• Adam Tilton

Are Wearables…Useful?

Recently I’ve been thinking about the usefulness of wearables (and consumer health gadgets in general). This may be a little surprising coming from me, but I believe the way that they’re currently built, used, and how the data is interpreted provides little-to-no benefit or behavior change. I’ve come to this conclusion from my own experiences with wearables (and my recent reviews of the Withings Scale and Oura Ring), but also from this same story I so often hear from users: They buy a device because they want to measure a particular metric, such as activity, weight, heart rate variability, sleep, glucose—the monitoring of which, they believe, will make them happier and healthier. Then, after a few months of use, the user develops some familiarity with their scores, i.e. they can infer what their score will be from their experience. They know if they go for a run, they’ll achieve their activity goal. Sleep poorly, they’ll have a bad recovery score. After seeing consistent scores for a few more months the day-to-day novelty of the data diminishes, and usually suddenly. By the time the user hits the six-month mark, they realize they are now caring for a device — charging it regularly, wearing it always, syncing with the app, checking the dashboard— but haven’t gained a material benefit or seen a significant and long-term shift in behavior. If they take it off at this point they may forget to ever put it back on, and why wouldn’t they?

There are exceptions that demonstrate useful interventions, such as the Apple Watch alerting the user of atrial fibrillation and sending them to the doctor. A life-saving intervention! That’s amazing, and maybe risk management and insurance are reasons enough for everyone to be instrumented. Beyond wearables, 8Sleep is building a tech-enabled bed that can both track your sleep and control the temperature of the bed to improve it. There are others too, that are mixing measurement with intervention, hoping to provide both in-the-moment and long-term value. And then there are the examples of what could be. Bryan Johnson seems to be on the right path at Blueprint. He’s investing significantly in measuring biomarkers that are clinically relevant to biological age. According to Bryan, measuring and combining enough of these leads can help people more confidently answer, “Am I healthy?” at least as a relative measure against population data. He’s also recently published an update that claims over his 8-month experiment with Blueprint, he’s reduced his epigenetic age by 5.2 yrs. That seems to indicate he’s getting younger, which I want to believe means he’ll live a longer, happier life. Okay, I’m in. That’s what I want too! And I believe people who regularly track sleep, exercise, heart rate, etc. are ultimately doing so in the hopes of this, too.

Except here’s what is interesting about this experiment: Wearable devices only play a small role in Bryan’s master plan. From what I gather from reading his materials, he uses Whoop to measure total sleep, minutes awake at night, and time to fall asleep, and the Polar H10 chest strap to measure heart rate. It doesn’t appear he tracks his exercises, but instead simply adheres to a routine (imagine that). Similarly for nutrition, he has it dialed to the point of madness. The most extensive measurements he’s collecting are blood panels, which he describes in some detail on his homepage for Blueprint. So, across what is generally understood to be the four pillars of health—sleep, exercise, recovery, and diet—he only seems interested in measuring a few things related to sleep, and otherwise, only the key biomarkers required to evaluate his epigenetic age. With that, he has constructed a set of interventions that suggest he’ll live a happier, healthier life.

Damning evidence for the utility of wearable devices in improving a person’s health. I hope as I continue to explore I find more exceptions. Do you know of any? Let me know!