You May Soon Be Able to Measure Blood Pressure From Your Finger

Valencell’s PPG sensors are teeny tiny and can measure blood pressure from your finger, wrist, or ear.

Valencell’s PPG sensors are teeny tiny and can measure blood pressure from your finger, wrist, or ear.
Image: Valencell

Wearable devices have become more sophisticated in recent years, with the ability to track everything from abnormal heart rates and atrial fibrillation to stress and even blood oxygen levels. However, monitoring blood pressure is a challenge for a wrist-worn device. Wearable components maker Valencell says it’s figured out how to measure blood pressure using photoplethysmography (PPG) heart rate sensors from your finger or wrist.

While Valencell might not be a household name, its tech can be found in tons of wearables from big-name companies, including Jabra, Suunto, LG, and Bose. They’ve been hinting at blood pressure-monitoring for years, and last year, Valencell announced it could identify hypertension via optical sensors in earbuds with 89% accuracy.

At the time, the company noted that while it had tested its tech on the finger and wrist, the accuracy simply wasn’t there yet. The problem, according to Valencell cofounder Dr. Steven LeBoeuf, is that PPG sensors collect a lot of data—which comes with a lot of noise. The company had intended to collect much more data in 2020 to refine accuracy for the finger and wrist, but the pandemic foiled those plans. Instead, LeBoeuf told Gizmodo the company had to get creative. In lieu of collecting more data, Valencell decided to refine its software to differentiate between “good” and “bad” quality signals from PPG data it already had.

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As a result, Valencell says this tech can now be embedded in smartwatches, fitness trackers, patches, and pulse oximeter finger clips. On top of that, Valencell’s approach to blood pressure-monitoring would be calibration-free and cuffless.

“I’d say our accuracy from the finger is about the same as the ear,” LeBouef says. He also noted that wrist accuracy also improved significantly from within 60mm of mercury per reading to 13mm. (10mm or lower is ideal for a calibration-free method.)

The exciting thing here is that Valencell’s tech wouldn’t require wearables makers to use a new sensor. PPG sensors—the teeny optical sensors that flash green light into your skin to measure your heart rate—are already widely used in wearables like Fitbits and the Apple Watch.

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Right now, most at-home blood pressure tech requires either calibration or is cuff-based. Omron’s HeartGuide, for example, is a smartwatch with an inflatable strap. Withings has also put out a futuristic blood pressure cuff. Samsung is testing a blood pressure-monitoring app that works with some of its smartwatches, but it requires you to first calibrate using—you guessed it—a cuff.

Cuff-based methods are accurate, but they do have some limitations. For example, Dr. LeBoeuf notes that the cuff method inherently comes with a two-minute wait time between cycles. That can be difficult in medical situations where you might want continuous blood pressure-monitoring in real-time (like during surgery, etc.). Cuffs also aren’t ideal for doctors trying to detect sleep apnea via blood pressure on slumbering patients, because the pressure of the cuff can cause patients to wake up. Plus, for dialysis patients, cuffs can also cause bruising. A non-invasive, passive monitoring system like the one Valencell is proposing would be beneficial in these instances.

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From a consumer perspective, a finger or wrist-based form factor is also preferable. In November, Valencell conducted a study and found that Americans with hypertension are inconsistent when it comes to monitoring their blood pressure. Only 31% of Americans said they measured their blood pressure “a few times per month, with another 31% saying they only measured “a few times a year.” Given a choice, the study respondents also said that they would likely measure more frequently if they could do so from a finger clip (41%), smartwatch (40%), or phone (32%).

LeBoeuf says the two methods are akin to chest strap heart rate monitors and wrist-based ones. While the chest straps are “far more accurate,” not as many people are willing to use or buy them, with sales volume around 10 million units per year. Meanwhile, wrist-based PPGs on smartwatches and fitness bands are convenient, passive, and included in more than hundreds of millions of units. Famously, the Apple Heart Study was able to enroll a record 400,000 participants from all 50 states in just eight months.

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This doesn’t mean your smartwatch or fitness tracker will be able to monitor your blood pressure in the next few months. Valencell says it’s pursuing clearance from the U.S. Food and Drug Administration in early 2021, which will in turn help wearables makers who want to embed this tech in their own devices. Individual gadget makers would then have to get FDA clearance for their particular device. Also, while Valencell’s tech could definitely have medical applications, like smartwatch ECGs, this would most likely be a tool to help people understand their baselines and get advice on when to seek official diagnoses from their doctors.

Still, this is exciting news as far as what we might be able to expect from future smartwatches and other types of wearables. And while the tech might not be available overnight, it’s quite possible that we’ll start measuring blood pressure from the finger or wrist in the next few years.

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We’re live from our couches covering CES 2021! Click here to read our complete coverage.

Philips Has a New Smart Toothbrush That Adapts as You Brush

Illustration for article titled Philips Has a New Smart Toothbrush That Adapts as You Brush

Image: Philips

It’s not CES without at least one AI-powered toothbrush that promises to revolutionize how you clean your mouth. It’s usually some form of Bluetooth connectivity with an app that lets you view which teeth you’ve brushed, and which ones you may have missed. At this year’s show, however, Philips’ Sonicare 9900 Prestige with SenseIQ takes it a step further—the brush uses AI to detect how much pressure you’re exerting, and then will adjust the intensity automatically.

Pressure-sensing isn’t a super new concept with connected toothbrushes. We saw it in the Oral-B Genius X and the Oral-B iO Series 9, which both display a red light when you’re brushing too hard. However, the Oral-B brushes rely on you, the brusher, to recognize your mistake and ease up. The Sonicare 9900 Prestige is meant to let you be lazy and brush however you like, with the toothbrush itself making up for your heavy-handedness.

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This takes some of the guesswork out of using a smart toothbrush. Many premium electronic toothbrushes sport several different modes and brush heads, depending on whether you want to whiten, clean, or say, focus on your gums. Philips says that’s unnecessary with the Sonicare 9900 Prestige, as it comes with a premium all-in-one brush head that is designed to do all these things at once. Supposedly, the triangular tip removes 100% more stains while longer, angled bristles remove 20x more plaque, clean deeper into your gums, and still provide “flex” in case you brush too hard.

The Sonicare 9900 Prestige does still offer the typical features you’d expect from a connected toothbrush. Namely, it works with the Philips Sonicare app to give you real-time guidance on “pressure, motion, position, duration, and frequency.” You can also get daily, weekly, monthly, and yearly progress reports and personalized recommendations on how to brush better.

That said, toothbrush apps are still kind of jank, considering how much these fancy toothbrushes cost. Speaking of cost, Philips is keeping mum on how much the Sonicare 9900 Prestige costs. Though, with words like “Prestige” in the title, it’s probably safe to assume this will cost a pretty penny.

We’re live from our couches covering CES 2021! Click here to read our complete coverage.

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This Stealth Startup Is Using Electrical Stimulation to Help People Walk Again

Some 33 million people in the U.S., or 1 in 7 Americans, have disabilities related to mobility, according to the Center for Disease Control and Prevention. Considered something of a silent health epidemic, the degree to which older and middle-aged Americans struggle with difficulties walking or climbing is immense.

However, a relatively new therapeutic technique, known as functional electrical stimulation, uses electrical pulses to artificially stimulate muscles and has shown some promise in increasing activity in people with impairments, such as neurological damage or multiple sclerosis.

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California startup Evolution Devices, Inc, based in Berkeley, has sought to leverage this therapeutic technique and harness it into a wearable, easy-to-use device. The company, founded in 2017, has spent the last three years developing the EvoWalk, a “non-intrusive sleeve” that is fitted around a person’s leg and uses tiny sensors to analyze their walking patterns (or “gait”). The sleeve subsequently utilizes machine learning and AI to create a customized personalized stimulation algorithm, a pattern of electrical stimulations, calibrated to stimulate their muscles and help them walk better.

“Through surface electrodes, the EvoWalk device sends an electrical impulse to contract the lower-leg muscle during the walking ‘swing phase,’ lifting the foot and allowing the patient to clear the ground and walk with greater stability and confidence, helping prevent falls,” the device’s creator, CEO of Evolution Devices Pierlugi Mantovani, said. “The EvoWalk uses patented machine learning algorithms to provide precise stimulation timing and report real-time detailed walking metrics to physical therapists, improving remote care.”

Evolution Devices has also been supercharged by some major funding—with approximately $1 million coming in from various sources, including significant grants from the National Science Foundation, the National Institution of Health, and the Toyota Mobility Foundation.

The EvoWalk is specifically designed to combat a disorder known as “foot drop,” a general term for difficulty walking caused by paralysis or weakness of muscles in the front part of the foot. Mantovani said he was inspired to create the device after his own father began to struggle with similar symptoms after being diagnosed with Multiple Sclerosis years ago. In 2017, Mantovani and his partners created the sleeve’s first prototype and have been building on it ever since.

“This first prototype successfully helped my dad walk better, and we knew that with improvements we could help significantly more people with neurological walking impairments as the best place to start,” said Mantovani. “Over the past three years, we have been innovating to achieve our vision to use our technology as a platform to assist and enhance all types of muscle movements.”

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All that hard work may be paying off soon. The EvoWalk’s beta device is scheduled to be completed later this month. The company plans to launch a virtual clinic in February and hopes to have clearance from the Food and Drug Administration by the 2nd quarter of this year.

Amazon Might Be Working on an Alexa-Enabled Sleep Apnea Gadget

Illustration for article titled Amazon Might Be Working on an Alexa-Enabled Sleep Apnea Gadget

Photo: Grant Hindsley/AFP (Getty Images)

Amazon might be working on an Alexa-enabled device that could potentially track sleep and detect sleep apnea, according to a Business Insider report.

Citing anonymous sources and an internal Amazon document, Business Insider claims the device is about the size of a person’s palm and looks like a hexagonal pad with a metal wire base. It’s meant to be placed on a person’s nightstand. The interesting bit is that the device will purportedly be contactless, utilizing millimeter-wave radar to track breathing and movement during sleep to detect whether someone may have sleep apnea. The device will probably also connect to other devices, as well as have a companion app for notifications. Internally, the project is supposedly called “Brahms”, after the composer Johannes Brahms. You know, the guy famous for writing lullabies, possibly because he, too, suffered from obstructive sleep apnea.

The report goes on to note that in the past year, Amazon has expanded the team responsible for building this device, and plans to build a “sleep-analysis” program that goes beyond sleep apnea.

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Gizmodo reached out to Amazon regarding Business Insider’s report but did not immediately receive a response.

If true, this isn’t terribly surprising news. In recent months, Amazon has signaled many times that it’s interested in expanding its healthcare and wearable tech business. Since November, Amazon has launched its Amazon Pharmacy service, added fitness tracking features to its Echo Buds, and also launched Halo, its very first fitness tracker.

The fact that Amazon may be targeting sleep apnea also makes sense. Sleep tracking devices aren’t new, and to set itself apart, Amazon would likely offer a feature that currently isn’t available. Of the medical conditions that health and wearable tech might be able to detect, sleep apnea is still up for grabs, affects an estimated 22 million Americans, and isn’t particularly easy to officially diagnose. Apple claimed its stake on atrial fibrillation via an ECG app way back in 2018 with the Apple Watch Series 4—and it took until 2020 for Fitbit and Samsung to catch up. Samsung has focused heavily on monitoring blood pressure. Meanwhile, Fitbit has been banging on about potentially detecting sleep apnea for years now, starting with the introduction of SpO2 sensors in its Ionic smartwatch. However, it wasn’t until early 2020 when it finally released its Estimated Oxygen Variation metric. At that time, Fitbit noted it was seeking FDA-clearance for a sleep apnea detection feature. Withings also announced its ScanWatch smartwatch last year, which also claimed to detect sleep apnea, though it’s still pending clearance from the FDA. Here we are a year later, and crickets.

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On top of that, sleep tracking has become an increasingly desirable feature, despite questions about overall accuracy. Apple finally added native sleep tracking with watchOS 7 in 2020. Recovery-focused, sleep tracking wearables like Whoop and the Oura Ring also nabbed headlines last year, partly because these devices were being used in studies to see whether they could detect covid-19. In any case, the global market for sleep tracking devices is expected to grow nearly 16% to $43.5 billion by 2026. You know Amazon wants a piece of that.

Stop Using Calorie-Counting Apps

Illustration for article titled Stop Using Calorie-Counting Apps

Photo: Victoria Song/Gizmodo

You. Yes, you, with your finger poised over the download button of some kind of diet or calorie-counting app. Stop it. I know January, a prime time for weight loss resolutions, is right around the corner, and that some of you might be feeling not-so-great about extra pounds gained during quarantine. Others might feel compelled to start 2021 with a fresh slate of healthy eating. Cool. Great. You don’t need a calorie-counting app for that.

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If you do a cursory Google search or follow any health and fitness accounts on social media, you’ll find dozens of articles and influencers touting the benefits of counting calories and recommending apps like MyFitnessPal, Noom, LoseIt!, and Chron-o-meter. Many cite studies that say people who keep food diaries are more likely to lose weight and keep it off. But, my friends, keeping a food diary is not necessarily the same thing as obsessively logging every single calorie that you put in your mouth.

The problem with many calorie-counting apps is in how they’re designed. Typically the on-boarding process has you enter your stats, including your height, current weight, goal weight, activity level, and in what time frame you want to lose (or gain) said weight. From there, the app will use some formula to calculate your basal metabolic rate (BMR). If all you did was lie down all day, without moving, your BMR would be the number of calories your body needs to keep everything running. From there, the app will likely generate a daily calorie allowance—a combination of your BMR, minus a certain number of calories based on your activity level and how fast you want to lose weight. This is some complicated math, but unless you opt for indirect calorimetry, a process that involves hooking yourself up to a ventilator for a period of time to measure the heat generated by the gases you exhale, you’re only getting a ballpark figure that may not even accurately apply to your individual body.

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Even MyFitnessPal admits in a blog that its estimates are not 100% accurate. Personally, MyFitnessPal told me that to lose about 1 pound a week, I’d have to eat roughly 1,370 calories a day. That’s a little too close to the 1,200 minimum recommended for women, and if you want to go by my Apple Watch, I burn roughly 2,100-2,500 calories a day. (Though I did appreciate that if I logged less than 1,000 calories in a day, MyFitnessPal chided me to eat more.)

So your calorie-counting app is probably giving you a daily allowance that’s inherently flawed right from the jump. Still, if you log calories, even if they’re an estimate, you’ll still get a pretty accurate picture of your caloric consumption, right? No!

While these apps’ calorie databases have vastly expanded over the past decade, anyone who’s ever used them for a few days can tell you about the limitations. If you cook a meal at home, you’re going to have to find the exact ingredient you use and meticulously measure the exact quantity you’ve used of said ingredient to get the most accurate measurement. Then, you have to save it as a recipe. This process, even in an app with a large database like MyFitnessPal, is tedious. Some will let you import a recipe from a website, but that feature doesn’t always work and doesn’t account for if you substitute an ingredient or two. Forget takeout or eating at a restaurant, unless it’s a fast-food chain that provides caloric information. This means that calorie-counting apps can incentivize you to eat packaged foods over healthier, home-cooked meals, simply because they’re easier to log.

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Even if you heroically commit to never eating out and meticulously creating logs for all your scratch-cooked meals, ingredient calorie counts are only estimates. No two medium potatoes have the same exact caloric content. How does the app define a medium versus large potato anyway? Unless you use a scale to measure your servings on a per gram basis, it’s extremely easy to over or underestimate your actual intake. (And who’s gonna lug around a scale all the time?) This Atlantic report notes that roughly 30% of people underestimate how much they eat. It also found people tended to exaggerate their healthy food intake. On top of all this, you can’t even 100% trust a nutrition label because the Food and Drug Administration lets manufacturers calculate calories using five different methods and allows up to a 20% margin of error. That 100-calorie snack could actually be as few as 80 calories or as much as 120 calories.

Say a miracle happened and your daily calorie allowance was spot on and you actually got an accurate account of how many calories you ate in a day. According to Scientific American, it’s virtually impossible to accurately calculate how many calories you actually absorb from the food you eat. Different preparation methods will impact how many calories you absorb—you get more from cooked meat than you would raw meat, for example. Fibrous foods are also harder for your body to break down. Your individual gut bacteria might also impact how many calories you absorb. I’ve never, ever come across a calorie-counting app that was able to mathematically account for that.

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This is to say nothing of calories burned, the inaccuracy of which is a rant for another day. However, many food-logging apps will add back calories burned to your daily allowance, lending credence to the idea that you can outrun a bad diet if you just exercise enough. That’s not how things work! Running a 10K doesn’t mean you suddenly have 600 or so extra calories to “spend” on three slices of pizza—not if you actually want to be healthy in the long run. A 2014 study in the British Journal of Sports Medicine noted that “physical activity does not promote weight loss” and that it actually does matter where your calories come from. The calories from sugar, fat, and protein will be metabolized differently. Can you use a calorie-counting app to track your macronutrients? Sure. But that app’s not going to be calculating where the calories you burned came from. Plus, whatever calorie burn estimate an app gives you for a given activity isn’t universally accurate either. Two 150-pound people will burn a different number of calories based on how much fat or lean muscle mass they have, and how active they are.

The whole point of food journaling isn’t to obsessively pore over arbitrary numbers. It’s to get a clearer picture of why, when, and how much food you eat—as well as how you felt while eating those foods. To do that, you’re better off just writing down what you eat in a notebook. Calorie-counting apps don’t make the process easier, they don’t explain the nuances of why “calories in, calories out” might not work for you, and they’re not even particularly accurate. The kicker is most people who download a calorie-counting app don’t keep up with it. This 2014 study found that when provided with a free self-monitoring app, only 2.58% of participants were active users and that the majority of those active users were already healthy.

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These apps focus on calories because it’s an easy way to visualize food intake, especially when it comes to weight loss. You don’t have to account for the nuances of the human body if you just tell people if they eat X calories they’ll lose Y pounds in Z months. The apps certainly don’t account for the false narratives they promote or the eating disorders they’ve been shown to exacerbate. There’s nothing wrong with wanting to lose a few pounds or with wanting to keep track of your food intake, whatever the reason may be. But instead of wasting time on a calorie-counting app that may only serve to drive you bananas, you might want to consult a registered dietician or your physician to safely and sustainably achieve those goals.