For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and chefs to plan, manage and measure their diet and exercise regimens.
Obviously, most of us don’t have the time or resources to diet and exercise like celebrities do, but new technologies are closing the gap. As an introduction to some of these new platforms and methods, we describe and discuss three examples in some detail. These technologies are not only exemplars of new classes of devices and approaches to diet and exercise, but also ones with which we have personal experience.
Reinventing the bathroom scale with WiFi
Withings is a consumer electronics company that produces several devices to monitor various parameters of health, specifically body weight, body mass index (BMI) and fat mass (Withings Body Scale) and blood pressure. The Body Scale looks like an expensive electronic bathroom scale, and it is one, but it also has the capability of transmitting a registered user’s data through a wireless computer network to a personalized online account where the data can be tracked over time, viewed as a snapshot (pictured left) and visualized in various ways via a web browser or smartphone app.
Withings allows a user to share his or her data via standard social media channels (Twitter, Facebook) and also to automatically upload data to an electronic medical record, specifically Microsoft HealthVault. A user can also cause an email to be sent to their personal physician and this email notifies that physician that the user wants to share their data and gives the doctor a link to access it.
A pedometer in four dimensions
Fitbitis both a tracking device and software platform that records waking and sleeping activities and allows users to analyze their activity patterns in terms of both intensity and duration. The device consists of a plastic clip about the size of your thumb and a small desktop “cradle” for both battery charging and wireless communication between the clip (tracker) that you wear on your clothing and the computer to which the cradle is attached via a USB cable. The underlying technology is a three-dimensional accelerometer combined with an altimeter encased, along with other electronics and a rechargeable battery, in the tracker clip.
The user places the clip on their belt, shirt pocket, armband, the bridge between the cups of a bra, etc. and then forgets about it. Then, whenever they are within about 15 feet of the desktop cradle, activity data stored in the tracker is transmitted to their computer and then on to a personalized website where the data can be viewed through web browser or smartphone app.
The tracker device is remarkably sturdy. After wearing it on pants pocket for 3 days, which included an airplane trip to another city and back, I had completely forgotten about it when I threw my pants in the wash. After full wash and dry cycles, the clip was still attached to my pants pocket and the device was undamaged and fully functional.
After purchasing and registering your device, the Fitbit website provides a personalized “dashboard” that allows you to visualize and monitor your activity in a variety of ways, e.g. steps taken, calories burned, etc. You can also manually enter other kinds of data, i.e. food intake, specific activities (e.g. walking, biking, Xbox gaming, etc.) and weight in your “journal.” If you are a Withings scale user, you can link your Withings data with your fitbit account. Like Withings, Fitbit allows a registered user to share his or her data via standard social media channels and automatically upload the data to Microsoft HealthVault.
Research studies consistently show that people who track what they eat lose more weight than those who don’t. Traditionally, one had to write down what they ate in a paper food journal, a method that hadn’t changed much in over 200 years. But now, thanks to ubiquitous smartphone cameras, you can easily create a food journal by taking pictures of what you eat and sharing the data with a diet buddy, dietician, social network or healthcare provider.
The first smartphone app to make food visual diet journaling the central feature of its approach was PhotoCalorie. Developed by a team of physicians, nutritionists and computer scientists at Harvard Medical School, MIT and Boston University, PhotoCalorie is also a sophisticated nutrition search engine and a propriety nutrition database that greatly simplifies the tedious task of calorie counting.
PhotoCalorie can be used in a number of ways. Typically, the user takes a photo of a food item or entire meal and then enters a brief description of what’s in the picture. The macronutrient content of the meal is then returned almost instantly to the smartphone. For example, the description “pork*2, broccoli, mashed potatoes” means two servings of pork and one serving each of broccoli and mashed potatoes. Alternatively, you can simply take the photo as a visual reminder of what you ate and enter the description or one or more meals later, say from your web browser at home.
PhotoCalorie also provides a realistic guide to food portion sizes, methods to set goals and monitor your progress and, as noted above, the ability to share your data with others. We’ve also seen an advanced prototype that is able to flag potential diet-drug interactions, such as the interference of Vitamin K-containing foods with warfarin (Coumadin) — PhotoCalorie can check a meal against a patient’s prescription drugs in Microsoft HealthVault.
The PhotoCalorie website features an informative blog. Recent articles have described overweight crash test dummies, fructose as a “poison,” replacement of the “food pyramid” with the “healthy eating plate,” restaurant reviews and even some recipes. The PhotoCalorie app and service are free, and the company is currently offering, at no charge, a personalized nutrition assessment for users who journal their diet for a week.
e-Patients and participatory medicine, what?
We have written about this topic before: “e-patients” are those that are empowered, engaged, equipped and enabled and practice participatory medicine, which is defined as “a cooperative model of health care that encourages and expects active involvement by all connected parties as integral to the full continuum of care. The ‘participatory’ concept may be applied to fitness, nutrition, mental health, end-of-life care and all issues broadly related to an individual’s health.”
The manifesto of the e-patient movement was published in 2007, and its major technology enabler at that time was the Internet, giving patients and/or their caregivers the ability to learn about their disease and to easily access “second” opinions via online health information resources. The movement has progressed to insist upon full access to medical records, including physicians’ notes, and the e-patient rallying cry is now “Gimme my damn data!”
In 2012, patients who are enabled by new technologies (such as those described above) are able to collect some of their own health data and store it in personally-controlled, electronic medical records. Recognizing this trend back in 2010, the editor of Wired magazine, Thomas Goetz (who also has a master’s degree in public health) published an influential book entitled The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine.
Michele Berman is a pediatrician who blogs at Celebrity Diagnosis.
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