Posted on by Geoff Clarke

The Future Is Now!

Is it just me or does it appear that folks are walking around in groups, just staring at their phones and not talking to each other? You know, more than usual…

Of course I’m talking about Pokémon GO, the augmented reality game that seems to have tapped into the greater social subconscious. Given it’s current popularity, it’s likely one of the more visible examples of the merging of technology with physical exercise.

The premise of the game is simple enough: Pokémon are little creatures you want to collect. The app lets you know when any are in your general vicinity…but there’s a catch. You have to actually get off the couch and walk to the specified location to attempt to add the creature to your collection. Additionally, the app has a speed threshold of 10mph to discourage people from biking or driving to the various locations. In other words, if you’re moving too fast when in route, you won’t be able to capture the Pokémon.

Entertaining, sure, but the game is pretty basic from the physical activity side of things. If you like general idea, however, there are plenty of apps that offer more robust exercise metrics within the construct of a game. Zombies, Run!, for example, not only has you running from the undead in a variety of customizable missions, but it enables you to track such stats as time, calories burnt, distance and pace. And, as discussed in a previous blog, there are a variety of smart watches available for folks who want to break down and analyze their workouts.

But where’s this all going? Does the utility of such apps and devices end with the individual consumers…or might the ever-increasing stockpile of exercise-related data be put to some other use at some point in time?

According to the World Bank, the average life expectancy of an American in 2014 was 79 years, up from 70 years in 1960.   This improvement is generally accredited to advancements in the health care industry and the implementation of preventative medicine.

And yet, according to the CDC, chronic diseases are still the leading forms of death and disability, place a disproportionate burden on our heath care system, and can significantly impact the quality of one’s life. While there are certain risk factors that are beyond our control (age, gender, race, heredity), modifiable factors (such as a sedentary life style, poor diet, and the use of tobacco products) are proven contributors to the development and acceleration of preventable chronic diseases. As our population is both growing and living longer, it is highly likely preventative medicine will begin to place greater priority on these modifiable factors.

Education will only go so far, though. What would it take to get the greater population to actively embrace better lifestyle choices?

Good question.

My pet theory is that it might all eventually boil down to health insurance premiums. High health insurance premiums, to be specific. In this hypothetical scenario modifiable lifestyle choices would be broken down into a variety of easily verifiable metrics; each of which would have a minimum recommended metric. Regularly meeting a minimum recommended metric would result in a slight break in the premium. Regularly meeting most of the minimum recommended metrics, however, would result in a much more sizable break.

In terms of physical activity, perhaps a metric would be meeting the American Heart Association’s baseline exercise regiment for cardiovascular health: 30 minutes of moderate exercise 5 days a week or 25 minutes of vigorous exercise 3 days a week. Perhaps exceeding this baseline would result in a larger discount. Regardless, the strategy would be to reward those who make healthy lifestyle choices instead of penalizing those who do not.

Far-fetched? Perhaps.

Admittedly, people wearing devices capable of monitoring exercise, vital stats, nutritional consumption, and alcohol and tobacco use sounds like something out of a Terry Gilliam flick. Yet just the other day I stumbled upon this advertisement which, one could argue, is a baby step in this direction:

Screen Shot 2016-07-19 at 11.08.20 AM

According to their website Health IQ claims to have negotiated lower heath insurance rates for their members “by measuring data from over 1MM health conscious [sic] people”.   The company’s belief, under Our Mission, is “…the best way to improve the health of the world is to celebrate the health conscious [sic] rather than harass and cajole those who are not.”

Minor grammatical error aside, I’m intrigued.

Posted on by Geoff Clarke

“Eighty percent of success is showing up.” – Woody Allen

Ahh, the marvels of the modern age. Sure, we’re still working on jet cars, but we’ve got access to the world’s information in our pockets, an abundance of cheap produce regardless of season, and machines that go “ping”. One of the downsides to all the technological wonders of our world, however, is that we’ve grown particularly sedentary. Over the past 50 years obesity rates in adults and children—not to mention the related onset of type two diabetes—has increased dramatically. And while what and how we are eating is certainly part of the problem, there’s no denying that, as a nation, we are not getting enough exercise.

According to the American Heart Association, the baseline exercise regiment for overall cardiovascular health is 30 minutes of moderate-intensity at least 5 days a week, 25 minutes of vigorous-intensity at least 3 days a week, or some hybrid of the two.   “So what’s the difference between moderate- and vigorous-intensity?” you ask. Good question.

The intensity of a workout is measured by one’s heart rate. The target heart rate for moderate-intensity workouts, such as brisk walking, water aerobics or even gardening is 50-69% of one’s maximum heart rate. The target heart rate for vigorous-intensity workouts , such as cycling over 10 miles an hour, jogging or swimming, is 70-85% of one’s maximum heart rate.

Heart rates are measured in beats per minute (bpm). While there are all kinds of fancy ways to pinpoint one’s maximum heart rate, to quickly estimate simply subtract your age from 220. For example, I’m 45, so my estimated maximum would be 175 bpm. That established, I can extrapolate that my estimated target range for a moderate workout is 88 – 121 bpm; 122 – 149 bpm for a vigorous workout.

I’ll further discuss heart monitoring devices in next week’s blog, but in the meanwhile here’s a quick tip to roughly gauge your heart rate: conversation will begin to become labored when one achieves the target heart rate for a vigorous workout.

Now that we hopefully have a better understanding of the AHA’s baseline exercise recommendations, by a show of hands how many of you meet or surpass these recommendations? In 2013, the Center for Disease Control and Prevention estimated that only 50% of American adults meet this guideline. Incorporate some basic muscle training—which federal government standards include—and this number drops to 20%.

Every year millions of people resolve on New Year’s Eve to “lose weight” or “go to the gym”. And every year it becomes challenging to find an open treadmill or weight machine…at least until mid-February. So, why is that?

In their book, “NASM Essentials of Personal Fitness Training”, The National Academy of Sports Medicine (NASM) attempts to understand these “resolutioners” within the framework of the transtheoretical model of behavior change.   Stages of this model, as adapted by the NASM, include:

  • Precontemplation
    • Not yet intending to exercise
  • Contemplation
    • Considering beginning to exercise in the next 6 months
  • Preparation –
    • Occasionally exercising
    • Planning to exercise in the next month
    • Believes in the health benefits of exercise though may have unrealistic expectation
  • Action
    • Exercising regularly for under 6 months
  • Maintenance
    • Exercising regularly for over 6 months
    • While the new habit (exercise) has become routine, one still may be susceptible to the allure of old habits

The NASM concludes that the lion share of resolutioners never make it past the preparation stage due to unrealistic expectations. Therefore, the role of the personal trainer is to set realistic goals and assist in the building of a social support network for their clients so that they can transcend to the Action and Maintenance phases of behavioral change.

Given that the book is a more-or-less a personal trainer manual, this conclusion is not terribly surprising, if perhaps oversimplified. I am going to suggest that those who manage to successfully alter their behavior, i.e. incorporate exercise into a weekly schedule, do so not merely because they had realistic expectations, but because somewhere in the Contemplation or Preparation phase there was a reassessment and reordering of priorities.

The simple fact of knowing you need to be more physically active doesn’t cut it. You’ll have all the best intentions, but there will always be a seemingly viable excuse waiting in the wings. Realize that your health is a priority, however, and you’ll see these excuses for what they really are.

After I decided to make my health a priority, I made a pact with myself:  over the course of the next year I had to exercise to some capacity 5 days a week.  This didn’t mean that I was going to give 110% every workout, but I had to show up.  By the end of the year, I could probably count on one hand how many times I failed to meet that goal.

Now don’t get me wrong, this really is just half the battle…or four-fifths the battle, as Woody Allen would have us believe. Without this psychological foundation, however, the path to long-term success is significantly more challenging, if not impossible.

So before you give voice to this year’s NYE Resolution—whatever it may be—mull it over a bit before-hand and make sure you’re ready to show up.