By David Ruohoniemi

Peer Reviewed

The obesity epidemic has been widely reported in recent years. In 2005, an estimated 23.2% of the earth's population was overweight and ix.eight% were obese. Projections show that this number will go on to increase. Equally much as 58% of the adult population worldwide volition be classified as obese or overweight by 2030.1 Contributors to obesity are multifactorial, encompassing modifiable and nonmodifiable risk factors, including nutrition, lifestyle, genetics, and ecology factors. A seminal review by Blair and Brodney in 1999 showed that an increase in physical activeness clearly reduced health risks associated with obesity.ii Despite this knowledge, activity rates remain low and concrete inactivity remains the fourth leading cause of death worldwide.3

A multifariousness of motivational methods accept been attempted by government organizations and insurers to increase physical activity. In the early 2000s, studies suggested that pedometers could effectively increase concrete activity. A systematic review found that pedometers increased concrete action by roughly 27% from baseline and were associated with a subtract in body-mass index.4 However, these findings were called into question past later studies that found insufficient evidence to support the employ of pedometers to improve physical inactivity, in office due to a lack of high-quality randomized controlled trials (RCT) and high discontinuation rates.v,6 There remains controversy regarding the efficacy of workplace pedometer programs.

Wearable fettle applied science is an intriguing next pace in the use of pedometers to increase activeness. The use of consumer wellness trackers has exploded since their initial inception. These multifunctional devices are capable of generating a plethora of data for consumers, ranging from pulse oximetry readings to electrocardiograms and footstep counters.7 Wearable devices and smart phones have already been shown to track pace counts with remarkable accuracy.8 Directly-to- consumer marketing of wearable devices often highlights purported health benefits. In fact, early behavioral studies accept shown that consumers focus on the perceived benefit of article of clothing devices over perceived harms.9 Despite the burgeoning marketplace and expanding medical technology, the wellness benefits of action trackers remain unclear.

Researchers accept recently begun to systematically examine the effect size of activity trackers with and without associated incentives. The TRIPPA study, published in 2016, randomized 800 participants to control, fitness tracker (Fitbit Zero), fitness tracker and cash incentives, and fitness tracker and clemency incentives.v The study found an increase in action at 6 months measured by moderate-to-vigorous physical action (MVPA) bout (walking) minutes per week in the action tracker plus greenbacks (29 MVPA, p=0.0024) and activity tracker plus charity incentive groups (21 MVPA, p=0.03) compared to control. However, the fitness tracker lonely group did not significantly increase activity relative to the control group. Furthermore, the benefits in both incentive groups were not sustained at the 12-month follow-up later incentives had been removed. The authors ended that there was no evidence of improved health outcomes and questioned the value of these devices.

A second study published in JAMA further called into question the utility of these devices to effect meaningful change. This study enrolled a total of 471 participants who were randomized to a standard behavioral weight loss intervention or a engineering-enhanced weight loss intervention.10 Both groups received a depression-calorie diet and a variety of behavioral interventions; the technology-enhanced group likewise received a wearable device at six months. Remarkably, the study constitute that the technology-enhanced group lost significantly less weight (3.5 kg) than the standard grouping (5.9 kg, divergence 2.4 kg, p = 0.002). While the authors did not conclude that the device acquired damage, the results added to growing bear witness that wearable devices are not superior to standard intervention.

Like to the aforementioned research into pedometers, there remains a paucity of large well-designed RCTs with wearable devices beyond these 2 studies. Furthermore, the substantial heterogeneity of smaller studies makes their findings difficult to interpret. For case, i written report found increased physical activity at 16 weeks in inactive elderly women, while another showed no benefit to an app-based fettle programme in Australian youth.xi,12 Both studies enrolled a full of roughly 50 patients, again underscoring their limitations. These studies provide piddling clarity without consistent inclusion criteria and defined endpoints.

The article of clothing fettle device market has grown at an exceptional rate. Recent market place assay predicts that the market will grow from xvi.ii billion USD in 2016 to 52.5 billion USD in 2024.thirteen Early evaluation of the utility of smart wearable devices is reminiscent of pedometer findings that ultimately failed to show a sustained benefit. Two big RCTs failed to testify any sustained benefit for either physical activity or weight loss. Heterogeneous pocket-sized studies provide alien evidence that is difficult to interpret, given the multifariousness of report populations and endpoints. There is currently no convincing evidence that wearable devices provide discernable health benefits despite the cost and marketing tactics. The field would benefit greatly from future large RCTs involving high-risk inactive patients to provide clarity on any potential benefit.

By David Ruohoniemi is a 2nd twelvemonth pupil at NYU School of Medicine

Reviewed by Michael Tanner, Physician, associate editor, Clinical Correlations

Image courtesy of Wikimedia Commons

References

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  2. Blair SN, Brodney S. Furnishings of physical inactivity and obesity on morbidity and mortality: current prove and research issues. Med Sci Sports Exerc. 1999;31(eleven Suppl):S646-662. https://www.ncbi.nlm.nih.gov/pubmed/10593541
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