The Skeptical Cardiologist

How Does Your Aerobic Fitness Compare to Normal For Your Age: Maximal Oxygen Uptake (MVO2) Through the Decades

Now that you’ve completed your Rockport Walking Test and have generated an estimate of your cardiorespiratory fitness (CRF) you are likely eager to know how your estimated MVO2 compares to healthy men or women your age.

Fortunately for all of us, Leonard Kaminsky and his colleagues have recently updated the best reference database for directly measured CRF determined from cardiopulmonary exercise testing (CPX.) These data are available in a paper published in Mayo Clinic Proceedings entitled “Updated Reference Standards for Cardiorespiratory Fitness Measured with Cardiopulmonary Exercise Testing: Data from the Fitness Registry and the Importance of Exercise National Database (FRIEND).”

Here are the characteristics of the population studied:

It’s pretty cool that there are 776 patients in the age range of 70-79 years and 173 in the age range of 80-89 years. I’ve had several readers complain that Apple Watch and Garmin devices only go up to 60 years of age.

This group is not representative of all Americans although there are individuals from all 50 states except for Alaska, Wyoming, and Nebraska. In addition to lacking Cornhuskers, people with COPD or known heart disease, stroke or peripheral arterial disease were excluded.

Inclusion criteria used to create the present cohort were: (1) no known pre-existing diagnosis of CVD (coronary artery disease, myocardial infarction, heart failure, peripheral arterial disease, or stroke); (2) no known pre-existing diagnosis of chronic obstructive pulmonary disease; (3) maximal CPX testing performed on a treadmill or cycle ergometer; (4) men and women aged 20 to 89 years; and (5) peak RER of greater than or equal to 1.0 to indicate a maximal effort.

Normal MVO2 Values from Age 20 to Age 90

Here are the values for MVO2 broken down according to age range, gender and percentile rank (10 to 90.)

If you are seeking the average for your gender and age group, look at the first column on the left which gives the percentile. Average is the 50th percentile, while the 90th percentile, the top row gives the average values for those individuals with outstanding performance, better than 90% of the others in that classification.

For my age decile of 60-69, the 50th percentile is 24.6 for men and 19.6 for men.

Of note , the 50th percentile for my age group is a little over half of the 46.5 found in men aged 20-29 years. The MVO2 drops by 13.5% per decade, averaging 4 ml/kg/min drop every 10 years.

My estimated MVO2 from both the Rockport test and my Apple Watch was about 37 which is significantly above the average of 24.6 which I was very happy to see.

To determine my percentile rank in the 60-69 year-old men I moved up the appropriate column from 50 until I found the closest match to 37.1. This turned out to be the 90th percentile which I am astounded by.

Another way of looking at these norms is to use descriptive terms instead of percentiles.

Are You Fair or Possibly Excellent?

This chart is from a 1990 study that aggregated published normal MVO2 values in seven countries, including the US for individuals up to 75 years of age.

It displays values for males with age on the x-axis and MVO2 on the y-axis. The horizontal lines correspond to varying fitness categories as follows:

I’ve put a vertical redline for my age and you can see it crosses the #4 line (average) for a 68-year old at 24 and crosses line 1 (circled in blue and excellent!) at 37. The average score for a 40-year old man (red circle) happens to be 37.

A final table from Kaminsky, et al, gives normal values and peak heart rates by decade. Note the dramatic drop in peak heart at maximal exercise from 186 beats per minute in twenty-somethings to 131 BPM in eighty-somethings. This is a major contributor to the drop in cardiac output which contributes to age-related fitness decline.

Men and Women Differ

Of note, the average MVO2 was higher for men than women at every decile. I know this seems sexist but I’m just showing the data.

To see if this was part of a misogynous incel plot, I put my Apple Watch on my wife’s petite wrist and had her take a walk to see what her estimated MVO2 might be. Oddly enough, it came back at 37, precisely the value I have been getting recently.

This made sense because when she and I run together we are comfortable at about the same pace.

Because she is in a lower age decile than me (and a woman), her value also placed her at the 90th percentile for age and gender. It’s probably a good thing for marital stability and harmony to have both members at the same percentile for MVO2!

Maintaining Independence and Function Despite the Age-related Drop in MVO2

As you move from 20 to 80 years of age your MVO2 drops precipitously from 45 to 21 ml/kg/minute leaving you with half of the cardio fitness you had when you were a youngster. Regular exercise training is your major tool to make sure you have enough fitness to stay highly functional into very old age.

I leave you with a graph to ponder from a review article entitled “Survival of the fittest: VO2max, a key predictor of longevity?

It plots physical fitness (as a combination of CRF and muscle strength) on the y-axis versus age on x-axis. With the knowledge of MVO2, you now have a great tool to determine your CRF component of this “arc of healthy life.”

You should aim to be as close as possible to the top (trained, aka excellent fitness) curve.

Your curve can be moved from the sedentary one which declines below the horizontal cross-hatched line of independence by the late 70s to the trained upper line which only crosses the line in the mid-90s.

Both lines converge on death at about the same time but the individual who regularly engages in aerobic exercise spends many more of their later years independent and functional with the physical capacity to do the things which make life enjoyable.

We don’t have a gold standard tool for the assessment of muscle strength (although we know poor hand-grip strength has been linked to premature mortality and is easy assessed) but regular resistance training is equally important to healthy aging as is CRF.

Gerontologically Yours,


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