Tag: health

  • Trucheck™ vs. Galleri®: Comparing Advanced Blood Tests for Early Cancer Detection

    Trucheck™ vs. Galleri®: Comparing Advanced Blood Tests for Early Cancer Detection

    Introduction – The Future of Cancer Screening with Advanced Blood Tests

    Cancer screening has taken a significant leap forward with the introduction of advanced blood tests like Trucheck™ and Galleri®. These innovative screening methods aim to detect cancer at its earliest stages, providing vital information for timely interventions and improved outcomes. In this blog, we will compare Trucheck™ and Galleri®, exploring their scientific principles, advantages, and considerations, to help you make informed decisions about cancer screening.

    How Do Trucheck™ and Galleri® Blood Tests Work?

    Trucheck™ – Detecting Circulating Tumor Cells (CTCs)

    Trucheck™, developed by Datar Cancer Genetics, focuses on detecting circulating tumour cells (CTCs) and circulating ensembles of tumour-associated cells (C-ETACs) in peripheral blood samples. By employing primary negative enrichment, Trucheck™ enables the survival of malignant cells while allowing non-malignant cells to undergo apoptosis (programmed cell death). The subsequent analysis of tissue-specific markers on these cells helps identify cancer types and their likely organ of origin. Trucheck™ offers high sensitivity, specificity, and an overall advantage in detecting over 70 solid organ cancers.

    Galleri® – Analyzing Cell-Free DNA (cfDNA) for Cancer Detection

    Galleri®, another groundbreaking blood test, detects over 50 types of cancer and predicts the origin of cancer signals with high accuracy. This test examines the methylation patterns of cell-free DNA (cfDNA) found in the bloodstream. Methylation patterns, which regulate gene expression, can be altered in cancer, contributing to tumour growth. By leveraging next-generation sequencing (NGS) and machine-learning algorithms, Galleri® analyses the methylation patterns of cfDNA to identify cancer-specific abnormalities. These patterns provide valuable information about the presence and origin of potential cancers.

    Accuracy & Sensitivity of Each Test

    Trucheck™ demonstrates an overall sensitivity ranging from 82.5% to 88.2% for different cancer types. It boasts a specificity of 99%, correctly identifying 99 out of 100 individuals without cancer. False positives occur at an estimated rate of 1% to 3% according to the studies available so far. Trucheck™ has been designed as a complement to, not replacement for, standard cancer screening, offering peace of mind to individuals with negative results while prompting further tests or referrals for those with positive results.

    Galleri®, as demonstrated in the SYMPLIFY study, achieved a sensitivity of 66.3% overall, ranging from 24.2% for stage I cancers to 95.3% for stage IV cancers. This demonstrates Galleri’s ability to detect cancer signals across various stages but that it is most reliable with later-stage tumours. With a positive predictive value (PPV) of 75.5% and a negative predictive value (NPV) of 97.6%, Galleri®shows promise in accurately identifying individuals with cancer. The test’s specificity stands at 98.4%, further enhancing its precision in distinguishing cancer from non-cancer cases.

    Availability & Cost – Which Test is More Accessible?

    Trucheck™ is available as a standalone test or add-on service for patients undergoing health screening at Coyne Medical and several other private clinics in London and beyond. It may not be covered by healthcare insurance or the NHS prior to a formal cancer diagnosis. Further diagnostic procedures and referrals prompted by positive results may require self-payment.

    On the other hand, Galleri® is currently being evaluated in clinical trials and is not widely available outside of these trials. The SYMPLIFY study demonstrated its potential in a cohort of patients referred for diagnostic investigations related to suspected gynaecological, lung, and gastrointestinal cancers. It is not currently available in the UK in private care. It is only available through NHS research trials. 

    Considerations and Future Implications:

    Both Trucheck™ and Galleri® have the potential to revolutionise cancer screening, but it’s important to consider certain factors. Trucheck™ offers a broader range of tests for different cancer types, while Galleri’s focus lies in detecting over 50 cancer types. Trucheck™ uses CTCs and their clusters as biomarkers, primarily for solid organ malignancies, whereas Galleri® examines cfDNA methylation patterns.

    While Trucheck™ and Galleri® boast impressive sensitivity, it’s crucial to understand that false negatives can still occur. Neither test can replace standard screening methods such as mammograms, colon cancer screening, or cervical screening. Additionally, the emotional impact and potential for anxiety associated with both tests’ results should be taken into consideration.

    Looking ahead, the development of advanced blood tests like Trucheck™ and Galleri® brings us closer to a future where early cancer detection becomes a reality. These tests have the potential to complement existing screening methods, offering individuals a comprehensive and personalised approach to cancer prevention and treatment.

    Trucheck™ and Galleri® blood tests represent groundbreaking advancements in cancer screening, utilising cutting-edge technologies and scientific understanding to improve early detection rates. Trucheck™ focuses on CTCs, while Galleri® examines cfDNA methylation patterns. Both tests demonstrate considerable accuracy and hold promise for transforming cancer diagnosis and treatment.

    It is essential to consult with healthcare professionals to determine the most suitable screening approach based on individual risk factors, age, and personal medical history. By considering these innovative blood tests alongside standard screening methods, we move closer to a future where early cancer detection becomes the norm, leading to better outcomes and improved quality of life. Trucheck™ cancer screening blood test is available at Coyne Medical. Learn more on our website here.

    Book a Cancer Blood Test in London at Coyne Medical

    It is essential to consult with healthcare professionals to determine the most suitable screening approach based on individual risk factors, age, and personal medical history. By considering these innovative blood tests alongside standard screening methods, we move closer to a future where early cancer detection becomes the norm, leading to better outcomes and improved quality of life. Trucheck™ cancer screening blood test is available at Coyne Medical.

    BOOK MULTICANCER EARLY DETECTION BLOOD TEST

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides
  • Trucheck™: Empowering Early Cancer Detection through Advanced Blood Screening

    Trucheck™: Empowering Early Cancer Detection through Advanced Blood Screening

    Can a Blood Test Really Detect Cancer?

    At Coyne Medical, we strive to provide our patients with the latest advancements in healthcare technology. In line with our commitment to offering the best screening options, we are excited to introduce Trucheck™, a revolutionary cancer screening blood test developed by Datar Cancer Genetics. Trucheck™ aims to detect cancer at its early stages which can potentially lead to improved outcomes, streamlined treatments, and reduced morbidity. In this blog, we will explore the features, advantages, and considerations associated with Trucheck™, shedding light on why it is a powerful addition to our health screening services.

    The Urgency of Early Cancer Diagnosis:

    The statistics on cancer are startling. 1 in 2 individuals born after 1960 will be diagnosed with cancer during their lifetime. Unfortunately, the majority of cancers (48%) are currently diagnosed at later stages (3 or 4). This often leads to more aggressive treatments and poorer outcomes. Detecting cancer early, specifically at stage 1, can significantly improve survival rates and make treatments more effective. Trucheck™ aims to address this critical need for early diagnosis by leveraging cutting-edge technology and scientific advancements.

    Understanding Trucheck™: The Science Behind the Test

    Trucheck™ is a cancer-screening blood test. It utilises the concept of circulating tumour cells (CTCs) and circulating ensembles of tumour-associated cells (C-ETACs) in blood samples. Through a process known as primary negative enrichment, Trucheck™ selectively allows non-malignant cells to undergo apoptosis (programmed cell death) while enabling the survival of malignant cells. These malignant cells are then analysed using multiplexed fluorescence immunocytochemistry (ICC) to identify tissue-specific markers associated with various different cancer types.

    The presence of CTCs alone is not diagnostic of cancer. Instead, a positive Trucheck™ result indicates a high risk of cancer, providing valuable information about the likely type of cancer (e.g., adenocarcinoma) and its potential organ of origin (e.g., lung). A positive result should prompt further tests or referrals, which may involve additional costs and might not be covered by private medical insurance or provided by the NHS until a formal cancer diagnosis is established. False positives, although relatively rare (estimated at 1% to a maximum of 3% in studies), can occur.

    The Test Procedure and Pre-Test Consultation:

    Detailed information about the Trucheck™ test, including its procedure, can be found on our website making it a valuable resource for patients considering this screening option. To ensure the best possible experience and outcomes, we offer pre-test consultations. During these consultations, we review the patient’s medical history, assess suitability, identify high-risk factors, and address any concerns or questions.

    Who Can Benefit from the Trucheck™ Cancer Screening Blood Test?

    Trucheck™ is suitable for individuals aged 18 and above who are asymptomatic or have minor symptoms not requiring urgent investigation. It is particularly recommended for patients who wish to take advantage of the opportunity to identify their risk of cancer at an early stage, aiding in timely diagnosis and treatment. The test selection varies based on age and gender, with options such as Trucheck™ Intelli (for over 40 years of age, detecting over 70 tumour types), Trucheck™ Breast (females over 40 years of age), Trucheck™ Prostate (males over 45 years of age), and Trucheck™ Colon (over 40 years of age).

    Advantages of Trucheck™:

    1. Early Cancer Detection: Trucheck™ has the ability to detect cancers at an early stage, even before symptoms manifest, leading to better treatment outcomes and improved survival rates.
    2. Comprehensive Screening: Trucheck™ Intelli offers a broad spectrum of detection, encompassing more than 70 types of early-stage cancer within the asymptomatic population.
    3. Sensitivity and Specificity: Trucheck™ demonstrates high sensitivity (e.g., 88.2% for Trucheck™ Intelli) in correctly identifying cancer cases, minimising false negatives, and achieving a specificity of 99% to reduce false positives.
    4. Minimally Invasive: Unlike invasive procedures or radiation-based tests, Trucheck™ involves a simple blood draw, making it a convenient and non-intrusive screening method.
    5. Peace of Mind: Negative Trucheck™ results provide reassurance, indicating a low chance of having an active malignancy.
    6. Targeted Follow-up: Positive results from Trucheck™ allow for fast-tracked and targeted follow-up, utilising imaging, biopsy, or other confirmatory methods, minimising unnecessary medical procedures and exposure.
    7. Comparative Advantage: Trucheck™ outperforms other cancer screening tests in terms of false positive rates, surpassing tests such as PSA testing, FIT testing, and mammograms. However, all of these tests are still an important part of screening for cancer. 

    Considerations and Limitations:

    While Trucheck™ offers significant advantages, it is essential to consider certain factors:

    1. Emotional Impact: The anticipation of results, as well as false positive or indeterminate outcomes, can lead to temporary anxiety for individuals and their families.
    2. Unproven Survival Impact: Although Trucheck™ aids in early diagnosis, further research is needed to demonstrate its impact on long-term survival rates.
    3. Complementary, Not Replacing Standard Screening: Trucheck™ does not replace conventional cancer screening methods, such as mammograms, colon cancer screening, lung cancer screening CT scans, and cervical screening. It is designed to complement these existing tests.
    4. Specific Cancer Types: Trucheck™ focuses on solid organ malignancies and cannot detect blood or lymphatic system cancers.
    5. Coverage and Costs: Trucheck™ may not be currently covered by healthcare insurance, and the costs associated with the test are privately funded by individuals. Additionally, following a positive result, further diagnostic procedures may require self-payment before a formal cancer diagnosis is established.

    With cancer being a prevalent and life-altering disease, the importance of early detection cannot be overstated. Trucheck™ provides a groundbreaking opportunity for individuals to proactively assess their risk of cancer and enable timely interventions. While acknowledging its limitations, Trucheck™ offers unparalleled advantages, including early cancer detection, comprehensiveness, convenience, and high sensitivity. At Coyne Medical, we believe Trucheck™ is a vital addition to our health screening services, empowering our patients to take control of their well-being and potentially improve their cancer outcomes and healthspan.

    It is really important to emphasise that Trucheck™ should be utilised alongside routine healthcare and standard cancer screening tests, ensuring comprehensive and holistic health monitoring. To learn more about Trucheck™ and its suitability for you, we encourage you to reach out to our expert medical professionals at Coyne Medical.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides

    Explore our other Health Guides

    Cardiovascular Health · Cancer · Longevity and Healthspan · Child Health · Men’s Health · Women’s Health · Nutrition and Lifestyle · Lab Tests and Results

  • Unravelling the Link Between Diet and Prostate Cancer: Insights from a Recent Study

    Unravelling the Link Between Diet and Prostate Cancer: Insights from a Recent Study

    Prostate cancer is a significant global health concern. It is the fourth most commonly diagnosed cancer worldwide and the second most diagnosed cancer in men. While certain factors like race, age, and family history are known to influence prostate cancer risk, the role of modifiable factors such as diet has been unclear. However, a recent study aimed to shed light on this topic by investigating the association between “a posteriori” dietary patterns and Prostate cancer risk.

    “A posteriori” is a Latin term that translates to “from the effect to the cause.” In the context of this study, it refers to the approach used to identify dietary patterns based on observed data. A posteriori dietary patterns are derived from the dietary information collected from the study participants, without predefining specific food groups or nutrient components. These patterns are created using statistical methods that analyse the actual dietary habits of the population under study. By examining the observed dietary intake and identifying patterns within the data, researchers can draw associations between certain dietary patterns and health outcomes, such as the risk of prostate cancer.

    The study used data from the European Prospective Investigation into Cancer and Nutrition Spanish cohort (EPIC-Spain), which included 15,296 men aged 29-69 years. Information on lifestyle, diet, and medical history was collected through questionnaires and standardised measurements. 181 men were excluded from the study for what was deemed “implausible” food intake!

    Three dietary patterns emerged from the analysis: Western, Prudent, and Mediterranean. The Western pattern involved a high consumption of high-fat dairy products, processed meat, refined grains, sweets, caloric drinks, convenience food, and sauces. The Prudent pattern consisted of high intakes of low-fat dairy products, vegetables, fruits, whole grains, and juices. The Mediterranean pattern represented high intakes of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil, with a low intake of juices. 

    The findings of the study revealed that high adherence to the Western dietary pattern was associated with a considerable increase in the risk of aggressive prostate. On the other hand, high adherence to the Prudent and Mediterranean patterns did not show significant effects on Prostate cancer risk.

    The Western dietary pattern, characterised by its consumption of dairy products, red and processed meats, sweets, convenience food, and snacks, was found to have detrimental effects on Prostate cancer risk. These foods contain compounds that disrupt prostate hormonal regulation, increase oxidative stress, and stimulate inflammation, all of which can contribute to the development and progression of prostate cancer.

    Interestingly, the study did not find a strong protective effect of the Mediterranean or Prudent dietary pattern against aggressive prostate cancer. Differences in dietary habits between study populations and changes in dietary patterns over time may explain these discrepancies. Further research is certainly needed to validate these findings, as the number of cohort studies on this topic is still limited.

    The study’s strengths lie in its longitudinal design, large sample size, and the use of a posteriori dietary patterns. These patterns provide a comprehensive understanding of the overall diet and its impact on prostate cancer risk, accounting for the interactions between different foods and nutrients.

    However, the study does have limitations. It was unable to track changes in diet over time, and information on family history of prostate cancer or race was not available. Nonetheless, the study adds to our knowledge about the association between dietary patterns and Prostate cancer risk, emphasising the importance of reducing the consumption of high-fat dairy products, red and processed meats, refined grains, sweets, caloric drinks, convenience food, and sauces to prevent prostate cancer.

    The study suggests that adherence to a Western dietary pattern increases the risk of aggressive prostate cancer, while high adherence to the Prudent and Mediterranean patterns does not significantly impact prostate cancer risk. These findings highlight the need for individuals to make healthier dietary choices by reducing the intake of detrimental foods and focusing on a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins. However, further research is needed to confirm these findings and deepen our understanding of the complex relationship between diet and prostate cancer.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides
  • Small Dietary Changes, Big Health Benefits: Lowering Cancer Risk with Non-Processed Foods

    Small Dietary Changes, Big Health Benefits: Lowering Cancer Risk with Non-Processed Foods

    Are you concerned about your cancer risk? A new study from the European Prospective Investigation into Cancer and Nutrition (EPIC) suggests that making a small change to your diet may significantly reduce your risk of cancer and thus improve longevity.

    The study found that when 10% of ultra-processed foods were replaced with non-processed foods, the overall risk of cancer and of specific cancers, such as colon and postmenopausal breast cancers, decreased. Crucially, these results held true even when adjusted for other risk factors for cancer such as BMI, alcohol and dietary intake, and food quality.

    So what are ultra-processed foods? They include foods like processed meats, fizzy drinks, packaged snacks, and ready meals. These foods typically contain eye-wateringly high levels of added sugar, salt, and fat, along with artificial colours, flavours, and preservatives. Unfortunately, these food have also been designed to taste great. 

    The study’s findings suggest that the processing of food may play a role in cancer development. By replacing just a small portion of ultra-processed foods with non-processed options, you may be able to reduce your cancer risk.

    Non-processed foods, by contrast, are foods that are minimally processed and remain close to their natural state. Examples, of course, include fruits, vegetables, whole grains, nuts, and seeds.

    The EPIC study is a large-scale epidemiological study that has investigated the association between dietary intake and cancer risk. The study recruited over 500,000 participants from 23 centres across 10 European countries between 1991 and 2001. Participants completed dietary questionnaires and were followed up for an average of 15 years. The study used the NOVA food processing classification system to categorise foods based on their level of processing. This system categorises foods into four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods.

    The study found that a 10% increase in the proportion of ultra-processed foods in the diet was associated with a 12% increase in overall cancer risk. In contrast, a 10% increase in the proportion of unprocessed or minimally processed foods was associated with a 10% decrease in overall cancer risk. The study also found that a higher intake of ultra-processed foods was associated with an increased risk of specific types of cancer, including breast, colorectal, and throat cancer.

    Overall, the study provides strong evidence that reducing the intake of ultra-processed foods and increasing the intake of unprocessed or minimally processed foods may lower the risk of developing cancer. It’s important to note that this study was a prospective cohort substitution study, meaning that it didn’t directly measure the effects of diet on cancer risk. Rather, it analysed the effects of substituting certain foods in the diet with other foods.

    Despite this limitation, the study’s findings remain compelling. If you’re looking to reduce your cancer risk, consider making small changes to your diet. Replace processed snacks with fresh fruits or veggies or nuts, swap sugary drinks for water (I drink a lot of naturally flavoured sparkling water) or unsweetened tea, and choose whole grains over refined grains. By making these simple changes, you may be able to reduce your cancer risk and improve your overall healthspan.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • VO2max Testing

    VO2max Testing

    At Coyne Medical, we are incredibly passionate about the use of exercise as medicine. A huge amount of medical evidence now shows that low levels of fitness are associated with an increased risk of dying from any cause, including heart and vascular disease and cancer rates. In comparison to smoking, having high blood pressure, high cholesterol, or type 2 diabetes mellitus, fitness is a stronger predictor of death. The fitter you are, the lower your chance of dying. The addition of fitness metrics to the standard medical risk variables enables medical professionals to more precisely categorise your disease risk. Being unfit is a massive risk factor for disease. 

    Higher fitness levels are not only associated with a lower risk of death. High fitness is also associated with a lower risk of chronic diseases. The least-fit and next-least-fit groups of people have the most to gain from increased fitness. With increased fitness, these groups have seen a massive reduction in adverse health outcomes. Indeed, bringing VO2 max from the “low” range to merely “below average” reduces mortality by 50%! So there is no need to come anywhere close to the world record of the highest VO2 max of 96.7 ml/kg/min. This highest-ever VO2 max was achieved by Norwegian cyclist Oskar Svendsen. Their cardiovascular risk also declines substantially with increased fitness. Ideally, all adults should have their fitness measured on a regular basis, just like any other preventative check, such as checking blood pressure. The most accurate way to measure your fitness is through a VO2 max test.

    Higher fitness levels are not only associated with a lower risk of death. High fitness is also associated with a lower risk of chronic diseases. The least-fit and next-least-fit groups of people have the most to gain from increased fitness. With increased fitness, these groups have seen a massive reduction in adverse health outcomes. Indeed, bringing VO2 max from the “low” range to merely “below average” reduces mortality by 50%! So there is no need to come anywhere close to the world record of the highest VO2 max of 96.7 ml/kg/min. This highest-ever VO2 max was achieved by Norwegian cyclist Oskar Svendsen. Cardiovascular risk also declines substantially with increased fitness. Ideally, all adults should have their fitness measured on a regular basis, just like any other preventative check, such as checking blood pressure. The most accurate way to measure your fitness is through a VO2 max test. 

    VO2 Max Testing

    VO2 max testing is a form of cardiopulmonary exercise testing (CPET). It is a method used to assess the performance of the heart and lungs at rest and during exercise. VO2 max testing is totally non-invasive. During the test, information about the heart and lungs is collected to understand if the body’s response to exercise is normal. 

    VO2 max, or maximal oxygen consumption, refers to the maximum amount of oxygen that an individual can utilise during intense or maximal exercise. This measurement is generally considered the best indicator of cardiovascular fitness and aerobic endurance. The more oxygen a person can use during high-level exercise, the more energy a person can produce. This test is the gold standard for determining fitness because the muscles need oxygen for prolonged aerobic exercise and the heart must pump adequate amounts of blood through the circulation to meet the demands of the exercise. There is a strong association between VO2 max and longevity. Thus, knowing VO2 max gives us a powerful metric that we know is associated with longevity and that we can objectively improve. That’s right, we can improve our VO2 max. 

    The benefits of VO2 max testing

    Aside from providing the impetus to get fitter in order to live longer, there are several reasons why VO2 max testing is so important:

    • Your current fitness can be accurately measured. This allows doctors to accurately classify your risk of a whole host of diseases. 
    • It allows the capability to create a really efficient, bespoke training programme tailored to you. 
    • It allows the evaluation of the effectiveness of a training programme 
    • It can establish what is optimal running speed or cycling wattage to maximally improve endurance fitness and optimally burn fat
    • It can assist in distinguishing causes of low fitness from cardiac or pulmonary causes
    • From a doctor’s perspective, it can be used to provide helpful prognostic information in those suffering from chronic diseases

    The data obtained from VO2 max testing enables the most precise and standardised quantification of fitness. The primary advantage is the direct measurement of fitness. This is  as opposed to estimating peak or maximal VO2. Establishing exercise intensities (training zones) based on VO2 max testing allows athletes to minimise the risk of injury and fatigue while also enhancing adaptations and responses to the training plan. 

    Older athletes, or those with underlying medical conditions, can also benefit from VO2 max testing. This is because it can provide risk stratification for disease. It also allows safe clearance to participate in sports events. VO2 max can also be used to set training zones and determine exercise limitations for older athletes.

    How VO2 Max is measured

    By putting on a face mask, the volume and gas concentrations of inspired and expired air can be directly measured. This measure is often used in research and is considered the most accurate. The test involves either exercising on a treadmill or a stationary bike. The intensity increases every few minutes until exhaustion. Thus, it is designed to achieve maximal effort. 

    What You Can Learn From VO2 Max Testing

    VO2max testing provided several different metrics that are incredibly useful. 

    • VO2Max
    • This is the maximum amount of oxygen that an individual can utilise during intense or maximal exercise. 
    • As mentioned earlier, there is a strong association between VO2 max and longevity. 
        • It defines the exercise limits of the heart and lungs in healthy people.
        • It decreases with age, 8%-10% per decade in trained individuals who continue to train vigorously. 
        • Men have a VO2 max that is 10%-20% higher than women.
    • Ventilatory Threshold (also known as lactate threshold/ VT1)
        • Anaerobic (without oxygen) metabolism occurs when muscle energy demands exceed oxygen delivery to the muscles.
        • As anaerobic metabolism begins, the breathing rate and breathing effort increase to aid in CO2 removal from the body.
        • At this point, blood lactate levels start to rise, VO2 levels peak, and CO2 production accelerates. Rising lactate levels inhibit performance. So our muscle’s ability to utilise and clear lactate is very important. Training at low intensity helps us clear lactate efficiently. 
        • The measurement sets the upper limit of low-intensity training. 
      • The peak respiratory exchange ratio
        • This is the objective measure of the maximal effort of the participant 
        • It has a huge advantage over estimated maximal heart rate (HRmax), which is often derived from the commonly used equation 220-age
        • When estimated, maximal HR has a large population error of up to 12 bpm and thus is not an ideal indicator of exercise effort
        • Fitness levels have also been shown to influence the decline in maximal HR with age making HRmax even more unreliable. 
    • 2nd Ventilatory threshold (Anaerobic Threshold)
      • At this point. lactate has quickly accumulated in the blood, necessitating heavy breathing to expel CO2.
      • This represents the transition point between moderate and high-intensity exercise.
      • Thus, it sets the limits of high-intensity training

    Implications for Exercise

    Knowing the right intensity to exercise at enables you to maximally improve your fitness performance. Polarised training has been shown to lead to the greatest improvements in endurance performance. This type of training consists of mainly low-intensity, high-volume training (75%).  There is a moderate amount of high-intensity or sprint interval training (20%), and a small amount of training at threshold intensity (5%). Establishing your VT1 and VT2 will help you get the most out of your training. What you can measure, you can manage.  VO2 max is the most accurate way to measure your fitness, and maintaining a high VO2 enhances longevity.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Longevity & Healthspan Guides