Will wearables and other gadgets make us healthier?

Is good health really all that digital?

I am not so sure. I am a skeptic.

I realize this is a risky thing to say these days. It’s hard to bet against Apple. And It was only seconds after Tweeting such doubt that John Nosta, an expert in digital health technology, tweeted back:

@drjohnm Health is very digital. @EricTopol #digitalhealth

— John Nosta (@JohnNosta) January 4, 2015

Well, yes, surely digital technology is important in the diagnosis and management of diseases. I couldn’t do ablation without engineering and technology. We use digital devices to monitor the heart’s rhythm, and said devices, such as the AliveCor iPhone ECG, herald improvements over clunky wired devices. Diabetes is monitored digitally. Vital signs are too. Dr. Eric Topol wrote recently about the (molecular) stethoscopes of the future. I don’t mean to say digital technology improvements are not improving medical care. They are.

But is the digital revolution correlating with better health? A look around America, call it the “general appearance” part of the exam, would suggest not. The view from my waiting room, my orthopedist’s waiting room, an airport, a mall, anywhere other than fitness enclaves like Boulder Colorado, would lead one to believe the correlation between tech and health is inverse. It seems the more digital, white-screen attached, we become, the fatter and sicker we get.

It’s ironic, perhaps metaphorical, when an obese sedentary smoker asks me about doing a screening ultrasound test to pick up early disease.

That’s how I feel about the fitness and health tracking business. I see the devices as fine tuning when what is most needed is simpler. Far simpler. And obvious.

My experience with bike tech is instructive. When I began cycling competitively, bike computers were in the midst of a revolution–not unlike the present revolution in health gadgets. At first, bike computers were crude; they measured only speed, distance and RPMs. But it was digital. You had data. The numbers enhanced the experience. Then the data got better. It went wireless, and power sensors allowed one to measure performance more truthfully. I got even more excited with the advent of power data. And most recently, GPS and social media apps, like Strava, have further boosted the digital revolution of cycling. Now I can measure and share my cycling performance against my peers.

All along this continuum, I embraced cycling technology. I was an early adopter. I was enthusiastic. I had training logs, spreadsheets and power plots. That was then.

The bikes in my garage today have no devices. I have only my sensations, my belt loops, the tightness of my bike jersey (it doesn’t shrink), and my placings in races.

I jettisoned the digital because I made a discovery: going fast on the bike comes from simpler more qualitative things. I found that eating better food, and less of it, helps. I found alcohol, at any dose, decreases watts. I found going to bed at a good hour increases endurance. And for me, high quality interval training interspersed with adequate rest works like magic.

My cycling health, in other words, did not need digital fine tuning. It needed the basics.

That’s how I feel about health for the masses. Nary does a man with a 38-inch waist need a digital watch. He needs a pair of sneakers, a jacket and a gutsy enough clinician to tell him to carve out time in his day to use them. He needs priorities. And on nutrition and sleep and kindness: it’s the same idea. Almost everyone knows the basics.

If health gadgets helped humans master the obvious, then I would be less skeptical.

JMM