Life Tech So you got a health monitor for Christmas. What does it actually tell you?
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So you got a health monitor for Christmas. What does it actually tell you?

From the Apple Watch to Fitbit, fitness trackers have taken off. But are they effective? Photo: Getty
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If you’re into exercise or have recently made a resolution to improve your fitness, chances are you’ve either thought about – or already have – a fitness tracking device.

Fitness trackers are devices used to track and monitor fitness-related data such as calorie consumption, distance covered, heart rate, sleep duration, sweat rate and body temperature.

For the average punter, the fitness band or watch are probably the most familiar examples of wearable health tech.

Yet, as we become increasingly more sick and burnt out (government data shows that in 2017-18, two-thirds of Australian adults were overweight or obese, while a 2018 survey by mental health technology company Medibio found that a third of Australian employees in the corporate sector suffer from mental illness, with 31 per cent of those people suffering from stress), the desire and need for a solution has never been greater.

Traditional fitness trackers

When it comes to fitness trackers, research shows the most reliable data comes from tracking physical activity, such as counting steps and activity minutes.

But as Professor Corneel Vandelanotte from Central Queensland University writes, “these reviews also indicate energy expenditure, calorie counts and sleep measures are less accurate”.

Advanced fitness trackers, which are promising to mine more complex data such as heart rate, brain waves, energy use and pulse to help detect conditions such as atrial fibrillation (a type of irregular heartbeat that brings increased risk of events like clots, heart attacks and strokes), are not quite as accurate.

The jury is out on whether the Apple Watch helps improve health. Photo: Getty

Professor of pediatrics at the Indiana University School of Medicine, Aaron E. Carroll undertook an analysis of (an Apple-funded) study of  whether the Apple Watch could identify atrial fibrillation.

He said accuracy involved more than just gathering data but must factor in people ignoring or failing to take action even when presented with data.

While his analysis does not say the Apple Watch failed, he concludes that “it’s debatable … how much of a difference it made to the participants’ health”.

But it’s not all doom and gloom. When asked if the fitness trackers are largely ineffective, Professor Vandelanotte said that “self-monitoring is an effective health behaviour change technique, certainly in relation to physical activity and sleep”.

“Whether activity is tracked using a fancy smartwatch or a good old-school pedometer doesn’t really matter. Also, how and where the sensors are placed (head, wrist, fingers) doesn’t really matter, as long as the data is reliable and presented in a meaningful user-friendly format (not something that only professionals can interpret).”

Sleep tech

For many years, fitness gadgets have focussed on measuring basic data such as footsteps or calories burned, but as the market expands, companies are now looking to see what else they can track – and sleep is on the radar.

While sleep tracking is still in its very early stages, companies are keen to try and get it on a ready market.

With data showing that nearly half of Australians are permanently sleep deprived – and four in 10 people who take benzodiazepines for longer than six weeks becoming dependent on them – finding a way to sleep well without using medication has become the holy grail.

Enter the Oura ring, a sleep tracker developed by Finland-based startup Oura Health that has become the latest craze in self-improvement wearables.

The ring is designed to be worn day and night, and contains infrared LEDs that measure your heart rate, blood volume and temperature as you sleep to capture variations in body heat, and a 3D accelerometer that can also track day-time activity.

Dr Ethan Weiss, a cardiologist at the University of California, wore the ring for nearly a year and says it is difficult to see how “any of that information can lead to improved sleep without some kind of program to help people interpret and then act on it”.

“I found that in my experience, all the information the ring provided was more of a burden than a benefit as it caused me to expect to be tired when I wasn’t, and ultimately led to more anxiety about my scores than any improvement it might have provided in my sleep or health,” he says.

“I think the technology is very cool, and I think they will eventually figure it out, but in its current incarnation it is not very useful to me or my patients.”

Professor Vandelanotte – who also studies sleep trackers – says that while the data can provide individuals with a better understanding of how good/bad their sleep was, the information itself may not be particularly helpful for doing something about it.

“Improving your sleep duration and quality is mainly driven by things you do when still awake, such as the time you go to bed, consistency of going to bed, getting up at the same time every day, sleep hygiene principles, making sure you sleep in a cool, dark, silent environment etc,” he says.

Meditation tech

While meditation technology is motivated by good scientific research, experts worry that technologies such as electroencephalography (EEG) headsets – which purport to pick up electrical activity emitted by the brain, and then interpret the data via an app to let you know when you’ve attained a meditative state – are little more than a gimmick.

EEG headsets purport to pick up the brain’s electrical activity. Photo: Muse

“For example, Muse 2 (an EEG headset) has seven sensors while typical research systems have 32, 64, 128, or even 256 channels or sensors,” says Dr Nicholas Van Dam, a psychology researcher and lecturer from The University of Melbourne.

“The number of channels/sensors is important because with fewer sensors, your ability to detect unique brain activity (i.e., specific to any given area of the brain) is diminished.”

He says that with only four sensors used for actual brain activity, “it is very hard to know what exactly the Muse system is measuring with respect to the brain”.

“Brain states are complex and, even with high-channel systems, the same brain regions can be active for different reasons. Measuring activity across only four broad areas of the brain is not going to provide very specific information.”

Learning to meditate is not easy, and research is constantly looking at ways to make it more effective. One study looking at EEG neuro-feedback (which incorporate real-time feedback of electro-encephalography (EEG) activity to teach self-regulation) found that it can potentially be used as an aid for meditation and relaxation.

However, another (2019) study found that Muse, when compared to unassisted relaxation, produced “equally effective short-term increases in heart rate variability, without additional benefit from neuro-feedback”.

Meditation is meant to be easy and requires no equipment – usually only the breath as a guide. Dr Van Dam says that introducing expensive equipment to help people get to deeper states more quickly is likely to be a gimmick.

Quantifying sleep data is also not helpful for everyone, especially if you’re trying to get a “high score”.

“Meditation, in my experience, is difficult and full of up-and-down experiences. Some days it feels like the practice is going really well, other days, it feels like it’s not working at all,” Dr Van Dam says.

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