Do iWant the iWatch?

Big news in the technology world - the Apple Watch was unveiled for the first time, and it's expected to arrive on shelves in 2015.  Of the multitude of fascinating features, one aspect that is getting a lot of attention is the iWatch's ability to track physical activity and provide integrated fitness/activity apps to help guide your progress.   You may find yourself asking - is this something that iWant? that iNeed? Will iBenefit?? Can iTrust it??

While there are many fitness apps out there, here's what catches my attention: the iWatch can measure your heart rate, and your total body movements (via an accelerometer).  It also uses the GPS and wifi in your iPhone to track how far you've moved.  There's a little circular icon that fills up each day as you move - even letting you know how many minutes you have stood during the day.

Pretty nifty that you can now track your activity, heart rate, and personal info all together in one internet-linked system.  I also really like the encouraging nature of the movement icons filling up, with Apple's stated goal to be 'Sit less, move more, and get some exercise by completing each ring each day.'

There are rumblings as well that the iWatch will someday be able to check blood sugar without poking the skin.   (Currently, the closest a diabetic can get to this is with a continuous glucose monitor, which still requires that a sensor is worn under the skin, and it has to be calibrated against the standard finger-poke twice a day.  There is also a brand new technology just approved in Europe early this month, whereby a small round sensor is placed on the skin with a small filament that is inserted just under the skin; a reader is scanned over the sensor to get a glucose result. More on this on drsue.ca soon - stay tuned.)      As testing blood sugars can be painful and frustrating for my diabetic patients, this news not only got me sitting up, but also spiked my own heart rate to well over 100.

With real time, painless monitoring of these parameters, I get carried away into a dream land where patients could be monitored in second-to-second real time with internet data transmission to their family members, caregivers, or health care professionals anywhere in the world... do I dare to dream?? (editorial note: there are a number of established glucose monitor companies working on this for blood glucose monitoring, in various stages of development)

Before we get carried away, though, we need a lot of questions answered.  How have they validated their technology?  How accurate is their accelerometer? How accurate is the heart rate monitor?  Can the heart rate monitor pick up irregularities and notify the patient or caregiver?  If they are going to incorporate a blood glucose monitor, how will this be tested and validated for precision and accuracy?  I suspect these details and information will become available as the iWatch unfolds into the marketplace, but if we as people, patients, and health care professionals are going to trust the data, we need to know that the studies have been done to prove that it is worthy of our trust.

Definitely exciting, though - my eyes will be focussed on these interesting developments in health technology.

Thanks to Glenn for the heads' up, and to Anita Dobson for her input.

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www.drsue.ca © 2014

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Downsize Fitness Comes to Canada!

The first of an American chain of stigma-free, welcoming gyms exclusively for people who struggle with their weight has arrived in Canada.  Rather than focusing on cardio burn, Downsize Fitness focuses on functional fitness - helping people learn exercises to gain strength and mobility for daily activities like getting to and from work, standing up from the floor, keeping up with kids - whatever each individual needs to help them lead their best life.

There are a variety of levels of exercise programs to help people address their individual needs, and a strong sense of community that helps to support members in their journey to improve their fitness.

As discussed in the Canadian Medical Association Journal, one of the barriers to exercise cited by people who struggle with their weight is a fear of being stigmatized at traditional gyms, so it's great to see facilities that will help to take down this particular obstacle in the weight struggle.

I'm looking forward to seeing more of these and similar facilities pop up around the country!

Follow me on twitter: @drsuepedersen

www.drsue.ca © 2014

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Landmark Study Shows Physical Activity Decreases Heart Attack Risk

We have all heard before that physical activity is important for overall health.  Believe it or not, it is now for the first time that we have solid evidence to prove that being more active in daily life decreases the risk of cardiovascular events (eg heart attacks) in particular.

The study, recently published in Lancet, assessed pedometer data (recording # steps per day) in over 9,000 people with prediabetes from 40 countries around the world.  They examined how many steps per day each person took at the beginning of the study and again at 1 year, and then followed them up for an additional 6 years.  They found that:

• people who were more active at baseline (start of the study) had a lower risk of cardiovascular events
• people who became more active over the course of a year had a lower risk of cardiovascular events at 6 years
• for every 2,000 steps/day increase in activity over a year (about one mile or 1.6 km), there was an 8% decrease in cardiovascular events!

Prior to this study, the studies suggesting that being more active decreases the risk of cardiovascular events have been based on less rigorous data and study design.  Also, previous studies have generally been based on self reported data (ie the person in the study gauges how active they are), whereas this study objectively measured number of steps per day with pedometers.  For these reasons, this study is considered a landmark trial in that it has shown us, very objectively and in a high quality study design, that being active really does decrease heart risk in a group of high risk individuals.

See if you can find ways to take more steps in your day!

Follow me on twitter: @drsuepedersen

www.drsue.ca © 2014

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The Air Bag for Cyclists

Here's an innovative way that Scandinavians are trying to improve cycling safety in commuter cyclists who don't use helmets (and perhaps also a clandestine effort to maintain some semblance of a hairstyle?!).

Meet the Swedish Hövding Air Bag - it's a zip bag worn around the neck (kind of like a neck warmer) that releases an airbag in a helmet shape upon sudden impact (check out the video to see how it works).

Some view this as potentially even safer than a traditional helmet, because it:

• Dissipates shock better with an airbag
• Protects the lower back of the head
• Does not twist the neck as the head is not locked to the helmet
• Supports the neck with a collar when inflated

Downsides of the Hövding?  It's expensive - around $500-600 - and from what I can gather, it can only be deployed once.  Also, deployment of the airbag is stimulated by a sudden impact.  So, what happens if you lose balance and just fall off your bike, with no sudden impact causing you to fall?  Will it deploy in time? Or if you fly over your handlebars head first, the head would be the first point of impact and therefore I can't see how there would be a stimulus to deploy ahead of time.  So it may not be a good choice for road riders and certainly not mountain bikes - more for the relaxed cycle commuter that permeates European culture.

Many European countries do not mandate helmet use, and may be hesitant to mandate them due to a fear that this will discourage people from using their bicycles as daily transport.  It seems like this could be a good alternative to the traditional helmet for commuter purposes.... but probably needs some user experience and time before we can know for sure.

And somehow, they've managed to make it look like it walked right off a European fashion runway....

Thanks to my friend Craig for the heads' up! (pun intended, haha)

Follow me on twitter: @drsuepedersen

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The Momentum of GOLD!

At the close of the amazing Sochi Olympic Winter Games, wherever you are in the world, take a moment to feel the energy that the athletes from around the globe have brought to the global arena.  Ride the wave of excitement, and use the energy to empower yourself and your family to get involved!   Be it a renewed commitment to a walking program or involvement in a new sport, take one permanent step forward from the close of the Olympics to leading your Best Life forever.

And if you are Canadian, you're probably very tired but also feeling very empowered this Sunday morning....

Team Canada Women and Men of hockey and all winter sports, you've made us so proud.

 Follow me on twitter: @drsuepedersen

www.drsue.ca © 2014

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Dangers of ‘Juicing’ – Steroids and Other Performance Enhancing Substances

In testing Olympic athletes so carefully for performance enhancing substances, it is not only because it is unfair and unsportsmanlike to use these drugs and hormones, but also because it's downright dangerous and must be harshly discouraged.

The list of potential adverse effects is long, and many are summarized in a recent case published in the Journal of Endocrinology & Metabolism.  The article also describes a case report that serves as a very serious warning to anyone taking performance enhancers or naturopathic supplements.

The case is that of a weight lifter and trainer who had a history of using a variety of performance enhancing substances, including various forms of testosterone (anabolic steroids), growth hormone, antiestrogens, and others.  He presented to hospital with a 10-day history of nausea, headache, abdominal cramps, and diarrhea.  He was found to be in liver, kidney, and heart failure. 

He did not survive.

The autopsy showed that he had suffered a combination of arsenic toxicity, and liver failure thought due to some of the testosterone (anabolic steroid) preparations that he was taking.  The source of arsenic toxicity was traced to an unlabelled bottle which was presumed to contain a performance enhancing substance.

Scary. 

As the article notes, studies have shown that anywhere from 5 to 64% of natural health products and performance enhancing substances are contaminated with one or more toxic elements.   As the author notes,

“The ready availability of performance enhancing substances, its unregulated use, and the unreliability of the contents (at the source of raw material or manufacture conditions) … contributed to the tragic outcome in this case.”

Long before this patient fell ill, his doctor was trying to ‘monitor’ the patient’s health on performance enhancers with liver ultrasound and liver tests, which had been normal five months prior to falling ill.  We can also learn from this case that monitoring patients on naturopathic substances and performance enhancers may be

“futile to prevent or even minimize harmful consequences”,

as simply finishing one bottle and starting another can bring with it a toxic contaminant that was not present in the first bottle.  Also, we often don't know what is in these performance enhancers, nor have they been studied properly to teach us exactly how a doctor should go about monitoring a patient taking them. 

This article and case should be taken under very serious consideration by anyone taking performance enhancers or naturopathic substances.  For their own sake as well as for the sanctity of sport, let's hope that athletes at Sochi are competing on fair ground!

Follow me on twitter: @drsuepedersen

www.drsue.ca © 2014

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