Can health tech help you hit summer running?
Can health tech help you hit summer running? Paul Smith trialled a suite of tools over 2 months, including MyFitnessPal, Nokia Health's Body Cardio scales and BP-801 wireless blood pressure monitor.
I’m generally fit and active. I ride a bike daily and hit mountain bike trails every week. However, despite no longer training and racing, I still ate like I was fuelling for intensive exercise. Unsurprisingly, this past winter my trousers were getting tight and my body was visibly sagging. I needed to make a change – my metabolism isn’t getting any younger.
So in September I resolved to cut back on starchy carb-heavy food and refined sugar and eat more protein and veges. My plan was to slash energy intake for a month, with the aim this would force a swift change in diet and body composition that would stick in the long run.
However, from previous half-hearted attempts at change, I knew willpower alone wouldn’t cut it. But we had 2 new Nokia Health products in the office to trial: the Body Cardio scales, which measure weight and body composition, and a BP-801 wireless blood pressure monitor. The timing was perfect.
Using the Nokia devices I measured:
I also measured:
Could using these high-tech (and not so high-tech) helpers really help me stick to my plan?
MyFitnessPal was perhaps the single most important monitor I used in my health quest, and it’s free. It’s an app that allows you to record everything you eat and drink.
The app links to a database of foods added by other users. That includes a lot of generic foods and ingredients, such as “banana, medium” and many more specific branded food products. A lot of these are US or UK brands, but you can use your phone to photograph a barcode and add that food to its database. During 2 months' logging my food, I found only a couple of local products that weren’t recognised from their barcode.
Food is entered as multiples of a portion. Those portions may be listed in imperial or metric measurements, depending on the source of the food (many generic and US foods are listed in ounces or cups, while UK, Australian and New Zealand foods are in grams and millilitres). It’s a little clunky working out conversions or finding a generic food in a known measurement. The barcode scanner removes the pain, though, as foods I scanned appeared in metric quantities. Once you’ve used the app for a few weeks, the lists of recently used and frequently used foods become useful shortcuts. Creating recipes also saves you entering a long list of ingredients each time you cook a meal.
You need to register with the app and offer up some personal data. Like most of these health and fitness apps, data privacy is a concern – by using them you are giving up a lot of personal information. Just my data in MyFitnessPal would allow analysis of what groceries I buy and how I exercise. That’s before analysing patterns and habits to make inferences about my family status, where I work, and so much more. So I was happy to see the Health Navigator Charitable Trust had scored the app very highly for security and privacy.
MyFitnessPal lets you set goals for daily energy intake and macro-nutrients (such as proportion of fat, protein and carbs). It shows a daily and weekly breakdown of your data compared to these goals with pie and bar charts. It presented reasonably complicated data in a really clear and useful way.
Why did I found the app so useful? MyFitnessPal forced me to be honest with myself. I’ve realised I’m brilliant at convincing myself I’m eating less than I am. Recording all my food clearly showed I’m eating far more than I need to. Using the app was labour intensive: I entered food into the app 3 or 4 times a day, weighing portions for the first few weeks to get a handle on quantities, scanning barcodes of new foods, and creating recipes of meals I made regularly. But that was part of why it worked so well for me: it forced me to review my data throughout the day and change my behaviour to stay on track.
Tracking my food became a routine. I’m not using the app now the trial is over, but I’m much more aware of how much I’m actually eating (and actually need to eat).
I’ve no reason to think I’m at risk of developing type 2 diabetes, but I was interested to see if slashing sugar and white carbs from my diet would have any effect on my blood glucose.
The only reliable way of measuring blood glucose is by using blood. Only a single drop is needed – but even that means sticking a needle in your fingertip. Caresens blood glucose meters and test strips are all too familiar for anyone with diabetes, they’ve been approved by Pharmac since 2012.
The CareLance is a spring-loaded device that fires a disposable needle into your finger at a set (and adjustable) depth. You just hold it to your finger, pull back the spring, brace for impact and press a button to fire the needle. It’s easy, but not pain-free.
The Pop N device is turned on by inserting a single-use test strip. Touching the tip of the strip to the drop on your finger takes triggers a measurement. I needed a couple of attempts at first to get the strip to “suck up” the droplet, but since then I’ve not had a measurement fail.
Up to 1000 measurements can be saved in the device’s memory and downloaded via a USB port. Individual results can be recalled or an average can be shown on the easy to read white on black display. Alarms can be set to flag abnormal results. I manually added my data to the Apple Health app so I could track any trends at a glance.
During the trial period, I saw my fasting blood sugar reduce slightly. Although it was in the “normal” range to start with, it was good to see it respond to dietary changes.
You manage the scales using the Nokia Health Mate app. Pairing took several attempts, but eventually worked through a WiFi connection. A few weeks into my trial, the scales had to be re-paired (using WiFi again). Later, the connection dropped again and would only pair using Bluetooth. It wasn’t perfect, but at least I never had to reinstall the app, which would lose all my data history.
Once paired, the scales are very easy to use. There’s only 1 button on the scales used to pair and to access simple setup, such as choosing metric or imperial measurements. The app controls everything else. Up to 8 user profiles can be set up – the scales recognise which user is standing on them by comparing current data to historical data. This worked well with my family, but we didn’t have 2 people with weights closer than 10kg.
Standing on the scales, measurements are recorded and displayed in a sequence set in the app. I liked that the weight settled each time, suggesting the scales weren’t just using the previous measurement (confirmed through testing by our colleagues at Choice in Australia). The display on the scales is small, but clear and easy to read with strong white on black contrast. Data is sent to the app moments after measurement. It’s saved in the scales too, ready to be synced once a connection to your phone is established.
A summary of each measurement synced to the Health Mate app is displayed in a timeline. A dashboard shows the latest measurements for each user along with an arrow indicating if the measurement is increasing or decreasing. Selecting a measurement in the dashboard shows weekly, monthly, quarterly and annual charts. The last 2 include an average line, which I found useful to cut through daily measurement noise.
The BP-801 paired first time with the Health Mate app using Bluetooth and didn’t drop during the trial.
Pressing the single button on the device opens the app and lets you select your user profile (from the same 8 recorded for the scales). You have 2 options for measurement: a single sample, or the average of 3. I initially used the average method as I assumed it would be more accurate. But most mornings, 1 of the 3 measurements failed with no reading supplied. Repositioning the cuff, as advised by a pop-up in the app, fixed the problem. But with the failures, measuring my blood pressure took about 5 minutes. I tried the single measurement and didn’t notice any change in accuracy, so I ditched the average method and saved about 4 minutes every morning. While measuring pressure, the BP-801 also records resting heart rate.
I found the BP-801 easy to use, but not faultless. The button to launch the app could be bigger with a more positive feel. It would be nice to record measurements without having a phone connected (as you can with the scales). But that would need a display built into the BP-801. The device syncs seamlessly with the Health Mate app, and with practice I’ve reduced the amount of failed measurements significantly.
Blood pressure is shown in the Health Mate app on a weekly or monthly chart, but only the latest heart rate data point can be shown – it can’t be viewed as a trend. That’s disappointing if you wanted to track improvements in fitness.
My blood pressure averaged 119/70 through the trial with no wild day-to-day variations. While I wouldn’t substitute the BP-801 reading for a clinical diagnosis, it was reassuring it was considered “ideal” by the medical profession and I had no cause for concern, even with the stress I put my body through during the trial.
Tests by our Australian colleagues at Choice found the Body Cardio scales were out by just 0.1% at 100kg and were sensitive enough to accurately record a series of 100g increases from 20kg to 21kg.
Body fat scales analyse your body composition by sending a small (but unnoticeable) electrical current through one foot and measuring how long it takes to reach the other foot. They claim to use that pulse to calculate your body composition, as fat doesn’t conduct electricity as well as lean tissue. However, Choice tests of body fat scales using this method show they aren’t as accurate as the “gold standard” clinical DEXA scan.
We compared the Body Cardio scales, which use the electrical pulse method, to DEXA scans for 3 people. The results confirmed the inaccuracy. One result showed a fat proportion just 0.3% off from the DEXA scan, but for 2 subjects the scales under-read body fat proportion by about 10%.
The BP-801 blood pressure cuff works like any other, by measuring the force of blood in veins and arteries in your upper (left) arm. The cuff is wrapped around your arm and inflated by a small pump to cut off blood flow. The air is then slowly released. That determines the blood pressure readings. We’ve tested the accuracy of the BP-801 and found it was excellent, consistently recording pressure within 4mmHg of a calibrated clinical device.
Note: Nokia have since advised us they are removing the Pulse Wave Velocity feature from the Nokia Body Cardio scales. See our update for more information.
Pulse wave velocity (PVW) measures arterial stiffness, which is linked to cardiovascular health risk. It is measured clinically using the SphygmoCor method. That requires expensive equipment, a trained operator, and about 20 minutes for each measurement. Withings (bought by Nokia in 2016) developed a way to measure PVW using a weight scales sensitive enough to feel pressure changes between heart beats. That’s the tech inside the Nokia Body Cardio. Is it accurate? A study published in the American Journal of Hypertension earlier this year compared the Withings scales to the clinical SphygmoCor method and found there was “acceptable correlation”.
But here’s the problem. Nothing I did altered my PWV measurement. It remained firmly in the range labelled “normal” by the Health Mate app, showed little fluctuation, and ended my 2-month trial exactly as it began at 6.4 m/s. The Nokia website offers advice about the measurement, suggesting PWV can be improved by losing weight, exercising and reducing salt and alcohol intake. During my trial I lost significant weight, reduced my salt intake and cut out alcohol, but saw no change in my PWV.
The Nokia Body Cardio scales measure standing pulse, but this wasn’t much use as the measurement varied considerably from day to day (from below 60bpm to almost 90bpm), despite being taken at the same time in the same conditions. My resting pulse readings taken with the BP-801 blood pressure monitor were more consistent.
Unfortunately, I couldn’t stop the scales measuring pulse without turning off the PWV measurement too, so each day I was presented with 2 conflicting measurements.
These “heart health” measurements are the main reason to choose these flagship Body Cardio scales over the cheaper Body+. I’m left thinking I could have saved myself $160 by choosing that model instead.
Now my 2-month trial is over, am I the lean, mean machine I hoped to become?
Well, I stuck with my dietary changes for the duration. I’m leaner, for sure, having shed 10% of my body weight and 25% of my body fat (according to the Body Cardio scales, supported by my loose clothing and waist measurement).
I think the daily regime using the devices and apps helped. I can’t know for sure if I’d have given up if I’d used a set of dumb bathroom scales, a tape measure and a mirror, but the constant routine of measurement and review generated a positive level of self-inflicted guilt (and pride) that kept me going. That’s where heath devices and apps like these become so powerful.
While the Body Cardio scales aren’t as precise as a clinical measurement, they were consistent in tracking my day-to-day progress. Over the trial period my body shape changed gradually, while the scales showed my fat percent trending down. The instant daily feedback gave me real motivation to stick with my plan.
I was pleasantly surprised by the app’s performance. However, it could be improved. As a self-confessed “data nerd” I’d welcome more control over displaying data, viewing trends and setting goals (a goal for weight could be added but not for the other measurements, which were shown against broad “normal” bands). But it served its purpose, despite these limitations.
It took commitment to get into a daily routine. It was a hassle to start, but after a couple of weeks, it became a habit. Most of the diet changes have stuck now that I’m back up to a sustainable energy intake, though I allow myself white carb treats now and then. Over the summer I’ll drop back to a measurement each week to keep myself motivated and make the change stick.
Over the trial, my body shape changed gradually, while the scales showed my fat percent trending down. The instant daily feedback motivated me to stick with my plan.
By Paul Smith
Head of Testing