Health trackers. Major fitness trend or management tool?

We live in an era of constant health monitoring and the belief that "what gets measured gets managed". And the number of self-monitored indicators is increasing every year. And with them, the market for health monitoring gadgets and apps is growing.

I'll admit, I'm a big fan of portable fitness gadgets and smart apps. My collection includes the latest smart watches for active lifestyles, smart goggles for swimming that track pace, speed and heart rate, several meditation apps paired with neuroprogrammes for stress management.

Wearable devices and apps can be wide-ranging.

Fitness trackers, such as FitBit, that track steps and heart rate. Smart watches like the Apple Watch, which measures oxygen saturation, sleep and has an electrocardiogram sensor. ECG monitors, such as Move ECG. Blood pressure monitors like HeartGuide that measure blood pressure and activity. Sleep trackers, like Oura Ring, that track sleep patterns and provide recommendations. Continuous glucose monitors (CGMs), like Freestyle Libre. Biosensors, like the Philips Biosensor, that measure various vital signs.

Basic models of wearable devices measure steps, stairs, calories and minutes of physical activity, while more advanced devices have 24-hour heart rate monitoring, built-in GPS systems, are used as a behaviour change tool and to monitor wellbeing.

In my opinion, the main value of all of the above wearable devices is that they are additional tools to motivate inactive people to get up and move. And also a way for overly active people to reduce their workload so they don't kill themselves while exercising. It's a great control tool. But just because you can measure something doesn't mean you should. Because it turns out that a person becomes a "slave to the lamp", well, or in our case a slave to gadgets.

And the obsession with which the user believes the indicators of the application or feels anxious about the failure of the programme, leads to negative consequences in the form of additional severe stress. For example, a sign that a tracker is interfering with your actual sleep is that you trust the app's readings more than your own sensations. And using a calorie tracker (especially in conjunction with monitoring calorie intake in PPD) can trigger or exacerbate pre-existing eating or compulsive psychopathologies.

Measurement errors

The functions of each type of wearable device are similar, but they all use different proprietary computing algorithms, user interfaces, and applications.

Researchers at Stanford University School of Medicine conducted a study where 7 fitness trackers measured heart rate quite accurately, but all of them gave a large error in the spent energy (active calories). And this data, by the way, is what most people base their diets on. Even the most accurate device was wrong on average by 27%, and the least accurate by 93%.

Overestimating or underestimating energy expenditure by 27% gives you a huge margin of error when trying to track your goals, diet planning and training. Let's talk about a margin of error close to 100%.....

Accelerometers pose a serious problem, especially when it comes to counting steps, as they don't actually count each step, but approximate it. The algorithms used in handheld devices and fitness trackers are most often designed to measure a purposeful walk, a steady, crisp, arm-waving stride. But if you limp, shuffle or don't move your arms while walking, your stride doesn't count.

And it's important to note that even with accurate step counting, energy expenditure is still the most important indicator, because it helps you achieve your body composition goals.

Without accurate readings of calories burned, you won't be able to accurately track your goals and build fitness goals.

There are problems with sleep trackers as well. To date, there are no universally accepted standards for determining the validity of commercially available wearable sleep and wakefulness tracking devices. The general consensus is that sleep trackers have very high sensitivity (>90%) but relatively low specificity (~50%). Simply put, they can't clearly distinguish between a state of still wakefulness, where you're already in bed but not yet asleep, and sleep. This leads to an inaccurate assessment of sleep performance.

Keep in mind that the reliability and validity of wearable technology is device-specific, and evaluations of existing devices can quickly become outdated. Objectively, research can't keep up with updates and new wearable technology product releases. And manufacturers themselves don't make it easy. To make the process more difficult, companies don't always share their algorithms for estimating steps, heart rate, and energy expenditure. The algorithms can be updated by the company at any time. And research results that we might publish today may not be relevant tomorrow.

How do i set up my tracker?

In the integrative physical and mental health community, there has long been a conversation about prescription use of some of the health gadgets. What does that mean? Using health trackers prescribed by a trusted doctor or specialist. But for now, it's just talk.

And now the following rules can be applied:

1. It is best to set up and monitor your health trackers together with a medical or fitness therapist according to your personal history, lifestyle and ultimate goals.

2. Consider health trackers as additional tools for maintaining a healthy lifestyle. Forgetting your tracker at home is no reason to cancel your workout. The app is too intrusive in suggesting activity - change the settings.

3. Trust your body and how you feel. This is the ultimate point where health trackers should take you. That is, it's ideal when e-mentors help instil the habit and then you don't need them anymore.

What can we track?

Activity. This includes pedometer readings, cardio workouts, and strength training. Studies show that consistent use of a fitness tracker - whether it's a traditional pedometer, smart watch or other wearable device - can increase your daily step count, especially if you've set a daily goal.

Easy access to data on your daily movement habits can also be a huge revelation if you don't exercise much, as well as providing you with information and support to start making healthy and inspiring changes to your routine. Activity trackers really do improve physical activity, body composition and fitness. According to a number of studies, you will take approximately 1800 extra steps per day, spend 40 extra minutes walking and increase moderate to vigorous physical activity by an average of 6 minutes each day.

Sleep. Few people track sleep quality metrics.

Yet a culture and discipline of sleep can reduce weight, improve well-being and enhance quality of life even without any other actions. Monitoring bedtime/evening, deep sleep duration, and factors that interfere with sleep is something that can make anyone's life and health better. Even though the algorithms are inaccurate.

Cycle Tracking App.

I have been planning loads according to my cycle for a long time. Since any woman's all month capacity level varies depending on the state of her hormonal system. And even during menopause plus/minus with a previously stable cycle, this rule is followed. I highly recommend paying attention to this indicator.

Additionally, we can track the quality of our diet, our stress levels, and our progress in dealing with bad habits.

Separately, it is worth noting the near-medical options of the trackers.

For example, detecting an irregular heart rhythm when the user is immobile or asleep.

But remember, consumer level trackers are not actually regulated by anyone. Whereas medical devices must be FDA approved or EC certified (we don't know where you bought them). Such devices have strong human clinical studies (the exact level of evidence required depends on the type of medical device being evaluated). And, as far as possible, a crystal clear reputation.

It is important to understand which health tracker you are using: household or medical. App developers most often categorise their apps themselves with the tags "health", "fitness" and "medical". The pitfalls of not being regulated are as follows: a diabetes management app offers comprehensive medical support without expert help; a physiotherapy app offers exercise plans without visible professional input; and stop-smoking apps may not be updated for several years.

Control, monitoring, reputation

To date, there has been an ongoing debate about the security of our personal data. Privacy policy rules are overly complex or confusing, leaving users unsure of what data they have agreed to share.

Sometimes the manufacturer requests or stores unnecessary amounts of data, and users receive nasty targeted advertising they didn't sign up for. According to a study published last year by the Care and Health App Review Organisation, most cycle trackers share data with third parties, such as reproductive centres.

Wearable technology also has many social problems, one of which is an over-reliance on technology. Theoretically, such dependence can lead to a false sense of security, overshadowing other important health factors.

Some wearable devices may pose a serious risk to people with electronic devices implanted in the heart, such as pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronisation therapy devices. The FDA warns that some mobile phones and smart watches equipped with high field strength magnets may cause some implanted medical devices to go into "magnetic mode" and suspend normal operation until the magnet is removed.

Objective safety assessments of portable medical devices such as fitness trackers have not kept pace with the emergence of exciting new gadgets.

Wearable technologies pose a risk of data leakage and theft. As wearable devices collect and store various metrics that may include sensitive information such as location (from the GPS systems used in some devices), this can be a concern.

The growing popularity of wearable fitness trackers has led to them becoming valuable evidence used by law enforcement agencies in investigations. The information available in these fitness trackers can be used by law enforcement agencies to prosecute or exonerate an individual.

Some credit card information, health data such as heart rate, GPS location, and other potentially identifying data have been discovered in the public domain. While the disclosed data alone is not enough to create an immediate serious problem for the user, it can be used as leverage to lure additional details from the user (and we wonder where so many phone scammers come from).

You can find a huge number of curious investigations at www.researchgate.net.

Afterword

Many people regard health trackers as a personal health therapist. But they will never replace a trainer or a doctor.

Regulating apps and health trackers is doable without slipping into stress and anxiety.

Finding a balance between discipline and enjoyment of life. And then it is quite possible to refuse trackers, taking care of your health on the level of feelings and personal knowledge about yourself

Wearable devices can be useful if you use them as a motivational tool to challenge yourself. But don't make them seriously responsible for your health. And remember, we live in an era of constant monitoring. What gets measured gets managed.

Author: fitness coach Alexandrina Thiel

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