Well, thanks for joining us today.
We're gonna take a look today about some fitness apps
and some heart rate monitors.
We're not going to talk about specific ones.
We're gonna talk more about generalities
as relates to some of the fitness apps that are out there
and some of the heart rate monitors
as we don't want to advertise
for any specific company or brand
unless one of those companies or brands
wish to provide some sponsorship.
Which point in time, we'll take a look
at what the science for that specific company has to say
as we want to make sure that we are giving
as accurate and as beneficial information as possible.
So we were talking the other day with some students
and some other people about cardio responses to exercise.
And a couple of students brought up a question that they had
because they were having a conversation
coming out of the workout.
And they were wondering about the accuracy
of the heart rate monitors
and if the fitness apps are worth using.
Whether they should only be using them
when they're running or doing cardio
or whether they should be wearing them
when they're lifting weights and doing other forms of exercise.
And so let's take a look at this
in terms of the science that's out there
as to which might be best
because there's a lot of fitness apps out there.
There's a lot of heart rate monitors out there.
And so we have to sit back
and we have to take a look at what does the science tell us
because there's a lot out there
and we need to understand a few things.
The following presentation contains information
that might contradict what you have previously heard
or believed to be true about how the human body works
and contains material that is not suitable
for close-minded individuals.
Enjoy.
So let's start by looking at what's meant
in terms of the fitness trackers
and what they are intending to look at
and what they are intending to measure.
So what are the fitness trackers?
They're either gonna measure cardiometabolic responses
or they're gonna measure the distance
that are being traveled by the individual
or we have some applications for some of the smartphones
that are out there that are going to go about measuring
and recording our workout progress
as a means to provide mechanisms for determining
our overall amount of physical activity that's taking place.
And so the tracker effects are gonna take a look
at the physiology of what's going on
in which we can take a look at
and what a lot of them are attempting to do is provide,
at least for the heart monitors, a measuring ability,
ability to measure physiological responses
that are similar to the ECG readouts
that we get within metabolic carts.
What we would use in the laboratory setup
where we would put electrodes on somebody's chest
and put a gas mask on somebody's, over somebody's mouth
to measure gas exchange within the exercise
where the electrodes on the chest
would give us the electrical activity
coming out from the heart.
And what we're attempting to do
when we're attempting to look at all of these features,
all these phenomenons within the various aspects
of the fitness trackers, at least for the heart monitors,
is we're looking at what is going on physiologically
within the heart.
So we'll start by taking a look at the heart rate monitors
in terms of what they're gonna measure
and we'll have some longer comments coming up here.
The heart monitors are meant to track
cardiometabolic effects
and they're gonna track cardiometabolic effects
by looking at the physiology of what's taking place
within the heart based off of the effects
of exercise on the heart.
And when we look at the effects of exercise on the heart,
we're really looking at is looking at how does
the contraction of the heart change
based off of physical exertion taking place?
And what the trackers are gonna do
is they're gonna actually be measuring
the electrical output, the ECG readouts.
The same type of readouts that we'd see
from the electrodes placed in somebody's heart,
somebody's chest in the hospital
to measure activity of the heart.
In terms of the exercise physiology part of the fitness,
what it's doing is it's gonna be doing the equivalency
of a metabolic heart analysis
for the heart rate response,
where we'd put electrodes on the person's chest
to measure electrical activity coming to the heart
and put a gas mask on the person
to measure the exchange of gases
between the body and the environment,
where we're able to determine what the metabolic activity
for that person happens to be.
The other way that we can look at these heart rate monitors
is based off of measuring blood flow rate
based off of using a peripheral monitor.
And the peripheral monitors are usually found
in the watches that we have.
And so we basically have two ways
of looking at heart rate responses.
We can either look at it based off of straps
going across the person's chest
that would act as the electrodes for the ECG,
or we can have monitors in the periphery
usually around the wrist,
or possibly looking at monitors on the person's finger.
The wrist and the finger measurements
are going to basically be measuring blood flow
through the arteries in the area
by using a photovoltaic, a camera and light measurement,
looking at the ability to receive
the light transmission being sent through
in an attempt to measure flow rate of blood
going through the arteries,
and by measuring the flow rate of blood
we're measuring the flow rate able to determine pulse rate.
The other thing that some of these peripheral monitors
will also measure is the amount of gases in the blood,
sometimes we'll test the pulse oximeter.
And the pulse oximeter is gonna measure
the percent of oxygen that we find within the blood
at any point in time.
I'll have a couple of comments on these
as we get into the longer discussion
of the technologies out there.
And so we either have the pulse oximeters
in the peripheral measures, or we have, like I said,
the chest straps that we'll place around the person's chest
that will give us the ECG readouts,
the electrical activity readouts coming from the heart.
Now, both of these are good
because they're gonna provide feedback,
but how good are they?
And that's one of the things we have to look at here,
and we'll take a little longer expose
on that here in a second.
If we look at what the data shows us,
we look at what the research shows us
from one of the current studies out there.
The most recent one that I've been able to find
is from the early 2020s.
It shows a correlation that is the likelihood
of having a correct response
between what the heart rate monitor is giving us
and what we get from our ECG.
And we're looking at for the very good ones
in the high 90s and for the less than good ones
in the high 80s in terms of percentages.
And that's pretty good.
But the problem is that with a lot of these,
we get a pretty big sway.
We get a pretty big deviation in heart rate measurements
that we would see in terms of plus minus differences
between what we get from the ECG
and what we get from the heart rate monitor itself.
And so if we're using it strictly for feedback mechanisms,
that's pretty good.
But if we're using it to do tracking
and looking at how we're improving,
that's not necessarily the best thing.
And part of that has to deal with what happens physiologically
to our cardiovascular system
as we do more conditioning, more training.
Part of it has to deal with how well the apparatus
are working at in terms of picking up
the physiological signals of response to exercise
that we see within the monitors themselves.
What we can stipulate from all of the studies
that we've seen, once again, going from the late 2020s,
it's the most recent study that I have come across
as it relates to specifically the heart rate monitors,
is that the chest strap versions of the heart rate monitors
are better than the watch only monitors.
And we'll talk a little about why that is here in a bit
when we get to a little bit longer discussion
on the use of trackers and the use of devices.
And so those are the fitness trackers that are there.
But we also have a whole host of other trackers
that can come about that typically are smart device,
smartphone, sometimes smartwatch,
applications that are gonna track activity.
And they're not gonna track activity
based off of heart response,
but off of GPS motion, GPS movement.
So it's gonna track your movement that you have
for the smartphones.
They also sometimes will have a pedometer
within the application,
within the health applications usually.
And what the pedometer is gonna do
is it's gonna measure steps and it's gonna take those steps
and attempt to equate it to distance traveled
based off of standardization of step length
relative to your entered body height
if you happen to have measured all of those aspects
of your fitness within the application.
Now there's also some other applications out there
that are not necessarily meant to track
your physiological responses or track your movements,
but are set up in such a way by various programmers
and various applications that are meant to be
more of a gym program, a workout program,
a workout regimen tracker, as opposed to a fitness tracker.
And there are a whole host of those types of applications,
a whole host of those types of programs out there.
What all of the application trackers do
is it increases some of the social networking
that we get within the gym culture
that increases accountability.
And the increase in accountability is good
because it's gonna hold me responsible for my actions.
And by holding me responsible for my actions,
it's going to make sure that I am going to follow through
with what I'm supposed to follow through.
And once again, there's a whole host of those various types
of gym program trackers that are out there.
And once again, I'm not going to sit here
and state one is better than the other,
but what we wanna make sure that we're doing
if we're using any of the gym trackers,
the gym program applications,
is ensure that the programs themselves are set up
such a way so as to be goal-oriented,
self-selected, self-monitored,
and self-motivating in such a way
so that the tracker itself, the application self,
does not become a coercive event
where you're going to choose to do the gym activity
in such a way that it becomes a self-monitored,
self-selective pattern of behavior.
Because what you don't wanna do is you don't wanna make
this tracker, this gym app,
something that is used as a means to coerce you
into being active, to being physically active
or into exercise.
If you're gonna use these as a coercive mechanism,
the likelihood of you actually becoming free
from needing the tracker is very low,
and the likelihood of you continually use the tracker
is very low.
So with all of those things in mind, we've seen a lot
of advertising about the different types of fitness tracking
and fitness applications that can go into smartwatches
and or other devices that allow for tracking fitnesses
and for tracking exercise.
But a question needs to be asked,
do these devices provide accurate and reliable information?
Is it worth getting the tracker?
Is it worth using the devices?
And it's very interesting that with the explosion
of technology and technology-based fitness devices,
there have not been very many large scale studies
to determine if these are just a general marketing ploy
or if we're actually able to have accurate information
from the wearable equipment.
Are we simply marketing as to have some sort
of information, proviable wearable equipment
that's supposed to support our healthy lifestyles?
Or is it something that will actually provide me mechanisms
to achieve health?
These devices have developed the ability to measure
or estimate a range of measurements
of how our body functions, heart rate, stress levels,
pulse ox, metabolic capacities,
calorie utilizations,
and even some provide feedback on muscle functions.
Having access to this information provides an advantage
to any athlete or exerciser trying
to maximize their performance or to that individual hoping
to gain a better understanding of their body.
However, we are currently limited in our use
of these technologies without having validation
for the measurements that we are attempting to track
as being accurate and reliable.
So what does the evidence show?
These devices can provide a means for feedback
as we previously mentioned,
but at the same time, it might not be anything more
than an expensive piece of jewelry.
The difference lies in the way that we are using
the devices to dictate the overall value
that can be obtained from them.
There's evidence to support the use of these devices
can help modify behavior more than track improvements
in overall health.
The stipulations that these devices can help lead
to long-term weight loss is very questionable
as the means by which they provide feedback
is not necessarily the best means to allow
for long-term management.
The same devices when leaked
with increased social interactions,
their internet sites help to provide a means
for accountability and hold us accountable
for completing exercise or continuing
with the dietary changes.
The social interactions and actions related
to the sociability of exercise and dietary changes
are things that we know work to improve overall continuance
in lifestyle intervention programs
if the program is developed in such a way
so as to be self-selected, self-monitored,
and self-maintained.
The evidence does show benefit when using these technologies
by providing in or developing guides
for meeting total activity goals
or in developing quote unquote healthy options,
whether those healthy options are increasing
in physical activity or in the possible food choices
that I make.
And this is where we have to remember,
there's no such thing as good food and bad food.
There are only good choices and bad choices.
The reliability and validity of these trackers
and many of the options and activities
that are suggested may limit what the trackers
and what the devices provide to the individual
and may become problematic for the individual
if they are not already fit.
As the pre-programmed devices fail to understand
that activity and exercise feels quite different
for those who live a sedentary lifestyle
or for those who are experiencing overfatness
relative to those who are already physically active
or of normal fat.
If we look at the reliability metrics
that we have in the research, we see a little bit more.
Based on the systematic reviews that we have,
there is some evidence to indicate
that wearable devices and smartphone applications
show a general level of good reliability for valid measures
up to a moderate level of physical activity.
But there's a problem.
First, most people do not engage in the level of activity
where the devices have been shown to be most reliable,
meaning the devices and the software programs
are not providing correct feedback to most individuals,
either allowing for an underestimation or an overestimation,
an underestimation or overestimation of energy expenditure,
cardiometabolic responses, distance traveled,
or for those who wish to track steps,
the total number of steps taken.
The underestimation is especially seen
for those who use weightlifting
or engaging in intense short duration endurance activities.
The overestimation is especially seen
for those who use very light intensity exercise,
particularly long duration, low intensity exercise,
such as walking or jogging,
which may be important if you're looking
to use these measures as goal markers.
Once again, remember, we're setting up
the exercise programs in such a way so as to be periodized
and the periodization will allow us to meet specific goals
based off of specific times,
but may come at a cost as not knowing
the accurate responses can limit my understanding,
my understanding about what is the metabolic cost
of the activity?
What is the total distance that I traveled?
What is the cardiometabolic response
that I have for that activity?
The inability to have accurate responses limits
our understanding of our overall level of activity
that could interfere with establishing
the proper global responses,
the proper responses seen throughout the body
necessary to eventually change body morphology
and or overall health.
These inaccuracies and low reliability
can provide incorrect and inappropriate feedback.
The incorrect and inappropriate feedback
will limit my long-term modifications of behavior,
may minimize my self-selection towards specific behaviors,
the inability to get the correct modification of behavior
would not allow for the desired changes to be met,
whether those changes are in body composition
and weight loss or in changes in overall level
of physical activity and health.
However, what we have to remember is
even if feedback is not entirely accurate,
having any feedback from any of the devices
may allow us to prevent a relapsing
and rebounding effect of yo-yoing
as we are getting feedback
to what our behaviors happen to be.
The relapsing and rebounding effects to yo-yoing
is found more often in those who attempt to do
health changes and weight loss changes
independent of social interactions,
meaning that even though we're not getting
or may not be getting very accurate feedback
from these devices, the use of the devices
and the use of the social network coming from the devices
can prevent the yo-yoing that tends to accompany
many of the long-term attempts at weight loss
and improvements in health.
Now we have to have a small little deviation here
in terms of some discussions.
And it may be off putting for some of you to hear this,
but there is some differences in skin tonality
based off of a protein pigment within the skin
that will have an effect on the ability
for some of our monitors to provide accurate
and reliable information.
The melanin pigment that we see in darker toned skin
interferes with the ability for the peripheral monitors,
the watch monitors, and the pulse oximeters
to correctly function.
The use of light as an optical method
for measuring changes in blood volume under the skin,
which is how these monitors work,
can have issues arise due to individuals skin pigmentation
where darker skin tones automatically will absorb
more light than lighter skin tones
that will disrupt the ability to get accurate measurements
from the optical method of measuring.
Beyond the skin pigment issue,
the use of the heart rate trackers,
particularly if we're gonna be using the extremities
and measuring of flow through the extremities,
can be slightly inaccurate due to what's referred to
as artifact.
That is the movement of the extremity,
the movement of the arms leads to variability within flow
through the vasculature of the arms.
And when this variability of flow comes in,
we can have irregular readings from the devices,
which is why the chest strap,
if we're looking at utilizing heart rates
as a measurement for fitness and for tracking fitness,
is more reliable than using the watch devices
that artifact can allow for an overestimation
of cardiometabolic responses to the exercise.
The placement of the device can lead to signal crossover
with other devices that you might have on.
So if I'm using my watch to measure my heart rate,
but it's also my smartwatch,
which is communicating with other devices
that I have on my body,
such as earbuds for listening to music
or some sort of music player,
the crosstalk that can come about can be two issues
in terms of the device's reliability
in terms of its ability to measure correctly.
If I'm using a smartphone application for measuring steps,
the placement that I have for the device will impact
the ability to accurately measure steps.
If I do not include my limb length,
how long are my legs,
how long is the lower extremity from the hip to the foot,
and what is my step, both walking as well as jogging
and running, I may not get accurate measures.
There are also issues that can arise due to morphology,
in particular the diameter of the wrist
and the ability to put the sensor in the correct location
relative to the arteries that would be available
for measuring blood flow through the area.
If we look at specifically the monitors
that are attempting to use movement
to determine energy expenditure,
we have other issues that come about.
One is the method by which we're going to measure
the movement, whether it is an accelerometer
that's going to measure the acceleration that's taking place,
whether it's a GPS monitor measuring
what is movement taking place,
whether there's a delay in recording
that does not provide for accurate measurements
in the total amount of movement taking place in the day.
We already talked a little bit about the pedometer
and making sure that it's correctly placed.
If I don't have the pedometer at a spot
that's going to measure limb swing,
that is the movement of the limb through space
during the motion, I may not get the correct cadence count,
the correct step count within the exercise that's going on.
If I'm using the GPS function on the smart devices
for tracking movement, the accuracy of the GPS receiver
is going to impact the accuracy of the distance
that is tracking me in terms of movement.
If I'm using an ergometer as opposed to doing exercise
out in the environment.
So ergometers would be things like stationary bikes,
the rowing machine, the stair steppers,
the versa climbers, the treadmills.
The accuracy of motion will be off.
If I'm doing some sort of high intensity,
low duration activity,
doing things like jump rope
or doing some of the burpee style exercise,
I'm not going to get accurate measures for movement.
Where I place the smart device will also impact
the ability to have correct movement recordings.
If I'm using an arm strap
as opposed to putting it into a hip pocket,
those types of locations can impact
how accurate the measurement I'm going to get
from that device.
While we can use the wearable devices,
these are not the only devices that are out there.
We have evidence that shows that using computer
and smart device applications to provide reliable
and valid means to monitor things like eating behaviors
is important as well.
We also have computer smart device applications
that will provide workout regimens for the individual
and workout suggestions for the individual.
What the computer and smart device applications provide for
is a means for logging your activities
and a means for logging your food consumptions.
Most of the smart devices
and most of the computer device applications
will allow me to monitor eating behaviors
most often based off of caloric balances,
which we most recently found out
to be not the most accurate means by which
to determine whether or not I'm going to have
a healthy dietary intake to meet my health and weight goals.
If you can find and if you can use applications
that do not monitor food intake based off of calories
but instead off of nutrients,
you'll have a more reliable means by which
to track your overall food consumptions
for both weight loss as well as for improvements in health.
Regardless of whether you're going to use it
to track calories or track nutrient loads,
the application and computer devices
allow you to monitor eating behaviors
and monitor gym behaviors
so that you're able to teach yourself
how to correctly eat and how to correctly pace
your workout programs.
One of the most important things that you have to remember
when it comes to the workout programs
is that the program needs to instill a sense
of periodization within the workout program.
Periodization is going to allow me to train
in the optimal eight to 12 week range
for a specific fitness goal with a secondary goal
possibly being changes in body morphology or in weight loss.
What we have to remember is that even if our goal
in the longterm is to lose weight,
all of the goals within the training regimen
should not be focused on the scale
as the scale can provide a negative reinforcer
for longterm behavior modification.
When we're using the application devices
and we're using the computer devices
to allow us to track what we're eating
and what we're doing in terms of physical activity,
it's important to remember
that there is no one specific diet to follow
that will allow me to be healthy
or will impart some sort of miracle weight loss.
If you're using applications or programs
that are not providing that,
you may wish to look at secondary methods
by which you can track.
What these devices and what these programs should allow for
is for you to see the things that you're eating
based off of serving size, amount eaten,
and the relative difference between the two
when you're eating in terms of meal timing.
So you can better understand how much you are eating
and how often you are eating
so you're better able to make changes in your eating habits.
The fitness trackers and the gym program applications
should provide feedback
as to what is your cardiometabolic responses,
what is your general level of intensity,
what is your progress to date
within the periodization of a program
so that you understand what changes have occurred,
what changes still need to occur
so as to meet your training and fitness goals.
These factors are very important
in developing the behavior changes necessary
for any long-term weight loss programs
or long-term modifications
to correct any sort of overfatness
that might impact your overall health.
For those that have or histories of yo-yoing,
these devices provide the feedback
that helps minimize the yo-yoing that has taken place.
So what can we say about these devices
and these applications?
The best that we can say is that these devices
and these applications provide feedback with our workout.
There is some evidence,
but the evidence is not entirely 100% across the board.
Once again, science says nothing is 100% across the board.
But beyond the feedback,
the evidence that we have is questionable
as to how accurate and reliable
some of the measuring devices happen to be
as relates to changes that we can track
in terms of comparisons.
It does help with reducing the yo-yoing effect
that can take place,
but the accuracy and the reliability of the measurements,
we're not 100% certain on.
And that's mainly because we have not done
very many large-scale studies.
It's difficult to say
that you can trigger overall changes in behavior
that is not coming from self-selective behavior
strictly by using these devices.
If you're using the devices out of a coercive setup,
the use of the device will become the coercion,
and you will only do it out of fear
of not meeting some sort of set standard
established by the device.
If you're getting alerts that say you have to do this,
you have to do that from the devices,
the device itself becomes the coercive or the coercer
within the exercise and within the changes
in overall health behaviors.
If you're using the device simply as a means
for tracking what you're doing,
the devices seem to be legitimate.
The devices seem to be legitimate.
While the companies report the ability
to provide accurate information to their users
from their devices or their downloadable applications,
the activity does not actually indicate
whether or not the devices are reliable and accurate.
Your activity may not allow for accuracy and reliability
from these devices.
When we look at the evidence that's available
within the medical and within the physiological research,
we are obligated to answer the question that we post.
How reliable, how accurate are these devices?
Are they worth the money?
And with every other physiological question that we have,
it's the same, yes, maybe no.
There's a lot of unanswered questions out there,
mainly because we're trying to use one thing
to measure a highly complex set of responses.
And so when we look at all of the evidence out there,
yes, they work.
Do they work to the extent that all of the advertisements
want us to think they do?
Probably not.
But that doesn't mean that they're not worth the investment.
They're not worth the investment
if you're using it strictly as a means
for tracking your changes on a daily basis,
on a weekly basis, on a monthly basis,
within your periodized exercise regimen
to meet your overall training goals.
They're worth it if you're using it
to have social interactions as relates to changes
in your daily life.
To have social interactions as relates to changes
that you have within your own behavioral,
within your own behaviors as relates to your overall health.
As we know, increased sociability
within the behavior modifications,
increase the likelihood for success,
particularly if we can get the changes to be
self-selected, self-monitored,
self-motivated in terms of the behaviors.
So use the fitness trackers,
however, don't rely on the fitness trackers.
Use the gym applications.
Don't rely on the gym applications.
Use the diet trackers.
Don't rely on the diet trackers.
The reliance on the devices will lead to a lack
of self-monitoring and self-motivating behaviors.
If we can get self-monitored, self-motivated behaviors,
the likelihood of yoga changes
and the likelihood of yo-yoing goes down
and improvement go up.
Well, thanks for joining us today.
Hopefully you got something out from the discussion here
on the fitness trackers and monitors and applications.
If you have specific ones
that you would like to know more about,
please drop it into the comments
and we would be more than happy to take a deeper dive
into specific ones out there.
Once again, the idea here was to not pick on specific
trackers and specific devices that are out there,
but give more of a general overtone
to what we happen to see.
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