50 Million Fitbits, 2.1 Billion Smart Phones, and a Whole New You
ELLE , November 2016
As a kid in Brazil, Sonia Sousa fell in love with Isaac Asimov's Fantastic Voyage, the story of a submarine crew who shrink to microscopic size and travel through the bloodstream of a wounded scientist. When she finished the book, Sousa recalls, "I walked into the living room and told my mother, 'I'm going to be a scientist and I'm going to be able to look inside the body.'" Her mother was skeptical, reminding Sonia that she'd previously declared her ambition to become a Formula 1 driver.
Sonia stuck to her dream. She earned a PhD in spectroscopy and joined the Silicon Valley start-up scene. Now, as the cofounder and CEO of Kenzen, she's pioneering new ways not just to peer inside our bodies, but to understand how we choose to live in them—and to improve our chances of doing so better, longer—using tiny sensors, big data, and the portable supercomputers we call smartphones.
All day, every day, we leave a data trail. Fitness bands and smart bras monitor our heart rate, count our steps, track our sleep. Google searches, social media posts, and online purchases offer clues to our mental and physical health. Smartphones don't just house our calendars, e-mail, photos, and music—they also record where we go, how much we move, what games we play, how often we call Mom. When we finally put them down, they have a pretty good idea we've gone to sleep.
Next, if Kenzen has its way, you'll have a small monitor stuck to your side, reading your every drop of sweat. The company's patches will soon be analyzing the perspiration of the San Francisco 49ers, the Houston Rockets, and FC Dallas soccer players, picking up on minute shifts in sodium, potassium, and pH; next year, Kenzen plans to roll out versions that check glucose (calories and energy expenditure), cortisol (stress), and lactate (muscle recovery). The goal is to spot health problems before serious trouble develops. "Our body is talking to us all the time. We just can't hear," Sousa says. Kenzen's system is "like a megaphone with a translator" that could, say, warn a construction worker of incipient heatstroke or tell a diabetic her glucose has dropped before she'd think to pause for a finger prick.
Whether for an individual or an entire population, this kind of aggressive measuring adds up to an ever-swelling stream of data. The carrot currently being chased by countless tech entrepreneurs, medical centers, and academic researchers is not just another "ultimate" tracking device (though they're in hot pursuit of that, too) but a way to harness the data from the ones we're already plugged into: figuring out how to collect, combine, and interpret all that information. And then how to use it—without becoming obnoxious, intrusive, or just plain creepy. (Some would argue that if our watches are ordering us to stand up on the hour, and our phones know we've ovulated before we do, we've already crossed that Rubicon.)
As sensors get more pervasive, more connected, and either more low-profile or far chicer, the measured life will increasingly become, well, regular old life. "What we call smart clothes today will eventually just be called clothes," proclaimed Stephane Marceau, the cofounder and CEO of Montreal-based OMsignal, at a recent conference on wearable tech. Instead of an optional wristband, Marceau's company wired up something most women really can't exercise without—a sports bra.
In the meantime, the many things measuring you will find ways to sync up. Under Armour has already equipped its SpeedForm Gemini 2 running shoe with a full suite of accompanying gadgetry, including a scale and an app that tracks your progress. Sure, the ELLE editor who tested the system found the task of getting its various bits to "speak" to each other more irritating than informative—not to mention a buzzkill to the bliss of lacing up and racing out the door. But these are early days. Now imagine smart refrigerators that talk to smart scales that feed directly to your cardiologist's office—or your trainer's. Camera apps that clock the calorie counts in all those artfully composed Instagram foodie shots and report back to your online grocery cart. Digital tattoos that could unlock your front door and trade data with a handshake. Smart toilets that monitor changes in intestinal microbes and flag your Walgreens account. Eventually these may seem as mundane as the previously unimaginable monitors now wrapped around so many wrists.
Intel anthropologist Genevieve Bell, whose job is to ponder the future of technology, calls the trend "mass precision." For the first time, "we have the ability to have both these large data sets and also deep data sets about an individual," she says.
The mass part—aka the kind of big data rendered by, say, the nearly 50 million trackers Fitbit has sold to date, or the 2.1 billion smartphone users on the planet—offers the chance to spot new patterns. You might have heard that it's a bad idea to weigh yourself every day. Don't believe it. Analyzing data from its Aria wireless scale, Fitbit discovered that people who weigh themselves daily are more likely to lose weight than those who don't—74 percent versus 65 percent in the first month. And they lose more: an average of 3 pounds in the first month and 9 pounds in the first six months, versus 1 pound and 2.5 pounds for those who weigh themselves two or three times a week. The frequent reminder seems key to staying on track.
Fitbit's findings record life "in the wild," as users actually live it, without the fallibilities of self-reporting or the artificial environment of a lab. Consider sleep apnea, says Shelten Yuen, the company's vice president for research and development: "The standard for care right now is you self-report—you find that you're drowsy; you go see your doctor; the doctor says, 'Why don't you go to a sleep lab?' Sleep labs are highly accurate environments in which you can monitor a person's physiology and sleep, but they're very different from your normal sleep environment—and it's usually just one night in that sleep clinic." No, your Fitbit is not equipped with all the tubes and wires you'd be attached to in a lab—yet. But for starters, consider what could happen if you hooked up a sleep-tracking band with your calendar and your food diary: more of those patterns. "Maybe I'd sleep better if my last meeting of the day wasn't with my boss," Bell says. "Or maybe I'd sleep better if I didn't have all that food at dinner."
Mass data can hide important individual factors, but mass precision teases them out—finding individualized takeaways from among the masses. Ever wonder why vegans and paleos seem equally convinced that they've found the one true way to weight loss? Bell cites a diet study published last November in which researchers at Israel's Weizmann Institute of Science continuously monitored the glucose of 800 people for a week. Even when everyone ate the same food, they showed very different blood sugar changes after meals. Crunching the data, researchers found distinctive patterns—notably, different intestinal microbes—that suggested which diets would work best for which people. Tested on another group of 100, the patterns held up.
Or take my migraines. Like most sufferers, I have conflicting hunches about possible causes. Not enough caffeine, too much caffeine, not enough sleep, too much sleep, red wine with dinner, or is it prosecco? I've probably missed a lot of nice wine for no good reason. Figuring out what's going on would require carefully tracking many kinds of data from my life—what I eat, when I sleep, what I'm working on—as well as looking for consistent triggers across many different migraine sufferers.
Similarly, combining enough real-time data might even answer a great medical mystery: What causes menopausal hot flashes—in general or in a particular woman? "Everybody knows that you sweat and you get flushed. Nobody knows what triggers this crazy temperature imbalance," Sousa says.
David Stark, medical director of the new Mount Sinai Institute for Next Generation Healthcare, is building a clinic that incorporates the data from patients' devices. Stark, who did a Stanford postdoc in biomedical informatics on top of his pediatric neurology training, sees the measured life as a chance to get a truer picture of well-being. "Health happens every day," he says. "In your home, where you live and work and eat and sleep, not in the doctor's office."