Dr. Eric Topol published a thoughtful breakdown of why VO2 max has become an overrated marker for cardiorespiratory fitness.
Three simple problems.
- Cardiorespiratory fitness is measured in METs – a practical, real-world measure of how your heart and lungs perform during actual activity. VO2 max, by contrast, requires a lab, a specialized mask, trained technicians, and exercising to absolute exhaustion. Most people use smartwatch estimates that carry a 10-15% error rate.
- Nearly all the data linking fitness to longevity outcomes comes from MET-based studies – not VO2 max studies. Peter Attia conflated the two, calling VO2 max the single most powerful marker for longevity while citing research that never measured it.
- The practical consequence is that people are now stressing over an unreliable number while ignoring what matters – living an active life that improves cardiorespiratory fitness.
I’d add a couple things.
First, metrics should never get in the way of common sense. If you want better cardiorespiratory fitness, sprint up a hill regularly. Or play basketball every week. Go for a brisk walk and occasionally sprint. These are all tests of the very thing you’re trying to improve. It’s important to focus on the actions, not the number.
Next, if you do track VO2 max on a wearable, the absolute number is less useful than the trend. In my experience, even if the reading is imprecise, the direction it moves maps well to periods when I’m consistently active. Trends are often the signal even when the number is noise.
And finally – be careful about treating any one voice as gospel. I read Outlive and it genuinely changed how I think about exercise. Breaking it down into cardiorespiratory fitness, strength, stability, and mobility gave me a framework that pushed me toward a health journey I’m grateful for.
While Dr. Peter Attia’s work has been valuable to me, I’ve also been upfront about my gripe with his push for expensive scans and statins (and his fall from grace recently has been sad to see).
All in all, a reminder to read widely, think critically, and don’t let metrics get in the way of common sense.

