The Future of Wearable Health Monitors

Friday May 2 | BY |
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Health Monitors

“Accelerometers do a good job at measuring forward motion, but they can’t sense all types of motion.”

I’m fascinated by cutting-edge personal wellness technology. We’re not there yet. Most of the gadgets we have are first generation “toys,” but a revolution in health self-management is coming soon.

Remember, you heard it first on Renegade Health.

Don’t Immerse Your FitBit in Water

In previous blogs, I wrote about how too much sitting damages our health. As a writer, I sit too much, and over time, I notice differences in my weight, energy, and mental clarity. I wanted to know if these changes were associated with the slower metabolism and reduced oxygenation associated with sitting too long. I also wanted to know how much activity I needed to do every day to compensate for hours of sitting at my computer.

I read an article in Wired Magazine on fitness monitors, checked them out online, and bought a Fitbit Flex.

Recently, I had to buy a second Fitbit Flex. The first one didn’t last too long. I wanted to see if it measured forward motion in the water. Don’t shower, swim, or go paddle boarding in the ocean with one on your wrist. They’re definitely not waterproof!

Most Fitness Trackers Measure Only Forward Steps

What is a fitness tracker? It’s nothing more than a mini accelerometer linked to a software algorithm that you access online, usually via a Bluetooth connection between your device and your computer.

Accelerometers do a good job at measuring forward motion, but they can’t sense all types of motion. For example, I did twenty yoga sun salutations wearing my Fitbit and it hardly registered. They don’t sense resistance training, either, so your bench presses at the gym or pull-ups in the doorway at home won’t show up. They also they can’t measure stationary cycling, but will register your workout on an elliptical machine or treadmill.

Basically, an accelerometer calculates steps taken. For example, it will measure your steps when you walk to the water fountain, or between your parked car and the Starbucks where you get your morning latte.

I wear my new Fitbit Flex to measure my daily steps and caloric output, and to estimate the energy output from my walks and runs. It doesn’t do a good job of measuring energy output on my bicycle rides.

In the clinic, it measures my steps walking around the medical center, climbing the two flights of stairs to my office, and walking from my car to the building. The device connects via Bluetooth to my MacBook Pro, and provides an easy-to-understand dashboard displaying my daily activity.

In a typical clinic day, I take about 5,250 steps, which burn about 2,360 calories—that is, 108% of my average diet of 2,200 calories per day. As long as my diet is stable and my general daily activity remains the same—and I don’t sit too much—my weight doesn’t change.

None of the steps during my average workday are considered very active, though.

In order to receive health benefits from exercise, at least 35 minutes each day to be very active— enough to work up a sweat.

Activity Level and Quality is Associated with Weight Change

If I include a 15-20 minute walk with my dog (a Havanese named “Jet” who is super active), I add another 2,000 steps. If at least 10 minutes of his walk include sprints, I burn an additional 1,500 calories.

At this pace, I would lose about one pound a week given the dietary weight loss orthodoxy of 1 pound of body fat = 3,500 calories (some formulas say 3,700 calories). This number is an estimate, not a perfect mathematical formula of the amount of energy contained in one pound of fatty tissue, but it makes a useful guideline for keeping tabs on calorie input and output.

The information gathered informs me if I’m sitting too much, not walking enough, or getting my activity level just right.

Wristband fitness trackers also estimate miles. For a better estimate of mileage, including a GPS map, I combined information from RunKeeper on my iPhone with data from the Fitbit dashboard.

Picking Up Your Pace Improves Fitness and Helps Weight Loss

Lots of my patients tell me that they walk every day, but they aren’t losing weight. What they don’t say is if their walking time is on a treadmill, the street, or a dirt trail. Intensity and surface make a difference. Bones need stress from weight-bearing and impact to stimulate growth.

It’s well known that long distance bicyclers are prone to osteoporosis, while cross-country runners have stronger bones. Researchers also know that weight lifting, jumping, and the pounding your body gets in martial arts helps keep bones strong.

On average days at the clinic, plus my writing in the evenings and getting in moderate activity, my metabolic balance is just right. I don’t gain or lose weight. But by my standards, it’s not enough for fitness and health. I picked up the pace.

I tracked a 2.2 miles sunset walk on Siesta Beach (voted #1 in America). Here’s what I found out about a typical day, including that long walk.

In the morning, I did a fast walk of just under a mile with Jet, followed by light gardening and a mini free-weight workout. Then, off to the clinic, followed by the sunset beach walk. My Fitbit dashboard displayed 50-60 very active minutes and 7,053 total steps equal to about 3.5 walk/run miles. I burned about 2,800 calories.

With more energy spent, I was hungrier, so I added a protein shake and more protein at breakfast. In one week, I lost one pound, felt better, had more energy and even slept better.

What’s On the Horizon for Personal Fitness Tracking?

I almost ordered a Nike Fuel Band SE because it’s supposed to be waterproof. But, I heard rumors that Nike was getting out of the wristband wearable business. By early 2014, Nike only had about 10% of the health tracker market, with Fitbit dominating the walk-your-way-to-health tech marketplace.

Where are personal wear-on-your-wrist activity trackers going next?

Game-changing technology that will transform the way you monitor your health is coming soon.

Apple CEO Tim Cook has been sporting a Nike Fuelband, holding his wrist in a prominent position for photographs, so it’s no surprise that he sits on Nike’s board of directors. It seems that Nike is fast becoming an important partner for Apple.

The iPhone 5S includes an advanced motion coprocessor, the M7, which allows fitness apps to track motion without turning on the full power of the main processor. For example, Runkeeper by LifeHacker tracks motion and connects to your Android or IOS phone’s GPS giving a perfect map of your run or bicycle ride.

The Nike+ App also tracks your runs. The Nike+ Sportwatch keeps track of your location, pace, distance, laps, calories burned, and with the Polar Wearlink+, it also tracks your heart rate. The Wearlink+ picks up your heart’s signals and transfers data to the Nike+ system, however it’s an additional piece of equipment—a soft fabric chest strap.

Personally, I don’t want so much stuff, especially when it’s strapped to my body and filling my pockets.

For now, I’m okay with my Fitbit Flex and Runkeeper. They do a good job of keeping track of the basics that I need to monitor my daily steps and to calculate walks, runs, or bike rides.

For more comprehensive personal health information, Nike and Apple need to make a quantum leap forward. By creating a new device, Apple will do what it does best: build a great consumer electronics device that will appeal to the masses for its simplicity and effectiveness. Adding advanced software that Nike has pioneered turns a wearable device into a personal health library.

You’ll soon be able to track key features of homeostasis including heart rate, blood pressure, hydration, blood sugar, and respiratory rate. Apple’s Healthbook is coming soon.

In the near future, your iPhone may track and keep a record of all your health information, not just activity and sleep. It’s also likely that wearable wrist devices will become the hardware that communicates in real time to your iPhone.

The new iWatch is just such as device. I understand that it’s just around the corner, but will require IOS 8, and that demands a new generation of smart phone—the iPhone 6.

I predict that within two years, I’ll be able to link my patients’ personal fitness data and vital signs into a cloud-based health and wellness record-keeping system that also stores their lab test results, to create individual health profiles. Add genetic markers, and they’ll have a disease-prevention monitoring system like no other.

Dr. J. E. Williams


Dr. Williams is a pioneer in integrative and functional medicine, the author of six books, and a practicing clinician with over 100,000 patient visits. His areas of interest include longevity and viral immunity. Formerly from San Diego, he now resides in Sarasota, Florida and practices at the Florida Integrative Medical Center. He teaches at NOVA Southeastern University and Emperor’s College of Oriental Medicine.

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  1. Mo says:

    Several things spring to mind as I read this article:
    1. I don’t think you’re going to get a personal health electronic to measure non-forward exercises unless it can somehow remotely measure the electrical impulses from your muscles to prove they’re working at something. And frankly, I’m not sure I’m comfortable with the idea of something that can tell EXACTLY what I’m doing physically at all time.
    2. I don’t have a problem with logging the exercise my Fitbit doesn’t pick up. It only takes about 2 seconds to choose the exercise and enter the time spent. While the trackers need a wider range of activities to choose from, the more ways you’re engaged with the monitoring, the more likely you’ll keep it up and do more. Passive monitoring is not necessarily motivating.
    3. Frankly, if someone need a device to tell you that being more active burns more calories and makes you healthier than being less active, they’re an idiot.
    4. I would like to see the devices be able to calculate or note variances related to uncontrollable factors. For example, you should be able to flag if you have a disease or condition that makes exercise more physically difficult. For example, what may be a light exercise for someone may work up a heck of a sweat in someone with a muscular disorder.
    5. Not everyone belongs to the APPLE CULT. If a product or system can’t be bothered to include other popular platforms in their accessibility, they’re losing market share. Even if I liked Nike, your comments turn me off of their tracker because I don’t have or even want an iPhone.
    6. If these companies are so “health-oriented”, I’d like to see them include info on their own responsibility. Fitbit considers itself environmentally responsible in the manufacture of their products. Nike, however, is notorious for using sweatshops in other countries to produce its shoes as well as a CEO who’s sexist and supports the Penn State Pedophile, so why would I want their health tracker?

    Just some thoughts.

  2. Not a doc says:

    Sorry Doc. Walking 5250 steps does burn 2360 calories. At most you may burn 150 calories. Certainly not 2360 calories. Please recheck your facts or change the device or app that tells you otherwise.

    Based on my height, weight and age, if I run a 9 minute mile for 5 miles, I’m only burning approx 700 calories. If I can walk 5250 steps which is approximately one mile, then I would walk a mile to burn more than 3 times the calories of me running for 5 miles.

  3. June Hanson says:

    Ah, I am so proud of my doctor. Your getting away from that computer, of yours. Taking control of a good exercise program, so that you will be a great example, to all your patients. Today, speed walking 2 miles, overcast , breezy, humid day. I sweat off so many calories, did not need a gizmo on my body. My brain knew, I was creating oxygen, pumping blood through my veins and giving it a terrific tune-up. Then, I climbed 4 flights of stairs, I was so regenerated. Never mind, yesterday, I climbed 6 flights of stairs. See, what your wonderful therapy, inspiration, has inspired in me? Now, when they invent something that can register my one and a half hour work out, in the pool yesterday of water walking forwards and backwards, jumping jacks, pumping weights,etc. plus talking to all my friends, at the same time. Then, they have really accomplished something. I will surely, buy one . Also, started aerobics, gaining energy, thanks to you. Tho, I have to take a short nap, so that I do not overdue.

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