Are Health Trackers Value It? Suggestions From Precision Diet

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Every day, Lina wore a ring that continuously monitored her heart rate, sleep quality, and activity. Most evenings she examined the data excitedly.

"It's wonderful. It changed my life," she said to anyone who asked. "You should definitely get one!"

Jeron? It was a different story.

He too used a device to track his sleep. But the more his smartwatch revealed, the more he threw himself over.

Lina and Jeron are among many people who use devices to track weight, body fat, running speed, steps, calories burned, calories burned, heart rate, body temperature, breathing rate, brain waves, and more.

Thanks to modern technology, we can know more about ourselves (and our customers) than ever before.

But does everyone benefit from so much information?

Who will answer like Lina? And who will answer like Jeron?

This article provides answers to these questions as well as:

Data and gadgets are cool. However, depending on the context and perspective, they can aid or interfere with a person's health efforts.

Here's what's right for you (or your customers).

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Data points help people understand how they are doing.

Let's say someone wants to improve their health. To achieve this goal, they might decide to replace their nightly ice cream with a piece of fruit.

To see if this change works, you could measure:

  • a behavior, e.g. B. how often they perform the action. For example, they could track the number of times they ate fruit instead of ice cream after dinner.
  • a result, such as your cholesterol level or blood pressure. The results can either be objective (like blood tests) or subjective, e.g. B. a person's stress or energy level.

In both cases, the information is an indicator of progress that can be used to assess whether a change is actually working.

But is it always good to keep track of progress?

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5 surprising truths about data tracking

Truth # 1: Different types of people live on different types of data.

Some people respond great to data.

However, other people can become anxious.

Rather than seeing their weight, heart rate variability, or sleep quality as a way to gauge the effectiveness of their work, some people view these metrics as a statement of who they are.

When someone takes data personally, they can step on the scales and feel hopeless and think, "What's wrong with me?"

Or they look at a sleep tracker and think, "My sleep sucks – I must be broken!"

Colorado State University PhD student Kayla Nuss, MA, MS, PN1 has focused much of her graduate research on the relationship between data trackers and exercise motivation.

Based on her findings as well as research by others, 1,2 she says people are more likely to take data personally if they:

✓ See the behavior they engage in as a chore and make comments like, "I have to do this to lose weight."

✓ You don't feel like you have a choice. Someone might say, "I don't want to exercise, but my doctor told me I have to."

✓ Do the behavior to avoid feeling guilty. In other words, they exercise because they don't want to feel bad about not exercising.

(For more information on how to see data differently later, see.)

Truth # 2: A measurement is only useful if it helps you make a decision.

For many people, portable devices offer an entertaining change of pace and satisfy curiosity.

Without an action plan, devices are interesting but not helpful. 3

Consider the difference between:

  1. Someone who is tracking their mile splits to see if their new workout plan improves their running speed.
  2. Someone who keeps track of their mileage splits because their watch does so automatically (so why not?).

Eventually, the first person will be able to make a decision: continue to follow the same training plan – or talk to their trainer about an adjustment.

The second person only has a few numbers – and possibly some frustration. They can even become overtrained if they continually strive to overcome their mile splits without following an exercise plan that ensures adequate recovery.

Truth # 3: Some trackers spit out inaccurate data.

Research has shown that the reliability of a tracker depends on a number of factors: the part of the body it is monitoring (fingers, wrist, arm, chest), the tracker's algorithm, the sensors used, and the activity being monitored.4,5

The least accurate indicators of progress include:

Distance: Although technology has improved in recent years, some trackers overestimate your distance when moving at higher speeds and underestimate your distance at slower speeds.

Trackers with GPS technology are usually more accurate than those without, although dense foliage and tall buildings can interfere with GPS signals. 6-8

Sleep quality: Sleep trackers tend to overestimate sleep hours and sleep efficiency, and underestimate the number of waking moments.9,4

Calorie Expenditure: In general, regardless of the tool, calories are difficult to measure. As a result, the calories listed on menus and food labels can vary by as much as 20 percent.10 (And that's not the only thing affecting the calorie count, as we detail in this infographic: The Surprising Calorie Counting Problem.)

Calorie Expenditure: Trackers that estimate your calorie expenditure often do so based on laboratory averages with large error rates (around 10-23 percent) .11,4 (Read More: The Problem With Tracking Calorie Expenditure.)

Consumer fitness trackers are about 30% less than total daily calorie consumption. In aerobic exercise, the devices show errors between 9% and 23%. This is what it looks like for a 300 calorie workout.

If someone is only using a tracker to get a sense of a general trend or pattern, that lack of accuracy may not be that important. But what if they base important decisions on these ads? Problems arise.

Let's say someone's watch reports that they burned a total of 400 calories during a run. So they think, “Yay! I ran hard. Now I can eat 400 extra calories. "

Not so fast.

First, you might think that you are eating 400 calories but actually consuming as much as 480 thanks to this wishful calorie math.

Second, they may have only burned 320 calories because of the large margins of error.

After all, the numbers shown on the device are not all of the extra calories burned by the activity itself.

Every time you see “Calories Burned” it also includes the number of calories you burned from normal, resting metabolism – and that would have burned whether you ran or sat very still. (For example, for a 180 pound person, that resting metabolic rate is about 1.2 calories per minute.)

Bottom line: you can easily eat more than 160 calories than you used up.

Truth # 4: High-tech trackers keep some people motivated – for about three months.

When a lot of people get a new smart device, they are absolutely obsessed. You wear it all the time. They study their data. They are trying to outperform their step, mile, or speed values.

It all works like magic.

Until it is not so.

“We humans get bored very quickly. We buy a fancy device that solves all of our problems and use it every day for a few weeks or months, ”says Kate Solovieva, MA, Pn2, a precision nutrition master coach.

“But then we take it off in the shower. Or the battery is empty and the charger is in the other room. We throw the device in our underwear drawer. For now. Two years later we are looking for a charger for our NEW stylish device, find the old one in the drawer and think … "Oh yes!"

Researchers call this the novelty factor.12,13 By the end of a year, only about 10 percent of people are using their trackers, a study found.14

Truth # 5: High-tech trackers can demotivate some people.

This is especially true for trackers that have preset goals, e.g. B. sleep a certain number of hours or walk a certain number of steps per day

If someone keeps failing to meet the goals set by the tracker, they may feel discouraged. Not only do they stop using the tracker, but they may also give up trying to improve the activity they are tracking, Nuss says.

“For some people, the tracker is the right tool. For others, this leads to a lingering "gosh, I'm sucking" feeling. "

Find out if data tracking is helping your customer

When it comes to data, there are basically three types of people:

  • People who benefit from a lot of data
  • People who benefit from some data – but don't need a lot of it
  • People who can be harmed by overemphasizing the data

Here you can find out which category a customer falls into.

People who benefit from a lot of data tend to:

✓ Be number-oriented. These clients are often technical, actuarial, or accounting attitudes.

✓ Have more advanced goals. This includes top athletes, bodybuilders, models, and other individuals who are paid based on appearance or performance. For them, a slight difference is the difference between first and tenth place.

✓ Show data as information – nothing more. Regardless of their occupation, the numbers don't define them. They are not part of their identity. For them, data can be helpful – because they can see it as just that.

People who benefit from some data tend to:

✓ Have simple goals. Among other things, you want to look or feel better, get in shape, or feel more energetic. And while some data will definitely help you make progress, you don't need a lot of it.

✓ Don't get too involved in the numbers. An unexpected event (like sudden weight gain) could certainly burn them to death. But with a little coaching, they can shift their focus from "this sucks" to "okay, this is interesting". What should i try next "

People who can be harmed by overemphasis on data tend to:

✓ Have an unhealthy obsession with food and / or fitness. These customers can focus on the numbers in such a way that they can't think of anything else.

✓ Have unclear basic values. If customers don't define how a goal aligns with their deeper values, they'll never feel good enough – no matter what the numbers say. Think: the person who always wants to lose five pounds, no matter what they weigh.

✓ Have inaccurate or incorrectly calibrated standards. For example, many amateur athletes beat each other up because they did not perform at the elite level. They don't have a realistic idea of ​​what to expect.

✓ Be concerned about the activities they want to track. Instead of feeling motivated by a sleep tracker, they could spin and throw even more

✓ Have perfectionist thought patterns, also known as "not good enough". When they talk about a measurement, they fit in with the story. If a timed training goal is not met, it quickly becomes "I'm slow" or "I'm sucking" rather than "I'll get it next time".

✓ Be so competitive that it will hurt or overwhelm you. Instead of taking a free or easy day, they could try to take more steps, beat their previous personal best, or destroy the competition during the day's workout.

Help customers use data effectively.

It would be great if all customers saw measurements simply as a way to test the effectiveness of their action plan. But that's not how many people start.

Here's how you can help customers view data as feedback.

Define progress.

Add specificity to the murky goals like "Lose Fat" and "Get Strong".

Losing fat could "bring my body fat percentage below 25 percent". And "getting strong" might "be able to get off the floor while holding one of my grandchildren".

Also tie these details to a deeper value by asking, "Why?" over and over. (See our 5 Why Worksheet for details.)

The conversation could go as follows:

Coach: Nice that you want to get stronger. Can you tell me a little more about it? Why is that a goal for you?

Client: Well, I used to feel strong and now I haven't. I want to feel like I am earlier.

Coach: Great answer! Let's dig even deeper. Why do you want to feel like you used to?

Client: Well, it sucks to be so weak. I used to be able to do things easily. Take groceries. It wasn't always difficult for me to carry the bags into the house. It is now.

Coach: That's really revealing. Why would you want these activities to feel easier?

Customer: When I've finished shopping and running errands, I'm so exhausted that I can barely get up, let alone hang out with my grandchildren. I don't want to be the grandma who can't do anything. I want to be right there with them.

Trainer: Bingo! Keep an eye on the strong grandma image. It will help you stay motivated. Now let's look at a few ways to measure your progress.

Talk about how you measure progress.

Nutrition trainers work with clients to create an initial plan of action based on what the client needs to do to get where they want to be.

Then they break that plan down into a small, specific action to try – eat an extra helping of vegetables a day, for example – and find a way to test it.

The test can track behavior and examine how consistently the customer ate an extra serving of vegetables. Or the test can track a result, maybe how energetic the customer is feeling every day.

In both cases, the action is tested – not the person taking the action.

To explain all of this for a customer interested in fat loss, one could say:

Trainer: I know your goal is to lose fat, but I'm not worried if you are losing weight right now. In the first few weeks we will be working on some basic skills that will help make the way you eat feel a lot easier. It's similar to investing now for a big payout later.

Customer: So…. I don't have to weigh myself now?

Coach: If you are comfortable with this it would be great if you did. Tracking your weight helps us get a better idea of ​​your true baseline. Does that sound okay to you?

Client: Yes, I think so. But I really want to lose weight right now.

Coach: I see. It's really hard to wait, but it will be worth it. The weight of the scale can fluctuate widely, so it is helpful to look at the trend over time as opposed to just one point in time. Just know that if the trend doesn't move down over time, we will work together to determine the reason and then tweak the original plan.

Client: Yes. I can try it.

Coach: That's great. And if you can't, that's fine. If this leads to negativity for you, we can switch to a different tracking method. OK?

Client: Yes. I have it.

Focus on patterns.

Nobody improves in a consistent linear way. Usually it is a two step forward and a backward step. An athlete can crush every single workout for a week, delay the next week, only to come back for the third week and hit another personal best.

See the table below for a visual representation for someone interested in fat loss.

Graph showing how body weight fluctuates over time.

The following conversation shows how you can help drive this house.

Customer: Ugh, my weight is all over the place! I gained 4 pounds in one day. How is that even possible? That burdens me.

Coach: I hear that. It is actually perfectly normal for your weight to vary from day to day. My weight has increased by up to 5 pounds in 24 hours based on my hydration status alone. So let's not worry about a one-day number. Let's pay attention to the general trend.

Client: How does it work?

Coach: Well, let's look at patterns – and use those patterns to make decisions. For example, when one of my clients stopped having dinner in the dining room and started eating in front of the television, his weight gained over time.

Another client had trouble sleeping at night when drinking two cups of coffee instead of one. In other words, we are not just looking at one event. We're looking for a trend. Does this make sense?

Customer: Yes, I understand. What you said about coffee? Completely me.

Consider using a different tracking method.

If, despite your best efforts to use measurements as feedback, a customer becomes more anxious, it is time to make some changes.

You could:

Ask your customer to collect data, but not to view it. For example, some smart scales can be programmed to send data to the coach but not display weight to the customer.

Do an experiment. For two weeks, propose to your client that they part with a fear-inducing tracking method. During their hiatus, they may pursue differently (or not at all).

For example, instead of using a sleep tracker, they can track an energy rating and sleep quality. Instead of trying to get a specific heart rate during a workout, you can also use the Rate of Perceived Exertion (RPE).

Re-evaluate after two weeks. Has your fear subsided?

Empower your customer. As a trainer, you don't need to know all the answers. Instead of immediately suggesting another tracking method, you can push it back to your client. You can ask any of the following questions:

"I hear the scale scares you a lot. I totally understand. I would like to explore this a little further, if you don't mind. What other methods can we use to measure how you are doing? What do you think will work?"
"From the outside, it doesn't seem like this tracking method is working for you. Would you agree? Is there any other way to track your progress that you think is working better?"
“So your training performance decreases. And it sounds like you're feeling personally attacked by the numbers. That's okay. This is actually quite normal. But I am curious to see how you feel when you lean into the opposite. What's good about finding out this information? Is there any way I can use this data to your advantage? "

Don't do it about you.

As much as possible, try to resist the urge to switch customers to your personal tracking solution.

Sure, your preferred tracking method could work great – for you.

And it might even help a lot of your customers.

But there will always be someone out of shape.

“As a coach, always remember that the opposite of your experience is possible,” says Solovieva.

“If a smart tracker is the best thing that has ever happened to you, be open to the idea that it could harm someone else. And when trackers send you to a dark place, understand that they can actually work very well for some of your customers. "

In other words, know your personal biases, stay open, listen deeply, and encourage customers to be part of the decision-making process.

In this way, you will help customers find the best tracking method for them – regardless of whether it contains a lot of data or little.

References

Click here to view the resources referenced in this article.

1. Nuss K., Moore K., Nelson T., Li K. Effects of motivational interviews and wearable fitness trackers on motivation and physical activity: A systematic review. Am J health promotion. 2020, July 14; 890117120939030.

2. Kerner C, Goodyear VA. The Motivational Influence of Wearable Technology for a Healthy Lifestyle: A Self-Determination Perspective for Fitbits in Teens. At J Health Educ. 2017, September 3; 48 (5): 287-97.

3. Frie K., Hartmann-Boyce J., Pilbeam C., Jebb S., Aveyard P. Analysis of self-regulatory behavior in response to daily weighing: a thinking study with follow-up interviews. Psychol health. 2020 Jan; 35 (1): 16-35.

4. Shin G., Jarrahi MH, Fei Y., Karami A., Gafinowitz N., Byun A. et al. Portable Activity Trackers, Accuracy, Acceptance, Acceptance, and Health Effects: A Systematic Review of the Literature. J Biomed Inform. 2019 May; 93: 103153.

5. Mahloko L, Adebesin F. A systematic literature review of the factors influencing the accuracy of consumer wearable health device data. In: Responsible design, implementation and use of information and communication technology. Springer International Publishing; 2020. p. 96-107.

6. Takacs J., Pollock CL, Günther JR, Bahar M., Napier C., Hunt MA. Validating the Fitbit One activity monitor while walking on the treadmill. J Sci Med Sport. 2014 Sep; 17 (5): 496-500.

7. Gilgen-Ammann R., Schweizer T., Wyss T. Accuracy of distance records in eight positionable sports watches: instrument validation study. JMIR Mhealth Uhealth. 2020, June 24; 8 (6): e17118.

8. Boolani A, Towler C, LeCours B, Blank H, Larue J, Fulk G. Accuracy of 6 commercially available activity monitors in measuring heart rate, calories burned, steps taken and distance traveled. Cardiopulm Phys Ther J. 2019, Oct. 30 (4): 153.

9. Evenson KR, Goto MM, Furberg RD. Systematic verification of the validity and reliability of consumer wearable activity trackers. Int J Behav Nutr Phys Act. 2015, December 18; 12: 159.

10. Center for Food Safety, Nutrition A. Guidelines on the development and use of databases for nutrition labeling (cited August 13, 2020).

11. Tedesco S., Sica M., Ancillao A., Timmons S., Barton J., O'Flynn B. Accuracy of consumer-level and research-grade activity trackers in outpatient settings in older adults. Plus one. 2019, May 21; 14 (5): e0216891.

12. Jakicic JM, Davis KK, Rogers RJ, King WC, Dr. Marcus, Helsel D. et al. Influence of wearable technology combined with lifestyle intervention on long-term weight loss: The IDEA randomized clinical trial. JAMA. 2016, September 20; 316 (11): 1161-71.

13. Finkelstein EA, Haaland BA, Bilger M, Sahasranaman A., Sloan RA, Nang EEK, et al. Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomized controlled trial. Lancet Diabetes Endocrinol. 2016 Dec; 4 (12): 983-95.

14. Shin G, Feng Y, Jarrahi MH, Gafinowitz N. Beyond the novelty: an investigation into the motivation for using long-term activity trackers with mixed methods. JAMIA Open. 2019 Apr; 2 (1): 62-72.

15. Kerner C, Goodyear VA. The Motivational Influence of Wearable Technology for a Healthy Lifestyle: A Self-Determination Perspective for Fitbits in Teens. At J Health Educ. 2017, September 3; 48 (5): 287-97.16.

16. Baron KG, Abbott S, Jao N, Manalo N, Mullen R. Orthosomnia: Do Some Patients Take the Quantified Self Too Far? J Clin Sleep Med. 2017, Feb.15; 13 (2): 351-4

If you are or want to be a trainer …

Learning how to coach clients, patients, friends, or family members through healthy eating and lifestyle changes – in ways that are tailored to their unique bodies, preferences, and circumstances – is both an art and a science.

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