Tracking what your body needs

Our bodies are always sending signals ... but are we listening? This hour, TED speakers explore new ways to track and understand our health — from cutting-edge technology to simple, everyday habits. Guests include exercise physiologist Keith Diaz, genomicist Michael Snyder and writer Lizzie Braicks-Rinker. TED Radio Hour+ listeners now get access to bonus episodes, with more ideas from TED speakers and deeper conversations with Manoush. By signing up for Plus, you directly support our work and public media, so all your episodes (like this one!) come to you without sponsor breaks. Learn more at plus.npr.org/ted http://plus.npr.org/ted. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Manoush Zomorodi?

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• 0:48Manoush Zomorodi?

  Ideas worth spreading. From TED and NPR, I'm Manoush Zomorodi. On the show today, tracking what the body needs. And one of the most basic things our bodies need is movement.

• 1:06Speaker 07

  So if you kind of map out the trajectories of our sedentary time and, you know, how much time we spend watching TV, how much time we spend sitting in a car, how much time we spend sitting at work, it's kind of been steadily increasing across decades.

• 1:20Manoush Zomorodi?

  This is exercise scientist Keith Diaz.

• 1:23Speaker 07

  And society and our cultural and societal norms are telling us you're supposed to sit at your desk. If you're not at your desk, you're not learning, you're not being productive.

• 1:30Manoush Zomorodi?

  Keith Diaz has spent the past 15 years researching the impacts of a sedentary lifestyle on our health and how much movement we really need to stay healthy. It all started with a headline that he desperately wanted to debunk.

• 1:46Speaker 07

  I came across some news headline. It was like in Runner's World magazine. It said something like, "Sitting is the new smoking, even if you're a runner." And I was like, you know, as a runner, I tend to see exercise as the cure-all, prevent-all for everything. And so for this article to, you know, put it out there that like, you know, what you do exercise-wise, you're running, that's not enough. I didn't believe it. And so I set off in my career to debunk that and show that, you know, that's not true. Exercise can overcome. That sitting isn't the kryptonite to exercise. And here we are, almost 15 years later, and... Man, I've come to see it in a very different light.

• 2:31Speaker 07

  We are living in the most sedentary era in modern history.

• 2:35Manoush Zomorodi?

  Keith Diaz continues from the TED stage.

• 2:38Speaker 07

  In a single year, the average adult now spends a full 187 days, over half of the year, sitting or physically idle. The bad news is that our bodies weren't designed for this. I know because I've spent my career as a scientist studying the harms of being highly sedentary. And what scientists have found is that being highly sedentary increases your risk of diabetes, cancer, dementia, heart disease, and ultimately, early death. Worse, this is true even if you exercise regularly. Exercise only makes up a tiny fraction of your day. The toxicity comes from when movement begins to disappear from your life.

• 3:24Speaker 07

  And this begs the question, why is an exercise alone enough? A part of the answer lies in our muscles. Our muscles are more than just a machinery that power movement. They're also really important for regulating things like our metabolism. Let's use blood sugar as an example. Our muscles are like sponges for blood sugar. When we regularly use and contract our muscles, they're like a moist sponge soaking up the sugar from the bloodstream. But when we don't regularly use and contract our muscle,

• 4:00Speaker 07

  like a dry and shriveled sponge, not really good at soaking up anything. Now here's the key, when we exercise, it re-wets the sponge. But eventually, that sponge dries out if you get little to no movement the rest of your day. If our muscles need regular use to function optimally, then outside of any exercise time, we need to be contracting them frequently through movement. The question that we asked in my lab is, what's the least amount of movement breaks that we need in order to offset the harms of being highly sedentary?

• 4:34Speaker 07

  And the answer, we found, was a five-minute walk every half hour.

• 4:40Manoush Zomorodi?

  In 2023, as part of the Body Electric Project, NPR partnered with Keith's team at Columbia University Medical Center to conduct a massive study with over 20,000 public radio listeners, testing how feasible this gold standard of five minutes of movement for every half hour of sedentary time was out of the lab.

• 5:03Speaker 07

  I mean, we set out really to answer the question, can people do movement breaks in the real world?

• 5:09Manoush Zomorodi?

  And the answer was yes. It wasn't easy at first, but once people committed to taking regular breaks throughout the day, they started noticing the positive effects on their mood, productivity, fatigue levels, and more. Plus, Keith now has an exciting update.

• 5:27Speaker 07

  What we're finding is that once people take about five movement breaks a day, you start to see diminishing returns in terms of their improvements in fatigue. Right? Like, after about five to six breaks a day, you don't get that much extra benefit from doing seven, eight, or nine. And so that, to me, seems like a little bit of a better message, too, that, you know, just strive for five. Would I love for it to be every half hour, every hour? That'd be great. But what we found in the real world is that people really had a hard time sticking to that regimented clock of every hour. But maybe this is a different way to think about it. Five times in your day, move for five minutes.

• 6:06Manoush Zomorodi?

  Our body is constantly sending us a signal about what it needs. But are we listening? What happens when we start paying closer attention, not just to how we feel, but to the patterns hidden inside our daily lives? From simple habits, like taking movement breaks, to cutting-edge wearables that track everything from sleep to stress, new tools are changing the way we understand our health. And so today on the show, we're exploring ways of tracking what the body needs.

• 6:39Manoush Zomorodi?

  For exercise scientist Keith Diaz, when it comes to changing our sedentary habits, Keith says we need to deal with what we think being productive looks like.

• 6:50Speaker 07

  One of the biggest concerns I often hear from employers and schools about movement breaks is that they worry that it's disruptive, that it'll hurt productivity and performance. But movement doesn't mean you have to stop working. You can have walking meetings. Pace around while you're on a call. Get walking pads. Or simply just move around while thinking. But the bigger idea and concept with movement breaks is that when you compare brain activity after movement versus after sitting, the differences are so striking. The brain after movement looks like one certainly far more ready to learn and to work. And yet, somewhere along the way, we decided that sitting and staring in front of a computer screen for eight hours straight is the best way to work.

• 7:35Speaker 07

  And that's where the real challenge lies. Productivity culture, convenience culture, and technology are re-engineering our lives and steadily removing the need for movement. We can have groceries deliveries and robots vacuum our floors without ever getting off the couch. And the consequences of this re-engineering is that we now often see movement as something to avoid.

• 8:02Manoush Zomorodi?

  So, a lot of people rely these days on their device, a smartphone, to ping them, you know, it's time to get up. You're actually not a fan, if I understand correctly, of fitness trackers, you've told me. So, like, what? How do you? How do you approach this?

• 8:20Speaker 07

  Yeah. I mean, why I'm not as much of a fan of it is that you're relying on kind of external cues still. And where I'd love to see this, and what the science kind of tells us on human behavior change, is that for us to build a habit, it has to be more so something internal, right? And so, when we kind of learn how to check back in with our bodies, right, and we don't have to rely on external cues to do that, that behavior is much more likely to stick. The example I always use... Is brushing teeth is like the ultimate health behavior that since we were kids, were taught and trained to do. But we also have tied it to cues in our day.

• 9:04Speaker 07

  We know that when we get ready in the morning to go and leave our house, or that when we get ready for bed at night, we automatically are cued by our environment that like, oh yeah, teeth brushing, that's next up. I put my pajamas on, I go brush my teeth. Like, that's just the natural part of it. And so getting to that place in our everyday lives for movement breaks, or just movement in general of like, okay, I just, I've just finished a work task. I'm gonna go take a movement break before I go on to the next one. I just finished a meeting. Before I go to the next one, I'm going to move, right? And tying it to cues in our day, rather than relying on some kind of device to remind us. Because a lot of people, at the end of the day, most people end up hating that reminder and ignore them.

• 9:45Manoush Zomorodi?

  Yeah, you know, it's annoying. It starts to annoy you. It starts to be like, okay, good to know, thanks, but I'm busy. So I guess my question is, what happens next? Like, our relationship with technology is getting even more entangled. So are we at this point where we have to be taught, be more specific, put language around, or doses, as you say, around things that like, you know, probably when I was a kid, if someone was like, did you get enough movement today? That would be kind of like, maybe not in school, but like generally, we were always moving. I had to move to go to the next class. Like, I had to move to go get a new book.

• 10:24Speaker 07

  Yeah, and maybe it's going back to that point of like harnessing, like this idea or notion that like, a body that moves is a more efficient and productive body as well. Like, what moves the needle for employers? Outside of like, policy changes, right? Is incentivizing employers to allow this to happen? I feel like I keep saying the same story again and again and again. And people want to keep talking about it. But nothing is changing. And that's where I just feel like, I feel stuck because I'm like, how much do I have to keep talking about it? How much more science needs to come out? Before somebody starts doing something about it.

• 11:10Manoush Zomorodi?

  OK, so I'm going to offer a more positive perspective, Keith. One is that we can actually change our habits pretty fast. Like, I'm thinking of going to Zoom for everything during the pandemic. And also, like, I definitely heard from the people who joined our study that once they committed to taking movement breaks, and they got their friends to try it, they got their office mates to try it, they realized that they wanted to keep doing it. But it starts with just getting people to try.

• 11:38Speaker 07

  Yeah. And I think what you're getting at is it's a grassroots movement. Right? Like, the top ain't changing things. So we're going to have to start from a different perspective and a different approach. And it's this trickle, trickle effect. And, you know, normalizing the behavior

• 11:58Speaker 07

  has to start with somebody willing, like, being willing to do it and step out of that comfort zone. Like, I'm always that guy in a Zoom call who, like, is walking on a treadmill while everybody else is sitting.

• 12:09Manoush Zomorodi?

  I know, it's weird to see you sitting right now, actually.

• 12:11Speaker 07

  Yeah. But, you know, then you start, some other people start thinking like, oh, like, I want to do that, too. So a couple of my staff members went out and got walking pads, right?

• 12:20Manoush Zomorodi?

  Nice.

• 12:21Speaker 07

  Like, when you make it acceptable, like, oh, that's totally a normal thing to do, and I wouldn't even think twice about it. Right? Like, we have to start changing that perception and that culture. And it may have to start with just people doing it and making it normal. And maybe eventually we'll get there.

• 12:36Manoush Zomorodi?

  I think we need a meme, like, touch grass worked really well. Maybe we need, like, dance on grass or something like that.

• 12:42Speaker 07

  Totally.

• 12:42Manoush Zomorodi?

  We're going to figure it out, Keith. We're on the journey.

• 12:45Speaker 07

  Totally.

• 12:45Manoush Zomorodi?

  All right, time for a movement break.

• 12:47Speaker 07

  Keep it going, keep it going.

• 12:50Manoush Zomorodi?

  That was Columbia University Medical Center's Keith Diaz. He is an exercise physiologist and also wrote the foreword to the book Body Electric: The Hidden Health Costs of the Digital Age and New Science to Reclaim Your Well-Being. You can see his full talk at ted.com. On the show today, tracking what the body needs. I'm Manoush Zomorodi, and you're listening to the TED Radio Hour from NPR. Stay with us.

• 13:30Manoush Zomorodi?

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• 14:51Manoush Zomorodi?

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• 14:58Manoush Zomorodi?

  It's the TED Radio Hour from NPR. I'm Manoush Zomorodi. Today on the show, tracking what your body needs. I have four smartwatches, so an Apple Fitbit, Sensomix, and a Whoop. I have two rings on me, an Oura ring and something called UltraHuman. This is Professor Michael Snyder. He's the director of the Stanford Center for Genomics and Personalized Medicine. I have hearing aids, which I do use for hearing, but they also do sensing as well. I have an exposometer that measures... Airborne exposures and I have my iPhone that tracks a few odds and ends like steps and things that some of that's redundant with the other watches.

• 15:40Manoush Zomorodi?

  And how long have you been collecting all of this information? Well, I've been collecting deep data on me for about 16 and a half years now. The wearable part I'd say runs for about 11 years, 12 years. Of course, wearables and tracking devices have been around for a long time, but the types of data they can collect is constantly getting more precise. Your resting heart rate, your heart rate variability, your blood oxygen, something you don't get in a doctor's office called galvanic stress response. This is conductance on your skin and it turns out that when you're stressed, you're sweating

• 16:21Manoush Zomorodi?

  more, so your skin gets more moist and when you're diabetic, your skin gets more dry. Some of the watches will, at least one of them, will detect blood pressure and measure that. Michael has spent decades doing massive studies using information collected from wearables and his research is changing our understanding of how genetic risks and personal habits combine to shape human health. And for individuals, as in what does this mean for you? Well, he believes that self-monitoring and collecting more of our own physical data will soon transform how we each stay healthy. These devices, they're not expensive now and they're only going to get cheaper in the future.

• 17:05Manoush Zomorodi?

  You could keep the individual people themselves healthy by catching when they first get ill, treat them, catch heart conditions. I think there's going to be a ton of stuff. Catch mental health problems like depression, anxiety. We're doing a lot of research there. Cardiovascular disease. You know, it's not going to be a perfect system, but even if we could catch 50% of these, it'd be amazing. I mean, I think people have been wearing like smart watches or, you know, collecting how many steps they're walking every day and this has been going on for a while now. As you said, like over a decade, but are we at some sort Of tipping point when people actually know what to do with this information.

• 17:46Manoush Zomorodi?

  Like, for example, I've been tracking my steps for six years and I rarely even look at the data. But is something changing when it comes to collecting information about our bodies?

• 17:58Speaker 06

  When these first came out, it's as you say, they were fitness trackers. And realistically, people put them on their wrist and they would, you know, wear them for three months. Say, yep, I know my pattern, I'm done, then they throw it in a drawer and be done with it. But I think what the tipping point is that you're referring to is that they're actually health monitors. They can track a lot more than just your steps. For example, resting heart rate, heart rate variability are really good indicators of your health. We've used them to be able to pick up when you're getting a viral infection in advance of symptoms. Because your heart rate goes up. What's powerful about them is they're measuring you 24/7. They're, they're always following you. And we've exploited this in a way that we can actually, if your heart rate's up for too high for too long,

• 18:43Speaker 06

  it triggers a red alert. And that can be indicative of a viral infection. And more recently, we've shown it's indicative of mental health stress as well.

• 18:52Manoush Zomorodi?

  Hmm. You actually told me a story about a Stanford researcher who had a heart attack. And there was data behind that that could have predicted that he was going to?

• 19:04Speaker 06

  Yeah, it's a very interesting study, you know, a little bit tragic to say the least. There was a person working in my lab for two years, very wonderful person. High energy, you meet this guy, you assume he's in great health and in great shape. And it turns out he was very much a believer in all of the wearable things that we were doing. He had an Apple Watch and an Oura ring. He would exercise pretty regularly on a Peloton, which also has tracking data. And basically, uh, one day, as he was running on his Peloton, actually quite intensely. And it turns out he died right after that.

• 19:43Speaker 06

  It was really quite tragic. And his wife, he, you know, knew how much he liked the lab and being there and shared the data with us and asked us to take a look at it. And because he had the Apple, the latest Apple Watch and also the Oura ring, we could track what was going on. It was very clear four months before he passed away. He had a significant, what I like to call step function, meaning his resting heart rate. Went up his heart rate variability dropped. His gait, which you can also get from a smartwatch shifted and his sleep also shifted.

• 20:17Speaker 06

  And so there was a sign something was off. Yet there was no system to relay that information back to say, hey, something's off. You should go get checked out. And I think that's what we need to do next.

• 20:34Speaker 06

  We have this for viral infection alerting, but we don't have it for all these other things, which is what we need to. And so we're now trying to study this further, you know, track people's, if you will, cardiovascular state. And then build a real time alerting system. We need to run proper studies first. But that is the goal to be able to see when, when you see something's off, you may not always know what it is. Like right now, we can't tell the difference between a respiratory viral infection and a anxiety attack. But we do know something's off. So you, we will be able to distinguish those in the future, by the way. There are enough ways to measure this and how we can tell them apart. But when we first set up the study, we couldn't. But we, but it does tell you something's off.

• 21:19Speaker 06

  And that, I think that should give you pause to look at this further.

• 21:23Manoush Zomorodi?

  I mean, it's interesting. My dad has a pacemaker that sends data constantly back to his cardiologist. But of course, it took him having a cardiac issue for him to need a pacemaker, which then sends back all of this data. So describe to me like how you see this working in the future, especially if it's not data that's specific to one particular organ function, right? You're talking about data that collected altogether forms a picture of someone's health.

• 21:54Speaker 06

  Yeah, the way I see it working is you wear these devices. Right now they're on your wrist or your ring or even in your ear if they're a hearing aid. I think in the future, they may all. Also be implantables because some people don't like to wear this stuff and if you just put it under your skin and kinda like your pet, your pet often has GPS trackers.

• 22:15Manoush Zomorodi?

  Oh yeah.

• 22:16Speaker 06

  Uh, so anyway, uh, I'm not saying people are the same as pets, but you get the idea. They can track some useful things and the point out of all of this is that we can track this stuff passively. Now, I do think there's enough information in these devices. You can get quite a bit of data. So we, for example, we can get a signal for red blood cell count because of the way, uh, the devices work. They actually look for it. They measure your oxygenated hemoglobin, so hemoglobin with oxygen, that's in your red blood cells. So they get, get a sense of your red blood cell count and that's valuable for anemia and dehydration. And then there are other parameters like the conductance on your skin. That's important for dryness.

• 22:59Speaker 06

  I mentioned earlier, that actually is a sign of diabetes. So there's enough parameters there that they can, they, they not only just tell you things are off, but they can give you some clues as to which direction they're off. So I, I think they will pull invaluable data and they'll just, just like your car, you probably look at your speed and your, your gas tank, but otherwise you don't really look at much in your car. And so the way I see it working is that there'll be all these sensors running in the background and then when something goes off, you'll get a red alert on your phone and you should go, probably go get it checked out. But yeah, people always ask me, what's the most important wearable to wear? And I always tell them a continuous glucose monitor because it's in part because we have

• 23:43Speaker 06

  so many people, uh, who are out of control with their, their glucose. These continuous glucose monitors are so visual that once you wear them, you'll never eat the same again. And I mean that in a good way, meaning you'll see exactly what spikes you and it's very personal, different foods spike different people. So you see what foods spike you, which ones don't, and you just gravitate towards the ones that don't and avoid the ones that do. And if you are gonna eat the ones that do spike your glucose, well, go do that brisk 15 minute walk and that'll suppress the spike. So there are things you

• 24:15Speaker 07

  can do to mitigate these. And in general, spiking is bad for your health. It correlates not only with diabetes, but cardiovascular disease. So I, I think we've got to get this under control. And we're, we're not there yet, that's for sure.

• 24:32Speaker 07

  Our healthcare system is broken.

• 24:34Manoush Zomorodi?

  Here's Michael Snyder on the TED stage.

• 24:37Speaker 07

  Our laboratory in the last 17 years has been trying to improve it. And along the way, I've even learned a lot of new things about my own health. It's broken because we practice sick care rather than healthcare. And even when we practice healthcare, if you think about it, it's a pretty archaic process. You will travel to a physician's office that really hasn't changed much in the last 40 years. When you're there, they'll take lots of blood and from all that blood and the time you're there, they actually don't make very many measurements. And from those measurements, they'll treat you based on population averages rather than the individual. We're trying to change all those steps. And one area in particular is remote health monitoring.

• 25:20Speaker 07

  What if you could measure your health with sensors and a dashboard, much like your car dashboard?

• 25:28Manoush Zomorodi?

  So you think also that in the future, like, just like we look at our car's dashboard, like, okay, are the tires inflated enough? How much gas do I have? I can check all the vital signs of my car, that we'll be able to do that for our bodies too?

• 25:40Speaker 07

  Absolutely. I think we need that because I think we want, just like our car, to run well and efficiently forever, or as long as you want to live.

• 25:50Manoush Zomorodi?

  But how do we get to a place where we think more of healthcare as preventive, like a personal dashboard to monitor our health in a sort of more holistic way?

• 26:03Speaker 07

  Yeah, well, we have to change the financial incentives. That's number one. What happens is people really only go to the doctor when they're ill. And so therefore, they only go every few years typically. There's no reason for any health plan to keep you healthy today. And that's why we practice sick care, because that's when people get paid. And the one exception to this is this life insurance.

• 26:26Manoush Zomorodi?

  Company, John Hancock, they have a vitality program that basically gives points. If you wear smartwatches and do things that keep you healthy, walk your 10,000 steps, for example. And so we need more things like that because in that case, the incentives are aligned. If people live longer, John Hancock makes more money. It's a life insurance company. So they wind up making more money if you live longer and you are healthier. So that's a good thing. And so again, they've got the financial incentives aligned. We need that for our health providers as well. That they, and in the whole system, it's pretty clear.

• 27:09Manoush Zomorodi?

  If you stay healthier, you know, you'll push off having all these chronic conditions. And hopefully, the idea is for us to live long, healthy lives and then just pass away sort of all at once. But not hang on there for the last decade of life. There are studies now that show that people live the last 11 to 15 years of their life, on average, with chronic conditions. Meaning they're living their last decade of life unhealthy, and that's not a good situation to be in. And so I think as these technologies get cheaper and cheaper, as they get more facile, like we talked about the heart attack case. If we automatically have people's information from their devices going to their doctor's office.

• 27:52Manoush Zomorodi?

  That would actually be much more accurate because your resting heart rate, first thing in the morning, is way more accurate than what's in a doctor's office. And so that stuff should just be online, sitting there when you walk in. Right now, your nurse takes your blood pressure and all these things. That can just get pulled straight in and it'd be more accurate, better data. And no more of this, well, when did this seem to go off? You could actually look at someone's heart rate information and see, wow, it looks like it went off, you know, three weeks ago or whenever. You can see it because of the jump up. So I think we can pull in information a lot better. And then the physician can make better assessments and spend less time on the routine things and spend more time

• 28:34Manoush Zomorodi?

  on more complex things. Now, of course, we're all going to have AI agents in the future. And the physician will be working with those to help actually better manage your health. Okay, my spidey sense, my worrying radar is going off beep beep beep right now. I want to push back on a few of these things. Okay, so first of all. Uh, digital privacy. Who's in charge of all of this data that's being collected? And if an insurance company is using it to incentivize me, couldn't they possibly also punish me or hold a pre-existing condition against me?

• 29:10Speaker 06

  Yeah, well, we would hope not. You're not allowed to be discriminated against for your genome information for health insurance. You can for life insurance, though. Unemployment, you're not allowed to be discriminated for that, from based on your genetic information. My own view is that we, obviously, if people are getting discriminated against, I do think we need laws to protect that. You know, I'm a believer that in any, you know, wealthy society, which I view the United States and most Western countries to be in, that you should have some minimal level of healthcare for your citizens. So I would hope that that would be the case for everyone. Obviously, it isn't, but we need to get there. But even if it were the case where, let's say, someone was using your smartwatch, I'd rather know

• 29:55Speaker 06

  that something is off and catch it with a watch than not know it exists and die of a heart attack, for example. So we need to, you know, the information is still valuable, but as it moves and becomes more facile, we do need, I think, I would argue, laws to protect people then in those circumstances.

• 30:18Manoush Zomorodi?

  The other concern I would have is that, uh, right now, this sounds like a rich person's, uh, healthcare system. I mean, you know, having someone to actually give your data to, a physician or a clinician, that means that you are seeing a doctor to begin with. How do we begin to make this more accessible? Right now, this is an expensive proposition.

• 30:42Speaker 06

  So you're right, the way we do deep data profiling, only rich people can afford it. And getting your genome sequence and some of these other things, uh, only people who pay out of pocket can do it. And, you know, we have a company called Q Bio that does whole-body MRI and a pretty deep medical testing. It's $3,500. So.

• 31:03Speaker 06

  A number of people can pay for that, but you know, probably the average working class family cannot, or they'd have to save up. I do think it would save money in the long term, but it only hits a subset of people. So there, I would say, yes, some people won't have access to that. But the one area where they will have access is the wearables. That's a neutralizer. So I think when you join a health plan, they should give you that smartwatch as part of the enrollment in the plan, because anyone can do it. You can do it remotely, too, right? You can live in the boonies and have this data transferred to your phone. Most people do have a phone, even when they live in remote parts of the

• 31:44Speaker 06

  world. 60% of the world has a phone, believe it or not, of adults. And so even in these remote places, they have a phone. All I have to do is link it to a smartwatch, and you've got a health tracking system that can track a fair number of things. Again, resting heart rate, heart rate variability. Heart rate variability, it's kind of a new metric that's popped up, that turns out to be a really great gauge of people's health.

• 32:07Manoush Zomorodi?

  Yeah, tell me about that, because I've been hearing it. I used to think that a steady heart rate was what you wanted, but that's actually not true.

• 32:14Speaker 06

  Yeah, that's correct. So you have, you know, what's called your sympathetic nervous system and parasympathetic nervous system. So voluntary and involuntary systems acting. And it turns out when they intersect, you wind up, if you're healthy, you get a variable heart rate, meaning they're not exactly the same beat per minute for every beat. There's a, just a little bit of a difference in milliseconds. And that's healthy. You actually should be having that. And when people's health goes down, either from a viral infection, heart conditions, and we saw this in the case I mentioned earlier about the person who had the heart failure, it's a general rule, your heart rate variability drops. And so

• 32:57Speaker 06

  it's a relatively new measure, but it turns out to be a very, very important one.

• 33:01Manoush Zomorodi?

  When we come back, more with geneticist Michael Snyder, and how his hearing aids monitor his social interactions. Would you want them? Today on the show, tracking what the body needs. I'm Manoush Zomorodi, and you're listening to the TED Radio Hour from NPR. We'll be right back.

• 33:31Speaker 01

  Stay tuned for the following announcements and messages from our sponsors.

• 33:35Manoush Zomorodi?

  This message comes from Cornerpiece, a podcast from TED. If you've ever stayed up at 2 AM wondering why some friendships last while others fall apart, or whether unconditional love actually exists, this show is for you. Check out Cornerpiece wherever you listen.

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• 34:21Manoush Zomorodi?

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• 34:50Manoush Zomorodi?

  It's the TED Radio Hour from NPR. I'm Manoush Zomorodi. Today on the show, tracking what the body needs. Stanford genetics professor Michael Snyder is a big believer in wearable technology. He regularly wears about eight devices, including four smartwatches, a few biotracking rings, and hearing aids that track different health measures 24/7. Snyder believes that individual health metrics tracked through these devices could bring about a revolutionary shift in how medicine is practiced.

• 35:26Manoush Zomorodi?

  But also, it could change how we interact with each other on a daily basis. Let's go back to Michael's hearing aids.

• 35:34Speaker 03

  There are these new hearing aids. They come from a company called Starkey, which is a hearing aid manufacturer. And they basically are collecting data. We're measuring how much they're interacting in the kinds of interactions. So how much they're in conversations, for example, with others? And how much they participate in this? We also measure, you know, TV time, how much they're, I suppose, on the internet by the voices announced, how much background noise is in their environment?

• 36:07Speaker 03

  So it captures all kinds of different information. And the goal is to try and understand what environments and how they interact with that environment will better lead to cognition, because we're doing cognition surveys as we go along. So we think this is very, very valuable information. We're not violating privacy. We're not collecting information about what they're saying, but more whether they're in these conversations or not.

• 36:32Speaker 03

  And so we know that's important. And I think what we're going to learn from this hearing aid study is exactly, you know, what kinds of interactions are important for keeping your cognition up. So we want to know what keeps you sharp. It's the number one thing people worry about most as they get older, is their cognition. They're afraid of dementia and Alzheimer's, and I don't blame them.

• 36:54Manoush Zomorodi?

  Can we talk more about how doctors currently use data? I guess most doctors, anyway. They rely on averages, right? So for example, I just got blood work done, and as long as each thing that they tested for was in the green zone, it came back as normal. Do you take issue with that approach?

• 37:13Speaker 03

  Population measurements, they are important. Don't get me wrong. If you're out of, you know, an individual range and you're very high on certain things, it is worth looking into. But equally important is knowing your baseline, because we all have very different baselines for heart rate, for skin temperature, for all these different things. And when you go off from your health, you'll get a jump up in that. But if you're, by today's world, if you're still in the normal range, nobody says anything. Anything to you. And a good example is, say, your heart rate is normally sixty. And suddenly, your resting heart rate goes to seventy-five. Something's off with you.

• 37:56Speaker 03

  Whereas seventy-five could be very normal for other people and probably wouldn't be flagged on a population average. And I think we need to get this into medicine. There's two things that count. One is your shift from your normal baseline. And the other is, are you, population average out of range? Both of those are important. And I would argue the first one's even more important. Shift from your baseline. And we can pick this up with wearables. We can pick this up with any kind of measurement. The micro sampling I mentioned earlier. Even your regular clinical measures. It's very important to know your trajectories.

• 38:32Manoush Zomorodi?

  Is there ever a point, though, where all this information is too much information? That people become hyper vigilant about every little thing that their body is doing? Keith Diaz, the researcher at Columbia with whom I partnered, he says, I can't wear a smartwatch because tracking my steps makes me crazy. I'll find myself, you know, looping around my backyard to make sure I get enough steps. Where's the line?

• 39:00Speaker 03

  Yeah, no. Well, obviously, we want everyone to be a healthy life. You don't want your devices making you unhealthy. My own view is there's no such thing as too much information. That this stuff is very, very valuable. But it's true, you don't want people freaking out. Like, you know, you know, people get their genome sequence and they're anxious about this sort of thing. You don't want them waking up every morning, oh, am I gonna get breast cancer? I'm gonna get breast cancer. But I'm a believer, the person owns their own data. If you are willing to share it, your physician can definitely see when things are going off. And you can see it, too. Imagine when you go into the doctor's office and you say you're not feeling well.

• 39:44Speaker 03

  First thing they ask is, so when did this start? You can almost always tell from your watch when it started. There's a shift. And suddenly, you could correlate that with maybe something that happened. In my case, when I got Lyme disease, it was picked up with a smartwatch and a pulse ox. I saw these shifts and I knew two weeks earlier, I was in rural Massachusetts helping my brother put up fences.

• 40:09Manoush Zomorodi?

  Where, you know, most ticks are lime infested in rural Massachusetts. I was there one day. And it's pretty clear because I was there one day. And then two weeks later, I saw the shift up. That it raised a strong possibility it was Lyme disease. I never got had a bull's eye. But it's just the whole timing and that turned out to be correct. It was Lyme disease. So I do think, again, this can be very, very important and valuable information. I I've been learning about this concept of interoception over the last year. This idea of the body sort of indicating to the brain what it needs. I mean, I hear people who are like, I don't even know if I sleep well anymore. I look at my device and it tells me. And sometimes I'm like, really? That's all I slept?

• 40:54Manoush Zomorodi?

  I thought I slept well. Do we start to lose touch with our embodied sense of self? When we start outsourcing all of our functions to being collected and tabulated by wearables? I would argue wearables for certain kinds of things like infectious disease, Afib. Those are really, really valuable, right? It's hard to argue with that. Hmm. We have some studies running now on transplant families. There's individuals with transplants. We're trying to make, see if anyone in the family gets ill. And if that happens, they get a red alert and they can isolate and not ideally infect the, you know, the person who had the transplant. And this has worked, actually.

• 41:36Manoush Zomorodi?

  So it's alerted people who could die if they actually got one of these respiratory viruses. So, so I think there are situations where it's good. Now, you picked the example of sleep, which I think is one of the more interesting ones. One of my colleagues here at Stanford has run a study that shows that depending what you tell people determines how they feel. So regardless of what the value is on their sleep device, if you tell them they had a good night's sleep from their score, even if they didn't, they actually wind up functioning very well that day. They do well. If you tell them they had a bad night's sleep, they actually don't function so well. So I think there, people are very influenced, like a lot by the score. So maybe that is a trickier one.

• 42:25Manoush Zomorodi?

  Earlier in our conversation, you said that continuous glucose monitors are the most important device someone could wear to keep track of their health. In an ideal world, how do you want to see people using them?

• 42:38Speaker 06

  Yeah, well, for one thing, I would say everybody wears one at least once a year, more if they're heading in the wrong direction, meaning their glucose out of control and it's getting worse. And they do it before they're diabetic. So, prevent diabetes, keep people healthy. So, we need to get them on these folks earlier. And because it's so visual, you will change your behavior in a good way. I'll tell you, when you wear one of these things and you drink a McDonald's shake, your glucose just goes through the roof and you'll think twice about drinking that shake again.

• 43:15Manoush Zomorodi?

  And what's the danger there, just for people who are not familiar?

• 43:19Speaker 06

  What it's doing, it's launching a lot of glucose into your blood. It winds up, your proteins get modified. And a key indicator of this is something called a hemoglobin A1C. It's a measure of your glucose levels. And that's associated with diabetes. Technically, diabetes doesn't kill you, but diabetes is associated with everything bad: cardiovascular disease, increased cancer. And so, you really want to keep your glucose levels down. And these devices, again, because they're so visual and it's real-time feedback, and I think if we get them out there, we can have a big transformation in preventing diabetes, in my opinion.

• 43:58Manoush Zomorodi?

  And what would that look like in terms of affecting society and not having so many people who are diabetic?

• 44:04Speaker 06

  I think probably as teenagers, we start, maybe before, we start putting these on. And then people would come where, earlier, if parents knew this stuff. If I knew 40 years ago what I knew now, I would have been eating very, very differently. And I think if, you know, new parents knew this stuff, they'd be a little more careful. Sugar is everywhere. So, I think, you know, I am very Pollyanna-ish. I think we can- Have a, you know, healthy society if we just educate people properly. Now, people tend to look at this stuff as they get old because their friends are getting unhealthy and this sort of thing. And we should really be doing it much, much earlier. You know, I know when you're young, you feel like you're invincible, you're going to live forever.

• 44:47Speaker 06

  But I think more of these pictures of showing two people are 75, one who's all stooped over and doesn't look very good at all, and another who looks like they're ready to run a marathon and looks incredibly fit. Those are very important visuals that I think will help people become healthy and strive for healthy lives. And I think the wearables and things we've been talking about are good ways to give feedback to keep people that way, keep them motivated to stay healthy.

• 45:18Manoush Zomorodi?

  That was Michael Snyder. He's a professor of genetics at Stanford University. You can hear his full talk at ted.com.

• 45:32Manoush Zomorodi?

  I have to say, I am fascinated by all the data that we can now collect from our bodies and the potential for truly personalized preventive medical treatments. But I am equally cautious about relying too much on data, to the point that we begin to ignore the sort of natural cues that our body is giving us when something is wrong. So we want to end our show with an idea about exactly that, with a speaker who is asking us to simply listen. Here's a very personal story from Lizzie Rakes Rinker from the TED stage. When you hear the term healthy, what comes to mind? What do you think of as health?

• 46:17Manoush Zomorodi?

  So when I was

• 46:18Speaker 03

  In college, I was a rower and it was my entire life. Everything that I did revolved around being healthy and being an athlete. I was arguably at my physical peak. I was obviously working out all the time, but I also was a really hardcore vegan. I had this elaborate regimen of vitamins and supplements that I took every day. I carried my emotional support water bottle with me wherever I went. And I was the cliche of a healthy person. However, the reason that I started really thinking about what it means to be well is that despite being super healthy on paper, being an athlete, I felt terrible, my friends. I was having panic attacks almost every week.

• 47:03Speaker 03

  I had this really weird chronic pain that no one could quite figure out. And I wasn't getting my periods. I just felt off, but I was really healthy, right? I kept saying, something doesn't feel right. And I couldn't really articulate what it was. So this is a picture of me from the middle of college. And nine days before my dad took this picture, moving me into my apartment,

• 47:29Speaker 03

  our mom, Becky, died after a really long and hard fought battle with cancer. And let me tell you, it kinda sucked. It is incredibly disorienting to watch somebody that you love be sick and die. It was incredibly disorienting to be going through that experience as I was a college athlete because one part of my life was completely revolved around optimizing my body and health and wellness. And I was seeing evidence every single day of that working. However, on the other side of my life, my mom did everything right. She was healthy, she was active. And she still got sick.

• 48:13Speaker 03

  And there was nothing that we could do about it. So because of my mom's illness and because of my experience as an athlete, I went on to make an entire career out of really exploring what it means to be healthy. So I'm gonna throw some definitions at you. Okay, the first one is health. The World Health Organization defines health as not having disease in your body. So in that instance, I was healthy. Nary a toxin was getting near this. I was obsessed with being clean and, you know, doing all the right workouts. But I couldn't really articulate what was going on. And what I've found in my work is that what I didn't have while I was healthy is I did not have any wellness. So holistic wellness is a trend that gets thrown around a lot.

• 48:57Speaker 03

  And it's rooted in this idea that we are a whole person, not just our bodies. So rather than putting all of the eggs into the physical basket, we start to look at our lives from the health of our environment. It looks at all of our circumstances, all of our lived experiences, and really takes those things into account to consider what we need. I've been working in wellness for 10 years. And I have coached hundreds of athletes. And I have seen a couple of things to always, always be true. The first, from an athletic standpoint, is that if an athlete does not have a holistic, balanced life, their performance will fail. It's not a matter of if, it's a matter of when.

• 49:39Speaker 03

  It is incredibly hard to keep it together and to care about, I don't know, going a little faster on the rowing machine if you are waiting to find out if your mom has made it out of surgery. If you don't have a safe home life, it's really hard to perform. The other thing that I see is that we're all shoulding on ourselves. I'm talking about all the things that we're like, ugh, I really should do more of X, Y, Z. And it might not even be a thing that you like. This happens to me a lot. I am really into running and people will find out this about me and come up to me and say, I should really get back into running. I used to be a big runner. And I'm like, oh, what happened? Did you get injured? And they're like, no, I hate running. I just really hate running. And I'm like, well, then why do you think you should be doing it? There are literally so many other ways that you can exercise, but this is what we do

• 50:24Speaker 03

  to ourselves. We tell ourselves we should be doing all of these things. We should be learning how to listen to our bodies. Like, what's the purpose of wellness? Is it just to lose weight? Is it just to look a certain way or to be able to go a little bit faster on the water? Or is the purpose of wellness and the balance of all of these different things to maybe, I don't know, make your life a little bit better instead of just your body. The last couple of months of my mom's life, she was very frail. She'd lost a lot of weight and she couldn't drive, so I had to drive her to the grocery store. And this woman saw her from across the way and ran up to her and was like, Becky, I haven't seen you in years. You look amazing. You look so good. You're so healthy. My mom was like, I am literally dying.

• 51:08Speaker 03

  But this is what we do to ourselves and to each other. We assume if you look a certain way, that you must be having a certain experience. And that is just not true. You cannot really tell anything about somebody's wellness or their lived experiences and their circumstances by the way that they look. And this is why we have to consider holistic wellness. And we have to start looking at our health as more than just our bodies, but everything that we experience. Those are the things that make a life. I'm going to leave you today with a quote from my favorite poem. And I said to my body softly, I want to be your friend. It took a long breath and replied, I have been waiting my whole life for this.

• 51:51Manoush Zomorodi?

  That was Lizzie Breaks Rinker. You can see her full talk at ted.com. Thank you so much for listening to our show today. This episode was produced by Katie Monteleone, Avery Keatley, and TED Talks Daily's Lucy Little. It was edited by Sanaz Meshkhanpour and me. Our production staff at NPR also includes Matthew Cloutier, Rachel Faulkner White, Phoeu Guerin, Harsha Nahada, and James Delahoussaye. Our executive producer is Irene Noguchi. Our audio engineer was Jimmy Keely. Our theme music was written by Ramtin Arablouei. Our partners at TED are Sal Khan, Logan McClure-Davda, Helen Walters, Roxane Highlash, and Daniela Balorozzo.

• 52:32Manoush Zomorodi?

  I'm Manoush Zamirodi, and you have been listening to the TED Radio Hour from NPR.

• 52:39Speaker 06

  Stay tuned for the following announcements and messages from our sponsors. This message comes from Cornerpiece, a podcast from TED. If you've ever stayed up at 2 a.m. wondering why some friendships last while others fall apart, or whether unconditional love actually exists, this show is for you. Check out Cornerpiece wherever you listen. This message comes from Charles Schwab with their original podcast, Choiceology. Choiceology is a show about the psychology and economics behind people's decisions. Download the latest episode and subscribe at schwab.com/podcast.