Infinite Health with Dr. Arasi Maran
May 23, 2026 · 36 min · 13 segments
Welcome to another episode of Infinite Health. What if the number that best predicts how long you'll live isn’t your blood pressure, cholesterol, or smoking status, but a metric almost no one has…
So let me start with this is a conversation which people don't focus on, or this is a topic people have very less awareness about, so I'm so glad that we're gonna explore this and dissect it out.
As a cardiologist, one of the things I ask myself every day when I look at a patient is: How long is this patient going to live, and also how well? And out of every modifiable variable I can measure, such as blood pressure, cholesterol, blood sugar, smoking status, none of them predicts mortality as powerful as VO2 max.
There's a Manseger study published in the JAMA Network in 2018 which looked at 122,000 patients who went treadmill testing at the Cleveland Clinic.
The lowest fitness group had nearly four times the mortality of the highest fitness group.
To put that into context, it's like smokers had 1.4 times the mortality of non-smokers.
People with heart disease or blockages in their blood vessels had 1.3 times the higher chance of dying compared to a person who does not have a heart disease.
But your VO2 max number was a more powerful predictor of how long you will live than your smoking status, than your blood pressure, or existing cardiovascular disease.
Now, is this a one-time thing or was this replicated? In 2024, a meta-analysis from the British Journal of Sports Medicine pulled together 119 cohort studies, and this covered about 20.9 million observations.
And with every one MET, metabolic equivalence, improvement in fitness, that's about 3.5 ml per kg per minute of VO2 max, this was associated with a 11 to 17% reduction in all-cause mortality.
But just by increasing your fitness level, you can reduce the rate or your all-cause mortality by 11 to 17% compared to a person whose exercise capacity is going down every year.
So when patients ask me what they can do to live longer, I tell them, "Train your aerobic capacity." There is no pill, no shortcut, no biohack, but the evidence is absolutely overwhelming.
VO2 max is the maximum amount of oxygen your body can take in or deliver and use during peak effort.
So let me start with this is a conversation which people don't focus on, or this is a topic people have very less awareness about, so I'm so glad that we're gonna explore this and dissect it out.
As a cardiologist, one of the things I ask myself every day when I look at a patient is: How long is this patient going to live, and also how well? And out of every modifiable variable I can measure, such as blood pressure, cholesterol, blood sugar, smoking status, none of them predicts mortality as powerful as VO2 max.
There's a Manseger study published in the JAMA Network in 2018 which looked at 122,000 patients who went treadmill testing at the Cleveland Clinic.
The lowest fitness group had nearly four times the mortality of the highest fitness group.
To put that into context, it's like smokers had 1.4 times the mortality of non-smokers.
People with heart disease or blockages in their blood vessels had 1.3 times the higher chance of dying compared to a person who does not have a heart disease.
But your VO2 max number was a more powerful predictor of how long you will live than your smoking status, than your blood pressure, or existing cardiovascular disease.
Now, is this a one-time thing or was this replicated? In 2024, a meta-analysis from the British Journal of Sports Medicine pulled together 119 cohort studies, and this covered about 20.9 million observations.
And with every one MET, metabolic equivalence, improvement in fitness, that's about 3.5 ml per kg per minute of VO2 max, this was associated with a 11 to 17% reduction in all-cause mortality.
But just by increasing your fitness level, you can reduce the rate or your all-cause mortality by 11 to 17% compared to a person whose exercise capacity is going down every year.
So when patients ask me what they can do to live longer, I tell them, "Train your aerobic capacity." There is no pill, no shortcut, no biohack, but the evidence is absolutely overwhelming.
VO2 max is the maximum amount of oxygen your body can take in or deliver and use during peak effort.
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