Wearable Fitness Trackers: They’re Popular, But Are they Accurate?

By Leandro Pucci, Contributing Writer

Wearable fitness trackers are everywhere these days.

Consumers are using these devices to monitor exercise, sleep, and a host of other related health parameters. Health care researchers are also using the devices in the context of clinical studies. The choice of brands, features, and styles of wearable trackers is also expanding rapidly. 

But are these devices reliable? Can we trust the numbers they give us? How accurate are they when it comes to gauging levels of energy expenditure, sleep cycles or other physiological measurements?

There is actually some medical literature on the accuracy of fitness trackers. The consensus seems to be that  consumer-level monitors show a good degree of accuracy for the measurement of steps, duration of activity, and sleep quality, but only moderate accuracy for quantifying total daily energy expenditure or energy output during physical activity (Ferguson T, et al. Int J Behav Nutr Phys Act. 2015 Mar 27;12:42)

Accelerometers vs Heart Rate Monitors

Fitness trackers come in two basic types: accelerometer-based monitors that use predictive equations applied to a user’s acceleration in different directions to estimate energy expenditure; and heart rate devices, that use equations based on age, height, gender, physical-activity level, and resting heart rate to estimate caloric expenditure.

Of the two, the first is more widespread in the consumer market. Popular devices such as the Fitbit, Jawbone, Nike Fuelband, and Polar Loop all fit under the accelerometer category.

A closer look at the different models shows that the mode of exercise being measured can play a huge role in accuracy of these monitors.

Dr. Gregory Welk, Director of the Nutrition and Wellness Research Center at Iowa State University heads a team of researchers that have been studying the accuracy of consumer-level activity monitors compared with the types of monitors used for scientific research.

His team has conducted research for twenty years on various types of accelerometers. Now that the consumer market is being literally flooded with these devices, and multiple manufacturers have released their devices largely without any documented evidence of accuracy, Welk thinks that the research community has a responsibility to help evaluate them, so consumers can make more informed, intelligent choices.

To verify if consumer-centric trackers give accurate readings on calories burned, Dr. Welk’s team recruited 56 men and women aged 18-65, who used the two types of monitors in the context of semi-structured periods of low activity, aerobic exercise, and resistance exercise.

The participants had an average Body Mass Index (BMI) of 24 kg/m², with body fat compositions averaging 21.2%. They were asked to simultaneously wear five consumer monitors and two research monitors while doing 20 minutes of sedentary activities of their choice, 25 minutes of aerobic exercise, and 25 minutes of resistance training with five-minute rests between the different activity periods.

They tested the Fitbit Flex, Jawbone UP 24, Misfit Shine, Nike FuelBand SE and Polar Loop devices representing the consumer products category. The professional research products were Actigraph GT3X-plus and BodyMedia Core.

The investigators used the Oxycon Mobile, a portable metabolic monitor that measures breathing, heart rate, and fat burned as a reference standard against which all the wearable monitors were compared

The average Energy Expenditure (total calories) measured by the Oxicon Mobile was just under 319 Kcal during the exercise periods. Measurements obtained from the consumer-level activity monitors varied from 275 Kcal to 396 Kcal. The research monitors had the most accurate total calories estimations.

Large Margin of Error

According to the researchers the Jawbone UP 24, Nike Fuelband SE and Fitbit Flex, in general, gave “reasonable accurate” estimations (Bai Y, et al. Med Sci Sport Exerc. 2015; 151-158)

In terms of measuring calorie expenditure during resistance exercise, all the trackers had no less than 25% margin of error in their results—a fairly large margin, according to the Iowa researchers.

For sedentary activity, the results also varied. The Misfit Shine, Nike Fuelband SE, and one research monitor had error rates of less than 20%. For the aerobic part of the test, one consumer tracker and one research tracker had error rates under 20%.

The overall margins of error in all devices were similar to results from earlier evaluations of consumer trackers by the University of Iowa team (Lee JM, et al. Med Sci Sports Exerc. 2014; 46(9): 1840-8).

What it comes down to is that in general, fitness trackers are more accurate or effective for activities such as walking or running on a level ground. When activities move away from this scenario the readings become less accurate.

Indeed, the devices have large margins of error for accurately estimating calories burned. But from the viewpoint of working practically with patients, they can still be great tools for promoting behavior change, so long as one does not focus too much on specific numbers.

The main value of tech tools like this is that they can promote accountability, and provide context for communication between practitioners and their patients. At the end of the day, the value of exercise trackers is that they really can help some people to get some exercise every day and to stay motivated.

Dr. Welk says there is an urgent need is for greater standardization with regard to the outputs and indicators used in wearable tracking devices. Consumer products will always vary in precision to some degree. But the emergence of some type of “Seal of Evidence” or an endorsement by a national regulatory group could go a long way in pushing companies to document, report, and ultimately improve the accuracy of their products.

Leandro M, Pucci is Candidate for a Master of Science degree in Nutrition and Integrative Health from Maryland University of Integrative Health (MUIH). He is currently working towards becoming a Certified Nutrition Specialist. He holds a Personal Trainer Certification by the American College of Sports Medicine, and is working on becoming Certified Strength and Conditioning Specialists by the National Strength and Conditioning Association.Leandro has a special interest in the health concerns related to metabolic syndrome, nutrition and exercise as medicine.

Healthy Camp Foods

The snow is melting, the air is becoming warmer and the days are growing longer, without a doubt camping season is right around the corner. While it seems like hot dogs and hamburgers are the easiest option for weekends spent in the woods, there are tons of healthy, easy options to bring along camping! A lot of food options will vary on whether you can pack a cooler or not. If you are car camping and can pack a cooler then your options are almost endless. If you are backpacking, your options aren’t as extensive but not to worry we’ve got you covered!

For breakfast if using a cooler, I love scrambled eggs with peppers, mushrooms, onions and garlic. You can purchase an egg holder, to prevent eggs from breaking for under five dollars at your local grocery store. If you have a cooking grate and a skillet (or camp stove) you can cook just about anything you can cook at home while camping. Another car camping breakfast favorite is breakfast quinoa tacos. Add a whole wheat tortilla, salsa, eggs and quinoa (maybe left over from the night before) and a protein packed breakfast is waiting for you! If I am without a cooler oatmeal is my go to. Quaker sells organic oats already individualized. Just add boiled water and you are set. I like to add nut butter for protein. I often keep hemp seeds, chia seeds and goji berries in a zip lock to add to my morning oatmeal. Bringing a small spice rack along can really improve on the flavor- cinnamon for the oatmeal! If you have some extra time on your hands before your trip, the yummylife does a great DIY oatmeal.

Snacks are must when camping, Nuts and nut betters are a great way to pack the protein. When hiking I do not get very hungry, nuts are an easy way to get some quick fuel without a heavy meal. Other easy snacks to bring along whether it's camping, hiking or traveling are fresh fruit, chopped vegetables, hummus with celery and carrots as well as whole grain or nut crackers and healthy energy bars (look for low sugar and a short list of healthy ingredients).Wild albacore tuna in a pouch with crackers is a very easy, delicious and protein packed option to bring along camping.

For dinner, I love to do a good stew. Precook the rice or quinoa at home, bring it along in a zip lock bag and bring an assortment of vegetables. Adding everything to a pot with vegetable broth or water (water may be the easiest when backpacking, as you can just filter this from your water source instead of carrying it in), let simmer, and in just a short time a delicious stew is made. This is also when the spice rack comes in handy to season the stew. Another great option is freezing left overs at home, think rice and veggies, and letting them thaw while camping.

Article by Danielle Fernandez

Nine Steps to Better Health Experts Want Men to Know

On average, men live 5 years less than women.  According to experts, if men were to pay attention to these nine things they would have better health and potentially narrow the longevity gap.

1. There is no Shame in Depression. It is a real physiological event, says certified athletic trainer Ken Locker. Men tend to think it's better to tough it out because they don't want to talk about it: "It might make things worse," or "I'm admitting weakness." Action: Talk to your family doctor who can recommend a professional counselor.
2. Yoga isn’t just a girl thing. Men should aim for cardio and muscle building exercise.  Yoga is great as you age because it helps with balance.
   Action: Ask friends for recommendations, and then try a class.
3. “No pain, no gain” is a none-sense.  Certified chiropractor, Logan Sherman has witnessed plenty of examples of the falsity of this silly saying.  Sherman stated that his male patients are guilty of pushing past the minor things that could be caught at an earlier stage, and turning them into an injury.
   Action: If you feel a twinge, rest. For plantar fasciitis, avoid going barefoot. Roll a tennis ball, golf ball or frozen water bottle under the foot several times a day. If the pain persists, check with your doctor
4.  Certain cancer screenings are imperative. “Prostate cancer is “the easiest cancer to kill if it’s detected,” Locker says. But men, of course, would happily skip that part of a physical, he says.  Another villain is colon cancer, which can be detected early, he says. “Men tend not to want to know, or to think they don’t have any problems.”
   Action: Schedule the screenings, for crying out loud.
5. You don’t need a gym to be fit.  “Gravity,” Locker says, “was the first gym ever invented.”
   Action:  What to do: Pushups, crunches and squats can be done anywhere. Ditto for walking.
6.  You don’t know what to do at the gym. “What men do that’s the biggest problem in exercise is not asking for help,” O’Bryant says. “It’s like that asking for directions thing. I go to the gym, and see people there for the first time and they think they automatically know what they’re doing. But they’re probably doing it wrong.”
   Action: What to do: Use a trainer. Most gyms offer a free session with membership.
7. Sunscreen isn’t for wusses. According to the American Academy of Dermatology, the incidence of melanoma is higher in women than men until age 45. By age 60, though, rates are twice as high. 
   Action: What to do: Use a zinc or titanium based face cream with SPF of at least 15, Locker says.  And Schedule a skin check at least once a year.
8. Exercising isn’t a free license to eat anything. “Men who are successful getting into physical activity often think that’s enough,” O’Bryant says. “‘I work out so I can eat what I want.’ ‘I work out so I can drink whatever I want
   Action: Think moderation. Also remember that diet “is not only related to heart health, but intimately related to brain health,” O’Bryant says. “It’s very, very powerful.”

Regular Tai Chi Practice Improves Arterial Compliance and Muscle Strength in Older Adults

"The widely-practiced traditional Chinese mind-body exercise known as Tai Chi has been scientifically validated for its health benefits."

The widely-practiced traditional Chinese mind-body exercise known as Tai Chi has been scientifically validated for its health benefits.  In a study recently published online in the European Journal of Preventive Cardiology, 65 older adults from Hong Kong were recruited.  Just less than half of them were practitioners of Tai Chi for a minimum of 1.5 hours weekly for 3 years.  The control group had no experience with Tai Chi.  Between the groups, there were no differences in age or defined levels of physical activity (light, moderate, or heavy).

Researchers found that the practitioners of Tai Chi experienced better blood pressures, vascular resistance, and pulse pressures in comparison to non-practitioners.  Both large and small artery compliance, predictors of cardiovascular health, were substantially higher (40-44%) in the Tai Chi group.  Those in the Tai Chi group also demonstrated better average muscle strength in knee extensors and flexors.  

Known for its aerobic benefits and ability to lower blood pressure, Tai Chi has been proven to improve cardiopulmonary function in individuals with heart conditions like chronic heart failure and myocardial infarction.  New research findings coupled with a significant historical record of use supports the notion that Tai Chi may be an excellent exercise strategy for improving cardiovascular health and muscle strength in older adults.   

Dr. Shana McQueen

Source:  http://www.sciencedaily.com/releases/2012/04/120404102136.htm

Obesity and Cardiovascular Health

"Keep you and your valentine's hearts healthy."

Until recently the association between obesity and coronary heart disease (CHD) seemed to be indirect. In recent years however, according to the American Heart Association these chronic diseases not only have increased in incidence but also are both caused by the same environmental precursors. As genes do contribute to a percentage of obesity cases, most along with CHD are inhibited by an increase in high fat and calorie intake, and a decrease in energy exertion through exercise. As BMI increases the number of instances of other factors increase as well. These include hypertension, low HDL levels, an impaired glucose tolerance, several other forms of heart disease, and non-insulin-dependent diabetes mellitus.

Studies suggest that little amounts of dietary and exercise changes at a time can dramatically improve a healthy weight and heart. 

Here are some general nutritional recommendations for cardiovascular disease prevention 
9 Tips to Prevent Heart Disease
   
1.  Alcohol in moderation 1-2 glasses, 2-3 times a wk
2.  Exercise 1 hr 5 x a week
3.  Eat more veggies
4.  Monitor blood pressure
5.  Increase Omega 3 Fatty acids
6.  Consume less dairy and meat
7.  Eliminate tobacco
8.  Check cholesterol
9.  Maintain a healthy weight

A good resource for additional information on specific diet strategies such as DASH, low-carb, and the Mediterranean diet read here:

http://www.mdpi.com/2072-6643/5/9/3646

Consult with your healthcare provider about what measures are appropriate in achieving your ideal weight as there are variations between individuals.  

For more information please read:

http://www.ncbi.nlm.nih.gov/pubmed/23777875

Mindfulness-Based Stress Reduction and Effects on Coronary Heart Disease

"bringing a certain quality of attention to moment-by-moment experience"

Coronary Heart Disease (CHD) and high blood pressure have both been linked to psychological risk factors such as anxiety and depression. Research surrounding Mindfulness-Based Stress Reduction (MBSR) for both anxiety and depression suggests this may indirectly lower CHD levels as well for patients.

MBSR is a process of bringing a certain quality of attention to moment-by-moment experience through the practice of mindful meditation. MBSR has been well documented to improve the function of the immune system and helping people cope with chronic illness. Research published in the IJoy International Journal of Yoga examines the effectiveness of MBSR on the reduction of anxiety and depression leading to lowered CHD levels within the body. This randomized control trial included a regular medical intervention with monthly consultations with a cardiologist. Over the course of eight weeks all participants completed the trial.

Outcome measures were computed using the Hospital Anxiety and Depression Scale, Perceived Stress Scale, Blood Pressure, and Body Mass Index. It was concluded that all patients experienced a significant reduction in perceived anxiety and depression, lowered blood pressure, and maintained this after a three month follow-up.

Getting involved in MBSR therapies can be easy to do on your own or with a group. Choose between guided meditation, yoga, tai chi, chi gong, or any other mindful relaxation therapy you enjoy.

For more information please read:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734636/

5 Easy Skin Protecting Tactics for Skiers & Snowboarders

Colorado is known for its high mountains, beautiful scenery, and great winter snow recreation. As high altitude equals thin air this also increases sun exposure resulting in Ultraviolet Ray (UV) levels being dangerously high. The importance of using sunscreen through all seasons is a must. Here are a few ways to decrease your exposure and additional research to back it up! 

1. Apply SPF 15+ sunscreen to exposed areas on the face about 30 minutes before going into the sun to allow sunscreen to absorb and become effective 

2. Re-apply sunscreen every 2 hours: this is the optimal recommendation to reduce exposure to ultraviolet (UV) radiation in sunlight for the prevention of skin cancer

3. Wear a brim: wearing a helmet with a brim or a helmet with a hat underneath that has a brim is an easy way to protect your skin from sun exposure all day long- no need to re apply!

4. Carry lip balm with you that has an SPF 15+ , this will improve sun protection on lips and avoid them chapping too

5. Wear eye protection even on cloudy days: overcast may seem to be less sunny however sun exposure remains the same. Continue wearing goggles during sports and sunglasses in between activities to keep your eyes along with the delicate skin around your eyes free of the sun’s harmful rays

Studies suggest that the compliance of wearing sunscreen during winter sports is well under the recommended amount. In a study published by the Journal of the American Academy of Dermatology, aspects of compliance were examined. Among a cohort of 4,837 adult skiers, sunscreen advice was given and results were measured. Based on the aforementioned suggestions, a low compliance rate resulted. This suggests the general skiing public perceives there susceptibility to skin cancer as low- even when provided with skin protection advice and statistics on adverse outcomes of noncompliance.

Natural Sunscreen Vs Chemical

When shopping for sunscreens be wary of your options. Sunscreens can often times contain toxic additives that are harmful to the body. Always opt for a truly natural sunscreen that does not contain parabens or pthalates.

Skin Deep provides the public with a searchable database of cosmetic products along with safety information please visit:

http://www.ewg.org/skindeep

For more information about AAD's study please read:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193866/

Enhancing Weight Loss Programs with Mobile Technology

Weight loss? There's an App for That!

There is little known surrounding the integration of technology with weight loss intervention. Noting this, The American Medical Association has recently implemented a study involving technology in a weight loss intervention to further the medical knowledge base surrounding it.

In this study participants were enrolled for a 12 month period in a weight loss program at the VA  outpatient clinic.  The two groups were assigned to a control group that received a weight loss intervention alone; and the second group received the intervention along with mobile technology additions. These included a Personal Digital Assistant (PDA) to log diet and physical activity and receiving bi-weekly coaching sessions over telephone. All participants’ weight were measured at baseline, 3, 6, 9, and 12 months, along with a follow-up.

The group that did not receive the technology support lost an average of 8.6 pounds less than the intervention group that also received the technology support. This equals to a 5% weight loss difference between the two groups. Results suggest that the use of technology can improve weight loss outcomes. Further research is needed to strengthen the amount of evidence that supports this.

For more information please visit:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684245/

A Review of Low-Volume High-Intensity Training and Its Benefits

Would you like to complete a three hour workout in 20 minutes? Read ahead.

Low-volume high-intensity training is not for everyone, but if you are in general good health you may be able to reap the benefits of this trendy exercise. Low-volume high-intensity training is noted for its structure, offering a very intense workout regime that gets your heart rate up. Since this “all out sprint” model cycles shortly timed but quick movements to times of rest, it results in a workout that takes a short length of time in all; yet also increases metabolism. Research suggests such exercise models may offer as much as an average aerobic workout would produce in three hours- in as little time as 20 minutes.

In a study published by the Journal of Sports Science and Medicine a cohort of men randomized between groups, low-volume high-intensity and all out sprint training were compared. The first group in the high- intensity completed 3-5 cycling bouts with 4 minute recovery, and the second completed 6-10 cycling bouts with 2 minutes recovery. Both groups resulted in similar performance at the end of four weeks. As this workout regime may not be for the faint of heart, the benefits are unweighable. By combining aerobic with anaerobic workouts this training provides great results with half the time and double repetitions.
This regime does support previous investigations of optional workouts such as continuous running, brisk walking, and various prolonged aerobic workouts that are effective in lowering ones risk for developing metabolic diseases.

For more information please visit:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737829/ A Practical Model of Low-Volume High-Intensity Interval Training Induces Performance and Metabolic Adaptations That Resemble ‘All-Out’ Sprint Interval Training

Supporting a Healthy Immune Response Through Diet and Exercise May Prevent Cancer Progression.

It is estimated that 180,000 women are diagnosed with Breast cancer within the United States each year

It is estimated that 180,000 women are diagnosed with Breast cancer within the United States each year.  Most diagnoses are determined at the localized stage, which means an estimated 5 year survival rate of 96%. With current technologies finding cancer in earlier stages along comes increased hope for higher survival rates. As technology is an asset for this cancer however, certain factors can predispose an individual to complications throughout the treatment. This includes co-morbidity rates, which are the simultaneous presence of two chronic diseases or conditions in a patient,  such as diabetes, osteoporosis, cardiovascular disease, and most notably, obesity. Obesity is pervasive epidemic that contributes to complications throughout cancer treatments and recovery.

Luckily, obesity is manageable.  In a recent study published in the International Journal of Behavioral Medicine, the effects of a weight loss intervention on body mass, fitness, and inflammatory biomarkers in overweight or obese breast cancer survivors was reviewed. During the study participants were enrolled in a 16 week long diet and fitness regime that promoted weight loss. At the end of the 16 weeks, the intervention group had many favorable outcomes compared to the control groups. The intervention group not only lost more weight, but also showed changes at a molecular level. What researchers particularly reported was an improvement in IL-6, an important gene involved in tissue cell mending and immune response, both very important aspects of cancer recovery.

Conclusively, reversing obesity among cancer survivors not only reduces weight between individuals, but also reduces inflammation and supports a health immune response which may influence the risk of cancer progression

For more information please visit:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3212681/ Effects of a Weight Loss Intervention on Body Mass, Fitness, and Inflammatory Biomarkers in Overweight or Obese Breast Cancer Survivors 

Healthy Lifestyle and Prostate Cancer Prevention for Men

It’s not the first time we've been told that living a healthy lifestyle is beneficial.

It’s not the first time we've been told that living a healthy lifestyle is beneficial. Acknowledging this statement is certainly true, yet what is the extent of it? Current cancer research tells us just that and gives us new hope in cancer prevention.

 

In a new Study titled “Healthy Habits Linked to Longer Telomeres in Prostate Cancer”, directed by the Preventive Medicine Research Institute, the association between a healthy lifestyle and chromosome length was explored. This study notes on previous findings that the length of telomeres, or protein complexes at the end of chromosomes, are linked to later cancer onset when a healthy lifestyle is implemented.

 

For this Study a cohort of 35 men with biopsy-proven, low risk prostate cancer, were opted into a lifestyle program. This program consisted of a diet low in fat and refined carbohydrates and high in whole fruits and vegetables; exercised aerobically for at least 30 minutes 6 days each week; engaged in stress management programs; and took part in a 1-hour weekly support group. Over a 5 year span, these men experienced a lengthening in telomeres, and consequently, an improvement in chromosome and overall health.

 

Results not only concluded an improvement in the intervention groups’ telomeres, but in the control group who were solely monitored for 5 years, in contrast, concluded with an overall shortening in telomeres.

 

As results are encouraging, further research into the correlation between lifestyle and health will continue to broaden the understanding of the extent of benefits our society may incur.

Fifty Percent of all Cancers Can Be Prevented.

Researchers  at the Union for International Cancer Control (UICC) World Cancer Congress 2012 stated that 50% of all cancers can be prevented simply by following the steps of what is known in cancer prevention such as:

Don't Smoke.  Smoking causes 1/3 of all cancers.

Lose weight.  Obesity causes 20% of all cancers.

Eat well.    Improvement in diet could reduce cancer incidence by 50% 

Exercise. Increases in physical activity could reduce cancer incidence by as much as 85% in 5 to 20 years.

Eradicating the main viruses associated with cancer worldwide which include human papillomavirus and hepatitis B and C  could lead to a 100% reduction in viral-related cancer incidence in 20 to 40 years.

Screening for colorectal cancer can reduce mortality by 30% to 40%.

Epidemiologists have shown thirty years ago that tobacco, alcohol, diet,  lack of physical activity, and obesity accounted for more than half of all cancer.

Running Less Than Twenty Miles a Week Better for Your Health than Long runs.

A new study in by Dr Carl Lavie (Ochsner Health System, New Orleans, LA) showed that the mortality benefits of running are best accumulated in shorter distances, specifically at less than 20 miles per week.   In fact, at longer distances, the researchers observed a U-shape relationship between mortality and running, with longer weekly distances trending back in the wrong direction, toward less mortality benefit.  

 Lavie stressed that the study is one of the largest to date, including data on more than 52 000 men and women participating in the Aerobics Center Longitudinal Study (ACLS), results will likely vary among individuals with differing athletic abilities or different ages.   Running was associated with a 19% lower risk of all-cause mortality when compared with individuals who did not run.  Individuals who ran six and seven miles per hour had a significant 21% and 27% lower risk of all-cause mortality, whereas those who ran eight or more miles per hour had a nonsignificant 7% lower risk of all-cause mortality.  Running up to 20 miles per week was associated with a significantly reduced risk of death, with the largest benefit observed in those who ran between 10 to 15 miles weekly.   For those who ran 20 to 25 miles and more than 25 miles per week, however, there was a nonsignificant 10% and 5% reduction in all-cause mortality. 

Lavie noted that it is impossible to say definitively that more running is making the reduction in all-cause mortality go in the other direction, as it's possible that unmeasured variables might have influenced the results.  It's possible that runners might not be taking care of themselves in other ways.  Endurance exercise may also be associated with coronary artery calcification, diastolic dysfunction, or arterial stiffening.  For a cardiovascular protection thirty to forty minutes of running is better that ninety minutes of running.  This study is showing that more is not better when it comes to exercise.