You’re ready. To sit less, move more, sleep eight hours a night—to adopt new habits in order to become the healthiest you possible. As I shared recently, I recommend shrinking the change you want to make to set yourself up for success. Can wearable technology for health also help? Should you use these devices to aid you in achieving your wellness goals? Can tracking measures like your activity level, heart rate, and sleep really add up to big health gains?
Let’s explore some of the wearables currently on the market and discuss how making lifestyle shifts using the data they provide may mean you not only look and feel better today, but also avoid chronic disease down the road.
Do you use wearables to track your health? These devices can help you hit your wellness goals—when they’re tracking the right things. Check out this article for my recommendation on the best tech to track your sleep, stress, and activity levels. #healthylifestyle #chriskresser
What Are Wearables, and Do We Really Need More Technology?
Wearables are smart electronic devices that can be worn on the body to track a variety of health markers, such as:
- Activity level: time spent sedentary, number of steps taken, etc.
- Sleep patterns
- Resting heart rate and heart rate variability
- Stress level
- Body temperature
A wide range of wearable health devices are available, from watches to rings—even shirts. I suspect we’ll see much more innovation in the coming years. After all, the industry is booming: analysts predict that more than 245 million devices will be purchased this year alone. Sales of smartwatches like the Apple Watch and products by Garmin, along with Fitbit’s watches and other fitness trackers, are on the rise, making these some of the most popular options today. (1)
And they do have merit. Although I often write about technology’s detrimental impact on health, these tech devices can support well-being.
They’re remarkable, really, in that they allow you to monitor wellness markers that not too long ago only doctors could track and measure. As a result, you gain important knowledge about your body that is vital to improving your health. What’s more, these devices take continuous, round-the-clock measurements, providing you with much more information than what you’ll get from annual trips to your physician, or even semi-regular visits to a healthcare practitioner. This wealth of data can also help your clinicians in making diagnoses and recommending treatments.
I see wearable health trackers as effective tools in your behavior-change toolkit. In this way, they integrate well into a Functional Medicine approach to healthcare. In Functional Medicine, we believe that for patients to overcome a persistent ailment, they must shift their behavior; we also know that behavior plays a major role in preventing—or contributing to—chronic disease.
Will Technology Revolutionize Healthcare—or Overwhelm Us?
While access to timely, relevant, and personalized information about your health will undoubtedly lead to better outcomes in some circumstances, these innovations do not come without potential downsides.
Sometimes, the explosion of unfiltered data from wearables can have unintended effects, like an increase in unnecessary tests and procedures or growing angst among patients about their health. Even some routine procedures are not without their risks—research shows that annual physicals are not only unnecessary, but potentially dangerous because they lead to unneeded procedures. (2)
The other potential risk here is that people will exclusively self-treat, and not seek out the care of a trained professional. There’s an old saying: “The doctor who treats himself has a fool for a patient.” Even an experienced clinician is better off seeking care from another clinician, rather than self-treating. The judgment and outside perspective of a skilled an experienced physician is invaluable. Of course this is even more true for someone without any medical training at all.
As someone who was completely failed by the conventional medical system, I believe in empowering patients to take charge of their own health. Better access to personalized data can help accomplish this goal, but it’s also important to be aware of the potential harm it could cause. Technology is a tool. It can be used wisely, or foolishly—it’s up to us.
But Do Wearables Work? A Look at the Research
In some intervention studies, fitness trackers have a moderate effect on increasing step count and physical activity, leading to improved health outcomes for wearers.
- Older patients who were given trackers increased their activity, lost weight, and had decreased LDL (“bad”) cholesterol levels after 12 to 14 weeks of use. (3)
- Obese and overweight participants who wore trackers for 36 weeks and increased their step count lost weight and saw marked improvements in their body mass index (BMI), body fat percentage, waste and hip circumferences, and other body composition measures; they also saw a bump in their HDL (“good”) cholesterol. (4)
- Overweight individuals who accumulated 10,000 steps per day over 12 weeks not only had lower body weight and BMI at the end of the study period than when they began, but they also experienced significant reductions in feelings of anxiety, depression, anger, fatigue, and confusion. (5)
However, the majority of the currently available research on activity trackers hasn’t concluded that they’re extraordinarily or overwhelmingly effective. In fact, some studies have found conflicting results to those mentioned above; in one, people wearing trackers lost less weight than those who used standard behavioral weight-loss approaches. (6)
All in all, the cumulative scientific results are mixed as to whether or not fitness trackers make people more fit. Even within studies, the results are often at odds and inconclusive. For instance, one study using the Fitbit generated tracker-damning headlines a couple of years ago. Yet, the results weren’t all bad: although wearers didn’t see improvements in weight or blood pressure, they did get more physical activity than non-wearers. (7) Another study published in 2018 found that the Fitbit increased wearers’ activity levels. But its authors noted that their research required participants to check in with a health coach (health coaching is extremely beneficial for behavior modification), and they suggested that it’s possible being accountable to someone did more for increasing participants’ exercise levels than self-monitoring with the tracker. (8)
A grain of salt: The latter study brings up an important caveat to wearables research. Many previous studies were conducted with devices that are now several years old. They were essentially glorified pedometers without other meaningful function. They didn’t connect to your smartphone. They didn’t track sleep or measure heart rate variability (HRV)—more on those in a minute. They didn’t factor in practices that can be crucial for behavior change, like goal-setting or community support, as in the most recent study.
Fortunately, today’s wearables are much more sophisticated. The better ones address the points mentioned above and then some, and can track activity, heart rate variability, and sleep all in one device.
Why Wearable Technology for Health Tracking Needs to Include Sleep and HRV
It’s not enough for your device to simply count your steps; it should track other important health indicators, like your sleep quality and your heart rate variability (HRV).
Why Sleep Matters
- Cardiovascular disease and diabetes risk
- Learning and memory problems
- An overall increase in mortality
What HRV Is, and Why It’s an Important Indicator to Track
HRV, which stands for “heart rate variability,” is a calculation of the time variation between each heartbeat. (It is not the same measurement as “heart rate,” which refers to the number of heart beats per second.) You may have heard about HRV in the context of assessing an athlete’s performance readiness. But it’s also useful in terms of evaluating stress in the human body. HRV involves measuring the function of the autonomic nervous system (ANS), part of the central nervous system that affects heart rate. To put it simply: if you’re stressed, you’ll have a low HRV; if you’re relaxed, a high HRV. (11)
No matter what diet you follow, what supplements you take, or how much exercise or sleep you get, if you don’t manage your stress, you’ll still be at risk for modern degenerative conditions like heart disease, diabetes, hypothyroidism, and autoimmunity. Low HRV specifically is tied to a host of chronic conditions, from chronic kidney disease to cardiovascular complications. (12, 13, 14)
Wearables can be an effective way to track progress, gather data, and gamify your health. They can offer a boost if you’re struggling to make a change stick.
Health coaches are another great resource for people who need help taking the next step toward their health goals. Health coaches work with clients who are trying to make changes—they may be switching up their diets, implementing a new fitness regimen, putting a treatment protocol from their doctor into practice, or simply taking their health to the next level. Everyone needs support, and health coaches excel at offering it.
My Recommendation: Find a Device That Tracks Everything
Of all the next-generation devices on the market that track a multitude of health indicators, I think the Oura smartring is the most effective, as it tracks your sleep, heart rate variability, body temperature, and activity level. I have one myself, and I use it extensively with patients. (To my knowledge, it’s the only wearable with sleep-tracking technology that has been validated by a peer-reviewed study.) (15)
Each morning, the Oura ring displays a sleep score in its app. This is an overall calculation of how well you slept, which takes into account total sleep, efficiency, quality, disturbances, REM sleep, deep sleep, sleep latency, sleep timing, and your lowest resting heart rate during sleep. This data can be used to make changes that will lead to better slumber. For example, lowest resting heart rate measures the lowest 10-minute average heart rate you experience during the night. This ranges anywhere between 40 and 100 for adults, and you can determine your average by looking at your data history. If you are significantly high or low, it can signal an increased need for recovery from activity or that you are in an active stress response and may benefit from interventions like mind/body relaxation techniques or breathing exercises.
The Oura ring also tracks your body temperature, which plays a role in everything from fitness to ovulation and HRV. According to Oura’s creators, a ring—versus, say, a watch—can gather more accurate heart data because of its position on the finger.
To succeed in adopting new, healthier habits, I encourage you to combine wearable technology with the shrinking the change technique. For example, if your big objective is to get more regular physical activity, use a wearable to help break that change into smaller, more achievable goals. The right fitness tracker can nudge you to take breaks if you sit at your desk all day and stand, stretch, or move; to get in your daily steps; to schedule a regular run, bike ride, or other workout of your choice, etc. And it will record this physical activity in real time—daily data you can use to celebrate each incremental win, as you get closer and closer to your big objective.
It may seem ironic to use technology to create more balance in your life. But technology is just a tool, and it’s up to us how we employ it. I’m a big fan of using technologies like these to create harmony through healthy habits.