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Can Wearable Tech Make Us Healthier? - The Apeiron Life Perspective

6 min read

What is it:

Tracking your health has become so ubiquitous that you might feel like an outsider if you’re not wearing at least one type of wearable. According to Pew Research Center, about one in five U.S. adults wear a smartwatch or fitness tracker. This ‘quantified-self’ movement is changing how people think and talk about health. The healthcare and fitness industry has high hopes that these devices will make people move more, sleep better and take up healthier lifestyles.


Recently wearables or activity trackers such as wristwatches and rings have significantly advanced. They can capture users’ vital signs, sleep, calorie intake, activity and recovery levels, and much more. After the data is analyzed, the system gives the user feedback based on the numbers. But as most behavioral science experts will tell you, knowledge alone isn’t enough to change behavior. So what does science say about wearables and their usefulness in making us healthier?



Purported claims:

  • Increase physical activity

  • Improve health

  • Increase weight loss

  • Increase performance, detect overtraining, and prevent injury

  • Enhance sleep quality



What the science says:

As obesity rates and chronic diseases such as cardiovascular disease keep climbing, wearables are seen as an inexpensive way to help turn this tide. A study published in the British Journal of Sports Medicine with overweight people using wearables and research-grade step counters found that those using commercially available trackers lost 6 pounds on average in 12 weeks, but people wearing research-grade step counters were able to shed up to 10 pounds.


A recent meta-analysis examining nearly 400 studies of all age groups on the effectiveness of wearables for increasing activity and improving health, found that fitness trackers can increase the walking time up to 40 mins a day or 1800 steps. On average, the increase for moderate to vigorous activity was 6 mins/day on average. In physiological outcomes such as lowered cholesterol, body weight, blood pressure, and lipid levels, the most improved measurements were body weight (-4.4 lbs on average), waist circumference, BMI, and aerobic capacity. But there was little evidence that wearing activity trackers significantly affected diastolic blood pressure, cholesterol, triglyceride, or fasting glucose levels. The typical timeframe of the studies was six months.


Medication adherence is one of healthcare's most significant and costliest problems, and wearables have been touted as a user-friendly solution to counter the issue. A recent study showed that patients with diabetes or hypertension who use activity trackers were more likely to take their medications as prescribed. The study also showed a positive association between medication adherence and frequency of activity tracking meaning that those who tracked their medication intake consistently also moved more.


The Apple Watch, specific models of Fitbit and Samsung watches, are now officially medical devices that can detect irregular heart rhythms (AFib). Studies on the accuracy of the devices to detect heart problems haven’t gotten a lot of support from the medical field. The Apple Watch 4 could only detect 41% of all AFib instances in a Cleveland Clinic study. Cardiologists say that the problem with smartwatches detecting AFib that they tend to be worn by young people whose prevalence of having AFib is small. The benefits of tracking AFib might be best with people who’re already diagnosed with the condition.


Whereas some studies are promising, the track record of wearables’ ability to make us healthier seems dubious. The conclusion of the researchers in Singapore who studied the effectiveness of activity tracers in increasing physical activity levels was blunt: ”We identified no evidence of improvements in health outcomes, either with or without incentives, calling into question the value of these devices for health promotion.”


Many studies also show that the initial enthusiasm and motivation with wearables quickly wane. About a third of the users will stop using them altogether or disregard the data they see. A 24-month weight loss study at the University of Pittsburgh placed participants on a low-calorie diet, prescribed exercise programs, and group counseling glasses. The results showed that after two years the group who used wearable technology actually lost less weight, only about half as much, than those without wearables. The study authors speculated that being able to see how many calories they burned during exercise resulted in people eating more than they normally would. Other studies have also reported that using wearables alone was less effective in eliciting change than methods where participants received personal feedback and counseling in addition to just wearing an activity tracker.


For competitive athletes, wearables pledge an affordable and easy way to monitor training quantitatively and prevent injuries. However, a pilot study among athletic trainers and strength and conditioning coaches revealed, that 76% of the interviewees had a “very negative” verdict on wearables and their ability to meet the end user's needs. The two most commonly cited reasons are that “wearables don’t measure what practitioners need” and “lack of trust with wearable solutions.” For example, the heart rate measurements aren’t always accurate and thus skew the data for how hard the athlete is working. Although wrist-worn devices are convenient and widely used for measuring heart rate, they are less accurate when performing high-intensity activities, and they mostly undervalue the HR readings when performing upper-body movements. So if your heart is pounding after pushing a sled at full speed across a room, but your wristwatch shows that you’re barely moving, you should ignore the data.


Wearables such as rings and wristbands that track sleep have exploded in popularity in recent years, as the importance of sleep to our health and longevity has finally reached a consensus in the overall population. Unfortunately, many sleep experts, as well as studies in sleep wearables reveal that these trackers poorly measure your actual sleep (duration, sleep cycles, and wakefulness). However, they can accurately record parameters like body temperature, HR, and heart rate variability (HRV). In a 2019 study that compared the Oura ring to in-lab polysomnography (PSG), a cold-standard in sleep study, Oura seemed to perform in line with the PSG, but when the researchers looked into each participant’s data, they found significant differences in accuracy, especially in sleep stages and total sleep time. A similar trend (inaccuracy in sleep stages and overall sleep) was detected in a study with Fitbit vs. PSG.


Even with the limits of accuracy, most sleep experts still agree that sleep trackers can help people realize how their lifestyle choices, such as alcohol use and staying up late, affect their sleep quality and thus hamper their readiness for the following day. For some people having hard data about how these interactions work can be a strong enough incentive to change their sleep hygiene which helps them improve their sleep and, ultimately, health.


Some studies have tracked the “dark side” of wearables, where the gadgets may make us physically and mentally unwell. For example, when accumulating a certain amount of activity hours, miles, or steps becomes obsessive and replaces the original purpose of just getting out there and moving. For some people, obsessive tracking and optimizing health can lead to anxiety or unhealthy behavior where they ignore how their body really feels and keeps pushing through illness and injuries. For more information on this type of behavior, here is a previous blog post on the signs of detrimental sleep habits called Orthosomnia.



Our take:

Wearables are not a magic bullet to better health and performance. They can be great tools, but you still have to be willing to do the hard work, whether it’s being active, losing weight, or sleeping more. Also, knowing what data to track and what to do with it is key to getting the best out of your wearable. Ultimately, continued usage is pivotal in making permanent lifestyle changes. Getting the correct support from healthcare professionals can help lighten the load of tracking your health and keep you on the path to reaching your physical and mental goals.

Will this benefit you?

Having hard numbers and data about your health and progress at your fingertips can be a powerful incentive. So if you’re a person who loves data, or needs regular feedback and reminders to keep on track with your goals, wearables can be very beneficial.



If you still want to try it, here’s what to keep an eye on:

Although most wearables these days can measure certain parameters (such as activity level, HR, HRV, and body temperature) pretty accurately, all technology is fallible. You have to be the judge of how hard you’ve worked out and how you’re feeling. If you’re a person who gets overwhelmed with a slew of data and graphs, wearables might not be for you. Or you need to find one with just a few key measurements you want to see to keep track of your progress.


We’re bombarded with information and data from every direction, so staying mindful of our feelings and bodily sensations can be hard. If using an activity tracker makes you overthink your health and obsess about your activity level while increasing your overall anxiety, it might be time to toss your gadget into a drawer. Remember, the most important thing is to get out there and move in whatever way is the most enjoyable and doable for you.



References and additional reading:

Biometric ring and sleep, exercise adherence:

Long term weight loss with or without wearables: https://jamanetwork.com/journals/jama/fullarticle/2553448

Wearables and weight loss: https://bjsm.bmj.com/content/55/16/917

Wearables and medicine adherence: https://www.jmir.org/2019/3/e11486/



 

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