Health & Family

Assessing the fitness of wearable tech

Elise Bloustein, 62, wears a Fitbit on her morning walk through Prospect Park in New York. Older adults are among those who could benefit most from fitness trackers, but experts say there’s a dark side to the devices for some.
Elise Bloustein, 62, wears a Fitbit on her morning walk through Prospect Park in New York. Older adults are among those who could benefit most from fitness trackers, but experts say there’s a dark side to the devices for some. NYT

Like many people who grew up long before personal computers and cellphones became ubiquitous, I’ve never tried a fitness tracker. I already know I walk about 5 miles a day, in addition to my daily swim. My weight is stable within a range of 2 pounds. I prefer to remain accountable only to myself, not to a gadget.

But several of my peers swear by their fitness trackers, and experts say that older adults are among those who could benefit most from such devices.

Elise Bloustein, a 62-year-old Brooklynite, calls the Fitbit she has worn daily since Christmas “my little health whisperer” that asks, “Have you walked today?” It has made her “hungry for walking,” she said, prompting her to triple her daily mileage, improve her diet and shed 13 pounds she had carried around since her first child was born.

By syncing the device with her iPhone via a free app and recording the foods she eats, she has learned to balance calorie input with output and to eat more fruits, vegetables and fiber. She also uses the device to monitor the quantity and quality of her sleep as she strives for seven solid hours of shut-eye a night.

“As a lawyer,” she said, “I spend the day sitting at my desk on the computer or the phone. I had read that the longer you sit, the sooner you’ll die. The Fitbit encourages me to get up and move. I now average 40 to 43 miles a week just walking.”

Bloustein got her sister, a 61-year-old high school social worker in San Francisco, hooked on the tracker as well. Instead of driving to do errands, her sister now walks to reach the number of steps she sets as her daily goal.

The main motivator for those who love a fitness tracker seems to be the pat on the back it gives them when goals are achieved. As my friend Fran Saunders put it, “It’s kind of cool when it buzzes because you’ve reached your 10,000 steps, especially when that happens early in the day.”

This surging industry of wearable technology – the Fitbit now has plenty of competition, including devices from Jawbone, Garmin, Nike and Misfit – has had brisk sales, particularly among young adults “motivated enough to want a device and be able to afford it,” Mitesh S. Patel and colleagues at the University of Pennsylvania wrote in the medical journal JAMA.

Alas, the experts noted, these are the people who least need a technological push to improve their health. “The individuals who might have the most to gain from these devices are likely to be older and less affluent,” they wrote, including those who are sedentary or have a chronic ailment and could benefit from more activity.

Furthermore, Patel said in an interview, for most people to sustain a health-promoting change in behavior, “it must be combined with effective engagement strategies,” like social reinforcement from family members, friends or colleagues, or financial incentives from employers.

Under the Affordable Care Act, employers can use part of employees’ health insurance dollars to fund workplace wellness programs, enabling them to underwrite some or all of the cost of wearable devices. But for workers to benefit from them, “they need to have skin in the game and perhaps get some kind of reward at the end of the month if goals are reached,” Patel said.

Factors beyond pure calories-in/calories-out can affect a person’s weight. Some have reported online that wearing a fitness tracker was counterproductive, resulting in weight gain. Korie Mulholland, a 24-year-old tutor in Chicago, wrote that “since I was walking 10 to 15 miles a day at my stand-up desk, it told me I could eat 2,200 to 2,400 calories a day.” But instead of losing weight, she gained, and after six months, she abandoned the tracker.

In a survey of 6,223 individuals, Endeavor Partners, a research firm, found that more than half who bought a fitness tracker had stopped using it, with one-third abandoning the tracker within six months.

Different folks need different strokes. Those motivated by competition, for example, might enjoy mileage contests with fellow workers or with participants in anonymous Web-based groups.

The Penn team suggested that users might “form teams that provide peer support and promote a sense of accountability” to maintain the new behavior, “perhaps aiming for everyone to achieve a minimum amount of activity rather than simply rewarding the power walkers.”

Rikke Duus and Mike Cooray, business school professors in Britain, recently interviewed 200 women who wore Fitbits, most of them constantly. In The Conversation, an academic site, the researchers observed that the device “had a profound impact on the women’s decision-making in terms of their diet, exercise and how they traveled from one place to another.” Many said they often took longer routes to reach their destinations.

Three-fourths of the users, half of them Americans, also said they had begun eating healthier food, smaller portions and less takeout. Nonetheless, Duus, a professor at University College London, said in an interview that there is a dark side to the tracker.

“In the beginning it was a very helpful friend, but after a while, many felt quite controlled by the device, feeling pressured to reach their daily targets and feeling guilty when they failed to do so,” she said. “It became more about reaching goals than doing what’s good for you.”

When the women weren’t wearing the tracker, they felt “naked” and that any activity they did was wasted, the researchers said. If it couldn’t be recorded, why bother doing it at all?

“People need to manage their relationship with the technology and not become dependent on it,” said Cooray, a professor at the Ashridge-Hult Business School. “You have to develop your own sense of what’s good and the ability to follow through on it.”

Wearable fitness trackers vary in price – from about $49 to $250 – and technical accuracy. “I don’t necessarily think of the Fitbit as 100 percent accurate,” Bloustein said. “Whether it’s accurate or not, it keeps me in a place I want to be.”

For those interested in saving money, a University of Pennsylvania study, published in February in JAMA, found that most smartphone applications were just as accurate as a wearable device in tracking someone’s physical activity.

“Compared with the 1 to 2 percent of adults in the U.S. that own a wearable device, more than 65 percent of adults carry a smartphone,” making the latter a more widely accessible and affordable way to monitor health behaviors, Patel said.