you obtain all health and longevity benefits from relatively modest exercise levels, levels that may seem shockingly low to exercise advocates. Doing more than that relatively low minimum might give some functional benefits, if, say, you simply enjoy challenging sports or recreational activities, but no further longevity benefits (though possible premature mortality benefits?). Doing a great deal more, well, you’re on your own there, in the club of those who are fans of extreme sports and activities and are willing to pay the price - to each their own.
Exercise as Medicine (Part 2)
I think Greger is dangerous and it is not helpful to listen to him at all even if he sometimes is correct.
For example, on calcium supplements he said that in the hundreds of mg calcium intake, bone loss was happening. He totally ignored the fact that the same graph showed a trend towards improvement in bone health at higher intake and didn’t mention this. The study also compares it with above 700 mg intake which he didn’t mention, instead made it sound like you’re safe above 400 mg.
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I found this really interesting… and disappointing 
Source: https://x.com/GuruAnaerobic/status/1987386660108034343?s=20
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Review article (Open access):
Biomarkers of aging: from molecules and surrogates to physiology and function
6.1. V̇o2max/Cardiorespiratory Fitness
6.1.1. V̇o2max: principle and testing.
At the moment, cardiorespiratory fitness is the most studied and best predictor of morbidity and all-cause as well as disease-related mortality (FIGURE 5, A AND B) (572–583). Cardiorespiratory fitness is assessed by measuring the maximal rate of oxygen consumption (V̇o2max). This concept was introduced by Archibald Hill and Hartley Lupton in 1923 (584) and has been developed ever since (585, 586). V̇o2max, sometimes also reported as V̇o2peak [the highest recorded V̇o2 in tests failing to reach a V̇o2max plateau, therefore potentially underestimating the true maximum (587, 588)], is a readout obtained in cardiopulmonary exercise tests that correlates with cardiorespiratory fitness and endurance capacity (589–593). Most often, V̇o2max, either reported as an absolute rate (mL/min) or normalized to body mass (mL/min/kg) (sometimes also normalized to lean body or skeletal muscle mass), is typically determined in graded maximal exercise tests by measuring ventilation and respiratory O2 concentrations (reaching a plateau), often combined with determination of blood lactate concentrations (e.g., approaching or exceeding 10.0 mmol/L), heart rate (reaching a plateau), respiratory exchange ratio (RER; ≥1.1), and perceived exertion [e.g., 19–20 on the Borg scale from 6 to 20 or 9–10 on a Borg Category-Ratio 10 (CR10) scale from 1 to 10], even though variations between protocols for some of these thresholds exist (594–596). The results depend on the exercise modality: treadmills or cycle ergometers are commonly used, but V̇o2max values can be acquired in any exercise setting that is amenable to breath-based oxygen analysis, e.g., rowing ergometers, all of which involve different sets of muscles. The V̇o2max often differs between testing modalities and prior task habituation: for example, runners might reach higher values on the treadmill, whereas cyclists or triathletes can excel on cycle ergometers (597). The choice of testing paradigm therefore depends on availability, practicality, intention for assessing task specificity, coadministration of other tests (for example, electrocardiography might be easier on cycle ergometers because of minimal upper body movement), and other factors.
V̇o2max integrates functional aspects of a number of organs and tissues that contribute to oxygen intake, distribution, extraction, and usage (FIGURE 5C) (598). Intake is affected by pulmonary capacity and function, in part depending on respiratory muscle functional capacity, which can be improved by specific training even in older adults (599). Distribution combines cardiac output parameters, oxygen carrying capacity by red blood cells, blood volume, and vascular properties. Extraction and usage, at least in the case of cardiopulmonary exercise tests, are mainly determined by the degree of tissue vascularization (hence the proximity of blood vessels and muscle cells), intramyofibrillar trapping of oxygen by myoglobin, and the rates of mitochondrial oxidative phosphorylation. The rate-limiting step that determines V̇o2max can be variable and, for example, shift depending on the training state, from oxygen usage in muscle fibers in the untrained to oxygen provisioning by cardiac output and tissue vascularization in trained athletes.
6.1.2. V̇o2max: age dependence and health/mortality prediction.
V̇o2max decreases progressively with age, at a rate of ∼7–10% per decade (corresponding to 4–4.6 mL/min/kg) (571, 600, 601), down to an “aerobic frailty threshold” of 17.5–18.0 mL/min/kg that is required for an independent lifestyle (574, 602, 603). At this point, individuals have to utilize almost their maximum aerobic capacity for tasks related to daily life and independence, associated with severe physical fatigability (604). In the worst case, this deterioration continues to fall below 10.5 mL/min/kg, when ∼30% of oxygen is used to maintain basal metabolic rate, potentially leading to fatal outcomes (574, 602). Accordingly, the assessment of V̇o2max constitutes a strong and independent predictor of morbidity and mortality in different populations, young and old, healthy and clinical (574, 576, 605). In fact, this strong link with mortality and various chronic conditions including heart failure, hypertension, stroke, chronic kidney disease, dementia, and depression was consistently demonstrated in an overview of meta-analyses that included >20.9 million observations (576). More specifically, having a low cardiorespiratory fitness is associated with a 41–53% higher relative risk for all-cause mortality compared to those with a high cardiorespiratory fitness (606). Strikingly, even in unfavorable conditions, such as abnormal glycemic status (607) or obesity, being fit is a strong predictor for reduced all-cause and cardiovascular disease mortality (608–611). In fact, relatively fit obese men (top 80% of the age-specific cardiorespiratory fitness) have a 50% lower cardiovascular disease mortality risk compared to normal-weight unfit men (lowest 20% of the age-specific cardiorespiratory fitness) (609). Indeed, cardiorespiratory fitness can mitigate risks of obesity in a significant manner, beyond those of unfit, normal-weight individuals (612). Similarly, high cardiorespiratory fitness can overcome an unfavorable genetic predisposition for dementia (613). Furthermore, cardiorespiratory fitness is a strong inverse predictor of heart failure risk irrespective of BMI (614). Importantly, even though up to 50% of the variability in V̇o2max in sedentary individuals is estimated to be of genetic origin (615) as well as other biological and methodological factors (616), trajectories can be strongly affected by exercise at young and old age (617–622), and even a moderate increase by 3.5 mL/min/kg [1 metabolic equivalent of task (MET)], achievable after 2–3 mo of training (602), reduces the risk of heart failure by 18% (572) and all-cause mortality by 11–17% (576, 606). Interestingly, despite exhibiting lower V̇o2max values, older athletes can reach high performance levels due to the ability to perform work closer to the V̇o2max compared to younger counterparts (623). Lifelong exercise habits provide most benefits to mitigate age-related declines in V̇o2max (624) and can confer benefits in old age (625). However, even in the very old, cardiorespiratory fitness can be improved, as exemplified in the case study of a 101-yr-old cyclist (626).
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On the topic of cardio fitness in general, if you want to keep more of your fitness, ditch metformin
Met[formin] blunts exercise training-mediated increases in vascular insulin sensitivity at the levels of conduit arteries and capillaries, in parallel with altered inflammation and glycemic benefits.
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Exactly this happened to me. My VO2max used to be 48, but after I had surgery and had to stop running, it dropped to 38 in a year or so. I still walk about 10k steps a day and use my bike instead of the car whenever possible, but it clearly isn’t enough to maintain it.
I’m about to start training again and add some running back into my workouts, and I’m hoping to regain at least some of that VO2max.
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I’m about to have surgery and will be unable to exercise for a few weeks at least. I also had to stop exercising because of spinal disc problems (hence surgery) for a couple of months, and I could tell my conditioning absolutely collapsed. Muscle decline was even more stark. Just a couple of months ago I was doing very strenuous squats including jumping squats with a 45lbs weight vest, and now I’m winded after 5 minutes of bodyweight squats.
I have noticed that with advancing age (I’m 67), you decondition extremely rapidly. When younger I could stop exercising and the decline in exercise capacity would be quite gradual. Now I stop exercising and my conditioning falls off a cliff.
Now that the diagnosis has been made, and a surgery date set for late December, I’ve resumed some exercise specially modified to spare the spine, because I will be immobilized for many weeks after the surgery and I don’t want to emerge from this with sarcopenia and frailty. I’m trying to build up some reserve.
As has been observed, older people decline in stages. There’s an event, you decline some and regain only part of your previous physical capacity. Then there’s another event and you decline further and so on. The trick is to try to regain your full exercise capacity after an event. That is what I am determined to do. I may have to adjust my exercise protocol, but I must do all I can to get back to 100% of my previous capacity.
For example, right now I cannot jog for longer than about 10 minutes due to spine issues. So instead, I’m doing a series of “high knees” intervals. It’s incredibly taxing on your cardio, I at present cannot do more than about 15 seconds in an interval (with proper form and max effort). So I do about 5 of those a day. I’m hoping to gradually increase the intervals, so in a few weeks before the surgery I’m at least in better shape and not like a human jellyfish. We’ll see.
Bottom line: you must fight to get your VO2Max back to a higher level and not allow an event (like surgery) to permanently set at a lower level. With age there will be a gradual decline anyway, but you try to avoid sharp drop offs after forced episodes of non-exercise.
After surgery and recovery, that will be my challenge. I must get back 100% of my conditioning and muscle strength and power. I am absolutely determined to meet that challenge.
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I’m 50, absolutely fit, feel decades younger, and a “simple” surgery set me back hard. It took me over a year just to rebuild my strength, and now I probably need another 6 months to get my endurance and VO2 max back. I totally get now how having surgery at an advanced age can basically wipe you out physically.
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An interesting piece from this year’s BSRA conference was that exercising the day before surgery helped reduce the harm to fitness from surgery. Not two days before, however.
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Looking at that graph, it seems the older you get, the less you benefit from exercising more than just enough not to be completely sedentary. I’ll save my time (as I don’t enjoy exercise and do so exclusively for health benefits), and do just enough to extract most of the benefits (roughly within recommendations) and bank the rest of the time to add to my actual “life enjoyment”. Ultimately, time is the only thing we can’t make more of, so each minute is precious. YMMV.
I wonder about that… to what extent are there diminishing returns in exercising as it relates to Vo2Max?
I’m not sure how generalizable that graph is above - or how representative it is (or of what group it is representative of?). Not sure of the source.
And I wonder, are the outliers just more intense or more regular exercisers, or is there something else like genetics going on… such as for this guy…
That guy seems to disprove the graph above. But working out for 3 hours per day is probably not on your plans.
Details here from CGPT5.1:
Here’s a summary and analysis of the paper titled “How to Be 80 Year Old and Have a VO₂max of a 35 Year Old”(How to Be 80 Year Old and Have a VO₂max of a 35 Year Old, Karlsen et al., 2015).
Executive Summary
- The paper reports on a case study of an 80-year-old man whose measured maximal oxygen uptake (VO₂max) was 50 mL·kg⁻¹·min⁻¹ (3.31 L·min⁻¹) — very high for his age.
- His cardiopulmonary, vascular and muscle metrics were all well-above expectation for someone his age: strong left ventricular systolic & diastolic function, excellent pulmonary diffusion capacity, above-average blood volume/hemoglobin mass, and a large skeletal muscle mass (49 % skeletal muscle mass) for his age.
- The subject had a lifelong history of physical activity, both endurance and strength training, and a very high daily activity level in his 80s: ~10,900 steps per day and approximately 2:51 hours per day of physical activity (moderate + vigorous) logged via a wearable.
- The authors suggest that his very high VO₂max is attributable to the combination of lifelong activity, maintaining a high fitness baseline, excellent organ/system function, and high ongoing activity volume. They note that while most decline in VO₂max with aging is inevitable, starting high and remaining active may mitigate the decrement.
- The paper frames this as more than an extraordinary outlier — it offers “how” someone at 80 yrs can have physiological fitness of someone decades younger — though as a single case it cannot establish causality or generalize widely.
Key Details / Findings
| Variable | Value | Comment |
|---|---|---|
| VO₂max | 50 mL·kg⁻¹·min⁻¹ = 3.31 L·min⁻¹ | Very high for an 80-yr-old. |
| Max HR | 175 beats·min⁻¹ | Indicates relatively well-preserved chronotropic capacity. |
| Oxygen pulse | 19 mL·beats⁻¹ | Suggests large stroke volume and good cardiac output. |
| Skeletal muscle mass | 49 % of body mass | Unusually high muscle mass for age, supportive of high oxygen utilization. |
| Daily steps | ~10,900 steps·day⁻¹ | High daily volume of movement compared to peers. |
| Daily physical-activity time | ~2 h 51 min·day⁻¹ | Combined moderate + vigorous intensity activities logged. |
| Lifelong activity history | Farm work from youth, endurance and strength training across life | The background context. |
Level of Exercise / Physical Activity to Achieve This VO₂max
From the data in the paper, we can infer what level of exercise this person performed. Important to note: the paper does not provide a detailed training log with weekly hours at specific intensities for the last decades, so some inference is needed — but the measured objective data (daily steps, active time, lifelong training) gives us a solid estimate.
Key points to infer exercise level:
- The subject logged 2:51 (hours:minutes) of physical activity each day (measured by activity sensor) when in his 80s.
- He logged ~10,900 steps/day.
- The activity sensor data broken down indicated ~1050 min·week⁻¹ of moderate activity and ~147 min·week⁻¹ of vigorous activity (i.e., ~15.75 h/week moderate + ~2.45 h/week vigorous) — note this appears in discussion as “seven times” and “two times” the recommendations for moderate and vigorous physical activity respectively.
- The authors write: “He is moderately and vigorously active, 1050 min·wk⁻¹ and 147 min·wk⁻¹, which is seven times and two times above the recommendations for moderate and high-intensity physical activity of ≥150 min·wk⁻¹ and ≥75 min·wk⁻¹, respectively.”
- The subject also reported “~ 90 min/week of structured endurance and strength training” by self-report (though the authors note self‐report is low and actual activity was much higher in daily non‐structured movement). This suggests that the bulk of his high activity level was from unstructured daily movement + lifelong lifestyle rather than just structured training.
Therefore, a practical summary of the exercise level:
- Daily movement: ~11,000 steps/day (which for many people is ~8–10 km walking equivalent, depending on stride length) plus additional dynamic movement (e.g., farm work style, strength training).
- Active time: ~3 hours of moderate + vigorous activity each day.
- Weekly minimum intensities: ~15–16 hours moderate intensity (~150–300 min/week is guideline), ~2½ hours vigorous intensity (vs guideline ~75 min/week).
- Lifelong consistent training: The subject had been physically active from youth (farm work) and maintained both endurance (e.g., cross-country skiing races into older age) and strength training.
- The authors note that volume (not just intensity) seems very high compared to typical older active individuals and likely contributed to maintaining such a high VO₂max at age 80.
In short : This man was well above typical activity guidelines — around 7× the recommended moderate-intensity volume and 2× the recommended vigorous-intensity volume (in his 80s), plus high muscle mass, strong organ reserve, and lifelong training history.
Actionable Insights (for your domain of longevity / health)
- For someone aiming to push VO₂max (or maintain a high VO₂max into older age), merely meeting the guidelines (150 min moderate / 75 min vigorous per week) may not be sufficient; volume and consistency matter greatly. This case indicates ~1000 min/week moderate + 150 min/week vigorous (~18 h/week) in old age.
- Lifelong maintenance of activity (endurance + strength) appears critical. Starting early and keeping up high levels of activity likely built a higher baseline which made later maintenance feasible.
- In older age, significant movement volumes (steps/day, hours of active time) may help preserve VO₂max; structured training alone isn’t the full story — daily lived movement matters.
- Strength training and muscle mass appear relevant: high skeletal muscle mass (49 % in this subject) likely supported mitochondrial capacity, peripheral oxygen utilization, and thus VO₂max.
- Monitoring daily movement (steps, active time) in addition to structured training might be useful in longevity protocols aiming to maximize cardiorespiratory fitness.
Well, a graph like that is not pulled out of thin air. It represents human data, what a member of the human cohort can expect. That’s reality, even if we wish it were not so. Decline is the norm, even among athletes. Note, that athletes outlive the general population on average by only a small number of years, around 3 or so in most countries. But can you have exceptions like that 80 year old? Sure! But so what, it’s the vast majority that matter. Calmet lived to 122, is that someone to point to when speaking of even the most health obsessed among us? Is Calmet really relevant to us? Is that 80 year old? Or is that graph by far more relevant? You could make two lines in a graph, all those in numbers who play the lottery, and the second line all those who actually win the lottery. Which line do you think is more relevant to you when you contemplate buying a lottery ticket? Same here - I am not about to devote 3 hours a day, lol, hoping I’ll be lucky enough to get the same results after a lifetime of such exercise as that 80yo… and that’s before we even ask the really relevant question: is that 80yo going to live longer than the next 80yo who only exercises 5% as much as that guy… 3hrs=180minutes, 5%of180minutes=9minutes. I’m willing to bet that an 80yo guy who exercises 9 minutes every single day, will live just as long (and in reasonable shape) as that exercise fanatic 80yo genetic lottery winner. Yeah, thanks, but no thanks 
!