Wearable Health Tech: Helpful Tool Or Health Hype

0:00 So, is a smartwatch, a continuous glucose monitor, a heart rate monitor, is it worth getting? And does the data real? Does it make a difference? >> These wearable technologies >> wearable, >> right? We're gonna give our opinion at the end of this. >> We sure are. Welcome to Talking with Docs and Dr. Braden. >> I'm Dr. Paul Z. >> They're everywhere. Look at us. >> Yeah. Here you go. See? So, well, we just gave away the answer. >> No, just because we do it doesn't mean we believe in it. >> Okay. Fair. Really? >> Yes. >> All right. Okay. Okay, we're going to tell you whether we think wearable technologies like this are worth it or not. >> And so we measure everything from from your steps to your heart rate to your sleep quality to your oxygen to your calories, your blood sugar. >> Your blood sugar. >> That's wild. >> You know what? When I when I was doing my masters, I did it in the Institute of Biomedical Engineering in the ultrasound group where we're using Doppler

0:46 ultrasound to simulate blood flow and look at blood flow. >> And the one sort of thing we could They're always chasing, but nobody can ever figure out how to do as to how to measure blood pressure non-invasively. >> Right? >> So, I'm always intrigued if any of these devices say, "Oh, we can measure blood pressure." Because I think there's not a very accurate way to measure blood pressure noninvasively. >> I think there's a couple companies that might argue that, but I'm not sure that they have the data to back up their argument. >> Well, I mean, you can put put on blood pressure cup. It's invasive, though. It's not continuous. Yeah. Um, sometimes they look at like the pulse in your wrist to the pulse somewhere when you put your finger on it. Yeah. And they look at check your sort of electrical. They relate the electrical conduction to your blood pressure. I don't think it's super accurate. >> I would agree. >> It's really hard thing to do.

1:32 >> Okay. Well, let's start at the beginning. So, let's start with steps. This is where a lot of this stuff started, right? Like I feel like kind of the Fitbit was kind of one of these first things that counted your steps. And when they've when they've measured your steps with um these types of devices versus the actual number of steps that you take, they're actually pretty accurate within five or 10%. Yeah. >> Um usually they don't necessarily always under or overestimate depends on the size of your steps. But I'd say they're pretty good at actually measuring what they're trying to measure, which is the number of steps. Now, does knowing the number of steps that you make every day, does it make a difference for you? Does it make a difference for your health? >> And that's up to you. I mean if you're if you measure it in distance you think I walk two blocks, three blocks, four blocks or kilometers or whatever uh or your number of steps because you want to see what you're doing when you're not consciously walking that distance. >> I think if you are interested in that

2:19 number, I think it is helpful because then it gives you that number for sure. >> And there's a couple interesting studies about this. So one study showed that people that wear devices that track their steps Yeah. >> actually take more steps like up to like 1500 more steps a day. >> Yes. >> Okay. That's the first thing. Yeah. Second thing is there's a study in GM in 2020 that that estimated that comparing a group of people that got an average of 4,000 steps a day. Yes. >> To a group that got an average of 8,000 steps a day, >> twice as many. >> The 8,000 group had 50% reduced risk of mortality. Death because of twice the number of steps. >> Twice the number of steps. Half the mortality >> does not mean that the steps are are causally related. We've talked about this all the time. Association versus causation. But something about those steps reduces your chance of dying. So

3:04 if wearing something increases your chance of walking more, we know that this is a good thing. Walking is good. >> Yeah, it could be an association because, well, I'm dying, so I can't do these steps, so that's why I have less steps. >> I guess I I guess. >> But yeah, and you know what? Way before Fitbit, they had mechanical devices that you could use. The pedometers, remember those? Leave a leave a comment if you've ever owned a pedometer before. >> And I think we did a video about the ideal number of steps in a day, and we can link it. And I think as Japanese study, I think they were using kind of that old school pedometer and came out around the 7500 number. >> So that that notion has been around forever. People interested how many steps. Do you use you use your smart technology to check your steps in the day? >> Nope. >> Me neither. My wife does. I show up say, "Oh my god, I did 10,000 steps." Yeah. But I personally I don't think I know how to access that. >> Sometimes I do it on vacation if I've

3:50 been walking a lot. I feel like I walked a lot today. But in general, at the end of the day, I'm like, "Oh, I need more steps." And because some people literally will be like, you know, I don't have an Apple Watch, but I know you can like close the rings on your Apple Watch. It says you need a certain number of steps. People feel like walking around their house to try to close that last ring. >> Yeah. Yeah. >> But I guess if that's what it takes to do that, then that's it's only a good thing. >> On vacation, I want to get like seven steps in the day. >> No, I walk a lot on vacation. Yeah. >> You're that guy. >> My kids used to hate it. They're like, "Can we take a cab?" I'm like, "No, we're in like New York City." No, we're walking. It's going to take 20 minutes to get a cab. You >> call this a vacation? >> That's right. Okay. All right. >> Okay. What else? Number two is your is your heart rate rhythm. So heart rate. So not only your rate but also your rhythm. So >> are devices good at measuring this nowadays? >> They are pretty good. I think they're fairly accurate at measuring because

4:36 it's not a tough thing to measure now. >> Uh from a wearable technology, right? And if you think about it, um wearable technologies been around way before >> it's been commercially available because people have been using these uh in cardiology. For example, if you present with some kind of arrhythmia or some kind of lightadedness or something, >> you'll often get a halter monitor or a monitor that you wear for 24 48 hours or even a week and those and then they it records everything and the cardiologist looks at all that data. Right. >> Right. So that wear this has been around for a long time. >> Just wear more leads I guess with the halter then >> you wear more leads with the halter. Although no some of the newer ones are just like a stick it >> just one single lead. Yes. >> Okay. So this works by something called photolethismography. So they use green light that is uniquely absorbed or more

5:23 absorbed by hemoglobin. >> Yeah. >> And then as the blood vessel and the hemoglobin is racing by this light, it can measure the the rate of the light and and also the rhythm. >> Um so it's pretty accurate for for heart rate. I would say that evidence shows that >> comparing a wristwatch to a chest strap actually a chest strap is much more much more reliable mostly because of the motion associated with specific types of exercise. If you're doing interval training or something that's more aggressive, wearing a a watch on your wrist is probably going to have a less accurate number. And I I would attest to this. I wear a chest rope when I run on the treadmill. >> Um because the numbers are always crazy and usually really low with the with the watch for me. >> Yeah. For me, I I'll use that if I'm on a stationary bike and I'm trying to just just to see what zone you're getting into. I use that a lot and and and I

6:09 find it pretty accurate because the stationary bike has its own one that measures it off your wrist, off your hands. Yes. Yes. And your hands aren't moving much on the stationary bike. >> Yeah. You don't bike like this. >> Yeah. Sometimes I do. >> Yeah. >> When I'm trying to impress people in the gym, >> right? >> I can do this. No hands. >> Look at me. >> Look at me. No hands on the stationary bike. And I'm not falling. >> I used to ride no hands on my bike. >> Sure. >> Actually, it's funny that you said that because yesterday I saw a kid that was riding no hands but standing up on his bike yesterday. >> That's tricky. >> I know. I I was impressed. >> That's like circus. >> Yeah. He had like a knapsack on and was looking at his phone standing up on his bike with no hands. I'm like >> like pranking. I'll see you later. >> You threw him three balls. Juggle these. >> That's right. Okay. So, for so for heart rate, I'd say reliable. And a nice thing with that is that you can Yeah. say, "Hey, I want to do zone two or I want to do some interval training and get into

6:55 zone five." It's pretty good at that. >> Super handy. >> So, for the arrhythmia stuff, same kind of principle. And actually, there was something called the Apple Heart Study or an Apple study where 419,000 people had Apple watches. And they were additions, I think, one, two, and three. Mhm. >> Of this group of people, um 0.5% were identified to have an irregular heartbeat. >> Right. >> So that's like about 2,000 people. And those 2,000 people then went for further testing. So this prompted them to go see their doctor or see the study coordinator. And of those 2,000 people, like one-third of them actually had new onset atrial fibrillation. >> So it overcalled it a little bit on that, which I'd rather it do overall it a few false positives better than some false negatives in that situation. >> Right. atrial fibrillation is something that can directly lead to the incidence of stroke. So this wearing watch

7:40 theoretically could have prevented some strokes. >> Yes. Atrial fibrillation is where your heart doesn't have a regular rhythm like it's supposed to. It's irregular and the atrium isn't really functioning like it's supposed to. So blood can pull in the atrium. >> If blood pools in the atrium of the heart, a small clot can form >> and if a small clot forms there and breaks off and goes to your brain, that is a stroke. So that's why people with atrial fibrillation you'll often see are on blood thinners to minimize the chance of a stroke. So if your watch can pick up, you know, and I've seen this, I've had a patient before who got diagnosed with atrial fibrillation. They said, "My watch picked it up." >> So it does happen where they they do actually pick these up. >> Obviously, you should be if you feel an irregular heart rate, you should probably go get that checked out, >> right? >> But if the watch can help pick that up.

8:26 If the watch is your go-to cardiologist, >> we don't suggest that. Okay? Obviously, you're not going to replace your visits to your doctor with your watch. But if it does pick up something that your doctor missed or that you missed, I think it's worth it. >> The one of the unique type of pseudo wearable technology that's really good is it's something called cardium mobile. It's actually a portable ECG. You put two of your fingers down and in the moment gives like medical grade ECG. Um, it is only single lead. So, a normal ECG has 12 leads and so has only one lead. So it can miss probably more signs of eskeeia or like an impending heart attack or previous heart attacks. But it is quite good at identifying arhythmias like atrial fibrillation. >> You only need one lead to pick up an arhythmia and and I think those things are fantastic. >> Okay. So next one is is sleep. >> Do you ever do you ever look at your

9:12 sleep numbers? >> No, because I don't wear my watch when I sleep. >> Oh, you don't? How come? >> Uh because it bugs me. >> Oh, like like the the physical presence of your watch? >> Yeah, it does. And I'm usually charging it when I'm sleeping. Got it. I charge it. Um, so no, I don't I don't either watch my watch here. We slept amazing. >> Didn't you didn't budge. >> Yeah. >> Yeah. So what? So I I do wear mine. Um, >> when do you charge it then? >> Honestly, the charge lasts so long. Usually I'll just charge it like either in the morning when I'm like brushing my teeth for like 15 minutes. Really? >> Oh yeah. >> Oh my. We won't talk about brands because that throw some shade on your brand or my brand, but my charge lasts a long time. >> Um, so I'd say sleep measurements done by your watch. measure a whole bunch of things. So, the thought is it can measure the the time when you go to sleep, the time when you wake up, and

9:58 kind of how you're sleeping in the middle. >> I would say it's quite good at estimating the amount of time that you're asleep. >> Okay. >> But compared to a sleep study, it is grossly inferior to the number of movements as well as the the stage of your sleep, whether you're getting REM sleep or deep sleep or light sleep. It's really not very good at this. And it spits out a number through an algorithm. And every watch or wearable technology provides the algorithms are not standardized, so you can't even compare them. No. with the goal being that you got a 100 being, yeah, you got the the best quality sleep. >> So, I'd say it's good at measuring the amount and probably can track a trend, but don't obsess if you didn't think you got enough REM because your watch said that. >> No, because then you'll have orthos or >> Yeah, you get obsessed with the quality of your sleep and then you can't sleep. >> What if your watch tells you you're not sleeping very well when you tomorrow I'm

10:43 going to sleep better? >> Yeah. >> How do you do? >> Watch this. I'm get I'm getting ready for tonight. >> I'm going to sleep better tonight. >> What you could do is maybe don't eat right before bed. you get a point alcohol. Don't get the caffeine. Don't you know there's a bunch of things. >> All right. How about just do those things without the >> sleepwatch? There there's two more things I'd say. So, one more thing that a lot of watches give you nowadays is the HRV or the heart rate variability >> as opposed to the Honda HRV. >> The Honda HRV. Yes. So, HRV, heart rate variability is essentially the amount of time between heartbeats. And this is variable. >> Yeah. Usually, we measure your heart rate by how many beats per certain time, right? This is sort of flipping that. It's one over that. Yeah. We're looking at the time, >> right? And for me, I used to Well, in two, I thought, well, you'd want it to

11:28 be the same all the time. You want your heart just to be pumping very regularly, same amount of time. >> That seems healthy. >> Yeah. So, actually, that would be a low HRV. And actually, a low RV HRV is a sign of of stress, poor quality sleep, uh sometimes not adequate recovery from exercise. So, a high HRV shows that something called your autonomic nervous system. So that's the combination of your fight orflight system and what's called your parasympathetic system, your rest and recovery system are both working properly. So your ability to respond to those things and having a more variable heart rate is actually better for you and a better sign of general health. >> Yes. Our astute watchers and viewers will say, "Wait a minute. Is it a large HRV and arrhythmia?" >> Yes. If your heart rate variable is too big, then you have an irregular heart rate. Yes. >> So the we're talking about within like milliseconds. >> Yeah. The number that it's giving you actually is a is one standard deviation

12:14 from the mean of a whole bunch of heart rate. But again, this is measured only intermittently. So, it's not a super reliable thing, but you're really watching for trends. >> Yeah. Okay. >> Don't obsess about it. >> The last one I think is really cool, really cool, is the continuous glucose monitor. >> Yeah. And you know what? >> We I have one and I might do it this week. So, this Yeah, we're going into March break around here. So, I think I I might do it and then we'll do a video about it. >> Yeah. I think that's brilliant. So, what it is, it's a device that you wear >> and it actually measures your glucose levels >> continuously, which is insane. >> And then sends it to your phone where you can record. One of our colleagues wears one and because she has diabetes, right? And and the alarm will go off, you know, sugar's too low, sugar's too

13:00 high. And I think in my opinion, I think it's revolutionized >> sugar control in people living with diabetes. >> That and the insulin pump, I totally agree. Like rather than all the finger pricks, oh man, >> twice a day, four times a day. >> Yeah. >> These continuous glucose monitors give you real time measurements of your glucose and you can it's great bio feedback, >> right? And like anything in 2026, >> if it's good for diabetics, maybe I should do it, >> right? >> I'm not diabetic though. But you know what? I just want to know. I want some more data. >> Yes. >> About what my blood sugars are doing when I'm doing certain activities or when I'm eating certain foods. So this has become a very common thing because you can buy them on Amazon or wherever else >> and have it brought to your house and then you put it on and you can see how your life responds. So what does the evidence say? So the evidence says for diabetics yes

13:45 >> people living with diabetes, >> game changer because the thing about people living with diabetes is that you want your baseline blood sugar to be lower. >> This reduces your risk of complications. >> You want to get into a range and you want to keep it in that range within what like about 70% of the time or something like that. I'm not exactly sure what the >> that's the target, but I think the more more is better without avoiding the lows kind of thing. >> But yeah, so so the average person, well, if that's good for you, can it not be good for me if I know how this happens? There's no evidence to show that people that do not have diabetes that wear continuous glucose monitors are healthier or live better. What I would say though is it does definitely teach you how sensitive your body is to exercise. Yes. >> So how much exercise will drop your sugars? And we did a video about, you know, should you go for a walk after dinner? >> I'm going to do that next week. I'm doing that.

14:30 >> Yes. Because everybody's different. So it does tell you uniquely how your body is reacting when you do it. I want you to check to not just what you eat, but the order in which you eat. >> Yeah. So I'm going to have a real long plan. So because a lot of people would say if you eat high fiber, low calorie, low carb foods first, this will blunt the response. And I I've done this once before, but we didn't do a video about it. But I remember eating like a like a sundae that had like a zillion calories in a gazillion grams of sugar and it didn't move my sugar barely. >> Had you eaten like a bunch of fiber just before? >> No way. >> No. I went in >> I want to see what happened. I want you to try eating just chocolate sundaes for three days straight and I want to see what happens. Okay, with this experiment like my version of superersized meat. >> Then I'm going to put >> You're going to come out like what happened Dr. Le bring it in boys. You'll be like, "What's that?" It's a giant

15:15 wheel. I want you to run in this wheel. >> That's right. >> Don't worry about the cage around you. >> Right. So, so not only exercise the hamster, >> the type of food and the order of the food. So, so we're going to So, I think it has a potential role for that, but probably do it like once and then stop like let it go. Don't be obsessed with the data. So, >> taking all of them all together, all of the wearable technologies. Is it something that is worth it? >> Yeah. In my opinion, I love it. I think it's I think it's a great application of technology. >> Yes. >> To get to bring technology to something that is geared toward health. So, if it in some way gets you to exercise more or eat properly or make good lifestyle changed sooner. >> Go to bed sooner. >> I think it's worth it personally. And I love the way and I use mine >> I use mine for heart rate during

16:02 exercise. I also use it for resting heart rate. Yeah. >> I've used it to look to see if there has been any arrhythmias or anything like that. Right. >> So, personally, I do use wearable technology. Yeah. Same. >> Both when I'm exercising, when I'm not exercising. Yeah. Not I mean I'm probably using about 10% or 20% of what's available out there. Yeah, to some degree I do use it. >> Yeah, same. I have a chest strap. I like I like kind of very specific zone kind of specific training. Um I do look at all the other stuff, the quality of my sleep, HRV. And it's funny because you can kind of guess like when you feel kind of bad, you're like, "Oh yeah, this is up or this is down or this is worse." >> I have a lie next to me sleep monitor. It's my wife. She lets me know you didn't have a good sleep. Yeah. >> And a vibe and she didn't. Yeah. So,

16:47 >> it's not good. >> That's that's helpful. >> Now, you know, leave a comment if you have something wearable or if you like it or you don't like it or whatever you use it for, share it. Share it with us. Share with our other viewers. If you like this video, please like it. Subscribe to our channel. Send it to someone who's considering purchasing some wearable technology. >> Yeah. And if you have one that we didn't mention Yeah. >> put it in there. Let us know about it. And someone else reading the comments will really benefit from it as much as we will from learning from you guys. So remember, you are in charge of your own health.