Comment by brandonb

The trick with the vo2 max measurement on the apple watch though is that the person can not waste any time during their outdoor walk and needs to maintain a brisk pace.

Then there's confounders like altitude, elevation gain that can sully the numbers.

It can be pretty great, but it needs a bit of control in order to get a proper reading.

The paper itself: https://www.apple.com/healthcare/docs/site/Using_Apple_Watch...

Seems like Apple's 95% accuracy estimate for VO2 max holds up.

  Thirty participants wore an Apple Watch for 5-10 days to generate a VO2 max estimate. Subsequently, they underwent a maximal exercise treadmill test in accordance with the modified Åstrand protocol. The agreement between measurements from Apple Watch and indirect calorimetry was assessed using Bland-Altman analysis, mean absolute percentage error (MAPE), and mean absolute error (MAE).

  Overall, Apple Watch underestimated VO2 max, with a mean difference of 6.07 mL/kg/min (95% CI 3.77–8.38). Limits of agreement indicated variability between measurement methods (lower -6.11 mL/kg/min; upper 18.26 mL/kg/min). MAPE was calculated as 13.31% (95% CI 10.01–16.61), and MAE was 6.92 mL/kg/min (95% CI 4.89–8.94).

  These findings indicate that Apple Watch VO2 max estimates require further refinement prior to clinical implementation. However, further consideration of Apple Watch as an alternative to conventional VO2 max prediction from submaximal exercise is warranted, given its practical utility.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12080799/