Overwhelming evidence indicates three lifestyle choices can help humans optimize wellness: increasing physical activity behaviors, decreasing sedentary behaviors, and consuming a well-balanced diet.
As director of the University Weight Control Center for more than 12 years, I supported the use of “structured lifestyle interventions” to increase participation in physical activities. This included group or individual counseling, introduction of behavior change and self-monitoring techniques, written information, and phone/online counseling.
Our program proved effective for changing behaviors, as long as people were enrolled. When the 12-week program concluded, nearly half of the participants did not maintain their newly learned exercise/nutrition behaviors during a one-year follow-up. Those participants reported it was too difficult to “do it on their own.” They needed continuous interaction, support, reminders, hints, and to-do lists. On a positive note, 50% of the participants (approximately) reported “success” at maintaining their new behaviors at the same one-year follow-up.
What are you wearing?
Most modern wearables can track vital signs, such as resting and activity pulse rate, and make comparisons with individuals of one’s same gender and age, reflecting changes (improvements) over time. (Image: iStock.)
Consumer-based health/fitness wearables can help one feel they are not doing this “on their own.” Wearables can monitor physical activity and specific health metrics and, when combined with a smartphone or computer, assist with a range of other motivational and health-monitoring tools. It’s just like the activities we performed in the clinic but with less expense. These tools include continuous heart monitoring with the diagnostic ability to detect rate and function abnormalities, blood oxygen saturation (PO2), sleep tracking, body temperature, blood pressure, and even blood glucose levels. These emerging technologies can provide ongoing support and motivation and interface with designated medical professionals.
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The health & fitness wearable marketplace will be worth an estimated $63.48 billion by 2027! Wow! Rising health awareness is a vital factor in increasing this market growth.
What can fitness/health wearables measure?
Step counter/exercise trackers Most wearable health/fitness devices include some sort of step counter that records how many steps and distances are covered for a given period. Prudent recommendations include a minimum of 7,000-10,000 steps daily to decrease sedentary risk syndrome (cardiovascular disease development). Most current wearable health/fitness devices also monitor acceleration, frequency, duration, intensity, and movement patterns. Some devices allow users to add running, cardio, dancing, cycling, and more. Summary information and recommendations data are available on request.
Vital sign monitor Most modern wearables can track vital signs, such as resting and activity pulse rate, and make comparisons with individuals of one’s same gender and age, reflecting changes (improvements) over time. Some devices offer selected body temperature readings, perspiration tracking, blood-oxygen saturation, and menstrual cycle data. By combining physical and workout data, the user can get a better picture of their overall health. Moreover, these data also can be stored and forwarded to an individual’s physician.
There are roughly 32,000 gyms in the U.S. with about 64 million people who regularly exercise in them. Of these, about 55% use a smartwatch to track their exercise duration, heart rate, steps, distance, and more. (Image: iStock.)
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Sleep recorder Keeping track of how much and how restful one sleeps is an important metric that offers important insight into health. Some trackers can discern and distinguish between sleep cycles, including REM sleep. Sleep quantity and quality represent an important indicator of health and wellness. In a previous column, I discussed different aspects of sleep and health.
Calorie tracking Most health & fitness wearables can track the number of calories expended during rest and physical activity; some allow the user to track calories consumed by entering the foods consumed.
Sync with other devices All health & fitness wearables can work with applications installed on a phone, tablet, or computer. Users can store data and compare progress with others (or just oneself) day-by-day or week-by-week. Some wearable devices are compatible with other tools, such as smart scales and clocks, or even specific exercise equipment. In some instances, one can instantaneously transfer data to a physician for review and evaluation. A growing number of devices can produce a medical-quality ECG (electrocardiogram) that offers a cursory evaluation of some heart anomalies and conditions like atrial fibrillation (AF), bradycardia, or tachycardia. These conditions may warrant further evaluation by a physician.
Expectations
Before you go out and buy a fitness/health tracker, make sure it’s worth it to you. Here are some of the pros and cons to consider.
Emerging technologies can provide ongoing support and motivation and interface with designated medical professionals. (Image credit: iStock.)
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Pros For many, tracking different fitness/health metrics can provide a better understanding of how you’re doing, not how you think you’re doing. This is important. Properly used, wearable data can provide the first indicator that something has gone haywire healthwise, and offers the opportunity to be proactive, not blindsided by an unwanted diagnosis.
Also, trackers can be very motivating, particularly to those who like numbers, notifications, digital rewards, comparisons, and reminders. When it’s cold outside, going for a winter walk may be a non-starter for many, but a simple reminder from a tracker may motivate one to produce enough steps to reach the day’s goal. The trackers feed into our competitive nature, pushing us toward the finish line, even when difficult.
Cons Not all fitness trackers are created equal. They have varying degrees of accuracy. Research indicates most trackers are reasonably accurate, but ‘reasonably’ isn’t perfect, which always leaves room for error. How much error depends on which device you choose. Inaccuracies can range from +/- 3% up to 20%. And another consideration is repeatability: Can the monitor accurately produce the same result on the same person on repeat use within a few minutes?
Any new gadget is fun for a while, and wearable trackers are no different. After some time, many individuals find themselves bored and over-stimulated with data, not to mention the need to constantly input and update data. The process can become anxiety-provoking, particularly for those who become obsessed with amassing the most data possible.
Another negative aspect is cost. There’s a tracker for every budget and style; you can spend $50, $1,000, or more. As with any technology, the more you spend, the more you get.
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Let’s talk about accuracy
Scientists have done numerous validation studies on most mainstream health & fitness trackers. The results indicate that accuracy is variable, depending on the technology used and what the tracker is trying to measure.
Any fitness tracker needs to accurately assess your activity level to be able to calculate it. A recent research review of the latest health & fitness trackers found that wrist- or arm-worn trackers for measuring energy expenditure varied in accuracy, depending on the task being performed. When the body’s movement was the only parameter being measured, they were less accurate than when the tracker also included a heart-rate monitor or body-heat sensor. In another study measuring aerobic workouts, caloric expenditure tended to be overestimated when working at a slower pace and underestimated when working at a faster pace.
Yet, in another study that compared 11 different trackers, researchers found that accuracy varied between them when counting steps. They tended to be better at correctly counting steps during brisk walking than day-to-day activities and intermittent walking when arm movements were frequently miscounted as steps.
Earlier-generation fitness trackers came with a chest band to measure heart rate by tracking the body’s electrical signals. These devices are very accurate. In contrast, modern fitness trackers worn on the wrist that measure heart rate using photoplethysmography (PPG) are less accurate, by varying degrees, depending on the tracker. These trackers contain LEDs (light-emitting diodes) that send light waves into your skin, and a photodetector captures the light that bounces off the wrist, which is then turned into information that the device’s inbuilt algorithms can analyze to determine heart rate. While these trackers have been shown to be accurate enough for measuring the heart rate of an average person, they are not suitable for research purposes and tend to produce erroneous, extreme readings, which might misinterpret the real-time exercise intensity.
Conclusions
Overall, the research on fitness & health trackers indicates that most people who use them tend to become more active, increase their step counts, and expend more energy at moderate and vigorous levels. They also found that trackers helped maintain good habits in the long term and could be helpful to medical professionals monitoring the health of their patients.
References
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ACSM. Wearable technology named top fitness trend for 2024.
Ash, G.I., et al. “Establishing a global standard for wearable devices in sport and exercise medicine: Perspectives from academic and industry stakeholders.” Sports Medicine. 2021;51(11):2237–50.
Chevance, G., et al. “Accuracy and precision of energy expenditure, heart rate, and steps measured by combined-sensing Fitbits against reference measures: Systematic review and meta-analysis.” JMIR mHealth and uHealth. 2022;10(4): e35626.
Fuller, D., et al. “Reliability and validity of commercially available wearable devices for measuring steps, energy expenditure, and heart rate: Systematic review. JMIR mHealth uHealth. 2020;8(9): e18694.
Gualtieri, L., et al. “Can a free wearable activity tracker change behavior? The impact of trackers on adults in a physician-led wellness group.” JMIR Research Protocols. 2016;5(4): e237.
Hickey, A.M., Freedson, P.S. “Utility of consumer physical activity trackers as an intervention tool in cardiovascular disease prevention and treatment.” Progress in Cardiovascular Diseases. 2016;58(6):613–9.
Hsueh-Wen, C., et al. “Accuracy of optical heart rate sensing technology in wearable fitness trackers for young and older adults: Validation and comparison study.” JMIR mHealth uHealth 2020;8(4):e14707.
Huhn, S., et al. “The impact of wearable technologies in health research: Scoping review.” JMIR mHealth uHealth. 2022;10(1): e34384.
Keogh, A., et al. “Breaking down the digital fortress: The unseen challenges in healthcare technology — Lessons learned from 10 years of research.” Sensors. 2024;24(12):3780.
Lupton, D. “The quantified self: A sociology of self-tracking.” Sociology of Health and Illness. 2016;39:1557–71.
Molina-Garcia, P., et al. “Validity of estimating the maximal oxygen consumption by consumer wearables: A systematic review with meta-analysis and expert statement of the INTERLIVE network.” Sports Medicine. 2022;52(7):1577–97.
Perez, M.V., et al. “Large-scale assessment of a smartwatch to identify atrial fibrillation.” New England Journal of Medicine. 2019;381(20):1909–17.
Piwek, L., et al. “The rise of consumer health wearables: Promises and barriers.” PLOS Medicine. 2016;13(2): e1001953.
Shilaih, M., et al. “Modern fertility awareness methods: Wrist wearables capture the changes in temperature associated with the menstrual cycle.” Biosci Reports. 2018;38(6): BSR20171279.
Spaccarotella, C., et al. “Assessment of non-invasive measurements of oxygen saturation and heart rate with an Apple Smartwatch: C0mparison with a standard pulse oximeter.” Journal of Clinical Medicine. 2022;11(6):1467.
Swee Sun Tang, M., et al. “Effectiveness of wearable trackers on physical activity in healthy adults: Systematic review and meta-analysis of randomized controlled trials.” JMIR mHealth uHealth 2020;8(7);e15576.
As the year winds down, many people take time to reflect on what has happened over the last 12 months. You might think about your accomplishments, the challenges you faced, the things you wish had gone differently, and the changes you hope to make in the coming year. It is a natural rhythm as the calendar turns over – and with it often comes the desire for a fresh start.
But one thing people rarely reflect on (or often ignore altogether) is their musculoskeletal health. We tend to focus on appearance, weight loss, and the goals we can measure on a scale or in a mirror. What often gets overlooked, however, are the subtle physical signals that something is not quite right.
Nagging back pain is a perfect example. It is easy to brush off – easy to label as normal – and even easier to assume it will go away on its own. Back pain can slowly become something you adapt to without realizing it. Suddenly you’re adjusting how you bend. You avoid certain activities. You modify how you sit or sleep. Back pain – if you’re not careful – can quickly blend into the backdrop of your daily life.
So if there’s one thing worth leaving behind as the year closes – it’s the back pain that has been following you around for months or even decades. Despite what you may have been told – you do not have to carry this year’s pain into the next one. And when you understand how back pain actually works – you may begin to see that addressing it is one of the most important steps you can take for your overall health as you move into a new year.
Back pain rarely arrives ‘out of nowhere’
Back pain might feel sudden, but there is almost always a history behind it. Most back problems develop gradually – from months or years of poor bending habits, long hours of sitting, repetitive strain, or small compensations your body has been making without your awareness.
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Until one day you sneeze, lean forward, or twist just a little too far – and suddenly you’ve “hurt your back”. People often blame the moment – but the true cause is usually what has been building underneath the surface.
The holidays (and other busy seasons) tend to make all of this worse. There is more sitting while traveling, more lifting and preparing, and more time spent on soft couches or unfamiliar beds while visiting family. The body is already managing the stress of daily life, and the extra demands of this season push it beyond what it can comfortably tolerate.
The good news? Once you understand that back pain is rarely the result of a single event “out of nowhere” – but rather the conclusion of small, repetitive microhabits over time – you can start to correct these. Small adjustments in how you bend, sit, lift, and move can make a remarkable difference.
Before you know it – not only will you have less back pain – but you’ll have far more control over it. And that kind of control changes everything.
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Back pain doesn’t just ‘go away’
It is easy to assume that once the holidays are over, life will settle down and so will your pain. But pain that lingers into the new year rarely behaves that way. When your back is aggravated from mechanical or movement problems – time alone does not fix it. Rest may help temporarily, but the root issue remains. Without addressing the way you move, sit, bend, or load your spine – the pain simply returns – and sometimes for the worse.
This is also why so many people begin January full of enthusiasm only to be sidelined by February or March. They unknowingly bring unresolved back pain into their new routines. Although exercise is one of the best medicines for back pain – it’s not quite that simple.
When you don’t have any back pain – exercise is excellent prevention. But when you’re already suffering – you need very specific exercises designed to correct underlying mechanical faults before jumping into generalized strengthening.
When your foundation is not solid – even the best fitness plan can falter. Back pain influences everything. It affects how you walk, lift, twist, and breathe. It interferes with sleep, dampens motivation, and makes you cautious without realizing why.
Don’t wait for back pain to “go away” on its own – and be cautious of quick-fix New Year’s programs where you risk layering new problems on top of old ones. Ignoring what your back is telling you now could leave you worse off in 2026 than you planned.
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Most back pain has a mechanical cause and a natural fix
The encouraging news is that most back pain (80%) can be resolved naturally when you understand its mechanical origins. The spine is incredibly resilient. It is designed to move, adapt, and support you through decades of life – even with arthritis or bulging discs are part of the equation.
When pain appears, it is usually signaling that something about your movement pattern needs attention. The body gives clear clues. Certain movements will feel better, others worse. How your symptoms behave throughout the day tells a more accurate story than any X-ray or MRI ever could. And once your story is fully realized – meaningful change and lasting relief become possible.
A new year is the perfect time to leave old movement patterns behind. You do not have to accept stiffness when you wake up – brace every time you bend to put on shoes – or avoid activities you enjoy because you fear making your back worse.
Small, strategic changes can make a big difference. And you don’t have to go at it alone. If leaving back pain in 2025 is one of your goals for 2026 – consider consulting with a mechanical back pain specialist who can help you sort through everything you’ve just read here. Or reach out to me personally – I’m always happy to help my loyal readers.
Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. For a copy of her free self-help guide for back pain – or to get in touch – visit www.cjphysicaltherapy.com or call 603-380-7902.
With 2026 just a week away, millions of Britons are wondering how to make it their healthiest year ever—including fitness guru Joe Wicks.
The 40-year-old became a household name during the coronavirus lockdowns when he became the ‘Nation’s PE Teacher’ by sharing daily workout videos which got the whole family moving.
But despite his association with—and love of—exercise, his top wellness recommendation for next year is at the other end of the scale… it’s sleep.
Speaking to PA, ‘We often don’t think about how important sleep is.
‘We have routines where we stay up late and we don’t get enough sleep, and so everything feels a bit harder.
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‘I think the first thing anyone should really focus on, regardless of your age, is really getting a good sleep routine.
‘Because that allows you the next day to wake up with energy, to exercise, with a bit more willpower with the food and discipline around that.’
The NHS recommends on average adults should get seven to nine hours sleep per night, children should get nine to 13 hours and toddlers and babies should get 12 to 17 hours.
Leading fitness guru Joe Wicks says his first tip for 2026 is making sure you get enough sleep
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Consistently failing to get enough shuteye has long been shown to raise the risk of obesity, heart disease and type 2 diabetes.
Meanwhile, getting enough sleep has been shown to boost the immune system, lower stress and improve attention.
It was one of ‘three pillars’ that he said are the most important things to focus on which also included exercise and nutrition.
After you’ve established a good sleep routine, then you can go about building a realistic fitness plan, he said.
‘You don’t have to train five days a week for an hour a day,’ he said.
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‘You could do three days a week for 20 minutes and that can be perfect for you, just to kind of keep your mental health in check and keep yourself fit and strong.
He added: ‘And with your food, you don’t have to ban every single ultra processed food and sugar and treat and thing you love to get results.
‘But you do need to focus on home cooking a bit more.
Joe Wicks with two of his four children
Joe shares four children with his wife Rosie, Indie, seven, Marley, six, Leni, three, and baby son Dusty, who is 15 months.
‘So, get in the kitchen, plan your meals, do your cooking, and they’re the things you’ve got to do in January, February, March, all the way through the year.
‘Because unless you can do it consistently, you’re never going to transform or reach your goal.’
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He asked, as a father, how can parents with busy schedules can prioritise their health and fitness.
‘You’ve just got to keep drawing yourself back to those key messages,’ he said.
‘If I eat well today and if I exercise, I’m going to sleep better, I’m going to wake up with energy.
‘I’m not going to be irritable with the kids and snappy because I’m really grumpy and I haven’t eaten well and I’m knackered.
‘They’re the mental health benefits you’ve got to keep drawing yourself back to.’
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However, he added that while things can go wrong that disrupt your routine, exercise can help you get through it.
‘You are always going to have challenges, there’s going to be stress, kids are going to get ill, you’re going to have redundancies, you might get fired, you might have a relationship breakdown,’ he said.
‘But you’ve always got to remember that exercise can help you through those times. We know it can because it’s an amazing antidepressant. Use it, lean on it.
‘It’s not a thing you have to do, but it is essential for health and happiness, it’s not just about body image.’
The fitness guru will be trying to help inspire people to start 2026 off the right way, in a one-off special on ITV on January 1, Joe Wick’s New Year’s Day.
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It will feature quick fire workouts to get people on their feet, recipes and exert wellness and motivation advice.
Fitness encompasses cardiovascular endurance, strength training, and mobility/flexibility. These are non-negotiables for continuing to live throughout your later years with your independence and ability to move and socialize still intact.
Instead of thinking simply about living longer, let’s use the start of a new year to focus on getting healthier, so we live better. More than any other time each year, the New Year is a popular time to focus on a “fresh start.” Temporal landmarks like New Year’s Day, Mondays, birthdays and the change of seasons are standard starting lines for many of us when we have a goal to work toward and bad habits to break.
Science Says Fitness Matters (Even More than Weight)
A recent study published in the British Journal of Medicine, Cardiorespiratory Fitness, BMI, and Mortality: A Systematic Review and Meta-Analysis, shows that, regardless of body weight (obese, overweight or normal), fitness matters more for all-cause mortality. They measured the weight, BMI and fitness of six groups: normal weight-fit; normal weight-unfit; overweight-fit; overweight-unfit; obese-fit; and obese-unfit.
The analyses revealed that individuals classified as fit, regardless of their BMI, did not have a statistically significantly higher risk of cardiovascular disease or all-cause mortality compared to normal weight-fit people. At the same time, all unfit groups across different BMI categories exhibited a two- to threefold higher risk of cardiovascular disease and all-cause mortality compared to their regular weight-fit counterparts.
About Body Mass Index (BMI)
Now, you may be saying, “But BMI is flawed!” Sure. BMI is not the best indicator for distinguishing normal weight, overweight and obesity because it is simply a height-to-weight ratio that does not account for differences in body fat/muscle composition, age, sex or other factors. Before you discredit this entire study because of the BMI issue, remember that it measured fitness levels among people of different sizes. Some had more muscle and were considered fit in the overweight/obese group, while others were deemed unfit in the normal weight group. Still, BMI helps place people of differing sizes (height and weight groups) and focuses on measuring each group’s fitness. In the end, fitness matters more than BMI, so the goal is to exercise, get in shape, build muscle and lose fat.
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Set Your Training Goals to Be Long-Term
It is fine to have short-term, specific training goals, such as strength gains and endurance times, or weight gain or weight loss. However, start this year with a 10-year fitness focus, as what you do in your 40s-50s will determine how you live in your 60s-70s. Always think 10 years ahead, no matter what your age, because what you gain today and maintain tomorrow is needed to continue to live independently for a few more generations in your family’s lineage. You can focus on longevity and optimal performance for your fitness and health goals at the same time by maintaining a consistent activity level and healthful nutrition, sleep and recovery.
Try This Goal: Make Annual Physical and Blood Screening Appointments
If you have not been to a doctor in a while, set an appointment in January, and get into the habit of annual health and wellness screenings. Treat annual physicals with the doctor as opportunities to PR (personal record) common blood work results, such as cholesterol, triglycerides, blood sugar, body weight and blood pressure. These are just the basics to help you assess how to adjust your sleep, nutrition, physical activity and stress management. These meetings are also quite satisfying when you achieve solid results that show health and wellness.
Don’t Give Up
While a large portion of us (nearly half of Americans) will create a New Year’s resolution, only about 9%-10% will achieve their goals. After a stressful holiday season, we are typically burned out in January. This may not be the best time to start a lifestyle change, complete with quitting bad habits (over-eating, smoking, drinking) and starting new healthy habits (gym membership, diet, etc.).
Instead, use the first few weeks of January to focus on stress mitigation and recovery. This should include building easy habits of walking every day, stretching, taking deep breaths and simply not overeating. This is a great way to move into a new fitness focus. Then, when feeling back to normal, focus a little harder, with more intensity, duration of training, and specificity to your fitness and health goals.
There are many ways to expand your “health-span.” Check out these options and get consistent with any or all of them:
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Final Advice
If you want to get started on a focused health and wellness goal of being able to do physical activities, stay social and be independent, start with the basics of walking and stretching daily for a month. The following month, add calisthenics such as squats, lunges, push-ups and the plank pose. The following month, add weights such as dumbbells or kettlebells, or suspension trainers such as the TRX.
This steady progression helps you ease into fitness habits gently and adds a new component each month to keep it interesting. To achieve results with lifelong wellness goals, you need to keep endurance, strength and mobility/flexibility as primary focuses. Stability, durability, balance, speed and agility can also be developed once you have built the foundation. This is the beauty of long-term goals. Focus on doing something each day, being disciplined about eating and drinking healthfully, and learning stress-mitigation techniques such as breathing to take into your next decade on this planet.
There are dozens of these types of articles at the Military.com Fitness Section. Check them out for ideas on specific ways to train.
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