How to Improve Your VO2 Max to Help Prevent Frailty, Boost Heart Health

How to improve your VO2 max: Age-specific strategies

According to Levine, adults in their 60s or 70s who work to increase their VO2 max can expect a 15 to 30 percent improvement within a few months. The key is to start slowly, then increase frequency, duration and intensity. Even individuals who have been sedentary can definitely increase VO2 max well into their 70s with the right exercise, he explains. 

Your 50s: Strengthen your heart —before stiffening sets in

Levine describes the 50s as a key window: late enough that age-related changes are starting to matter, but early enough that there is still plenty of room to improve and preserve function.

Aim for a VO2 max in the mid 30s ml/kg/min for women and upper 30s to 40s ml/kg/min for men.

Your 60s: Reverse heart stiffening — while you still can

This is the decade when you might first feel a loss of stamina. Stairs feel steeper. Recovery takes longer. A fast walk feels more demanding than it used to. But Levine says measurable improvement in VO2 max is realistic within a few months of dedicated training.

Your VO2 max target: over 30 ml/kg/min for women and over 35 ml/kg/min for men.

Your 70s: Protect mobility and prevent frailty

Levine says that even in your 70s, a year of progressive training can still produce a 15 to 20 percent improvement in VO2 max. That’s a powerful reminder that it is never too late. But he also emphasizes that as you move through your 70s and beyond, protecting strength, balance and overall functional capacity becomes just as important as building aerobic fitness. You want to move with ease, without falling.

A realistic target for VO2 max at this age is in the upper 20s ml/kg/min for women and 30s ml/kg/min for men.

Your weekly plan: What to do and how often to do it

Levine created what he describes as a “prescription for life” that calls for 4 to 5 days a week of dedicated exercise to stay fit . Don’t view this as a once-in-a-while routine, but a lifelong commitment to aging better. Here’s your plan for each week:

• Moderate intensity: Two to three days a week, do something for at least 30 minutes at a pace at which you could hold a conversation. This can be a brisk walk or a bike ride. 
• Fun day: Choose one day every week to enjoy an activity like pickleball, hiking or a walk with friends. It should be fun, easy and take at least 60 minutes. And definitely make it social.
• High intensity: This is where the VO2 max magic happens. You need to push yourself to get your heart rate to 85 to 95 percent of its maximum for one day a week (once you’ve built up to it, aim for twice a week). There are several ways you can do this, but Levine and Wittstein both favor the “Norwegian 4x4”: Warm up, sprint for four minutes and spend three minutes in active recovery; repeat the sprint-and-recovery pattern four times, then cool down. . Do this once or twice a week. Wittstein says that the sprint portion does not have to involve running. What matters is pushing hard enough to raise your heart rate and challenge your cardiovascular system. That can mean brisk walking uphill or on a treadmill incline, cycling, rowing, pool intervals, or using an air bike, stair machine or SkiErg.
• Resistance training: No fitness plan is complete without strength training, all types of which support this VO2 max program. Muscle mass and bone density start declining around age 30. Focus on preserving that muscle, power and function and help improve your VO2 max by lifting weights, or using your own body weight or exercise bands, twice a week.  

Wittstein says low-impact activities — like the ones listed above — are especially helpful if you have knee pain, osteoarthritis or other joint issues that may cause discomfort. She personally spends her twice-a-week high-intensity days on an air bike, which forces you to use your arms, legs and core and gets your heart rate up.

Another option is to embrace the joint-friendly Japanese Interval Walking Training (IWT) method, where you warm up, speed-walk for three minutes, walk slowly for three minutes and repeat the speed/slow-walk pattern five times before cooling down. In many studies of older adults, this exercise improved aerobic capacity, leg strength and — as a bonus — blood pressure. If you can’t run, this is an effective way to improve your VO2 max.

Levine recommends tai chi as a moderate-intensity or fun-day activity because it increases heart rate and can help improve your balance and mobility, especially if you are in your 70s or beyond.

Track your progress: How to know if it’s working

There are several ways to track improvements in your VO2 max and cardiorespiratory fitness. The “How do you feel?” test is favored by both Levine and Wittstein because it will tell you without a doubt if climbing those stairs or that hill or walking that mile is easier now than it was before. But if you do want more accurate information, check out these options used by many fitness experts:

• Lab-based cardiopulmonary exercise test (CPET). This is considered the gold standard of VO2 max testing, but you must visit a specialized sports performance lab or cardiology center. You will wear a mask that measures oxygen use while using a treadmill or bike.
• Rockport walk test. This is a 1-mile walk, going as fast as you can without jogging. The test uses your time and ending heart rate to estimate VO2 max. It is practical, accessible and often more appropriate than a run test for many people 50-plus. Here’s how to calculate your VO2 max: 132.853 – (0.0769 x your weight in pounds) – (0.3877 x your age) + (6.315 x your sex at birth, where sex = 1 for men, 0 for women) – (3.2649 x 1-mile walk time in minutes) – (0.1565 x ending heart rate).
• Cooper test. This classic test tracks how far you can go in 12 minutes, usually by running or walking. Here’s how to do it: On a flat track and after you warm up, run or run/walk as far as you can in 12 minutes. Measure the total distance covered in meters. Your VO2 max = (distance in meters – 504.9) ÷ 44.73. This test is more suitable for fitter adults than for beginners with knee or joint issues. Make sure to check in with your doctor before doing it. (Read more about this test's inventor, Dr. Kenneth Cooper.)
• Timed 1-mile walk or run/walk. Levine says this may be one of the simplest real-world ways to gauge progress. Walk or run/walk the same mile every few weeks and see whether you can cover it faster and with less breathlessness.
• Wearables. Dr. Levine does not recommend relying on watches and rings for absolute VO2 max measurements because the readings are only estimates and can be inaccurate. However, many experts say they can be helpful for accountability, motivation (“Did I get my 10,000 steps in today?), and for trends (are numbers going higher or lower?). The easiest way to track real progress, he says, is to use the 1-mile walk test (above) or just know that when stairs and hills feel easier, you’ll know it’s working!

The big takeaway

VO2 max is not only about fitness. It’s about your freedom and the ability to move through your days and your life with more energy, ease and independence. And the good news is that “it’s never too late,” says Levine. Start where you are, keep going and protect your ability to age better.