How (not) to track your health

Vox

3 days ago

is a senior technology correspondent at Vox and author of the User Friendly newsletter. He's spent 15 years covering the intersection of technology, culture, and politics at places like The Atlantic, Gizmodo, and Vice.
You'd think I would have been more self-conscious about walking around New York City while wearing no fewer than six health trackers at a time. For the first six months of this year, I wore smart rings on both hands, fitness bands on both wrists, biosensors plugged into my arms, and sometimes even headphones that monitored my brain activity. I was a little embarrassed, sure, but mostly I was anxious.
This health tracking ensemble was part of an experiment — a failed one, I'll admit. By tracking as many health metrics as possible, I thought I'd find a way to feel younger, more energetic, and more fit. Products like the Oura ring, the Whoop band, the Apple Watch, and a growing variety of continuous glucose monitors promise to track things like your heart rate, body temperature, and metabolic health metrics, while their companion apps crunch that data into actionable advice about how to live your life. If one health tracker is good for you, theoretically, half a dozen should be great.
What I learned from obsessively tracking my health for half a year is that paying too much attention to what your body is doing can ruin your life. Or at least it can ruin your understanding of healthy living, since too much information can steer your brain toward assuming the worst. Looking at the readouts from these fitness tracking apps sent me down dark holes of Googling symptoms and self-diagnosing conditions that my doctor assured me I did not have. But, I reasoned, he did not have all of the data that the health tracker collected, so he could be wrong, and AI, which is increasingly embedded in this tech, is very good at diagnosing things.
I wouldn't caution against any and all health tracking. Now that the experiment is over, I'm only ever wearing one health tracker at a time. I've gained a new appreciation for how technology could become an essential part of healthy living in the near future, if you do it right. I'm not saying I have all the answers, but there are some things I would recommend to tracker-curious readers. And there are some things I would avoid at all costs.
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Do wear a smart ring when you sleep
Out of over a dozen gadgets tested, the one device that I added to my daily routine is an Oura ring that I only wear at night. (During the day, I wear an Apple Watch.) An Oura ring is a sensor-packed smart ring that measures a lot of the same things as a smartwatch, but is easier to wear while you sleep. The ring keeps track of your heart rate and movement to sense how well you sleep. Exactly how it does this is controversial with some sleep doctors, but it nonetheless generates a sleep score, which is oddly compelling.
The first thing I do every morning, I'm almost embarrassed to say, is check my sleep score in the Oura app. If it's bad, I feel vindicated for feeling groggy. If it's good, I feel energized, even if I still feel groggy. The sleep score is a made-up metric, one that may or may not be correct based on how Oura's algorithms calculate various factors, but paying attention to the score was helpful for me.
'The way that we think about how we've slept can really make us feel better,' Thea Gallagher, a psychologist at NYU Langone Health, told me. 'If we think we've had a good night of sleep, we will actually feel better physically and mentally and emotionally.'
Placebo effect notwithstanding, I'm also surprised by how much I listen to an app when it tells me to go to bed. Thanks to the Oura app, I've developed better sleeping habits, and frankly, I feel better.
Do start out with a clear goal in mind
When I first got an Apple Watch, I liked the rings that track how much you move. Moving more seemed like an easy goal that would improve my health. But some trackers seem to collect data for the sake of collecting data, with no particular objective.
Continuous glucose monitors, or CGMs, have been lifesavers for people with diabetes for years, but a growing list of companies sell them to non-diabetics over the counter. These biosensors stick a filament into your skin that measures the amount of glucose in your interstitial fluid, which can give you a good guess about what your blood glucose is at any given moment. If you don't know a lot about how metabolism works, the readouts can be horrifying. The first bowl of cereal I ate spiked my blood sugar outside of the normal range, which threw me into a panic — a panic that didn't entirely subside until I stopped wearing these sensors.
Part of what fueled that anxiety was the fact that I didn't actually know how to make sense of the data that these monitors spit out. Most of them alert you when your glucose is spiking and then give you some kind of score, but it's not clear what a good score indicates other than that you've managed to eat fewer carbs, probably. The whole experience can feel like a high-tech diet.
'There's not a lot of time and effort spent on figuring out what is the actual question that I have that's really important to me and that I'm willing to go through some some effort and troubleshooting in order to come out the other side with a genuine discovery that I can use in my regular life,' said Gary Wolf, a tech journalist and founder of Quantified Self, a community of people who have been tracking their health metrics since the mid-2000s.
Don't send your poop or blood to anyone in the mail
Health tracking isn't confined to wearable devices. Some companies, like Viome, Function Health, and Ultrahuman, are getting into the labwork business. The idea is that you can pay for extra testing and get all the results back in an app that promises to help you understand the intricate details of your gut microbiome or metabolic health. Some assign you a biological age based on your test results, and all of them cost many hundreds of dollars.
I did a battery of tests through Viome, including the gut microbiome test, which involved filling up little vials with poop and blood and dropping them at a post office. (Disclosure: Viome waived the fees for me.) The results seemed to tell me nothing that I didn't already reveal on the pre-test questionnaire, but I did have the opportunity to buy some very expensive supplements to address my problem areas. I don't recommend doing any of this.
Don't pay for a subscription unless the gadget really improves your life
If you've ever seen someone wearing a band around their wrist with a little hunk of plastic where the watch face should be, you've seen a Whoop band. This fitness-forward health tracker works a lot like a smartwatch without a screen, but the app is geared toward gym rats. The app not only gives you a strain score that measures how hard you've worked out, it also encourages you to recover. It costs $30 a month to enjoy all the features.
It's not just Whoop that wants you to keep paying. Oura also charges a subscription fee to unlock all of its features, but it's just $6. Apple has the Fitness+ subscription for $10, but that includes a bunch of classes, not unique features on the Watch. All of these little fees add up over time, so if you really just want basic functionality, skip the subscription. Without it, you can still see your sleep, readiness, and activity scores on an Oura ring. (That's all I look at anyway.) The Whoop band doesn't work at all if you don't pay.
Do take breaks
The best advice I got from the many experts I talked to throughout my health tracking journey was to take off the devices from time to time. The absolute flood of information about my health often made me uneasy, and it even led to some disordered behaviors, especially when it came to tracking my glucose levels and seeing my readings start veering away from normal levels. Still, I wondered if I shouldn't intervene somehow.
'Sometimes atypical results found by wearables can make people anxious, and it may be difficult to offer them definite reassurance for these results,' said Dr. David Klonoff, president of the Diabetes Technology Society. 'If traditional medicine cannot provide definite answers, then these people sometimes turn to natural or alternative medicine.'
Some health tracking companies want to take your money every month to keep using their services. Some want to sell you the latest generation of their device. Some want to sell you supplements. They all want you to keep using the trackers and apps, even if they're not necessarily making you healthier. That's good to keep in mind.
So check in with yourself when you're wearing a health tracker. Take it off, and leave it off for a while. Without a torrent of alerts telling you to stand, sleep, or eat, you may actually feel better.