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Interview with Bob Summers about HealthKit and Fitness Apps

A long-time digital entrepreneur, Bob Summers has founded several startups over the last twenty years. His current endeavor, Fitnet, helps individuals achieve their health goals by providing easy-to-access fitness sessions through their mobile device (currently available in the App Store). Some of Bob’s previous startups include TechPad, EnergyWare and the nanoCom Corporation. Aside from being an online entrepreneur, Bob partakes in community and economic development as a member of the Board of Directors for the Roanoke – Blacksburg Technology Council and Virginia Tech Entrepreneur Club. Bob also led the installation of gigabit fiber access into Blacksburg, making it the world’s first free open access gigabit Wi-Fi network.


1) As a developer of health and wellness apps, what excites you by the recent announcement of HealthKit at the 2014 Apple Worldwide Developers Conference (WWDC)?

The conference has been a lot of fun and the energy has been really high. 5000 developers, all picked by lottery and the result is that 75% of the developers are new. The rumor mill was that Apple was going to announce a wearable but that wasn’t the case. Instead, they announced HealthKit, which I believe is the first step in that direction, because Apple needs a piece of foundational software like this in the ecosystem before they can really execute well on a wearable so that any device they come out with can be built on top of it. Any good application needs to have a good software ecosystem, and HealthKit makes sense for them given the proliferation of health and wellness apps in the App Store. There are now over 40,000 health and fitness apps and it is a terrible user experience that each time you try a new wellness app you have to fill out the same health information. The same frustration that we have when we have to fill out new paperwork with a new doctor… telling them the same stuff we have time and time again… that same experience is true for health and wellness apps. A good app may not get used just because the user doesn’t want to have to go through the process of answering the same questions they just did for an inferior app. HealthKit means this type of information is now portable, stored locally in the HealthKit repository, and users don’t have to rely on apps to talk to each other through APIs and the Internet. This will now all happen locally within the user’s phone. All of these individual apps, with unique APIs, have stifled innovation for too long. It’s exciting stuff. There are some limits since it is new. It is not yet available for the iPad, but I’m sure that will resolve itself in short order. There is clearly a lot of excitement about it so I’m sure it will evolve quickly. It excites me too because it means I’m in the right space.

2) Outside of HealthKit, what other big takeaways excited you from Apple’s Worldwide Developers Conference and the unveiling of iOS8?

The introduction of a new programming language, Swift, is the most exciting thing at the conference in my opinion. It is a programming language that is more approachable, less noisy, and extremely powerful at the same time. Why this is so exciting is it is going to bring in more developers and create more inclusivity within the developer community. Objective C, which is what a lot of folks currently develop in, is a difficult language for people to get their hands around. In my opinion, Swift is a game changer in regards to efficiency, which will allow developers to iterate more quickly, test more things, which in the end will lead to better products. It is going to bring in more developers and lower the cost of development. This is really a big deal because more competition in this space is ultimately going to benefit the end user. In my view, this is going to have a massive effect on the marketplace.

3) You have an impressive success rate at technology competitions, are there any sharable keys to your success that have helped stack the odds in your favor?

One, there is some serendipity regarding my story because I’m in the health and wellness space and that’s just a hot market right now, so one key to share is either through luck, or by choice, pick a hot market. I can take credit for really paying attention to my presentations. In competitions (pretty much all competition not just technical ones) the best presentation is going to win, right? You can have better elements than anyone there but if they’re not passed along to the judges properly then how are they going to know? So there is some salesmanship that for better or worse is important to hone before you get in front of judges. Also, experience is going to help. I’ve been at this awhile, but that said, that doesn’t mean I don’t practice each time either. Just because I have a good track record doesn’t mean I can now go in and win these things easily. I do the work (through practice, prototyping, etc.) and I’m sure that is a major component to my success. Also, I go into these situations with an open-mind, but I will then quickly focus. This is important in two ways. One, I don’t get stuck on anything preconceived. For instance, I have a great idea, but it does not fit the parameters of the competition. I spend the whole time trying to figure out how to jam a square peg into a square hole. That’s just not going to work. Two, I kill ideas quickly. Understand the challenge, brainstorm a lot of ideas, then pick the right one – not a few – but the right one and spend time making that idea great. If you pick a few ideas to consider you start to dilute your energy (and time) thinking about multiple pathways. These strategies have worked for me.

4) In your opinion, specific to health and wellness apps, where do you believe people are currently getting it right, and where is there room for improvement?

I’ve been really inspired about what Nike was able to do in the sense that they made my data usable. They took what I provided and did not just spit it back to me but gave me suggestions and added value to it. Innovators that are going beyond just collecting metrics and data are getting it right. Mobile competitors like Android will come out with their own version of HealthKit and soon applications that don’t enhance your collected data will quickly fade away anyway.

Where I think there is room for improvement is there are all these great platforms out there and none of them are really talking to each other. What a terrible experience for the general consumer, right? I am tracking my food intake over here, and my activity over here, and doing mindfulness exercises over here. Not very much out there is integrated even though, and I truly believe this from my interaction with competitors, we all want to help our clients and users. We don’t want to get in their way. We want what is best for them. Yet, we do little to make it easy for them to correlate their data and look at their health in a holistic way. In that regard, we could be doing a lot better to unify in a way that doesn’t hurt our respective businesses, while making our products work better (in collective) for the end user.

5) Your app has seen impress growth. What are your top three growth hacking strategies?

There is no secret sauce here. One is persistence. You got to want it and work at it every day. Without this strategy, I’m not sure how you make it. I don’t have any shortcuts that replace hard work. The second would be find great partners. What can you offer other people (you must give first to receive), and once you have that established how can you use what you have (and offer it through partnerships) to expand your reach and/or benefit from a competence that you might not inherently have yourself. For instance, I have partnered with fitness celebrities. For them, I have an innovative vehicle for which they can deliver content in a unique way. For me, I gain a content expert pertaining to health and fitness. It’s a win-win. Lastly, make meaningful contacts and connections and keep them updated. I do keep a list of valuable influencers and advisories and make sure I stay engaged with them. If you want a successful endeavor you need a promoter. If you are not that person, then you might need to acquire that expertise through someone that knows public relations. It’s not a secret that good PR will assist you with growth, but some forget it is a strategy that you can do well or poorly… where perhaps hoping something goes viral is more of a wish than a strategy. 

Interview with Apple about Health and Fitness Apps

Apple’s App Store is the go-to marketplace for all iOS device users, including iPhones and iPads. This digital distribution platform, maintained by Apple, allows users to browse and download a wide range of different types of useful (and not so useful) applications. The App Store started in 2008, roughly a year after the first iPhone was sold. The original iPhone was launched with only built-in apps, but based on consumer demand and smart business principles, Apple began letting independent developers build and profit from iOS applications (which they are able to sell through Apple).  Although the App Store was a tremendous hit right from launch, profiting from app development is known to be a precarious proposition (as documented in the Fast Company article, Striking It Rich In The App Store: For Developers, It’s More Casino Than Gold Mine). Despite the risks, the App Store launched with roughly 500 apps, and presently is home to over one million. It is estimated to have over 40,000 health and wellness apps in the market, but the usefulness and utility of a majority of these apps is consistently questioned (ex. Time’s article: Bad News About Your Favorite Health Apps: They Don’t Work). The information for this interview took place over a three hour period, with seven employees from the app store speaking specifically about health, wellness, and medical apps. Apple has not endorsed this interview and it is comprised as a composite of various responses from the various individuals. 


1. What makes a good wellness or fitness mobile app? When a developer asks you for advice on how to build a great product what do you tell them?

There isn’t one recipe for building a great app. We work with various developers at varying capacities. Ultimately, our job is to ensure that Apple’s marketplace is curated in a way that maximizes the user experience.  Obviously, everyone benefits when we can help developers produce their best work, which is true across all of our channels. Apple is known for usability, so in that regard we would like that tradition to carry through to anyone developing on our platform. Therefore, a good wellness or fitness app is one that ensures a great user experience for the intended audience. In addition to that, it must create utility that the end-user otherwise would not have. There also has to be a sensibility about cognitive load and user-centric design. Is the app really solving a problem or creating one? Is the app creating value by innovating or improving upon something else, or is it simply crowding the marketplace? These are questions worth asking. When we reach out and work with developers, it is usually because we’ve identified potential, but we also see opportunities where we can help the app improve. We have different teams that work with developers directly on coding issues, as well as a team that helps identify user interface improvements.

2. How can digital health app developers go about app store optimization (ASO) and does Apple support this type of app promotion?

As a rule, Apple does not help developers with app store optimization. There are services outside of Apple that claim they can assist with this, but it is really about simple fundamentals and multivariate testing their marketing. There aren’t that many variables involved so an app creator can simply play around and see if tweaking any of them creates a lift and/or improvement in sales.  This includes trying different app icons, changing the app’s title, making sure the description of the app uses relevant keywords a potential user of the app would search for, and really paying attention to the wording in the first two lines of the description to make sure any relevant information about the app is relayed quickly to catch the consumers attention quickly.

3. I come to the table with allegiances to the Quantified Self (QS) and Health 2.0 communities, yet it seems that much of the popular health and fitness apps today are more content focused, and from where I sit it seems like Apple is not really tapped into these communities (with the exception of Rock Health).  Why do you think that is?

Interpreting our lack of visibility in the QS and digital health communities is not necessary a fair judgment, and a little misleading. We are here to support anyone who makes a good app and to develop relationships with key individuals. Outreach into these communities isn’t necessarily a function of the App Store. If you look at it from simply a demand standpoint (meaning we get plenty of health and fitness app submissions per day), clearly we are covered. So there isn’t really a need for us to go out to these communities and drum up business. Furthermore, we like to work with a wide range of developers, span from big corporations to lone developers. There are a lot of groups out there making great apps.

4. What is the biggest challenge facing the Apple App Store today?

Like most innovative organizations, we have a flood of work and limited staff. We get a tremendous amount of product submissions daily, which means that we tend to be in a perpetual state of triage. Our internal systems are custom built so we don’t benefit from system upgrades that someone might see if they were running a third-party SaaS system. We do the best with the resources we have. We genuinely care about the people developing these products. Like any entrepreneur, often these individuals have invested significant time, money, and energy into their product… some have gone as far as to find themselves in sink or swim situations. We try to help the best we can, but we just do not have the current capacity to help everyone.

5. How can mHealth and digital health developers benefit from iOS 8 and Healthbook?

There is no way to answer that. Apple will not discuss future products and releases, so all that can be said is that the blogosphere has been wrong before. People that work for the App Store get very little information about  internal workings of the company. This is primarily to protect us, since we are an external facing team. Anything in active development could potentially change, so it could be harmful for us to discuss something not yet released because it is subject to change. Of course, the future is going to be exciting. Take the M7 chip for example, it’s really impressive the way it’s being used by health and wellness developers. We principally focus on what is possible now, and that is what developers should be focused on anyway. The present is as exciting as the future.

Interview with Mike Leveque about Fitness Innovation

Mike Leveque has a decade of executive leadership experience in health and wellness innovation. He previously was the President and Chief Operating Officer of Star Trac Fitness and is currently the Chief Operating Officer of MYZONE. MYZONE is a chest strap and monitoring system that displays heart rate, calories, time and effort to a LCD monitor, while simultaneously creating an online logbook of all physical activity that can be viewed anywhere in the world through the Internet.


1) The MYZONE device relies on heart rate and time as the primary data sources by which to track an individual’s overall activity. When compared to accelerometers – aside from the obvious advantage that the MYZONE device is able to more effectively capture effort from activities where movement is limited (ex. spinning, group training, etc.) – what additional advantages does heart rate tracking have over the standard tracking offered by traditional pedometers/accelerometers?

First of all, the pedometer is limited to the movement of the device. If you are wearing a pedometer on your foot and exercise on a Krank Cycle, you will not log activity. Additionally, there may be cases where a bumpy road triggers step credit on a pedometer. Lastly, the pedometer/accelerometer can only calculate a standardized step credit. For example, let’s say a user is cross country skiing, the “steps” credited will be nowhere near equal in intensity to a similar amount of “steps” while taking a walk on the beach at the same velocity.

In the 2008 Physical Activity Guidelines for Americans from The Center for Disease Control, it is recommended that every adult exercise each week for one hundred and fifty minutes at moderate intensity  or seventy-five minutes at vigorous intensity. Never does it recommend a certain number of steps, because there is simply no accurate way to measure the intensity of physical activity via a pedometer or an accelerometer.

A recent report from Flinders University in Australia has found that there is an unbalanced relationship between steps and high-intensity training. In the report Dr. Norton states, “Most physical activity guidelines recommend a 30 minute daily walk but we found that it would take 50 hours of walking to achieve the same aerobic fitness that you could get from just one hour of high-intensity (or vigorous) activity.”

Heart rate monitoring provides a level of accuracy that pedometers and accelerometers cannot. Every body reacts differently to exercise and the beat of your heart is the only accurate way to measure effort during physical activity. This accuracy allows our MYZONE software to provide user-generated content to track metrics such as average effort, time in user specific zones and caloric expenditure during exercise. Because the MYZONE software logs the user’s age, gender, weight and every heart beat during a workout session, it can utilize those four variables to calculate the calories burned during a particular session. This is much more accurate than the algorithms used by pedometers and accelerometers.

2) At the Quantified Self Conference this year Gary Wolf made a comment eluding that corporate wellness is somewhat degrading the sanctity of self-tracking. He was then reticent about the sentiment but my interpretation is he was alluding to the potential damage program parameters can have on motivation and personal drive when it pertains to the positive benefits tracking can have on wellness. In other words, limiting autonomy and confining options (ex. a company that only offers step challenges) might actually end up doing more harm than good. How important do you think it is to let the individual set their own health and wellness goals (opposed to them being mandated)?

I believe most reasonable executives would agree that utopia would be providing regular health assessments, thoroughly educating each employee individually on their results and then allowing them to set the most appropriate health and wellness goals that motivate them to achieve a better future state. However, a wellness program that is customized to each employee is neither practical nor cost effective for most companies. So then the question becomes, is the net benefit positive of a standardized program where the goal or goals are set by the firm? After taking into account the human cost of capital and other direct costs, the vast majority of studies agree that there is a strong return on investment of any wellness program that encourages increasing regular physical activity, even if the participants are not able to set their own goals.

3) When it is difficult enough to get the layperson to understand the existing wellness vernacular, what is the added value/utility of introducing a new branded concept like MYZONE Effort Points (MEPs) for measuring and tracking physical activity? How does this improve upon the existing lexicon and contribute to a better user experience?

The two main benefits of MYZONE Effort Points (MEPs) are standardization and gamification. Since MEPs progressively reward a user for increasing effort in their personal heart rate zones, we have created somewhat of a golf handicap in the awarding of points to users. For instance a deconditioned user may rapidly enter their higher point earning zone but they will fatigue more quickly than a well-conditioned athlete. A well-conditioned athlete, with an efficient cardiovascular system, may have a hard time approaching the high point earning zones but they can maintain durations in their lower zones for much longer than a deconditioned user might. The benefit is the system rewards general effort and standardizes for various levels of physical fitness .

Many users need an increase in their motivation to achieve their goals. Through gamification, MEPs allow MYZONE users and their fitness facilities to encourage attainment of health and wellness targets by establishing user challenges, goals setting and rewarding goal achievement. Cycling various user groups through individual and/or collective challenges has proven to engage and maintain club member participation in an exercise program while simultaneously creating the stickiness of the member to the associated fitness facility.

4) Current science suggests that if you can get an individual intrinsically motivated to stay healthy (ex. focus on the benefits of general well-being), adherence to behavior change will generally be longer lasting when compared to an individual who was extrinsically motivated (ex. the carrot of winning a weight loss challenge). If this is true, what role can technology play in fostering intrinsic motivation?

Utilization of technology is an effective mechanism to provide an individual with user generated content (UGC) of their physical activity and its related outcomes. UGC, such as duration of a training session, intensity of a training session and an accurate caloric expenditure total, helps educate the MYZONE user as to how effective an exercise session has been. It creates a currency by which all future sessions can be compared.

Since the MYZONE system can be linked to a body composition analyzer, a MYZONE user can track important biometric information, such as weight, BMI, body fat percentage and muscle mass to gauge whether or not they are benefiting from their current regime. MYZONE and devices like it can also provide the user a basal metabolic rate calculation to help the user regulate food consumption to achieve their health goals. It is through this increased availability of information that an individual can track their activity and make better decisions.

5) What currently excites you the most about the accelerated advancement of personal technology as it pertains to health management? What do you see on the horizon that you believe is going to be a game changer?

Accessibility of data as it relates to physical fitness will allow fitness facilities to add gamification to their offering. When deployed correctly, gamification will support the club’s efforts to attract, integrate and retain members at levels the fitness industry has never seen. In addition, personal technology will aid in the club’s outreach to provide richer feedback to corporate clients. The holy grail of technology as it relates to fitness is linking activity to lower health care costs and ultimately lower insurance premiums. Once this happens and information is accessible to all individuals, the fitness industry should grow exponentially.

Interview with Ari Meisel about Self-Tracking

Ari Meisel is a productivity optimization expert who coaches clients on optimizing, automating and outsourcing every task possible. Ari’s Achievement Architecture coaching program is an optimization framework design that helps individuals and teams improve their effectiveness and reduce the amount of time they spend on tasks. Ari’s personal website The Art of Less Doing has become a go-to resource for those seeking to improve productivity either in business, life, and/or health. Ari also has courses on wellness and productivity available from Udemy.


1) There is a lot of talk about what it might take to cross the proverbial chasm with regards to making bio-hacking more commercially viable. In your opinion, what do you think is important to get right regarding bringing the benefits of self-tracking to a wider audience? What’s currently missing?

Nowadays you can track everything… from how many emails you have sent, to how many calories you have burned… or even how many calories you have eaten if you have the right sensor. It’s so easy to do this stuff without even thinking about it now, which is great… which is the first step. The second part of it though is making this data actionable, and as far as I’m concerned there are very, very few products that provide the lay person with any sort of usable data. It is one thing to see that you’re losing this many calories today, and this many yesterday, and so on and so forth, but what does the average person do with that? Unfortunately, there are not a lot of ways that people can correlate this data and make it actionable. There is a really great website called Tictrac where you can do drag and drop corollaries; Tictrac is a step in the right direction.

2) You’ve made mention that you have some particular effective shortcuts for improving running speed? This is my gratuitous, self-serving question: I’m a Clydesdale runner who has been stuck at 8:45 minute miles for a few years now despite various training regimens. What do you suggest for someone like me that might help me move the needle?

The obvious ones are H.I.I.T. (High Intensity Interval Training) programs, workouts that involve high intensity drills with short periods of rest… there are a lot of different interval workout types that help you increase speed and efficacy from sprinting to plyometrics. I think that fartlek training is really good too, and not only because it has an awesome name. What I have actually found to be extremely effective as far as speed, and I know it sounds like stupidly obvious, but I recommend increasing leg strength. Once I started doing really heavy squats and box jumps my speed went from a mile PR of 6:17 to running one mile in 5:45. In my opinion, you simply add more horsepower when running isn’t the only thing you do to get better at running. Adding plyometric and explosive movement training makes your runs feel like every time your foot hits the ground you’re on a rubber band and ready to go again once you hit that next stride.

3) A bit outside the realm of health and wellness specifically, but knowing your expertise encompasses systematic lifestyle improvements and predicated on the assumption that generally people want to fix everything at the same time — and quickly — when a coaching client comes to you and wants to improve wellness and productivity at the same time, where do you usually have them start?

What’s the difference, really? The truth is productivity and wellness go hand in hand. It’s so funny because I invariably have somebody come to me for coaching on one of these and we always work on both. Basically, I can make you as technologically efficient from a productivity standpoint as you can possibly be, but if you’re not sleeping well enough and/or not eating right, there is going to be a limit to how much you can produce, or how happy you are going to be with your results. For instance, some come to me and say they want to be a speed reader, which most people can certainly do, but at the same time if you can increase mental focus, retention, and memory by reducing stress and improving well-being you’re going to be a faster reader because part of being a faster reader is not having to reread things.

My method is to tackle the biggest problems first. This methodology quickly addresses the low hanging fruit. So I start with “What are your biggest productivity challenges? Give me the three top things that frustrate you.” Always, always the answers I get back are inevitably two productivity things and one wellness thing or two wellness things and one productivity thing. So they’ll say something like, “I’m not sleeping great and I have to finish X number of things by the end of the day.” It’s always that mix. So if you ask somebody “what is stopping you from being the best you can be?” the answer usually covers productivity and well-being. I’m also a big believer in moving the needle at the onset of our engagement, and quickly, because progress begets progress. The worst that somebody can do is to stagnate and as long as they are doing something, even if it’s a tiny thing, that’s progress.

4) The buzz last year regarding bio-hacking was enabling, through technology, users to make better correlations by aggregating different tracking devices. There are a few options such as Open Sen.se in an attempt to increase the benefit of tracking, but so far I’m unaware of any solutions that are super user-friendly. What strategies and/or tech do you use to increase the value and utility of tracking multiple modalities?

I have already mentioned Tictrac. I find that if you ask the right questions, a lot of the time people can give you the answers about the real issue. But I say that at least with half of my clients, a lot of it involves putting those trackers in place and then letting me read the values. So whether it’s RescueTime to see how often they are checking their email; or Fitbit to track activity I won’t even ask them to look at their own data at first. In my experience I find it is more helpful if I help my client first amass data and start by making recommendations based on their data as a first step in our relationship. I can help them better understand their data after they’re comfortable with it. People usually come to me because they are overwhelmed. They don’t have the time to do the things they want to do or they’re overwhelmed because they are stressed. These are compounding issues so I don’t want to introduce a complex solution just yet. I can introduce a sophisticated set of tools but take on the heavy lifting of interpretation until we make some progress. Not to beat a dead horse but fatigue is not an isolated issue. Are you not sleeping because you’re working too late, because you didn’t get enough done for the day and you are stressed, or are you tired because you’re eating too late and you’re eating really badly… or are you sleeping poorly because you don’t have the right environment in your bedroom? You need data to make a diagnosis and cause will rarely be just one thing.

5) One of the many valuable qualities of the content you curate is your intimate knowledge of the latest technologies that enable shortcuts and optimization. What’s out there, either now or on the horizon, that really excites you regarding wellness innovation?

I dream all day about finding new and interesting ways to use two particular services: one is IFTTT.com and the other one is Zapier. Zapier has identical functionality to IFTTT.com but it’s much more business focused. IFTTT.com has like 60 different services, everything from Twitter to Facebook, Gmail and stuff like that and services that 90% of the computing-using world uses. Zapier has those things as well but it also has things like Salesforce, MailChimp and PayPal and a lot more business focus things. So IFTTT.com will do so much regarding automation but Zapier really lets you drill down and get some unbelievably detailed things done. Through these websites I’m always trying to think of ways I can automate things to make them more efficient.

These kinds of things really get me really jazzed up. The great thing about automating some of these processes is it actually allows you to track things a lot better as well, because you know when the requests were made; you know how long it took to get them done and you can correlate those things a little bit too if you’re tracking your own productivity. It’s a lot easier to go back and see how and when things have happened and how often you did them through these services. They also let you compile things in effective ways. For instance, you can have Zapier set up that every time you make a sale on PayPal the sale is added to a Google spreadsheet, so right there you can make a data set that you wouldn’t have had otherwise. There’s a whole lot of creative ways that you can use this functionality to make your life easier.

Interview with Dr. Howard Jacobson about Nutrition and Scientific Inquiry

Dr. Howard Jacobson is a health educator and contributing author to T. Colin Campbell’s new book Whole: Rethinking the Science of Nutrition. He holds a Masters of Public Health and Doctor of Health Studies from Temple University, and a Bachelor of Arts degree in history from Princeton. Howard also founded FitFam.com as a resource for busy parents trying to raise fit and healthy children. He speaks, coaches, and consults on marketing for small and green businesses, health and fitness for individuals and families, and permaculture and planetary sustainability.


Here are my 5 questions with Dr. Jacobson and his answers:

1) A number of articles have been written over the past 10 years that raise concerns about clinical studies that address public health, food, and nutrition- related issues.  As examples, an essay written by Nobelist, James Watson, plays down the importance of anti-oxidants in diets (New Scientist,  March 16, 2013); a New Yorker article from December, 2010, entitled  “THE TRUTH WEARS OFF – Is there something wrong with the scientific method?” describes the difficulty in repeating and validating complex drug, public health and related clinical studies. Do you believe there is a single source of truth that applies to the global population regarding nutritional information?

I believe there is a really thick veil between us and the “Truth”, so the best we can do is be really respectful regarding what we do know. I look at Truth as a dinner guest. You invite Truth to dinner with the utmost humility. In my opinion, that is how you glean Truth from scientific study. You ask Truth to come for a visit, with the hope of getting yourself a little closer to true objective reality. Given there are so many ways of asking questions it seems to me the most respectful thing to do is to encourage  people to ask lots and lots of questions in various different ways – from micro-concerns to global issues and everything in between – then look at all the information you’ve amassed and try to create nested priorities. When claims are made off isolated studies (as discussed in the article you mentioned THE TRUTH WEARS OFF), they’re often reputed as fact and acted upon, only to find out as time passes that the benefits are only applicable in a scientific setting, or worse, they cannot be replicated. Given that goes on, I think a strong case can be made for judgment through diversity. You can approach scientific inquiry like an ecosystem. An overabundance of one type of organism is going to create havoc. You need diversity in any system so when weird things occur, and they will, you will have enough information you can rely on the preponderance. In this sense, when you come up with a counter-intuitive study – instead of sensationalizing it and broadcasting it as Truth – nest it as part of a holistic approach to inquiry and weigh its significance. So in the case of nutrition, we can look around the world and see that the people who tend to be slim, healthy, and live long lives are those that tend to eat a lot of complex carbohydrates, very little processed food, and not that many animal products. There is a large body of evidence to support this. So using this as a starting point, in my opinion, it is ridiculous to promote a 70% fat and protein diet when it flies in the face of a really robust empirical observation. I believe it is fair to be suspicious of purported evidence and mechanisms discovered in isolation that contradict more holistic observations that have proven evident through more vigorous means.

2) What advice do you have for consumers of this type of information in making nutritional judgments given the criticism that nutritional advice seems to come from a very diverse group of researchers and evaluators?

I’ll approach the question like this, given we live in a very unnatural society and we have the power of choice, how shall we eat? So someone might suggest let’s eat like a caveman… well, but wait, we do not live in that paradigm. We are not roaming the earth essentially working out eight hours a day, at least not most of us, that lifestyle involved a lot of physical labor. We now have unique demands that are specific to the environment we’ve created. It is a bigger issue than just being anthropological in nature however. We have power over our environment and ecosystem, so shouldn’t we make choices that are sustainable? That is one issue. Another is that as individuals we’re all different. If you are eating in a manner that is sustaining you in a healthy way, you are at a healthy weight and all your biomarkers are optimal, then maybe you do not need advice? I’m not a doctrinarian saying there is a single approach and everyone should eat a certain way. I will close by saying in spite of what I have just said, I think as individuals there is an obligation to be considerate of the fact we operate in a system larger than ourselves. For instance, there are a lot of ways to make a living. Some of these occupations might be harmful to other people but be financially advantageous. The spectator might look at an individual in one of these occupations and think that person is happy because of wealth and/or other measures, but pull back the lens and it proves to be a much bleaker picture. You can use this analogy regarding our food choices as well. Nutritional advice might be suitable for an individual but in the context of societal concerns be terrible (i.e. unsustainable farming practices, workforce exploitation, etc.). For these reasons I do suggest that the context of the information you consume is important to consider. Think beyond food choices that sustain only you, but choices that sustain your community, as well as the Earth.

3) An interesting section of your book deals with reductionism and the development of the many sub-specialties that now define aspects of biology. However, those with whom I have previously discussed the question of reductionism seem to argue that because science has advanced so much and has become so complex that some kind of subdivision is a necessity (this is true in both biology and life science).  There is simply too much to know.  They are also quick to point out that in addressing broad questions, the first and essential step is to put together teams with diverse viewpoints. The team approach also seems to be at the heart of what is often referred to as bench to bed or translational research. Isn’t reductionism needed so that others can “stand on the shoulders of giants”?

Let me clarify I’m not against reductionist research. On the contrary, reductionist research is an important part of a holistic view. The opposite position would be like a left-armed man saying, “well, I am left-handed so let me cut off the right one.” To be a literate scientific society we need all types of research. What we decry in the book is people who spend their lives looking down microscopes and then try to convince the rest of us that they’re the only ones that can see the Truth.  Again, as I posit in your first question there is no “single source of Truth”.

4) You also have some interesting perspectives on reductionistic approaches with regard to addressing broad questions.  If the goal is to make a recommendation, isn’t it necessary to have some sense of the mechanism of the putative interaction?  The point being that recommendations most likely come from a reductive process or require methods or concepts that are products of reductionism (e.g., good compositional data or knowledge of what a single component in food might do). Could you give some insights in approaching food related research questions, particularly when making an association to a given health aspect it may be a necessity to only be correlative without a lot of fundamental information? 

Having a passion and conviction for something you’re involved in is very human, especially among intelligent, successful individuals. Scientists who make an important finding tend to get identified with it, and that’s okay. It is very rare for scientists, or anyone for that matter, to be truly egoless. You need drive to do meaningful work. Part of the beauty of the scientific method is the desire to prove that you are right. The challenge is separating the real Truth from rhetoric. The issue in our modern society is that through media and other means, interpretation of Truth can sometimes actually be disseminated as Truth and that’s a big issue. It’s a big issue for two reasons. One, it gives the people with money a real advantage, because with money you can basically disseminate a distorted (aka your) version of Truth. Two, and even more concerning, is that reductionism is used to create marketable products with purported benefits that rarely can be achieved (at least as advertised) in a real-world environment.

Consumers have a hard time telling the difference between marketing and science. For instance, a lot of discourse has been spinning around the Cheerios’ ad featuring a biracial couple because of the alleged proactive portrayal of a mixed race couple, when we would be better served discussing the merits of the claim that Cheerios are good for your heart. These claims about Cheerios being good for your heart are so far from any scientific truth… they are loosely based on tangential data, and turned into marketing messages based on ingredients studied in isolation. I believe this controversy is more worthy of debate. It is like the old fable of a guy searching for his keys under a streetlamp. He lost his keys in the dark but the lamp was the easiest place to look so he started there.

The spirit of Whole is to suggest that in most cases nutrition is too complex to associate an expected outcome with a single nutrient. It’s like asking, “What is the best note in a particular symphony?” You certainly can take out a single note and examine it, but the examination is going to be of little use in creating your next symphony.

5) Given the complexity of the arguments made in your book, if the reader is to walk away understanding one concept what would you hope that is?

There is almost always a larger “whole” to examine. When you’re examining anything always try to see if you can broaden the context of your inquiry. Ask these questions: In what cases is the concept true? In what cases is the concept only a half-truth? In what cases is the concept false? The laws of phenomena are so unbelievably complex that whenever we attempt to break things into smaller pieces – as useful as it is to do so – we need to appreciate that some things are lost in the process. Reductionism very often comes with a cost or trade-off, and when that trade-off is not fully explored – or worse omitted for the economic benefit of special interests – the things that society loses in the process are not mitigated by societal gain… and worse yet, the gains are usually not shared equally but rather benefit only a select group of individuals (through monetary gain). Regarding nutrition specifically, as a society we have evolved in such a way that a plant-based diet simply makes sense. Eating is a way we turn the world into ourselves. It is one of the most intimate things we do and it is a shared commonality amongst all of us, so I believe it really does behoove us to slow things down and focus on building habits that will contribute to the greater good… as individuals… as an ecosystem… and for the betterment of the planet.

Interview with Matthew Heineman about Healthcare in America

Matthew Heineman is an accomplished producer, director and cinematographer. His current documentary film is Escape Fire: The Fight to Rescue American Healthcare,” a film which he co-directed and co-produced with Susan Froemke. The documentary examines the deficits and challenges in the healthcare system of America.


Here are my 5 questions with Matthew and his answers:

1) An escape fire (a fire started to escape a bigger fire) is a significant metaphor used throughout the film. It implies an “improvised, effective solution” to an issue failed by traditional approaches. In the context of your film, where do you see escape fires first taking hold if change is to occur: with patient choice, with medical practice, another avenue, or a systemic movement towards change?

For the first year and a half of making this film the working title was A Tale of Two Systems, which is really one of the worst film titles of all time. During the making of the film someone sent us an essay called “Escape Fire: Lessons for the Future of the Health Care System,” by Dr. Don Berwick based on a speech that he gave about 10 years earlier where he draws a metaphor between a forest fire in 1949 and our burning healthcare system. In the essay Dr. Berwick is essentially saying that there are solutions right in front of us, but because we’re so stuck in the status quo, we can’t recognize them.

And so I think, in the context of the film, there are many escape fires that we’ve pointed out but first and foremost we have a disease care system not a health care system; a system that is oriented and profits from sickness, not from keeping people healthy. So we as a society need to find ways to create a system of health; a system that incentivizes people to be healthier; a system that incentivizes doctors and team-based systems to provide care before disease actually takes place as opposed to only treating disease after it occurs. Seventy-five percent of healthcare costs in America are diseases that are largely preventable.

This is really a multifactorial problem, and as such really requires multifactorial solutions. But change is happening. We are seeing change happening all across the county, positive change. As we’ve been able to meet people all across the country from screening the film hundreds of times we’ve found change is really happening at the local level. And as this change is occurring community by community, hospital by hospital, hopefully it will become the norm, not the exception.

2) It is clear that Steven Burd, the CEO of Safeway, is a pioneer in reducing employee health care costs and is highlighted in Escape Fire for his efforts in influencing his workforce to create healthier behaviors through extrinsic means. What’s your opinion on the role of this economic innovation in motivating people to engage in healthier behavior?

In 2005, Safeway had a billion dollar health care bill and Steven Burd realized that it was clearly not sustainable. So, he incentivized his employees to eat healthier, lower their cholesterol, lower their weight, stop smoking and through that he not only improved the health of his employees, but he improved the bottom line for his company. I think providing positive incentives holds great promise in creating a healthier society. There are many, many large corporations, and small corporations as well, that are doing (or trying to do) what Safeway has successfully done.

I really believe that the private sector has a big role to play in terms of helping to solve our healthcare crisis. Roughly 178 million people get their healthcare through their employer, so if more solutions can come out of the private sector we will all be better off. The key is not to blame the individual–it’s my belief these incentives should not be positioned as penalties. In my opinion, the key is to figure out how to incentivize people to stay healthy. And with Safeway, it’s important to acknowledge that the story is not just about incentives; Mr. Burd changed the company’s culture. He changed how his employees thought about health and healthcare and provided opportunities for them to make changes–that’s why he was so successful.

3) There are so many facets to the ongoing health care crisis in America. If you were able to create Escape Fire Part II with unlimited resources and access what would be the next chapter of your exploration of this topic?

I think if we were going to do a part two we would start looking at the ramifications of The Patient Protection and Affordable Care Act. There are many aspects of the Act that people really don’t quite understand and that are going to play out over the next couple of years. One key element are Accountable Care Organizations that are moving us away from a “fee for service” model that currently compensates and incentivizes quantity over quality. It would be interesting to examine whether paying for outcomes – i.e. paying for quality – is a better way of doing things. Also looking at the expansion of electronic health records and other ways that make the system more efficient are key aspects that we were not able to examine in the original film but are key aspects of this complex story.

4) I found it compelling in Escape Fire that Dr. Martin (a physician whose story is documented in the film) externally struggles with the lack of a crisis counselor during the lunch hour when one of her patients is in need, but internally struggles with the desire to maintain her own autonomy — and practice medicine on her terms — stating, “I’m not interested in getting my productivity up, I’m interested in helping patients.” A quagmire is evident in the balance between accessibility and quality of care. In your exploration of this topic, do you believe it’s possible for the system to have it both ways?

Yes, the problem Dr. Martin faced in the film is only going to get more poignant as time goes on. It is estimated that we will have 30 million more people entering the system with the new healthcare legislation. We already have a shortage of primary health doctors, so the story we see with Dr. Martin where she’s forced to see a revolving door of patients that is going to be an ever-growing problem if we don’t change it.

It is very important to give access to care, but it is also important that doctors are given the ability to spend more time with patients. One solution might be that doctors aren’t the only ones to meet with patients. We can create more team-based systems in healthcare, where nurses and nurse practitioners provide more of the day-to-day, week-to-week, follow-ups freeing up doctor availability. In my opinion, the model in which Dr. Martin was operating where she was forced to see so many patients per hour, that is simply not sustainable. I don’t think anyone would be happy in that model. Patients aren’t happy, doctors aren’t happy, so the model needs to change.

5) You’ve stated that you hope Escape Fire can “catalyze a paradigm shift in how our country views health and healing.” With this aspiration in mind, what does success look like in five years?

The film has now been seen by millions of people and it’s been an enormously gratifying journey from the Sundance Film Festival and other festivals, to playing theaters, iTunes, CNN, etc. I think we’ve really helped raise awareness and helped elevate the issues around healthcare in a digestible and non-political way. One of the reasons we made this film is there’s so much hyperbole and misinformation on the topic of healthcare and we really wanted to try to bring clarity to the situation.

The legacy of the film is the question, “how do we create a highly sustainable healthcare system in the 21st century?” We do that by encouraging individuals and institutions to change. So I hope the film continues to do that, that we continue to raise awareness, that we continue to be used a tool to help propel change.

The momentum is already there. We’ve partnered with the Department of Veterans Affairs, one of the largest healthcare systems in America, and they used the film to launch their Patient Centered Care initiative and humanize various internal issues to their doctors and their leadership. My hope is we can continue to inspire, not just large institutions, but individuals too.

Interview with Sky Christopherson about Biometric Hacking

Sky Christopherson has an impressive list of accomplishments. He is a former member of the U.S. Cycling Team and trained in the top-secret ‘Project 96′ Olympic training program for the Atlanta Olympics. Sky is also a successful entrepreneur and filmmaker. He is the founder of Vicaso, an Internet start-up company involved in producing high dynamic range (HDR) imaging primarily for real estate markets. He authored and directed the film The Greater Meaning of Water, an award winning story of a man who finds an escape from chronic lung disease through free diving. At the time of publishing this interview, Sky currently holds a world record in sprint cycling. He is a founding partner of Optimized Athlete (OAthlete.com), a firm engaged in using genomics, self quantification, and bioinformatics to improve human performance. As if that where not enough to keep one busy, he is also currently finishing production on a feature length documentary about the US Women’s Cycling Team’s journey to Silver in the 2012 Summer Olympics in London.


Here are my 5 questions talking with Sky and his answers:

1. In a Quantified Self presentation you joked about Kashmir Hill’s term describing self-tracking as “Extreme Navel-Gazing”, which subtly highlights that in its present state consumer quantifying is far from reaching the masses. However, it does appear that momentum is slowly building. For instance in the past few weeks AliveCor, a heart monitor for the iPhone, just received FDA approval. With that in mind, what do you think it is going to take to cross the chasm regarding mass adoption of biometric hardware?

Things are already moving at an accelerated pace. First, the market of available devices is exploding. Every time you go in the Apple Store you see a new device on the ever-growing wall of digital health devices. Gone are the clunky, difficult to use remnants of the ‘Telemedicine’ era, and in are trendy, colorful, well designed devices of the consumer digital health movement. Products with good design and usability will lead to much better consumer adoption. Second, influential athletes are increasingly becoming early adopters, which is going to increase exposure. Something important to note about biometrics being adopted by my clients is that they’re not using these tools simply to improve performance – what they are actually doing is maximizing their baseline health, something we call ‘Health Performance’. When you think about it in these terms, improving baseline health is a benefit desirable by almost everyone. While athletes can create exposure for these types of devices, people are going to view these products as an integrated medical solution as well… especially now with the Patient Protection and Affordable Care Act placing more accountability in the lap of the consumer. The potential impact of self-empowered consumers on the medical field can be profound, as Dr. Eric Topol discusses in his recent book The Creative Destruction of Medicine

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2. A criticism of biometric hardware is that most devices are just improvements on what people have already been able to do (for over a decade) with standard preexisting devices and a spreadsheet (ex. pedometers, blood pressure monitors, scales, etc.). You’re a Board Member of Zeo Inc. which is a notable exception. What else excites you out there regarding the changing landscape of tracking that is completely new?

The innovations around integration and correlation are particularly exciting. Usable products, products with a focus on great UX, mean more users will be willing to collect more data. Armed with more data – and more importantly data from multiple sources – we can do exciting things with convergence using mathematical integration. Increasing strides in processing power and programming mean we can find correlations and new insights that were not there before because… these things have been too cumbersome up to now to extrapolate with now antiquated technologies… this will soon change… it is already changing. We will see unprecedented insight into individualized, multivariate health and wellness factors. Once you see more clearly what factors are leading to which outcomes in your life, you can act to better influence them.

3. You have presented about personally using the Dexcom Glucose Monitor to make real-time glucose adjustments that positively impacted your well-being. Personally I use the Motorola MOTOACTV to dynamically adjust my music selection while running to songs that increase my performance. What other tracking innovations have you witnessed, where through data feedback, users can make real-time modifications and see immediate impact?

At Optimized Athlete, we are using a mixture of off-the-shelf and proprietary sensors to optimize athletic performance. Working with one athlete, we discovered a substantial Vitamin D deficiency through a blood and genetics test. After reviewing the data, we not only modified the athlete’s skin exposure to sunlight, we were even able to recommend eye light exposures at select times of the day to influence circadian rhythms, resulting in many benefits including better quality sleep and enhanced recovery. An example of a device we used was the Dexcom continuous blood glucose tracking sensor. I can personally attest that monitoring of blood sugar is very insightful. It forces you to think ahead about everything you eat and drink. You no longer think of blood sugar levels as static points… they become longitudinal vectors in your mind. Also, since dietary intake has a delayed impact, it becomes like playing a game of ‘future telling’, which you can get quite skilled at after longer term use of the sensor. Through this type of learned discipline I was able to reduce cycles of drowsiness after meal consumption that had affected me up until that point. As a result, I now have much more sustained energy throughout the day without the use of caffeine.

4. With the first three questions in mind, what is your vision for Optimized Athlete adding to this narrative? How did Optimized Athlete help the US Women’s Cycling Team win Silver in this year’s Olympic Games?

The challenge was significant. The U.S. Women’s Cycling Team was 5th place at the World Championships just a month before, and with only two months until the Olympics were not expected to medal. When we arrived in Spain we met a team that was basically underfunded and only had one coach, while comparatively their competition were well funded and had experts staffed full-time: sports physiologists, psychologists, video analysis, you name it. Without any of this, we had to figure out how to ‘boot-strap’ a performance plan with almost no money. We started with a genetic test for each athlete to provide context to the design of the tracking and intervention strategies. Then, we used a mixture of off-the-shelf and proprietary sensors to track performance and used some pretty powerful math behind it all. What unfolded was amazing. The team became self-empowered by the data. We were able to make dozens of small adjustments to routine, environment, etc. The data was also a driver for inter-competition as well as a driver for improved performance. The team broke a national record just weeks before arriving to London, much more confident they were Olympic contenders. None-the-less, analysts professed the team had an extremely low chance of placing. In the end the American girls beat heavily favored Australia in the semi-finals, and won a Silver medal at the London Olympics. The story was so fascinating, we are making a documentary film about it, due out sometime next year.

5. You currently hold a world record on the velodrome which you were able to do at the age of 35 after a departure from competitive sport. On a personal level, how much do you attribute tracking to the success of your comeback?

I have been asked this before, and the assumption is that tracking might have made me mindful of my past experiences and therefore somehow can be attributed to getting me back to my historic baseline. I’m confident it did much more than that. For starters it helped fill gaps in understanding that were not there in the previous Olympic preparation programs I participated in. In prior efforts we did not have the ability to formulate such a complete picture with data amassed continuously 24/7. This time around I benefited from genetic testing, sleep data, glucose tracking, etc. Armed with my data the breadth of personal insights were now richer and more insightful than before. I was finally able to close feedback loops. Furthermore, and this is an important point, with data in hand I was able to optimize my outside support. By sharing my data I could say to people (direct and indirect influencers), “Hey, look at this. Can you help me?” As Rajiv Mehta points out in our documentary film, we do not exist in bubbles. Our behavior depends on our close circles of supporters. As a result, it improved my support network and allowed me to take an evidence-based training approach. Therefore, I believe modern tracking concepts not only helped me go beyond performances from ‘Project 96′ to break a World Record, but also help me maximize my long-term ‘Health Performance’.

Interview with Ken Snyder about Biometric Data

Kenneth Snyder is the founder of the London-based start-up LifeGadget which is a platform for aggregating and analyzing one’s social, activity, health and wellness data through a contextual interface. Ken has almost two decades of experience in Information Technology through a diverse range of experience spanning from leadership positions at established players such as Sapient to founding roles at various start-ups. When Ken is not working on his next project he shares his entrepreneurial passion through various strategy workshops in the United Kingdom.


Here are my 5 questions with Ken and his answers:

1) Only a few years back there was a budding hope that simply empowering someone with their own health data, with nothing else needed, would be enough to see measurable improvement based on the attribute being measured (see Data is the Next Blockbuster Drug). The current general belief is that some sort of guidance is a necessary component for human improvement and that data, for the simple sake of data, is an ineffective intervention. What is your point of view on the importance of data and its role given this context?

The word empowerment means different things to different people. I believe data is very valuable and is allowing us to see correlations and patterns that we simply did not have access to before. For me there are four powerful aspects to tracking data:

  1. The ability to reflect on historic data to identify patterns, patterns which are pretty much imperceptible experientially.
  2. The ability to share historic artifacts about yourself with others – be it your doctor, a wellness advocate, and/or social supporter such as a family member. For many people memory is a poor substitute for the truth.
  3. The ability to make predictions and correlations based on multiple data sources. For instance, weight by itself can be interesting, but put that into an ecosystem with other data and it gets a lot more interesting. One can begin to derive secondary effects and make better choices.
  4. The ability to make data sharing frictionless and explicit. In other words, data sets are becoming rich and the integrity of the data is getting better as we move away from pen and paper.

That said there are still some universal truths that are important. For instance, sustainability is one. The four aspects I just mentioned don’t mean anything if the means to which one tracks their data is difficult. If the process/method is difficult then utility is compromised. Another truth is that people’s goals change and interest in anything tends to trend in an angulating fashion. This needs to be incorporated into the ease of use of collecting data since it’s a norm, and developers should build products around expecting data to come in ebbs and flows.

2) LifeGadget is being developed in part so that people will better understand their behavior and choices holistically. How profound do you speculate facilitating better access to biometric and behavioral data will move the needle towards allowing users to find unique correlations in aspects of changeable behavior that aren’t available today?

There is a balance between the value data provides and the effort needed to get data. We are getting better at lowering the effort threshold by reducing the friction between users and their data. We are also making data more enjoyable through various methodologies such as gamification. Regarding your question, single variables are important but it is exploring the complex relationship between those variables that ultimately will really move the needle.

For someone to really understand what is going on, they need access to a more complicated picture of their environment. As individuals we are usually not well-suited (without good tools) to explore our raw data and extrapolate meaning from that environment. Secondarily, even those that might be great at Excel modeling and have the aptitude to generate meaningful complex algorithms won’t have the time to do it just for themselves. Great tools let people bring forth observations quickly and easily by finding meaningful relationships in the data effortlessly.

3) One of major themes of this year’s Quantified Self Conference was the fact that hardware and software manufacturers have done little to standardize biometric data types. With the exception of the FIT Protocol and Open mHealth Architecture data standards for biometric data practically do not exist. What do you perceive as the implications of this, both as an advocate of the space and a product developer?

We are still in what I call a “Wild West” environment, meaning rapid change is taking place. At a personal level I naturally gravitate to these types of environments. This type of great change is very exciting. Since it is still a land grab you have players like Nike that do not want standards because it gives them a competitive advantage. Also it is important to note that not having standards creates a lower cost for start-ups and pioneers because they’re not limited by boundaries. However, from an infrastructure standpoint standards are starting to develop and that is unlikely to slow down… things like OAuth 2.0 and RESTful APIs are making data integration easier and cheaper to orchestrate.

I believe when a standard(s) do begin to take root you will see a very rapid move towards standardization. I suspect this will happen – the drawbridge will get lowered if you will – when businesses see value in collaboration. This will naturally happen as the ecosystem evolves. The industries that service this data will push for it and data producers will either fall in line or face exclusion.

4) Aside from the issue discussed in question three, what is one thing you would do today to improve the biometric tracking industry at large if you had unlimited resources?

I think one potential roadblock is the inherent cautiousness of the healthcare industry. If I had unlimited resources I would use them to influence the constructive disruption of the healthcare industry. I’m not suggesting we throw out caution, but I am suggesting we don’t let it get in the way of innovation. A great example is the stethoscope. The stethoscope was invented and it took another 30 years for it to get adopted by the healthcare industry. These types of delays as it pertains to biometric data innovation would be catastrophic. People need better access to genetic data and data generated by remote monitoring now. There is so much potential but progress is being hindered by legal and risk-based boundaries. For example the Federal Trade Commission is blocking the ability to see real-time glucose monitoring… why? Seriously, what is the harm in that? This is where I would like to see the industry improve.

5) The space is evolving rapidly, in part driven by the need for innovation to help improve healthcare. A recent article from CNN (Tracking Your Body with Technology) suggests that mind-blowing devices are on the horizon. From what you have seen and heard, what excites you the most about the future of self-tracking, biometric hardware, and/or mHealth?

I am excited about the rapid growth of this sector and the acknowledgment that it is beneficial to people (and these benefits are only getting better). I am excited to be involved in this not only professionally, but also personally. I started going to Quantified Self meet-ups because I have been tracking my own data for years. I’m excited that devices are improving with each iteration. For example, sleep tracking devices right now, in my opinion, are good but not great. I’m excited to see devices such as the Zeo get better because sleep quality is such an important piece of the puzzle… so we need better data regarding sleep. Another thing that excites me is seeing the way we track food intake improve. No one has gotten that down yet but someone will. This goes back to my answer to question two… right now the effort to track food is too high to maintain sustainability, but someone will solve this and that excites me. Lastly, it excites me to think that blood and biometric markers will likely be available to consumers without having to puncture the skin. Things like cholesterol, reactive protein counts, and other standard measures will be easily obtained without a blood draw. Once this happens we are going to be able to do some really great correlative analysis and really empower people with a clear, unique picture of their data and what their data means.

Interview with Brian Russell about Wearable Sensors

Brian Russell is the Founder and Chief Executive Officer of Zephyr Technologies, a biotechnological company that specializes in remote monitoring and mobile health (mHealth) products. Zephyr Technologies is an industry leader in health monitoring solutions and has been supplying advanced monitoring technology to groups such as the National Football League, US Special Forces, National Guard Civil Support Teams, and the NASA Ames Research Center (to name a few) for nearly a decade. Zephyr also has a proven track record of helping athletes measure, track and subsequently enhance their performance and endurance.


Here are my 5 questions with Brian and his answers:

1) Science has come a long way regarding the ability to tailor performance enhancing regimes against one’s biological markers. Where is science now with regards to tailoring performance enhancing regimes as it pertains to immediate biological feedback (allowing users to make adjustments in real-time)?

So previously accuracy was the problem, which has been solved for the most part now. Now companies like our own are looking at specific problems and doing a complete integration of the solution. Smart phones have really moved us forward in that regard, and biometric devices are also getting a lot more wearable. The overall experience can now be a very natural, entertaining experience that is also helping you improve performance. Furthermore, the devices are more user-friendly today so the education load needed to get going on a device has almost gone to zero, plus the experience is becoming more social.

The fact that we can now accurately measure somebody in either a shirt, patch or strap, and give them information in real time on devices they are familiar with is incredible. Plus, you have devices like Motorola’s MOTOACTV that can alter your environment based on your performance. In the case of MOTOACTV it is the music you hear, but that is just the tip of the iceberg.

Devices are now letting people close the loop on their goals too. Up until recently one could argue biometric devices were really just arming people with data, which is great. However, now a user can say, “what’s my goal?” and can use these devices to make better choices. It used to be that the primary success metric for most was race day. That is nonsensical and not appropriate for the masses. With something like our new product ZephyrLIFE you can assess your stress level and/or fitness level and manipulate your activity against real-time feedback. So again, we can now close the loop for the user. We start the goal at the top, then we add a stimulus and track the performance of that stimulus (which is what the industry has been doing for years), but now we also are adding the element of immediate feedback whether it is suggested tweaks to behavior or a change in the users environment such as the example with MOTOACTV.

Also, the software is getting better. VO2 Max use to be the big thing but a big part of that marker is genetic. Your anaerobic threshold can now be determined with a high degree of accuracy through consumer biometric devices. Using good software we can create custom workout regimens tailored to the user based on training zones, which is nothing new, but it doesn’t end there… these protocols use to only be prescriptive, now the software is adaptable so you can challenge your program’s recommendations and change up the workout to see if you get better results. If you do, the software starts to learn this and continues to optimize a workout for you that gets you results as quickly as possible. The days of using normative data to calibrate these initiatives will soon be a thing of the past and that’s terrific and is leading to a super cool user experience.

2) With the advances in sport biometric devices, do you think that there might be some interesting synergies with the expanding consumer biofeedback market?

That’s a great question actually. If you look at the latest research regarding all the 10,000 step programs, they are failing in a lot of areas because we are learning through study that exercise intensity is an important part of the equation for reducing stress. So for the sake of improving our nation’s health, I am hoping people will move on from just these counting step type programs. Accelerometers are neat, they are very cheap and simple, but they don’t address using muscle or heart rate activity. You lose visibility regarding heart rate and stress and therefore nothing about the user’s mental state is captured.

If you are healthy and you introduce some sort of stress, great. However, if you are unhealthy then maybe adding a high level of stress into your life is not a good idea. This is where advances, such as the ones we are driving, are really adding value for consumers. We are enabling people to make healthy choices about their activity, so we are a perfect example of something that started with sport and now is really improving the lives of a broader audience. For instance, hypertension is one of the top three killers in the country at the moment so we can also use devices in conjunction with behavioral psychology and motivate people to take action using their own data. And here is the magic: we know exercise metabolizes stress hormones so sport, exercise, fitness, whatever you want to call it is not just for athletes. It is proven to improve overall well-being. And it goes both ways, products that are being designed for consumers regarding sleep and stress will help athletes perform better too.

Also, most people now agree exercise is medicine. The medical bill for this country is almost up to 25 percent of GDP, which is significantly higher than any of the other G6 countries. We know that exercise reduces diabetes when introduced to an at risk population. And it is not like these people need to become Ironmen, simple changes at the right intensity have huge results and so with regards to your question there is a significant benefit in the two sides influencing each other. If we agree exercise is medicine then these devices give us visibility and tools across the health continuum. They help focus people on staying well instead of the alternative, which is medical intervention. As a society we are only accustomed to worrying about health when we are sick. The departure for this flawed system is exciting!

3) For someone just starting to track athletic performance through data, what do you believe should be focused on first (regarding this new information) to make the biggest personal impact?

Let’s start with someone who used to be active but because of various life events adopted a sedentary lifestyle and now is motivated to get back in shape. For the sake of this example let’s say the person in question has chosen to run as the way to get fit. First off, for the majority of the population one shouldn’t jump into a standard training regimen (ex. some 5 day a week program). So I would suggest to this person, for a couple of weeks choose to run one or two times during the week, for no more than 20 minutes. In these training sessions focus not on the effort but running “well”, good form, steady biometrics, etc. In layman terms, run in a way your body really likes… feel your feet, feel your heels, feel your knees, make sure your muscles, your glutes, your thighs, are doing what they should do. So that is the first thing I suggest.

Number two is looking at your sleep. Sleep hygiene is so underrated when it comes to performance. So track your sleep and do what it takes to improve in this area. Figure out what works best for you, whether that is lowering your caffeine consumption or not watching television in your bedroom, do whatever it takes to get restful sleep and start doing it every night.

Three is about creating a closed loop system with your device of choice based on personalized goals. So whether someone is motivated by performance, or reducing stress, we calibrate the routine to optimizing against that goal which keeps the person engaged and then this positive cycle feeds itself.

And the last pieces are the workout and proper recovery, so I personally believe that workouts should be spaced out at least 48 hours apart from each other. If you workout smart and give yourself enough time to recover from your workouts most people will see measurable improvement in their wellness within four weeks.

Once we’ve accomplished getting you fit then we can talk about more advance tactics like gamification, social sharing, and competition to see if any of these initiatives are in line with your personality… helping you move the needle even more.

4) I asked Gear Fisher this same question, and I would be interested to hear your answer: where do you think the balance between a platform’s utility and ability to be user friendly lie? Dealing with the unfortunate reality that in the world of fitness that positive outcomes are for the most part reliant on user compliance, is it sometimes necessary to compromise sophistication for usability?

We have some fundamental beliefs here at Zephyr. If you can present people’s data to them in an easy to understand way… they will get it, they’ll see the picture. Once they get it, the experience will be entertaining which assists one in making positive changes easier. The story I love to tell is the time I had a bioharness on my young daughter and I caught her playing with her breath so that she could see how it affected her ECG on our family’s computer monitor. I didn’t provoke her or encourage her… good devices when designed right foster this type of self discovery.

We use a ZephyrLife Score to give users an easy biometric gauge if that is something that works for them, other products have similar functionality. With a well designed product if you want to go deeper you have the ability to do that easily as well, it is about usability. Something like the ZephyrLife Score also lets people compare themselves against other groups whether that is other members of the same sex in their age group, their friends, or their cohorts at work is up to the way the campaign is set up. Regardless, of the specific set up it is all about letting people self educate in a way that is meaningful and specific to their goals and style of achieving goals. Technology should never smack someone in the forehead; usability is paramount.

5) Looking out at the landscape of mHealth and wearable devices with regards to biometric tracking, what do you think is going to be the next industry game changer?

I think it is three things, two are current and one is up and coming. The first, which is now, is that the option for insertion of biometric sensors in wearable items is plentiful. You can put them is a compression shirt, you can put them in a watch, people now have choices about what to wear and how to wear them, so that is happening now. There are even disposable devices entering the market for certain applications, so choice – moving beyond just a chest strap – that is exciting!

Second, accuracy is now a requirement. We are getting medical grade data now, so with the right algorithms you can get home from a workout and an alert is waiting for you that says, “This is not a diagnosis but your heart rate data suggests you might benefit from seeing a cardiologist,” and as such you are able to save lives with simply your own data. How cool is that?

The third thing is the way we will soon be handling the data. Frictionless sharing – using things like cellular transmitters – getting the biometric data to the Cloud will involve no effort on the user’s part… this is also very exciting. The data is there when the user is ready for it but it is always being collected. We are removing all of the hassle factors for the user, which will lead to better adoption and ultimately help this country get back on its feet again regarding their health.

Interview with Nadeem Kassam about Biometric Devices

Nadeem Kassam is a serial entrepreneur and investor who has been focusing on innovation in the health and wellness arena for over a decade. He is a Director at Zynik Capital and founder and Chief Alliance Officer for BASIS, a revolutionary new biometric device. Nadeem’s passion is to make wellness more socially appealing through technology and is a recognized thought leader in this space. If you are interested in learning more from Nadeem Kassam you can visit his blog at www.nadeemkassam.com/blog.


Here are the 5 questions with Nadeem and his answers:

1) Biometric devices like heart rate monitors and accelerometers have been around since you began your journey into exploring health and wellness technology over a decade ago; what has changed in the last 12 months that has made biometric devices much more interesting than they have been in the last 12 years?

Technology is accelerating at an exponential rate, and so everything from batteries, to Bluetooth, to the smartphone ecosystem have become cheaper, faster, and smaller. Also, the space is heating up, from cool start-ups and new entrants like Jawbone, Nike+ and others, increased awareness and technical talent, and – very important – increased venture capital dollars are being allocated to our sector. We used to talk about “when” the mobile space would hit and now we are talking about how fast it is going to explode and then mature…

2) Biometric devices have not yet “crossed the chasm” but they seem to be getting close. In your opinion, what are the signs to look for that will indicate we are reaching the tipping point of mass adoption?

I really like that you’ve asked me “when” will mass adoption occur and not “if”. People like you know it is just assumed, I love that. The signs will come from the press, evident on the wrists of Middle America like the white earphones of the iPod, and when mass amounts of “consumer” health data actually begin to influence healthcare in this country.

3) Do you believe this market will ever consolidate in a similar fashion to digital audio devices and smart phones? Or is the assortment of data available from our bodies large enough that there will always be a need for a large number of biometric device manufacturer types to focus and specialize in specific areas of interest (e.g. weight, movement, blood glucose, blood pressure, heart rate, etc.).

It has been my vision for almost a decade that, “in the end there can only be one.” I don’t mean just one company standing, as I believe there is a lot of space in this huge industry for strong competitors. I mean, that at the end of the day, humans are only going to want one biometric device strapped to their body. I believe the wrist is the natural place for that device. This device will fit within an ecosystem of the smartphone, and the PC/TV, as these devices continue to learn how to interact with our bodies to give true meaning while entertaining us on the way to personal and social well-being.

4) Aside from your involvement with the BASIS device which is extremely exciting, what in the biometric space is on the horizon that excites you the most? In addition, where do you think the industry can do better?

The stuff that excites me the most, unfortunately, I really can’t talk about yet. But let’s just say that medical technology is advancing so fast, that invasive techniques are becoming more passive. But to give you an answer, I find it exciting that the day in which we have consumer devices that are truly medical grade, but possess a user experience that rivals Apple, is not that far away. I’m also very excited about the merger between mind and body and how new technologies will bring what has traditionally been known as ‘biofeedback’ into the mainstream.

It’s not so much what our industry could do better … We are still in the early stages and we are just figuring out collaborations between great companies. Awesome organizations have emerged like Rock Health to foster entrepreneurship in this space and Steve Krein’s StartUp Health program that has been set up to not only foster friendships and synergistic relationships in this industry, but also to help grow the industry as a whole. As a product of our industry’s lifecycle, we are working on what we can do better, and it’s exciting!

5) Borrowing from David Hansson, how do you plan to ‘put a dent in the universe’? When you are done leaving your footprint, how do you want to be remembered?

If there is one thing that I have learned from my father it is that you are never done, it only becomes grander, more enjoyable and relaxed as you get older. I want to be remembered as a great father, leader, and philanthropist to those that knew me, and as a radical spark of change for those who did not. I want to help make a powerful impact on health and wellness in the world and will use fun and entertainment to do just that.