The Importance of VO2 Max Testing: How to Read Your Results

Cenegenics® goes far beyond any routine medical examination. We offer advanced testing that achieves advanced results. The measure of oxygen that you utilize in day to day activities plays a vital role in accurately understanding the full picture of your current health. By gathering these results we can further personalize your program around your specific, body, goals and lifestyle.

Importance of VO2 Max Testing at Cenegenics®

VO2 max testing assesses the maximal oxygen consumption used during bouts of intense, taxing exercise. It’s presently considered the gold standard in measuring cardiovascular fitness among medical experts. It can accurately assess your cardiorespiratory functioning.

Not only does this test indicate your aerobic fitness level, but it also provides a wealth of useful information on which to base a tailored exercise regimen. VO2 max testing also reveals powerful insights into your overall wellness, including warnings of potential cardiac or respiratory disease symptoms.

At Cenegenics®, we use only the most established, accurate and trusted testing procedures available.

How is VO2 Max Testing Performed?

Like most medical testing, there are multiple ways to perform the same evaluation, VO2 max is no different. The most common way includes walking on a treadmill set at a 10% incline.

Every two minutes, both the treadmill’s speed and grade increase until your maximal work capacity is reached. While some consider this to be the most thorough means of testing, it also increases the risk of injury. Walking or running at high speeds for an extended period of time can be dangerous, especially for those who are overweight or generally sedentary.

When you reach high levels of exhaustion the risk of falling becomes a real possibility. All necessary precautions must be taken in order to ensure your safety first and foremost.

A safer alternative to the treadmill test is a cycle ergometer. The main idea of slowly and steadily increasing the intensity is the same, but with much less risk of injury.

How to Read VO2 Max Test Results

We use cutting-edge VO2 max software that provides extremely accurate and useful information. Using this data simplifies and streamlines the process of understanding you results.

One of the most outstanding qualities of this test is its ability to track all of the following data in 15-second intervals for the duration of the entire test, allowing our physicians to observe not only the changes that occur but also how quickly physiologic markers shift as the exercise intensity increases. Simply put, this helps us track your body’s every move while in a state of exertion.

Relative and Absolute VO2 Max

Absolute VO2 max (L/min) is a total value, while relative VO2 max (ml/kg/min) brings body weight into the equation. The relative value is more personalized and therefore a more precise indicator of your overall health than the absolute value.

For example, you may have a high absolute value, but compared to factoring in your body weight, it could be determined that you have a very low relative value which indicates less than optimum health.

Carbon Dioxide Expelled (VCO2)

VCO2 (L/min) is a value that correlates with VO2. As exercise intensity increases, oxygen consumption (VO2) increase right along with it. As more oxygen is consumed, more CO2 is created and released through breathing.

The volume of carbon dioxide expelled after transporting oxygen throughout your body is measured by VCO2. CO2 is also created as a byproduct of energy production inside your body during vigorous exercise.

Metabolic Equivalents (METS)

Also known as metabolic equivalents, METS identify how much oxygen you consume at rest. One MET is defined as 3.5 ml/kg/hour, which is equivalent to the energy cost of simply sitting. This measurement provides a straightforward means of measuring exercise intensity via oxygen consumption, and may be beneficial especially in athletic performance.

Most up-to-date treadmills have a built in feature that displays the METS of a certain intensity level. They can be a good indicator of intensity for tracking progress through specific workouts, and can at times, be recommended by exercise physiologists.

Heart Rate (HR)

Heart rate is one the your probably familiar with. Remember P.E class, and holding taking your pulse for 10 seconds and multiplying it by 6? That’s what this is. It’s important to know how many beats per minute your heart performs at rest and exercise. It’s a key inducator of how hard your body is working at rest. The harder it has to work, the more room for improvement you have. We want your heart working as little as it has to when you are sedentary, which for most people, is a large part of the day. Most people have a resting heart rate between 60 and 100 bpm. Whereas trained athletes could easily have a resting HR as low as 40 bpm. In general, physicians tend to recommend a target heart rate during moderate exercise of roughly 50-70% of maximum HR, or 70-80% of maximum HR during vigorous exercise. Your maximal beats per minute will naturally change with age, but with healthy lifestyle choices you can certainly improve your overall heart health and lower your resting bpm.

Respiratory Exchange Ratio (RER)

RER stands for respiratory exchange ratio. It is one of the most valuable pieces of information derived from a VO2 max test. RER helps us determine what fuel source your body was burning while exercising.

During periods of rest, you typically burn fat for energy. It’s a slow process, that requires lots of oxygen. Your body also uses fat during low-intensity exercise, as long as your body can get enough oxygen, it’s preference is to use fat for fuel.

As you up the exercise intensity, your body no longer has the time or oxygen to break down fats quickly enough to provide energy. It goes straight to carbohydrates stored in your muscles and liver, known as glycogen stores. Carbohydrates don’t require much oxygen to be broken down for energy and the process is quick compared to fats.

Your body is in a constant state of flux between carbs and fats for energy. While watching T.V your body is running on almost solely fat. When sprinting up a hill your body is utilizing a majority of carbs to get the job done. Depending on what your day physically consists of, could have a large impact the proper diet and training regimen for your unique body.

Respiratory Rate (RR)

Respiratory rate, or RR, is measured in breaths per minute. While at rest, an adult averages between 12 to 20 breaths per minute. As you go about your daily activities, your respiratory rate will increase and decrease.The difference between climbing a flight of stairs and sitting at a desk is all shown through your RR.

Tidal Volume (VT)

VT (L) is tidal volume. It’s the volume of air that is transported in and out of your lungs with each breath. As exercise intensity increases, a larger demand for oxygen is created, which requires more breaths per minute. Simply put, your body takes big breaths compared to small breaths.

Ventilation (VE)

VE (L/min) refers to ventilation. This is how much you breathe. Ventilation increases with exercise intensity, removing carbon dioxide and increasing oxygen supply.

Why Do a VO2 Max Test?

With all of the above data points combined, a VO2 max test provides you with a better understanding of your overall health, potential disease risk factors, and fitness levels. The VO2 max test is a solid predictor of long-term health and significant disease risk. Any serious lifetime wellness plan is incomplete without a proper VO2 max test.

What if working up a quick sweat could save your heart? Low VO2 max values have been linked to a high risk of cardiovascular disease. Believe it or not, this one test is a more accurate indicator than smoking, hypertension, diabetes, or high cholesterol. It’s powerful.

All variables are important, but when evaluating your overall health, the relative VO2 max and METS are the most important indicators. Above all the others, these two data points can reveal the most about your current health status.

VO2 testing combines your general health and overall fitness level together... providing practical and applicable information. This data can transform you current exercise plan. Not all exercise equipment has the ability to analyze VO2, but a simple heart rate (HR) monitor will allow you to implement the data.

Everything from smart phones to fitbits have the ability to measure your heart rate and provide you with instantaneous feedback. By using heart rate as a method of prescribing exercise, you can match it your to the desired intensity. This makes it easier to track results and have a base for progress.

How, precisely, is this done? If a lower training intensity or steady-state cardiovascular exercise is ideal, your physician will match the specific RER to your respective heart rate value and recommend that you stay in that range.

On the other hand, if high-intensity interval training (HIIT) would better support your goals, your physician will adjust the values accordingly. Your goal when exercising is to stay within the given range. Typically a heart rate monitor will beep or buzz when you fall below or exceed a desired range. This helps you slow down, speed up, lower weight, or increase resistance... depending on your goals and target heart rate zone.

Maximizing Results at Cenegenics® with VO2

At Cenegenics®, our goal to encompass all aspects of your health and wellness and focus on your body as a whole. We use the data from your VO2 test to adjust your comprehensive program and minimize risk factors for age-related diseases. After completing the assessment, your data will be analyzed by a Cenegenics® certified physician. A qualified exercise coach and nutrition counselor will also help in making recommendations and adjustments to your unique plan.

Once you have your target heart rate zone, you’ll have a clearly defined path to your personalized workouts. By working within this target range, you will be performing anaerobic exercise at times, which will stimulate the EPOC effect.

EPOC stands for excess post-exercise oxygen consumption. It refers to the period of time following physical activity during which your body uses oxygen to generate adenosine triphosphate (ATP), clear out lactate, return normal oxygen flow to the rest of your body, and restore your body’s temperature to a normal level. After exercising, your body’s metabolism will be stoked and active. This is a time where you can sit back, relax, and reap the rewards of burning extra calories from your high intensity workout.

HIIT training involves short bursts of exercise that are an all out maximal effort. The time can vary by preference, but usually lasts between 10 to 60 seconds. This is followed by a brief rest period of 30 to 120 seconds. These durations will vary based on your fitness level and heart rate zone. Here’s how a HIIT workout might look... after a five-minute warmup, you perform a 15-second max sprint followed by a 45-second rest. Simple, but extremely effective. You would repeat this cycle for a total of ten minutes, followed by a five-minute cool down and some stretching.

In a mere 20 minutes, the caloric expenditure can exceed that of a 30 to 45 minute low-intensity steady state workout. Talk about bang for your buck! It’s for this reason that HIIT is widely recommended by Cenegenics® physicians and favored by Cenegenics® patients. It saves time and is generally more effective than traditional steady state cardio models.

Using VO2 max testing is the best way to prescribe personalized exercise guidelines and wellness measures to lower your risk of disease and increase your quality of life. Cenegenics® patients are not only better able to achieve their weight loss goals and maintain their results; they are also more energetic, alert, and functional. There’s no better investment in your health than VO2 max testing. Your Cenegenics® team is waiting!

key resources

This guide was produced with contributions from the following key resources:

The Cenegenics® Education and Research Foundation

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics® Education and Research Foundation

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics® Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

[1] “Know Your Target Heart Rates for Exercise, Losing Weight and Health.” American Heart Association, Inc. 2018. Retrieved from URL:

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