How to Increase VO2 Max: Four Steps for Success
Written by 
Dr. Michael Ruscio, DC on
March 28, 2025
Written by
Dr. Michael Ruscio, DC on March 28, 2025
—
Reviewed by 
Hilary Watts
A strong heart and lungs can help us maintain vibrant health year after year. VO2 max may be the best way for us to assess and monitor the health of these important organs.
VO2 max represents the maximum amount of oxygen the body can absorb during intense exercise. A low VO2 max is associated with a higher risk of poor health outcomes, and a higher VO2 max is associated with longevity.
Fortunately, if VO2 max is low, we can take steps to improve it. Before I share how to increase VO2 max, let me help you understand what it is and why it’s a metric you may want to keep track of as you get older.
What Is VO2 Max?
VO2 max is the maximum amount of oxygen the body can use during exercise 1. Since oxygen is a key player in how our cells make energy, absorbing as much of it into the bloodstream (oxygen consumption) as possible means our cells can perform more work 2.
Outside of being able to exercise at a higher aerobic capacity, VO2 max matters because it provides clues about our circulatory, lung, and heart health 1 3.
A low VO2 max means the heart and muscles aren’t as efficient as they could be, which impacts overall health and lifespan.
The great news is that we can take steps to improve VO2 max, and every unit increase is associated with a 9% lower risk of dying from any cause 1.
How Is VO2 Max Measured?
The gold standard for measuring VO2 max is in a medical lab with a physiologist 1. You’ll wear a mask to measure maximal oxygen uptake while you work as hard as you can on a stationary bike or treadmill.
If formal VO2 max testing isn’t an option, completing one or both of these at-home VO2 max tests can provide a good estimate 4:
- Cooper 12-minute run test
- 2,000-meter rowing test
Cooper 12-Minute Run Test
Choose a flat surface like a 400-meter track (a treadmill works, too) and follow these steps:
- Warm up for at least 5 minutes and make sure to be well-hydrated.
- Run as fast as you can for 12 minutes while keeping track of the number of laps you complete.
- Cool down by walking for 5–10 minutes.
- Use this chart to calculate your distance in 12 minutes (or the treadmill display).
- Enter your information into this VO2 max calculator.
2,000-Meter Rowing Test
Choose a Concept2 rower (available at many fitness facilities) and follow these steps:
- Warm up for at least 5 minutes and make sure to be well-hydrated.
- Set the distance to 2,000 meters.
- Row as fast and hard as you can until you reach 2,000 meters.
- Cool down by walking or slowly rowing for 5–10 minutes.
- Visit this Concept2 VO2 max calculator.
- Enter your information and compare your result to the VO2 max chart.
Many fitness trackers also estimate VO2 max based on heart rate and speed during runs. But they’re not as accurate as formal testing and likely not as accurate as the Cooper 12-minute run test or the 2,000-meter rowing test.
VO2 max results are based on age, gender, and training status, so there isn’t one perfect VO2 max number to target. For example, a VO2 max that’s ‘good’ for a 70-year-old would be ‘poor’ for a 20-year-old.
Instead of comparing your VO2 max to that of an elite cyclist or endurance athlete, it’s best to use a population table to determine where your baseline is compared to others similar to you.
If you aren’t where you want to be, learning how to increase VO2 max levels and monitoring your trend over time is a better way to assess progress.
Can VO2 Max Improve?
VO2 max can be improved, especially for people who aren’t accustomed to physical activity.
People who routinely perform endurance training can also improve their VO2 max level, but the increase may be more subtle when compared to an untrained person.
In other words, the more highly trained you are, the more challenging it becomes to see significant movement on VO2 max levels.
What Exercises Are Best for Improving VO2 Max?
High-intensity exercise is the best way to improve VO2 max levels. However, if you aren’t currently exercising, I recommend laying a healthy exercise foundation first before diving into more intense sessions.
Working up to 2–3 hours of low-to-moderate aerobic exercise per week can help prepare your body for more intensity, prevent burnout and injury, and avoid negative immune system effects 5. Aerobic exercise includes activities like walking, swimming, cycling, and cardio machines like the stair-climber and elliptical.
The following steps can help you improve your VO2 max. People who are new to exercise should start at step one. Seasoned exercisers may be able to start at step four.
Step One: Determine Your Ideal Aerobic Heart Rate
Knowing your ideal aerobic heart rate is important for getting the most out of cardio training sessions.
There are different formulas for determining your target heart rate during aerobic training. My colleague Mike T. Nelson recommends using the Phil Maffetone equation, which involves subtracting your age from 180. Using a 50-year-old person as an example, the ideal heart rate for improving aerobic fitness would be around 130 beats per minute (180 – 50 = 130).
Staying at or below this heart rate during cardiovascular sessions will improve aerobic capacity over time. Going above this heart rate switches the body into anaerobic mode, which still has health benefits but doesn’t improve cardiorespiratory efficiency.
A heart rate monitor or fitness tracker (like a Garmin, Polar, or Apple watch) can be very helpful for staying on track with exercise intensity.
Step Two: Walk As Much As Possible
Once the target heart rate is determined, you may want to begin improving cardiovascular fitness by walking as much and as often as possible. Consider gradually increasing to at least 2–3 hours of walking each week over the course of 8–12 weeks.
Step Three: Ramp Up Cardio
Once you’re consistently walking for exercise, consider adding some low-intensity and moderate-intensity cardiovascular sessions (such as cycling, jogging, swimming, rowing, or hiking) to your training plan. Starting with 10 minutes, 5–6 days per week is great.
As your fitness level improves, slowly increase your time in these sessions to the goal of 20–40 minutes, 5–6 days per week (at your ideal heart rate).
Step Four: Optimize VO2 Max
Once you’re consistently performing 20–40 minutes of low-to-moderate intensity cardiovascular exercise most days of the week, you’re ready to add in some high-intensity interval training (HIIT) to optimize VO2 max.
All HIIT training programs (performed at 90–95% of maximum heart rate) can improve VO2 max. The following table details the two most common protocols:
| Protocol | How to Implement | Total Time | Sessions Per Week |
| 8×20 seconds 6 |
|
4 minutes of work, not including warm-up or cool-down | 3 |
| 4×4 minutes 7 8 |
|
28 minutes of work, not including warm-up or cool-down | 3 |
Both of these types of training improve VO2 max, but the 4×4-minute method seems to be the most effective 9. However, this doesn’t mean that every session needs to be the 4×4—if you’re short on time, the 8×20-second method will still help you march toward your VO2 max goal.
Adequately warming up and cooling down for HIIT sessions and appropriate nutrition and hydration can promote recovery and prevent injuries. I encourage my clients to:
- Eat a nutrient-dense diet with adequate protein and carbohydrates 10 11 12. Protein is integral for muscle repair and recovery. Including high-protein foods such as lean meats, fish, eggs, nuts, seeds, dairy (if tolerated), and soy can help meet protein goals. And a variety of different fruits and vegetables provide the vitamins, minerals, water, and phytonutrients our bodies need to repair after intense training sessions.
- Hydrate with fluids such as water and healthy electrolyte drinks before, during, and after intense exercise 10. Men and women need approximately 15.5 cups (124 ounces) and 11.5 cups (92 ounces) of fluid each day, respectively—but this number includes the amount of fluid we get from food, too 13.
VO2 Max Limitations
Although VO2 max can be a helpful measure whether we’re endurance athletes or just starting to increase our physical activity, it does have limitations.
VO2 max doesn’t tell us how strong our muscles are and is not the best predictor of running performance 14.
Additionally, VO2 max:
- Can’t predict long-term changes in body weight or body composition 15 16
- May not be the most accurate measure of aerobic capacity as we get older due to a natural loss of muscle mass 17
Training to improve VO2 max specifically is a worthwhile endeavor. But it’s just one metric to consider when it comes to health, longevity, and fitness performance.
VO2 Max: The Higher, The Better
VO2 max is a measure of cardiorespiratory fitness—higher is better. But there isn’t one number for which to aim.
It’s likely best to determine VO2 max (either in a professional lab or with an at-home estimation) and then monitor your trend over time based on your age, gender, and training status.
The best way to increase VO2 max is to include high-intensity interval workouts a few times weekly. The 8×20-second and 4×4-minute methods are both effective, but any high-intensity exercise can increase VO2 max.
If you’re new to exercise, it’s best to lay a healthy foundation first. Building up to 2–3 hours of low-to-moderate intensity cardiovascular exercise each week can help prepare your body for the higher intensity.
We’re passionate about fitness and would love to help you reach your exercise goals. Contact us at the Ruscio Institute for Functional Health for an appointment.
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Dr. Michael Ruscio is a DC, natural health provider, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.➕ References
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