 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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 As I write this inaugural blog post for the brand-spanking new Dr Kate website, I am sitting in a jet-lagged haze where I can’t decide whether the next few hours should be spent sleeping, or spent making the most of daytime, knowing that when I get to work tonight I’ll still feel tired regardless of how long or how little I slept for today. Ahh yes, the wonderful world of night shift. If you are a nurse, doctor, hospitality or transport worker or someone else lucky enough to be in a 24/7 career, you will know this feeling precisely. But did you know just how hazardous shift work can be to your health? Shift workers are more likely to be obese, have heart disease, metabolic syndrome (a cluster of pre-diabetes, high blood pressure, high cholesterol and abdominal obesity), suffer mood disturbances, have accidents both at work and on the journey to/from work, and may even have higher risks of some cancers though the evidence isn’t quite as clear. How can simply being awake and working at night do all this damage? Mostly it is thought to be due to the body’s internal clock which controls hormones, digestion, body temperature, heart rate and of course the sleep-wake cycle. Also known as circadian rhythms, they rely on exposure to light during the day (and lack thereof at night) to keep everything running as planned. It seems that confusing our natural sleep-wake cycle changes the release of hormones that influence digestion and metabolism, and may cause higher blood pressure (especially when shift work is prolonged), and has pretty marked impacts on mood, alertness and cognitive function in the short term. As well as stuffing up the hormones that control how we feel, our digestion, weight and most basic bodily functions; shift work quite simply means that many workers just don’t get enough sleep. Even someone who has never worked a night shift in their life knows how much easier it is to order take away, be tempted to eat that last row of chocolate and skip the gym when you are tired, and if this goes on for months or years the consequent damage to your health is pretty obvious. So now all that grim part is out of the way, what can you do as a shift worker to counteract these risks as much as possible and to just feel better when you are working the graveyard shift? Here are my personal insiders’ tips… 1. Get as much good quality sleep as possible Throw away the 8 hour rule, stop tracking it on your FitBit and stop watching the clock. Just make your bedroom as dark, cool and comfy as possible and don’t overthink it. Simple things like an eye mask, ear plugs, blackout blinds or window shades or even a fan can make your sleep haven just that little bit more inviting and help you stay asleep longer. If you aren’t tired or sleep isn't happening, get up and do something else until you do feel tired enough. One of the hardest things when sleeping in the day is to actually stay asleep for more than a couple of hours at a time - your body likes sleeping at night when your body temp is lower (yes that’s why around at 2am at work you are reaching for a jumper as well as a coffee) so sleeping at midday in summer is like fighting your own physiology. Power naps can be effective in reducing fatigue and I like to have an hour nap ending about half an hour before I need to leave for work to help me feel refreshed and ready to start my work day. 2. Avoid caffeine hangovers If you are going to have anything containing caffeine, keep it to the first few hours of your shift and not within 6 hours of the time you’ll be trying to sleep. Steer clear of energy drinks and stimulant medications which have a whole host of other problems associated with them (and where energy drinks are concerned, are not worth the filthy amount of sugar in each can). 3. Mentally switch off the second you sign out of work Meditate, listen to music on the drive home, watch 20 mins of trashy TV or take the dog for a walk - whatever you need to do to clear your mind before you hit the hay. Keep a to do list next to your bed and offload anything to it that is floating around your mind as you are trying to sleep. 4. Get into a routine Figure out which part of the day is the best sleeping time for you - it might be the second you walk in the door after work, or might not be until the afternoon, but try and stick to somewhat of a day to day routine. It not only helps your body get into the zone of sleeping when your head hits the pillow but also helps you feel more human and get more done with the time you aren’t at work. 5. Eat sensibly If you are on a rotating roster and know you have nights coming up, prepare snacks and meals for before and at work in advance. I like to have a stack of meals in the freezer that I’ve made in bulk so I can sleep until just before work starts and have a healthy dinner (/breakfast) ready in no time. If you have a healthy snack to eat overnight it also makes resisting those staff room chocolates and vending machine chips much easier. Have your kitchen fully stocked before your run of nights begins so you have decent food at your fingertips and don’t have to do grocery shopping on 2 hours sleep - this always ends in buying multiple blocks of chocolate and cakes that weren't on the list. 6. Stay active You don’t need to run 10k every day to keep your health and fitness on track while you throw your body through the night shift ringer, but you do need to do something active every day to help counter-act those aforementioned risks. As with any exercise, find something you like doing that gets your heart rate up and makes you sweat and do it regularly. My active pursuit for today was hitting up my old friend the trampoline park for an hour and I can tell you that not only are my legs sore now but I know I’lI have a solid pre-work power nap because of it! 7. Stay safe DON’T DRIVE HOME FROM WORK IF YOU ARE OVER-TIRED. In capitals because it is so so so important for those finishing work as everyone else is starting their day. All too often there are fatal car accidents involving nurses and others who have been at work all night and don’t want to trouble someone else for a lift home when they are really too fatigued to safely drive themselves. It’s not worth it - check yourself before you get behind the wheel and keep an eye out for your colleagues. Pump the air conditioning, blast some music and drive with a full bladder if you must but don’t risk your life and everyone else’s on the road - check the RMS tool “Test Your Tired Self” for more info (http://www.testyourtiredself.com.au). 8. Soak up some sunshine It’s much easier in summer with longer days to find time to catch some rays, but no matter what time of the year, it’s especially important for those who might spend most daylight hours under the covers to get out and make some vitamin D! It does wonders for your mood and alertness to feel some sunlight on your skin after working under fluorescent lights all night. 9. Look out for your colleagues There is a sense of camaraderie in my workplace after hours - everyone works really well as a team and it makes stressful moments much more tolerable. Be there for your colleagues and they will be there for you - keep an eye out for anyone who isn’t coping and remember that lack of sleep can wreak havoc on a person’s mood so lend an ear where one is needed. Just be a nice human - this goes for all working hours! 10. Look on the bright side This all sounds like a long list of cons about working nights but remember there are some positives!! Think of the extra money, the ability to be flexible around your other commitments and the fact your workplace may be quieter at night - whatever the highlights may be. Focus on these and you’ll be out the other side of your night shifts in no time! What are your night shift hacks that make being awake all night easier, or improve your sleep in the day? Do you have any other insiders tips on how to survive and thrive as a shift worker? Let me know below! References: http://www.testyourtiredself.com.au https://www.mja.com.au/journal/2013/199/8/sleep-loss-and-circadian-disruption-shift-work-health-burden-and-management https://www.betterhealth.vic.gov.au/health/healthyliving/shiftwork http://occmed.oxfordjournals.org/content/61/2/78.full |
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