July 1, 2025 • 22 mins
In this episode, Dr. Nicole Saphier and Dr. Paul Saphier discuss RFK Jr.'s bold initiative for every American to wear a health tracker within four years. The conversation delves into the potential benefits of wearable technology in promoting health and prevention, while also addressing significant concerns regarding data privacy, accuracy, and the mental health implications of tracking devices. The episode highlights the importance of understanding how data is used and the potential conflicts of interest in health recommendations, ultimately emphasizing that while technology can aid health, it cannot replace personal responsibility and lifestyle changes. Wellness Unmasked is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Tuesday & Friday.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to Wellness. I'm mass I'm doctor Nicole Sapphire. Today
we are going to tackle a headline that's making waves
across the health and tech spaces, RFK Junior's bold announcement
that every American should be wearing a health tracker within
the next four years. Boy did my x feed light
up with this. Some people loved it, some people hated it.
Will this usher in a new era of preventative health
(00:24):
and accountability or does it raise serious questions about privacy,
data and individual freedom and do they even work?
Speaker 2 (00:33):
Stay tuned.
Speaker 1 (00:33):
We are going to break down the benefits, the concerns,
and what this means for you. So for this conversation,
because it dives into the tech realm, Everyone who knows
me knows that I am probably the least tech savvy
person that there ever was. However, despite the fact that
I'm a radiologist and I'm constantly using tech in AI
(00:54):
and on a computer, for this conversation, I'm bringing in
my husband, doctor Paul Sapphire, and a vascular nurse surgeon
who is incredibly tech savvy and has some very interesting
opinions and perspectives.
Speaker 2 (01:06):
On these wearable trackers. Paul, thanks for joining.
Speaker 3 (01:09):
Well, thank you for that glowing introduction.
Speaker 2 (01:12):
You know, here's the thing.
Speaker 1 (01:13):
A lot of our friends, colleagues, patients all wear these devices.
You know, we're talking about Apple watches, the fitbits, even
those Aura rings. You see some people wearing the rings
that monitors them and it gives information back to their
smart device.
Speaker 2 (01:29):
You know, what's your.
Speaker 1 (01:30):
Big overall opinion on these digital health trackers.
Speaker 4 (01:34):
Well, first off, I think the concept of having accurate
and reliable information that you can then utilize to change
your habits, whether to exercise more sleep, you modify your
sleep regromens that get better sleep en half and so
and so forth, you know, changing the way you may
have your diet to lower your glycemic index sugars in
your body. I understand that, and I applause that. I
(01:57):
think that conceptually, that's a great idea. The question, of course,
is how accurate and reliable and usable is that information?
How where are we garnering that information, how are we
driving that information?
Speaker 3 (02:09):
And then how do you use it?
Speaker 1 (02:10):
Well, So, one of the things my concern is, let
me go back up for a second. In about twenty
twenty three, about forty five percent of Americans owned some
sort of fitness or smart watch, making them really a
mainstream gadget. But when you look at the data on
these In a twenty twenty two meta analysis, a really
(02:31):
big study I think it had about seventy five hundred
participants published in the British Journal of Sports Medicine, they
found activity trackers did boost activity by roughly eighteen hundred
steps per day and this led to modest weight loss.
So that would be a good thing, right If people
are actively monitoring their movements and they're seeing maybe they
(02:53):
were below you know, their goal for the day, for
the week, for even the month, if that gave them
an incentive, how could that not be a good thing.
Speaker 3 (03:00):
Well, I think you're looking at a very self selecting population, right.
Speaker 4 (03:03):
The people that are purchasing and utilizing these personal trackers
have an objective in mind. Either they're not feeling great
and they want to modify what they're doing in their
lives to feel better. Maybe they are over weight and
they're trying to lose weight, or maybe they're incredibly health
conscious to begin with and they're already you know, some
type of you know, either recreational or amateur performance athlete,
(03:27):
and they want to enhance their performance, So I think
that you're you know, there is a very self selecting
population at play there. In my opinion, again, the biggest
thing that I always wonder about is how accurate and
reliable is the information that we're guarding, And certainly we.
Speaker 3 (03:42):
See that not only in.
Speaker 4 (03:46):
Recreational advices such as these trackers, but also in every
aspect in healthcare that you and I use every day.
Speaker 3 (03:52):
How accurate and reliable.
Speaker 4 (03:54):
Is safe For instance, like a twelve le DKG so
that we use to to check the.
Speaker 3 (03:59):
Heart rate in somebody. You know, there's different levels of.
Speaker 4 (04:03):
Invasiveness that enhance how accurate something is in terms of
the data that's called from it. You know, when I
think about what I do for a living, you can
do what's called a spot EEG. You essentially tape little
electroludes onto somebody's scalp and you get to see how
accurate or you get to see how how their brain
(04:24):
waves are functioning to look for seizure activity. But then
there's even further enhanced levels of interrogation. You can do
what's called stereotactic depth electro monitoring. Well you actually in
certain little probes deep into the portions of the brain
and much of that.
Speaker 3 (04:41):
Obviously, all these different levels of invasements, at risks and
complications and also benefit. So you have to you have
to weigh that. I guess where I'm going that is,
how accurate is the information that we're deriving from these
trackers and what are you doing about that information?
Speaker 1 (04:58):
Well, we know it's interesting you brought up EKG different
from the EEG Looking for Seizure monitor, but the EKG
Apple came out with their own Apple Heart Study. So
one of the things that have proved beneficial of these
health trackers is potentially increasing movement, which you pointed out
one of the limitations It is a self selected population
(05:19):
who are already getting these who are probably wanting to
boost their activity. But the Apple Heart study, which had
over about four hundred thousand participants, showed that the monitor
was able to detect atrial fibrillation in zero point five
percent of users unknowingly, meaning the users had no idea
that they had this heart arrhythmia, which obviously you know
(05:43):
being a stroke specialist, that atrial fibrillation causes an increased
risk of stroke. So this allowed these patients to have
early medical intervention. So on one hand, I mean if
it is able to detect irregular heart rhythms and potentially
alert use you can alert your clinician that might be
a good thing, be saving lives from all the arrhythmias,
(06:05):
not just atrial fibrillation, but other ones that may be
leading to a heart attack.
Speaker 4 (06:09):
Hey listen, I think having more data and applying that
data either for monitoring the screening purposes is incredibly useful.
Certainly as a clinician myself, the more data that I
have that I can offer my patients to help guide
their treatment, their care, so on and so forth, certainly
is invaluable.
Speaker 3 (06:30):
And I think that's really quite interesting.
Speaker 4 (06:32):
You know, can we use these trackers to pick up,
to your point, a cardiac dis rhythmia, an irregular heartbeat
before it actually becomes a problem, and put them on
some type of therapy that decreases the risk of stroke
and so and so forth.
Speaker 3 (06:45):
Again, a fundamental question.
Speaker 4 (06:46):
That I have, and I'm not certainly arbitrating at the
judgment here, but fundamental question that I have is how
accurate is the data? And what are you doing? How
often are you changing what you do?
Speaker 2 (07:00):
Yeah? No, you bring up very valid concerns there.
Speaker 1 (07:02):
Before we get into what happens with the data, because
I definitely want to pick your brain on that. I
just want to also highlight a couple of other things
that they're saying could be beneficial for having these trackers.
One is monitoring real time blood glue close. I think
RFK Junior is saying if someone is able to see
that after I don't know, a big meal of hamburger
(07:24):
and fries, they see their blood sugar shoot up, they
may then be able to take that information and perhaps
at the next meal they're not eating such a carbohydrate
heavy meal. I think he's trying to give the power
back to the people in that sense that by educating
them on what their actions are doing to their body,
(07:46):
perhaps people will take that information.
Speaker 2 (07:49):
The skeptic in me, though, however.
Speaker 1 (07:53):
Is essentially that a tracker shines a spotlight on the habits.
While it can motivate and educate, especially when combined with
a game plan, a gadget is not going to ensure
long term health. That's really going to be your habits.
And I think, yes, it's a good good that this
tracker is going to give you information saying, oh, look
at your blood sugar went up after you ate this meal.
(08:14):
But at the end of the day, I'm pretty confident
that most Americans know if they go out and eat
a carbo heavy meal, that's probably not nearly as good
for them as if they're eating the fruits and vegetables.
And it's really more about access to healthier foods than educating.
Speaker 3 (08:30):
All right, that's where I was initially going. What I mentioned,
what are you doing with that data?
Speaker 4 (08:35):
So if you track your to your point, your glycimic index,
oh my gosh, I have a thirty percent increase in
my blood gluecose level. I'm just making something about, well,
these these trackers don't measure your blood glucose level, but
let's just say your blue close level in your body,
your third percent increase after a certain meal. If to
your point, you're not changing the way that you eat,
(08:58):
or you change the types.
Speaker 3 (09:00):
Of food that you're consuming, you're not really doing.
Speaker 4 (09:02):
Anything about data rights on an individual level.
Speaker 3 (09:05):
That's that's what I think about.
Speaker 4 (09:07):
You know, if you can derive at zero point five
percent of the people that are you know, purchasing these
these trackers for just you know, casual use, you're finding
you know that zero point five percent of that are
going to have acial fibrillation, which they didn't know, and
then you can institute a therapy for that person or
(09:28):
some type of medication to reduce the risk of stroke.
That's huge, It's potentially enormous, right, So that's why that's
where I'm going when I say, what are you doing
with that data?
Speaker 1 (09:37):
Yeah, but just like every other shiny new toy. I mean,
we have three kids, we know this. You get some fancy,
shiny new toy and the novelty wears off over time.
And Jamma actually published a study, granted it was almost
a decade ago, but it was looking at these fitness
trackers when they were kind of first coming onto the market,
(09:58):
and they said, you know, it's really short lived benefits
of these trackers because without persistent coaching, activity trackers really
didn't drive long term weight loss, which is one of
the primary reasons a lot of people got these were
to increase their activity levels. But the reality is, you know,
clinically speaking, there may not be a significant health impact,
(10:19):
meaning simply strapping on a gadget doesn't necessarily guarantee that
you're going to.
Speaker 2 (10:24):
Have better blood pressure or lower cholesterol.
Speaker 1 (10:27):
And lastly, one of the things that I'm most concerned
about because we have a friend who I'm not naming
names here, but you're going to know who I'm talking about.
They have what's called essentially orthosomnia, which is they are
obsessed with the metrics that their fitness tracker produces, and
if they're not meeting it like it actually causes. It's
(10:49):
a level of mental illness because they have this increased
anxiety or guilt, this overall obsession with achieving these ideometrics.
And we already have a mental illness crisis in the country.
The last thing we need is to obsess over another thing.
Speaker 4 (11:04):
Well, certainly we see people obsessing over any type of
technology that is intimately associated with them.
Speaker 3 (11:11):
Obviously the phones and the smart watches come to mind.
Speaker 4 (11:15):
But I think that you know what you mentioned from
my perspective, for any type of technology, certainly so that
I use in my professional realm as well as personal
ease of use, accessibility.
Speaker 3 (11:29):
And then reliability.
Speaker 4 (11:30):
Slash efficacy of those of those devices are paramount to
compliance with us. Right, So ease of use you got
to make it. That's why Apple in general did such
a great job with all their computers. Right they were like, hey,
we're the user friendly computers, and they assume they were
so ease of use is very you know, think of
me as as as a country simple individual. I'm just
(11:53):
you know, I'm not so so intelligent. Let me figure
how to use this thing very easily. Accessibility, make sure
that I can get into my hands, make it affordable,
make it ubiquitous all throughout, and then reliably and efficacy,
make sure that what I'm using it for is going
to work.
Speaker 3 (12:11):
Right. So, I think those are.
Speaker 4 (12:12):
Fundamentally how these things will actually ultimately serve a benefit.
Speaker 1 (12:19):
Well, truthfully, I believe, and this is the reason I
don't wear a health tracker. Is a gadget, is a tool.
It's not a solution. It's not going to give you
the motivation that you actually need to transform your lifestyle
for long term health gains. So I will raising my
hand right now. I have never worn a health tracker,
although I am very much into health and wellness, and
(12:40):
I applaud RFK Junior with his goal that he thinks
every American should be wearing one within four years.
Speaker 2 (12:47):
I likely will not.
Speaker 1 (12:48):
Be one of those Americans, but I will continue to
talk about any data that shows that why maybe we
should or why we shouldn't. But here's a question, Paul,
and this is what I saw a lot on social
media was as soon as this, As soon as RFK
Junior made this announcement, people were like, whoa big government
(13:10):
coming to really oversee us. I mean, we're not just
talking about, I know, raising taxes. We're talking about they
want to know intimate details about our body.
Speaker 4 (13:21):
Well, yeah, I mean I think that raises a huge
level of concern for myself. You know, these these trackers,
let's just say it's tracking your your step camp.
Speaker 3 (13:31):
Right, let's say.
Speaker 2 (13:34):
That you is it tracking your location too? Do they
always know where you are?
Speaker 4 (13:38):
But even before we get to that, first of all,
who is using that data?
Speaker 3 (13:43):
Who owns that data and who and how are they
using it?
Speaker 4 (13:45):
So now you know, we're kind of segueing from using
that data to improve your own exercise routine or regimen.
So now who's using that data for data mining purposes?
Are we right?
Speaker 3 (13:57):
So?
Speaker 4 (13:57):
You you have device, you have a you have a
first year you have a hardware device, you have the
software capability, you have who's storing that data? Where's that
that had being transmitted? There's a lot of fingers that
are touching that data. And the question ultimately is who
owns that data and what can they use it for.
So let's say the Let's say you're an individual, you're
(14:19):
documented it's being twenty percent overweight, and you had a
certain number of steps per year in twenty twenty four, right,
and now your health insurance company sees that your primary
care positions is recommending increased exercise. Let's say that in
twenty twenty five the number of steps you've taken actually
goes down by five percent. Are they no honer going
(14:41):
to pay for some of the healthcare that you required
because you weren't meeting the goals that your primary care
position outlined for you, and so you're considered a non
compliant individual.
Speaker 3 (14:51):
I know it sounds a little a little far fetched,
but ultimately.
Speaker 2 (14:54):
Well I don't think it sounds far so far fetched
because if you.
Speaker 1 (14:57):
Think about what is going on when you talk about
Medicaid recipients, you know, the people who can't afford healthcare.
So it's the state and federal government funded healthcare Medicaid.
They're wanting to put on work requirements saying if you
are an able bodied individual, then you to get Medicaid
and some of the other services you need to be
working as well. Are they now tracking these individuals?
Speaker 4 (15:19):
Sure, say you're on say you have insulin dependent diabetes
and you're using one of these one of these glucose
continues glucose monitors right with the auto insulin delivery system,
and let's say that for three month time period they
saw a significant surge in your glycemic index. Are they
(15:41):
going to now assume that you're eating habits are contrary
to what would be advisable for someone with incident deependent diabetes,
and now they're going to start cutting back how much
they're going to cover your cost for expensive medication. I mean,
I get that I could see a world in which
some these so these health carriers I should potentially do that.
Speaker 1 (16:04):
More coming up on Wellness Unmasked with doctor Nicole Sapphire.
So data privacy is an issue what they do with that.
While in theory it sounds good and maybe in some
very small pockets you can understand why there may be
some benefit, the concern is who owns the data, what
do they do with the data? Do all of a
(16:26):
sudden you're going to start seeing if you're a fitness
tracker or whatever shows that you go to certain locations,
or you're going to start seeing ads because now they
know your location or where you've been. You know what
about the RKE Junior mentioned that he wanted people to
be wearing these wearable trackers because he wanted to decrease
the expense of some of the medications, like the GLP
(16:48):
ones that people.
Speaker 2 (16:49):
Are taking because they're overweight.
Speaker 1 (16:50):
So he's thinking, if people are aware of their steps,
maybe they're going to lose weight, and therefore maybe it'll
decrease the costs on the GLP ones. I personally think
this is a massive stretch. I don't think that wearing
these health trackers are really going to provide the motivation
that people need. I think that there are other ways
to incentivize people that I laid out in my book
(17:13):
from twenty twenty.
Speaker 2 (17:14):
Make America Healthy Again.
Speaker 1 (17:17):
But another thing that I saw online people very concerned
about data privacy, data mining. They certainly don't want the
government monitoring their every move, how they sleep, or they go,
how they eat, what they do. But also a potential
conflict of interest between the Secretary of Health and Human
Services RFK Junior, his senior advisor Calli Means, and his sister.
(17:43):
Who is the Surgeon General nominatee Casey means, who owns
a company that actually sells these devices?
Speaker 2 (17:50):
What are your thoughts on that?
Speaker 3 (17:51):
Right?
Speaker 5 (17:51):
Well, I think there is a stretch of saying that
by having everybody having a tracker, increasing steps and improving
nutritional regiments is going to decrease the cost.
Speaker 3 (18:05):
Of GLP want. I think that's the stretch.
Speaker 4 (18:07):
I think it will definitely increase the sales of personal trackers,
and that's for sure.
Speaker 3 (18:12):
And when you have someone that is sitting as the CMO, the.
Speaker 4 (18:17):
Chief medical officer for a company that's valuated at three
hundred million dollars such as Levels, and they are advocating
for a non FDA approved app to monitor.
Speaker 3 (18:30):
Glue coaster in every person in the United States, for instance.
Speaker 4 (18:33):
Yeah, there seems to be a little bit of a
conflict of interest there.
Speaker 2 (18:37):
Yeah.
Speaker 1 (18:37):
The doctor case means, again, who's the Surgeon general nominee
that RFK Junior you really wanted since day one? He
was from sources tell me he was very dissatisfied with
the initial nominee, who doctor Jeanette Neschwatt whose nomination was pulled.
Doctor Casey means the current nominee. She's the co founder
(18:59):
of Level's Health, which which is a company that develops
apps to integrate continuous glucose monitor data and other.
Speaker 2 (19:05):
Wearable device metrics.
Speaker 1 (19:06):
So as a founder and stakeholder in a company that's
reliable on these wearable devices, she certainly has financial interest
in promoting their use. So this role obviously creates a
potential conflict of interests when making recommendations about wearable devices.
And that is the role of Surgeon General is to
put forth recommendations for the health of our nation. So
(19:28):
it's really important for audiences and patients to be aware
of this potential financial conflict when assessing her recommendations and
just overall commentary on wearables.
Speaker 4 (19:39):
One hundred percent, I mean, I believe that Levels raised
one hundred million dollars last year alone investors. So if
all of a sudden their sales skyrocket, which they already have,
or they continue to skyrocket because there's a quote RFK,
there will be a marketing blitz. Craig to the United
stays in order to disseminate any type of work, we
(20:00):
arable for every type of work, I should say to
everybody in the United States, well sales will absolutely shoot up,
and the valuation the company will in turn rise.
Speaker 1 (20:11):
I mean, I don't love that he did come out
and say there's going to be a massive one like
you've never seen before. It sounded very Trump esque that
they're going to do a massive campaign to get people
to wear these wearables, and they're going to be that
campaign will be funded by tax dollars. So our tax
dollars are going to fund this campaign, which is ultimately
(20:32):
going to financially benefit the private sector, of which the
Surgeon General nominee has a big stake in. I don't
know that raises some massive red legs to me.
Speaker 4 (20:42):
I mean, I think there's certain things that are inarguable
about what he says.
Speaker 3 (20:45):
Do we have an obsc problem in the United States? Yes?
Speaker 4 (20:49):
Should we have a national agenda to improve physical mental
health as well as nutritional health? Yes?
Speaker 3 (20:58):
Inarguably.
Speaker 4 (20:59):
I think those those types of statements I one hundred
percent support, And I think that ultimately, if people wish
to take control of their health, they should focus in
on modifying their behaviors.
Speaker 3 (21:12):
Not just you slapping a risk monitor or ring on you.
Speaker 4 (21:16):
I mean those if they ultimately are proven to have
a significant and reliable on effective measure and change how
people's health is delivered.
Speaker 3 (21:27):
Absolutely. I mean, then maybe that can be a.
Speaker 4 (21:29):
Useful tool, but there is no substitute for If you
have a nutritional issue, seeing a nutrition is working with
your physician, working on your own terms to modify your behavior.
If physical activity is an issue as well, you have
limitations you know, finding some type.
Speaker 3 (21:44):
Of regimen that's going to work with you, you know,
physical therapy, physiatry, so on and so forth.
Speaker 1 (21:48):
Right, Well, a tracker can track, but it can't transform,
and real health will come from habits, support and making
that data work for you if you are someone who
wants to wear these trackers.
Speaker 2 (21:59):
Paul, thanks so much for joining us on Wellness on Mass.
Speaker 3 (22:02):
Thank you so uch for having me.
Speaker 1 (22:03):
That's it for today's episode of Wellness Unmass. The idea
of a health tracker on every American's risk is both
intriguing and controversial, and it forces us to ask ourselves
how far we're willing to go for better health and
where we draw the line for privacy and personal choice.
Thanks for joining me. I'm doctor Nicole Sapphire and thanks
for listening to Wellness Unmass on America's number one podcast
(22:25):
network iHeart follow wellness on Mass with doctor Nicole Shire
and start listening on the free iHeartRadio app or wherever
you get your podcasts, and we will catch you next time.
Welcome to Wellness. I'm mass I'm doctor Nicole Sapphire. Today
we are going to tackle a headline that's making waves
across the health and tech spaces, RFK Junior's bold announcement
that every American should be wearing a health tracker within
the next four years. Boy did my x feed light
up with this. Some people loved it, some people hated it.
Will this usher in a new era of preventative health
(00:24):
and accountability or does it raise serious questions about privacy,
data and individual freedom and do they even work?
Speaker 2 (00:33):
Stay tuned.
Speaker 1 (00:33):
We are going to break down the benefits, the concerns,
and what this means for you. So for this conversation,
because it dives into the tech realm, Everyone who knows
me knows that I am probably the least tech savvy
person that there ever was. However, despite the fact that
I'm a radiologist and I'm constantly using tech in AI
(00:54):
and on a computer, for this conversation, I'm bringing in
my husband, doctor Paul Sapphire, and a vascular nurse surgeon
who is incredibly tech savvy and has some very interesting
opinions and perspectives.
Speaker 2 (01:06):
On these wearable trackers. Paul, thanks for joining.
Speaker 3 (01:09):
Well, thank you for that glowing introduction.
Speaker 2 (01:12):
You know, here's the thing.
Speaker 1 (01:13):
A lot of our friends, colleagues, patients all wear these devices.
You know, we're talking about Apple watches, the fitbits, even
those Aura rings. You see some people wearing the rings
that monitors them and it gives information back to their
smart device.
Speaker 2 (01:29):
You know, what's your.
Speaker 1 (01:30):
Big overall opinion on these digital health trackers.
Speaker 4 (01:34):
Well, first off, I think the concept of having accurate
and reliable information that you can then utilize to change
your habits, whether to exercise more sleep, you modify your
sleep regromens that get better sleep en half and so
and so forth, you know, changing the way you may
have your diet to lower your glycemic index sugars in
your body. I understand that, and I applause that. I
(01:57):
think that conceptually, that's a great idea. The question, of course,
is how accurate and reliable and usable is that information?
How where are we garnering that information, how are we
driving that information?
Speaker 3 (02:09):
And then how do you use it?
Speaker 1 (02:10):
Well, So, one of the things my concern is, let
me go back up for a second. In about twenty
twenty three, about forty five percent of Americans owned some
sort of fitness or smart watch, making them really a
mainstream gadget. But when you look at the data on
these In a twenty twenty two meta analysis, a really
(02:31):
big study I think it had about seventy five hundred
participants published in the British Journal of Sports Medicine, they
found activity trackers did boost activity by roughly eighteen hundred
steps per day and this led to modest weight loss.
So that would be a good thing, right If people
are actively monitoring their movements and they're seeing maybe they
(02:53):
were below you know, their goal for the day, for
the week, for even the month, if that gave them
an incentive, how could that not be a good thing.
Speaker 3 (03:00):
Well, I think you're looking at a very self selecting population, right.
Speaker 4 (03:03):
The people that are purchasing and utilizing these personal trackers
have an objective in mind. Either they're not feeling great
and they want to modify what they're doing in their
lives to feel better. Maybe they are over weight and
they're trying to lose weight, or maybe they're incredibly health
conscious to begin with and they're already you know, some
type of you know, either recreational or amateur performance athlete,
(03:27):
and they want to enhance their performance, So I think
that you're you know, there is a very self selecting
population at play there. In my opinion, again, the biggest
thing that I always wonder about is how accurate and
reliable is the information that we're guarding, And certainly we.
Speaker 3 (03:42):
See that not only in.
Speaker 4 (03:46):
Recreational advices such as these trackers, but also in every
aspect in healthcare that you and I use every day.
Speaker 3 (03:52):
How accurate and reliable.
Speaker 4 (03:54):
Is safe For instance, like a twelve le DKG so
that we use to to check the.
Speaker 3 (03:59):
Heart rate in somebody. You know, there's different levels of.
Speaker 4 (04:03):
Invasiveness that enhance how accurate something is in terms of
the data that's called from it. You know, when I
think about what I do for a living, you can
do what's called a spot EEG. You essentially tape little
electroludes onto somebody's scalp and you get to see how
accurate or you get to see how how their brain
(04:24):
waves are functioning to look for seizure activity. But then
there's even further enhanced levels of interrogation. You can do
what's called stereotactic depth electro monitoring. Well you actually in
certain little probes deep into the portions of the brain
and much of that.
Speaker 3 (04:41):
Obviously, all these different levels of invasements, at risks and
complications and also benefit. So you have to you have
to weigh that. I guess where I'm going that is,
how accurate is the information that we're deriving from these
trackers and what are you doing about that information?
Speaker 1 (04:58):
Well, we know it's interesting you brought up EKG different
from the EEG Looking for Seizure monitor, but the EKG
Apple came out with their own Apple Heart Study. So
one of the things that have proved beneficial of these
health trackers is potentially increasing movement, which you pointed out
one of the limitations It is a self selected population
(05:19):
who are already getting these who are probably wanting to
boost their activity. But the Apple Heart study, which had
over about four hundred thousand participants, showed that the monitor
was able to detect atrial fibrillation in zero point five
percent of users unknowingly, meaning the users had no idea
that they had this heart arrhythmia, which obviously you know
(05:43):
being a stroke specialist, that atrial fibrillation causes an increased
risk of stroke. So this allowed these patients to have
early medical intervention. So on one hand, I mean if
it is able to detect irregular heart rhythms and potentially
alert use you can alert your clinician that might be
a good thing, be saving lives from all the arrhythmias,
(06:05):
not just atrial fibrillation, but other ones that may be
leading to a heart attack.
Speaker 4 (06:09):
Hey listen, I think having more data and applying that
data either for monitoring the screening purposes is incredibly useful.
Certainly as a clinician myself, the more data that I
have that I can offer my patients to help guide
their treatment, their care, so on and so forth, certainly
is invaluable.
Speaker 3 (06:30):
And I think that's really quite interesting.
Speaker 4 (06:32):
You know, can we use these trackers to pick up,
to your point, a cardiac dis rhythmia, an irregular heartbeat
before it actually becomes a problem, and put them on
some type of therapy that decreases the risk of stroke
and so and so forth.
Speaker 3 (06:45):
Again, a fundamental question.
Speaker 4 (06:46):
That I have, and I'm not certainly arbitrating at the
judgment here, but fundamental question that I have is how
accurate is the data? And what are you doing? How
often are you changing what you do?
Speaker 2 (07:00):
Yeah? No, you bring up very valid concerns there.
Speaker 1 (07:02):
Before we get into what happens with the data, because
I definitely want to pick your brain on that. I
just want to also highlight a couple of other things
that they're saying could be beneficial for having these trackers.
One is monitoring real time blood glue close. I think
RFK Junior is saying if someone is able to see
that after I don't know, a big meal of hamburger
(07:24):
and fries, they see their blood sugar shoot up, they
may then be able to take that information and perhaps
at the next meal they're not eating such a carbohydrate
heavy meal. I think he's trying to give the power
back to the people in that sense that by educating
them on what their actions are doing to their body,
(07:46):
perhaps people will take that information.
Speaker 2 (07:49):
The skeptic in me, though, however.
Speaker 1 (07:53):
Is essentially that a tracker shines a spotlight on the habits.
While it can motivate and educate, especially when combined with
a game plan, a gadget is not going to ensure
long term health. That's really going to be your habits.
And I think, yes, it's a good good that this
tracker is going to give you information saying, oh, look
at your blood sugar went up after you ate this meal.
(08:14):
But at the end of the day, I'm pretty confident
that most Americans know if they go out and eat
a carbo heavy meal, that's probably not nearly as good
for them as if they're eating the fruits and vegetables.
And it's really more about access to healthier foods than educating.
Speaker 3 (08:30):
All right, that's where I was initially going. What I mentioned,
what are you doing with that data?
Speaker 4 (08:35):
So if you track your to your point, your glycimic index,
oh my gosh, I have a thirty percent increase in
my blood gluecose level. I'm just making something about, well,
these these trackers don't measure your blood glucose level, but
let's just say your blue close level in your body,
your third percent increase after a certain meal. If to
your point, you're not changing the way that you eat,
(08:58):
or you change the types.
Speaker 3 (09:00):
Of food that you're consuming, you're not really doing.
Speaker 4 (09:02):
Anything about data rights on an individual level.
Speaker 3 (09:05):
That's that's what I think about.
Speaker 4 (09:07):
You know, if you can derive at zero point five
percent of the people that are you know, purchasing these
these trackers for just you know, casual use, you're finding
you know that zero point five percent of that are
going to have acial fibrillation, which they didn't know, and
then you can institute a therapy for that person or
(09:28):
some type of medication to reduce the risk of stroke.
That's huge, It's potentially enormous, right, So that's why that's
where I'm going when I say, what are you doing
with that data?
Speaker 1 (09:37):
Yeah, but just like every other shiny new toy. I mean,
we have three kids, we know this. You get some fancy,
shiny new toy and the novelty wears off over time.
And Jamma actually published a study, granted it was almost
a decade ago, but it was looking at these fitness
trackers when they were kind of first coming onto the market,
(09:58):
and they said, you know, it's really short lived benefits
of these trackers because without persistent coaching, activity trackers really
didn't drive long term weight loss, which is one of
the primary reasons a lot of people got these were
to increase their activity levels. But the reality is, you know,
clinically speaking, there may not be a significant health impact,
(10:19):
meaning simply strapping on a gadget doesn't necessarily guarantee that
you're going to.
Speaker 2 (10:24):
Have better blood pressure or lower cholesterol.
Speaker 1 (10:27):
And lastly, one of the things that I'm most concerned
about because we have a friend who I'm not naming
names here, but you're going to know who I'm talking about.
They have what's called essentially orthosomnia, which is they are
obsessed with the metrics that their fitness tracker produces, and
if they're not meeting it like it actually causes. It's
(10:49):
a level of mental illness because they have this increased
anxiety or guilt, this overall obsession with achieving these ideometrics.
And we already have a mental illness crisis in the country.
The last thing we need is to obsess over another thing.
Speaker 4 (11:04):
Well, certainly we see people obsessing over any type of
technology that is intimately associated with them.
Speaker 3 (11:11):
Obviously the phones and the smart watches come to mind.
Speaker 4 (11:15):
But I think that you know what you mentioned from
my perspective, for any type of technology, certainly so that
I use in my professional realm as well as personal
ease of use, accessibility.
Speaker 3 (11:29):
And then reliability.
Speaker 4 (11:30):
Slash efficacy of those of those devices are paramount to
compliance with us. Right, So ease of use you got
to make it. That's why Apple in general did such
a great job with all their computers. Right they were like, hey,
we're the user friendly computers, and they assume they were
so ease of use is very you know, think of
me as as as a country simple individual. I'm just
(11:53):
you know, I'm not so so intelligent. Let me figure
how to use this thing very easily. Accessibility, make sure
that I can get into my hands, make it affordable,
make it ubiquitous all throughout, and then reliably and efficacy,
make sure that what I'm using it for is going
to work.
Speaker 3 (12:11):
Right. So, I think those are.
Speaker 4 (12:12):
Fundamentally how these things will actually ultimately serve a benefit.
Speaker 1 (12:19):
Well, truthfully, I believe, and this is the reason I
don't wear a health tracker. Is a gadget, is a tool.
It's not a solution. It's not going to give you
the motivation that you actually need to transform your lifestyle
for long term health gains. So I will raising my
hand right now. I have never worn a health tracker,
although I am very much into health and wellness, and
(12:40):
I applaud RFK Junior with his goal that he thinks
every American should be wearing one within four years.
Speaker 2 (12:47):
I likely will not.
Speaker 1 (12:48):
Be one of those Americans, but I will continue to
talk about any data that shows that why maybe we
should or why we shouldn't. But here's a question, Paul,
and this is what I saw a lot on social
media was as soon as this, As soon as RFK
Junior made this announcement, people were like, whoa big government
(13:10):
coming to really oversee us. I mean, we're not just
talking about, I know, raising taxes. We're talking about they
want to know intimate details about our body.
Speaker 4 (13:21):
Well, yeah, I mean I think that raises a huge
level of concern for myself. You know, these these trackers,
let's just say it's tracking your your step camp.
Speaker 3 (13:31):
Right, let's say.
Speaker 2 (13:34):
That you is it tracking your location too? Do they
always know where you are?
Speaker 4 (13:38):
But even before we get to that, first of all,
who is using that data?
Speaker 3 (13:43):
Who owns that data and who and how are they
using it?
Speaker 4 (13:45):
So now you know, we're kind of segueing from using
that data to improve your own exercise routine or regimen.
So now who's using that data for data mining purposes?
Are we right?
Speaker 3 (13:57):
So?
Speaker 4 (13:57):
You you have device, you have a you have a
first year you have a hardware device, you have the
software capability, you have who's storing that data? Where's that
that had being transmitted? There's a lot of fingers that
are touching that data. And the question ultimately is who
owns that data and what can they use it for.
So let's say the Let's say you're an individual, you're
(14:19):
documented it's being twenty percent overweight, and you had a
certain number of steps per year in twenty twenty four, right,
and now your health insurance company sees that your primary
care positions is recommending increased exercise. Let's say that in
twenty twenty five the number of steps you've taken actually
goes down by five percent. Are they no honer going
(14:41):
to pay for some of the healthcare that you required
because you weren't meeting the goals that your primary care
position outlined for you, and so you're considered a non
compliant individual.
Speaker 3 (14:51):
I know it sounds a little a little far fetched,
but ultimately.
Speaker 2 (14:54):
Well I don't think it sounds far so far fetched
because if you.
Speaker 1 (14:57):
Think about what is going on when you talk about
Medicaid recipients, you know, the people who can't afford healthcare.
So it's the state and federal government funded healthcare Medicaid.
They're wanting to put on work requirements saying if you
are an able bodied individual, then you to get Medicaid
and some of the other services you need to be
working as well. Are they now tracking these individuals?
Speaker 4 (15:19):
Sure, say you're on say you have insulin dependent diabetes
and you're using one of these one of these glucose
continues glucose monitors right with the auto insulin delivery system,
and let's say that for three month time period they
saw a significant surge in your glycemic index. Are they
(15:41):
going to now assume that you're eating habits are contrary
to what would be advisable for someone with incident deependent diabetes,
and now they're going to start cutting back how much
they're going to cover your cost for expensive medication. I mean,
I get that I could see a world in which
some these so these health carriers I should potentially do that.
Speaker 1 (16:04):
More coming up on Wellness Unmasked with doctor Nicole Sapphire.
So data privacy is an issue what they do with that.
While in theory it sounds good and maybe in some
very small pockets you can understand why there may be
some benefit, the concern is who owns the data, what
do they do with the data? Do all of a
(16:26):
sudden you're going to start seeing if you're a fitness
tracker or whatever shows that you go to certain locations,
or you're going to start seeing ads because now they
know your location or where you've been. You know what
about the RKE Junior mentioned that he wanted people to
be wearing these wearable trackers because he wanted to decrease
the expense of some of the medications, like the GLP
(16:48):
ones that people.
Speaker 2 (16:49):
Are taking because they're overweight.
Speaker 1 (16:50):
So he's thinking, if people are aware of their steps,
maybe they're going to lose weight, and therefore maybe it'll
decrease the costs on the GLP ones. I personally think
this is a massive stretch. I don't think that wearing
these health trackers are really going to provide the motivation
that people need. I think that there are other ways
to incentivize people that I laid out in my book
(17:13):
from twenty twenty.
Speaker 2 (17:14):
Make America Healthy Again.
Speaker 1 (17:17):
But another thing that I saw online people very concerned
about data privacy, data mining. They certainly don't want the
government monitoring their every move, how they sleep, or they go,
how they eat, what they do. But also a potential
conflict of interest between the Secretary of Health and Human
Services RFK Junior, his senior advisor Calli Means, and his sister.
(17:43):
Who is the Surgeon General nominatee Casey means, who owns
a company that actually sells these devices?
Speaker 2 (17:50):
What are your thoughts on that?
Speaker 3 (17:51):
Right?
Speaker 5 (17:51):
Well, I think there is a stretch of saying that
by having everybody having a tracker, increasing steps and improving
nutritional regiments is going to decrease the cost.
Speaker 3 (18:05):
Of GLP want. I think that's the stretch.
Speaker 4 (18:07):
I think it will definitely increase the sales of personal trackers,
and that's for sure.
Speaker 3 (18:12):
And when you have someone that is sitting as the CMO, the.
Speaker 4 (18:17):
Chief medical officer for a company that's valuated at three
hundred million dollars such as Levels, and they are advocating
for a non FDA approved app to monitor.
Speaker 3 (18:30):
Glue coaster in every person in the United States, for instance.
Speaker 4 (18:33):
Yeah, there seems to be a little bit of a
conflict of interest there.
Speaker 2 (18:37):
Yeah.
Speaker 1 (18:37):
The doctor case means, again, who's the Surgeon general nominee
that RFK Junior you really wanted since day one? He
was from sources tell me he was very dissatisfied with
the initial nominee, who doctor Jeanette Neschwatt whose nomination was pulled.
Doctor Casey means the current nominee. She's the co founder
(18:59):
of Level's Health, which which is a company that develops
apps to integrate continuous glucose monitor data and other.
Speaker 2 (19:05):
Wearable device metrics.
Speaker 1 (19:06):
So as a founder and stakeholder in a company that's
reliable on these wearable devices, she certainly has financial interest
in promoting their use. So this role obviously creates a
potential conflict of interests when making recommendations about wearable devices.
And that is the role of Surgeon General is to
put forth recommendations for the health of our nation. So
(19:28):
it's really important for audiences and patients to be aware
of this potential financial conflict when assessing her recommendations and
just overall commentary on wearables.
Speaker 4 (19:39):
One hundred percent, I mean, I believe that Levels raised
one hundred million dollars last year alone investors. So if
all of a sudden their sales skyrocket, which they already have,
or they continue to skyrocket because there's a quote RFK,
there will be a marketing blitz. Craig to the United
stays in order to disseminate any type of work, we
(20:00):
arable for every type of work, I should say to
everybody in the United States, well sales will absolutely shoot up,
and the valuation the company will in turn rise.
Speaker 1 (20:11):
I mean, I don't love that he did come out
and say there's going to be a massive one like
you've never seen before. It sounded very Trump esque that
they're going to do a massive campaign to get people
to wear these wearables, and they're going to be that
campaign will be funded by tax dollars. So our tax
dollars are going to fund this campaign, which is ultimately
(20:32):
going to financially benefit the private sector, of which the
Surgeon General nominee has a big stake in. I don't
know that raises some massive red legs to me.
Speaker 4 (20:42):
I mean, I think there's certain things that are inarguable
about what he says.
Speaker 3 (20:45):
Do we have an obsc problem in the United States? Yes?
Speaker 4 (20:49):
Should we have a national agenda to improve physical mental
health as well as nutritional health? Yes?
Speaker 3 (20:58):
Inarguably.
Speaker 4 (20:59):
I think those those types of statements I one hundred
percent support, And I think that ultimately, if people wish
to take control of their health, they should focus in
on modifying their behaviors.
Speaker 3 (21:12):
Not just you slapping a risk monitor or ring on you.
Speaker 4 (21:16):
I mean those if they ultimately are proven to have
a significant and reliable on effective measure and change how
people's health is delivered.
Speaker 3 (21:27):
Absolutely. I mean, then maybe that can be a.
Speaker 4 (21:29):
Useful tool, but there is no substitute for If you
have a nutritional issue, seeing a nutrition is working with
your physician, working on your own terms to modify your behavior.
If physical activity is an issue as well, you have
limitations you know, finding some type.
Speaker 3 (21:44):
Of regimen that's going to work with you, you know,
physical therapy, physiatry, so on and so forth.
Speaker 1 (21:48):
Right, Well, a tracker can track, but it can't transform,
and real health will come from habits, support and making
that data work for you if you are someone who
wants to wear these trackers.
Speaker 2 (21:59):
Paul, thanks so much for joining us on Wellness on Mass.
Speaker 3 (22:02):
Thank you so uch for having me.
Speaker 1 (22:03):
That's it for today's episode of Wellness Unmass. The idea
of a health tracker on every American's risk is both
intriguing and controversial, and it forces us to ask ourselves
how far we're willing to go for better health and
where we draw the line for privacy and personal choice.
Thanks for joining me. I'm doctor Nicole Sapphire and thanks
for listening to Wellness Unmass on America's number one podcast
(22:25):
network iHeart follow wellness on Mass with doctor Nicole Shire
and start listening on the free iHeartRadio app or wherever
you get your podcasts, and we will catch you next time.
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