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Health & Fitness Redefined
Health and Fitness Redefined with Anthony Amen. Take a dive into the health world as we learn how to overcome adversity, depict fact vs fiction and see health & fitness in a whole new light.Fitness Is Medicine
Health & Fitness Redefined
Heart Rate, Sensors, and the Promise of New Tech
Unlock the secrets of your own health as we bring you an enlightening conversation with Andrew, a seasoned internist turned digital health trailblazer. This episode promises to revolutionize the way you think about wearable technology and its untapped potential in providing continuous, personalized health data. From Andrew's compelling journey of transitioning from traditional medicine to the cutting-edge field of digital health, we explore how devices like the Apple Watch are setting new standards in the realm of health monitoring and challenging the status quo of intermittent clinical assessments.
Ever wondered how your autonomic nervous system orchestrates your daily biological functions without you even noticing? Our discussion takes you behind the scenes of heart rate variability (HRV) and its intricate relationship with your body’s circadian rhythms. We scrutinize the accuracy of wearable devices and dissect the much-debated 10,000 steps per day guideline. Whether you're a wearable tech enthusiast or a curious skeptic, you'll gain nuanced insights into how these gadgets can serve as invaluable tools for your health management, despite their current limitations.
Think you know how your wearable device works? Think again. We break down the science behind biometric sensors, revealing how green and red light measure heart rate and oxygen saturation. Andrew sheds light on why wrist-worn devices face unique challenges, especially during physical activity. Looking ahead, we speculate on the future of wearable health tech, including promising advancements like non-invasive glucose monitoring. This episode is a must-listen for anyone eager to understand the complexities of physiological data and leverage wearable tech to enhance overall well-being.
Hello and welcome to how to Finish Redefined. I'm your host, anthony Amen, and today we have another great episode for you. I was thinking about labeling the show why the F are you wearing an Apple Watch? But I think for real, we should probably talk about wearables, what you're looking at, what those rings mean. I sit down with clients all the time in the office and they go look, I completed a ring. And then I go what does that mean? I don't know, but I did it. So we have a great guest today. On for that. So, without further ado, welcome to the show, andrew. Andrew, it's a pleasure to have you on today.
Speaker 2:Yeah, thanks for having me on, Anthony. Hope you liked my little intro. Yeah, I loved it.
Speaker 1:You did it.
Speaker 2:Yeah, great, I want to talk a little bit about you and how you got into this space. To begin with, yeah, I am an internist, so I practice taking care of patients admitted to the hospital. So that's what I, you know. I went to medical school, did that in the beginning, and then I got actually interested in acupuncture and in acupuncture I was very interested in sort of what are meridians and points, because no one really know what these acupuncture points and meridians were. And then I found out that there were some electrical properties that were associated with these points and meridians. And then so I started to study sort of biophysics and biological engineering, took some courses at MIT for credit in biological engineering and then started to study sort of the electrical properties of acupuncture.
Speaker 2:But then the funding for acupuncture sort of waned off because I think there was some major large clinical trials that showed that acupuncture like Verum, like true acupuncture, really didn't differ all that much from sham acupuncture. And so I realized I kind of need to sort of shift my focus onto something different, and so I was very interested at that time in sort of the whole body approach that traditional Chinese medicine takes and recognizing that there is sort of a balance of the human body and I also recognize that there is some of that information can be obtained from some of the time series that you get, like heart rates, that you get continuously, so which is different than you know. As a doctor, you, you know, often see patients that come in intermittently, so you get sort of vital signs and oftentimes those vital signs, like you know, heart rate, blood pressure, weights, et cetera, those those obtain, yeah, maybe like once every six months or once every year or something like that. So you're not really getting continuous data. But, as it turns out, if you're monitoring heart rate continuously, like you're able to do now with these wearable devices, is that there is a lot of fluctuations in the heart rate, and that fluctuations contains some very interesting and useful information.
Speaker 2:And so that got me into digital health, studying the heart rate signals using all these different mathematical approaches, and I became sort of the associate director for Center for Dynamical Biomarkers, which you know is electrical signals from the brain and other electrical signals too. So that's where I kind of got into this field and then decided after COVID, that I was burnt out, wanted to sort of change my life's trajectory and left and, you know, joined a startup Actually it was a spin-off from our lab and that startup is called Labfront and I'm the chief medical officer for that startup right now.
Speaker 1:That's awesome, man. That's a nice little career path change. I'm going to start with something totally off-topic. We're not really off-topic just because it's such a pet peeve of mine.
Speaker 1:So you mentioned being a doctor looking at different numbers like heart rate and et cetera and different spikes and stuff. So I'm talking about two different points here One heart rate average heart rate and two average body temperature. And what I'm getting at is that when I go to the doctor just an example and my resting heart rate is up around 95 beats per minute, right, what do you tell me as a physician?
Speaker 1:if that, I would say that's pretty high, like see, that's not what I I was told by my doctor that 95 beats per minute is, below 100, unhealthy.
Speaker 2:Yeah, you know that's true, and I think you have to sort of take everything in context, because a lot of people don't, you know, like when they come to the hospital or the clinic they're not exactly relaxed Oftentimes. You know these hospitals are located in sort of downtown or the city where you have to go through traffic and you know you're waiting for a long period of time before the doctor sees you. So you're angry and anxious. So, yes, so maybe that doctor saw, like most common, it's probably not infrequent to see a heart rate that high. But yeah, if you're kind of like resting at home, not doing all that much, then ideally your heart rate should be lower than that.
Speaker 1:Yeah, I agree. My point getting out, which is unrelated, which just kind of get to the point, is I came in resting, heart rate showed 95, body temperature showed 99. So they said, oh, you're good, the doctor will come, et cetera. But two hours later my fever spiked even higher, my heart rate raised even higher, end up having the flu. I got the chills on a whole nine yards. But for me personally, as someone athletic, my heart rate actually sits down in the 50s and then my body temperature it usually sits like 97.5, 97.6. So having a temperature of 99 showed I had a temperature. But they go off of averages and then going off these averages they're saying you're still in that average range. We're not off an individual, case-by-case basis because people can have different resting heart rate averages and different body temperature averages, which is kind of my point.
Speaker 2:Oh yeah, you hit a very important point. I mean that not only there's a lot of inter individual variability, like there's obviously differences between people, but there's also intra individual variability and like your heart rate can change obviously through the day and the night and it should ideally sort of drop during slow wave sleep or deep sleep early in the night or, I should say, early morning, and then your temperature also should change, and there's some very interesting information that comes from temperature as well, and the temperature should sort of dip and reaches nadir around, you know, 2 to 4 am and that's a marker of your circadian rhythm. So if it's off, maybe because your circadian rhythm's off, or if you have a fever or if you're stressed, then that's an indication that your body's not, you know, in a healthy state.
Speaker 1:Yeah, yeah. So it's so interesting, but let's get back to the main point. So when you're looking at all these markers right, somebody, people are tracking all the time right now I think the biggest ones are movement, like it tracks exercise to a component of the wearable. It tracks heart rate, it tracks sleep, step count. Those are probably the big top four, right?
Speaker 2:Right, oh, definitely.
Speaker 1:Out of all of those four, which is the one somebody, if they were to pick one, pay the most attention to?
Speaker 2:Oh, I think the step count is probably what everyone pays attention to. I mean, I think that's sort of what popularized in the beginning these wearables, these smart wearables, these smart watches so I guess that's what people pay attention to. Um, whether that's the most important thing, I'm not really sure, but yeah, to me I think it's all. Like the big things that you mentioned sleep, uh, steps, heart rate and heart rate variability um are probably the biggest ones.
Speaker 1:Yeah, yeah, and when you're looking with, I've done a bunch of shows on steps, so I'm just going to skip steps, step count, go back and listen to the previous episodes on that. But let's talk about, I think, what I think is probably the most important is resting, heart rate and heart rate zones. So is there something you should look for as an individual when tracking on your watch for heart rate, like where should you aim to be on a day-to-day basis and what should you? How should you access your wearable to make sure that you're in the right track? Like give me something so I don't wear one.
Speaker 2:So oh, okay, okay, that's actually unusual for someone who's you know like an athlete to not have a like, a garment or something like that you know why.
Speaker 1:The reason I don't like the obsessiveness over it.
Speaker 2:Yeah, it makes sense. Yeah, actually, from an athletic like, from an athlete's point of view, I think the obviously heart rate is something many pay attention to. Many very athletic individuals tend to have sort of parasympathetic dominance over sympathetic, so their heart rate could go, you know, like marathon runners, tend to be as low as 40s to 50s. But I think the area that certain device companies like Whoop has popularized is this idea of heart rate recovery or this recovery, and that's the idea of heart rate variability and that's what people often pay attention to. And it's probably an area that's relatively understudied, believe it or not, because there's a lot of variations between people and also dynamic changes that you get from heart rate variability, and there's also multiple ways of assessing heart rate variability. There's at least 60 plus heart rate variability measures that are out there, and you know so. Heart rate variability has been around since the 1980s, or actually as early as the 1960s to 1970s, but the one that has actually been popularized most frequently is RMSSD. So the root mean squared of the successive differences and what they're doing is they're assessing the time between each beat and then figuring out how different it is for that, you know, inter beat interval, and then that gives you an indication of what's called the respiratory sinus arrhythmia. This is going to be a little scientific speak, but maybe I'll.
Speaker 2:Yeah, so respiratory sinus arrhythmia is the is the physiology behind that. You see the changes that you see in heart rate that's associated with breathing. So when you breathe in, your heart rate goes up and as you breathe out, your heart rate goes down. And how that works is that. That is predominantly.
Speaker 2:Yeah, most people would think that when you breathe in, your heart rate goes up because your sympathetic system is activated and as you breathe out, your parasympathetic is being activated. But actually that's not the case. What's actually happening is that when you're breathing in, your parasympathetic is being withdrawn, so there's like an attenuation of your parasympathetic and so the sympathetic tone that's there is unbalanced, like it is, so it is unimpeded. So the heart rate goes up and as you breathe out, their parasympathetic goes. It gets back in, you know, in tone, and so it causes your heart rate to go down, to get that go down.
Speaker 2:So this, the changes that you get with breathing, is causes this respiratory sinus arrhythmia, and this respiratory sinus arrhythmia is a marker of your parasympathetic nervous system, simply because that's the part that is being modulated as you breathe. So, and that's that's why you know, know, when you're exercising or if you're stressed, your parasympathetic is obviously going to be withdrawn or it's going to be much lower compared to their sympathetic, and that's sort of a marker of heart rate variability, low heart rate variability. And that's what athletes look for to see if they're over trained, um, and you know, probably should take a break and recover I love that, and and just for layman's terms, just for those listening, what's the difference between parasympathetic and sympathetic?
Speaker 2:Yeah, so parasympathetic. So those are two branches of the autonomic nervous system. It's the nervous system that's responsible for the unconscious control of your body, and so you know, like you're not thinking about how your gut works, how to produce urine, and so you know, like you're not thinking about how your gut works, how to produce urine or even sometimes how you breathe. I mean, breathing is a little unusual because it has the conscious component and the subconscious component as well. But the autonomic nervous system has these two branches, actually have three branches, which is the enteric nervous system, which I'm not going to talk about, but the two branches are the sympathetic and parasympathetic. And the parasympathetic is, you know, known for the rest and relaxation, recovery.
Speaker 1:The sympathetic is the fight or flight response part of the autonomic nervous system. Gotcha, thank you for that. Yeah, so yeah, it's very interesting. You're just looking for heart variability, right? You want to see your heart rate, like you said in the beginning, going based off your circadian rhythm yes, that one actually is a different uh rhythm.
Speaker 2:So so the heart rate variability that we we see in the watches and everything that's talking about the respiratory science, for them, yeah, that's very short term, that's like, you know, uh, every uh, that's kind of like the rhythm, I think. It's like, um, I'm trying to recall it's like four seconds to seven seconds or that. That's the cycle but which they focus on. But then there is also a longer term fluctuations that you get, um, which includes the circadian rhythm doctor okay yeah, so that that's.
Speaker 2:That's different. That's so your heart rate, your r, rmssd, or the heart rate variability, is not necessarily going to reflect the circadian rhythm of that necessarily. But it gets really complicated because RMSSD, which is the heart, like short-term heart rate variability, is further modulated by your circadian rhythm. So your heart rate variability does indeed go down at night, but it's different than your heart rate going down.
Speaker 1:Gotcha Makes sense.
Speaker 2:Or heart rate variability goes up, I'm sure. Sorry at night, Sorry, it's the reverse.
Speaker 1:Yeah, of course, even longer. Yeah, gotcha, I love it. Thank you for that. And then, kind of the really take this back. And for those that were watchers, I'm sorry to really take this back, and for those that wear watches, I'm sorry. What are those rings? What are they measuring? What are they set at? Is it different for every wearable? Like I said, I don't wear one, so just you explain it to me.
Speaker 2:Yeah, those rings, you know. I think the most popular one is Aura Ring, which many people know about. Actually, there are a lot of them, I don't. One is Aura Ring, which many people know about.
Speaker 1:Actually, there are a lot of I don't mean the Aura Ring like on your finger, I meant like the rings on the watches. People want to complete them. It says oh, you completed it, like the circles they're completing.
Speaker 2:Oh, got it. Actually, I'm not aware of those.
Speaker 1:Maybe you're talking about the step count, so you have a certain goal and then if you have different goals for different things associated with it, and then they hit it and they get, their watch goes off and they're like congratulations, you're in today's Target.
Speaker 2:Yeah yeah, I I don't know. I mean that that's just kind of like a way to um for these device companies to sort of have you a little bit more addicted or paying attention to your watches, so that you're.
Speaker 1:This is why I don't have one.
Speaker 2:Yeah, I know, I know. So yeah, I guess that's what it is and it's arbitrary. I guess the step count that everyone talks about is 10,000 steps, and I'm trying to recall where that actually that number came from, but apparently it was not based on any major study, you know.
Speaker 1:So you know, do a whole episode on that, okay, cool, but I'll give the category. Yeah, 10,000 was actually literally picked out of the blue because it sounded good, because it was a nice whole even number. But the average American gets anywhere between 2,000 to 3,500 steps a day. The recommended daily allowance to hit a bare minimum is between 5 and 5,500. And then the order to see optimal goals from steps is 13,000.
Speaker 2:Oh, okay, and how do they determine that? Is that determined based on like, obviously like mortality long term? I wonder how they study that it was based on mortality.
Speaker 1:Okay, Was the one they were looking at which makes sense. I mean, if you're walking 13,000 steps I mean going off of what my phone says once in a while, I burn like 1000 calories doing that. So if you're burning 1000 calories while walking and then you're burning your BMR, which is whatever your resting metabolic rate is, and then if you're exercising on top of that, you can be burning three 4,000 calories.
Speaker 2:Yeah, plus all the food consumption.
Speaker 1:We're getting in Right, right. So it's very, very interesting to see that I have a question and maybe my audience doesn't want to hear this, but I'm curious how accurate is the heart rate measured off a watch? Because I know when testing people like ourselves, we're going up here I mean we can get down here and you're on our pulse, but like it's difficult, and then it's just sitting on top Like how accurate is that heart rate?
Speaker 2:Yeah, you ask a really good question and, if you don't mind, I might go into a little bit of the science behind it.
Speaker 2:Yeah, please, yeah. So they're not the heart rate off of these. Watches are based off what's called a PPG photoplethysmography. So if you notice, you don't have a smartwatch, but if you have a watch, you notice that the green light turns on and occasionally the red light turns on on sort of the back of the watch. Actually, I'm not sure if it turns on for my watch. Actually it is on right now, but it's green, you can see it's sort of flashing like that. It's green, you can see, it's sort of flashing like that.
Speaker 2:What it is doing is it is sending out light and then it sends out that light, and then that light it's a pulse of light, and then it gets reflect back to the sensor, which is on the same side, so on the back of your watch. So this light gets reflected off your skin and back onto the sensor, and what happens is particularly for green light. So hemoglobin absorbs the green light, the frequency of light that's associated with green pretty well, and so what happens is that if there's more blood flow through the area under the skin, then you're going to get more absorption of the green light and there's going to be less light reflected back or scattered back to the receiver, the sensor on the watch, and so it's sensing that, and so what's actually sensing is the volume of blood under the skin, and you may also notice. So the green light is often used. Because the green light is pretty good, it actually doesn't get scattered much. It's like halfway in the spectrum, like you have blue light on the other side, which is high frequency light, and then you have red on the opposite side and green is right in the middle, because it absorbs hemoglobin well but also scatters less. It's able to penetrate a little deeper than blue light, for instance, because it doesn't get scattered as much. And so the green light is the one that measures your heart rate.
Speaker 2:However, the red light is the one actually, you see, when it comes on, is actually measuring your oxygen saturation, because the red and the infrared light is the way it's absorbed differently, dependent on whether the hemoglobin, which is the compound that binds oxygen, is bound to oxygen or not. So whether it's a, you know, oxygenated hemoglobin or deoxygenated hemoglobin, not. So whether it's a, you know, hemoxygenated hemoglobin or deoxygenated hemoglobin. So if you put two lights on to this hemoglobin, they get absorbed differently based on how much of the blood is oxygenated or not, and so the red light, when it's turns on it, measures your oxygen saturation. So, whether it's like above, if it's 95% oxygen saturation or so, so the green light measures your heart rate. The green light measures your heart rate. The red light measures your oxygen saturation. So your question about I'm sorry, this is a long answer to your question, no, that's awesome. Yeah, so the answer to your question is how accurate with it?
Speaker 2:Now, the problem with the green light is that it goes only very superficially. When we go into the hospital to get your oxygen saturation heart rate, we have a what's called a transmitter oximeter. So what it does is you have something that's latched onto your finger. You have one side, usually on the back of the finger. You have light, red light that then subsequently shines completely through on the other side to have a sensor. So it's called like the light gets completely transmitted through and then the sensor sort of determines like is influenced by the blood that goes through the finger, and so those tend to be more accurate compared to the watch, which has the sensor on the same side as the light, where the light is coming from. And so what happens is the light shines and it gets reflected to the sensor and the same side as the light, where the light is coming from.
Speaker 2:And so what happens is the light shines and it gets reflected to the sensor and the green light, because of the nature of it, it only assesses, basically, the blood flow at the very superficial part of the skin, so I think it's like a few millimeters.
Speaker 2:So what it is is assessing the blood flow in the very, you know, on the superficial parts of the skin. And so what happens is that if you, for instance, get too cold and so your vessels constrict and your skin is not getting in much blood, or if you're moving around a lot, where the watch is compressing the skin because you're running or something like that, it's going to affect the blood flow under the skin and it's going to cause problems with the signal that you get to measure heart rate. And so this is why PPGs aren't all that great when it comes to heart rate measurements or even heart rate variability measurements. When you're exercising because that's when you're sort of moving a lot the watch is compressing the skin. The skin is, you know, the blood flow through the skin is what? The heart rate, what the device is assessing? To assess heart rate and heart rate variability.
Speaker 1:So then, two questions off of that. The first one is would it be dependent also on people who have deeper veins, like those that don't lift or work out whatsoever compared to those that are constantly doing strength training, are very vascular? Would that make a difference?
Speaker 2:Yeah, that's a great question. I think from my experience no, not really. I think what it is is that you know the skin generally. You know skin, in order to remain healthy, needs to get blood flow, and so you're going to have arterioles, small capillaries that sort of go that deliver, that exist in the superficial parts of the skin to deliver nutrients so that your skin can sort of, you know, continue to grow, protect.
Speaker 1:But what if the person has, let's say, type 2 diabetes and they're not getting that kind of flow right?
Speaker 2:Yeah, usually, you know, that's a great question. I think maybe in certain individuals who have really bad blood flow superficially, then you may have problems with the heart rate. You know having these devices. But in general I think that you have to really be at almost pretty sick to have that consistently, because you need a certain amount of blood to your skin in order to be alive.
Speaker 1:Very interesting. And the second question is why don't you'll know this? Why don't? If you said putting it to like through the skin is more accurate, right? Why don't they have a separate receiver on the opposite side so it does go through?
Speaker 2:Probably a number of factors. Well, first of all, for the finger it's easy because it's shorter surface area, Short and thin, yeah. For the wrist, you have bone and the bone is the end muscles, and so you have a lot, not only a long, longer distance for the light to travel, but you also have structures that sort of impede transmission of light. That's one reason, but the other major reason is that a lot of these device companies want to make sure that you know people are wearing these devices and not have to charge it every minute, because the amount of light and to make sure it transmit through the other side to the sensor would be quite a lot. It would be quite intense and that's going to consume the battery and by the time you get a few heart rates you'll need to recharge the battery again. So that's the issue.
Speaker 1:Interesting. So then, going back to what I originally thought I was talking about, the Aurora ring right, that's the one that sits through your finger like a regular ring. Is that then more accurate? Because I'm assuming on that the light goes straight through.
Speaker 2:It does not actually so it still uses the green light yeah yeah, it does not actually.
Speaker 2:So it still uses the green light.
Speaker 2:Yeah, yeah, it does not. So if you notice, like the light that comes out of the O-ring, it's not that strong, and so it's still green light too. So the green, you know, it's not red light. So red is needed in order to transmit through, because red is the one that's able to penetrate through, and this is why, like when you're in the dark and you shine a flashlight in front of your finger, your finger looks red, because it's only the red light that passes through your finger. So the same thing is that, you know, I think, they only use green, and so it's only getting the superficial layers. And the reason Aura, or many of these ring companies that are coming out, feel that the finger is best is because the capillaries, the small vessels, are much more superficial on the palm, like, particularly on the palmar aspects, and so, you could see, it's just easier to get a better PPG signal from the finger, and I think that's the theory from which they sort of chose to go for the finger as opposed to the wrist.
Speaker 1:So then, just to kind of educate guests here and please correct me if I'm wrong- yeah. Wearables in and of themselves for athletes probably not overly accurate, but the general public? It's going to give you a good idea of where you're at and still, if it's off by a little bit, you're going by law of averages. So you know you're on the right track to get healthier by doing more, starting to see a drop. It's not perfect, but it shows you a good baseline of where to get. Is that fair?
Speaker 2:Yeah, I would say that's fair, although I think this is an evolving area. I think this is the first time that we've been able to get this much data continuously and, like our company, for instance, partners with Garmin, for instance, and Garmin enables us to get data from the watches continuously, 24 hours a day, seven days a week. Most watches don't do that right, so they get the data intermittently, but now if we have the opportunity to get heart rate like continuously 24 hours a day, then we can start evaluating certain patterns. That wasn't there before and we're finding out that there's a lot of things that can affect heart rate variability. That you know interesting, like obviously stress can affect that, so your heart rate variability goes down.
Speaker 2:But it also is a marker of what's called emotional regulation. So those individuals that have higher heart rate variability, based on RMSSD, have a tendency to have better emotional regulation. In other words, your prefrontal cortex, which is sort of your thinking part of your brain, is able to subdue sort of your subconscious instincts. You know, if you're angry, you get frustrated, anxious. There's a part of your brain that sort of subdues that and apparently that ability is correlated with your heart rate variability. So the more the higher your heart rate.
Speaker 2:Yeah, so I mean, that's only recently. That's sort of I think there's some studies, but I think it needs to be validated further. But this is why you know Navy SEALs, a lot of the special forces, they're focusing on heart rate variability because that's a marker of your ability to perform in sort of high stress situations.
Speaker 1:so which you see like you're. You put yourself in a high stress workout, for example, like, can you control yourself enough to get through? You can't overreact like I do spartan races going 13 miles, that's not. Oh. I lifted this up and put this down like, okay, I gotta control my emotions and push myself through this to get through it, right, yeah. And then you see it a lot with just teenagers your, their prefrontal cork test isn't complete, isn't grown completely, so they overreact a lot more to a lot more things and, oh, this is the end of the world. I'm done as someone that has it complete after the age of 25, and they're able to really, okay, okay, I get this, I get this, I get this. Even those that are untrained, like you go. Untrained individuals. They tend to give up a lot quicker. They tend not to push themselves through, but they can become trained to teach that response that's right.
Speaker 2:Yes, absolutely. Um, yeah, so it sounds like you have kids, or? Do you have kids or no? I don't I just talk about this a lot, okay, okay, all right, uh, yeah, um yeah, I guess, as, as a parent, you you'll, you know, you'll go through that teenage stage when yes, I was a psychology major and I owned two gyms, so I probably should have prefaced that.
Speaker 2:Okay, got it, got it, yeah. So, yeah, yeah, certainly, that's the interesting part it can be enhanced. So there's a part of you that so you can enhance your heart rate variability and actually, interestingly, by the act of improving your heart rate variability, there seems to be evidence that you actually are improving emotional regulation. So it's a two-way street. It's not just because your emotional regulation is good that your heart rate variability is good. It's actually, if your heart rate variability is good, then it actually may improve your emotional regulation.
Speaker 2:And you know this is why sometimes meditation you know, certainly professional athletes do this a decent amount, because they realize that you know, in order to enhance, like you know, to think and under stress, to rationalize things, but also to think very quickly, you kind of need a very balanced autonomic nervous system and and so meditation is an important way of doing that. And, and I guess the best way to do apparently is to breathe every 10 seconds, so five seconds in, five seconds out, and if you continue to do like 20 minutes a day or something like that, then that apparently can train your bear reflex, all the parts that makes up, sort of your heart rate variability number, that that can be enhanced.
Speaker 1:Uh over time. My wife tells me I never get mad. It's like a great emotional control, probably better than most people I know. Yeah, I contributed to practice, like you said. Like I'm in a business, constant stress, so it's trying to learn to control that. I work out consistently, not every day, I don't overtrain like you said, but I get five days a weekend. I know where my body needs to go, I see it. If I don't work out and I just let stress bundle up, my emotional control dwindles. But if I focus on my sleep, I focus on exercise, control the windows. But if I focus on my sleep, I focus on exercise, then I notice my worst control gets way better and I just don't have those outlashes.
Speaker 2:Yeah, yeah, it sounds like. Do you listen to your body, like you, obviously, when you feel like you know, when you're overtrained, you know that you're tired, so then you, basically you're like the perfect example of how you should sort of live day to day. It's just like listen to your body, sleep well, sleep is really important because that's how you restore your personality.
Speaker 1:Let me be clear, I am not perfect.
Speaker 1:I don't want anyone thinking that I am definitely not. I have my life. Here's a great example and I don't mind. I think in the United States I had sleep apnea and like that's something like I have and it screws my sleep up Like I feel it from last night. I know certain things, but I think, because I know that I'm way more like 930, got to go to bed. I got to keep it perfect because I don't want to feel like when I wake up in the morning I hit my bus Right right, I'm curious, since you don't have a watch, I'm still curious to see what your heart rate variability would be right now?
Speaker 1:Yeah, I have no idea. It'd be interesting to see that range. I know I test my heart rate every six months, once a year. I know it's not heart rate variability, but it doesn't really. If it goes above 80, I'm sick. Yeah, I know it's not heart availability, but it doesn't really. If it goes above 80, I'm sick. Yeah, yeah.
Speaker 2:But you do. You do have a point. I mean, like there there is limitations for these watches. Like if you pay too much attention to it, then that can add stress to some people. So it you know there's a balance to all of this obviously.
Speaker 1:I know I see it a lot. I see people stress about getting little things on their watch and I'm like you're doing the opposite of what you're supposed to be doing. Stop stressing.
Speaker 2:Yeah, it's really bad for sleep, because those people who have trouble sleeping, they're anxious about not getting a good enough sleep, and so when your watch tells you exactly that, then it's just reinforcing their fears and it just goes in the cycle.
Speaker 1:So I agree with you on that one. Yeah, what do you think, because I know we're going to start wrapping this up where do you think this technology is headed? What do you think is the next big thing that's going to come out, that's going to hit the market and it's going to be either good for research or good just for general usage.
Speaker 2:Yeah, that's a great question. I think more and more things are coming out in terms of physiological markers that could be assessed. So we're used to heart rate, step count, you know activity, oxygen saturation, but more recently, temperature is becoming, you know, available in certain devices or rings, for instance, can do that. I also think they're probably going to be in the next three to five years some way to assess glucose using some topic, you know, optical technology, as opposed to sort of having a needle like a continuous glucose monitoring. I think there's going to be improvements in technology so that we get additional data that we didn't get before. So that's one thing, but the second part is actually trying to figure out what to do with all this continuous data like this very rich data that we've never had before and we're, for instance, for heart rate. I mean, that's the something that we've been able to get for years, but it's only recently that we've gotten a lot of data on that and we're finding that there is a lot of complexity in heart rate.
Speaker 2:And I could spend a whole nother sort of podcast talking about nonlinear dynamics, chaos theory, this idea of fractal physiology. That also is completely new, and this is idea of sort of like scales, like multiple scales, and your heart rate actually being responsive to multiple components of your body that operates at different timescales. So, for instance, your heart is responsive to your breathing, as we talked about, but it's responsive to your cardiovascular system, so, like your vascular system, so the renin angiotensin, it's sensitive to your metabolism. Your temperature is responsive to your, your day to day cycle. It's could be, you know, sensitive to your monthly cycle if you're a woman. So there's that rich data that the heart actually reflects all that complexity in your body, and we have yet to sort of understand the intricacies of all that. And I think that's going to be the next stage of sort of changing the way health is looked at.
Speaker 1:Can I give you a personal trainer? Thing that we want done.
Speaker 2:Yeah.
Speaker 1:Some way to accurately measure BMR. I know there's breathing tests you can do to get it very accurate, but I'm talking just simple, day to day. Someone's wearing a watch showing how many calories a day they're actively burning at rest. Because on the watches, just so. Everyone knows it's not accurate. It goes off the Harris-Bennett equation. Yeah, exactly.
Speaker 2:That's the right equation, right? Yeah, I don't remember the equation, but yeah, you're absolutely right, it's not accurate. I think it's based on BMI or something like that. I forgot what it was.
Speaker 1:Yeah, so I would love something like that, and I know that's totally just selfish but if anyone can do it, you can right.
Speaker 2:Andrew, I don't know about that, but it's duly noted. I think that's something that we'll have to think about. Yeah, it'll probably entail temperature, carbon dioxide, oxygen. Whatever. There's going to be an exciting project to pursue.
Speaker 1:Yeah, muscle mass something, how much body fat someone has's gonna be. It's gonna be fun. I have a feeling you could do this, though, but anyway, I'm gonna ask you the final two questions. I said everybody. The first one is if you were to summarize this episode in one or two sentences, what would be your take-home message?
Speaker 2:uh, I would say that heart rate, heart rate variability, um have um that you get from the devices have some limitations, but it has a future in terms of the way like we've only touched the surface and understanding the intricacies of that. And I would say that digital health in general is a promising area and I think it's a paradigm shift. It's like learning to deal with data that's not just intermittent or sporadic, it's not like once a month or once every year. We're now dealing with rich data and this will enable us to sort of advance health and fitness in a different way.
Speaker 1:I love it. And then the second question how can people find you, get a hold of you and learn more about your company?
Speaker 2:Yeah, you could check our website, labfrontcom, and we're primarily surveying clinical researchers. But if they're an athlete who is very interested in studying your own physiology, yeah, just check out labfrontcom. And yeah, you could possibly also email me at andrewatllabfrontcom. I guess that's the best way to reach me.
Speaker 1:I love it. Thank you, andrew, for coming on. Thank you, guys for listening to this week's episode of Pop the Fitness Redefined. Don't forget, hit that subscribe button and join us next week as we dive deeper into this ever-changing field and remember fitness is medicine. Until next time, time. Outro Music.
