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Smarter, safer workouts with a wearable fitness tracker – Harvard Health

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Smarter, safer workouts with a wearable fitness tracker – Harvard Health


Do you need a little extra inspiration to be more active throughout the day? Or perhaps you’re wondering if your workouts are challenging enough to optimize your cardiovascular health. And if you have any type of heart disease, you’ll want to be sure you’re not pushing yourself too hard during vigorous physical activity. For each of these situations, a wearable fitness tracker may be a worthwhile investment, especially when you consider that exercise is widely considered the best medicine — not just for your heart but for your overall health.

You may already own such a device, as most smart watches include a range of fitness tracking features alongside their other functions. Other options include wrist-worn bands and smart rings that focus primarily on health and fitness tracking.

“The information these wearables provide is measurable, meaningful, and motivating,” says Dr. Sawalla Guseh, director of the Cardiovascular Performance Program at Harvard-affiliated Massachusetts General Hospital. “It’s like having a goal-setting coach with you around the clock,” he says.

Long-term monitoring may also alert you to heart problems, says Dr. Guseh. “I had one patient who didn’t feel chest pain or related symptoms, but he noticed his exercise performance declining over time. It turned out he had coronary artery disease,” he says.

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Features to watch

Here are some of the features on wearable fitness devices that are worth checking out.

Stand or move reminders. Many wearables feature customizable notifications — a message on the watch face or a sound or vibration — to remind you to stand up and move around for a short period of time to break up long stretches of sitting. Even dedicated runners need to avoid being sedentary throughout the day to keep their hearts healthy, says Dr. Guseh (see “Stand up for your heart” in the June 2025 Heart Letter).

Daily step counts. Although you’ve likely heard that 10,000 steps per day is a good goal, that number was based on a Japanese marketing scheme and not actual data. Recent evidence finds that a lower number — anywhere from 4,000 to 7,000 daily steps — is linked to improved heart health. A smartphone (provided you carry it with you most of the day) can give a close estimate of your daily step count, but a wearable will be more accurate. Data from your smart watch automatically syncs with your smartphone, and most have apps that display trends in your step counts and other exercise data over weeks, months, and years.

Heart rate zones. Wearables make it easier to assess your exercise effort with heart rate zones, which classify how intensely you’re exercising by measuring your heart rate. The zones are based on your maximum (or peak) heart rate (MHR) — an estimate of the upper limit of what your cardiovascular system can handle during physical activity. A commonly used formula for MHR is 220 beats per minute minus your age, but you should consider this a ballpark figure, since factors other than age are at play.

Different wearables have varied numbers of heart rate zones, although five is typical. Zones 2 and 3 are generally thought to correspond to moderate-intensity exercise, while zones 4 and 5 correspond to vigorous-intensity exercise. But because they’re not individualized, they may not be accurate for everyone, Dr. Guseh notes. Ideally, you should do at least 150 minutes of moderate-intensity exercise, or 75 minutes or more of vigorous-intensity exercise, or an equivalent combination every week.

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Heart rate recovery (HRR). This value reflects your heart’s ability to return to its normal, resting pace after you stop exercising. It’s the difference between your peak heart rate during exercise and your heart rate at a set time after you stop (typically one to two minutes). A value of 20 beats per minute is considered good, and higher is even better.

Maximal oxygen consumption (VO2 max). This value is the maximum amount of oxygen a person can use during intense exercise. It can be measured directly when a person runs on a treadmill with an oxygen mask in a lab. Some wearables estimate it based on an algorithm that uses data such as your MHR, HRR, pace, weight, and sex. VO2 max is a powerful predictor of cardiovascular health. “The absolute number may not always be accurate, but the trends can be useful. If your VO2 max rises over time, that’s a strong sign your training is improving your fitness,” says Dr. Guseh.

Heart rate variability (HRV). This value is a measure of the variation in time between heartbeats — differences that are just fractions of a second. More variability (a higher value) suggests better heart health, because it reflects the heart’s ability to respond quickly to rapid changes occurring throughout the body. Most wearables report this value, but there isn’t a recommended target because it varies widely depending on your age, sex, fitness level, and medical history. However, it can be useful to track trends in your HRV over time. HRV often falls after a period or stress or illness but then bounces back — a sign that you’re good to go back to exercising, says Dr. Guseh.

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Exercising after a heart disease diagnosis

Anyone who’s had a heart attack, heart surgery, or other heart disease diagnosis should attend cardiac rehabilitation, a personalized program of supervised exercise and heart-healthy lifestyle coaching. It starts with an exercise stress test, which involves closely monitoring your heart during exercise to tailor an effective yet safe exercise program for you.

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“Cardiac rehab is a tried-and-true method of helping people get back into shape, with a standardized protocol that works well for most people,” says cardiologist Dr. Sawalla Guseh, assistant professor of medicine at Harvard Medical School. However, people who were previously exercising at higher intensities and therefore quite fit may get bored at cardiac rehab because it’s too easy for them, he says. If that’s the case for you, consider requesting a referral to a sports cardiologist, who can provide more rigorous and detailed testing and advice, including a specific heart rate threshold you should be careful not to exceed.



Image: © Oscar Wong/Getty Images

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Strengthen your lower abs with this unusual but beginner-friendly core exercise

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Strengthen your lower abs with this unusual but beginner-friendly core exercise

We’re always on the lookout for new core exercises to add to our fitness routines, especially ones that help improve form and control. Midlife trainer Dr Won Dolegowski created the barbell back-supported knee raise with exactly this in mind, saying the movement ‘trains your lower abs without stressing your lower back’ while also teaching core control by reducing momentum and swinging.

‘A strong core goes beyond aesthetics. You need it for better posture, to protect your back and to carry you through life,’ she says.

Sarah Campus, PT, instructor, nutrition coach and founder of LDN MUMS FITNESS, explains how to perform the exercise with proper form, why it’s so effective and the key muscles it works.


How to do the barbell back-supported knee raise

  • Set up a barbell on a rack so it sits at lower-back height when you’re positioned beneath it. Add a hip-thrust pad for comfort.
  • Lean your lower back against the bar for support and stability, keeping your core engaged throughout.
  • Raise your knees towards your chest by curling your pelvis upwards, rather than simply lifting your legs.
  • Slowly lower your legs back down with control, avoiding swinging or arching through the lower back.

Muscles worked

The movement mainly targets the core muscles, says Campus, including:

  • Rectus abdominis – particularly during the lifting phase of the knee raise
  • Hip flexors – which help lift the knees
  • Obliques – which assist with stability and pelvic control
  • Transverse abdominals – for deep core stabilisation

Other muscles involved include:

  • Quadriceps – which help maintain leg position
  • Forearm and grip muscles – which help support your hold on the bar
  • Shoulders and upper back – which stabilise the torso against the support

Benefits of the barbell back-supported knee raise

Campus says the exercise offers several key benefits:

  • The core stays under constant tension throughout the movement, as the back support reduces momentum and swinging.
  • It helps stabilise the spine and pelvis, reducing strain on the lower back and making the exercise feel safer and more comfortable.
  • Because the torso stays in a fixed position, it’s easier to perform a proper pelvic curl at the top of the movement, helping improve lower-ab engagement and control.
  • It can also help strengthen grip, adds Dolegowski.

Modifications of the barbell back-supported knee raise

1. Reverse crunches

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  • Lie on your back with your legs extended and arms by your sides, palms facing down. For extra support, place your hands underneath your hips.
  • Press your lower back into the floor and brace your core by pulling your belly button towards your spine.
  • Engage your lower abs to lift your legs and curl your knees towards your chest, allowing your hips to lift slightly off the floor at the top of the movement.
  • Slowly lower your hips back down with control before extending your legs back to the starting position.

2. Hanging knee raises

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  • Hang from a bar with your hands slightly wider than shoulder-width apart. Pull your shoulder blades down and brace your core.
  • Bend your knees and raise them towards your chest using your core muscles, aiming to bring them up to hip height without swinging.
  • Pause briefly at the top of the movement while keeping your torso stable.
  • Slowly lower your legs back to the starting position with control.

3. Captain’s chair leg raises

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  • Position yourself in a captain’s chair with your back against the support pad and your forearms resting on the arm pads. Let your legs hang straight down.
  • Brace your core and slowly raise your straight legs until they reach hip height or slightly higher.
  • Pause briefly at the top while keeping your torso steady and avoiding swinging.
  • Lower your legs back down slowly and with control before repeating.

Having a strong core is about far more than sporting a six-pack. Build functional mid-section strength – while also improving your power, posture, coordination and balance – with WH COLLECTIVE coach Izy George’s 4-week core challenge. Download the Women’s Health UK app to access the full training plan today.

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Headshot of Sarah Campus

Sarah Campus is a highly qualified women’s PT, Nutrition Coach, Running Coach, Distance Runner, mum of 3 and founder of LDN MUMS FITNESS.

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She’s the host of the Soho House Run Club in Chiswick and a STRAVA and TOMMY’s marathon coach and ambassador. She specialises helping non-runners get into competitive distance running.

As a fitness and holistic wellness expert, Sarah regularly features on TV and in Magazines, offering tips and advice to keep the whole family healthy and active.

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What is Americans’ favorite exercise? New study reveals a surprising trend in fitness habits

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What is Americans’ favorite exercise? New study reveals a surprising trend in fitness habits
Walking is often treated as the simplest, most sustainable way to stay active and for good reason. It requires no equipment, no gym membership, and it fits easily into daily life. But a large new analysis suggests that while walking is extremely popular, it may not be enough on its own for most people to meet widely recommended fitness benchmarks.

A study published in the open-access journal PLOS ONE analyzed data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, drawing on survey responses from almost 400,000 U.S. adults. The objective was to know which leisure-time physical activities people prefer and whether those options align with federal activity guidelines.

Walking is most popular but not the most effective for fitness goals

The results were notable. Walking appeared as the most frequently reported leisure-time physical activity across both urban and rural groups. In fact, roughly 44.1% of adults indicated that walking was their main form of exercise.

However, popularity did not translate into achieving recommended health standards. Based on the analysis, individuals who primarily walked had the highest likelihood of not meeting either aerobic or muscle-strengthening guidelines compared with other exercise categories. Even more significant, only about one in four walkers (25%) satisfied both recommended benchmarks, while approximately 22% failed to meet either requirement at all. In contrast, participants who reported running, resistance training, or conditioning workouts as their primary activities were considerably more likely to achieve federal physical activity targets.

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What the guidelines actually require

The American College of Sports Medicine recommends that adults get:

  • At least 150 minutes per week of moderate-intensity aerobic activity
  • Plus muscle-strengthening exercises on two to three days per week

While walking can contribute to aerobic activity mainly if done briskly, it generally does not fulfill the strength-training requirement on its own.

Rural vs urban differences in activity patterns

The study also revealed geographic variations in exercise behavior. Rural residents were more likely to participate in activities such as gardening, hunting, and fishing, whereas urban residents showed higher engagement in running, cycling, dancing, and weight training. Despite differing preferences, urban participants were overall more likely to meet both aerobic and strength-based guidelines compared to rural populations. Researchers suggest that access to facilities, infrastructure availability, and cultural influences may contribute to these differences.

Why this matters: muscle is a key part of health

A key takeaway from the study is that physical activity guidelines are not just about movement, but about different types of movement. Walking supports cardiovascular fitness and daily activity levels, but it does not significantly develop or preserve muscle mass. This distinction is important because muscle deterioration begins gradually with age. Research indicates that adults may lose around 3% to 8% of muscle mass per decade after age 30, a condition known as sarcopenia. This decline is associated with slower metabolism, increased fat storage, reduced mobility, and higher risk of falls and fractures in later life.

Resistance training helps counteract this decline. Studies show it can increase lean muscle mass, boost resting metabolic rate by approximately 7%, and reduce body fat. A large meta-analysis also found resistance training linked to:

  • 15% lower risk of all-cause mortality
  • 19% lower cardiovascular disease mortality
  • 14% lower cancer mortality

The most notable benefits were observed with around 60 minutes per week of resistance exercise, making it a time-efficient health strategy. Additionally, resistance training supports mental well-being by improving mood and increasing BDNF (brain-derived neurotrophic factor), which promotes brain health and neural growth.

What truly makes the difference

The study aligns with broader longevity research suggesting that higher-effort activities tend to deliver stronger physiological benefits.

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Running, weight training, and conditioning workouts share a common feature: they sufficiently challenge the body to trigger adaptation. Walking, although beneficial, generally remains in a lower-intensity range that may not fully satisfy all fitness requirements on its own.

In practical terms:

  • Walking supports general cardiovascular health, mental well-being, and daily movement
  • Resistance training builds and preserves muscle, supports metabolism, and reduces age-related decline
  • Higher-intensity cardio (running, cycling, HIIT) improves cardiovascular fitness more efficiently and helps meet aerobic goals faster

Expert perspective from the study

The researchers emphasized that the findings are not meant to discourage walking but to emphasize gaps between perception and results.

As lead researcher Christiaan Abildso explained:

“We expected to see that walking would continue to be the most common physical activity. However, it was surprising to see that nearly one in four adults who walk as their main activity did not meet either of the physical activity guidelines. That is, they reported less than the recommended 150 minutes per week of moderate-intensity aerobic activity and fewer than the recommended two days per week of muscle-strengthening activity, such as yoga or exercises with resistance bands,”

He also pointed to wider environmental and structural elements influencing activity levels:

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“What we might be seeing in these rural–urban differences in preferences may just reflect what people have access to or what is culturally supported. In our work, we see a need to continue to support our partners in small towns and rural places by creating physical, social, and cultural conditions that support physical activity. This could mean creating a wide shoulder on a country road for running and cycling, helping a senior centre with their chair exercise programming, creating or improving park spaces, expanding the national network of rail trails, renovating abandoned and dilapidated structures (brownfields) into viable activity centres, keeping school facilities open to the public, and many other strategies. Everyone needs to ask, ‘how does what we’re doing affect physical activity?’, in order to help get people more active, more often, in more places,”

FAQs:

1. Is walking good for health?
Yes, walking supports heart health and general well-being. It is a low-impact activity suitable for most people.

2. Can walking replace all exercise?
Not entirely, because it does not build muscle strength effectively. A balanced routine usually includes strength training.

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Exercise improves fitness for kids, adults with FA, study finds

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Exercise improves fitness for kids, adults with FA, study finds

A combination of exercise and an energy-boosting supplement may improve physical fitness in children and adults with Friedreich’s ataxia (FA), although the added benefit of the supplement over exercise alone remains unclear, according to results from a clinical trial.

Those who participated in a 12-week program combining aerobic and strength training with nicotinamide riboside supplementation saw a significant increase in cardiopulmonary fitness, the body’s ability to supply oxygen to muscles during physical activity, compared with trial participants who did not exercise and received a placebo.

However, researchers found no significant difference between the combination group and participants who followed the same exercise program without supplementation, indicating the study did not show a clear added benefit of the supplement beyond exercise alone.

“The combination of nicotinamide riboside plus exercise for 12 weeks was safe and increased cardiopulmonary fitness in children and adults with Friedreich’s ataxia,” the researchers wrote. “Longer studies are needed to establish whether adding nicotinamide riboside to exercise could be considered as part of a long-term, comprehensive treatment approach.”

The study, “Safety and efficacy of individualised exercise and NAD+ precursor supplementation in patients with Friedreich’s ataxia in the USA: a single-centre, 2 × 2 factorial, randomised controlled trial,” was published in The Lancet Neurology.

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Fatigue, safety worries limit participation

FA is caused by mutations that reduce the production of frataxin, a protein needed for cells to generate energy. When frataxin levels are too low, cells in energy-demanding tissues, such as the nervous system, heart, and muscles, gradually deteriorate, leading to FA symptoms including impaired coordination, fatigue, muscle weakness, and difficulty walking. People with FA also have markedly reduced cardiopulmonary fitness.

Although current guidelines recommend exercise to help manage symptoms, clinical evidence in people with FA is limited, and participation is often low due to barriers such as fatigue and safety concerns, the researchers noted.

Studies in other conditions have shown that supplementation with NAD+ precursors — compounds that raise levels of NAD+, a molecule involved in cellular energy production — can improve muscle function. These findings have raised the possibility that increasing NAD+ might complement or enhance the benefits of exercise alone. However, there’s limited research on whether these therapies might improve FA patients’ ability to exercise.

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The team of researchers in the U.S. conducted a 12-week clinical trial (NCT04192136) involving 66 people with FA enrolled at a single center in Philadelphia from September 2020 to April 2025.

Half of the participants were children, ages 10 to 17, and half were adults, ages 18 and older. Most (56%) were male. The overall mean age was 20.3. At the start of the study, participants generally had lower-than-average muscle mass and slightly higher body fat compared with reference values for the general population.

Participants were randomly assigned to one of four groups: 17 received a placebo and served as controls, 17 received only the NAD+ precursor nicotinamide riboside, 16 followed a structured exercise program and were given a placebo, and 16 followed the exercise program in addition to supplementation with nicotinamide riboside. All participants completed the study.

The exercise program consisted of three aerobic and two resistance training sessions per week, performed at home under remote supervision. Participants took nicotinamide riboside or placebo orally each day using weight-based dosing: one capsule (300 mg) for patients weighing 24-48 kg (about 53-110 lbs) and three capsules (900 mg) for patients weighing more than 72 kg (about 159 lbs). The study’s main goal was to assess changes in peak oxygen uptake (VO₂), a key measure of cardiopulmonary fitness.

At the end of the 12-week program, participants who received both exercise and nicotinamide riboside showed the greatest improvements in cardiopulmonary fitness. Peak VO₂ increased by 13.2% in the combination group, compared with a 3.9% decline in the control group.

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VO₂ rose by 9.5% with exercise alone and 5% with nicotinamide riboside alone, but those changes were not statistically significant compared with controls.

The combination was not significantly more effective than exercise alone, indicating no clear added benefit from the supplement.

Some secondary measures improved. Compared with controls, the combination group reached higher maximum workloads during exercise, and oxygen pulse — a measure of how efficiently the body uses oxygen — improved in both the combination and exercise-only groups. Participants in the combination group also reported spending more time in physical activity and leisure exercise.

The interventions were generally safe and well-tolerated. No serious adverse events were reported, and all side effects were mild or moderate. The most common ones were skin problems (53%), gastrointestinal symptoms (45%), upper respiratory infections (35%), and falls (20%).

Falls, a known barrier to exercise in FA, occurred at similar rates across all groups, and no increase in heart-related or other adverse events was seen in participants assigned to exercise.

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In an accompanying commentary, “Targeting exercise, energy, or both in Friedreich’s ataxia,” published in The Lancet Neurology, two researchers in Germany highlighted the study’s implications.

The trial’s findings extend existing clinical evidence on the benefits of exercise in FA by using an objective measure of fitness, such as peak VO₂, and by demonstrating that a home-based intervention is feasible, they wrote. Further studies “are needed to determine durability and clinical significance of fitness gains and to clarify any incremental contribution of nicotinamide riboside beyond structured exercise,” they said.

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