Tracking what your body needs

Summary

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TED Radio Hour | "Tracking What Your Body Needs"

Host: Manoush Zomorodi
Date: July 10, 2026
Featured Guests: Dr. Keith Diaz (Columbia University), Dr. Michael Snyder (Stanford University), Lizzie Rakes Rinker

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Overview

This episode explores the evolving relationship between our bodies, health, and technology. Host Manoush Zomorodi leads conversations with exercise scientists and geneticists to examine how movement, self-awareness, and tracking devices can help us better understand—and respond to—our body’s needs. The show highlights lessons from cutting-edge research, practical habit-building tips, the promise and pitfalls of personal health data, and a deeply personal reflection on the true meaning of wellness beyond the numbers.

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Key Discussion Points & Insights

1. The Importance of Movement—Why Sitting is "the New Smoking"

Guest: Dr. Keith Diaz

• Decades of research show that sedentary lifestyles are on the rise, with adults now spending over half their year sitting or physically idle ([02:21]).
• Sitting too much increases risks for diabetes, cancer, dementia, heart disease, and early death—even for people who exercise regularly ([02:39]).
• Muscles regulate metabolism and blood sugar; they need frequent, regular contraction to function optimally. Sporadic exercise is not enough—consistent movement through the day is crucial.
• Lab findings: The most effective, feasible movement break is a 5-minute walk every half hour ([04:23]). In real-world studies, however, just five breaks a day still yield significant health benefits without diminishing returns ([05:10]).
• Culturally, society equates sitting at a desk with productivity—a mindset that needs to shift ([06:33]).

Notable Quote:

"The bad news is that our bodies weren't designed for this... the toxicity comes from when movement begins to disappear from your life."
—Keith Diaz ([02:31])

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2. How to Build Habits—Internal vs. External Cues for Movement

• Fitness trackers are helpful for prompting movement but may not build lasting habits ([08:03]).
• Sustainable behavior change ties movement to daily routines or environment—like brushing your teeth ([08:53]).
• Internal cues (after meetings, finishing a task) are preferable to annoying device reminders.

Notable Quote:

"Getting to that place in our everyday lives for movement... of like, ‘Okay, I've just finished a work task. I'm going to go take a movement break before I go on to the next one’... That behavior is much more likely to stick."
—Keith Diaz ([08:53])

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3. Changing Culture—Grassroots Change and Normalizing Movement

• Institutional change is slow; grassroots efforts by individuals and small groups can start momentum.
• Normalizing movement (walking during meetings, using treadmill desks) can influence others ([11:21]).
• "Touch grass" memes as possible motivators for widespread habit change ([12:19]).

Notable Moment:

"I'm always that guy in a Zoom call who, like, is walking on a treadmill while everybody else is sitting ... then you start, some other people start thinking, 'Oh, like I want to do that too.'" —Keith Diaz ([11:21])

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4. The Rise of Wearables: Tracking Deeper, Acting Smarter

Guest: Dr. Michael Snyder

• Dr. Snyder personally uses multiple smartwatches, rings, and hearing aids, collecting data for over a decade ([15:38]).
• Modern wearables track more than steps—metrics now include heart rate variability, blood oxygen, galvanic skin response, blood pressure, and more ([16:38]).
• Wearables can detect early warning signs for viral infections, stress, and potentially cardiovascular issues before symptoms appear ([17:31]).
• The "health dashboard" analogy: Just as drivers monitor a car’s systems, soon people might "monitor" their bodies for early signs of trouble ([25:08], [25:59]).

Notable Story:
Dr. Snyder recounts the death of a fit researcher whose wearable data showed notable changes (resting heart rate, sleep, gait) four months before a fatal heart attack—highlighting the life-saving potential of real-time personal data ([19:36]).

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5. Preventive Care—Changing Healthcare to "Health Care" Instead of "Sick Care"

• The current medical model treats illness rather than maintaining wellness.
• Wearables and continuous monitoring could enable individualized, preventative care ([25:08], [26:12]).
• Aligning financial incentives (like John Hancock's Vitality program) could encourage health plans and providers to prioritize prevention ([26:35]).

Notable Quote:

"It's broken because we practice sick care rather than healthcare... What if you can measure your health with sensors and a dashboard much like your car dashboard?"
—Michael Snyder ([25:08])

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6. Access, Equity, and Data Privacy Concerns

• Right now, deep-data profiling is expensive and mostly available to the wealthy ([31:13]).
• Basic health tracking via wearable devices is becoming more accessible and could be integrated widely (e.g., as a standard part of health insurance enrollment) ([31:13]).
• Data privacy is a major concern; laws are needed to prevent discrimination, especially around health and genetic information ([29:24]).

Notable Exchange:

"Couldn't they possibly also punish me or hold a preexisting condition against me?"
—Manoush Zomorodi
"We do need, I think, laws that protect people then in those circumstances."
—Michael Snyder ([29:24])

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7. Understanding Health Beyond Data: The Human Side

Guest: Lizzie Rakes Rinker

• True health is not just an absence of disease or a set of metrics, but a holistic state tied to mental, emotional, and physical wellness ([47:11]).
• Rinker shares her story of peak physical fitness as a rower while experiencing panic, pain, and emotional distress—her "healthy" exterior masking deeper struggles.
• Wellness is more than doing what you "should"; it's about what makes life better, not just your body.

Notable Quote:

"You cannot really tell anything about somebody's wellness or their lived experiences and their circumstances by the way that they look... I want to be your friend. I took a long breath and replied, I have been waiting my whole life for this."
—Lizzie Rakes Rinker ([51:32], paraphrased at [52:31])

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Memorable Quotes & Moments (with Timestamps)

• "Exercise only makes up a tiny fraction of your day. The toxicity comes from when movement begins to disappear." —Keith Diaz ([02:39])
• "Just drive for five...what we found in the real world is that people really had a hard time sticking to that regimented clock of every hour. Five times in your day, move for five minutes." —Keith Diaz ([05:10])
• "These devices, they're not expensive now and they're only going to get cheaper...even if we could catch 50% of these [illnesses], it'd be amazing." —Michael Snyder ([17:31])
• "There's no such thing as too much information...But you don't want your devices making you unhealthy." —Michael Snyder ([40:02])
• "We should really be doing it much, much earlier...I think more of these pictures of showing two people are 75, one who's all stooped over and doesn't look very good at all, and another who looks like they're ready to run a marathon...will help motivate people to stay healthy." —Michael Snyder ([45:06])
• "I have been waiting my whole life for this." —Lizzie Rakes Rinker (quoting a poem, [52:31])

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Major Takeaways

• Movement matters: Regular small breaks matter more than occasional, intense exercise. Even five 5-minute breaks/day can meaningfully reduce fatigue and other health risks.
• Habits stick with internal cues: Integrate movement into routines and environments for sustainable change; don't rely solely on tech reminders.
• Technology is powerful—but not the full answer: Wearables help detect early changes in health, but equitable access and privacy protections are crucial. Not all health can be quantified.
• Prevention—not just treatment: The healthcare system must evolve to value and incentivize long-term wellness, using wearables as tools, not just novelty gadgets.
• Wellness is holistic: Physical appearance or tracking stats can't tell the whole health story. Emotional, environmental, and personal well-being are equally important.

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Timestamps for Key Segments

• 00:30: Introduction to episode theme—tracking what the body needs
• 01:06–05:48: Keith Diaz on sedentary behaviors and movement break research
• 06:33–12:27: Habits, culture, and normalizing movement
• 15:38–19:24: Michael Snyder on wearables and expanding types of biometric data
• 19:36–22:26: Case study—wearables detecting early warning signs for heart attack
• 25:08–29:24: Shifting to preventive care, health dashboards, and financial incentives for wellness
• 29:24–32:38: Privacy, equity, and access to health tracking tools
• 32:38–33:35: Heart rate variability explained
• 41:38–43:27: Interoception vs. data overload (are we losing touch with our own bodies?)
• 47:11–52:52: Lizzie Rakes Rinker’s story—wellness as holistic, not just physical

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Closing

“Tracking What Your Body Needs” challenges listeners to rethink productivity, autonomy, and the true meaning of health in a data-saturated world. While sensors and algorithms are changing healthcare, the episode reminds us that our deepest well-being also depends on self-awareness, community, and listening to the signals—both digital and organic—our bodies send.

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Transcript

[Minouche Zamarodi]

This is the TED Radio Hour. Each week, groundbreaking TED Talks.

[Keith Diaz]

Our job now is to dream big.

[Minouche Zamarodi]

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[Narrator/Announcer]

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[Minouche Zamarodi]

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[Michael Snyder]

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[Minouche Zamarodi]

I literally feel like I'm a different person.

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Yes.

[Minouche Zamarodi]

Do you feel that way? Ideas worth spreading from TED and npr. I'm Minouche Zumarodi. On the show today, tracking what the body needs. And one of the most basic things our bodies need is movement.

[Keith Diaz]

So if you kind of map out the trajectories of our sedentary time and you know, how much time we spend watching tv, how much time we spend sitting in a car, how much time we we spend sitting at work, it's kind of been like steadily increasing across decades.

[Minouche Zamarodi]

This is exercise scientist Keith Diaz.

[Keith Diaz]

And society and our cultural and societal norms are telling us you're supposed to sit in your desk. If you're not in your desk, you're not learning, you're not being productive.

[Minouche Zamarodi]

Keith Diaz has spent the past 15 years researching the impacts of a sedentary lifestyle on our health and how much movement we really need to stay healthy. It all started with a headline that he desperately wanted to debunk.

[Keith Diaz]

I came across some news headliners. It was like in Runner's World magazine it said something like, sitting is a new smoking, even if you're a runner. And I was like, you know, as a runner, I tend to see exercise as the cure all, prevent all, for everything. And so for this article to, you know, put it out there that like, you know, what you do exercise wise, you're running. That's not enough. I didn't believe it. And so I set off in my career to debunk that and show that, no, that's not true. Exercise can overcome that. Sitting isn't the kryptonite to exercise. And here we are almost 15 years later and man, I've come to see it in a very different light.

[Keith Diaz (TED Talk Segment)]

We are living in the most sedentary era in modern history.

[Minouche Zamarodi]

Keith Diaz continues from the TED stage.

[Keith Diaz (TED Talk Segment)]

In a single year, the average adult now spent a full 187 days over half of the year sitting or physically idle. The bad news is that our bodies weren't designed for this. I know because I've spent my career as a scientist studying the harms of being highly sedentary. And what scientists have found is that being highly sedentary increases your risk of diabetes, cancer, dementia, heart disease, and ultimately early death. Worse, this is true even if you exercise regularly. Exercise only makes up a tiny fraction of your day. The toxicity comes from when movement begins to disappear from your life. And this begs the question, why isn't exercise alone enough? Part of the answer lies in our muscles. Our muscles are more than just a machinery that power movement. They're also really important for regulating things like our metabolism. Let's use blood sugar as an example. Our muscles are like sponges for blood sugar. When we regularly use and contract our muscles, they're like a moist sponge soaking up the sugar from the bloodstream.

[Keith Diaz]

But.

[Keith Diaz (TED Talk Segment)]

But when we don't regularly use and contract our muscle, like a dry and shriveled up sponge, not really good at soaking up anything. Now here's the when we exercise, it rewets the sponge, but eventually that sponge dries out if you get little to no movement the rest of your day. If our muscles need regular use to function optimally, then outside of any exercise time, we need to be contracting them frequently through movement. The question that we asked in my lab is what's the least amount of movement breaks that we need in order to offset the harms of being highly sedentary? And the answer we found was a five minute walk every half hour.

[Minouche Zamarodi]

In 2023, as part of the Body Electric project, NPR partnered with Keith's team at Columbia University Medical center to conduct a massive study with over 20,000 public radio listeners testing feasible. This gold standard of five minutes of movement for every half hour of sedentary time was out of the lab.

[Keith Diaz]

I mean, we set out really to answer the question, can people do movement breaks in the real world?

[Minouche Zamarodi]

And the answer was yes. It wasn't easy at first, but once people committed to taking regular breaks throughout the day, they started noticing the positive effects on their mood, productivity, fatigue levels and more. Plus, Keith now has an exciting update.

[Keith Diaz]

What we're finding is that once people take about five movement breaks a day, you start to see diminishing returns in terms of their improvements in fatigue. Right. Like after about five to six breaks a day, you don't get that much extra benefit from doing 7, 8, or 9. And so that to me seems like a little bit of a better message too, that just drive for five would I love for it to be every half hour, every hour. That'd be great. But what we found in the real world is that people really had a hard time sticking to that regimented clock of every hour. But maybe this was a different way to think about it. Five times in your day move for five minutes.

[Minouche Zamarodi]

Our body is constantly sending us a signal about what it needs. But are we listening? What happens when we start paying closer attention not just to how we feel, but to the patterns hidden inside our daily lives? From simple habits like taking movement breaks to cutting edge wearables that track everything from sleep to stress, new tools are changing the way we understand our health. And so today on the show, we're exploring ways of tracking what the body needs for exercise scientist Keith Diaz. When it comes to changing our sedentary habits, Keith says we need to deal with what we think being productive looks like.

[Keith Diaz (TED Talk Segment)]

One of the biggest concerns I often hear from employers in schools about movement breaks is that they worry that it's disruptive, that it'll hurt productivity and performance. But movement doesn't mean you have to stop working. You can have walking meetings, pace around while you're on a call, get walking pads, or simply just move around while thinking. But the bigger idea and concept with movement breaks is that when you compare brain activity after movement versus after sitting, the differences are so striking. The brain after movement looks like one certainly far more ready to learn and to work. And yet, somewhere along the way, we decided that sitting and staring in front of a computer screen for eight hours

[Keith Diaz]

straight is the best way to work.

[Keith Diaz (TED Talk Segment)]

And that's where the real challenge lies. Productivity, culture, convenience, culture and technology are re engineering our lives and steadily removing the need for movement. We can have groceries delivered and robots vacuum our floors without ever getting off the couch. And the consequences of this re engineering is that we now often see movement as something to avoid.

[Minouche Zamarodi]

So a lot of people rely these days on their device, a smartphone, to ping them. You know, it's time to get up. You're actually not a fan, if I understand correctly, of fitness trackers. You've told me. So, like what, how do you. How do you approach this?

[Keith Diaz]

Yeah, I mean, why I'm not as much of a fan of it is that you're relying on kind of external cues still. And where I'd love to see this and what the science kind of tells us on human behavior change is that for us to build a habit, it has to be more so something internal. Right. And so when we kind of learn how to check back in with our bodies, we don't have to rely on external cues to do that. That behavior is much more likely to stick. The example I always use is brushing teeth is like the ultimate health behavior. That since we were kids, we're taught and trained to do. But we also have tied it to cues in our day. We know that when we get ready in the morning to go and leave our house or that when we get ready for bed at night, we automatically are cued by our environment that like, oh, yeah, teeth brushing. That's next up. I put my pajamas on, I go brush my teeth. Like, that's just the natural part of it. And so getting to that place in our everyday lives for movement breaks or just movement in general of like, okay, I've just finished a work task. I'm going to go take a movement break before I go on to the next one. I just finished a meeting. Before I go to the next one, I'm going to move right. And tying it to cues in our day rather than relying on some kind of device to remind us. Because people. At the end of the day, most people end up hating that reminder and ignore them.

[Minouche Zamarodi]

Yeah. You know, it's annoying. It starts to annoy you. It starts to be like, okay, good to know. Thanks. But I'm busy. So I guess my question is, what happens next? Like, our relationship with technology is getting even more entangled. So are we at this point where we have to be taught. Be more specific, Put language around or doses, as you say, around things that, like, you know, probably when I was a kid, if someone was like, did you get enough movement today? That would be kind of like, maybe not in school, but, like, generally, we were always moving. I had to move to go to the next class. Like, I had to move to go get a new book.

[Keith Diaz]

Yeah. And maybe it's going back to that point of, like, harnessing, like, this idea or notion that, like, a body that moves is a more efficient and productive body as well. Like, what moves the needle for employers outside of, like, policy changes. Right. Is incentivizing employers to allow this to happen. I feel like I keep saying the same story again and again and again, and people want to keep talking about it, but nothing is changing. And that's where I just feel like I feel stuck because I'm like, how much do I have to keep talking about it? How much more science needs to come out before somebody starts doing something about it.

[Minouche Zamarodi]

Okay. So I'm going to offer a more positive perspective, Keith. One is that we can actually change our habits pretty fast. Like, I'm thinking of going to zoom for everything during the pandemic. And also, like, I definitely heard from the people who joined our study that once they committed to taking movement breaks and they got their friends to try it. They got their office mates to try it. They realized that they wanted to keep doing it. But it starts with just getting people to try.

[Keith Diaz]

Yeah. And I think what you're getting at is it's a grassroots movement. Right. Like, the top ain't changing things. So we're gonna have to start from a different perspective and a different approach. And it's this trickle effect. And, you know, normalizing the behavior has to start with somebody, like, being willing to do it and step out of that comfort zone. Like, I'm always that guy in a zoom call who, like, is walking on a treadmill while everybody else is sitting.

[Minouche Zamarodi]

You know, it's weird to see you sitting right now, actually.

[Keith Diaz]

Yeah. But, you know, then you start, some other people start thinking, like, oh, like I want to do that too. So a couple of my staff members went out and got walking pads. Right. And so, like, when you make it acceptable, like, oh, that's totally a normal thing to do. And I wouldn't even think twice about it. Right. Like, we have to start changing that perception and that culture. And it may have to start with just people doing it and making it normal. And maybe eventually we'll get there.

[Minouche Zamarodi]

I think we need a meme like touch grass worked really well. Maybe we need like dance on grass or something like that.

[Keith Diaz]

Totally.

[Minouche Zamarodi]

We're gonna figure it out, Keith. We're on the journey.

[Keith Diaz]

Totally.

[Minouche Zamarodi]

All right, time for a movement break.

[Keith Diaz]

Keep it going, Keep it going.

[Minouche Zamarodi]

That was Columbia University Medical Center's Keith Diaz. He is an exercise physiologist and also wrote the foreword to the book Body Electric the Hidden Health Costs of the Digital Age and New Science to reclaim your well being. You can see his full [e-mail] on the show today. Tracking what the body needs. I'm Anoush Zamarodi and you're listening to the TED Radio Hour from npr. Stay with us. This message comes from cookunity, the first chef led meal delivery service where every meal is handcrafted in local micro kitchens, not mass produced in large facilities. With hundreds of dishes to choose from and over 10 different dietary preferences like high protein, low sodium, GLP1 and more. Taste what happens when real award winning chefs make fresh, small batched meals just for you? Go to cookunity.com radiohour or enter code radiohow hour before checkout to get 50% off your first order.

[Narrator/Announcer]

This message comes from Midi Health, a virtual care platform for women in perimenopause and menopause. Chief Medical Officer Dr. Kathleen Jordan shares the wide range of symptoms they work to address for women in midlife.

[Lizzie Rakes Rinker]

There's dry eyes, dry hair, dry skin. There's dry mouth, trouble sleeping, panic and anxiety attacks.

[Keith Diaz]

When we ask patients about common symptoms,

[Lizzie Rakes Rinker]

on average they report six MIDI Health

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Committed to helping women in midlife with perimenopause and menopause care, accessible via telehealth visits at. Join MIDI.com support for this podcast and the following message come from Strawberry Me. Be honest. Are you happy with your job? Are you stuck in a job you've outgrown or never wanted in the first place? Are your reasons for staying really just excuses for not leaving? Let a career coach from Strawberry Me help you get unstuck, discover the benefits of having a dedicated career coach in your Corner and get 50% off your first coaching session at Strawberry Me NPR this message comes from Capella University. That spark you feel? That's your drive for more. Capella University's flexpath learning format lets you earn your degree at your pace without putting life on pause. Learn [e-mail] if you're loving the show

[Minouche Zamarodi]

this week, or even just liking it, you will probably love our Body Electric newsletter. It's where we go even deeper into understanding the impact of technology on our body and mind, and where you can get ideas to live better with your devices. Subscribe [e-mail] newsletters it's the TED Radio Hour from NPR. I'm Minouche Zumarodi. Today on the show, tracking what your body needs.

[Michael Snyder]

I have four smartwatches, so an Apple, Fitbit, Sensomics and a Whoop. I have two rings on me, an Oura ring and something called Ultra Human.

[Minouche Zamarodi]

This is Professor Michael Snyder. He's the director of the Stanford center for Genomics and Personalized Medicine.

[Michael Snyder]

I have hearing aids, which I do use for hearing, but they also do sensing as well. I have an exposometer that measures airborne exposures and I have my iPhone that tracks a few odds and ends like steps and things. Some of that's redundant with the other watches.

[Minouche Zamarodi]

And how long have you been collecting all of this information?

[Michael Snyder]

Well, I've been collecting deep data on me for about 16 and a half years now. The wearable part I'd say runs for about 11 years, 12 years.

[Minouche Zamarodi]

Of course, wearables and tracking devices have been around for a long time, but the types of data they can collect is constantly getting more precise.

[Michael Snyder]

Your resting heart rate, your heart rate variability, your blood oxygen, something you don't get in a doctor's office called Galvanic stress response. This is conductance on your skin. And it turns out that when you're stressed, you're sweating more, so your skin gets more moist, and when you're diabetic, your skin gets more dry. Some of the watches will, at least one of them will detect blood pressure and measure that.

[Minouche Zamarodi]

Michael has spent decades doing massive studies using information collected from wearables. And his research is changing our understanding of how genetic risks and personal habits combine to shape human health and for individuals. As in, what does this mean for you? Well, he believes that self monitoring and collecting more of our own physical data will soon transform how we each stay healthy.

[Michael Snyder]

These devices, they're not expensive now and they're only going to get cheaper in the future. You can keep the individual people themselves healthy by, you know, catching when they first get ill, treat them, catch heart conditions. I think there's going to be a ton of stuff catch mental health problems like depression, anxiety. We're doing a lot of research there. Cardiovascular disease, you know, it's not going to be a perfect system, but even if we could catch 50% of these, it'd be amazing.

[Minouche Zamarodi]

I mean, I think people have been wearing, like, smartwatches or, you know, collecting how many steps they're walking every day. And this has been going on for a while now, as you said, like over a decade. But are we at some sort of tipping point when people actually know what to do with this information? Like, for example, I've been tracking my steps for six years and I rarely even look at the data. But is something changing when it comes to collecting information about our bodies?

[Michael Snyder]

When these first came out, it's as you say, they were fitness trackers. And realistically, people put them on their wrist and they would wear them for three months, say, yep, I know my pattern, I'm done. Then they throw it in a drawer and be done with it. But I think what the tipping point is that you're referring to is that they're actually health monitors. They can track a lot more than just your steps. For example, resting heart rate, heart rate variability are really good indicators of your health. We've used them to be able to pick up when you're getting a viral infection in advance of symptoms because your heart rate goes up. What's powerful about them is they're measuring you 24, 7. They're always following you. And we've exploited this in a way that we can actually. If your heart rate's up for too high for too long, it triggers a red alert. And that can be indicative of a viral infection. And more recently we've shown it's indicative of mental health stress as well.

[Minouche Zamarodi]

You actually told me a story about a Stanford researcher who had a heart attack and there was data behind that that could have predicted that he was going to.

[Michael Snyder]

Yeah, it was a very interesting study, you know, a little bit tragic to say the least. There's a person working in my lab for two years, very wonderful person, high energy. You meet this guy, you assume he's in great health and in great shape. And it turns out he was very much a believer in all of the wearable things that we were doing. He had an Apple watch and an OURA ring. He would exercise pretty regularly on a peloton, which also has tracking data. And basically one day as he was riding on his peloton, actually quite intensely, and it turns out he died right after that. It was really quite tragic. And his wife, he knew how much he liked the lab and being there and shared the data with us and asked us to take a look at it. And because he had the latest Apple watch and also the Oura ring, we could track what was going on. It was very clear. Four months before he passed away, he had a significant, what I like to call step function, meaning his resting heart rate went up, his heart rate variability dropped. His gait, which you can also get from a smartwatch, shifted. And his sleep also shifted. And so there was a sign something was off, yet there was no system to relay that information back to say, hey, something's off, you should go get checked out. And I think that's what we need to do next. We have this for viral infection alerting, but we don't have it for all these other things, which is what we need to. And so we're now trying to study this further, you know, track people's, if you will, cardiovascular state and then build a real time alerting system. We need to run proper studies first, but that is the goal, to be able to see when we, when you see something's off, you may not always know what it is. Like right now we can't tell the difference between a respiratory viral infection and an anxiety attack, but we do know something's off, so we will be able to distinguish those in the future. By the way, there are enough ways to measure this now we can tell them apart, but when we first set up the study we couldn't. But it does tell you something's off. And I think that should give you pause to, to look at this further.

[Minouche Zamarodi]

I mean, it's interesting. My dad has a pacemaker that sends data constantly back to his cardiologist. But of course, it took him having a cardiac issue for him to need a pacemaker, which then sends back all of this data. So describe to me, like, how you see this working in the future, especially if it's not data that's specific to one particular organ function. Right. You're talking about data that collected all together forms a picture of someone's health.

[Michael Snyder]

Yeah. The way I see it working is you wear these devices, right now they're on your wrist or your ring or even in your ear if they're a hearing aid. I think in the future they may also be implantables because some people don't like to wear this stuff. And if you just put it under your skin and kind of like your pet, your pet often has GPS trackers.

[Minouche Zamarodi]

Oh, yeah.

[Michael Snyder]

So anyway, I'm not saying people are the same as pets, but you get the idea they can track some useful things. And the point out of all of this is that we can track the stuff passively. Now, I do think there's enough information in these devices. You can get quite a bit of data. So, for example, we can get a signal for red blood cell count. Because of the way the devices work, they actually look for. They measure your oxygenated hemoglobin, so hemoglobin with oxygen that's in your red blood cells, so they get a sense of your red blood cell count. And that's valuable for anemia and dehydration. And then there are other parameters like the conductance on your skin that's important for dryness I mentioned earlier, that actually is a sign of diabetes. So there's enough parameters there that they can. They not only just tell you things are off, but they can give you some clues as to which direction they're off. So I think they will pull invaluable data and they'll just. Just like your car, you probably look at your speed and your. Your gas tank, but otherwise you don't really look at much in your car. And so the way I see it working is that there'll be all these sensors running in the background, and then when something goes off, you'll get a red alert on your phone and you should probably go get it checked out. But yeah, people always ask me what's the most important wearable to wear. And I always tell them a continuous glucose monitor because it's in part because we have so many people who are out of control with their. Their glucose. These continuous glucose monitors are so visual that once you wear them, you'll never eat the same again. And I mean that in a good way. Meaning you'll see exactly what spikes you. And this is very personal, different foods spike different people. So you see what foods spike you, which ones don't, and you just gravitate towards the ones that don't and, and avoid the ones that do. And if you are going to eat the ones that do spike your glucose, well, go do that brisk 15 minute walk and that'll suppress the spike. So there are things you can do to mitigate these. And in general, spiking is bad for your health. It correlates not only with diabetes, but cardiovascular disease. So I think we've got to get this under control and we're not there yet, that's for sure. Our health care system is broken.

[Minouche Zamarodi]

Here's Michael Snyder on the TED stage.

[Michael Snyder]

Our laboratory in the last 17 years has been trying to improve it. And along the way I've even learned a lot of new things about my own health. It's broken because we practice sick care rather than health care. And even when we practice healthcare, if you think about it, it's a pretty archaic process. You will travel to a physician's office that really hasn't changed much in the last 40 years. When you're there, they'll take lots of blood and from all that blood, in the time you're there, they actually don't make very many measurements. And from those measurements will treat you based on population averages rather than the individual. We're trying to change all those steps and one area in particular is remote health monitoring. What if you can measure your health with sensors and a dashboard much like your car dashboard?

[Minouche Zamarodi]

So you think also that in the future, just like we look at our car's dashboard, like, okay, are the tires inflated enough? How much gas do I have? I can check all the vital signs of my car. That we'll be able to do that for our bodies too?

[Michael Snyder]

Absolutely. I think we need that because I think we want just like our car to run well and efficiently forever or as long as you want to live.

[Minouche Zamarodi]

But how do we get to a place where we think more of healthcare as preventive, like a personal dashboard to monitor our health in a sort of more holistic way?

[Michael Snyder]

Yeah, well, we have to change the financial incentives. That's number one. What happens is people really only go to the doctor when they're ill. And so therefore they only go every few years. Typically, there's no reason for any health plan to keep you healthy today. And that's why we practice sick care, because that's when people get paid. And the one exception to this is this life insurance company, John Hancock. They have a vitality program that basically gives points if you wear smartwatches and do things that keep you healthy, walk your 10,000 steps, for example. And so we need more things like that because in that case, the incentives are aligned. If people live longer, John Hancock makes more money. It's a life insurance company, so they wind up making more money if you live longer and you are healthier. So that's a good thing. And so again, they've got the financial incentives aligned. We need that for our health providers as well, that they. And in the whole system it's pretty clear if you stay healthier, you know, you'll push off having all these chronic conditions. And hopefully the idea is for us to live long, healthy lives and then just pass away sort of all at once, but not hang on there for the last decade of life. There are studies now that show that people live the last 11 to 15 years of their life on average with chronic conditions, meaning they're living their last decade of life unhealthy. And that's not a good situation to be in. And so I think as these technologies get cheaper and cheaper, as they get more facile, like we talked about the heart attack case, if we automatically have people's information from their devices going to their doctor's office, that would actually be much more accurate because your resting heart rate first thing in the morning is way more accurate than what's in a doctor's office. And so that stuff should just be online, sitting there. When you walk in right now, your nurse takes your blood pressure and all these things that can just get pulled straight in. And it'd be more accurate, better data, and no more of this. Well, when did this seem to go off? You could actually look at someone's heart rate information and see, wow, looks like it went off, you know, three weeks ago or whatever. You can see it because of a jump up. So I think we can pull in information a lot better and then the physician can make better assessments and spend less time on the routine things and spend more time on more complex things. Now, of course, we're all going to have AI agents in the future and the physician will be working with those to help actually better manage your health.

[Minouche Zamarodi]

Okay, my spidey sense, my, my worrying radar is going off. Beep, beep, beep. Right now I want to push back on a few of these things.

[Lizzie Rakes Rinker]

Okay?

[Minouche Zamarodi]

So first of all, Digital privacy. Who's in charge of all of this data that's being collected? And if an insurance company is using it to incentivize me, couldn't they possibly also punish me or hold a pre existing condition against me?

[Michael Snyder]

Yeah, well, we would hope not. You're not allowed to be discriminated against for your genome information. For health insurance, you can. For life insurance though, and employment, you're not allowed to be discriminated for that based on your genetic information. My own view is that we obviously, if people are getting discriminated against, I do think we need laws to protect that. You know, I'm a believer that in any, you know, wealthy society, which I view the United States and most western countries to be in, that you should have some minimal level of health care for your citizens. So I would hope that that would be the case for everyone. Obviously it isn't, but we need to get there. But even if it were the case where, let's say someone was using your smartwatch, I'd rather know that something is off and catch it with a watch than not know it exists and die of a heart attack, for example. So we need to, you know, the information is still valuable, but as it moves and becomes more facile, we do need, I think I would argue, laws that protect people then in those circumstances.

[Minouche Zamarodi]

The other concern I would have is that right now this sounds like a rich person's health care system. I mean, you know, having someone to actually give your data to a physician or a client clinician, that means that you are seeing a doctor to begin with. How do we begin to make this more accessible? Right now? This is an expensive proposition.

[Michael Snyder]

So you're right. The way we do deep data profiling, only rich people can afford it. And getting your genome sequence and some of these other things, only people who pay out of pocket can do it. And you know, we have a company called Qbio that does whole body MRI and a pretty deep medical testing. It's $3,500. So a number of people can pay for that, but probably the average working class family cannot or they'd have to save up. I do think it would save money in the long term, but it only hits a subset of people. So there I would say yes, some people won't have access to that, but the one area where they will have access is the wearables. That's a neutralizer. So I think when you join a health plan, they should give you that smartwatch as part of the enrollment in the plan because anyone can do it. You can do it remotely too, right? You can live in the boonies and have this data transferred to your phone. Most people do have a phone, even when they live in remote parts of the world. 60% of the world has a phone, believe it or not, of adults. And so even in these remote places, they have a phone. All you have to do is link it to a smartwatch and you've got a health tracking system that can track a fair number of things. Again, resting heart rate, heart rate variability. Heart rate variability. It's kind of a new metric that's popped up that turns out to be a really great gauge in people's health.

[Minouche Zamarodi]

Yeah, tell me about that because I've been hearing it. I used to think that a steady heart rate was what you wanted, but that's actually not true.

[Michael Snyder]

Yeah, that's correct. So you have what's called your sympathetic nervous system and parasympathetic nervous system. So voluntary and involuntary systems acting and it turns out when they intersect, you wind up, if you're healthy, you get a variable heart rate, meaning they're not exactly the same beat per minute. For every beat, there's just a little bit of a difference in milliseconds. And that's healthy. You actually should be having that. And when people's health goes down, either from a viral infection, heart conditions, and we saw this in the case I mentioned earlier about the person who had the heart failure, it's a general rule your heart rate variability drops. And so it's a relatively new measure, but it turns out to be a very, very important one.

[Minouche Zamarodi]

When we come back, more with geneticist Michael Snyder and how his hearing aids monitor his social interactions. Would you want them today on the show tracking what the body needs? I'm Anoush Zomorodi and you're listening to the TED Radio hour from npr. We'll be right back.

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[Minouche Zamarodi]

it's the TED Radio Hour from NPR. I'm Minouche Zumarodi. Today on the show, tracking what the body needs. Stanford genetics professor Michael Snyder is a big believer in wearable technology. He regularly wears about eight devices, including four smartwatches, a few bio tracking rings, and hearing aids that track different health measures. 24, 7 Snyder believes that individual health metrics tracked through these devices could bring about a revolutionary shift in how medicine is practiced, but also it could change how we interact with each other on a daily basis. Let's go back to Michael's hearing aids.

[Michael Snyder]

There are these new hearing aids. They come from a company called Starkey, which is a hearing aid manufacturer. And they basically are collecting data. We're measuring how much they're interacting and the kinds of interactions. So how much they're in conversations, for example, with others and how much they participate in this. We also measure, you know, TV time, how much they're, I suppose on the Internet by the voices announced how much background noise is in their environment. So it captures all kinds of different information. And the goal is to try and understand what environments and how they interact with that environment will better lead to cognition because we're doing cognition surveys as we go along. So we think this is very, very valuable information. We're not violating privacy. We're not collecting information about what they're saying, but more whether they're in these conversations or not. And so we know that's important. And I think what we're going to learn from this Hearing aid study is exactly, you know, what kinds of interactions are important for keeping your cognition up. So we want to know what keeps you sharp. It's the number one thing people worry about most as they get older is their cognition. They're afraid of dementia and Alzheimer's, and I don't blame them.

[Minouche Zamarodi]

Can we talk more about how doctors currently use data? I guess most doctors anyway, they rely on averages, right? So, for example, I just got blood work done, and as long as each thing that they tested for was in the green zone, it came back as normal. Do you take issue with that approach?

[Michael Snyder]

Population measurements, they are important. Don't get me wrong. If you're out of, you know, an individual range and you're very high on certain things, it is worth looking into. But equally important is knowing your baseline, because we all have very different baselines for heart rate, for skin temperature, for all these different things. And when you go off from your health, you'll get a jump up in that. But if you're by today's world, if you're still in a normal range, nobody says anything to you. And a good example is, let's say your heart rate is normally 60, and suddenly your resting heart rate goes to 75. Something's off with you. Whereas 75 could be very normal for other people and probably wouldn't be flagged on a population average. And I think we need to get this into medicine. There's two things that count. One is your shift from your normal baseline, and the other is population average, out of range. Both of those are important, and I would argue the first one's even more important. Shift from your baseline, and we can pick this up with wearables. We can pick this up with any kind of measurement, the micro sampling I mentioned earlier, even your regular clinical measures. It's very important to know your trajectories.

[Minouche Zamarodi]

Is there ever a point, though, where all this information is too much information? That people become hyper vigilant about every little thing that their body is doing? Keith Diaz, the researcher at Columbia with whom I partnered, he says I can't wear a smartwatch because tracking my steps makes me crazy. I'll find myself, you know, looping around my backyard to make sure I get enough steps. Where's the line?

[Michael Snyder]

Yeah, no. Well, obviously we want everyone to be a healthy life. You don't want your devices making you unhealthy. My own view is there's no such thing as too much information, that this stuff is very, very valuable. But it's true. You don't want people Freaking out, like, you know, people get their genome sequence and they're anxious about this sort of thing. You don't want them waking up every morning, oh, am I going to get breast cancer? I'm going to get breast cancer. But I'm a believer the person owns their own data. If you are willing to share it, your physician can definitely see when things are going off. And you can see it too. Imagine when you go into the doctor's office and say you're not feeling well. First thing they ask is, so when did this start? You can almost always tell from your watch when it started. There's a shift. And suddenly you could correlate that with maybe something that happened. In my case, when I got Lyme disease, it was picked up with a smartwatch and a pulse ox. I saw these shifts and I knew two weeks earlier, I was in rural Massachusetts helping my brother put up fences where, you know, most ticks are. Lyme infested in rural Massachusetts. I was there one day, and it's pretty clear because I was there one day and then two weeks later I saw the shift up. It raised a strong possibility it was Lyme disease. I never had a bullseye, but it's just the whole timing and that turned out to be correct. It was Lyme disease. So I. I do think again, this can be very, very important, valuable information.

[Minouche Zamarodi]

I've been learning about this concept of interoception over the last year, this idea of the body sort of indicating to the brain what it needs. I mean, I hear people who are like, I don't even know if I sleep well anymore. I look at my device and it tells me. And sometimes I'm like, really? That's all? I slept. I thought I slept well. Do we start to lose touch with our embodied sense of self when we start outsourcing all of our functions to being collected and tabulated by wearables?

[Michael Snyder]

I would argue wearables for certain kinds of things, like infectious disease, afib. Those are really, really valuable. Right? It's hard to argue with that. We have some studies running now on transplant families. There's individuals with transplants who are trying to make see if anyone in the family gets ill, and if that happens, they get a red alert. And they can isolate and not ideally infect the person who had the transplant. And this has worked, actually. So it's alerted people who could die if they actually got one of these respiratory virals. So I think there are situations where it's good. Now you picked the example of sleep, which I think is One of the more interesting ones, one of my colleagues here at Stanford has run a study that shows that depending what you tell people determines how they feel. So regardless of what the value is on their sleep device, if you tell them they had a good night's sleep from their score, even if they didn't, they actually wind up functioning very well that day. They do well. If you tell them they had a bad night's sleep, they actually don't function so well. So I think there people are very influenced psychologically by the score. So maybe that is a trickier one.

[Minouche Zamarodi]

Earlier in our conversation, you said that continuous glucose monitors are the most important device someone could wear to keep track of their health. In an ideal world, how do you want to see people using them?

[Michael Snyder]

Yeah. Well, for one thing, I would say everybody wears one at least once a year, more if they're heading in the wrong direction, meaning their glucose out control and it's getting worse and they do it before they're diabetic. So prevent diabetes, keep people healthy. So we need to get them on these folks earlier. And because it's so visual, you will change your behavior in a good way. I'll tell you, when you wear one of these things and you drink a McDonald's shake, your glucose just goes through the roof and you'll think twice about drinking that shake again.

[Minouche Zamarodi]

And what's the danger there? Just for people who are not familiar,

[Michael Snyder]

what it's doing is it's launching a lot of glucose into your blood. It winds up, your proteins get modified. And a key indicator of this is something called hemoglobin A1C. It's a measure of your glucose levels and that's associated with diabetes. Technically, diabetes doesn't kill you, but diabetes is associated with everything. Bad cardiovascular disease, increased cancer. And so you really want to keep your glucose levels down. And these devices, again, because they're so visual and it's real time feedback. And I think if we get them out there, we can have a big transformation in preventing diabetes, in my opinion.

[Minouche Zamarodi]

And what would that look like in terms of affecting society and not having so many people who are diabetic?

[Michael Snyder]

I think probably as teenagers we start maybe before we start putting these on and then people become aware earlier, parents knew this stuff. If I knew 40 years ago what I knew now, I would have been eating very, very differently. And I think if new parents knew this stuff, they'd be a little more careful. Sugar is everywhere. So I think I am very Pollyannish. I think we can have a healthy society if we just educate people properly. Now, people tend to look at this stuff as they get old because their friends are getting unhealthy and this sort of thing. And we should really be doing it much, much earlier. I know when you're young, you feel like you're invincible, you're going to live forever. But I think more of these pictures of showing two people are 75, one who's all stooped over and doesn't look very good at all, and another who looks like they're ready to run a marathon and looks incredibly fit. Those are very important visuals that I think will help people become healthy and strive for healthy lives. And I think the wearables and things we've been talking about are good ways to give feedback to keep people that way, keep them motivated to stay healthy.

[Minouche Zamarodi]

That was Michael Snyder. He's a professor of genetics at Stanford University. You can hear his full [e-mail]. I have to say I am fascinated by all the data that we can now collect from our bodies and the potential for truly personalized, preventive medical treatments. But I am equally cautious about relying too much on data to the point that we begin to ignore the sort of natural cues that our body is giving us when something is wrong. So we want to end our show with an idea about exactly, exactly that. With a speaker who is asking us to simply listen. Here's a very personal story from Lizzie Rakes Rinker from the TED stage.

[Lizzie Rakes Rinker]

When you hear the term healthy, what comes to mind? What do you think of as health? So when I was in college, I was a rower and it was my entire life. Everything that I did revolved around being healthy and being an athlete. I was arguably at my physical peak. I was obviously working out all the time. But I also was a really hardcore vegan. I had this elaborate regimen of vitamins and supplements that I took every day. I carried my emotional support water bottle with me wherever I went. And I was a cliche of a healthy person. However, the reason that I started really thinking about what it means to be well is that despite being super healthy on paper, being an athlete, I felt terrible. My friends, I was having panic attacks almost every week. I had this really weird chronic pain that no one could quite figure out. And I wasn't getting my periods. I just felt off. But I was really healthy, right? I kept saying, something doesn't feel right, and I couldn't really articulate what it was. So this is a picture of me from the middle of college and nine days before my dad took this picture, moving me into My apartment. Our mom, Becky, died after a really long and hard fought battle with cancer. And let me tell you, it kind of sucked. It is incredibly disorienting to watch somebody that you love be sick and die. It was incredibly disorienting to be going through that experience as I was a college athlete, because one part of my life was completely revolved around optimizing my body and health and wellness. And I was seeing evidence every single day of that working. However, on the other side of my life, my mom did everything right. She was healthy, she was active, she still got sick and there was nothing that we could do about it. So because of my mom's illness and because of my experience as an athlete, I went on to make an entire career out of really exploring what it means to be healthy. So I'm going to throw some definitions at you, okay? The first one is health. The World Health Organization defines health as not having disease in your body. So in that instance, I was healthy. Nary atoxin was getting near this. I was obsessed with being clean and doing all the right workouts, but I couldn't really articulate what was going on. And what I found in my work is that what I didn't have while I was healthy is I did not have any wellness. So holistic wellness is a trend that gets thrown around a lot. And it's rooted in this idea that we are a whole person, not just our bodies. So rather than putting all of the eggs into the physical basket, we start to look at our lives from the health of our environment. It looks at all of our circumstances, all of our lived experiences, and really takes those things into account to consider what we need. I've been working in wellness for 10 years and I have coached hundreds of athletes. And I have seen a couple things to always, always be true. The first, from an athletic standpoint is that if an athlete does not have a holistic balance life, their performance will fail. It's not a matter of if, it's a matter of when. It is incredibly hard to keep it together and to care about, I don't know, going a little faster on the rowing machine. If you are waiting to find out if your mom has made it out of surgery, if you don't have a safe home life, it's really hard to perform. The other thing that I see is that we're all shoulding on ourselves. I'm talking about all the things that we're like, ugh, I really should do more of X, Y, Z and it might not even be a thing that you like. This happens to me a lot. I am really into running, and people will find out this about me and come up to me and say, I should really get back into running. I used to be a big runner. I'm like, oh, what happened? Did you get injured? They're like, no, I hate running. I just really hate running. And I'm like, well, then why do you think you should be doing it? There are literally so many other ways that you can exercise. But this is what we do to ourselves. We tell ourselves we should be doing all of this, of these things. We should be learning how to listen to our bodies. Like, what's the purpose of wellness? Is it just to lose weight? Is it just to look a certain way or to be able to go a little bit faster on the water? Or is the purpose of wellness and the balance of all of these different things to maybe, I don't know, make your life a little bit better instead of just your body? The last couple months of my mom's life, she was very frail. She'd lost a lot of weight and she couldn't drive. So I had to drive her to the grocery store. And this woman saw her from across the way and ran up to her and was like, becky, I haven't seen you in years. You look amazing. You look so good. You're so healthy. My mom was like, I am literally dying. But this is what we do to ourselves and to each other. We assume if you look a certain way that you must be having a certain experience, and that is just not true. You cannot really tell anything about somebody's wellness or their lived experiences and their circumstances by the way that they look. And this is why we have to consider holistic wellness. And we have to start looking at our health as more than just our bodies, but everything that we experience. Those are the things that make a life. I'm going to leave you today with a quote from my favorite poem. And I said to my body softly, I want to be your friend. I took a long breath and replied, I have been waiting my whole life for this.

[Minouche Zamarodi]

That was Lizzie Brake's rinker. You can see her full [e-mail] thank you so much for listening to our show today. This episode was produced by Katie Monteleone, Avery Keatley and TED Talks Daily's Lucy Little. It was edited by Sanaz Meshkinpour and me. Our production staff at NPR also includes Matthew Cloutier, Rachel Faulkner White, FIO Guerin, Harsha Nahada, and James Delahosy. Our executive producer is Irene Noguchi. Our audio engineer was Jimmy Keeley. Our theme music was written by Ramtin Arablouei. Our partners at TED are sal Khan, Logan McClure, Davda, Helen Walters, Roxanne Hylash, and Daniela Valarezzo. I'm Minouche Zamarodi, and you have been listening to the TED Radio Hour from npr.

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