Fitness trackers - do they actually improve your health?

The effectiveness of Fitbit and other fitness trackers has recently been under fire as a study in The Lancet Diabetes & Endocrinology did the rounds last month, claiming that fitness trackers did not improve health outcomes. Fitbit addicts everywhere were defending their step challenges and meticulous meeting of daily goals as news outlets jumped on the revelation that maybe these fitness trackers are simply a waste of time.

As a self-confessed Fitbit junkie, I was interested to look a bit further into the evidence and find out whether I am just wasting my tracking stats for nothing. I found a whirlwind of conflicting evidence and a range of small studies looking at the use of trackers in different demographics and overwhelmingly a few things stood out. 

Wearing a fitness tracker increased the amount of activity in most studies
Even in the study that has been splashed through the Sydney Morning Herald (http://www.smh.com.au/national/health/fitbit-fails-the-selfimprovement-test-study-finds-20161004-grudh9.html) and other news sites recently, the group that wore Fitbits did do more exercise than those who didn’t, but at the end of the study there was no difference in weight, blood pressure or other health outcomes compared to those who didn’t wear a Fitbit. Interactive trackers also have been shown to get people moving more than standard old-school pedometers. However - across multiple studies, it seems that while people wearing trackers are taking more steps and doing more leisurely activity, the amount of moderate-vigourous exercise (i.e. the kind that is needed for fitness gains) is not increased.

Fitness trackers are reasonably accurate for counting steps, less so for calculating calories burnt and assessing sleep
There have been a bunch of studies done to determine how accurate the various monitors are, and it seems they are generally quite good at counting steps but much less accurate when it comes to determining energy expenditure (a.k.a. calories burnt) and sleep. However, a few studies comparing trackers directly to traditional sleep monitors used in medical settings determined that for tracking sleep cycles over multiple days, commercial fitness trackers are reliable enough for this purpose - just don’t expect minute to minute analysis of sleep quality to be completely accurate.

Weight loss generally isn’t drastically increased by wearing a fitness tracker
There are small studies where a weight loss benefit is seen, but most of the research shows no significant weight loss benefit from wearing a tracker alone. Most of these trials have given a group of participants all the same diet and exercise advice and then given half of them a tracker to use for a designated timeframe and it seems that the tracker doesn’t provide any significant weight loss benefit over and above traditional diet and exercise advice alone.

The social networking associated with the wearable monitor is a significant contributor to increasing activity levels
The apps and social aspects of wearable trackers allow for goal setting, accountability, self-monitoring and feedback and social recognition and support; all of which are known to be beneficial in health behaviour change. Perhaps these are the aspects of the devices that need to be promoted or used more effectively to help people meet their health and fitness goals.

Deciding to stop using your tracker isn’t going to ruin your fitness goals
A recent American study followed up people who had decided to stop using their trackers to see whether their fitness levels and amount of exercise changed. It turns out overall people still did the same amount of exercise, but they feel guilty about not monitoring and tracking it. So stopping the vigilant monitoring might make you feel like you’ve fallen off the wagon but in most cases it doesn’t actually make you do less exercise.

Fitbit, Jawbone, Garmin or Apple Watch - none of them will be a magic fitness cure-all
Looking over all the recent studies, it is pretty obvious that none of these devices will magically improve your health and fitness and cause you to lose weight any more than tried and true exercise and diet changes. The psychological impacts of these devices needs further study as they appear to have a motivational benefit in improving activity levels but not vigorous (and even more beneficial) exercise, so maybe the knowledge around types of exercise needs to be better dispersed amongst device users. 


So if you are a dedicated tracker of exercise, step counts, sleep and water intake; or if you are considering investing in a wearable tracker, are you wasting your time? Well it depends on what your goals are - not everyone who wears a Fitbit or Jawbone is wanting to lose weight and I think a lot of the research data seems to ignore that. By understanding the various reasons people use the devices and what they hope to achieve by wearing them, only then is it possible to say whether that Fitbit is effective or not. If you want to lose weight and plan on getting a tracker but don’t make significant changes to your diet and exercise then don’t expect to see the kilos come off. If you want to keep tabs on your steps and beat your friends in step challenges then chances are that wearing a tracker will make you walk more. If you want to log your workouts and monitor progress in a handy app then the goal-setting and accountability functions could be of great use.

Looking over the research and pondering the ways people use these devices in their lives, here are a few ways you can maximise the benefits and avoid the pitfalls.

Customise your goals and continually update them
The standard 10k step goals, calorie burn goals and others that come programmed on fitness tracking apps are not necessarily going to fit with the goals that you are wanting to achieve for yourself. If you want to lose weight, you need to increase your activity above whatever you are currently doing as well as reducing calorie intake, so if you are doing 9000 steps in an average day before trying to lose weight then just aiming to do 10k probably isn’t enough to make much of a difference. Instead try upping the goal to 15000 and give yourself something to strive for. If your goal is to improve fitness, focusing on running distances, weights lifted, resting heart rate and other stats are going to be of more use than the basic step count which many of the apps place front and centre.

Get social
Involving friends in your activities is a great way of being accountable and introducing a bit of friendly competition - as long as you don’t skip out on the swimming/weights training/other activity because it will earn less steps than going for a walk - leisurely walks aren’t a bad thing, but if your goal is to improve fitness then there are more effective exercises to do. Instead of just focusing on your weekly step contest, involve friends in your healthy lifestyle in other ways like doing high intensity aerobics classes together, getting active with a bike ride on the weekend or have a fortnightly afternoon of healthy meal prep.

Remember that the step goal might not always be the most important
See above. Mentioning this twice because it’s the biggest take-home point. As satisfying as it is to have that magical 10000 steps be reached, have a think about what that actually means and whether there is a better goal you can set yourself. 

Take a break
It seems that taking off your tracker won’t send your exercise routine down the drain but it might make you feel guilty. You might want to take a week or two breather from wearing your tracker and see how you feel - if you still feel motivated to be active every day and eat healthily, chances are you will still do these things, you just won’t have your phone flashing at you to celebrate your daily successes. Instead you can celebrate the simple joy of going for a run or a swim or spin class and soak in how good you feel afterwards and not feel compelled to jump straight on your phone to see what your heart rate was doing. In a world where people spend most of the day staring at their phones, maybe this is the bit of reprieve that some of us need!


Are you addicted to your fitness tracker? Has it helped or hindered your healthy lifestyle? I’d love to hear from you!



REFERENCES

Daniel A. Epstein, Monica Caraway, Chuck Johnston, An Ping, James Fogarty, Sean A. Munson
Beyond Abandonment to Next Steps: Understanding and Designing for Life after Personal Informatics Tool Use
University of Washington

Lyons EJ; Lewis ZH; Mayrsohn BG; Rowland JL
Behavior change techniques implemented in electronic lifestyle activity monitors: a systematic content analysis
Journal of Medical Internet Research. 16(8):e192, 2014

Cadmus-Bertram LA; Marcus BH; Patterson RE; Parker BA; Morey BL.
Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women
​American Journal of Preventive Medicine. 49(3):414-8, 2015 Sep

Greene J; Sacks R; Piniewski B; Kil D; Hahn JS
The impact of an online social network with wireless monitoring devices on physical activity and weight loss.
Journal of Primary Care & Community Health. 4(3):189-94, 2013 Jul 1

Finkelstein, Eric A et al.
Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial
The Lancet Diabetes & Endocrinology
http://www.thelancet.com/journals/landia/article/PIIS2213-8587(16)30284-4/abstract

Evenson KR; Goto MM; Furberg RD
Systematic review of the validity and reliability of consumer-wearable activity trackers
International Journal of Behavioral Nutrition & Physical Activity. 12:159, 2015

de Zambotti M; Claudatos S; Inkelis S; Colrain IM; Baker FC
Evaluation of a consumer fitness-tracking device to assess sleep in adults
Chronobiology International. 32(7):1024-8, 2015

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