VO2 Max Decoded: A Doctor's Guide to Longevity and Vitality with Dr Ashley Chambers
Introduction
Are you ready to transform your understanding of exercise and unlock the secret to a longer, healthier life? In this eye-opening episode, Dr. Ashley Chambers reveals the game-changing concept of VO2 max - a powerful indicator of your body's fitness that goes far beyond simple step counting.
Discover three revolutionary insights that will change how you approach movement:
- Learn how your body's oxygen consumption can predict your risk of disease and longevity
- Uncover the perfect exercise formula that combines strength, cardio, and intelligent intensity
- Understand why exercise is your ultimate tool for mental resilience and age-defying vitality
Whether you're a fitness novice or a seasoned athlete, this episode will inspire you to rethink your approach to health, offering practical, science-backed strategies to boost your fitness and quality of life. Get ready to breathe, move, and thrive!
Healthy and Strong workshop details: https://www.drorlena.com/healthy-strong
Connect with Dr Ashley Chambers
IG: https://www.instagram.com/theproactivemd/
LI: https://www.linkedin.com/in/ashleychambersmd/
Transcription of Podcast
Dr Orlena (00:01.099)
Hello, hello, hello. Welcome to Fit and Fabulous with me, Dr. Orlena I am super excited today because we have another wonderful guest. We're gonna be talking about leading our best, healthiest lives, which I always love talking about, specifically relating to exercise and how we can really use exercise to impact our lives. Dr. Ashley Chambers, hello and welcome.
Ashley Chambers (00:24.632)
Hi, Dr. Arlena, thank you so much for having me.
Dr Orlena (00:27.521)
Well, thank you so much for spending some time with us. Do you want to start by just introducing yourself and telling people a little bit about what it is that you do?
Ashley Chambers (00:35.18)
Yes, of course. Hi, all. I'm Ashley Chambers. I'm an internal medicine doc practicing outpatient internal medicine in Columbus, Ohio. I see adults, you know, kind of of all ages and ranges, and I've been doing it about 12 years. So it's fantastic. I have lots of wonderful patients. I love focusing on prevention, primary care, kind of being proactive, helping prevent disease.
I became lifestyle medicine certified over the course of last year and have loved kind of shifting that into my practice and really kind of focusing on that preventative approach using nutrition, movement, exercise, stress management, kind of all those things to help lead people to better health.
Dr Orlena (01:18.135)
Perfect, all the things that we love talking about here. Now we are going to go and talk about exercise, but before we dive into exercise, I think it's really interesting to take a pause. I only did adult medicine, so I did pediatrics. So I didn't do adult medicine for that much, but one of the things that I really think about when I look back on my short time in adult medicine is how much of, how many of the people were there related to lifestyle.
in one way or another. So before you started doing lifestyle, can you just talk a little bit about that, about how seeing people with things that were preventable really broke your heart, I'm guessing.
Ashley Chambers (01:56.652)
Yes, 100%. It's been a journey. Again, been practicing about 12 years, so I think in kind of the beginning of your career, you're just kind of learning the science, right, and learning how to treat people and how to use medication. And really, especially for the last probably four or five years, it's become so apparent that we're really good at treating disease and being reactive and kind of putting out fires all day long, right? Medicine for this, medicine for that. But knowing that you're just doing
folks almost to disservice by not taking a step back and looking at, how can we prevent these things in the first place? And knowing there are tools out there and ways to do it and science to back that up, to use nutrition and exercise and movement to help prevent disease and promote health. So yes, it is almost, yes, heartbreaking to use your words in that, like, whoa, we need to kind of shift the whole approach. But it's awesome that it can be done and.
People in lifestyle medicine are doing it and that's very empowering. So I've been working on incorporating these changes in my practice and how I practice and my approach with patients and it's been really fun.
Dr Orlena (03:02.836)
Yeah, perfect. And I think for me, as I say, I didn't do heaps of adult medicine, but it was really obvious for some people, like the people who smoked or the people who had...
alcoholic liver disease and you could see, there's really a direct cause between this big thing that they're doing and the illness they had. But then I think when I looked back more than anything, it was, my goodness, actually so many of the other diseases, it may not be one particular thing that is contributing, but a combination of different things, which means...
actually they find themselves in poor health and not really realizing that there are things and I think this is another heartbreaking thing is that people don't realize that actually they can make a really really big improvement in their health by changing lifestyle issues. just do you want to...
Ashley Chambers (03:54.99)
100%.
Dr Orlena (03:58.175)
Talk a little, before we go into exercise, do you want to give an overview of the things that you really think are important and make a big difference in improving people's health? And there, what I say, avoiding going to the doctors.
Ashley Chambers (04:11.95)
100%. Yes, I think the pillars of lifestyle medicine, Coming back to those, and I mean, I think it's also no coincidence that it seems to align in prevention of so many diseases, nutrition, exercise, sleep, stress management, social connection, right? All of these together, and to your point, often it's a combination of them.
But the great thing is you can make just small changes in one or two of these areas and have just an exponential improvement in quality of life and treatment of disease and prevention of disease.
Dr Orlena (04:48.862)
Yeah, and I think the other great thing that I find is that they're all related. So, you know, you think about stress and you think, well, how can I reduce stress? Well, we can think about what stress is and how we can do that. But also, eating healthily is going to help you reduce stress and having a good system to eat healthily is going to help you reduce stress. Doing some exercise, I personally think the best thing to avoid stress is to go and exercise. It's my...
I don't think I realized, I exercise quite a lot and it wasn't until a few months ago I was really thinking about this as I cycled home from the swimming pool thinking I think something had been going on in my life thinking I'm so glad I had my exercise because now I feel like I can take on the day but it's a really big help in stress and sleep obviously is very related to stress and so all of these pillars are interconnected.
Personally, I always tell people to aim for about 80%. It's not about getting anything perfect. I think people always think, I didn't do this perfectly, so now I just have to give up. And it's like, no, just go for good enough. And that's fine. Go for good enough and all of the pillars, and then suddenly your life will just feel amazing, amazing.
Ashley Chambers (05:59.886)
Yes, yes, and I echo you in feeling super passionate about exercise. think if there's one personally I cling to the most, it's the power of exercise. Realized about myself that it's so integral to kind of even waking me up and helping me feel sharp and patient with my kids. You know, they're five and seven and even when they were little and those are challenging years, but to go squeeze in 20 minutes of exercise, not even much, and to have that like...
calming, grounding moment was so powerful for the rest of the day. And I want people to feel that and to have that. It's amazing.
Dr Orlena (06:37.546)
Yeah, and I think, you know, another thing, exactly, women who have young children and then, and this was my story as well. So I started swimming when my kids were really little and they were having swimming classes. But I think a lot of women, mothers, just don't make time for themselves. And there's no blame in that. I totally get it. It's really difficult looking after kids. But when we are looking after kids and they're very emotionally draining.
It's really difficult to make time because we've got to look after our kids. And also there's a certain amount of guilt. I remember I felt really guilty when I decided that I was going to gasp, go and do an hour's yoga a week. my husband was sort of pushing me out of the door going, your kids are going to be fine. They'll be absolutely fine. Just go and do the yoga and come back less grumpy.
Okay, let's talk about the O2 Max. Do you want to start by explaining what it is and why it is a really interesting thing that we should all know about?
Ashley Chambers (07:34.754)
Yes, definitely. So VO2 max is a measure of your maximum aerobic capacity. It's a measure of your body's maximal rate of oxygen consumption. So when you're exercising, you're taking in oxygen, taking in through your lungs, through your alveoli, converting it and making ultimately energy, right? Energy in your muscles, energy to function, run, do what you're doing. And it is...
a predictor and there's significant evidence that the higher your VO2 max, the lower your risk of death from all causes but cardiovascular disease and overall mortality. the other piece is that it is a measure of kind of, it takes into a lot of different systems, into account a lot of different systems when you kind of are saying, hey, you have a high VO2 max.
It's also looking at your muscle quality, how your muscles are functioning together, your mitochondrial function. So when you compare it to measuring like your BMI or your glucose, your blood pressure, your lipids, those are all just kind of one individual piece. Vio2Max kind of takes into all these systems together and kind of gives you an overall marker of longevity and cardiovascular fitness.
Dr Orlena (08:51.456)
So when you say it's, can you repeat the first bit that you said, please?
Ashley Chambers (08:57.418)
It's a measure of your body's maximal rate of oxygen consumption.
Dr Orlena (09:02.272)
So does that mean that it's basically measured when you're all out, going your fastest, or is it measured all the time?
Ashley Chambers (09:09.49)
It, and I'll kind of talk a minute or two about how like in the lab it's measured, but yes, it is when you are going as fast as you can go on a treadmill, on a bike, as hard as you can, how fast your body's converting that oxygen into energy. That kind of rate is the measurement.
Dr Orlena (09:26.806)
So a lot of people, if they haven't been exercising, like if you're just walking, for example, and you're walking in that sort of zone two, where you're looking at your heart rate being like 120, as opposed to 150 high, those people, their VO2 max is probably, if they've got a smartwatch which is measuring it, it's probably not actually measuring the total maximum because they need to get a bit of a sweat up before they're actually gonna be able to measure it.
Ashley Chambers (09:52.59)
Correct, yes. The watch algorithm, right, if you have an Apple watch, it'll spit out a VO2 max and the data uses heart rate and then a bunch of algorithms to calculate. But yes, it needs that higher data to calculate. Traditionally, VO2 max is measured in a metabolic lab, like in an exercise lab on a treadmill, and I can talk about that later too. okay, perfect.
Dr Orlena (10:14.74)
You can talk about that now if you want to.
Ashley Chambers (10:17.618)
It traditionally is done with an exercise physiologist in a lab with a treadmill or sometimes a rower or a stationary bike and a metabolic cart. And they use a, you wear a mask that is kind of measuring, know, it measures oxygen in, carbon dioxide out, and you're breathing all through your mouth. Your nose is traditionally plugged. You wear a heart rate monitor and there's a protocol they take you through on a treadmill.
for instance, that slowly increases the incline and the speed until you reach kind of your max output, your 10 out of 10 over 10 out of 10, where you can't go anymore, and that's when the study ends and spits out kind of using all their equations and the physiology to find the VO2 max number.
Dr Orlena (11:06.74)
And can people get that done? Will people do that? Will your doctor do that? Or is that something that you have to go and find a physiology lab to measure?
Ashley Chambers (11:13.624)
Traditionally, you have to find a physiology lab for this. I recently kind of embarked on this journey in Columbus, Ohio, where I live. after some digging, I ended up at a health center associated with one of our big hospital systems. And that was the general, there were a couple of different health systems that did it, but there's usually, at least in Columbus, there aren't any like freestanding places. That being said, where I went, they said they can take anybody, right? Like you don't have to be an employee, you don't have to.
be a patient there or have a referral, you can just walk in and it was about $130 to have it done.
Dr Orlena (11:47.156)
And you talked about the Apple watch measuring it. Is the Apple the only one that does it or do others measure it as well?
Ashley Chambers (11:53.9)
I don't quote me on that, but I think there are other devices that do. I don't know which one.
Dr Orlena (11:58.165)
And are they relatively accurate or?
Ashley Chambers (12:02.509)
personal experience and from what I've read they're not as accurate as kind of the gold standard in the lab test. Mine was about four or five points lower on my Apple Watch than it was in the lab.
Dr Orlena (12:06.838)
Sure.
Dr Orlena (12:13.556)
And we want it to be higher, not lower.
Ashley Chambers (12:16.512)
Yes, we want it to be higher. So my lab measure.
Dr Orlena (12:18.644)
so that's actually a bonus. So if you've got your Apple watch, presumably all the levels which are done on the internet are published, are published by people who have done them properly in the lab. So if we're measuring lower, then that's actually a bonus because we're probably higher. All right. Okay, so what is, so if you could just sort of explain like having a good or bad VO2 max, what is that sort of, you talked about like, you know, overall,
Ashley Chambers (12:32.047)
Yes, exactly.
Dr Orlena (12:47.348)
mortality, which is good, but there are more specific things that VO2 max will tell us.
Ashley Chambers (12:54.894)
100%. And just for range of reference too, I'll kind of spit out some numbers, but for the average 45-year-old woman, her VO2 max is about 31 to 32. Average 45-year-old man is about 35 to 38. And then for a different frame of reference, a female Olympian marathoner is probably about 65 to 75. And that's measured milliliters per kilogram per minute. So kind of gives us...
Dr Orlena (13:17.268)
Wow.
Dr Orlena (13:20.854)
65, I think mine was in the 40s, but, and that was obviously measured on my Apple watch, perhaps it was a little bit more.
Ashley Chambers (13:26.83)
Yeah, it's high, but it's higher. So just, yes, for frame of reference. So we know that the other piece is VO2 max will fall with age. So the thought is the higher we can get it earlier on and hold on to that, the more better cardiovascular fitness we will have as we age, which is the goal. And so VO2 max measure of this aerobic capacity.
but also kind of reflects just our ability to carry out tasks and do things we like to do. Shopping, hiking, lifting grandkids, right? Staying physically active. So I think in a practical sense, the higher we can get the VO2 max, know, knowing it's gonna fall as we age, but then, you know, as we're in our 80s, we're still up here doing the things we like to do, going on the hike and feeling good and feeling well enough to stay physically active. So.
I think if we think of it as like, here's a measure of your overall fitness, we want it as high as we can, especially as we're younger. And then we want to try to maintain it as high as we can as we age.
Dr Orlena (14:29.408)
Perfect, and how do we maintain it?
Ashley Chambers (14:32.546)
Yes, so ways to adjust your VO2 max, right? Ways to increase your VO2 max. So like we kind of talked about, if you're starting at zero, any physical activity at all is going to increase your VO2 max, which is great, right? I think kind of to our earlier conversation, you start starting at nothing, like any exercise is so fantastic. Even, know, that zone two, starting there, working on kind of just low level walking, cycling, getting out 150 minutes, 300 minutes a week is fantastic. That will increase your VO2 max.
If you're already physically fit, you're already fairly active, increasing that high intensity exercise is what's going to boost your VO2 max. And specifically, looking at kind of these longer intervals, so not interval training and necessarily 30 second intervals, but more of like three, four, five minute intervals at probably like seven to eight RPE intensity. So, proceedings.
Dr Orlena (15:30.558)
Is that what we call sit exercise?
Ashley Chambers (15:33.306)
It, my understanding is it's a little different than sit in that I've seen sit sprint intervals being shorter and a bit like a 10 out of 10 level. This is more of like that seven to eight intensity, but for like four minutes. So, you you're able to do it a little longer than you would like the really high intensity, but I do think there's benefit in the sit too. So it's, I think they're kind of tomato, tomato, right?
Dr Orlena (15:48.406)
Okay.
Dr Orlena (15:59.723)
Do all of them, do all of them. So you're doing it for four minutes. like intensity seven to eight for four minutes. And then presumably you want to rest and then repeat.
Ashley Chambers (16:01.452)
Exactly. I think there's benefits to both.
Ashley Chambers (16:12.268)
Yes, yes, rest for, and that rest is very important. Also in like sit intervals, that rest is very important. So like four minutes of rest, right? You wanna fully recover and then you do it again at least about four times. The data is that, you know, if you're doing longer intervals, it's at least four times repeat. If they're a little shorter intervals, then you repeat more of them. But the total duration of exercise is probably about the same.
Dr Orlena (16:37.408)
So we've got hit where we're doing short, like 30 seconds, and then resting for a short period of time, but not resting such that we fully recovered, and then repeating that. We've got sit, which is going full out, resting for a minute or two minutes so that we do feel fully recovered. And then we've got this increase your VO2 max, which we haven't got a name for, which is four minutes, and then rest for another four minutes and then repeat.
Ashley Chambers (17:03.31)
Correct. Yes.
Dr Orlena (17:04.392)
Okay, and what about, so what about doing, for example, longer? So for example, I swim in the pool and we'll, like I do an hour, but we do, you know, we do different things. Or for example, I might just go for a swim in the sea where I'm just swimming for an hour or so. Does that affect my VO2 max?
Ashley Chambers (17:27.392)
My understanding is that's a little less of VO2 max improvement, but more of that zone two cardio probably, in that your heart rate is maybe your 130s, 140s, not so intense that you can't maybe talk. You're not going at your highest exertion, but you're able to maintain it for longer periods of time. Now, the great thing is that that though will also improve your mitochondrial function and effect.
longevity and health over the long term. So I think there are great benefits to that exercise too, just in a little bit different way from VO2 max improvement. So also fantastic piece to incorporate plus like the mental wellbeing of exercise like that, especially something like swimming in the ocean. I can only imagine it's amazing.
Dr Orlena (18:02.144)
Perfect.
Dr Orlena (18:10.462)
Yeah. But I think it's a really good idea to have different bits of exercise that you can do. So actually my swimming training, and I think it doesn't matter whether it's swimming training or whether you go to a spin class or something, but a class like that where they're going to be giving you different exercises, they're probably going to do some of these, go for a bit longer, do a little bit of sit, do a little bit of hit. They're kind of incorporated into the class. And I think that's really useful. And then having some exercise, which is your relax perhaps.
walking or swimming or cycling, kind of connect with nature if you can, relax a little bit and perhaps you you're getting into zone two, perhaps three or four, like you know if you go up a hill for example and you're cycling you're going to be getting into zones, well it depends how steep the hill is I guess, but pushing up a little bit there as well. But having a different variety of exercise I think is always useful as well.
Ashley Chambers (18:57.454)
.
Ashley Chambers (19:04.78)
Yes, and I always tell my patients, like our body loves a variety of things, you know, and not to leave out strength training, you know, that's of paramount importance with age and longevity. So pulling that in, but you know, folks who do lots of strength training and no cardio, I'm always encouraging them to find ways to incorporate some cardio in, but then also the strength training. And then also, yes, being in nature, a long, slow jog, you know, a hike. I mean, it's all powerful, especially combined together. Our body loves all those things.
Dr Orlena (19:34.08)
Perfect. So what is your overall recommendation for exercise?
Ashley Chambers (19:39.16)
When I speak to my patients, usually it's kind of as I kind of lead off with, hey, our body loves this mix of things. Ideally three days of strength training. And that can be kind of meeting you where you're at, right? If you're just starting, that's kind of some lower weights, kind of learning your way around the gym or doing some stuff at home. There's lots of great online content too in terms of folks starting out with strength training.
But ultimately I encourage them to really lean into like lifting heavier weights, right? And really building that bone density and that muscle over time. But then incorporating cardio, right? Two to three days of cardio, also a mix of more of that zone two steady state and then working in some kind of interval training one to two days a week.
Dr Orlena (20:09.44)
Yeah.
Dr Orlena (20:25.686)
Perfect, perfect. Fabulous, well I totally agree. I have to confess, I combine my weights with a HIIT exercise, because actually that works quite well. That's my sort day off, my swimming is definitely my... What about you? I would say people need to have an exercise that lights them up, that they totally love doing. So what is your exercise that lights you up?
Ashley Chambers (20:46.658)
Yes, so I've always been a runner and I would have said for a long time that that was always going to be my favorite thing. And I ran races pre-kids a little bit, less so now, and now it's more of a casual, maybe connect with nature choice, right? A four mile run on the weekend to zone out. But I have discovered a community of classes in my five minute drive from my house.
It's a woman-owned business and she brings women together who lift weights and teaches these classes to great music and it's a bit of its strength and some hit, right? She does some cardio mixed in, but there's an upper body day, a lower body day and a full body day and showing up in the morning, you know, early three days a week with the same women, it's just been powerful. So that has, over the past year has been...
really amazing for me. And I think the community and the connection has been awesome. So speaking back to kind of the importance of social connection and community, it kind of ties it all together for me. And it's been great.
Dr Orlena (21:47.531)
Perfect, perfect. I love it. And I think a couple of things as well that you really highlight, and I'm all for making things easy for people, because I think when things are easy, then they're far more likely to get done. And number one, you've got a community around you, so it's always far more fun. Like I see my friends in the swimming pool, we often do different things, but like in the changing room, it's nice to have that connection with people. But also there are studies that show that if you join a gym that's quite close to you, so five minutes, you're far more likely to go than if the gym is like a long way away. And I think it is about using things
that are close to us. So and sometimes that might not be the perfect thing but we can. We often you know might be a little bit like don't want to do that but actually do it for a little bit and you'll probably fall in love with it and enjoy whatever it is that is really close to you.
Ashley Chambers (22:23.97)
Yes.
Ashley Chambers (22:34.69)
Yes, I would have never thought I'd be going, you know, at 5 a.m. to these gym classes, but A, also, I pay for it ahead of time, so that holds me accountable, and I sign up ahead of time, and they know if you're not there, so I think that accountability, you know, kind of speaks to me. But yes, and knowing these other women are gonna be there at the same time, and we all got up early to do it, and you know, it's been amazing. So I think you have to find kind of, like you said, what works for you what motivates you, and different people are motivated by different things, but.
Dr Orlena (22:43.082)
Yeah.
Dr Orlena (22:56.65)
sounds fabulous.
Ashley Chambers (23:04.236)
I always encourage my patients to kind of give that some thought as to setting up a system that serves you.
Dr Orlena (23:10.036)
Yeah, and I think it's amazing that you have women in your gym. And I've definitely talked to, we have a gym in our swimming pool, but I've spoken to some of the older ladies there and say, why don't you go and use the weight machine? And they're like, well, because I don't really know how to use it. And I totally get that. It's a bit intimidating. And there are often young men there. Luckily, if you go in the morning, my son is one of these young men, but he goes after school. So early in the morning, he's at school. you know, there are, if you get to know the times as well.
And actually, some of the men are actually very pleasant and not scary at all. You you think they'd be really scary. They're really polite and really happy to help. But I do get that first bit is, my goodness, women lifting weights. Really? It's scary. And I think sometimes we just have to make it work for ourselves, basically.
Ashley Chambers (23:59.778)
Yes, 100%. And then just start to try and try a couple things and it doesn't have to be kind of all in 100 % from the beginning, right? Starting small and kind of just dipping your feet in and seeing what it feels like.
Dr Orlena (24:08.064)
Yeah.
Dr Orlena (24:11.776)
Perfect, perfect. Ashley, thank you so much for spending some time with us. Where can people find you and your services that you offer?
Ashley Chambers (24:20.002)
Yes, so I am mostly Instagram and LinkedIn. You can find me there. I'm practicing in Columbus, Ohio. So if you just kind of look me up on the internet, I'm there. Okay, perfect, perfect. Yes, thank you, it's a pleasure. So great to be here and have a great day.
Dr Orlena (24:30.346)
I'll leave a link. If you send me the link, I'll leave a link in the show notes. Perfect. Thank you very much.
