Peter Attia's Surprisingly Simple VO2 Max Routine for Longevity
When Peter Attia, M.D., talks about longevity, people tend to listen. The physician, researcher, and founder of Early Medical has become one of the most influential voices in longevity science, translating complex physiology into practical strategies anyone can use to extend both lifespan and healthspan.
In a recent conversation on the mindbodygreen podcast, Attia shared one of the core pillars of his personal longevity routine: VO2 max training. It’s a metric he has championed for years, and one he still considers the strongest predictor of lifespan we currently have.
Even better? His approach is far more accessible than people might assume. You don’t need wearables, complicated programming, or a lab-grade setup. Just effort, awareness, and a weekly commitment.
VO2 max is the best predictor of longevity
Attia is clear. Even with all the biomarkers we now have, VO2 max hasn’t been dethroned. “VO2 max is the best predictor of lifespan,” he said. We have decades of standardized data, consistent measurement methods, and clear associations between higher cardiorespiratory fitness and lower mortality risk.
He notes that strength is a close second, but both metrics outperform traditional risk factors like hypertension or high cholesterol. Being unfit, he says, is one of the biggest and most overlooked liabilities for healthspan.
So what exactly makes VO2 max so meaningful?
It’s a direct reflection of how well your body can use oxygen during high-intensity effort, a measure of cardiovascular, pulmonary, and muscular efficiency all at once. In other words, it’s a whole-body snapshot of how resilient your system is under stress. And resilience is what tends to predict how well we age.
Inside Peter Attia’s VO2 max protocol
While Attia has the physiology background to optimize every detail, his actual routine is refreshingly straightforward. He trains VO2 max once per week, typically on Saturday, aiming for a total of 25 to 30 minutes of very hard effort in intervals.
A typical workout might look like:
- Three or four 8-minute intervals at his hardest sustainable effort
- Or six rounds of 4-minute intervals
- Sometimes he swaps in high-intensity swim intervals (2 to 4 minutes each)
The goal isn’t a perfect heart rate zone; it’s consistent, near-maximal effort.
Attia actually avoids using heart rate as a guide. “My VO2 max efforts from week to week can vary by 10 beats per minute,” he said. Instead, he relies on the rate of perceived exertion (RPE) and, on the bike, a power meter to ensure the effort is steady.
The feeling of the interval should build over time. “If you’re doing a four-minute interval at constant effort,” he explained, “the first minute’s going to feel pretty easy… by the third minute you’re in a lot of pain.” That nonlinear burn is exactly what signals you’re tapping into the VO2 max system.
But here’s the part people often miss: you don’t need tech to do this.
“You don’t need a power meter, and you don’t need a heart rate monitor. You can just go off exertion,” Attia emphasized. Even if your intervals are only 80% as efficient as someone optimizing every variable, “that is still fantastic.”
This is the core of Attia’s philosophy: VO2 max training should challenge you, not overwhelm you with complexity.
How to start implementing VO2 max training yourself
The beauty of Attia’s approach is that it works with whatever you already have—no bike, power meter, or perfect training loop required. You can build VO2 max through running, rowing, swimming, or even hiking up a steep incline. The key is effort, not equipment.
Here’s a simple, approachable way to begin:
Start with one VO2 max session per week
This is enough to make meaningful progress. Consistency beats intensity.
Pick an interval structure that matches your fitness level
Begin with short, challenging efforts and equal rest, such as:
- 4 x 3 minutes at very hard effort
As you adapt, you can work your way up to:
- 6 x 4 minutes, or
- 3 x 8 minutes of sustained hard work
Use perceived exertion as your guide
Instead of relying on heart rate, focus on how the interval feels. You should be able to hold the pace for the full duration, but just barely. The final stretch should feel significantly harder than the beginning.
Keep your pace steady from start to finish
Aim for an even effort rather than a fast start that fizzles out. You want a smooth, consistent push for the entire interval.
Don’t worry about perfection
Some days you’ll hit the effort perfectly; other days you won’t. That’s still productive. VO2 max improves through regular exposure to challenging work, not flawless execution.
The takeaway
VO2 max may sound technical, but Attia makes it clear you don’t need to be a physiology enthusiast to reap its benefits. At its core, VO2 max training is about showing up once a week and pushing yourself just past your comfort zone. It’s about building a body that can handle stress, recover faster, and stay capable for decades.