Cardiovascular Endurance and How to Increase O2 Delivery

Cardiovascular endurance is defined as the ability of the heart to provide enough oxygen to muscles during physical exercise for a long period of time. Elite endurance athletes always have very high VO2max (usually over 70 ml/kg/min in males). VO2max (maximum O2 consumption measured in ml of O2 per kg of body weight in 1 minute) is mainly an inherited factor. Therefore, you need to have super genes to become an Olympic champion. However, whatever your current VO2max, optimum training can increase it by up to 15-20 units. Let us consider how.

Oxygen is provided via respiration. Therefore, it is necessary to find out the ideal or optimum breathing patterns at rest and during exercise that provide maximum O2 amounts for muscles of the body.

Clinical experience of more than 150 Soviet and Russian medical doctors with sick patients and elite athletes suggests that people with more frequent and deep breathing at rest have reduced cardio fitness and less O2 levels in cells. My own experience with hundreds of students agrees with observations of these doctors.

If you pay close attention to breathing of very fit and healthy elite athletes at rest and during exercise, you can notice that they breathe slower and less in both situations. (Note that millions of people believe that breathing deeper or more air improves O2 delivery to cells, but hundreds of clinical studies proved that hyperventilation reduces O2 transport to body cells.) Here is a summary of main findings related to 4 common breathing patterns at rest. You can click the links to see dozens of studies that confirm these numbers.

Table. MV (Minute Ventilation) and Rf (Respiratory Frequency) at rest

Condition	MV, L/min	Rf, breaths/min	Oxygen extraction, %	Breath pattern	References (click below for details)
Diseases*	12-18	>18	<12 %	Overbreathing	Over 40 studies
Healthy	6-7	10-12	25 %	Normal	Results of 14 studies
Norm	6	12	25 %	Normal	Medical textbooks
Super-health	2	3	>60 %	Ideal	Observations/yoga

*Chronic diseases include heart disease, diabetes, asthma, COPD, cystic fibrosis, cancer, and many others. Study Hyperventilation Syndrome for references and numbers.

As it is easy to observe, heavy breathing at rest results in relatively heavy breathing during exercise and that makes moderate or intensive exercise in the sick very difficult or impossible.

Table. Minute ventilation during moderate exercise (15-fold metabolism)

Condition	Minute ventilation	Short-term respiratory effects	Blood lactate	Duration of performance
Chronic diseases	About 150 L/min	Maximum mouth ventilation	Very high	A few minutes
Normal breathing	90 L/min	Heavy nose breathing	Elevated	1-2 hours
Super health states	30 L/min	Easy nose breathing	Nearly normal	Many hours

In spite of huge improvements in diet, modern people are less fit and have reduced cardio endurance in comparison with people living about a century ago. This graph explains the cause.

Furthermore, fast or deep breathing at rest undermines desire of ordinary people and athletes to exercise, their sports performance and cardiovascular endurance, as the next Table shows.

Table. Effects of automatic breathing patterns on cardiovascular endurance

Body-oxygen level	Breathing pattern	Level of cardiovascular endurance
1-5 s CP	Very heavy breathing pattern	Physical activity can be life-threatening since acute exacerbation can occur at any moment due to critically low body oxygen level. No performance.
5-10 s CP	Heavy breathing pattern	Exercise can cause acute exacerbation of health problems (asthma attacks, stroke, angina pain, seizures, and so forth). Poor performance
11-20 s CP	Ineffective breathing pattern	Most people experience and complain about chronic fatigue, but can walk with only nose breathing for hours on a flat surface. Fit athletes can exercise with mouth breathing. Cardiovascular endurance and health are greatly compromised.
20-30 s CP	Deep breathing pattern	There are less or no complaints about fatigue. Physical activity (e.g., easy relaxed jogging) is well tolerated, but requires considerable psychological effort and self-discipline, unless one is an athlete. Reduced cardiovascular endurance.
30-40 s CP	Light degree of hyperventilation	Exercise is comfortable and relatively easy, but a systematic or daily exercise routine generally requires some self-discipline. Subnormal level of cardiovascular endurance.
40-60 s daily CP, less than 40 s morning CP	Subnormal breathing pattern	Exercise is easy and pleasant; nose breathing during exercise is natural and comfortable. Nearly normal levels of cardiovascular endurance and performance.
About 60 s morning CP	Normal breathing pattern	Exercise is joyful and people crave it. Level of energy is very high. If people force themselves not to exercise, their CP drops. Physiologically normal cardiovascular endurance.
Over 90 s MCP	Very light breathing pattern	States of super health with enhanced cardiovascular endurance

For more information how basal breathing patterns determine health symptoms, lifestyle, and health states, visit Buteyko Table of Health Zones.

Lifestyle factor:	Body oxygen < 30 s	Body oxygen > 50 s
Energy level	Medium, low, or very low	High
Desire to exercise	Not strong, but possible	Craving and joy of exercise
Intensive exercise with nose breathing	Hard or impossible	Easy and effortless
Typical mind states	Confusion, anxiety, depression	Focus, concentration, clarity
Craving for coffee, sugar and junk foods	Present	Absent
Addictions to smoking, alcohol, and drugs	Possible	Absent
Desire to eat raw foods	Weak and rare	Very common and natural
Correct posture	Rare and requires efforts	Natural and automatic
Sleep	Often of poor quality; > 7 hours	Excellent quality; < 5 hours naturally

How to increase cardiovascular endurance (lifestyle)

There are 3 main respiratory factors that produce negative effects on body oxygenation and cardiovascular endurance: thoracic (chest) breathing, mouth breathing (during sleep or exercise), and habitual overbreathing (increased breathing frequency and tidal volume at rest). All these factors reduce body oxygenation and worsen sport performance, physical health, sleep, recovery from injuries, digestion, metabolism of carbohydrates, lipids, proteins, and many other fundamental physiological parameters. One needs to reverse these factors in order to increase cardio fitness and VO2max.

Our basal or unconscious breathing pattern at rest is the main factor that defines cell oxygen levels. Hence, when we breathe faster and deeper at rest (chronic hyperventilation), we have less oxygen in body cells and less desire and motivation to exercise. Furthermore, overbreathing, which is present in over 90% of modern athletes, leads to reduced cardiovascular endurance, hampered recovery after workout and injuries, symptoms of chronic diseases, and many other negative effects.

How to improve cardio fitness (goals)

You can increase your cardiorespiratory and cardiovascular endurance and VO2max by slower and easier breathing at rest. You need to breathe so slowly that your body oxygenation gets up to 50-60 seconds 24/7. Then you will be very fit and will enjoy exercise and greatly improved physical health. If you want to be super fit, you need to get up to 2-3 minutes for the body-oxygen test by slowing down your automatic or unconscious breathing to 3-5 breaths per minute. One can get up to 5-7 units of VO2max increase (in ml/kg/min) by changing their basal breathing pattern. This site provides detailed instructions how to increase cardiorespiratory endurance using natural remedies and techniques.

This YouTube video (on the right side) explains how and why exercise with nose breathing is the most essential health factor for an ordinary person in order to fight and cure chronic diseases (such as asthma, hypertension, diabetes and many others) and increase cardio fitness. The video provides quotes from Dr. Buteyko Lecture at the Moscow State University. You can also click this link to watch the same video on YouTube: How to improve cardiovascular endurance.

During exercise, if you are unfit, nose breathing is hard or even impossible. If you are in competitive sports and fitness and want to improve cardiovascular endurance, there is one great device that maximize exercise benefits for fit people: Training Mask. It allows one to increase exercise efficiency nearly 2 times even in comparison with exercise with strictly nasal breathing. Learn more about effects of Training mask on cardiorespiratory endurance on this page: Training Mask.

Web pages about cardiovascular endurance, physical exercise, running, body building, and sports:
- Cardiovascular endurance and body O2 levels: How brain and body oxygenation influence cardiovascular endurance, desire to exercise, fitness-related lifestyle factors and physical health
- Physical health: It is impossible without high body-oxygen levels since low tissue oxygenation promotes chronic fatigue, diseases and abnormal states of the mind
- Breathing techniques for running: Which breathing techniques provide maximum body oxygenation at rest and during running?
- Benefits of physical activity: The main benefits of correct physical activity for health are due to more oxygen in body cells. Learn how to exercise correctly to get maximum benefits from exercise and sports
- Benefits of running correctly include increased cell and body-oxygen levels provided that you run with nose breathing only (in and out) mimicking some effects of high-altitude training
- Effects of exercise on the respiratory system: They are short-term and long-term and mainly depend on your breathing route: mouth vs. nose breathing
- Effects of lifestyle factors on sport performance are individual, but they all relate to increased O2 levels in body cells
- How to build more body muscle with less diet protein: Bodybuilding does not require as much protein in one's diet to build muscles if the body cells are well oxygenated due to correct breathing 24/7
- Graded exercise therapy: How to Make It Very Effective: Graded exercise therapy can be very beneficial, if it is done with one old key rule: nose breathing only
- Training Mask: Most advanced forms of physical exercise to boost body oxygenation, VO2max, endurance, and health.

Short sport and fitness articles: Breathing at rest, cardiovascular endurance and sport performance:
- Simple breathing exercise for higher VO2max
- Changing VO2max by breathing differently at rest
- Exercise is joy only when the body is oxygenated at rest
- When exercise is 100% safe for chronic diseases
- Why modern man gets little, if any, benefits from exercise
- Which exercise parameters increase body oxygenation

Reference pages: Breathing norms and medical facts:
- Breathing norms: Parameters, graph, and description of the normal breathing pattern
- 6 breathing myths: Myths and superstitions about breathing and body oxygenation (prevalence: over 90%)
- Hyperventilation: Definitions of hyperventilation: their advantages and weak points
- Hyperventilation syndrome: Western scientific evidence about prevalence of chronic hyperventilation in patients with chronic conditions (37 medical studies)
- Normal minute ventilation: Small and slow breathing at rest is enjoyed by healthy subjects (14 studies)
- Hyperventilation prevalence: Present in over 90% of normal people (24 medical studies)
- HV and hypoxia: How and why deep breathing reduces oxygenation of cells and tissues of all vital organs
- Body-oxygen test (CP test) : How to measure your own breathing and body oxygenation (two in one) using a simple DIY test
- Body oxygen in healthy: Results for the body-oxygen test for healthy people (27 medical studies)
- Body oxygen in sick : Results for the body-oxygen test for sick people (14 medical studies)
- Buteyko Table of Health Zones: Clinical description and ranges for breathing zones: from the critically ill (severely sick) up to super healthy people with maximum possible body oxygenation
- Morning hyperventilation: Why people feel worse and critically ill people are most likely to die during early morning hours

References: pages about CO2 effect:
- Vasodilation: CO2 expands arteries and arterioles facilitating perfusion (or blood supply) to all vital organs
- The Bohr effect: How and why oxygen is released by red blood cells in tissues
- Cell oxygen levels: How alveolar CO2 influences oxygen transport
- Oxygen transport: O2 transport is controlled by vasoconstriction-vasodilation and the Bohr effects, both of which rely on CO2
- Free radical generation: Reactive oxygen species are produced within cells due to anaerobic cell respiration caused by cell hypoxia
- Inflammatory response: Chronic inflammation in fueled by the hypoxia-inducible factor 1, while normal breathing reduces and eliminates inflammation
- Nerve stabilization: People remain calm due to calmative or sedative effects of carbon dioxide in neurons or nerve cells
- Muscle relaxation: Relaxation of muscle cells is normal at high CO2, while hypocapnia causes muscular tension, poor posture and, sometimes, aggression and violence
- Bronchodilation: Dilation of airways (bronchi and bronchioles) is caused by carbon dioxide, and their constriction by hypocapnia (low CO2)
- Blood pH: Regulation of blood pH due to breathing and regulation of other bodily fluids
- CO2: lung damage: Elevated carbon dioxide prevents lung injury and promotes healing of lung tissues
- CO2: Topical carbon dioxide can heal skin and tissues
- Synthesis of glutamine in the brain, CO2 fixation, and other chemical reactions
- Deep breathing myth: Ignorant and naive people promote the idea that deep breathing and breathing more air at rest is beneficial for health
- Breathing control: How is our breathing regulated? Why hypocapnia makes breathing uneven, irregular and erratic.

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