Why do we care about VO2 max and muscle mass?
The rationale for emphasizing VO2 max and muscle mass is simple: these are the metrics with the greatest implications for healthspan and lifespan.
VO2 max, a measure of the body’s maximal ability to utilize oxygen during intense exercise, is indicative of overall cardiorespiratory fitness and, as discussed in detail in a recent premium newsletter, has been shown in multiple large-scale studies to be strongly and inversely associated with all-cause mortality risk across all adult age groups. Indeed, a low VO2 max is reported to be a far better predictor of mortality than diabetes, cancer, cardiovascular disease, smoking, or even age¹. The strength of this association can in large part be attributed to the fact that, in contrast to many other performance metrics, a high VO2 max requires consistency in training over relatively long spans of time and reflects not only aerobic fitness but body composition as well, underscoring the importance of maintaining this metric at a high level throughout life.
In addition to VO2 max, muscle mass – and to a greater extent, muscle strength – is also inversely correlated with mortality. As explained in AMA #27, low muscle mass (meeting clinical definitions of sarcopenia) has been reported to be associated with a 60% increase in risk of mortality relative to the absence of sarcopenia². Inadequate muscle leads to metabolic dysfunction and frailty, both of which can limit both quality and duration of life, but unfortunately, gradual losses of muscle mass and muscle strength are features of the aging process that cannot fully be avoided. Therefore, the most effective strategy for preventing sarcopenia in our latter decades of life is to build and maintain as much muscle as possible leading up to (and including) those decades – in other words, to ensure that we have enough muscle to buffer against the inevitable losses over time.
Focus on outputs over inputs
Many research studies claim to identify an “optimal” amount of time to devote to exercise each day or week in order to maximize health and lifespan benefits, but in the short video below, I explain why these results can be deceiving – and why focusing on outcomes of exercise, i.e., VO2 max and muscle mass, is a better strategy for setting goals around exercise and determining what is or isn’t “enough.”
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