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What Is The Fragility Line & Why Does It Matter For Longevity

Ava Durgin
Author:
January 24, 2025
Ava Durgin
Assistant Health Editor
By Ava Durgin
Assistant Health Editor
Ava Durgin is the Assistant Health Editor at mindbodygreen. She is a recent graduate from Duke University where she received a B.A. in Global Health and Psychology. In her previous work, Ava served as the Patient Education Lead for Duke Hospital affiliated programs, focusing on combating food insecurity and childhood obesity.
Vonda Wright, M.D.
Image by Vonda Wright x mbg creative
January 24, 2025

Imagine reaching a point where standing up from a chair or carrying groceries becomes a challenge. This isn't just a part of aging—it's the result of declining physical fitness. On the mindbodygreen podcast, orthopedic surgeon and member of the mindbodygreen scientific advisory board Vonda Wright, M.D., calls this critical threshold the fragility line, and understanding it could be the key to staying strong, active, and independent for life.

The fragility line, explained

Every decade, we lose about 10% of our VO2 max—the maximum amount of oxygen our bodies can use during intense exercise. This metric isn't just for elite athletes; it's one of the most powerful indicators of overall health and longevity. VO2 max reflects how efficiently your heart, lungs, and muscles work together to fuel your body.

Here's where the fragility line comes in:

  • For men, a VO2 max of 18 marks this critical point.
  • For women, it's 16.

Dropping below this threshold means basic daily tasks—getting up from a chair and walking across a room—become increasingly difficult. Shockingly, once someone crosses this line, there's a 1 in 3 chance they will end up in a nursing home due to the loss of independence.

Why VO2 max matters for longevity

A higher VO2 max doesn't just help you run faster—it's linked to a longer lifespan, better brain health, lower inflammation, and improved blood sugar regulation. It also protects against cardiovascular disease and supports a healthier body composition. In other words, it's a full-body investment in your future.

For women, maintaining and improving VO2 max is even more crucial. Women naturally have about 20% lower VO2 max than men due to differences in body composition, blood volume, and oxygen transport. This means women need a strategic approach to stay ahead of the fragility line.

How to stay above the fragility line

1. Know your number

Wright emphasizes the importance of getting your VO2 max tested. And no, this doesn't mean you need to sprint until you're gasping on a treadmill. Many fitness centers offer submaximal tests, or you can use wearable tech (like the Oura Ring, which has a six-minute walking test) for a quick estimate.

2. Incorporate smart cardio

Forget the old-school advice to log endless miles on the treadmill. Instead, Wright recommends incorporating sprint intervals into your routine once a week:

  • Warm up for 10 minutes.
  • Sprint at maximum effort for 30 seconds.
  • Recover by walking for 1–2 minutes to get your heart rate back down.
  • Repeat for 4–6 rounds.

3. Lift heavy

Strength training isn't just for muscle growth—it's essential for cardiovascular health. Lifting heavy weights challenges your heart and lungs, supporting VO2 max and keeping you physically capable.

Lifestyle hacks to boost VO2 max

Exercise is essential, but other habits can also support your VO2 max, such as:

Iron intake

Iron is crucial1 for oxygen transport. Low iron levels—especially common in women2—can limit endurance. Eating iron-rich foods (like leafy greens and lean meats) or supplementing can make a big difference.

Urolithin A

This gut-derived compound improves VO2 max by supporting mitochondrial health and muscle endurance. You can boost it naturally by eating pomegranates, walnuts, and almonds.

Breathwork

Practicing intentional breathing strengthens your lungs and diaphragm, improving oxygen efficiency. Just a few minutes of daily breathwork can give your VO2 max a noticeable lift.

Post-workout sauna

Heat exposure after workouts increases blood flow and heart rate, boosting cardiovascular fitness. Research shows that combining sauna use with exercise can significantly improve VO2 max.3

The takeaway

Aging doesn't have to mean losing your independence. By prioritizing your VO2 max, you can protect your ability to move, live, and thrive on your own terms. Whether it's through strength training, smarter cardio, or small daily habits, staying above the fragility line is within your control.

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