Is Counting Steps A Waste of Time?

Everyday I see a new ‘wearable’ product being launched with the promise that it would motivate me to be more active, lose weight, improve health & prevent all the potential ill effects of inactivity. Yet as a father of two kids there is never enough time to be active and certainly not the two hours it takes to complete the daily recommended activity goal of 10,000 steps!

So what’s the solution ? In a seminal piece of work, Paul T. Williams from the Lawrence Berkeley National Lab analyzed over 30 different studies covering over 2 million person years of follow-up to conclusively demonstrate that being fit is much more beneficial (i.e. lower risk of heart disease) than being active. In fact even a moderate improvement in fitness is more beneficial than being the most active person on the planet!

Fitness here is specifically defined as ‘cardio-respiratory fitness’ i.e. the ability of your heart & lungs to supply oxygen to your muscles when engaged in sustained physical activity.

As a result, the American Heart Association in 2013 issued a policy statement stating that “Cardio-respiratory fitness is the most important correlate of overall health status … and perhaps the strongest predictor for CVD and total mortality”. So if you have time to focus on improving one thing, that should be your fitness level not your activity.

Not to suggest that counting steps (or calories) is not beneficial at all … but it doesn’t seem like a smart way to improve your health. Fitness on the other hand is best improved through short bursts of high intensity training … so you actually spend less time yet can be healthier!


1. Paul T. Williams, Lawrence Berkeley National Laboratory, Med Sci Sports Exerc. 2001 May ; 33(5): 754–761
2. Donatello, Rebeka J. (2005). Health, The Basics. San Francisco: Pearson Education, Inc. (
3. Kaminsky et al A National Registry for Cardiorespiratory Fitness. Circulation. 2013;127:652-662

How to Measure Your Metabolic Health (with some help from Apple)

From the poll I ran last week it looks like people really want to understand their “metabolic health” Below are the first set of wireframes that show you how the app could look.

So what is Metabolic Health?

In simple terms its the efficiency with which your body is able to supply the necessary fuel for your energy needs.


MetabolicFitness_UI_v9_ActivityProfile_Update MetabolicFitness_UI_v9_7Low metabolic health puts you at increased risk for heart disease or diabetes. High metabolic health has a protective effect that to some extent can compensate for higher body weight.

The screen on the left shows you the 5 different levels of Metabolic Health – the lower your level, the higher your risk of getting diabetes or heart disease.

How will the app measure my Metabolic Health?

The first step is to enter a few basic details (height, weight, etc.). Next the app runs an analysis of your last week’s activity with the help of the iPhone 5s’ motion sensor to calculate your metabolic profile. (The middle screen shows your activity profile including how intensely you are moving).

This is based on pretty cool work done by NASA & UMass – we’ve modified this to accept the kind of data that the iPhone can provide. Accuracy is about 82% compared to going to a lab – which is useful if you’re trying to get a broad sense of where you stand and want to have a tool that can help you assess if you’re making improvements.

You can also see how active you’ve been versus clinical guidelines & use that as a tool to drive your metabolic health higher (screen on the right). Interestingly, increasing intensity of your activity is likely to have a bigger impact on your metabolic health than increasing the amount of time you spend being active.

Love to hear your comments / thoughts / suggestions below on what you personally find useful and how we could improve this app.

Want to be the first to test it or download it ? Sign up below :

[This is Week 2 of my involvement in the Lean Startup Challenge, Boston – applying lean principles to health technology product development You can read about my Week 1 experience here].

Lean Startup Challenge Boston 2013!

Hurrah! We got accepted into the Lean Startup Challenge Boston as one of ~25 teams selected to participate in the contest. The goal of the Lean Startup Movement is to help you quickly & cost-effectively identify your ‘Minimum Viable Product’ through repeated hypothesis testing until you’re reached the point where you know your idea is actually going to work!



Last Friday was the kick-off at the Boston Globe HQ and we had a great crowd. As a Rochester based startup I find its really helpful to get out & meet people whenever you can in Boston and other cities – gives you a broader perspective. Also given our relationship with UMass Amherst and other emerging partnerships in the Boston area, we’ve begun to feel part of the Boston community & there’s no better place to incubate a health tech startup.

Within a few minutes of arriving there we were all busy being fed and getting to know the other teams. Admit I don’t remember every startup but some ideas stood out – particularly those from teams I had the chance to meet.

Artistbomb : which is trying to make it easier for event locations to host a band Smart360Biz : which is trying to improve organizational efficiency

Runparty : helping runners real-time sync music with their friends

We finished the evening with a 60-second pitch including one I did for Revvo (yes that’s the name of the startup I’m working on!) – exercise therapy for diabetes patients that could potentially help stop or reverse the progression of the condition.

The next couple of days were busy with grounding in the foundations of the lean startup idea – useful even for someone who had read Eric Ries’ book on the topic and applied it to product development in a big healthcare organisation.

I’ve shared a couple of the presentations here and here. In fact what I personally found most useful (& practical to boot) was the 1-page Lean Canvas that you can use to define your idea across a number of dimensions. Its simple, easy to do & really a living / working document that you can share with others in your startup + potentially use for investor discussions etc.


So over the next few weeks I’m hoping to use the lean startup challenge as an opportunity to test if we can actually find a group of people who have lower than average levels of metabolic health, who are concerned about their metabolic health and are willing to take action to address that. I’m going to test this via an iphone app (the iPhone 5s’ new M7 co-processor creates the capability to actually measure metabolic health simply & easily).

Last week’s poll was a great starting point (thanks to all of you who participated) – to my slight (but pleasant) surprise – out of the app ideas listed, people were in fact most interested in measuring their metabolic health (45% picked this as their top idea) – so at least we have a strong foundation to build on.

Next step is to get a bit more granular on what kind of info (within the constraints of an iPhone screen size & measurement capability) is going to be most relevant & interesting – so you should shortly see a few draft wireframes on this blog! Look out for that and don’t forget to give me your feedback.

Cool Ideas to Leverage the iPhone’s New M7 Processor

20130910_134447-L1-580x326Apple launched the iPhone 5s earlier this week and one of the interesting new capabilities it revealed was the M7 chip that continuously tracks data from the accelerometer, gyroscope and compass. All 3 sensors have been previously available but until now could not be run in the background (something I would have really liked to have had 3 years ago when I buit Fitaide which used the accelerometer).

There’s already been speculation on the potential impact this could have on wearables like Fitbit & Nike Fuelband, which pretty much offer the same benefit today in a dedicated device. On the plus side this could also end up helping wearables by giving them a user base to upgrade from a ‘lite’ experience, so its not a surprise that Nike was amongst the first to launch an app, called Nike+ Moves.

The core technology however has many potential applications and got me thinking about doing an experimental app that could demonstrate some cool new features. Here are a few ideas, pick the one you would personally like to use. Also let me know, via comments or other means, any other suggestions you have.

UPDATE (09/25) : The poll is now closed, thanks to everyone who participated. You can see the results below. And now comes the fun stuff … we’re going to build out an app that will have the top 2 features that won in the poll. Look out for the wireframes in the blog post below!