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Want to know what works for treating overweight and obesity?

This past week, the National Academy of Medicine (NAM, formerly Institute of Medicine) hosted two events in which I participated: (1) a full-afternoon discussion on obesity prevention and management, (2) a full-day workshop on treating overweight and obesity.

The afternoon discussion occurred through the Innovation Collaborative known by the awkward abbreviation, ICSSPMO (Integrated Clinical and Social Systems for the Prevention and Management of Obesity). As with all NAM collaboratives, ICSSPMO is comprised of national experts representing diverse stakeholder groups. Im not at liberty to share the specifics from ICSSPMO meeting at this time, but rest assured big ideas were discussed that will be ready for wider dissemination soon. I have no doubt that the models and initiatives under development will translate to better care for obese patients and improved health more broadly for communities.

What I am at liberty to share from the NAM last week is the content of the full-day workshop: The Challenge of Treating Obesity and Overweight - Learning What Works and Making it Happen. The workshop was hosted by the Roundtable on Obesity Solutions of NAMs Food and Nutrition Board. It focused on treating obesity (including severe obesity) in adults and children, as well as where things stand and how to move forward in terms of obesity providers, payment, and policy.

Below are some high-level highlights from the day. Full details will be available soon on the NAM website in a full slide deck of presentations and complete video.

If behavioral treatment were a drug, it would be approvable, was one emphasized lesson from the NAM workshop. Unfortunately, the type of behavioral treatment offered most often in primary care offices is not effective. This treatment can take the form of little more than simple advice to eat less and move more, which is not at all helpful ... and in fact creates and blames victims.

Effective behavioral treatment entails not just advising patients what to change but how to change. It includes guidance on stimulus control, goal setting, problem solving, stress reduction, self-monitoring, and relapse prevention.

Intensity of treatment matters too; the more treatment contact (the less patients have to struggle on their own), the better. Intensive lifestyle interventions (e.g., around diet, exercise, sleep, stress reduction, etc.) produce meaningful weight loss and other health benefits.

But even with well-designed, high-intensity lifestyle interventions for behavior modification, there are currently disparities in outcomes. Patient age matters as children are not just little adults and their growth and maturity play roles in success. Race/ethnicity plays a role too as there are racial ethnic disparities in intervention effectiveness (although, reassuringly, disparities tend to diminish over time).

When behavior modification isnt enough, there are weight-loss medications to considernine of them, in fact (five for long-term use). At least that is the case for adults. In children, only two meds are approved for use (or three if you consider kids who are 16 years and older).

Weight reduction early on with medication predicts later success. But effectiveness for the different drugs varies and some side effects can be unpleasant (for adults or children)e.g., flatulence, stomach pain, and greasy anal leakage. Emerging medications may be more personalized, less problematic, and target novel pathways including gene mutations.

Failing behavior modification and medication alone, surgery may be an option. Of the three most common procedures, gastric bypass (Roux-en-Y) seems to be more effective than gastric sleeve (sleeve gastrectomy), and both procedures are more effective than gastric banding (a.k.a. lap band). For all surgeries, the safety has improved dramatically over the years and the complication rates have gone downfor adults and kids.

For kids though, decisional capacity and physiologic maturity are issues. Nonetheless, high-quality evidence supports weight-loss surgery in a pediatric population. In fact (as in adults) bariatric procedures or often termed metabolic surgery because a variety of factors like blood sugar, blood pressure, and cholesterol improve after surgery, largely independent of weight loss.

There are also several less-invasive procedures that are now approved, like gastric balloons, nerve stimulators, and tubes that suck stomach contents into external containers. At the present time, it is not fully clear what the role is for these emerging (and not always pleasant) options.

For the severely obese, combinations are neededcombinations of therapies (with medications added after bariatric surgery to a backbone of behavioral management, for instance) but also combinations in treatment-team members (which might include surgeons, gastroenterologists, obesity medicine physicians, dietitians, psychologists, and various support staff).

In spite of solid and growing evidence for behavioral interventions, medications, and surgery, there are still unanswered questions. For example, can we deliver effective behavioral therapies through modes of contact that are not in-person (e.g., telephone, text, remote sensors and various apps)? What is the long-term efficacy of medications? How do drugs and surgery work in disparities populations? What are the predictors of response to any treatment (demographic, genetic, etc.)?

Several presenters emphasized a need for greater infrastructure, training a provider workforce with specialized knowledge of obesity. Obesity Medicine is the fastest growing specialty field in medicine, and there needs to be additional fellowship opportunities. Also, all physicians need greater training in obesity, and testing for minimal competencies (of note: the current U.S. Medical Licensing Exam lacks any meaningful coverage of obesity).

Physicians need to understand obesity as a complex chronic disease (like hypertension or diabetes), not a moral failing. And allied health personnel, like nurse practitioners, physicians associates, and social workers, would also benefit from training (and certification).

All providers should be knowledgeable about disparities and inequalities, and all should use patient-centered, non-judgmental, patient-first language (e.g., the patient who has obesity [affliction] not the obese patient [stigmatizing identity]). Those providing primary care need not provide all interventions but should know what is out there and be able to link to obesity medicine specialists.

There were anecdotes of elected officials misunderstanding obesity as a problem of deficient will power, and one made worse by government handouts like Food Stamps (not my words, but very nearly a direct quote of one Senator). Policy makers need to understand that obesity is much more complex than mere calorie considerations. In fact, focusing on calories might mislead and harm public health.

For policy, there is urgency, related in no small part to growth in childhood obesity. Elected officials need to recognize that children develop the same weight-related problems as adults (e.g., diabetes, hypertension, high cholesterol) but carry them longer and have additional unique issues to bear (like orthopedic problems from extra weight burden on immature skeletons). Childhood body weight predicts preventable disease and premature death in adulthood. And beyond health implications, the cost considerations of increasing obesity and obesity-related chronic diseases (for individuals and our society) are staggering.

Given the substantial costs, it is not hard to make a case that treating obesity would be a good return on investment. Payers, of course, have to consider various factors in covering services, but when the same payer bears the cost of the intervention (e.g., medication) and the cost of not treating (e.g., worsening diabetes, hypertension, high cholesterol, arthritis, depression, respiratory illness, etc.), it is hard to understand pervasive coverage denials and ubiquitous prior-authorizations. Still, that is the current experience in practice. Emerging policies, like the Treat and Reduce Obesity Act for Medicare, might help move insurers across the board to better coverage for a variety of obesity treatments.

In the interim, we know a lot about what works (what really works) for the treatment overweight and obesity. As a society, we just need to do a better job of making it happen.

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What works (what REALLY works) for treating overweight and obesity - Huffington Post

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Evolving trends dietary guidelines, moving to new plate visual by Rupa Nallamothu | Apr 10 2017 | 21 hours ago

The food pyramid, a product of the Dietary Guidelines for Americans, represents the optimal number of servings per day from each of the major food groups. The government uses the food pyramid to communicate healthy eating guidelines to families, children and adults. The U.S. Departments of Health and Agriculture collaborate to produce the guidelines, which have changed over the past few years.

Within USDA, the Center for Nutrition Policy and Promotion is the lead agency that manages the process with support from the Agricultural Research Service, professor of medicine Anna Maria Siega-Riz said.

In 2011, MyPlate replaced the original food pyramid structure with a diagram of a plate separated by food group. MyPlate currently serves as the the basis for federal food and nutrition policy, with the new diagram enabling guidelines to focus on each consumer individually.

The change from the food pyramid to MyPlate marked a shift from a nutritional diet to a personal approach. Instead of referring solely to serving sizes, appropriate proportions of each food group are outlined in relation to that of the other groups.

Food groups represented in MyPlate include grains, fruits, vegetables, protein and dairy. For women 19 to 30 years old, the diagram recommends two cups of fruit, six ounces of grains, two and a half cups of vegetables, five and a half ounces of protein and three cups of dairy products daily. The dietary recommendations for men in this age group are similar, requiring only an additional ounce of protein and grains and an additional half cup of vegetables.

The guidelines specify that the grains group should be further divided into whole grains and refined grains. Based on the diagram, refined grains intake should be limited to half that of whole grains. Furthermore, the consumption of saturated fats should be limited to less than 10 percent of total daily caloric intake

Disagreements between consumers or industries and the government often arise relating to the guidelines endorsement of certain foods. In 2015, when the Dietary Guidelines for Americans Committee almost did not endorse red meat as part of the healthy diet, the meat industry came into conflict with the DGAC.

There was a strong political backlash from the meat industry [in 2015], led by the North American Meat Institute, which also strongly opposed the DGAC recommendation to take environmental sustainability into consideration when making dietary recommendations. Ultimately these sustainability provisions were not included in the final Guidelines, Politics Prof. Paul Freedman said.

The DGAC puts out healthy eating recommendations with the intent of helping individuals achieve and maintain a healthy weight, decreasing the prevalence of diseases and promoting an increased level of health for everyone two years and older.

The food pyramid was the governments translation of the Dietary Guidelines into actionable consumer messages that [are] crucial to help individuals, families and communities achieve healthy eating patterns, Siega-Riz said.

The primary purpose of food diagrams is to prevent disease. Specifically, the guidelines seek to prevent diet-related chronic diseases, such as cardiovascular disease, type 2 diabetes, certain cancers and obesity.

The guidelines are reevaluated every five years. Since the guidelines are based on nutritional science and surveys of the population, the DGAC publishes reports based on their research findings and justifying the information within MyPlate. Currently, guidelines focus on eating patterns due to recent research suggesting most Americans do not consume a diet reflecting the DGACs recommendations.

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Bringing an individualized approach to diet - University of Virginia The Cavalier Daily

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April 10, 2017 12:42 ET | Source: YourUpdateTV

video-release

NEW YORK, April 10, 2017 (GLOBE NEWSWIRE) -- There is a nutritional gap in America, a disconnect between what our bodies are getting and what our bodies actually need. A recent study suggests that 60% of Americans report they have a healthy diet and yet 94% of Americans fall short of dietary recommendations. Recently, Dr. Tieraona Low Dog, Health Expert and Author of National Geographics Fortify Your Life: Your Guide to Vitamins, Minerals and More, teamed with YourUpdateTV to discuss this troubling nutritional gap and what we can do to close it.

A video accompanying this announcement is available athttp://www.globenewswire.com/NewsRoom/AttachmentNg/cfa8ac84-42ff-428d-aaa1-b527e34dd720

When it comes to eating well, Americans may have good intentions, but the truth is that many of us fall short of an ideal diet. It is extremely difficult to get all the nutrients we need on diet alone, even when we do our best to eat well. More than two thirds (67%) of adults believe they can get all of their nutrients by eating a healthy diet, which simply may not be realistic.

Despite this challenge, many adults are not taking advantage of multivitamins which can go a long way towards closing the nutritional gap. In an effort to address this significant nutrition and awareness gap, MegaFood is asking Americans to make 2017 the best year yet by pledging to improve their own life by taking a multivitamin and help support someone in need with a 1-for-1 pledge and product donation.

The MegaPledge campaign is a first step towards curing nutritional poverty, shedding light on the fact that most Americans are just not getting what they need in terms of nutrition. Additionally, MegaFood is teaming up with Wholesome Wave, a non-profit organization that will donate two servings of fruits and veggies to someone in need for each pledge made.

Formulated by Dr. Low Dog, each MegaFood multivitamin offers 70% or more of the suggested Daily Value intake of key nutrients in just two tablets, and features the active form of B6, methylated B12 and folate, vitamins K1 and K2, and choline based on her recommendations for optimal dietary supplementation.

For more information, please visit MegaFood.com/MegaPledge

About MegaFood Fresh from farm to tablet, MegaFood is as real as it gets. Since 1973, MegaFood has been committed to making products that use real food from family-owned farms to make a real difference, and has produced some of the most effective and award-winning supplements available today.

About YourUpdateTV: YourUpdateTVis a social media video portal for organizations to share their content, produced by award-winning video communications firm, D S Simon Media (http://www.dssimon.com). It includes separate channels for Health and Wellness, Lifestyle, Media and Entertainment, Money and Finance, Social Responsibility, Sports and Technology.

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What's Missing from the American Diet? - GlobeNewswire (press release)

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MARQUETTE, Mich. (WLUC) - It's almost beach weather and that means time to get in shape!There are several diets that can help lead to a healthier lifestyle.

The Paleo Diet or often deemed, 'Cave Man Diet,' is a nutritional diet that mimics what our early ancestors ate.

"It's basically the concept of staying clear of dairy, grains, and sugar and some of these other inflammatory foods and moving towards lean meats, grass fed meats, vegetables and fruits," said Integrated Wellness President Brandon Turino.

It's a relatively strict regimen that seeks to eliminate all processed food. By doing so, researchers claim your body will quickly begin to reap the benefits. They claim, the diet has been found to have lower rates of cancer and heart disease.

"It allows them to integrate a whole food diet that's much easier, said Co-Op Produce Employee Zachary Schneider. It's the way humans evolved to eat. It's a lot easier for us to digest. It's a little bit closer to our original diet as home sapiens."

The premise of the diet, states that human beings all share the same make-up and DNA, indicating there some foods we should and should not be consuming. While this lifestyle shift may be difficult at first, it's better to start slowly and focus on what you can eat instead of the other way around.

Some healthy replacements found at the Marquette Food Co-Op include the Couscous Salad or the Aztec Quinoa Salad. Both of these options fit into the Paleo Diet.

Some other options include a bun-less burger or vegetable pastas. But like every new diet, it will take your body around a month to adjust to any dietary changes.

For the latest News, Weather and Sports, tune into your TV6 News and FOX UP News.

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Learning the benefits of a Paleo Diet - UpperMichigansSource.com

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We've teamed up with health website Healthista.com to launch our diet survey and to give one lucky reader the opportunity to win a Raleigh Sherwood bike worth over 330

DO you have an opinion on dieting? We want to hear from you!

Whetheryou think one works better than another or you just hate the idea altogether,our diet survey covers it all.

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HEALTHISTA.COM

We have teamed up with one of the countrys fastest growing health websites, Healthista.com, to find outwhat you really thinkabout diets.

Not only can you fill it out in under five minutes, completing the survey automatically enters you into aprize draw to win the aboveRaleigh bike worth over 330.

Click hereto complete the survey and for your chance to win.

Entries close midnight Sunday 30th April 2017. Click here for full T&Cs.

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What do you really think of diets? Fill out our diet survey and be in for a chance of winning a Raleigh bike - The Sun

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There are some common-sense things you can do to fight memory problems. Not surprisingly, they involve diet, exercise and maintaining overall good health.

Studies have shown that exercise helps generate new brain cells in the temporal lobes, the data banks in the brain that store memory, according to Palm Beach Gardens neurologist Dr. Michael Tuchman.

There also are other factors that might affect all forms of dementia. They are high blood pressure, eating foods that are high in cholesterol, and diabetes, which is known to be a risk factor, even for Alzheimers itself, Tuchman said.

We know that if you eat smart less fat and more fish and if you exercise, your likelihood of expressing dementia, even of the Alzheimers type, is somewhat reduced.

You might delay the expression of the disease by a year or a year and a half. And thats a good thing, because thats another year or a year and a half that you have a quality of life.

Daily consumption of berries especially blueberries and strawberries has been linked to preventing dementia, according to Dr. James Loomis, medical director of the Barnard Medical Center in Washington. The center is associated with the Physicians Committee for Responsible Medicine, an organization that promotes a plant-based diet as a way to avoid many types of illnesses.

Blueberries have been associated with lower risk of dementia across the board, Loomis said. Its an extremely potent antioxidant.

While its difficult to prove cause and effect with diets, population studies comparing one group to another suggest there might be some validity to the connection between diet and dementia.

Women who consumed at least one serving of blueberries and two servings of strawberries a day slowed the rate of cognitive decline by as much as two years, Loomis said.

Staying intellectually engaged is another benefit.

The only way we learn something and retain it, is by making connections between neurons thats how memory works, Tuchman said. The more you put into the bank in the beginning, the more you can afford to take something out and still have something left over.

He said hes often asked if doing mental exercises delays the onset of dementia.

I think as long as you stay intellectually engaged it doesnt matter what you do. Theres no evidence that one is better than something else. When youre not intellectually engaged, that seems to produce a worse outcome.

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Diet, exercise can fight memory problems - Palm Beach Daily News

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Kate Hudson attends the 2017 'Vanity Fair' Oscar party hosted by Graydon Carter at the Wallis Annenberg Center for the Performing Arts on Feb. 26, 2017, in Beverly Hills. John Shearer/Getty Images

The recipe for Kate Hudsons awe-inspiring abs: a mix of beans, spinach and kale. In a new interview with Self, the actress, 37, reveals she has tried a slew of eating plans, from the paleo diet to pescetarianism to this Ayurvedic thing that was no nightshades and you eat real clean.

But nothing made the fitness fanatic she runs athletic apparel company, Fabletics feel better than eating vegan.

Now Hudson, mom to sons Ryder, 13, and Bingham, 5, follows a modified version of the meat- and dairy-free diet, sticking to greens and legumes two or three days a week.

If you like meat, to be predominantly plant-based is good for you, she explains to the mag. So why not be predominantly plant-based and every once in a while if you go to a great steakhouse, have a steak? I kind of try to look at it like that. (Another favorite: the veggie-based Impossible Burger at Crossroads Kitchen in L.A., which she calls one of the greatest things.)

When it comes to fitness, the Pretty Happy: Healthy Ways to Love Your Body author sticks to her tried-and-true. I love Pilates, thats always what I will do, and I know its boring but it really is the foundation of everything that I do, says the Deepwater Horizon actress, who trains with longtime pro Nicole Stuart. I believe in traditional Pilates because I think that our bodies need to be aligned, and what that does for your body is it makes it so strong.

And when shes not toning on the Cadillac reformer, the star loves to just dance it out. As she tells the mag, Any dance aerobic workout just makes me feel happy.

Can't get enough of Us? Sign up now for the Us Weekly newsletter packed with the latest celeb news, hot pics and more!

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Kate Hudson Reveals Her Best Diet Secret - Us Weekly

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Grain-free diets are one of the largest growing segments of the pet food market. More and more pet owners are choosing these diets, which are billed as more natural and less likely to cause health problems and allergies. It all sounds greatexcept that those claims are not true.

There is no reliable evidence that suggests that its harmful to feed grains to dogs or cats. Whole grains contain valuable dietary nutrients, including vitamins, minerals, essential fatty acids and fiber. Some grain products have protein that is easier for your pet to digest than some protein from meat. Even refined grains such as white rice can be beneficial for your pets health, depending on the type of diet and the pet.

The vast majority of dogs and cats are very efficient at digesting and using more than 90 percent of the nutrients from grains in the amounts typically found in pet foods. While food allergies in pets are uncommon, allergies to grains are even rarer. The small number of pets that have allergies are most often allergic to animal proteins, such as chicken, beef and dairy. Gluten intolerance is also exceedingly rare in pets. Gastrointestinal symptoms caused by consuming gluten have been confirmed in just one inbred family of Irish setters.

Grain-free diets can vary widely in terms of their nutritional profiles. Some are lower in carbohydrates, which means that they can be quite high in both fat and calories. Other grain-free diets merely substitute similar amounts of highly refined starches, such as those from potatoes or tapioca (also called cassava), in place of grains. These ingredients may provide fewer nutrients and less fiber than whole grains, and foods containing them can cost more.

Other pet food companies use ingredients such as peas, beans or lentils instead of grains to provide carbohydrates, but these ingredients are not necessarily any better for your pet than grains and may cause digestive upset in some animals.

The bottom line is that grain-free is a marketing concept designed to sell pet food, not an evidenced-based solution for helping your pet live a long, healthy life.

Submit a question to Ask the Expert.

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With concerns about mercury poisoning, is it safe to give canned tuna to cats as a treat?

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Is a grain-free diet healthier for my dogs and cats? - Tufts Now

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By Armin Rosen/JNS.org

For a millennia-old religious celebration that has little to do with physical wellbeing, the Passover holiday offers unexpected health-related opportunities.

Thanks to its eight-day ritual ban on eating nearly any food thats wheat or grain-based, the annual Jewish commemoration of the biblical exodus from Egypt imposes a mostly gluten-free diet on the people who celebrate it. Many of the foods eschewed during Passover are particularly high in gluten, notes Dr. Arun Swaminath, director of the inflammatory bowel disease program at Northwell Healths Lenox Hill Hospital in New York City.

Breads, pasta, pizza, bulgur, couscous and beer are all big sources of gluten-containing foods, Swaminath says.

Ironically, for gluten-free aficionados, the prohibition of many of these high-gluten foods during Passover also extends to typical substitutes for gluten like corn, rice and most other grains. In other words, the Passover holiday requires significant changes for everyone, which is appropriate given that the dietary restriction was created to help Jews remember and even reenact their distant ancestors ordeal.

The holidays mostly gluten-free diet wont have many health consequences for most Jews observing Passoverbut it could have some real benefits for some of them. As Swaminath explains, eight days is just long enough for a gluten-free diet to result in noticeable health gains for people who may have celiac disease without realizing it. Improvements in digestion, energy level or sense of mental clarity during a weeklong bread, pasta and beer-free holiday could indicate that someone has an undiagnosed celiac condition.

If you suddenly feel better during Passover, you should you talk to your gastroenterologist over why that might be, Swaminath recommends.

Non-celiacs could potentially see improvements during the holiday, too. Although its still a matter of scientific controversy, Swaminath says its possible some people experience what he describes as non-celiac gluten sensitivity.

There isnt a lot of agreement across disciplines about how to diagnose this or who even qualifies, he explains.

Proof for the phenomenon is entirely anecdotal. Nevertheless, significant numbers of patients have described experiencing improvements in health after cutting gluten out of their dietbut without having celiac disease or showing any clinically provable sensitivity to gluten.

Swaminath says that one possible explanation for non-celiacs benefiting from a gluten-free diet is that high-gluten foods usually also have an especially large amount of poorly absorbed sugars that introduce bacteria to the intestinal tract, causing indigestion and bloating. Even if people on a gluten-free diet dont have a gluten sensitivity, theyre still eating fewer of these non-absorbent sugars as an unintended result of reducing their gluten intake.

Before you rejoice in the potential health benefits of a mostly gluten-free holiday, you should note that there is one important food consumed on Passover that is still fairly high in gluten. Yes, matzahthe square sheet of dry and oppressively bland cracker-like matter that Jews are commanded to eat during the holidayhas plenty of gluten. So while Passover is an ideal chance to experience the potential benefits of a low-gluten diet, you will need to moderate your matzah intake. Or, as Swaminath notes, you may also consider choosing one of the non-wheat containing matzahs on the market, including oat and spelt-based matzahs.

Regardless, Passover still doesnt need to be a gluten-intensive holiday, even for observers who cant get their hands on the non-wheat stuff. While Jews are commanded to eat matzah on Passover, they arent required to eat that much of it. A small nibble during the seders, the ritual meals held on the first two nights of the holiday, satisfies the holidays matzah-eating requirement. Given Matzahs legendary taste profile, many Jews would be happy to avoid eating more of it than they absolutely need to, even if theyre not going gluten-free.

Yet a little of the bread of affliction wont hurt most non-celiacs, even those who want to experience the effects of a gluten-free diet.

A tiny exposure to gluten to meet religious observance and obligation may be reasonable or necessary, Swaminath says.

Armin Rosen is a New York-based writer and reporter.

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The surprising benefits of the Passover diet - JNS.org

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"It's very exciting because we've had so much advance in technology during such a short period," lead researcher Lisa Cadmus-Bertram said. "These trackers are such an enormous improvement over what we used to have."

For the small study, Cadmus-Bertram and her team at the University of Wisconsin looked at how the trackers worked for 40 healthy middle-age adults, compared with an ECG and against each other. The participants wore four devices during the test: a Fitbit Surge, a Fitbit Charge, a Mio Fuse and a Basis Peak smartwatch.

Compared with the ECG reading, wearable products varied in their accuracy. The Fitbit Charge performed the best at rest, measuring within 5 beats per minute of the ECG reading 95% of the time. The Basis Peak activity tracker was shown to be within 22.6 bpm of the ECG reading during the 10-minute resting test.

Although data were not provided to show readings at each measured time, Cadmus-Bertram suggested that outliers -- numbers well outside normal readings -- may have caused a wider range.

Critics, however, say that the devices are not performing up to their advertised promises and could supply users with dangerously inaccurate information.

Questions about the devices and their accuracy sparked a class-action lawsuit in 2016 over the technology in Fitbit trackers. The lawsuit was filed on behalf of people who bought Fitbits especially to help track their heart rates, whether for health reasons or to make sure they are getting the most out of their workouts. The lawsuit is ongoing.

"However accurate they may be at rest, the Fitbits are wildly inaccurate as heart rate monitors when worn during moderate- and high-intensity exercise, which is precisely the purpose for which Fitbit (in particular) markets them to consumers," said Jonathan Selbin, one of the attorneys who filed the lawsuit.

Physicians and researchers note that the trackers aren't medical devices. Selbin and others point out that Fitbit, in particular, "claims to be a 'Digital Healthcare Company' and is actively trying to get corporations and insurers to make health care decisions based upon data they collect."

Researchers and physicians said the technology has a long way to go. Dr. Nisha Jhalani, a cardiologist at NewYork-Presbyterian/Columbia University Medical Center, who was not involved in the new study, noted that the technology in ECG machines and LED-based activity trackers is entirely different.

"Electrocardiography, or ECG, involves placing electrodes on the skin surface to measure electrical impulses generated by the heart muscle itself. The LED technology used in fitness trackers is an indirect measurement looking at the changes in light reflection through the skin during each heartbeat," she said.

If you've ever worn a wrist heart monitor, you may have noticed a time or two during exercise when your heart rate read inaccurately low for a few ticks before getting it right. These hiccups are one reason, researchers say, why the range of accuracy of these devices is so wide.

"A tracker will give you the occasional crazy reading, but most of the readings will be quite a bit closer than that," Cadmus-Bertram said.

Overall, researchers and experts are encouraged by the improving technology and continue to promote the use of fitness trackers to provide more information about a user's health.

"Fitness trackers are a great way to make people aware of their activity level throughout the day," Jhalani said. "Oftentimes, our perceived activity is much more than actual time spent we spend moving, especially people whose jobs involve sitting at a desk for hours at a time."

Heart rate data, she says, can be an empowering tool that can allow users to be more aware of their heart health and overall fitness.

"It is good for people to see their heart rate, both at rest and with exercise. Low resting heart rates, in the 60 to 70s bpm range, are considered generally healthy. High resting heart rates, especially when close to 100 bpm or higher, can be a sign of high stress levels or other medical conditions," Jhalani said.

"How quickly the heart rate goes back to normal after exercise also holds a lot of information. Quicker indicates better cardiopulmonary fitness level."

The compact, convenient and more stylish design achieved by using LED technology versus ECG comes with a few tradeoffs.

"LED technology can be affected by variables such as how loosely or tightly the tracker is worn, the user's skin tone or any other interference between the sensor and the skin. It can also become inaccurate with motion, which is why it doesn't fare as well as ECG with exercise," Jhalani said.

In response to the new study, Fitbit said in a statement that its trackers "are not intended to be medical devices and, unlike chest straps, wrist-based trackers fit conveniently and comfortably into everyday life, providing continuous heart rate for up to several days without recharging (vs. a couple hours at a time) to give a more informed picture of your overall health."

Representatives from Mio also emphasized that the product is a consumer device. "We need to make understanding heart rate easier for the average consumer," the company said in a statement. "This opportunity defocuses the importance of needing to know the exact heart rate at any one time, and rather put emphasis on understanding what getting your heart rate up does for your health over time."

Representatives from Basis could not be reached; the fitness tracker used in this study was recalled in September. According to the company's website, the recall is "because the watch can overheat, which could result in burns or blisters on the skin surface."

As a commercial product, Jhalani said, the overall impact is a positive one. "I think it keeps people from becoming complacent and empowers them to work towards a healthier lifestyle."

"While you wouldn't want to rely on a commercial tracker if you need absolute precision during exercise," Cadmus-Bertram said, "there's also no reason for the general public not to use it for feedback and motivation."

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Fitness trackers' heart rate monitoring accurate enough for most, study says - CNN

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