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TECH: Live Long and Prosper
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During the last 100 years, healthcare has changed considerably and so have outcomes. Life expectancy for example has risen consistently; an American can be expected to live 60% longer today compared with 1900. But during the last 2 decades, as lifestyles have changed, general levels of health have declined, and for the first time, some experts are suggesting, that life expectancy in developed countries may fall. Despite the fall in well being, healthcare budgets are spiralling upwards. Healthcare in the USA accounts for 17.9% of GDP and it is expected to grow faster than national income over the foreseeable future. Throughout western industrial regions healthcare for all is becoming unsustainable. 
 
It is estimated that at least 70% of the total healthcare expenditure is related to lifestyle and can be attributed to just 10 health risks. If overweight Americans (currently 3 out of 5 citizens) collectively made behaviour adjustments and returned to what they weighed in 1991, they would save the country more than USD 1 trillion a year. It’s no wonder that as the waistbands throughout the west expand, governments are emphasising the importance of a healthy lifestyle. It’s the only way healthcare, in the future, can continue to be affordable. It also has the added benefit that the cost of keeping fit and healthy, whether that is through exercise or diet, is usually paid for from the individuals’ own pocket.
 
There can be few people who haven’t heard the warnings about sedentary lifestyles, stress, diet and obesity. We know that regular exercise, eating a balanced diet, going to bed early, cutting back on fat, drinking responsibly and quitting smoking, will not just make our lives feel longer, but actually result in us feeling better for longer. We know that and most aspire, at least intermittently, to do something about it. For example over 16% of adult Britons are currently members of a gym, one of the highest rates in Europe, but 22% used to be members of the gym. The problem is not that we don’t want to live in a way that is healthier, but that we lack the power to keep it going, the alternative lifestyle is so much more attractive. Exercise is hard work and for the non-sporty type boring. Whereas, eating, drinking and staying up late is what makes life worth living. Often the amount of exercise required to offset a good night out exceeds the amount of effort and time that is available during the subsequent busy weeks. 
 
This is where technology can help; preventing disease by motivating people to adopt healthier lifestyles, by making exercise more effective, by targeting the things that matter to health and above all, tailoring the intervention to the individual. 
 
More Effective Exercise
The management mantra, ‘if you can’t measure it you can’t manage it’ is a principle that any weight watcher will be familiar with. But the use of common bathroom scales that just measure weight is now as medically dated as leech craft. The Withings body analyser also tracks your body mass index and total body fat as well as communicate wirelessly with your pc to plot the results over time. 
 
Technology can also be used to track the biorhythms of vital body functions, including heart rate and blood pressure. The simplest device is a heart rate monitor. This will allow you to measure how hard you are exercising and inform you to increase or slow down the level of your training intensity, or will tell you when you have done enough for one session.
 
More sophisticated devices can be worn permanently to monitor: the number of steps taken, distance travelled, stairs climbed, sleeping patterns, blood flow, temperature, sweat levels, and blood oxygen. The BodyMedia FIT armband takes over 5000 readings of your body every minute and includes a calorie counter, so you can monitor your input and output of energy. You can download the information to your PC for in-depth analysis of your training schedule and diet and track your progress against personal training programmes. 
 
Motivation
If a display extrapolating your results to show your fitness in 5 years time doesn’t motivate you to work harder, then using the supporting software applications to publish and tweet your shameful failings maybe will. Most of the sophisticated devices have on line user groups that allow you to share your results and your experiences with others.
 
One study showed that a group using a measuring device while exercising lost 3 times more weight than people without the device. No wonder that the biorhythm monitoring market is expected to reach USD 100 million in sales by 2015.
 
One advantage of monitoring exercise and diet over time is that you can still enjoy a bottle of wine and a wedge of high fat cheese at the weekend and know how many meals of celery and miles of marathon runs are needed to balance that excess afterwards. 
 
And that’s another problem. The average jogger will burn only 10 calories a minute. It takes about 30 minutes just to burn off a single Mars or Snickers bar. If you enjoyed a beer after work that’s another 15 minutes workout time. The amount of time you need to spend on that running machine quickly adds up. If you’re not enjoying your run then you may wonder whether the actual amount of time spent working off the double cheeseburger is longer than the theoretical amount of life lost from eating it.
 
There is a whole range of products that take advantage of technology to make exercise more fun. From Wii Fit, which is more game than an exercise, to a hi-tech racer that hooks up to a plasma TV and uses "Tour Concept" software to give sitting-room cyclists a host of virtual tracks, including the Tour de France route. 
 
If time is the problem then the most efficient idea has to be the Treadmill desk. This combines a running machine and a desk, so that you can exercise while you’re working; great for people who think on their feet!
 
Being motivated to monitor your diet and maintain that exercise regime is great, but even the greatest gym jogging junkie can still be struck down by a random illness. Being a non smoking, teetotaller, vegetarian, and a marathon runner may increase your chances of a longer life, but it doesn’t make you immune from diseases and disorders.
 
DNA Predisposition testing
This is where DNA predisposition testing maybe useful. A growing number of companies are using the latest science and technology to give you a snapshot of your genome, revealing your genetic predisposition for important health conditions. The concept of a genetic test is to look into your DNA and to identify key markers that, if present, may cause you to be predisposed to serious diseases. The results can be used to look into your own future and take the necessary steps to help avoid the conditions altogether.
 
As well as identifying rare diseases that are caused by mistakes in your DNA, they can also assess your risk of developing, at present, 25 other conditions. The testing kits are ordered on line, you return a sample by post and a personalised report arrives within two weeks. Each condition will be ranked according to your estimated lifetime risk, and will be qualified as high, medium or low risk.
Among the diseases currently assessed include cardiovascular issues, some cancers, such as lung, prostate and breast, immune system disorders and some age related illnesses such as osteoarthritis and Alzheimer’s.
 
The commercially available tests only provide you with an indication of how much more at risk of developing a particular condition you are than the rest of the population. If your risk of developing a disease is low, then it’s not because you’ll never get that disease, it just means that you are no more likely to develop it than the general population. Not having the marker that predisposes you to diabetes doesn’t mean it’s ok to live on chocolate biscuits. But it might put your mind at rest if you know you have a history of an illness within the family.
 
Early detection
altDespite the changes in medical science the art of medicine still relies on bumps, pains and other symptoms being felt by the patient or discovered by the physician. More sophisticated technology such as the microscope the x-ray and the MRI machine have made finding problems easier and earlier. Advances in screening technology have allowed for the detection of pre-cancerous cells before they become cancerous, but they are all too expensive to be deployed generally. Screening and imaging is used for at risk groups- including those already presenting with symptoms. Symptoms that rely on being found, principally, by self checking.
In the near future, diagnostic gene chips will rely on detecting the underlying molecular processes that trigger disease in the months, or years before the patient feels a twinge or lump.
 
DNA chips contain a strip of DNA from within a virus or bacteria or genetic disease. That strip can be used to track down a matching strand from a patient’s blood sample. Dozens, even hundreds of potentially offending pathogens, genetic diseases, or other ailments can be diagnosed on the surface of a single chip. Then the chip is placed in an analyser that can read the patterns of genes and transfer the information directly into computers capable of interpreting the results.
 
Regular health checks will be possible by posting a blood sample to online labs in the same way that DNA predisposition testing is already performed. They will screen your sample at a molecular level for hundreds of diseases. With early detection and precise diagnostics comes the opportunity for targeted drugs; a specific drug to treat specific diseases in a specific individual.
 
The ancient approach to medicine, whereby we suffer a few days before seeing a doctor, may be coming to an end. Healthcare will become more of our own responsibility, whether it’s keeping ourselves healthy or having regular health checks. Without these changes current healthcare systems will become unsustainable and increasingly rationed. The good news is that technology will give us the power to take control of our own health and no doubt governments will add incentives on top of the current education to help motivate looking after ourselves. Excluding a rise in sporting injuries, technology will help makes us healthier and live longer too.
 

By Robert Watt

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