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  • Erin & Jaci

Fitness Trackers: Friend or Foe?

“Close to 1 in 10 adults over age 18 owns an activity tracker” (1) You can’t go anywhere these days without seeing someone wearing an iWatch or a Fitbit. People are now more than ever becoming accountable for their health and wellness and tracking via a fitness tracker has become a part of this movement. Fitness trackers have been around for quite sometime but they didn’t start making mainstream headway until about the early 2000s. But, with all of this information available to us, is it really getting us to our #healthgoals or could it be sabotaging them? You will be very surprised by the truth behind tracking every little move you make.


Fitness trackers are shown to have an increased benefit in one's overall health and wellness (2), (1), (3) and the goals they have set for themselves. With that being said, I am going to start with discussing the benefits of wearing a fitness tracker. As you may have guessed there are more benefits to fitness trackers than disadvantages (sorry to blow the suspenseful ending!). But, its true. In the review of research and articles, overall conclusions agree that there is either a benefit to using fitness trackers or that more data needs to be collected in terms of the accuracy of trackers. Regardless, fitness trackers are motivating and encouraging those who mostly live a sedentary lifestyle, to get up and move!


“Without personal accountability, we cannot grow nor can we every improve ourselves”


Let's start with the fact that people need to be held accountable and a fitness tracker is a great entry point into this lifestyle change. Whether this accountability is purely to you or to a group, it can motivate you to meet your goals. A fitness tracker can make you accountable for hitting a certain number of steps a day (personally my goal is 10,000), meeting your caloric output goal, getting your workout in, or (with the Apple iWatch) standing for at least 12 hours a day. With your fitness tracker, the only person you can hold accountable is yourself. Who will meet those 10,000 steps a day? Who will perform the 30 minutes of exercise recommended 5 days a week? You! That's the answer!

If the accountability is not to you, group accountability (either physically meeting or through social media) is often be more motivating than just performing and meeting these goals alone (4). I know for me, I love the “sharing” feature on my Apple iWatch. This means that I can link with other people (friends and family) and share/monitor physical activity. You have the option to send them motivating messages when they finish a workout or a new feature where you can “compete” against one another, either in regards to the amount of calories you burn, your exercise duration, or your standing time (its called “closing your rings”). My husband and I are both competitive in nature so we compete every week and send each other sarcastic, yet motivating, messages when we complete a workout. I find this to be more motivating than anything—and this is all due to the competitive nature that has been conditioned in me since age 8.


Another accountability factor would be reporting your findings to your doctor. As a family practitioner I like to know how often and how long my patient exercises. With fitness trackers my patients are able to monitor this and bring up these statistics on their smartphone during the appointment. This form of accountability is not only beneficial for the patient but for their healthcare provider as it allows them to give further motivation if its warranted.


Branching from accountability as a fitness tracker benefit, there are certain companies that provide an incentive program with wearing a fitness tracker and meeting certain goals. Companies such as John Hancock (a life insurance company) or UnitedHealthcare (a health insurance company) provide an incentive program to their clients. For example, this September John Hancock announced (5) that they would stop writing traditional life insurance policies and only sell interactive policies where clients use fitness trackers via wrist monitors or their smartphone app. This program offers certain incentives to their clients when they hit particular health goals. What's the reason for this change? “Brooks Tingle, president and chief executive of John Hancock, put it frankly to the New York Times: “The longer people live, the more money we make. If we can collectively help our customers live just a bit longer, it’s quite advantageous for us as a company.” (5). While this does benefits their company, it also benefits the client as it will motive them to exercise and become physically active overall. FitBit, one of the most popular fitness tracker companies, provides health insurances and employees options for their clients in which wearing a fitness tracker and meeting certain criteria (hitting a certain amount of steps is the main objective with their policies) allows for lower premiums and qualifies for certain prizes or even cash-back. If this doesn’t motivate you enough I don’t know what will!


Another benefit of fitness trackers these days is that they can connect to your smartphone. For instance, the Apple iWatch Series 3 and 4 allow you to answer your phone from the watch itself! Yes—real life Dick Tracy (if you don’t know who Dick Tracy is—google it!) Not only can the newest fitness trackers answer phone calls, they can receive and send text messages, get weather updates, receive app notifications, and... tell the time! But in all seriousness, fitness trackers are giving us the ability to not be chained to our phones at all times and allow us to have a bit of freedom to filter out what is important enough to use our phones and what can wait. I personally find this very liberating as I feel looking at my phone every few minutes is more socially rude than glancing at your watch. At least thats my opinion.


Sleep is something that we as a society really struggle with. I can’t even count how many patients A DAY that we see in clinic who are having difficulty either falling asleep, staying asleep, or both. One in four Americans develop some type of insomnia a year (6) and in 2014 the Center for Disease Control (CDC) reported “34.8% (age-adjusted = 35.7%) of Florida adults reported usually sleeping <7 hours in a 24- hour period.” (6) In a nutshell, we are not sleeping like we should.


“In general, sleep tracking devices are fair to good at detecting sleep but poor at determining wakefulness. They are inaccurate for determining absolute sleep parameters (ie, total sleep time, sleep efficiency, wake time after sleep onset, and sleep onset latency) and in distinguishing the different sleep stages compared to polysomnography [sleep study]” (1). Sleep studies are still considered the “gold standard” when it comes to evaluating patient’s actual sleep patterns, any disordered breathing while sleeping, and periodic limb movements and for diagnosing narcolepsy. But with the aid of certain fitness trackers (Fitbit, Jawbone, Nike Fuel band) we have the ability to gain some knowledge on what our sleep patterns look like and, if there is some discrepancies, it can be further investigated with the appropriate diagnostic tools.


Now, what reasons could there be to NOT wear a fitness tracker?


To be honest there really isn’t. There are some studies that question the validity and accuracy of the results from fitness trackers (steps, heart rate, caloric output etc) (8) (9). In the end it is not a “perfect science” but it gives insight into what areas need improvement and in what areas goals are being met.


Another question raised with the use of fitness trackers is the potential for becoming obsessed. In review of clinical studies and articles, it is not quite clear if this has become a factor but this is a question myself and Erin have raised ourselves. It is known in patients with eating disorders or body dysmorphia—“a mental disorder in which you can't stop thinking about one or more perceived defects or flaws in your appearance” (10) one can become obsessed with the idea of perfection. This “perfection” could also mean overextending caloric output. One could workout obsessively to meet that goal and potentially inflict serious harm on themselves. It very well could be an issue that is seen within psychological fields, but we must raise some awareness of this potential issue since we often identify patients with eating disorders and other psychological disorders in family medicine as well.


Other than the concerns listed above fitness trackers seem to have an overall benefit for those individuals wanting to change their lifestyle and meet their health and wellness goals.


Ok, so which one do I choose?


With so many options out there, it very easily can become confusing on which fitness tracker to choose.


In one clinical study published in June 2018, it was concluded that “Garmin device was more accurate at reflecting step count across a broader range of walking cadences than the Fitbit, but neither strongly reflected intensity of activity. While not intended to replace research grade devices, these wrist-worn devices may be a clinically useful adjunct to exercise therapy to increase physical activity in people with PD.” (11). So there can be variations between each brand, dependent on your physical needs.

Now, I am not a “tech person,” but I do understand effectiveness of these fitness trackers. And I am only going to give my opinion from this point onwards in this blog post.


My very first fitness tracker journey began with the Jawbone UP, but unfortunately their company is in the process of liquidation. You can still find their products on amazon but I wouldn’t trust it as there is no company to support any issue. Funny finding: the fitness tracker I had (that was $100) is now selling for $10—#mindblown. It tracked your physical activity and sleep, which was great back then (about 8 or 9 years ago). You physically had to attach the device to your smartphone to download data, which only worked about 3/4 of the time. Eventually, it just stopped working one day and that was around the time the company was sold—so no customer support.


My second fitness tracker was the Garmin Vivofit 3. This is the tracker that I probably had the longest. It was waterproof, tracked all of my fitness routines, and was pretty accurate. The data transfers via bluetooth. You can also receive text messages, emails, and notifications, but you are unable to respond. If you are looking for a fitness tracker that makes life simpler I probably wouldn’t suggest this one. But if you want a tracker that is pretty inexpensive and has great customer support (it stopped working one time for me and they sent me a new one free the next day!), and you just want to track your activity, this is a great option.


The tracker I am currently using, and have been for the past 1.5 years, is the Series 2 Apple iWatch. I know they are up to Series 4 but I can honestly say I have been very happy with this model. What I love about this fitness tracker is that, yes it counts your steps, but it's more based on your activity level for the day. It monitors your caloric output, exercise time, and standing time as part of your “activity rings” for the day. It is essentially like a mini-competition on a daily basis—which for me is great due to my competitive nature. Not only for tracking my fitness, but for helping me filter out what is important and what is not. Remember the additional benefits a fitness tracker that I mentioned earlier in this post? Well I feel that it allows me to be more present when I am out to dinner with a friend or hanging out with my kids and hubby. I am not constantly looking at my phone to see if I missed a text message or an important email. I can just quickly glance at my watch and continue with my life—which as of lately I have been extra grateful for so I can be present during my time of transition in my occupation. This tracker is probably amongst the “most expensive,” but you can find good deals on it. When I bought mine there happened to be a very good sale going on which brought the price down to $199! And considering that I wear it every day and have had it for the past 1.5 years, I’d say it was a good deal.


If my information didn’t really help you at all, here are some other blog posts that may help!

https://www.digitaltrends.com/wearables/best-fitness-trackers/

https://www.tomsguide.com/us/best-fitness-trackers,review-2066.html

https://www.cnet.com/reviews/best-fitness-trackers-wearable-tech/


And with Black Friday coming up, be on the lookout for good deals on these fitness trackers! #MerryChristmasToYou


I hope you that guys found this blog post helpful and, as always, if you have any questions for us or want to add anything please don’ t hesitate to contact us via email or social media.


Have an amazing week and always remember to #FollowYourGut,


Jaci


Resources

1) https://www.mdedge.com/ccjm/article/139215/sleep-medicine/apps-and-fitness-trackers-measure-sleep-are-they-useful

2) https://www.hopkinsmedicine.org/health/healthy_heart/move_more/could-a-fitness-tracker-boost-your-heart-health

3)https://jamanetwork.com/journals/jamacardiology/fullarticle/2513306

4)https://www.ncbi.nlm.nih.gov/pubmed/29173072

5)https://www.vox.com/the-goods/2018/9/20/17883720/fitbit-john-hancock-interactive-life-insurance

6)https://www.sciencedaily.com/releases/2018/06/180605154114.htm

7) https://www.cdc.gov/sleep/pdf/states508

8)https://mhealth.jmir.org/2018/8/e10527/)

9) https://www.jmir.org/2018/3/e110/

10) https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/symptoms-causes/syc-20353938

11) https://www.sciencedirect.com/science/article/pii/S0966636218304363?via%3Dihub

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