When Google acquired Fitbit for $2.1 billion in January 2021, many consumers were sceptical about the deal’s long-term implications. Over five years later, the acquisition makes sense, but not without an uproar from its core group of users.

In May of this year, Google finally retired the Fitbit app (alongside the launch of the Fitbit Air in the US), and Google Health was born, with AI capabilities front and centre to its service. One and a half months in, and with the fallout in the past, a new update bridges the gap between the old Fitbit app and the new Google Health.

You can now add more metrics in the “Today” view, all sleep that is greater than 20 minutes will count toward the 24-hour total sleep duration, and more. The “Today” view is a customisable daily dashboard that displays all core health stats at the very top. Fitbit was my favourite health app (I’ve worn a Fitbit and multiple Google Pixel Watches in the past), and finally, with the latest update, Google Health too seems to be making the grade.

But beyond the functionality of any one health app, there is one crucial question that needs answering: Where lies the gap between the deluge of health data and AI analyses and actual medical advice from professional medical doctors?

The case for health data

There are plenty of wearables—smartwatches, fitness bands, screenless trackers and smart rings—and their accuracy may vary. Still, tracking is better than not doing so. A physician friend from Ahmedabad feels his metrics give him an objective overall picture of his health.

Dr Kartikeya Bhargava, Senior Director, Electophysiology, Cardiac Care, Medanta Gurugram, has a similar view. “These metrics are useful because they help with self-awareness of lifestyle habits and can flag changes that warrant closer attention,” he says.

Dr Sonal Makhija, a dermatologist, wears a Whoop band to track her sleep quality, Heart Rate Variability (HRV), and biological age. Dr Arbinder Kumar Singal, Chief Business Officer, Preventive & Digital Health, PB Healthcare, wears a fitness ring to track his movement, heart rate and sleep—the three most important metrics for him.

“These devices are adjuncts, and not replacements for medical-grade monitoring,” Bhargava says. “It’s about having an additional set of data about patients’ health, while they are going through their daily activities”. Singal says that while a blood pressure monitor or an ECG machine is classified and approved by the drug regulator before it’s sold, a fitness band or ring doesn’t undergo any rigorous testing. “It’s treated as a wellness gadget, not a medical device,” she says.

Tracking traps

While these health apps and wearables may differ, they are useful for gamifying fitness. In a Telegram fitness group I’m part of, a casual conversation sparked a walking challenge, which helped with consistency and discipline. This friendly competition helps keep people engaged, improve consistency, reduce stress. In some cases, it became the gateway to bigger fitness goals like running, hiking or strength training.

All the physicians I spoke with agree that the quality of metrics being tracked has improved dramatically over the years. They do differ to the extent that these data points can be used for self-diagnosis. Still, all conclude that they warrant further investigation and shouldn’t be treated as either gospel or induce unnecessary panic.

Bhargava says that if an app highlights a metric that indicates a health problem, then it should prompt further medical evaluation. “It should not be a reason to conclude that there’s a medical condition. Sometimes ECG recorded on the smartwatch during an episode of palpitation may be the first clue to the presence of a heart rhythm disorder and provides useful diagnostic data,” he says. “Dips in HRV or elevated RHR before you feel sick is an actual physiological phenomenon. Your body’s autonomic nervous system often reacts before symptoms show up,” says Makhija.

Singal reminds that companies that make these health apps have their own parameters for interpreting health data. “The science behind numbers like heart rate variability or VO2 max is shaky, and every brand calculates its own ‘recovery’ or ‘fitness’ score differently. I’ve seen independent tests where these scores are off by enough to wrongly bump someone up or down a whole fitness category, so I’d take the number as a rough trend, not gospel,” he says.

Patients have been increasingly showing up for a doctor’s appointment armed with data like sleep scores, and heart rate tracking from their devices. Bhargava says that often the patient needs reassurance that nothing is actually wrong with them. “Health app data is definitely useful as a conversation starter, not a treatment protocol,” sums up Makhija.

Data and diagnosis

If the data and analysis from these devices shouldn’t be taken as the gospel truth, how big is the gulf in reality? “Wearables measure physiological signals, but they don’t have your history, your labs, or the ability to examine you,” Says Makhija. The data may have, as she puts it, improved when it comes to quality, but the interpretation still leaves much to be desired.

“Algorithms in health apps convert data into scores and warnings as per the population trend; they may not account for individual clinical context, including symptoms, medical history, and risk factors,” adds Makhija.

Wearables, after all, are but screening tools, while medicine relies on validated diagnostic tests and clinical analysis. Every notification isn’t a definitive diagnosis.

Singal says that while most apps count only the total steps, they “miss how much you move through the day, which matters just as much”. He would love to see someone build a metric that tracks this, beyond just counting steps.

The universe of wearables

There are three broad categories of wearables in the market today: smartwatches, fitness bands (with or without a screen), and smart rings, each with its own app, algorithm, and scores. For beginners, the best bet is a fitness band or, in case they’d like notifications, a basic smartwatch. Those are fairly accurate and can be an easy way to get one started with fitness tracking.

In the world of smartwatches, the Apple Watch, Samsung Watch, and Pixel Watch (Google) are the top players. For the more serious fitness nerds and athletes, there is Garmin’s suite of smartwatches, some of which go beyond the remit and function as rugged outdoor tool watches. Then there are smaller players like Amazfit.

When it comes to fitness bands, there are many types, with products ranging from tiny-screen models to the new and popular screenless trackers. Amazfit, Noise, Fitbit, Samsung, Polar Loop, and Whoop are the main players, but there are many more in the market.

Finally, the newest category is the smart ring. Oura is the biggest player here, with the Oura Ring 4 having just launched in India. Then there is Ultrahuman, which was at war with Oura in the US and finally prevailed. Samsung Galaxy launched their ring a year ago, and there is also Amazfit’s Helio Ring.

Some of these come with subscriptions for further data analysis, AI coaches, and other premium-only features. While others, such as the Ultrahuman, are subscription-free.

With Apple, Samsung, Google, Garmin, Oura and Whoop dominating the scene (as they are much more accurate, robust, and comfortable) and the others fast catching up, there’s plenty of choice across price ranges these days.

I’ll end with my two cents on the topic: A tracker will be far more accurate than tracking via your smartphone, which isn’t always in your pocket or in the palm of your hand. Tracking even the basics will get you moving much more each day. Even that little spark may grow into something much larger. Forget the 10,000 steps myth. Even if you’re moving more than you did last month, and doing nothing else concerning your fitness and health, that’s a win in my book.

Sahil Bhalla is a Delhi-based writer. He posts @IMSahilBhalla.

When Google acquired Fitbit for $2.1 billion in January 2021, many consumers were sceptical about the deal’s long-term implications. Over five years later, the acquisition makes sense, but not without an uproar from its core group of users.

In May of this year, Google finally retired the Fitbit app (alongside the launch of the Fitbit Air in the US), and Google Health was born, with AI capabilities front and centre to its service. One and a half months in, and with the fallout in the past, a new update bridges the gap between the old Fitbit app and the new Google Health.

You can now add more metrics in the “Today” view, all sleep that is greater than 20 minutes will count toward the 24-hour total sleep duration, and more. The “Today” view is a customisable daily dashboard that displays all core health stats at the very top. Fitbit was my favourite health app (I’ve worn a Fitbit and multiple Google Pixel Watches in the past), and finally, with the latest update, Google Health too seems to be making the grade.

But beyond the functionality of any one health app, there is one crucial question that needs answering: Where lies the gap between the deluge of health data and AI analyses and actual medical advice from professional medical doctors?

The case for health data

There are plenty of wearables—smartwatches, fitness bands, screenless trackers and smart rings—and their accuracy may vary. Still, tracking is better than not doing so. A physician friend from Ahmedabad feels his metrics give him an objective overall picture of his health.

Dr Kartikeya Bhargava, Senior Director, Electophysiology, Cardiac Care, Medanta Gurugram, has a similar view. “These metrics are useful because they help with self-awareness of lifestyle habits and can flag changes that warrant closer attention,” he says.

Dr Sonal Makhija, a dermatologist, wears a Whoop band to track her sleep quality, Heart Rate Variability (HRV), and biological age. Dr Arbinder Kumar Singal, Chief Business Officer, Preventive & Digital Health, PB Healthcare, wears a fitness ring to track his movement, heart rate and sleep—the three most important metrics for him.

“These devices are adjuncts, and not replacements for medical-grade monitoring,” Bhargava says. “It’s about having an additional set of data about patients’ health, while they are going through their daily activities”. Singal says that while a blood pressure monitor or an ECG machine is classified and approved by the drug regulator before it’s sold, a fitness band or ring doesn’t undergo any rigorous testing. “It’s treated as a wellness gadget, not a medical device,” she says.

Tracking traps

While these health apps and wearables may differ, they are useful for gamifying fitness. In a Telegram fitness group I’m part of, a casual conversation sparked a walking challenge, which helped with consistency and discipline. This friendly competition helps keep people engaged, improve consistency, reduce stress. In some cases, it became the gateway to bigger fitness goals like running, hiking or strength training.

All the physicians I spoke with agree that the quality of metrics being tracked has improved dramatically over the years. They do differ to the extent that these data points can be used for self-diagnosis. Still, all conclude that they warrant further investigation and shouldn’t be treated as either gospel or induce unnecessary panic.

Bhargava says that if an app highlights a metric that indicates a health problem, then it should prompt further medical evaluation. “It should not be a reason to conclude that there’s a medical condition. Sometimes ECG recorded on the smartwatch during an episode of palpitation may be the first clue to the presence of a heart rhythm disorder and provides useful diagnostic data,” he says. “Dips in HRV or elevated RHR before you feel sick is an actual physiological phenomenon. Your body’s autonomic nervous system often reacts before symptoms show up,” says Makhija.

Singal reminds that companies that make these health apps have their own parameters for interpreting health data. “The science behind numbers like heart rate variability or VO2 max is shaky, and every brand calculates its own ‘recovery’ or ‘fitness’ score differently. I’ve seen independent tests where these scores are off by enough to wrongly bump someone up or down a whole fitness category, so I’d take the number as a rough trend, not gospel,” he says.

Patients have been increasingly showing up for a doctor’s appointment armed with data like sleep scores, and heart rate tracking from their devices. Bhargava says that often the patient needs reassurance that nothing is actually wrong with them. “Health app data is definitely useful as a conversation starter, not a treatment protocol,” sums up Makhija.

Data and diagnosis

If the data and analysis from these devices shouldn’t be taken as the gospel truth, how big is the gulf in reality? “Wearables measure physiological signals, but they don’t have your history, your labs, or the ability to examine you,” Says Makhija. The data may have, as she puts it, improved when it comes to quality, but the interpretation still leaves much to be desired.

“Algorithms in health apps convert data into scores and warnings as per the population trend; they may not account for individual clinical context, including symptoms, medical history, and risk factors,” adds Makhija.

Wearables, after all, are but screening tools, while medicine relies on validated diagnostic tests and clinical analysis. Every notification isn’t a definitive diagnosis.

Singal says that while most apps count only the total steps, they “miss how much you move through the day, which matters just as much”. He would love to see someone build a metric that tracks this, beyond just counting steps.

The universe of wearables

There are three broad categories of wearables in the market today: smartwatches, fitness bands (with or without a screen), and smart rings, each with its own app, algorithm, and scores. For beginners, the best bet is a fitness band or, in case they’d like notifications, a basic smartwatch. Those are fairly accurate and can be an easy way to get one started with fitness tracking.

In the world of smartwatches, the Apple Watch, Samsung Watch, and Pixel Watch (Google) are the top players. For the more serious fitness nerds and athletes, there is Garmin’s suite of smartwatches, some of which go beyond the remit and function as rugged outdoor tool watches. Then there are smaller players like Amazfit.

When it comes to fitness bands, there are many types, with products ranging from tiny-screen models to the new and popular screenless trackers. Amazfit, Noise, Fitbit, Samsung, Polar Loop, and Whoop are the main players, but there are many more in the market.

Finally, the newest category is the smart ring. Oura is the biggest player here, with the Oura Ring 4 having just launched in India. Then there is Ultrahuman, which was at war with Oura in the US and finally prevailed. Samsung Galaxy launched their ring a year ago, and there is also Amazfit’s Helio Ring.

Some of these come with subscriptions for further data analysis, AI coaches, and other premium-only features. While others, such as the Ultrahuman, are subscription-free.

With Apple, Samsung, Google, Garmin, Oura and Whoop dominating the scene (as they are much more accurate, robust, and comfortable) and the others fast catching up, there’s plenty of choice across price ranges these days.

I’ll end with my two cents on the topic: A tracker will be far more accurate than tracking via your smartphone, which isn’t always in your pocket or in the palm of your hand. Tracking even the basics will get you moving much more each day. Even that little spark may grow into something much larger. Forget the 10,000 steps myth. Even if you’re moving more than you did last month, and doing nothing else concerning your fitness and health, that’s a win in my book.

Sahil Bhalla is a Delhi-based writer. He posts @IMSahilBhalla.