With the proliferation of watches, pendants, straps, and other wearable health trackers that monitor aspects of our biology, advocates for these devices say that ordinary people can now get the benefit of instant feedback to not only track their health and fitness, but take steps to improve them as well.
But this concept of instant feedback impacting actions and habits isn’t new. Consider the story of a 1970s Amsterdam housing development.
Like many subdivisions in those days, all the houses there were pretty much identical. But for some unknown reason, some of the units had their electric meters in the basement, while others had theirs in the front hall.
Then the energy crisis struck. OPEC (Organization of the Petroleum Exporting Countries) embargoed oil, prices skyrocketed, and individuals and governments started paying attention to their energy consumption. That’s when Dutch authorities noticed that the houses with energy meters in the front hall, in full view, had 30% lower energy usage than those with meters tucked away in the basement.
This was a huge deal. Simply placing a feedback mechanism where the residents could see it on a daily basis did more to reduce energy consumption than all the public service announcements, incentives, and social pressure the government or the free market could muster.
Business theorist Peter Drucker is often quoted as saying, “What gets measured, gets managed.” And some of the world’s most successful organizations deploy this kind of well-timed feedback relentlessly. Activity trackers are also utilizing this kind of visible, measured feedback, allegedly making it a lot easier to measure results and create motivation and accountability.
Health and Fitness Trackers Are Here to Stay
Even a decade ago, health monitoring would have been possible only with expensive, bulky equipment provided to you by a medical professional. Now, you can purchase and use a small wearable device and track health info on an app.
As the costs of medical care threaten to sink our entire economy, some insurance companies even provide health and fitness trackers, or give discounts to encourage healthy living. Healthcare professionals can help their patients and clients more effectively when they have a clearer picture of how they’re doing beyond notoriously inaccurate self-reports and intermittent assessments. And having numbers at their fingertips empowers ordinary people to take control of their own health.
One thing’s for sure: as a result of their ease of use, accessibility, and affordability, the activity tracker industry is booming. About 1 in 3 Americans are using some sort of health tracking device.
But what are the actual benefits of health tracking? Are health trackers worth it? Does the data support their use? And what are some of the top options out there if you want to get started with health and fitness trackers (aka wearables)?
What Is a Health Tracker?
Health trackers, also known as fitness trackers, activity trackers, or wearable technology, are electronic devices designed to track and collect personal health and exercise data. Health trackers commonly take the form of a watch. But other types are available in the form of rings, bands and bracelets, head or chest straps, and even patches. They track biological phenomena like heart rate and breathing, as well as activity through markers like steps, oxygen saturation, distance traveled, flights climbed, and so on.
Not only do these devices provide ongoing health information, but they also maintain digital logs and can measure and report on your progress over time.
But keeping track of health parameters isn’t enough by itself to change behavior. The true power of these trackers is their ability to provide real-time feedback so you can make better choices for your health.
You can set up alerts and reminders to exercise, drink water, go to bed, meditate, or pretty much any other activity you want. These can be time-based reminders (take a deep breath every afternoon at 3 pm) or conditional (“Hey, you’ve been sitting on your butt for an hour; get up and go for a walk”).
Many of the health and fitness trackers available also work with smartphone apps, so you can aggregate data from many sources into a single “personal trainer in your pocket” that tells you what to do to maximize your health.
Benefits & Downsides of Health Tracking
Remember that Peter Drucker insight about the benefits of measurement that I shared at the beginning of this article? Two things about that: First, he never said it. The line first appeared in a 1956 paper by V. F. Ridgway that argued against obsessive and mindless tracking. Secondly, this is what the full quote actually says: “What gets measured gets managed — even when it’s pointless to measure and manage it, and even if it harms the purpose of the organization to do so.”
Just because you can measure something doesn’t mean it’s the right thing to measure, or that you’re measuring it accurately. While some forms of tracking are helpful, others can actually distract you from what’s important. Like that old joke about the person looking for their keys under the lamppost, because the light is better there, you can focus on what the trackers tell you at the expense of what really matters. So, let’s take a thoughtful look at the benefits and downsides of health tracking.
Benefits of Health Tracking
Pay Attention to Different Areas of Health
On the upside, tracking things like your heart rate or sleep can offer insights into different aspects of your health. Just as the bathroom scale can tip you off that it’s time to ease off the desserts, a wearable can let you know that you’ve been going to bed too late, or that your heart rate accelerates whenever you visit your cranky Aunt Minerva.
Wearables can also clue you in to new areas of your health to consider. For example, recognizing the association of sedentarism (the practice of sitting for long periods of time each day) with poor health and early death. Many trackers automatically alert you when you’ve been sitting for more than 45 minutes and urge you to stand or do a few stretches to wake up your body.
Easier to Achieve Goals
Health trackers can also amp up your motivation and make it easier to achieve your goals. As the companies that manufacture and market these devices deploy behavioral scientists to increase compliance and effectiveness, many adjust their interfaces to make the data more useful. Apple Watch, for example, offers a gamified experience in which wearers can build “streaks” and earn badges.
And when you get accurate feedback on your progress, you can take smarter steps to get the results you want. For example, with some health trackers, you can get an instant alert that your heart rate variability (HRV: a measure of the resilience of your nervous system and a proxy for overall health) has dropped, which could motivate you to take proactive steps to support your overall health.
Accountability & Social Sharing
Since we know that social pressure is a powerful motivator, some trackers allow for activity sharing with friends and family to increase accountability — or even to create some friendly competition.
Monitor a Health Condition
Trackers also enable you to monitor a health condition, or to potentially alert you of one. If you have a problem with a slow heart rate, for example, the device can tell you if your heart rate falls below a certain number. Or, if you have trouble sleeping, the tracker can analyze your sleep cycles, heart rate, or oxygen saturation, and help you optimize them. You may find that you sleep better when you go to bed at a certain time, exercise a certain amount, or partake in or avoid specific habits or activities close to bedtime.
Some people have said their health tracker made the ultimate difference in their lives. In 2018, a Tampa Bay teenager was rushed to the hospital after her Apple Watch instructed her to seek medical attention immediately, after her pulse shot up to 190 beats per minute. The care she was able to receive, for what turned out to be kidney failure, saved her life.
Improve Your Habits
The benefits aren’t always that dramatic, of course. A tracker may simply inspire you to improve your lifestyle habits over time. In general, people who use health and fitness trackers move more and are less sedentary than others. One study found that people wearing a tracker walked nearly a mile more per day than those who didn’t. And the results persisted over 13 weeks.
And people who exercise are more likely to engage in other health-promoting behaviors, like eating well.
Affordability
As the market has grown, the prices of health and fitness trackers have dropped. Depending on the included features, you can find a health tracker anywhere from $25 to $400. But if you have a smartphone, you might already have a health tracker and not realize it. For example, Apple Health, an app that’s on every iPhone, will count your steps, measure your average step length, and even report on any asymmetries between your right and left leg strides.
Downsides of Health Trackers
Even with all those potential benefits, there are some disadvantages to health trackers as well.
Privacy Threats
The best publicized of these downsides to health tracking is the threat to your privacy. If you don’t read the dozens of scrolling pages of fine print, you might not realize that the app you’re using may share your data, or sell it to advertisers and social media companies.
If you don’t want Facebook to know about your heart rate at any given moment, or where you are in your menstrual cycle, you might want to read the fine print or reconsider that particular tracker.
Fortunately, there’s a bipartisan bill, introduced to the US Congress in February, 2021, called the Smartwatch Data Act, that would prohibit the sharing of data from wearables with advertisers and social media companies. (As of 2024, the bill is being reviewed by the Committee on Health, Education, Labor, and Pensions).
Inaccuracies
Trackers tend to be better at measuring some things than others. A 2017 study out of Stanford University Medical School found that wristband fitness trackers can measure heart rate accurately (within 5%), but fail to accurately account for calories burned (with an average error of 27%, and the worst one off by 93%). Even heart rate isn’t a sure thing, as the data can be skewed based on the wearer’s skin color and body mass index.
A 2018 study out of British Columbia assessed the various tracking functions of Fitbit devices. Researchers found that the pedometer function was pretty good at counting steps, but the sleep tracking was way off. Also, the Fitbits underestimated distance for faster-paced walking, and did a poor job of accounting for upper-body workouts.
Anxiety
Just as people can become addicted to video games and smartphones, we can get obsessive about monitoring the results of our wearables. A 2020 study reported in the Journal of Medical Internet Research found that heart patients ages 55-74 were as likely to feel anxious, doubtful, and confused by the data they received from wearables as they were reassured and empowered. Some felt nudged into good behavior, while others felt pressured or experienced the interface as nagging.
Accessibility
Like a lot of technology, trackers are designed for a “default” human being, which in this case appears to be an able-bodied Caucasian. Just as people of color may find that their wristband device doesn’t accurately measure their heart rate, people with mobility impairments may not benefit much from a movement tracker. The devices aren’t set up out of the box to recognize wheelchair activity, for example.
There is also a need for activity recognition that supports a wider range of human movement, including what’s known as exergaming (video games that require various forms of physical movement to interact with the controller, and which can also track various forms of health data internally).
Types of Health Trackers and What They Offer
One way to categorize health and fitness trackers is by their form factor. These are just some of the most popular types of wearables, but there are also armbands and nerve stimulators that can target specific health concerns and conditions.
Wristbands
The majority of health and fitness trackers look like wristwatches. The most well-known examples include the Apple Watch, various models of Fitbit, and the Amazfit. These are among the most comprehensive of all such devices, tracking a variety of health categories: sleep, exercise, steps and distance traveled, heart rate, water consumption, blood oxygen, etc.
Other wristwatch trackers may appeal specifically to athletes, capturing data and providing prompts to help runners, cyclists, and swimmers improve their speed, stamina, and efficiency. Garmin, Coros, and Suunto are three popular brands that assist in training and races.
Many of these trackers integrate with apps on a smartphone, and can be used to track additional data like food consumption, weight, menstrual cycle, and so on. The more features (including waterproofing, scratch resistance, GPS, music storage, customizable watch faces, and actual telephone capabilities a la Dick Tracy), the more expensive these devices tend to become.
Personal anecdote: I got a Fitbit Sense in 2020 and have loved it. Since I got it, I find myself sleeping more and exercising more. I find it fun to track my activities, sleep hours, and heart rate, and notice myself checking (perhaps a bit too often!) how many steps I’ve taken, how much time I’ve spent with accelerated heart rate, and even what my sleep score was the previous night. For me, the information is fun and motivating.
Clip-on Devices
The main feature of most clip-on health trackers is their ability to count steps like an analog pedometer. But some go much further, tracking sleep, workouts, and menstrual cycles, too. Cyclists often use clip-on wearables with GPS that can display route details as well as biometrics. Because they can clip onto bike handlebars as well as clothing, wearers can keep an eye on their maps and stats without having to look at a watch.
Examples of clip-on manufacturers include CooSpo and Garmin.
Rings and Other Jewelry Items
Less obvious, but often more costly, are health tracking jewelry. The most common kinds are rings, but there are also necklace and bracelet health trackers that are meant to be fashionable not just functional. Bellabeat is the most well-known “smart jewelry” company that focuses on bracelets and necklaces over rings. Because they lack displays, however, these types of wearables have to be paired with a smartphone to view data.
The chief advantage of a ring is also its main disadvantage: because it’s so small, it’s easy to lose if you take it off (or if it slips off during exercise). Examples of ring trackers include Oura, which claims to capture highly accurate sleep data with its finger sensors, and SleepOn, which tracks not only heart rate, but blood oxygen saturation (which drops during sleep apnea) and vibration (with the ability to alert the wearer to their own snoring and nudge them into a different sleep position).
I’ve tested out the Oura ring, appreciated the aesthetic (it’s a ring, after all!), and found it very effective for tracking sleep with tremendous precision. I was frustrated that it didn’t track heart rate during the day, but now their newer models offer 24/7 heart rate monitoring, so it’s back in the running (so to speak!) as one of the top-tier options, as far as I’m concerned. You can get it right here.
Chest Straps
These are usually not stand-alone trackers, but require an additional device to which they can transmit the data they collect — like a smartphone stationary bike, treadmill, or rowing machine. Chest straps mainly focus on heart rate, assessing the pulses in the chest with greater accuracy than those in a finger or wrist. Examples of chest strap brands include Polar, CooSpo, and Wahoo.
Is Health Tracking for You?
Biometric trackers can be a valuable tool for gleaning actionable information about your health and habits — and for increasing accountability and positive motivation. If you decide to get one, the best choice for you will likely depend on what health information you’re looking for, cost, ease of use, and aesthetic considerations.
In general, people who get biometric trackers tend to form healthier habits. But at the end of the day, the value of data is in how you use it. If you use a health tracker and become obsessive and anxious, or beat yourself up about your stats, it may be wiser to find other ways to motivate yourself. But if you’re able to use health and fitness wearables to celebrate victories and encourage positive action, then it could be a potent ally to your health and life goals.
Tell us in the comments:
- What health habits could a wearable assist you in installing or improving?
Feature image: iStock.com/Rocky89
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