How to Increase VO2 Max: Evidence-Based Training Types and the Gains to Expect

Can VO2 Max Really Be Increased?

Yes. VO2 max is partly genetic but changes meaningfully with training. A 2015 systematic review and meta-analysis in Sports Medicine pooled 28 controlled trials in healthy adults aged 18-45 (723 participants in total; mean age 25.1, baseline VO2 max 40.8 ml/kg/min) that lasted at least 2 weeks and measured VO2 max before and after training.

This article summarizes what that body of evidence says; it does not provide a personal training program.

What Did the Meta-Analysis Find?

• Endurance training: an average VO2 max gain of 4.9 ml/kg/min vs. non-exercising controls (95% confidence limits ±1.4).
• High-intensity interval training (HIIT): an average gain of 5.5 ml/kg/min vs. controls (±1.2).
• Head to head: HIIT produced about 1.2 ml/kg/min more gain than continuous endurance training (±0.9), which the authors described as a possibly small advantage.
• Duration and starting fitness: gains were larger in longer programs and in people with lower baseline fitness.

So both routes raise VO2 max meaningfully; HIIT has an edge, but a small one. The wide confidence intervals are a reminder that individual results can differ from these averages.

The Two Routes in Practice, and the General Framework

• Long, low-to-moderate intensity aerobic activity: walking, easy running, cycling. The WHO 2020 guidelines recommend 150-300 minutes of moderate or 75-150 minutes of vigorous aerobic activity per week (or an equivalent mix) for adults.
• HIIT: short, hard efforts interspersed with recovery. The protocols in the meta-analysis varied widely; there is no single "right" protocol.
• Muscle strengthening: the WHO guidelines also recommend regular muscle-strengthening in addition to aerobic activity. In the randomized trial below, resistance training also raised VO2 max, but it separated from endurance training on cellular markers such as telomeres.

In a six-month randomized trial of 124 healthy, previously inactive people (Werner et al., 2019; three 45-minute sessions per week), continuous running, 4×4 interval training and resistance training all increased VO2 max. For someone who is sedentary, the message is that, at low starting fitness, starting regularly may matter more than the exact method.

Limitations

• Young, healthy samples: participants in the meta-analysis were 18-45; results do not transfer directly to older adults or people with disease.
• Consistency: studies lasted weeks to months; gains can be lost if training stops.
• Raising VO2 max ≠ proven lower mortality: the strong link between high fitness and lower mortality comes from observational studies. Nothing here directly proves that raising VO2 max through training lowers risk by the same amount.
• Measurement: the reference method is a laboratory exercise test; wearable-device estimates are less precise.

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