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Reference equations for peak oxygen uptake during cycle ergometry based on body composition estimates.

Everton Santana1,2, Nicholas Cauwenberghs1, Patrick Khoury2

  • 1Research Unit of Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.

BMJ Open Sport & Exercise Medicine
|July 14, 2026
PubMed
Summary

New equations estimate peak oxygen uptake (VO2peak) using sex, age, body composition, and weight for cycle ergometer testing. These sex-specific formulas improve VO2peak comparisons in healthy adults.

Keywords:
Body compositionCardiology preventionExercise testingFitness testingSports & exercise medicine

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Area of Science:

  • Exercise Physiology
  • Cardiopulmonary Exercise Testing (CPET)
  • Biostatistics

Background:

  • Accurate assessment of cardiorespiratory fitness is crucial for clinical and sports settings.
  • Existing reference equations for peak oxygen uptake (VO2peak) may not adequately account for individual body composition differences.
  • Cycle ergometer cardiopulmonary exercise testing (CPET) is a common method for assessing VO2peak.

Purpose of the Study:

  • To develop sex-specific reference equations for VO2peak derived from cycle ergometer CPET.
  • To integrate estimated lean body mass (eLBM) and estimated body fat percentage (eBF) into these equations.
  • To provide a tool for calibrated comparisons of an individual's VO2peak against healthy norms.

Main Methods:

  • Pooled data from apparently healthy adults across multiple cohorts (Belgium and USA).
  • Developed sex-specific regression equations using 70% of the data for training.
  • Validated the equations on the remaining 30% of the data, assessing the standard error of estimate (SEE).

Main Results:

  • Derived distinct VO2peak reference equations for females and males incorporating eLBM, eBF, and age.
  • For females, the SEE was 279.9 mL·min⁻¹; for males, the SEE was 434.2 mL·min⁻¹.
  • The developed equations demonstrated good calibration across different subgroups.

Conclusions:

  • The new sex-specific equations provide a calibrated method for comparing an individual's VO2peak.
  • These equations effectively utilize estimated body composition (eLBM and eBF) and age.
  • This advancement enhances the interpretation of CPET results in clinical and research contexts.