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  • Writer's pictureRyan Allen

Worthwhile wearables

In our quest to stay proactive with all things pertaining to our health, we constantly want to assess how we’re doing and ways we can improve. In an ideal world, we would have insight into every last component of our blood, cells, and bodily systems at all times, but this is obviously unattainable (at least now). While we have access to many static tests for these things–like all the lab tests you receive when you go to the doctor–there are only certain things that allow for continuous, rather noninvasive monitoring of different metrics. These tools can be invaluable for gauging various aspects of health, because we can see things in flux. We can observe how measurements change over time, in response to certain variables, and their different tendencies. After all, this is how life plays out: as a movie, not a snapshot. This provides us much greater insight to make actionable modifications to our behavior and influence our health. This is not to deemphasize the importance of static tests, which can be unbelievably informative, especially given the tools we currently have. Rather, it is to encourage the widespread use of wearable devices for proactive health tracking.

Of course, there is a limit to how many wearables one could possibly choose, whether it be financial, aesthetic, or simply how much space you have on your body to accommodate these things. It can be difficult to weigh all the options out there. That said, the reality is that many are useful in different ways, or are equally viable options to attain the same outcome. In this post, I’m going to outline the wearables that I have personally chosen to use, and why I feel they are most worth the investment for anyone.

The Apple Watch continues to impress me with all of the things it can track, as well as the ability to give me certain quick information when I need it without checking my phone (weather, time, blood sugar by pairing with my CGM, important notifications, etc.). However, I continue to utilize it primarily for the excellent breadth of insight it gives me into my exercise performance and improvement. The quality of the cardiovascular data using Apple Watch is actually quite good, with the ability to perform a clinical grade electrocardiogram (EKG or ECG) on demand, measure oxygen saturation in the blood, provide an (okay) estimation of VO2 max for cardiorespiratory fitness, and more. It even has a new feature to show your real-time zone (1-5) of physiological exertion based on heart rate, which is very important to ensure we’re training the appropriate energy system during a cardio workout (zone 2 and burning the most fat, zone 5 and demanding the most energy, etc.). Some may recall that heart rate is not actually the most accurate indicator of training zone, but this still provides a useful approximation. I have come to rely on my watch for basically logging every workout I do, and having this record has become incredibly useful to go back and track my progress. Particularly during training for our Ironman and now for our upcoming physical challenge, the accuracy of tracking distance covered and elevation change has been quite useful. With the accuracy of the heart rate data, I can see how I responded differently to various exercise demands. The wrist location hardly ever interferes with exercise, which is why I keep this tool with me virtually at all times while I’m up and moving.

I love my Apple Watch for when I’m up and moving, but I actually do not love it when I’m trying to sleep. I tend to sleep with my wrist up fairly close to my face, and the blue light hue right up against my eyes does not tend to favor restorative sleep. Instead, I charge my Apple Watch at night and opt for the remarkable Oura Ring to provide my nighttime data. A much easier device to slip on and forget while sleeping, Oura also tracks numerous metrics that the Apple Watch cannot, many of which are critical for monitoring circadian rhythms, energy levels, overall readiness, recovery, and sleep: heart rate variability (HRV), resting heart rate (RHR), body temperature, etc. Additionally, Oura is certainly among the most accurate sleep trackers out there relative to the gold standard of polysomnography in a sleep laboratory. The sleep-wake determination is believed to be rather precise (around 70% of the time, possibly greater), though the specific staging may be less so. However, Oura has recently developed a new sleep staging algorithm that many believe better reflects the subjective experience of their night’s sleep. Not to mention, Oura’s sleep staging can still be useful to the individual regardless of absolute accuracy, because it is consistent night to night. Therefore, one can judge nights of sleep on a relative basis to themselves, but not necessarily in comparison to others. While I very much prefer Oura for overall knowledge of my health, wellness, and readiness and wear it most of the day, I definitely favor Apple Watch when it comes to exercise. Oura can track workouts, though I find the interface a little less helpful and informative than the depth and ease that Apple Watch provides. The ring can also be disruptive for workouts where one has to hold or lift anything heavy, which rules out a lot of strength training exercises.

To first address the elephant in the room: yes, I of course wear this because it’s all but obligatory for a type 1 diabetic to track their blood sugar. That said, even if I was not diabetic, I would still wear one if I could afford it. I truly believe that this is an invaluable tool for everyone, and we will see far more widespread use with time, as the technology becomes more accessible for a broader range of people (I am especially encouraged by the recently released Dexcom G7 device). Many times on the blog, I have written about the extensive insights I have gained from over a year’s use of this device, and they simply keep on coming. To my knowledge, this is virtually the only device we currently have to measure an actual metabolite in the blood in real time. Though blood sugar is by no means an all-encompassing metric for health, it is super informative to view its response in all sorts of circumstances: in response to a meal, a high-intensity workout vs. lower-intensity, stressful situations, sleep vs. wake, sleep deprivation, etc. In case you missed it, I have covered many of these details I have personally observed with my CGM, the Dexcom G6, in my recent post. That said, I believe CGM is crucial for each individual to see how their own blood sugar behaves at different times, since these things are so specific to the person and the time. Not to mention, while many trends in insulin sensitivity, blood sugar spikes, and average blood sugar do pertain to overall health and fitness, each person responds uniquely to various situations. Lastly, on top of this device’s purpose to inform the individual of what actually happens with their blood sugar, it is also undoubtedly an accountability tool. No question, there have been times where I have refrained from eating a certain food, made sure I slept well instead of staying up late, or otherwise chosen a healthy alternative behavior because I’ve thought about how my blood sugar would respond. Though this tool may not immediately be on your radar due to pricing for non-diabetics, I certainly would continue to monitor it (I promise, no pun intended) for when it becomes more available to the general public.


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