Okay, I'm sold. Doctors should start recommending wearable computing, the digital devices that count steps, calories burned and even how restfully you sleep. Used properly, these gadgets can be life-altering.
About eight months ago, I diagnosed yet another overweight patient with Type 2 diabetes. Nothing unusual about that – a busy family doctor will see two to five new diabetic patients per day. But the young fellow I saw was striking: He was just 16 years old, yet he had full-on, adult-class diabetes. When I broke the news, his whole family was in tears, and made me repeat the blood tests to confirm the diagnosis.
That got to me. I thought, "Hey, all this benign health advice that I keep dispensing – to eat right, get enough exercise and lose weight – I had better start following it myself; and patients should, too."
That's when I discovered digital trackers. Now 25 pounds lighter myself, I think it's time doctors learn about and start officially prescribing these new mobile devices. (To evaluate different devices, right now I'm using UP! by Jawbone, the Samsung Gear Fit watch and the Runtastic Orbit watch.)
Whether it's a wristband, watch or a smallish box that can be clipped to your belt, these trackers offer real-time, instantaneous feedback on your day.
Not reaching your goal of 10,000 daily steps? No problem: Your bluetooth-enabled device will ask your phone to prompt you to get moving. Staying under 1,500 calories as part of your weight-loss diet? You might get a digital medal of honour congratulating you, or perhaps your linked friends will cheer you on. Didn't sleep well last night? Your tracker's phone app might invite you to cut down on stress, caffeine or even to turn in early to pay off your sleep debt. Want to know the exact distance you just ran? The GPS locator will show you the route, and even recommend changes. An app might even ask you to walk off the excess calories that you ate at that party.
As trivial as these reminders and reinforcements sound, they work. The prompts are personalized, immediate, unfiltered and offer corrective advice. They're hard to ignore and you can't lie your way out of them. Some apps even seem to get angry, using more aggressive language, if you don't listen.
Writing in the Journal of Medical Internet Research, Dr. Jason Fanning, an exercise physiologist at the University of Illinois at Urbana-Champaign, found that real-time mobile feedback increased users' "moderate to vigorous physical activity by 177.7 minutes per week." By just giving advice, there's no way doctors achieve numbers like that, even if we deliver the exercise message urgently. In fact, as Fanning notes, despite all our efforts, "less than half of all adults" in North America get recommended exercise levels.
My own patients describe similar findings. David, 24, believed he got enough activity with his job, family and busy lifestyle. But wearing the Runtastic Orbit, a smartwatch, he discovered he fell short of his activity goal. To improve his daily step-count, and armed with individualized knowledge of his day, he will walk on the spot when he's watching the evening news or a movie, or go for a short run.
Another unexpected benefit of digital recording is that you can see the trend lines of your life. All the wearable devices have a suite of related health apps, and these are improving explosively. Want to see your activity for the past week or month? Want to know how much more deep sleep you're getting with that new pillow, or how your calorie intake changed with recent diet changes? All such self-inquiries can be answered – instantly and privately.
In fact, now there are digital devices that measure your weight, heart rate, blood pressure, body fat, blood oxygen, room carbon dioxide, light levels, altitude, idle time and if baby falls into the pool. (In research studies, patients are even being asked to take pictures of their food, and then they receive estimated calorie-counts from a dietitian.)
This is incredible, and part of a new generation of self-awareness. You can become your own information resource centre. As more of our devices talk to each other, perhaps the time will come when doctors will download your personal data as part of your medical records.
With the pace of technology, a device is already out of date by the time you buy it. Apple, Google, Nike, Samsung, even Ralph Lauren are releasing evermore devices, even smart clothing and shoewear.
This is great news for consumers – and doctors. With apps that record, graph, alert and reinforce more, all that health information can be put to use to frighten, inspire and empower people to take better care of themselves.