The Measure of Life

When Abhay Jani contracted Covid in May this year, he resolved to improve his health. A professional in the startup space, Jani is healthy by most standards. Only 25 years old, he works out almost daily, even using a fitness band to keep track of his workout. But what he knew he must do, he now says, was eat right.

“That was where it was pretty bad for me. I never looked much into my food habits. When Covid happened, I was moving between cities [from Ahmedabad to Baroda], so my food habits got worse,” he says. “Even my doctor was saying I needed to improve my diet.”

So a little over two months ago, Jani began using a new device that tracks his body’s blood sugar levels. This device—called Cyborg and brought out by the Bengaluru-based startup Ultrahuman—consists of a coin-sized skin patch that a user wears constantly, usually on an arm. By measuring the wearer’s glucose levels 24×7, the device allows the user to monitor the effects of food and exercise habits on the body, and adjust their lifestyle accordingly. Continuous glucose monitors such as this might have originally been made for diabetics but through devices such as Cyborg, even the healthy are beginning to use them for their fitness needs.
“I now know a lot about what the food I eat is doing to me. There have been some surprises. Like I assumed, a mixed vegetable curry consisting of potatoes, or say something like bhindi, wouldn’t be so bad. But I can see now that it leads to a big glucose level spike, unlike some other dishes. I’ve cut down or removed some food entirely. Like I have replaced aloo paratha with items like rava, upma or poha,” Jani says. “What the device has done for me is to help me understand my body’s metabolism. I now have a pretty accurate picture of my body’s fitness and what the food I eat is doing to it.”

Monitoring glucose levels is just the latest—and among the most advanced things—we can do with new technology. We are moving beyond just counting our steps. By using smartwatches, activity bands, or just a coin-sized patch on our skin, we are now tracking our glucose levels, heartbeats, blood pressure, respiratory rates, sleep, workouts, and even the rhythm and electric activity of our hearts. Through the collection of this intimate data of ourselves, and the possibility of acting upon it, these devices promise a new type of self-optimisation.

Health tracking through the usage of these devices may have long been moving in this direction. But the pandemic, manufacturers say, is further accelerating their adoption. “We are seeing a massive shift in consumers wanting to take charge of their health. Terms like SpO2 [oxygen saturation], body temperature, resting heart rate have become part of our household discussions,” says Vishal Gondal, CEO and founder of the fitness technology firm GOQii. “Because of the pandemic we are now seeing a massive wave of consumers saying I want to monitor these [vital signs], and take proactive steps to be healthier.”

Unlike most other fitness tracking firms, GOQii’s business model isn’t built on the hardware, but rather around it. Its devices, which measure many of these advanced metrics, are bundled together with consultations with health coaches and doctors (apart from the ability to buy health products on its platform and connect the data generated to insurance plans) on a subscription-based business model to build what Gondal calls a complete remote health monitoring solution. The firm already sells partnered devices which are connected to its platform, such as a continuous glucose monitoring device from Abbott Laboratories for diabetics.

One of the platform’s most popular initiatives was launched during the pandemic, where people who had contracted Covid and were quarantining themselves at home could use GOQii’s devices to track their vitals and share the data with their doctors. The platform has now even introduced a wearable device for children, apart from foraying into the home fitness category with smart treadmills and smart skipping ropes. “What we believe is that whether it is monitoring someone’s blood pressure levels, or glucose levels, or say fitness tools such as a treadmill or a skipping rope, all healthcare data and devices will eventually be connected, and this will eventually flow through a GOQii-type platform,” Gondal says.

A few years ago, Mohit Kumar, who along with Vatsal Singhal founded Runnr, the food ordering app which was later acquired by Zomato, was attending the popular Tiger Muay Thai martial arts camp in Thailand, where several top mixed martial arts athletes train, when he noticed how many of these athletes were tracking health metrics such as their heart rate variability, sleep, body temperature and blood sugar levels to optimise their training and recovery.

“This was my first introduction to biomarkers,” Kumar says. “That got me thinking—can we bring this [biomarker trackers] to everybody?”

Kumar and Singhal established Ultrahuman that through its Cyborg device allows users to track their blood sugar levels and provides a metabolic health score. Glucose levels are an interesting biomarker, he says, because almost everything from sleep, stress levels, exercise to our food habits affects it. “A close lived experience with glucose is a great way of bringing accountability and insight into our bodies,” he says.

Tracking one’s blood sugar levels over time, Kumar believes, will bring out a fundamental change in the way we conceive of fitness. Most ideas of fitness, he points out, revolve around doing some workout, and most devices measure this state of activity. But a person who lives in a low-stress environment is generally more active and leads a better lifestyle, may be healthier and even live longer than a person who solely goes to the gym and eats organic food, Kumar says. A device like Cyborg, through its ability to measure an individual’s blood sugar level, thus has the potential to measure one’s lifestyle, to work in the background even during the user’s moments of inactivity.

What the device tells us is not just about the food being consumed, but our body’s response to it. “The same pizza you eat in your 20s is different from when you eat it in your 30s and 40s because the underlying systems have changed. Your body metabolism has changed,” Kumar says.

Currently available in limited numbers in its beta stage, a larger commercial launch is still about a year away. According to the company, it is further improving the device’s accuracy and adding more biosensors to it, such as heart rate variability, body temperature, respiratory rate and sleep. “Right now, we are capturing the overall impact of things like sleep and exercise. But we want to see how much of, say, response to food is driven by your state of recovery, or stress or sleep, and how much by the actual food,” he says. “We want people to be able to make the least amount of behavioural change to make the most amount of impact.”

The pandemic is changing many of our wellness and fitness routines. So, while it is making some of us strap on wearable devices that track our sleep or glucose levels, it is also making many of us incorporate our workout routines entirely indoors. An interesting startup based in Hyderabad, Portl, allows one to combine these two preoccupations, and many more, through the novel form of a smart mirror. About 6×2.5 feet in size, with a sleek, 43-inch HD screen, large enough, according to the company, to enhance experience, but compact enough to fit into a space-constrained Indian home, this mirror will broadcast visual fitness-based content in the form of live or on-demand videos, allowing users to work out on a range of routines, from HIIT (high intensity interval training), strength and power endurance programmes, to dance-based, meditation and yoga programmes, and more. It also analyses users’ body movements and asks them to right incorrect postures.

The device, which will be out in about a month’s time, also comes with a separate device, about the size of one’s palm, which allows a user to track their core vitals, such as blood pressure, glucose levels, respiratory rates and ECGs.

“Getting people moving and keeping them fit is important. But underlying causes which may not be apparent are also crucial. These are important indicators of a person’s present health condition. And it is something we can now accurately do without visiting a diagnostic centre or hospital,” says Indraneel Gupta, who along with Vishal Chandapeta founded the startup. Over time, Portl’s smart mirrors will see further development, Gupta says, from the present fitness workout and personal health monitoring, to nutritional coaching and telemedicine integration.

But how much do these fitness-based devices really work? Can data gleaned from them lead us to truly improve our lives? Or are we trying to solve the problem of our modern unhealthy lives, a substantial part of which has been created by the proliferation of gadgets, by throwing one more gadget at it?

According to Ultrahuman’s Mohit Kumar, a device such as his can bring about lasting change, one that is also easier to sustain than unrealistic fitness goals. After wearing the device for several months, he has found the best window to do his dinners, avoiding both the glucose spikes when he eats too late, and hypoglycaemia (the dipping of blood sugar levels below normal) when he eats too early. He now also avoids excessive screen time, such as the 15-to-16 hours sometimes spent in front of a device earlier leading to glucose levels falling unnaturally. He has also learnt, he says, that by lifting heavier weights during strength training, it allows him to improve his metabolic score. “Like everyone else, I love carbs. [This way, with more strength training], I can make more leg room to eat more of carbs,” he says.

Ankit Kumar agrees with the kind of benefits tracking one’s health through smart devices can bring about. A 23-year-old who works as a growth consultant with several startups, Kumar has something of an itinerant lifestyle. He’s been living in several places over the past couple of years, from Delhi, Bengaluru, Himachal Pradesh to Uttar Pradesh currently, sometimes at hostels and homestays and even his relatives’ homes. This lifestyle coupled with poor food habits meant that when he looked down at the weighing scale atop which he stood in December last year, he found it at 110 kg. Over the last six months, he has transformed his lifestyle, working out daily, going for long walks, eating carefully and doing intermittent fasts. Two months ago, he also started tracking his glucose level through Ultrahuman’s Cyborg. This way, he has now lost about 35 kg. “To become fit, what I’ve realised is you need to do it smartly,” he says.

blood pressuredevicesglucose levelshealthheartbeatsrespiratory ratesUltrahumanWellness Issue 2021