{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:24:14Z","timestamp":1783085054870,"version":"3.54.6"},"reference-count":12,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["G025625N"],"award-info":[{"award-number":["G025625N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004497","name":"Onderzoeksraad, KU Leuven","doi-asserted-by":"publisher","award":["C24M\/21\/025"],"award-info":[{"award-number":["C24M\/21\/025"]}],"id":[{"id":"10.13039\/501100004497","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004497","name":"Onderzoeksraad, KU Leuven","doi-asserted-by":"publisher","award":["DB\/22\/010\/BM"],"award-info":[{"award-number":["DB\/22\/010\/BM"]}],"id":[{"id":"10.13039\/501100004497","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019607","name":"Stanford Cardiovascular Institute, School of Medicine, Stanford University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019607","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Wu-Tsai Human Performance Alliance"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2026,6,17]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Objectives<\/jats:title>\n \n To derive sex-specific peak oxygen uptake (VO\n 2<\/jats:sub>\n peak) reference equations for cycle ergometer cardiopulmonary exercise testing (CPET) that integrate estimations of lean body mass (eLBM) and body fat percentage (eBF) based on sex, age, height and weight.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We pooled data from apparently healthy adults who performed cycle ergometry in Belgium (FLEMENGHO and iCOMPEER cohorts) and the USA (FRIEND registry). Per subgroup of sex, age and body mass index (BMI), 70% of the data was used for training the equations and 30% for testing them.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The cohort consisted of 1778 females and 1243 males. For females, the mean age was 49.8\u00b113.3 years, BMI 27.1\u00b14.9\u2009kg\u00b7m\n \u22122<\/jats:sup>\n and VO\n 2<\/jats:sub>\n peak 1488.4\u00b1360.3\u2009mL\u00b7min\n \u22121<\/jats:sup>\n . For males, the mean age was 50.2\u00b113.3 years, BMI 27.6\u00b14.0\u2009kg\u00b7m\n \u22122<\/jats:sup>\n and VO\n 2<\/jats:sub>\n peak 2467.1\u00b1595.5\u2009mL\u00b7min\n \u22121<\/jats:sup>\n . The reference equation for females was\n <\/jats:p>\n \n \n \n \n \n \n \n \n \n V<\/m:mi>\n \n O<\/m:mi>\n \n 2<\/m:mn>\n \n p<\/m:mi>\n e<\/m:mi>\n a<\/m:mi>\n k<\/m:mi>\n <\/m:mrow>\n ,<\/m:mo>\n \n \n <\/m:mrow>\n \n f<\/m:mi>\n e<\/m:mi>\n m<\/m:mi>\n a<\/m:mi>\n l<\/m:mi>\n e<\/m:mi>\n s<\/m:mi>\n <\/m:mrow>\n <\/m:mrow>\n <\/m:msub>\n \n [<\/m:mo>\n \n \n m<\/m:mi>\n L<\/m:mi>\n <\/m:mrow>\n \u00d7<\/m:mo>\n \n \n m<\/m:mi>\n i<\/m:mi>\n n<\/m:mi>\n <\/m:mrow>\n \n \u2212<\/m:mo>\n 1<\/m:mn>\n <\/m:mrow>\n <\/m:msup>\n <\/m:mrow>\n ]<\/m:mo>\n <\/m:mrow>\n <\/m:mtd>\n <\/m:mtr>\n \n \n \n =<\/m:mo>\n 1335.9<\/m:mn>\n +<\/m:mo>\n 31.3<\/m:mn>\n \u00d7<\/m:mo>\n \n e<\/m:mi>\n L<\/m:mi>\n B<\/m:mi>\n M<\/m:mi>\n <\/m:mrow>\n \n (<\/m:mo>\n \n k<\/m:mi>\n g<\/m:mi>\n <\/m:mrow>\n )<\/m:mo>\n <\/m:mrow>\n <\/m:mtd>\n <\/m:mtr>\n \n \n \n \n \u2212<\/m:mo>\n 21.8<\/m:mn>\n \u00d7<\/m:mo>\n \n e<\/m:mi>\n B<\/m:mi>\n F<\/m:mi>\n <\/m:mrow>\n \n (<\/m:mo>\n %<\/m:mi>\n )<\/m:mo>\n <\/m:mrow>\n \u2212<\/m:mo>\n 0.119<\/m:mn>\n \u00d7<\/m:mo>\n \n \n a<\/m:mi>\n g<\/m:mi>\n e<\/m:mi>\n <\/m:mrow>\n \n 2<\/m:mn>\n <\/m:mrow>\n <\/m:msup>\n <\/m:mtd>\n <\/m:mtr>\n <\/m:mtable>\n <\/m:mstyle>\n <\/m:mrow>\n <\/m:mstyle>\n <\/m:math>\n <\/jats:inline-formula>\n .\n <\/jats:p>\n \n In the test set, the SE of VO\n 2<\/jats:sub>\n peak estimates (SEE) was 279.9\u2009mL\u00b7min\n \u22121<\/jats:sup>\n . For males, the equation was\n \n \n \n \n \n \n \n \n V<\/m:mi>\n \n O<\/m:mi>\n \n 2<\/m:mn>\n \n p<\/m:mi>\n e<\/m:mi>\n a<\/m:mi>\n k<\/m:mi>\n <\/m:mrow>\n ,<\/m:mo>\n \n \n <\/m:mrow>\n \n m<\/m:mi>\n a<\/m:mi>\n l<\/m:mi>\n e<\/m:mi>\n s<\/m:mi>\n <\/m:mrow>\n <\/m:mrow>\n <\/m:msub>\n \n [<\/m:mo>\n \n \n m<\/m:mi>\n L<\/m:mi>\n <\/m:mrow>\n \u00d7<\/m:mo>\n \n \n m<\/m:mi>\n i<\/m:mi>\n n<\/m:mi>\n <\/m:mrow>\n \n \u2212<\/m:mo>\n 1<\/m:mn>\n <\/m:mrow>\n <\/m:msup>\n <\/m:mrow>\n ]<\/m:mo>\n <\/m:mrow>\n <\/m:mtd>\n <\/m:mtr>\n \n \n \n =<\/m:mo>\n 2264.4<\/m:mn>\n +<\/m:mo>\n 42.5<\/m:mn>\n \u00d7<\/m:mo>\n \n e<\/m:mi>\n L<\/m:mi>\n B<\/m:mi>\n M<\/m:mi>\n <\/m:mrow>\n \n (<\/m:mo>\n \n k<\/m:mi>\n g<\/m:mi>\n <\/m:mrow>\n )<\/m:mo>\n <\/m:mrow>\n <\/m:mtd>\n <\/m:mtr>\n \n \n \n \n \u2212<\/m:mo>\n 71.2<\/m:mn>\n \u00d7<\/m:mo>\n \n e<\/m:mi>\n B<\/m:mi>\n F<\/m:mi>\n <\/m:mrow>\n \n (<\/m:mo>\n %<\/m:mi>\n )<\/m:mo>\n <\/m:mrow>\n \u2212<\/m:mo>\n 0.134<\/m:mn>\n \u00d7<\/m:mo>\n \n \n a<\/m:mi>\n g<\/m:mi>\n e<\/m:mi>\n <\/m:mrow>\n \n 2<\/m:mn>\n <\/m:mrow>\n <\/m:msup>\n <\/m:mtd>\n <\/m:mtr>\n <\/m:mtable>\n <\/m:mstyle>\n <\/m:mrow>\n <\/m:mstyle>\n <\/m:math>\n <\/jats:inline-formula>\n .\n <\/jats:p>\n \n In the test set, SEE=434.2\u2009mL\u00b7min\n \u22121<\/jats:sup>\n . Per cent-predicted VO\n 2<\/jats:sub>\n peak calculated with the proposed equations presented a good calibration among subgroups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The proposed equations allowed calibrated comparisons of an individual\u2019s VO\n 2<\/jats:sub>\n peak to that of healthy individuals matched by sex, age and estimated body composition.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjsem-2025-003127","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:10:38Z","timestamp":1783084238000},"page":"e003127","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Reference equations for peak oxygen uptake during cycle ergometry based on body composition estimates"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6014-9857","authenticated-orcid":false,"given":"Everton","family":"Santana","sequence":"first","affiliation":[{"name":"Research Unit of Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium"},{"name":"Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Cauwenberghs","sequence":"additional","affiliation":[{"name":"Research Unit of Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Khoury","sequence":"additional","affiliation":[{"name":"Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jomme","family":"Claes","sequence":"additional","affiliation":[{"name":"Research Group of Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Ntalianis","sequence":"additional","affiliation":[{"name":"Research Unit of Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Arena","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Illinois Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Harber","sequence":"additional","affiliation":[{"name":"Health Sciences, Taylor University, Upland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaatje","family":"Goetschalckx","sequence":"additional","affiliation":[{"name":"Cardiovascular Diseases, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard A","family":"Kaminsky","sequence":"additional","affiliation":[{"name":"Fisher Institute of Health and Well-Being, Ball State University, Muncie, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0578-4954","authenticated-orcid":false,"given":"V\u00e9ronique","family":"Cornelissen","sequence":"additional","affiliation":[{"name":"Research Group of Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2592-136X","authenticated-orcid":false,"given":"Jonathan","family":"Myers","sequence":"additional","affiliation":[{"name":"Cardiology, VA Palo Alto Health Care System, Palo Alto, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Haddad","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA"},{"name":"Wu Tsai Human Performance Alliance, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Kuznetsova","sequence":"additional","affiliation":[{"name":"Research Unit of Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"2026070306051567000_12.3.e003127.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000461"},{"key":"2026070306051567000_12.3.e003127.2","unstructured":"Hansen JE , Sue DY , Wasserman K . Principles of exercise testing and interpretation, including pathophysiology and clinical applications. In: Principles of Exercise Testing and Interpretation, Including Pathophysiology and Clinical Applications. 3rd edn. Philadelphia (Pa: Lippincott Williams and Wilkins, 1999."},{"key":"2026070306051567000_12.3.e003127.3","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1097\/HJR.0b013e328336a124","article-title":"Influence of age, sex, body size, smoking, and \u03b2 blockade on key gas exchange exercise parameters in an adult population","volume":"17","author":"Sven","year":"2010","journal-title":"European Journal of Cardiovascular Prevention & Rehabilitation"},{"key":"2026070306051567000_12.3.e003127.4","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1093\/eurjpc\/zwaf045","article-title":"Reference equations for peak oxygen uptake for treadmill cardiopulmonary exercise tests based on the NHANES lean body mass equations, a FRIEND registry study","volume":"33","author":"Santana","year":"2026","journal-title":"Eur J Prev Cardiol"},{"key":"2026070306051567000_12.3.e003127.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2021.08.020"},{"key":"2026070306051567000_12.3.e003127.6","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200939030-00002"},{"key":"2026070306051567000_12.3.e003127.7","doi-asserted-by":"crossref","DOI":"10.1016\/j.isci.2024.110792","article-title":"Improving cardiovascular risk stratification through multivariate time-series analysis of cardiopulmonary exercise test data","volume":"27","author":"Ntalianis","year":"2024","journal-title":"iScience"},{"key":"2026070306051567000_12.3.e003127.8","unstructured":"World Health Organization . Obesity: preventing and managing the global epidemic. report of a who consultation. Geneva, Switzerland World Health Organization (WHO technical report series: 894); 2000."},{"key":"2026070306051567000_12.3.e003127.9","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114517002665"},{"key":"2026070306051567000_12.3.e003127.10","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1093\/eurjpc\/zwaf056","article-title":"There is a new kid in town: body composition metrics to optimize reference equations for peak oxygen consumption during treadmill tests","volume":"33","author":"Mueller","year":"2026","journal-title":"Eur J Prev Cardiol"},{"key":"2026070306051567000_12.3.e003127.11","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1249\/MSS.0000000000003463","article-title":"Comparison of Cardiorespiratory Fitness Prediction Equations and Generation of New Predictive Model for Patients with Obesity","volume":"56","author":"Vecchiato","year":"2024","journal-title":"Med Sci Sports Exerc"},{"key":"2026070306051567000_12.3.e003127.12","doi-asserted-by":"crossref","first-page":"102933","DOI":"10.1016\/j.arr.2025.102933","article-title":"The effects of eccentric versus traditional resistance training on muscle strength, power, hypertrophy, and functional performance in older adults: A systematic review with multilevel meta-analysis of randomized controlled trials","volume":"113","author":"Chaabene","year":"2026","journal-title":"Ageing Res Rev"}],"container-title":["BMJ Open Sport & Exercise Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsem-2025-003127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:10:45Z","timestamp":1783084245000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopensem.bmj.com\/lookup\/doi\/10.1136\/bmjsem-2025-003127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,7,3]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjsem-2025-003127"],"URL":"https:\/\/doi.org\/10.1136\/bmjsem-2025-003127","relation":{},"ISSN":["2055-7647"],"issn-type":[{"value":"2055-7647","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}