Even in our age of advanced medicine with MRI scanners, designer drugs and robotic surgery, the day-to-day job of a GP has changed relatively little. People come to us feeling a sense of ill health, and we help steer them through a course that aims to achieve an improved sense of wellness. Sometimes this involves robotic surgery, but on the whole, it’s a simple chat about how they are living their life - are they getting enough sleep, in a job they like, eating good food, exercising? An Australian study showed that somewhere between 60 and 70% of primary care visits were due to lifestyle based diseases – things that would be better, or non-existent, if we made different lifestyle choices – whether to drink, whether to smoke, what to eat, whether to mountain bike today…..
A common topic is activity and exercise, as there is such strong evidence that increasing the amount we move has a huge beneficial effect on our health. One of the most easily quoted public health messages of the last decade is the ‘10,000 steps per day’. However, just like the ‘5 a day’ this 10,000 steps is an arbitrary figure. What studies actually show is that the more anyone does, the better, and the greatest benefits in health are seen at the lower end of the scale, so increasing from 2000 to 4000 steps has a bigger positive impact than changing from 8000 to 10,000 – although there is still benefit from increases at any stage. I see more people of all ages and fitness levels wearing ‘activity trackers’ that monitor our steps, heartrate, sleep patterns and can log diet and weight. They are marketed with the promise of making us exercise more, which makes us fitter and healthier – that sounds fabulous, but do activity trackers make us fitter?
The answer is no - well, to give the companies their due, perhaps for some of us they help a little, but studies show that generally there is no overall fitness improvement because:
- they tend to be bought by the already relatively fit and motivated
- a third of us stop wearing them at 6 months, and half by a year, due to small inconveniences, such as having to charge them regularly, and the constant reminder of the failures without seeing any progress
Some groups have voiced concerns about the use of activity trackers and fitness apps as they record a huge amount of personal data. A report in the British Medical Journal in 2016 showed that data is often sold or ‘leaked’ with little or no protective encryption. Some work places base bonuses on the data, and insurance companies are starting to adjust premiums according to it, which is all the more concerning when many of the common trackers are found to have error rates of up to 25%, in recording calorie count, step totals or calories burned.
In the world of ‘fitness apps’ things get more personal, as they add in the aspect of a ‘social exercise network’. Here are some to try:
- Strava is very popular - you compete against local runners and bike riders on routes, share photos and receive ‘kudos’.
- Fitocracy is a role-play game linked to exercise – the more exercise you do the more game tasks are completed.
- Athlinks allows you to compare your times against a database of public race results.
- Pact asks you make a ‘pact’ to exercise and select an amount of money to pay for each day you miss. If you achieve your goal you are paid a reward which is funded by payments from people who don’t achieve their pact.
- Zombies, Run! – you run away from (fictional) zombies.
However, fitness trackers are just a measurement tool, not an intervention and they do not give you the strategy to make changes. If you are going to enter the world of fitness trackers and apps here are a few things to think about to get the most out of them:
- Ignore the calorie burned count and do not base what you eat on it – it’s too inaccurate
- Set your own goals
- Create attainable micro challenges and reward daily achievement
- Make exercise social