VO2max and Substrate Crossover Point (VO2MAX-CROSS)

August 28, 2026 updated by: Celil Kaçoğlu

Higher VO2max Delays Substrate Switching and Shifts the Crossover Point to Greater Oxygen Uptake During Incremental Exerciseebys

This study aims to investigate the relationship between maximal oxygen uptake (VO2max) and the substrate crossover point during incremental exercise. A total of 20 physical education students are recruited to complete a maximal incremental treadmill test using the standard Bruce protocol. Indirect calorimetry is utilized to assess oxygen uptake (VO2), carbon dioxide production (VCO2), and energy substrate utilization patterns. The substrate crossover point is operationally defined at a respiratory exchange ratio (RER) threshold of 0.85, indicating the metabolic transition toward predominant carbohydrate oxidation. The primary objective is to evaluate how variations in aerobic capacity influence the timing, oxygen uptake, and heart rate (HR) responses at this metabolic transition threshold.

Study Overview

Detailed Description

This study evaluates the relationship between maximal oxygen uptake (VO2max) and the substrate crossover point during incremental treadmill exercise in young, physically active individuals. Substrate utilization kinetics and metabolic flexibility represent critical components of cardiovascular conditioning and endurance performance; however, the impact of continuous variations in aerobic capacity on the onset of metabolic transition requires detailed investigation.

Participants undergo anthropometric testing followed by a maximal graded exercise test on a motor-driven treadmill following the standard Bruce protocol. Breath-by-breath expired gas analysis using indirect calorimetry continuously monitors oxygen uptake (VO2), carbon dioxide production (VCO2), and minute ventilation (VE) throughout the test. Respiratory exchange ratio (RER) values are calculated continuously. The substrate crossover point is operationally defined as the exercise intensity corresponding to an RER threshold of 0.85, representing the metabolic transition where carbohydrate oxidation becomes the predominant contributor to total energy expenditure over lipid oxidation.

Key outcome measures extracted at this threshold include:

Time to reach the crossover point (minutes)

Absolute oxygen uptake at crossover (liters per minute [L/min])

Relative oxygen uptake at crossover (milliliters per kilogram per minute [mL/kg/min])

Percentage of maximal oxygen uptake at crossover (%VO2max)

Heart rate at crossover (beats per minute [bpm])

Statistical associations between maximal aerobic capacity (VO2max) and the primary outcome measures at the crossover point are analyzed using linear correlation and regression models to determine how cardiorespiratory fitness alters substrate switching kinetics under progressive physical strain.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Tepebaşi
      • Eskişehir, Tepebaşi, Turkey (Türkiye), 26100
        • Eskişehir Technical University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Healthy male or female physical education students aged 18 to 30 years
  • Regularly physically active (participating in structured physical activity at least 3 days per week)
  • Medically cleared and capable of performing maximal graded treadmill exercise testing to voluntary exhaustion
  • Willing and able to provide written informed consent

Exclusion Criteria:

  • History of cardiovascular, pulmonary, metabolic, renal, or neuromuscular disorders
  • Acute musculoskeletal injury or orthopedic condition that impairs treadmill running or maximal exertion
  • Current use of prescription medications, stimulants, or dietary supplements known to alter metabolic rate, heart rate, or substrate oxidation
  • Use of tobacco, nicotine products, or alcohol within 24 hours prior to testing
  • Consumption of caffeine or vigorous physical exercise within 24 hours prior to the exercise trial

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Exercise Testing Group
: Healthy young adult participants who undergo a single maximal incremental treadmill exercise test using the Bruce Protocol to assess cardiorespiratory fitness (VO2max) and substrate crossover kinetics.
Participants perform a maximal treadmill exercise test following the standardized Bruce Protocol. The test begins with a warm-up, followed by progressive 3-minute stages with continuous increases in speed and incline until voluntary exhaustion. Indirect calorimetry is used continuously via breath-by-breath gas analysis to measure VO2VCO2, and RER for substrate crossover determination.
Other Names:
  • Bruce Treadmill Protocol
  • Maximal Incremental Exercise Test
  • Graded Exercise Testing (GXT)
  • Maximal Treadmill Exercise Test

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to reach the substrate crossover point
Time Frame: Time Frame: Baseline (single test session, Day 1)

Measure Description: Elapsed time (in minutes) from the start of the incremental treadmill test (Bruce protocol) to the point where the respiratory exchange ratio (RER) reaches 0.85, indicating the metabolic crossover where carbohydrate oxidation becomes the predominant fuel source.

Time Frame: Baseline (single exercise test session, Day 1) Unit of Measure: Minutes

Time Frame: Baseline (single test session, Day 1)
Relative oxygen uptake at the crossover point
Time Frame: Measure Description: Measured continuously during the incremental exercise test using indirect calorimetry, recorded specifically at the point where the respiratory exchange ratio (RER) reaches 0.85. Time Frame: Baseline

Measure Title: Relative oxygen uptake at the substrate crossover point Measure Description: Oxygen uptake (VO2) normalized to body weight (mL/kg/min) recorded at the moment the substrate crossover point (respiratory exchange ratio [RER] = 0.85) is reached during the maximal incremental treadmill test (Bruce protocol).

Time Frame: Baseline

Measure Description: Measured continuously during the incremental exercise test using indirect calorimetry, recorded specifically at the point where the respiratory exchange ratio (RER) reaches 0.85. Time Frame: Baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of VO2max at the crossover point
Time Frame: Measure Description: Relative oxygen uptake (VO2) at the substrate crossover point (respiratory exchange ratio [RER] = 0.85) expressed as a % of the participant's maximal oxygen uptake (VO2max), calculated upon completion of the Bruce protocol

Measure Title: Percentage of maximal oxygen uptake at the substrate crossover point

Measure Description: Relative oxygen uptake (VO2) at the substrate crossover point (respiratory exchange ratio [RER] = 0.85) expressed as a percentage (%) of the participant's maximal oxygen uptake (VO2max) during the Bruce protocol treadmill test.

Time Frame: Baseline

Measure Description: Relative oxygen uptake (VO2) at the substrate crossover point (respiratory exchange ratio [RER] = 0.85) expressed as a % of the participant's maximal oxygen uptake (VO2max), calculated upon completion of the Bruce protocol
Heart rate at the crossover point
Time Frame: Measure Description: Heart rate (HR) in beats per minute (bpm) measured continuously during the incremental treadmill test (Bruce protocol), recorded at the substrate crossover threshold (respiratory exchange ratio [RER] = 0.85). Time Frame: Baseline

Measure Title: Heart rate at the substrate crossover point Measure Description: Heart rate (HR) recorded in beats per minute (bpm) using a telemetric heart rate monitor at the point where the substrate crossover threshold (respiratory exchange ratio [RER] = 0.85) is achieved during the maximal incremental treadmill test (Bruce protocol).

Time Frame: Baseline

Measure Description: Heart rate (HR) in beats per minute (bpm) measured continuously during the incremental treadmill test (Bruce protocol), recorded at the substrate crossover threshold (respiratory exchange ratio [RER] = 0.85). Time Frame: Baseline
Maximal oxygen consumption (VO2max)
Time Frame: Measure Description: Relative maximal oxygen uptake (VO2max in mL/kg/min) assessed at maximal exertion at the end of the Bruce protocol treadmill test to voluntary exhaustion via indirect calorimetry. Time Frame: Baseline

Measure Description:

The highest rate of relative oxygen uptake (VO2 in mL/kg/min) attained during the maximal graded exercise test (Bruce protocol) to voluntary exhaustion via indirect calorimetry.

Time Frame: Baseline

Measure Description: Relative maximal oxygen uptake (VO2max in mL/kg/min) assessed at maximal exertion at the end of the Bruce protocol treadmill test to voluntary exhaustion via indirect calorimetry. Time Frame: Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: celil kaçoğlu, Ph.D., Eskişehir Teknik Üniversitesi

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2026

Primary Completion (Actual)

June 30, 2026

Study Completion (Actual)

July 15, 2026

Study Registration Dates

First Submitted

August 25, 2026

First Submitted That Met QC Criteria

August 28, 2026

First Posted (Actual)

September 2, 2026

Study Record Updates

Last Update Posted (Actual)

September 2, 2026

Last Update Submitted That Met QC Criteria

August 28, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be publicly shared due to privacy and ethical constraints aimed at protecting participant confidentiality. However, de-identified aggregated data or specific data sets may be made available from the corresponding author upon reasonable academic request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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