Accuracy of heart rate watches: Implications for weight management
- Wallen, Matthew, Gomersall, Sjaan, Keating, Shelley, Wisløff, Og Ulrik, Coombes, Jeff
- Authors: Wallen, Matthew , Gomersall, Sjaan , Keating, Shelley , Wisløff, Og Ulrik , Coombes, Jeff
- Date: 2016
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 11, no. 5 (2016), p.
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- Description: Background: Wrist-worn monitors claim to provide accurate measures of heart rate and energy expenditure. People wishing to lose weight use these devices to monitor energy balance, however the accuracy of these devices to measure such parameters has not been established. Aim: To determine the accuracy of four wrist-worn devices (Apple Watch, Fitbit Charge HR, Samsung Gear S and Mio Alpha) to measure heart rate and energy expenditure at rest and during exercise. Methods: Twenty-two healthy volunteers (50% female; aged 24 ± 5.6 years) completed ∼1-hr protocols involving supine and seated rest, walking and running on a treadmill and cycling on an ergometer. Data from the devices collected during the protocol were compared with reference methods: electrocardiography (heart rate) and indirect calorimetry (energy expenditure). Results: None of the devices performed significantly better overall, however heart rate was consistently more accurate than energy expenditure across all four devices. Correlations between the devices and reference methods were moderate to strong for heart rate (0.67-0.95 [0.35 to 0.98]) and weak to strong for energy expenditure (0.16-0.86 [-0.25 to 0.95]). All devices underestimated both outcomes compared to reference methods. The percentage error for heart rate was small across the devices (range: 1-9%) but greater for energy expenditure (9-43%). Similarly, limits of agreement were considerably narrower for heart rate (ranging from -27.3 to 13.1 bpm) than energy expenditure (ranging from -266.7 to 65.7 kcals) across devices. Conclusion: These devices accurately measure heart rate. However, estimates of energy expenditure are poor and would have implications for people using these devices for weight loss. © 2016 Wallen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Authors: Wallen, Matthew , Gomersall, Sjaan , Keating, Shelley , Wisløff, Og Ulrik , Coombes, Jeff
- Date: 2016
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 11, no. 5 (2016), p.
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- Description: Background: Wrist-worn monitors claim to provide accurate measures of heart rate and energy expenditure. People wishing to lose weight use these devices to monitor energy balance, however the accuracy of these devices to measure such parameters has not been established. Aim: To determine the accuracy of four wrist-worn devices (Apple Watch, Fitbit Charge HR, Samsung Gear S and Mio Alpha) to measure heart rate and energy expenditure at rest and during exercise. Methods: Twenty-two healthy volunteers (50% female; aged 24 ± 5.6 years) completed ∼1-hr protocols involving supine and seated rest, walking and running on a treadmill and cycling on an ergometer. Data from the devices collected during the protocol were compared with reference methods: electrocardiography (heart rate) and indirect calorimetry (energy expenditure). Results: None of the devices performed significantly better overall, however heart rate was consistently more accurate than energy expenditure across all four devices. Correlations between the devices and reference methods were moderate to strong for heart rate (0.67-0.95 [0.35 to 0.98]) and weak to strong for energy expenditure (0.16-0.86 [-0.25 to 0.95]). All devices underestimated both outcomes compared to reference methods. The percentage error for heart rate was small across the devices (range: 1-9%) but greater for energy expenditure (9-43%). Similarly, limits of agreement were considerably narrower for heart rate (ranging from -27.3 to 13.1 bpm) than energy expenditure (ranging from -266.7 to 65.7 kcals) across devices. Conclusion: These devices accurately measure heart rate. However, estimates of energy expenditure are poor and would have implications for people using these devices for weight loss. © 2016 Wallen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Ramos, Joyce, Dalleck, Lance, Borrani, Fabio, Beetham, Kassia, Mielke, Gregore, Dias, Katrin, Wallen, Matthew, Keating, Shelley, Fassett, Robert, Coombes, Jeff
- Authors: Ramos, Joyce , Dalleck, Lance , Borrani, Fabio , Beetham, Kassia , Mielke, Gregore , Dias, Katrin , Wallen, Matthew , Keating, Shelley , Fassett, Robert , Coombes, Jeff
- Date: 2017
- Type: Text , Journal article
- Relation: International Journal of Cardiology Vol. , no. (2017), p.
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- Description: Background: Insulin resistance has been postulated to play a central role in the co-appearance of various cardiovascular disease risk factors constituting the metabolic syndrome (MetS). There is evidence that altered cardiac autonomic function (CAF) may precede the onset of insulin resistance. Exercise training has been shown to improve CAF in different populations, yet little is known regarding the exercise dose response for CAF. The aim of this study was to investigate the impact of different volumes of high-intensity interval training (HIIT) and traditional moderate-intensity continuous training (MICT) on CAF in participants with MetS. Methods: Individuals with MetS (n=56) were randomised into the following 16-week training interventions: i) MICT (n=16, 30min at 60-70%HRpeak, 5×/week); ii) 4HIIT (n=19, 4×4min bouts at 85-95%HRpeak, interspersed with 3min of active recovery at 50-70%HRpeak, 3×/week); or iii) 1HIIT (n=21, 1×4min bout at 85-95%HRpeak, 3×/week). R-R interval recorded for 5min in a supine position at pre- and post-intervention was used to derive linear (SDNN, RMSSD, pNN50, LF, HF, LF/HF) and non-linear (SD1, SD2, Alpha1, Alpha2, SampEn) heart rate variability (HRV) indices as measures of CAF. Group×time interaction effects were examined (ANCOVA) and Eta squared (η2) interaction effect sizes calculated. Results: While there were no significant between-group differences in CAF indices, there were small-to-medium group×time interaction effects on SDNN [F(2,52)=0.70, p=0.50, η2 =0.02], RMSSD [F(2,52)=1.35, p=0.27, η2 =0.03], HF power [F(2,52)=1.27, p=0.29, η2 =0.03], SD1 [F(2,52)=0.47, p=0.63, η2 =0.01], and SD2 [F(2,52)=0.41, p=0.67, η2 =0.01]. The following represent the relative percentage increases across these variables for 4HIIT, MICT, and 1HIIT respectively (SDNN, +30%, +17%, 9%; RMSSD, +30%, +22%, -2%; HF power, +69%, +18%, +7%; SD1, +30%, +22%,-2%; SD2, +22%, +14%, 4%). Conclusions: There were no significant between-group differences for the effects of exercise dose on CAF indices, however; high-volume HIIT demonstrated the greatest magnitude of effect for improving CAF in individuals with MetS. © 2017 Elsevier Ireland Ltd.
High-intensity interval training for the management of nonalcoholic steatohepatitis : participant experiences and perspectives
- Keating, Shelley, Croci, Ilaria, Wallen, Matthew, Cox, Emily, Coombes, Jeff, Burton, Nicola, Macdonald, Graeme, Hickman, Ingrid
- Authors: Keating, Shelley , Croci, Ilaria , Wallen, Matthew , Cox, Emily , Coombes, Jeff , Burton, Nicola , Macdonald, Graeme , Hickman, Ingrid
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Clinical and Translational Hepatology Vol. 11, no. 5 (2023), p. 1050-1060
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- Description: Background and Aims: High-intensity interval training (HIIT) is a therapeutic option for people with nonalcoholic steatohepatitis (NASH). However, the perspectives and experiences of HIIT for people with NASH are unknown, limiting translation of research. We explored the experiences and perspectives of both professionally supervised and self-directed HIIT in people with NASH and evaluated participant-reported knowledge, barriers, and enablers to commencing and sus-taining HIIT. Methods: Twelve participants with NASH un-derwent 12 weeks of supervised HIIT (3 days/week, 4×4 minutes at 85–95% maximal heart rate, interspersed with 3 minutes active recovery), followed by 12-weeks of self-directed (unsupervised) HIIT. One-on-one, semistructured participant interviews were conducted by exercise staff prior to HIIT and following both supervised and self-directed HIIT to explore prior knowledge, barriers, enablers, and outcomes at each stage. Interviews were audio-recorded, transcribed, coded, and thematically analyzed by two independent re-searchers. Results: Four dominant themes were identified: (1) no awareness of/experience with HIIT and ambivalence about exercise capabilities; (2) multiple medical and social barriers to commencing and continuing HIIT; (3) exercise specialist support was a highly valued enabler, and (4) HIIT was enjoyed and provided holistic benefits. Conclusions: People with NASH may lack knowledge of and confidence for HIIT, and experience multiple complex barriers to commencing and continuing HIIT. Exercise specialist support is a key enabler to sustained engagement. These factors need to be addressed in future clinical programs to augment the uptake and long-term sustainability of HIIT by people with NASH so they can experience the range of related benefits. © 2023 The Author(s).
- Authors: Keating, Shelley , Croci, Ilaria , Wallen, Matthew , Cox, Emily , Coombes, Jeff , Burton, Nicola , Macdonald, Graeme , Hickman, Ingrid
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Clinical and Translational Hepatology Vol. 11, no. 5 (2023), p. 1050-1060
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- Description: Background and Aims: High-intensity interval training (HIIT) is a therapeutic option for people with nonalcoholic steatohepatitis (NASH). However, the perspectives and experiences of HIIT for people with NASH are unknown, limiting translation of research. We explored the experiences and perspectives of both professionally supervised and self-directed HIIT in people with NASH and evaluated participant-reported knowledge, barriers, and enablers to commencing and sus-taining HIIT. Methods: Twelve participants with NASH un-derwent 12 weeks of supervised HIIT (3 days/week, 4×4 minutes at 85–95% maximal heart rate, interspersed with 3 minutes active recovery), followed by 12-weeks of self-directed (unsupervised) HIIT. One-on-one, semistructured participant interviews were conducted by exercise staff prior to HIIT and following both supervised and self-directed HIIT to explore prior knowledge, barriers, enablers, and outcomes at each stage. Interviews were audio-recorded, transcribed, coded, and thematically analyzed by two independent re-searchers. Results: Four dominant themes were identified: (1) no awareness of/experience with HIIT and ambivalence about exercise capabilities; (2) multiple medical and social barriers to commencing and continuing HIIT; (3) exercise specialist support was a highly valued enabler, and (4) HIIT was enjoyed and provided holistic benefits. Conclusions: People with NASH may lack knowledge of and confidence for HIIT, and experience multiple complex barriers to commencing and continuing HIIT. Exercise specialist support is a key enabler to sustained engagement. These factors need to be addressed in future clinical programs to augment the uptake and long-term sustainability of HIIT by people with NASH so they can experience the range of related benefits. © 2023 The Author(s).
High-intensity interval training is safe, feasible and efficacious in nonalcoholic steatohepatitis : a randomized controlled trial
- Keating, Shelley, Croci, Ilaria, Wallen, Matthew, Cox, Emily, Thuzar, Moe, Pham, Uyen, Mielke, Gregore, Coombes, Jeff, Macdonald, Graeme, Hickman, Ingrid
- Authors: Keating, Shelley , Croci, Ilaria , Wallen, Matthew , Cox, Emily , Thuzar, Moe , Pham, Uyen , Mielke, Gregore , Coombes, Jeff , Macdonald, Graeme , Hickman, Ingrid
- Date: 2023
- Type: Text , Journal article
- Relation: Digestive Diseases and Sciences Vol. 68, no. 5 (2023), p. 2123-2139
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- Description: Background: High-Intensity Interval Training (HIIT) involves bursts of high-intensity exercise interspersed with lower-intensity exercise recovery. HIIT may benefit cardiometabolic health in people with nonalcoholic steatohepatitis (NASH). Aims: We aimed to examine the safety, feasibility, and efficacy of 12-weeks of supervised HIIT compared with a sham-exercise control (CON) for improving aerobic fitness and peripheral insulin sensitivity in biopsy-proven NASH. Methods: Participants based in the community [(n = 14, 56 ± 10 years, BMI 39.2 ± 6.7 kg/m2, 64% male), NAFLD Activity Score 5 (range 3–7)] were randomized to 12-weeks of supervised HIIT (n = 8, 4 × 4 min at 85–95% maximal heart rate, interspersed with 3 min active recovery; 3 days/week) or CON (n = 6, stretching; 3 days/week). Safety (adverse events) and feasibility determined as
- Authors: Keating, Shelley , Croci, Ilaria , Wallen, Matthew , Cox, Emily , Thuzar, Moe , Pham, Uyen , Mielke, Gregore , Coombes, Jeff , Macdonald, Graeme , Hickman, Ingrid
- Date: 2023
- Type: Text , Journal article
- Relation: Digestive Diseases and Sciences Vol. 68, no. 5 (2023), p. 2123-2139
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- Description: Background: High-Intensity Interval Training (HIIT) involves bursts of high-intensity exercise interspersed with lower-intensity exercise recovery. HIIT may benefit cardiometabolic health in people with nonalcoholic steatohepatitis (NASH). Aims: We aimed to examine the safety, feasibility, and efficacy of 12-weeks of supervised HIIT compared with a sham-exercise control (CON) for improving aerobic fitness and peripheral insulin sensitivity in biopsy-proven NASH. Methods: Participants based in the community [(n = 14, 56 ± 10 years, BMI 39.2 ± 6.7 kg/m2, 64% male), NAFLD Activity Score 5 (range 3–7)] were randomized to 12-weeks of supervised HIIT (n = 8, 4 × 4 min at 85–95% maximal heart rate, interspersed with 3 min active recovery; 3 days/week) or CON (n = 6, stretching; 3 days/week). Safety (adverse events) and feasibility determined as
Impact of beta-blockers on cardiopulmonary exercise testingin patients with advanced liver disease
- Wallen, Matthew, Hall, Adrian, Dias, Katrin, Ramos, Joyce, Keating, Shelley, Woodward, Aidan, Skinner, Tina, Macdonald, Graeme, Arena, Ross, Coombes, Jeff
- Authors: Wallen, Matthew , Hall, Adrian , Dias, Katrin , Ramos, Joyce , Keating, Shelley , Woodward, Aidan , Skinner, Tina , Macdonald, Graeme , Arena, Ross , Coombes, Jeff
- Date: 2017
- Type: Text , Journal article
- Relation: Alimentary Pharmacology and Therapeutics Vol. , no. (2017), p. 1-7
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- Description: Summary Background: Patients with advanced liver disease may develop portal hypertensionthat can result in variceal haemorrhage. Beta-blockers reduce portal pressure andminimise haemorrhage risk. These medications may attenuate measures of car-diopulmonary performance, such as the ventilatory threshold and peak oxygenuptake measured via cardiopulmonary exercise testing. Aim: To determine the effect of beta-blockers on cardiopulmonary exercise testingvariables in patients with advanced liver disease. Methods: This was a cross-sectional analysis of 72 participants who completed acardiopulmonary exercise test before liver transplantation. All participants remainedon their usual beta-blocker dose and timing prior to the test. Variables measuredduring cardiopulmonary exercise testing included the ventilatory threshold, peakoxygen uptake, heart rate, oxygen pulse, the oxygen uptake efficiency slope and theventilatory equivalents for carbon dioxide slope. Results: Participants taking beta-blockers (n = 28) had a lower ventilatory threshold(P <.01) and peak oxygen uptake (P = .02), compared to participants not takingbeta-blockers. After adjusting for age, the model of end-stage liver-disease score,liver-disease aetiology, presence of refractory ascites and ventilatory thresholdremained significantly lower in the beta-blocker group (P = .04). The oxygen uptakeefficiency slope was not impacted by beta-blocker use. Conclusions: Ventilatory threshold is reduced in patients with advanced liver dis-ease taking beta-blockers compared to those not taking the medication. This mayincorrectly risk stratify patients on beta-blockers and has implications for patientmanagement before and after liver transplantation. The oxygen uptake efficiencyslope was not influenced by beta-blockers and may therefore be a better measureof cardiopulmonary performance in this patient population.
- Ramos, Joyce, Dalleck, Lance, Borrani, Fabio, Beetham, Kassia, Wallen, Matthew, Mallard, Alistair, Clark, Bronwyn, Gomersall, Sjaan, Keating, Shelley, Fassett, Robert, Coombes, Jeff
- Authors: Ramos, Joyce , Dalleck, Lance , Borrani, Fabio , Beetham, Kassia , Wallen, Matthew , Mallard, Alistair , Clark, Bronwyn , Gomersall, Sjaan , Keating, Shelley , Fassett, Robert , Coombes, Jeff
- Date: 2017
- Type: Text , Journal article
- Relation: Metabolic Syndrome and Related Disorders Vol. 15, no. 7 (2017), p. 319-328
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- Description: BACKGROUND: High-intensity interval training (HIIT) is superior to moderate-intensity continuous training (MICT) at improving cardiometabolic risk. However, the optimal volume of HIIT to reduce the severity of the metabolic syndrome (MetS) has yet to be investigated. The aim of this study was to examine the impact of different volumes of HIIT and MICT on MetS severity (MetS z-score). METHODS: This was a substudy of the "Exercise in prevention of Metabolic Syndrome" (EX-MET) multicenter trial, reporting data collected at the Brisbane site. Ninety-nine adults diagnosed with MetS were randomized to one of the following 16-week interventions: (1) MICT [n = 34, 30 min at 60%-70% heart rate (HR) peak/session, 150 min/week]; (2) 4HIIT (n = 34, 4 × 4 min bouts at 85%-95% HR peak, interspersed with 3 min active recovery at 50%-70% HR peak, 114 min/week); or (3) 1HIIT (n = 31, 1 × 4 min bout at 85%-95% HR peak, 51 min/week). Z-scores were derived from levels of MetS risk factors before and after the intervention. RESULTS: Eighty-one participants completed post-testing (MICT, n = 26; 4HIIT, n = 28, 1HIIT, n = 27). After excluding 16 participants who had a change in medication dosage or type during the intervention, a total of 65 participants were included in the analysis [MICT, n = 22, age 55 ± 10 years, body mass index (BMI) 32 ± 6 kg/m; 4HIIT, n = 22, 56 ± 10 years, 35 ± 9 kg/m2; 1HIIT, n = 21, 57 ± 8 years, 32 ± 5 kg/m). MetS severity reduced following all interventions (pre- to post-MetS z-score: MICT, 1.80 ± 1.93 to 0.90 ± 1.93; 4HIIT, 2.75 ± 2.56 to 2.17 ± 2.71; 1HIIT, 2.48 ± 3.38 to 0.84 ± 2.98), with no significant differences between groups. There were no reported adverse events that were directly related to the exercise interventions. CONCLUSIONS: Low-volume HIIT (51 min/week) was as effective as high-volume HIIT (114 min/week) and MICT (150 min/week) in ameliorating MetS severity.
- Keating, Shelley, Parker, Helen, Hickman, Ingrid, Gomersall, Sjaan, Wallen, Matthew, Coombes, Jeff, Macdonald, Graeme, George, Jacob, Johnson, Nathan
- Authors: Keating, Shelley , Parker, Helen , Hickman, Ingrid , Gomersall, Sjaan , Wallen, Matthew , Coombes, Jeff , Macdonald, Graeme , George, Jacob , Johnson, Nathan
- Date: 2017
- Type: Text , Journal article
- Relation: Liver International Vol. 37, no. 12 (2017), p.1907-1915
- Full Text: false
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- Description: Background & Aims: Research in NAFLD management is commonly based on quantitative assessment of liver fat by proton-magnetic resonance spectroscopy (1H-MRS), and translation of this into clinical practice is currently limited by availability and expense. Novel steatosis biomarkers have been proposed for the prediction of liver fatness; however, whether these are suitable for detecting changes in liver fat is unknown. We aimed to determine the accuracy of these indices, and waist circumference (WC), in quantifying longitudinal change in 1H-MRS-quantified liver fat. Methods: We performed a secondary analysis using data from 97 overweight/obese adults (age: 39.7±11.5 years, body mass index: 30.7±4.4 kg/m2, liver fat: 6.0±4.8%, 65% male) who completed either an 8-week exercise or 12-week nutraceutical intervention, with varying degrees of change in liver fat. Baseline and post-intervention measures were liver fat (1H-MRS), NAFLD Liver Fat Score, Liver Fat Equation (LFE), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), the Visceral Adiposity Index (VAI) and WC. Results: Only the change in HSI, FLI and WC was associated with change in liver fat; however, correlations were weak to moderate. There was no agreement between the LFE and 1H-MRS for detecting liver fat change. Only change in WC significantly affected change in liver fat (P<.001), and WC AUROC for the presence of steatosis was 0.65 and 0.78 for men and women respectively.Conclusions: Novel indices are limited in their ability to detect longitudinal change in liver fat. Waist circumference may offer modest utility as a surrogate to infer liver fat change with lifestyle interventions.
- Description: Background & Aims: Research in NAFLD management is commonly based on quantitative assessment of liver fat by proton-magnetic resonance spectroscopy (1H-MRS), and translation of this into clinical practice is currently limited by availability and expense. Novel steatosis biomarkers have been proposed for the prediction of liver fatness; however, whether these are suitable for detecting changes in liver fat is unknown. We aimed to determine the accuracy of these indices, and waist circumference (WC), in quantifying longitudinal change in 1H-MRS-quantified liver fat. Methods: We performed a secondary analysis using data from 97 overweight/obese adults (age: 39.7±11.5 years, body mass index: 30.7±4.4 kg/m2, liver fat: 6.0±4.8%, 65% male) who completed either an 8-week exercise or 12-week nutraceutical intervention, with varying degrees of change in liver fat. Baseline and post-intervention measures were liver fat (1H-MRS), NAFLD Liver Fat Score, Liver Fat Equation (LFE), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), the Visceral Adiposity Index (VAI) and WC. Results: Only the change in HSI, FLI and WC was associated with change in liver fat; however, correlations were weak to moderate. There was no agreement between the LFE and 1H-MRS for detecting liver fat change. Only change in WC significantly affected change in liver fat (
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