Is there really a proportional relationship between VO2max and body weight? A review article

Maximum oxygen uptake (VO2max) is a "gold standard" in aerobic capacity assessment, playing a vital role in various fields. However, ratio scaling ([Formula: see text]), the present method used to express relative VO2max, should be suspected due to its theoretical deficiencies. Therefore, the aim of the study was to revise the quantitative relationship between VO2max and body weight (bw). Dimensional analysis was utilized to deduce their theoretical relationship, while linear or nonlinear regression analysis based on four mathematical models (ratio scaling, linear function, simple allometric model and full allometric model) were utilized in statistics analysis to verify the theoretical relationship. Besides, to investigate the effect of ratio scaling on removing body weight, Pearson correlation coefficient was used to analyze the correlation between [Formula: see text] and bw. All the relevant data were collected from published references. Dimensional analysis suggested VO2max be proportional to [Formula: see text]. Statistics analysis displayed that four mathematical expressions were VO2max = 0.047bw (p<0.01, R2 = 0.68), VO2max = 0.036bw+0.71 (p<0.01, R2 = 0.76), VO2max = 0.10bw0.82 (p<0.01, R2 = 0.93) and VO2max = 0.23bw0.66-0.48 (p<0.01, R2 = 0.81) respectively. Pearson correlation coefficient showed a significant moderately negative relation between [Formula: see text] and bw (r = -0.42, p<0.01), while there was no correlation between [Formula: see text] and bw (r = 0.066, p = 0.41). Although statistics analysis did not fully verify the theoretical result, both dimensional and statistics analysis suggested ratio scaling distort the relationship and power function be more appropriate to describe the relationship. Additionally, we hypothesized that lean mass, rather than body weight, plays a more essential role in eliminating the gap between theoretical and experimental b values, and is more appropriate to standardize VO2max, future studies can focus more on it.