2020 has been the year I’ve thought about my personal health and fitness more than any other year to date. Perhaps it’s because I had a pretty intense 2019, which made me gain weight and feel exhausted. Perhaps it’s because health and well-being products are central to the thesis of the fund I’ve been working on. Perhaps it’s because I marked my 35th birthday and after realising that I’m no longer as infinitely energetic as I was in my 20s, it’s as good a time as any to realise that we’re not immortal and invincible and making our fitness a priority is probably a good idea, regardless of what’s your focus in life at the moment.
Getting hit by a pandemic, where little is known about the novel virus causing it, also probably made an impact on wanting to have a healthy immune system.
Thus from the beginning of the year I ended up finally using a number of devices I had bought through crowdfunds and pre-sales over the last couple of years. I also bought new ones and ended up having a lot of conversations about them. I thought my experiences would be useful to others so I’ve written it down here with some links.
*I’m not getting paid by any of these companies, or doing it to get affiliate compensation.
1. The Oura Ring
A lot has been written about the Oura ring and it’s been called “the personal health tracking device to beat in 2020”. I got mine in the pre-sale a couple of years ago. I have always been quite impressed by the craftsmanship and how much is packed in the tiny form factor. It measures sleep cycles, including deep and REM sleep, heart rate, breathing rate, body temperature, steps, and when exercises, and also heart rate variability (HRV), which seems to be a very interesting thing to keep track of. Check out the study referenced here by Imperial College for example (on this particular one the data was collected by Whoop, which is a product I haven’t tried.) Here is another study on the same topic and another article explaining it in a more basic way. If you search the internet there are many more. It also measures a bunch of other things and packs a week of battery life, which is a game changer for me. The battery lost some capacity on mine after a while and Oura replaced the ring, after some good support experience.
As Covid hit, Oura launched a study in partnership with UCSF trying to map data collected on their platform with Covid infections in order to provide early detection. I’ve been participating in the study since the beginning and lately they’ve been using it in major US sports leagues to support tracking of infected athletes. Not clear to me if it’s going to work, but I like where the technology is going.
The biggest lesson learned for me here was - initially when I started using it a couple of years ago my mistake was that I kept it on my bedside and only put it on at night when I remembered. The issue is that it takes into account your activity level to provide its metrics, however for some reason it doesn’t pull the data from Apple Health which gets collected from my Apple Watch, for example, and only relies on its own collected data. At the beginning of the March lockdown I essentially moved from constant jetlag doing 56 mostly long-haul flights in the 6 months prior to being stuck at home without enough activity to get tired and under the health and economic anxieties the pandemic brought. My quality of sleep quickly suffered and the Oura ring had an unquestionable and very substantial benefit in helping me get that back under control.
2. Pocket Monkii
These are such a simple product, but I can’t possibly recommend them enough. I’ve used a TRX in various gyms and always thought it was a cool thing. I never considered seriously doing it at home before this product though. Generally I’ve always struggled to maintain a routine without the “peer pressure” and energy of other people in the gym or workout class. It’s not out of lack of trying. At home I have yoga mats, sets of elastic bands, weights, a couple of larger kettlebells and probably other things I’m forgetting about. I’ve tried setting up a routine with all of those and with using different apps for bodyweight exercises. However, none of it stuck.
But the Monkii is super portable, so you can have it with you everywhere, and generally doesn't require you to get on the ground, which I personally find very unpleasant unless it’s really clean and I’m wearing appropriate clothes. But with this one I got started at a time when I had just gained about 6kg of fat after the marathon of the world tour we did with the accelerator programme we were running at the time and a fairly low level of motivation and mental energy. I was in the worst shape I’ve been in a very long time. Still, the routines start super easy, build up the challenge very gradually, are quite short, and designed to really make you do something every day. After initially managing to do about 2 months of daily sessions, skipping only a couple of days along the way, there was a feeling of substantial improvement.
If you feel like getting a cheaper knock off version you can get one of these, or even use the guide on how to make your own by the founder of Monkii in case you can’t afford their product. I have no reservations in supporting them though and I think the app and routines they’ve developed are amazing.
3. Lumen
I got this one while they were running their first crowdfund a couple of years ago, but I missed the delivery and it got returned to the sender. I managed to recover it this year and it came at a time when I wasn’t at all in the mood for some intense diet. As mentioned I was 5+ kg of fat up, low energy, but was already doing the Monkii thing described above and feeling like getting in better shape. Didn’t want to put too much pressure and expectations on myself, but was curious about the product so set it up.
In a nutshell it’s designed to help you get on a ketogenic diet and do intermittent fasting and to help you to track if it’s working or not. You blow in the device in the morning and before and after certain events during the day and it measures the CO2 level in your breath. Such events are runs, exercises, meals and so on. It takes about a month to get it fully calibrated.
There are several really cool things that I really liked about it.
The application is beautiful and uses a snapchat story-like interface to help you learn about your metabolism. Even though I had read up on those topics in the context of keto and IF and currently have a few people around me doing it, I still found it very useful and insightful.
All the other diet like products I’ve tried are a bit too intense, I fail to meet them and then lose motivation. With this one, first of all I didn’t realise that the product would put me on a diet and I’d have to track my nutrition, as I thought it’s just a tracker. I was about to not do it, but was curious, so I started using it just measuring things and not trying to follow the plan it had put out for me at all.
What I liked about it is that it focuses on metabolic flexibility rather than keeping you in fat burning mode as much as possible. Essentially it seems that for most of us, when we decide to starve our body of carbs for a change, it takes 3-5 days for the metabolism to adequately switch to burning fat. The goal set up on Lumen tracks to what extent this is happening and puts you on a path, which alternates between eating your usual amount of carbs, then reducing them for a while and then in certain times asking you to just eat all the sweets in the world (or so it says, I never got to that bit). The goal is to teach your body to more rapidly switch in fat burning when there aren’t enough carbs.
While I wasn’t trying to go on the diet, just looking at the beautiful interface the mantra of “whatever doesn’t get measured doesn’t get managed“ somehow came into effect. I was going on fat burning mode just naturally from time to time and as I picked up that I’m “just about not eating one snack in the evening away from getting there”, it became quite difficult to ruin that and eat that snack. Without really trying I lost a couple of kg of fat over 6-7 weeks. Overall between the Monkii, the behaviour change Lumen taught me, the improvements in sleep and the occasional run, I lost 7 kg in a couple of months at the beginning of the pandemic and started feeling much better without too much effort put into it.
Interestingly among the debate about the benefits and risks of intermittent fasting, some researchers are speculating that it’d be a good strategy for priming your immune system in response to tackling Covid and similar infectious risks.
One important lesson learned was that I should have paired using the Lumen with some kind of meal tracker, because it was quite difficult to calculate in my head how many units of carbs I had the previous day. I’ve only tried Noom for a while, but didn’t find it workable. Have read that My Fitness Pal is good, but haven’t tried it yet.
A disclaimer - I’m probably the last person you should listen to about nutrition. I’ve heard that there are many other products that help you measure ketosis and have no idea if this is the best one. I just liked the build quality and quality of the app and it kind of did something for me for a while. Now thinking about actually going on it’s programme for a couple of months at some point.
4. Withings Body Cardio Scale
As I was using the Lumen it required that I input my weight, ideally every morning. I didn’t own a scale and went on to buy one, but thought that doing the input manually would be tedious so I looked for a WiFi connected one. The one I picked up caught my eye because besides measuring fat, muscle, bone mass and BMI, it also measured something called Pulse Wave Velocity (PWV), which I hadn’t heard of at the time.
PWV is a measure of arterial stiffness, or the rate at which pressure waves move down the vessel. It is used clinically as a measure of arterial stiffness. According to the Journal of the American College of Cardiology and to the European Society of Hypertension, PWV is highly reproducible, and predicts future cardiovascular events and all-cause mortality independent of conventional cardiovascular risk factors.
When I took the first measurement it was above 8, which is in the red and is apparently bad. Really annoying and I actually got somewhat worried. It was at the end of several really stressful weeks. The week after that was quite easy and I managed to sleep well and exercise a lot and it immediately dropped. And as I measure it every morning I’ve anecdotally seen quite a strong correlation between how my previous couple of days were in terms of how well I slept, exercised and what’s my overall anxiety vs happiness and the score of that PWV index.
Don’t really know if I’m imagining it and if this index should be that volatile in the first place, but the Withings Scale does seem to have been clinically validated and there’s a lot of scientific research around what are the implications of this measurement. When it managed to get not just in the normal zone, but in the ‘very good’ green part of it I was really pleased and it was yet another small reward feedback loop that has been helping me stay motivated.
Very keen to learn more about what it means once I have the time to read up on it.
5. Nourished
This is a company in the UK that 3D prints personalised nutrition supplements and vitamins for you. It seemed a bit like a gimmick at first to be honest (it actually probably is). But as just over half the population my Vit D is slightly low and I’m not great at taking my vitamins and figuring out how much to take and what to take and so on. So decided to give it a try and put all the things everyone was saying we should be eating to have an expectation for a lighter version of Covid once we catch it. Namely Vitamin D3, Zinc and Selenium. Put on a few other goody things there too. It has a questionnaire that helps you figure out what would be good for you based on your current needs and goals and can add up to 7 per daily serving. It sends you a box with a month's supply over the post and you can update the cocktail every month.
Best thing about it is that it’s one piece of thing you need to ingest. Looks yummy and pretty and tastes good. So you don’t get the unpleasantry of taking pills, which personally I don’t find too appealing with it’s association of medicine and being ill that at least I have.
Have to admit that I haven’t missed a day since I subscribed and my Vit D is back to normal, last I checked it. At 29 GBP / mo I don’t know if it’s the most cost effective way to get these nutrients or if they’re the best quality possible, but it works for me for the time being and I’ll let more nutrition knowledgeable people scrutinise on those grounds.
6. Pulse oximeters
Ok feel free to call me a hypochondriac or whatever, but admittedly especially in the first half of 2020, I was half convinced I’m having the Covid thing and was getting quite worried. Randomly discovered that a pulse oximeter is something a lot more accessible that I had thought and got one. This was before it was being talked about and I suspect there might be some shortage already. It really helped me verify that I’m not actually suffering from any real shortness of breath and happy, silent hypoxia or whatever it’s called, when I was feeling exhausted or anxious. It’s amazing what your body can make you feel under the right psychological stimulation. It’s important to interpret those signals correctly.
It also came in handy when we were having debates with friends about if masks on longer flights affect your ability to breathe properly and other similar pursuits. At least in my case, to my surprise my oximeter thing would show numbers in the low 90s and on one occasion the high 80s, after 4h with a mask on an A320 NEO. Different airplanes maintain cabin pressure at different altitude equivalents and imagine that’d have some effect. To my further surprise this didn’t constitute a very substantial discomfort. My baseline is consistently 98-99 even with an N95 mask when shopping or doing light physical activity. Advice on the internet would suggest that <95 you should call a doctor and <90 you should go to the ER.
Disclaimer: haven’t done research on that topic and would take most of what is being written in the news media with a pinch of salt. Whenever I’ve cared about something Covid related I’ve found that it’s not too hard to just go to scientific journals and skim through papers and you get much more out of it. Be it a bit time consuming initially it saves you some of the sensationalism and supports deeper understanding.
Most importantly it came really handy when my mom got infected and we had to figure out if and when to take her to the ER. She had no symptoms days into being diagnosed besides fatigue and some shortness of breath. The doctors were relaxed about it and general advice would suggest that there’s no need to do this sort of monitoring at home. However when her readings were showing figures in the 80s we went to the hospital, which led to having her put on oxygen therapy. And then while she was undergoing this therapy at home it was useful to monitor the effect. If we hadn’t done so, I gather, she’d be at risk of more severe complications. Thankfully she seems to be recovering well now.
Something to note - dirty fingers or nailpolish may affect the measurements. A potential workaround is to put it on your toe.
7. Chronomics
I didn’t know exactly what epigenetics is until a friend started working on Chronomix after completing a PhD in Cambridge in the field. Or at least I had forgotten what it’s called as I now recall we did study about it in high school a bit. And had no idea how the science around it has developed in recent years.
And then I never got around to checking out the product until the beginning of this year. Now that I’ve gone through the experience I think it’s super cool and useful.
Livescience.com gives the simplest explanation of epigenetics that I found: It literally means "above" or "on top of" genetics. It refers to external modifications to DNA that turn genes "on" or "off." These modifications do not change the DNA sequence, but instead, they affect how cells "read" genes.
It’s kind of what makes one cell become a brain cell and another a muscle cell and so on. They all have the same DNA, but different parts of it manifest. Also it turns out that this is how aging works and is in many cases affected by the environment. Things like stress, pollution, smoking, drinking, food and so on can substantially affect how our DNA manifests itself and determine our biological age in comparison to our chronological age and the various risks of disease like cancer. More specifically it can read into how different behaviours that we have like smoking or drinking alcohol have an effect on our epigenetics.
We already know some of these things are in principle bad for us and we chose to still do them regardless, because we feel that this is part of having a full life experience. However it’s good to know how bad exactly and when perhaps we should stop.
I’ve always been of 2 minds about genetic testing for a number of reasons. One of which is wondering if knowing about some of these risks, if you can’t do much about it is useful. The fact that the focus with products like Chronomix is not on the genome, but rather on how our environment and behaviors affects how it’s being manifested is what makes the difference. A lot of these effects are apparently reversible over time with the correct behavior changes. And in some cases we might learn that things we’re concerned about haven’t actually affected us.
The product includes detailed surveys that help you quantify the different environmental influences you might be exposed to, however the results don’t take this into account, but rather only read into the analysis of the sample provided.
What I got out of it were a few very actionable things I can change in my diet and behavior. It also comes with a platform that you can use to book sessions with specialists to whom you can give access to your metrics and have them consult you. Like the other examples above, having a few pretty graphs and metrics that you can influence to point in the right direction is highly motivating for me and I’m eager to try things and do the reading a year from the first one and then again the following year and see the results.
That being said unlike many of the other programmes these tests still wouldn’t be affordable for many people and I count myself fortunate that I’m able to take them and work towards maintaining my good health.
In conclusion
A few weeks ago I wasn’t even familiar with the ‘quantifiable self’ movement, but apparently I’ve somewhat joined it. Wouldn’t count myself as a data fetishist just yet, however I do find the ability to monitor myself and have something quantifiable to strive for as quite appealing. And largely because of those capabilities, 2020 did bring with it fitness and health improvements I can only be grateful for.
It made me think about methodically creating a health stack and figuring out how to incorporate it in my life.
The next challenge with it is how to integrate those new measurements in some kind of a dashboard or just in my normal work routines, so it doesn’t become too cumbersome. And also to think about the different data privacy challenges, so I don’t feed into more evil coming out of the internet economy as we’ve developed it. Admittedly I did get some measurement fatigue, especially with the Lumen which requires a bit of work for accurate data collection, but when habits form it becomes like muscle memory.
What’s your health stack like? Would love to be part of future conversations on those topics.
