HEALTH

Stanford U: Wearables of the future will be used as early warning system

BY Michael Johnsen

STANFORD, Calif.  — The future of wearables may not only be in self-care, where users collect health data points to help guide their lifestyle choices, but also as a diagnostic tool to diagnose disease earlier in its cycle, according to a study released by Stanford University School of Medicine Thursday.

Wearable sensors that monitor heart rate, activity, skin temperature and other variables can reveal a lot about what is going on inside a person, including the onset of infection, inflammation and even insulin resistance, according the researchers.

Over the course of the study, the Stanford team of researchers collected nearly 2 billion measurements from 60 people, including continuous data from each participant's wearable biosensor devices and periodic data from laboratory tests of their blood chemistry, gene expression and other measures. Participants wore between one and eight commercially available activity monitors and other monitors that collected more than 250,000 measurements a day. The team collected data on weight; heart rate; oxygen in the blood; skin temperature; activity, including sleep, steps, walking, biking and running; calories expended; acceleration; and even exposure to gamma rays and X-rays.

The study demonstrated that, given a baseline range of values for each person, it is possible to monitor deviations from normal and associate those deviations with environmental conditions, illness or other factors that affect health. Distinctive patterns of deviation from normal seem to correlate with particular health problems. Algorithms designed to pick up on these patterns of change could potentially contribute to clinical diagnostics and research.

The work is an example of Stanford Medicine's focus on precision health, whose goal is to anticipate and prevent disease in the healthy and to precisely diagnose and treat disease in the ill.

Anecdotally, the study helped diagnose a significant health issue in lead researcher Michael Snyder long before he would have sought treatment.

On a long flight to Norway for a family vacation last year, lead researcher Snyder noticed changes in his heart rate and blood oxygen levels. As one of the 60 participants in the digital health study, he was wearing seven biosensors. From previous trips, Snyder knew that his oxygen levels normally dropped during airplane flights and that his heart rate increased at the beginning of a flight — as occurred in other participants. But the values typically returned to normal over the course of a long flight and after landing. This time, his numbers didn't return to baseline. Something was up, and Snyder wasn't completely surprised when he went on to develop a fever and other signs of illness.

Two weeks earlier, he'd been helping his brother build a fence in rural Massachusetts, so his biggest concern was that he might have been bitten by a tick and infected with Lyme disease. In Norway, Snyder persuaded a doctor to give him a prescription for doxycycline, an antibiotic known to combat Lyme disease. Subsequent tests confirmed that Snyder had indeed been infected with the Lyme microorganism.

Snyder was impressed that the wearable biosensors picked up the infection before he even knew he was sick. "Wearables helped make the initial diagnosis," he said. Subsequent data analysis confirmed his suspicion that the deviations from normal heart rate and oxygen levels on the flight to Norway had indeed been quite abnormal.

The wearable devices could also help distinguish participants with insulin resistance, a precursor for Type 2 diabetes. Of 20 participants who received glucose tests, 12 were insulin- resistant. The team designed and tested an algorithm combining participants' daily steps, daytime heart rate and the difference between daytime and nighttime heart rate. The algorithm was able to process the data from just these few simple measures to predict which individuals in the study were likely to be insulin-resistant.

During a visit to the doctor, patients normally have their blood pressure and body temperature measured, but such data is typically collected only every year or two and often ignored unless the results are outside of normal range for entire populations. But biomedical researchers envisage a future in which human health is monitored continuously.

"We have more sensors on our cars than we have on human beings," Snyder said. In the future, he said, he expects the situation will be reversed and people will have more sensors than cars do. Already, consumers have purchased millions of wearable devices, including more than 50 million smart watches and 20 million other fitness monitors. Most monitors are used to track activity, but they could easily be adjusted to more directly track health measures, Snyder said.

With a precision health approach, every person could know his or her normal baseline for dozens of measures. Automatic data analysis could spot patterns of outlier data points and flag the onset of ill health, providing an opportunity for intervention, prevention or cure.

Michael Snyder, professor and chair of genetics, Stanford University,  is the senior author of the study, which was published online Jan. 12 in PLOS Biology. Postdoctoral scholars Xiao Li and Jessilyn Dunn, and software engineer Denis Salins share lead authorship.
 

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GNC, Walmart founding members of Supplement Safety and Compliance Initiative

BY Michael Johnsen

WASHINGTON, D.C. – The Natural Products Association on Wednesday formed the Supplement Safety and Compliance Initiative, bringing together some of the largest retailers of natural products and supplements, including GNC and Walmart, on self-regulating the sale of VMS products.

“This pioneering initiative sends a clear message to millions of consumers that they can have confidence in the safety and authenticity of the dietary supplements and natural products they use each and every day,” stated Dan Fabricant, CEO and executive director of NPA. “Our industry is safe because of initiatives like SSCI and our commitment to consumer protection and quality control. NPA is thrilled to work with founding SSCI members GNC and Walmart and industry leaders Vitamin Shoppe and Whole Foods to develop a retailer driven and consumer focused Industry Leadership Group."
 
SSCI focuses on the entire product life cycle and welcomes all certifying bodies to participate in future benchmarking.  
 
SSCI will set out to accomplish the following goals:

  • Reduce supplement safety risks, recalls and harms by delivering equivalence and convergence between effective supplement safety management systems;
  • Develop core competencies and capacity building in supplement safety to create effective global systems;
  • Drive global change through benchmarking of all standards, domestic and international;
  • Provide unique stakeholder platform for collaboration, knowledge sharing and networking;
  • Manage costs by eliminating redundancy in certification and improving operational efficiency;
  • Increase the number of qualified auditors available to manufacturers, further increasing consumer safety;
  • Address the myriad of standards available globally by allowing various schemes in the international community to benchmark their standard to one overarching standard; and
  • Design a tiered structure that accommodates the unique needs of small ingredient suppliers (i.e. organic, wild-crafted herbs), manufacturers and retailers.

 
“Similar retailer driven initiatives have been developed for foods but never applied to dietary supplements until now. SSCI will continue to promote safety, and consumer confidence in each step of the supply chain from farm to store shelf,” Fabricant said.
 
 

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Walgreens Flu Index captures budding flu season by market

BY Michael Johnsen

DEERFIELD, Ill.  — The latest Walgreens Flu Index issued Thursday recorded sharp upticks in several U.S. markets, including those markets in Utah, Mississippi, Hawaii and Puerto Rico.

The weekly Flu Index shows which populations are experiencing the most incidences of influenza each week based on Index methodology and does not measure actual levels or severity of flu activity, Walgreens noted. But with the ability to generate hyper-local data across most U.S. markets, the Flu Index is an online, interactive resource allowing anyone to search and find information regarding the most current state of influenza in their community.

For the week of Jan. 8, the top 10 markets as measured by flu activity were:

  1. Harlingen-Weslaco-Brownsville-McAllen, Texas;
  2. Lafayette, La.;
  3. Lincoln & Hastings-Kearney, Neb.;
  4. Columbus-Tupelo-West Point-Houston, Miss.;
  5. Monterey – Salinas, Calif.;
  6. Oklahoma City;
  7. Salt Lake City;
  8. Honolulu;
  9. Puerto Rico; and
  10. Beaumont-Port Arthur, Texas.

The top 10 markets with the greatest flu activity gains were:

  1. Harlingen-Weslaco-Brownsville-McAllen, Texas;
  2. Lafayette, La.;
  3. Miami-Ft. Lauderdale, Fla.;
  4. Columbus-Tupelo-West Point-Houston, Miss.;
  5. Puerto Rico;
  6. Lincoln & Hastings-Kearney, Neb.;
  7. Columbia-Jefferson City, Mo.;
  8. Salt Lake City;
  9. Mobile, Ala.-Pensacola (Ft. Walton Beach), Fla.; and
  10. Bakersfield, Calif.

The Walgreens Flu Index is compiled using weekly retail prescription data for antiviral medications used to treat influenza across Walgreens locations nationwide. The data is analyzed at state and geographic market levels to measure absolute impact and incremental change of antiviral medications on a per store average basis, and does not include markets in which Walgreens has fewer than 10 retail locations.

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