The comprehensive study by Lang et al. (2024) offers invaluable insights for fitness professionals, illustrating the substantial benefits of improved cardiorespiratory fitness (CRF) on health outcomes. This article will discuss the implications of these findings, suggest practical applications, and provide a periodised training programme that personal trainers can adapt for their clients.

Key Findings

The systematic review by Lang et al. analysed over 20.9 million observations and underscored the predictive power of CRF in reducing morbidity and mortality. High levels of CRF are associated with significant reductions in risks for all-cause mortality, heart failure, and cardiovascular mortality. Each one-unit increase in metabolic equivalent of task (MET) corresponds to an 11%-18% decrease in all-cause mortality risk.

These findings emphasise the critical role of CRF in health and longevity. Integrating CRF assessments into training programmes can serve as a powerful motivator for clients, providing tangible goals linked to health benefits rather than aesthetic outcomes alone.

Practical Applications

  1. CRF Assessment and Monitoring
    • Implement initial and periodic CRF assessments using submaximal exercise tests like the 6-minute walk test or step tests.
    • Use these assessments to set personalised fitness goals and track progress, adjusting programmes as CRF improves.
  2. Client Education
    • Educate clients on the importance of CRF for long-term health, using data from the study to highlight the potential reduction in health risks.
    • Discuss the impact of lifestyle changes on CRF and overall wellness.
  3. Inclusive Fitness Programming
    • Develop inclusive programmes that cater to varying levels of initial fitness, ensuring progressions are realistic and based on individual CRF levels.
    • Incorporate a variety of aerobic exercises (cycling, swimming, brisk walking) to maintain client engagement and cater to personal preferences.
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Periodised CRF Improvement Programme

A well-structured periodised programme is pivotal for enhancing cardiorespiratory fitness (CRF), a key determinant of overall health and longevity. The following 12-week periodised training programme is designed to progressively improve CRF by systematically increasing the intensity, duration, and complexity of aerobic exercises. This approach allows individuals of varying fitness levels to gradually adapt to the demands of the exercise, enhancing their aerobic capacity while minimising the risk of injury and overtraining.

You may adjust the intensity and duration based on the client’s initial fitness assessment and progression.

Phase 1: Foundation (Weeks 1-4)

  • Objective: Build an aerobic base and habituate to regular exercise.
  • Frequency: 3 days/week.
  • Intensity: 55-65% of estimated max heart rate (HRmax).
  • Duration: 20-30 minutes of continuous or interval aerobic training (e.g., 1 min jog, 2 min walk).

Phase 2: Improvement (Weeks 5-8)

  • Objective: Increase aerobic capacity.
  • Frequency: 4 days/week.
  • Intensity: 65-75% of HRmax.
  • Duration: 30-40 minutes of mixed-intensity aerobic activities (e.g., cycling with varying resistance).

Phase 3: Maintenance and Peak (Weeks 9-12)

  • Objective: Maximise CRF improvements.
  • Frequency: 4-5 days/week.
  • Intensity: 75-85% of HRmax in intervals.
  • Duration: 40-50 minutes, incorporating longer intervals (e.g., 3 min high intensity, 2 min low intensity).

Starting with foundational exercises to build a basic aerobic base, the programme escalates through phases that introduce more challenging workouts, ensuring continuous improvement. By the end of the programme, clients will have achieved significant gains in CRF, contributing to reduced risks of chronic diseases and improved quality of life. This programme is adaptable for a wide range of clients, from beginners to more experienced exercisers, providing a comprehensive approach to fitness that prioritises health and functional ability.

The evidence presented by Lang et al. supports the incorporation of cardiorespiratory fitness into fitness regimens, not just as a marker of athletic performance but as a crucial determinant of health. By adopting a structured, periodised approach to training that focuses on CRF, fitness professionals can significantly impact their clients’ health outcomes, leading to a reduction in disease risk and enhancement of life quality.


Lang, J.J., Prince, S.A., Merucci, K., et al. (2024). Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults: an overview of meta-analyses representing over 20.9 million observations from 199 unique cohort studies. Br J Sports Med, 58, 556–566. Click here to review the full research article

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