After all these years my mother still holds the record for the most tragically wrong holiday gift. The sad thing is most of it was thought-out and given in the spirit of goodwill and love. Unfortunately a misunderstanding of psychology set the stage for some holiday bad cheer.
The year before my father's father was taken by a heart attack in his early 70s. Dad was something of a workaholic with a fondness for ice cream and all things fried. Since he wasn't exactly following his doctor's advice, Mom reasoned monitoring was the answer. On the recommendation of the family doctor she bought a beautiful sphygmomanometer - exactly the same device found in his office.
I knew about it and had a look before it was wrapped. Fine instruments are beautiful and she got the top of the line model. Using an old stop watch we tried it out on each other. Sweet. It even seemed fun. I thought about finding a nice logbook for a gift, but fortunately was derailed. Christmas would be her's to lose.
For years there wasn't much money, but this had been a good year and my sister and I had great expectations. He probably had great expectations... expectations that continued until the moment he unwarped his own precision medicial instrument.
It is difficult to mask disappointment. Expectations were shattered by reality. He got up without saying much and walked out. Mom passed a bowl of M&Ms around.
Sensors are cheap. Soon the devices we carry will be passively monitoring some of our vital signs creating biometric selfies in the process. How much of a difference this will make and to what segments of the population? Will the information be accurate enough to act on, will we know how to use it, will we act on it, and who else will be party to it?
The notion of wellness goes back to mid 1840s London and the founding of the YMCA by George Williams. It was a reaction to the physical and social displacements visited upon England by the Industrial Revolution. The idea was to give young men (and later young women) a safe haven where they could improve their health through competition in sport and become better Christians as part of the bargain.
The movement grew rapidly and with it amateur and professional sport. Later in the century the American branch of the Y creating the 'safe' sports of volleyball and basketball. As part of the Muscular Christianity movement churches sponsored youth sports as safe haven from the dangers of urban life. Calisthenics became popular and part of primary education the US and many European countries. An Olympic movement emerged for the upper class.
About the same time great advances were being made in sanitation and a few people, nominally the wealthy, began to worry about what they ate. Towards the end of the century we have the curious story of the Kellogg brothers...
Perhaps you've seen The Road to Wellville - the film adaptation of a novel by T.C. Boyle. Funny and recommended, but I didn't realize until today that much of it is accurate. During this morning's rowing session I caught a bit on the Kellogg brothers on the Science Friday podcast. (audio, about 21 minutes) I won't spoil it as it is very entertaining involving gorillas, a wolf, a sanitarium, the first exercise recordings, brass bands, corn flakes and an obsession with constipation.
There have been ups and downs in active wellness over the years. Current trends are not terribly encouraging with fewer than 20% of adults meeting minimal recommended levels of exercise and about 5% getting the recommended 30 minutes of aerobic exercise a day.1
My physician has pointed to work that suggests if Americans met minimum recommended fitness and nutrition levels that the savings in healthcare costs would be greater than the massive amount of waste and inefficiency that currently plagues the system. Denmark and the Netherlands recognize this with pedestrian and cycling infrastructure costs partly being paid for by healthcare savings. Most of us have problems following advice. Perhaps we'll exercise for a few weeks after some bad news from a physical exam. Perhaps we'll spend a half year on a diet to lose twenty pounds. Unfortunately most of us have problems maintaining these levels.
We already have ubiquitous measurement tools - scales and the fit of our clothing is ubiquitous as is our level of exhaustion as part of normal life. We can get fitbits and other monitors, but sales tend to saturate. It has been shown that people who use them for more than a few months are the people who are in the fit 20% - the people who meet the recommended minimum fitness levels.
I suspect the same will be true with biometric selfies and 'videos'. Most of us will just ignore the information. For those who use it clear actions need to be suggested. Particularly with diet and nutrition that turns out to be difficult as the underlying science is not well understood and anything deeper than the general recommendations of today is unlikely for some time.
What might happen is insurance plans might require the data as part of their risk management. We're already seeing this with companies offering incentives for employees who wear fitbits and report the results. Perhaps we'll see individualized risk management on the part of insurers before individualized wellness.
The motivation problem needs to be cracked.2 B.J. Fogg and others have taken some steps, but the field is waiting for real innovation. At the same time solid wellness information needs to be clear. It exists, but there is an enormous amount of wrong information and many people can't separate good advice from snake oil. Huge social problems. I wouldn't expect miracles any time soon.
1 It is difficult getting historical statistics, but fitness levels tend to be low along with decreasing nutrition levels. One high level source is from the federal fitness site.
2 There are promising paths. My undergrad school required physical education, but the focus was on matching students with activities they enjoy and might continue with after graduation. It was like having your own personal trainer who is looking at the next thirty years or more of your life. I have poor eye-hand coordination and am a terrible jumper and sprinter, but I have reasonable endurance. Cycling and rowing were recommended. Like many others who exercise regularly, I have put together a small social web that offers support. In particularly I owe a lot to a one time professional athlete who is good at offering encouragement when it is needed and figuring out the right mix of exercises and challenges.
This time a guest recipe from Sandra. Really fine chai! I've made two batches. One used tumeric and almond coconut milk and the other used nutmeg and orange peel and straight up almond milk. You *really* should give this one a try!
Sandra's Chai Tea
° Whole Cloves (8-10)
° Cinnamon stick (1)
° Cardamom pods or the ground spice (1/8-1/4 )tsp
° Fresh ginger (½-1) tsp
° fresh turmeric (1/2 tsp)
° grated fresh nutmeg 1/8 tsp)
· orange peel
° star anis
° black tea
° Milk (regular, skim, Soy Almond, etc)
Put all ingredients onto a tea strainer. Pour hot water over all ingredients. Add milk and allow to steep until water cools enough to drink. OMG!!!