How tracking your health metrics can help you live longer

Zahi Fayyad practices what he preaches. As a professor of radiology and director of the Institute of Biomedical Engineering and Imaging at Mount Sinai, Fayyad is leading a study investigating how we can better use our health data to help us live healthier and, therefore, longer. In his New York City lab, he recently showed off his current digital health devices (which are rotating as new gadgets become available): the Oura ring and the Garmin watch. It is also used ECG belt To measure his heart rate every day, and sometimes he will be placed on a continuous glucose monitor to track his glucose levels.

Fayyad is convinced that the trend towards collecting more health data, on a more continuous basis – enabled by the explosion of wearable devices – will revolutionize healthcare. Keeping track of risk factors for chronic diseases such as heart disease, diabetes, and obesity can help not only doctors but all health-conscious consumers identify when these conditions begin and perhaps avoid them altogether.

In the lab, his team is developing better, more flexible, inconspicuous patches to monitor health metrics, such as bandage-like patches embedded with sophisticated sensors that can pick up deeper vibrations from the opening and closing of valves in the heart, for example. Fayyad shared his vision for how healthcare is changing, as well as how we can leverage technology to ensure that we not only live more years, but that we are healthier and able to enjoy it more.

This interview has been condensed and edited for clarity.

How did you get involved in longevity research?

My interest has always been to try to better understand lifestyle exposure on the body, specifically initially, on the cardiovascular system. As we started to evolve in terms of what else we had to look at, we started thinking about how we might modify things through the immune system and communication with the brain. When we’ve looked at all the lifestyle exposures—diet, exercise, sleep, stress—how can we begin to study them? It is difficult to put them all on the table.

More than eight years ago, we began a research program involving various projects funded by the National Institutes of Health. We focused on people exposed to chronic stress or a traumatic event. We wanted to understand how the cardiovascular and immune systems were modified by stress, so we created a platform to try to figure out what was happening. My background is in photography, and photography is a great tool for examining multiple organs of the body and understanding the connections between them.

I was interested not only in chronic stress, but also in all the other exposures we face. As this field developed, people began to talk not only about chronic diseases, but also about health and longevity. I told myself that studying chronic diseases is not enough. We needed to understand what health is in general.

How do you define health?

When you look at [scientific] Literature, we know very little about health. We understand illness, but we do not understand health. I wanted to start expanding the platform with the technology we have now, so it included not only imaging methods, but also things related to digital health, like wearables, or sensors that went off [in popularity] During and after coronavirus. We are starting to integrate these technologies one by one.

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Finally, because I’m an exercise enthusiast, I started pursuing the measurements we can make using photography and digital health to understand the effect of force on the body. Strength is one measure that will continue to be a surrogate indicator of aging as people age.

All this data is being collected in a project called the Digital Twin Study. Can you describe what a digital twin project involves?

The idea initially came from NASA while they were launching rockets in the Apollo program. They needed a way to launch this rocket, so they created a digital twin of the same rocket here on Earth. This way, if they run into a problem, they can know what went wrong and what they should do.

They do the same thing with airplanes. A [plane] It has more than 30,000 sensors tracking everything you do, from takeoff to landing. All of this information is sent in real time back to the ground to the station so they can maintain safety but also maintenance.

I started thinking, why aren’t these dual digital tools implemented for humans? But you need a lot of information to create twins. Going to the doctor once a year and having all the laboratory tests done will give you a comprehensive view of your health. Basically, you’re still missing the other 364 days. You can’t build a digital twin out of that. You need constantly updated information. Once you have that — say the blood measurements you take at home on a quarterly basis — that information can feed into the digital twin.

Continuous monitoring [of health metrics] At home, such as heart rate, body temperature, and oxygen saturation are now possible with the latest wearable devices. We need this constant updating. It doesn’t have to be all real-time, but we need the information as frequently as possible so we can create that view of that physical entity in digital form.

What can we do with a digital twin?

Once we have all this health information in digital form, we will be able to run simulations. Now that I understand a person’s health trajectory based on the information collected, the idea is, can I predict what might happen to you in a year, three years, or five years? Once I see changes in your path, the digital twin can be questioned to say, how can I correct this?

Simulation is cheap. I can do billions of simulations to try to deal with the factors that affect someone’s health, for example, through a different diet. Will this have any impact on your path? We can do the same with exercise, sleep, and other mental health factors.

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The digital twin becomes a tool for us to create these agents. Now I have multiple factors, each of them improving different lifestyle factors, from diet to exercise to sleep and stress. I can give you specific information in the morning or on a weekly basis to try to improve.

Now suddenly, you have in your pocket many doctors or many people who give you specific recommendations.

Can a digital twin be used to help prevent disease?

I’m looking to intervene before it gets to the level of having a heart attack for example. I’m an engineer by training, and I have a set of data points, and they give me a curve that represents the trajectory of someone’s health. Let’s say you’re stable, stable, stable, and then all of a sudden you start seeing a little drop in some of the measurements. By the way, this decline is pre-symptomatic, you are not sick, or you do not have any symptoms. But even if you haven’t had a heart attack yet, your body is secreting things into your bloodstream related to cancer, heart disease, and even cognitive changes.

I can now see these decreases. That’s when I want to intervene. I want to try to predict small changes, and eventually change them.

You recently launched a digital twin study and provided people with a swag bag of health devices. Can you tell us what you measure and why?

Let’s start with what we offer them so they can monitor at home, or on an ongoing basis. We chose the Oura Ring because we tested it, and people don’t mind wearing the ring constantly, compared to a watch. It provides us with information about physical activity, sleep, heart rate variability, O2 saturation, VO2 max, and body temperature.

We also provide people with a blood pressure cuff so they can measure their blood pressure at home. We ask them to measure it twice a day, in the morning and in the afternoon, and to do this two days a week. We have access to the data by connecting to our digital health app.

We also give them a weighing scale, which I use myself.

Another device we offer is the continuous glucose monitor. It gives us estimated glucose values, and we ask them to wear it for two weeks and repeat every three months.

For respiratory function, we send them home with a spirometer to measure lung function; It gives us three different measures of lung capacity, and they use it once a week.

To measure the quality of the air and the environment that people live in, we have a silicone strip that is chemically treated and analyzed here at Mount Sinai to give us an idea of ​​exposure to pesticides and anything else in the environment. We do this for two weeks twice a year. After wearing it for two weeks, they send it to us, and we give them a report on the types of exposures they might have.

Then there is a device that measures particles in the air. It seems like [computer] A mouse is something you place on a table to capture certain particles in the air.

We also perform two types of blood tests on a quarterly basis. One is a small scalpel cartridge that we ask people to use on each shoulder. Samples are studied for proteins, which provides us with information about immune proteins. We also analyze metabolites and lipids.

Finally, we do blood markers, a whole gamut of which includes lipids, triglycerides, HbA1C, and hormones. This is done by finger pricking a dried blood card that people send to our laboratories.

Study participants also come once a year for a health visit. We test muscle strength and grip strength, and take a sample for whole genome sequencing. We also take stool and saliva samples to measure her microbiome [the bacteria that normally live in and on the body].

Each study recipient also receives an annual MRI, which is different from the scans doctors generally use for screening. This is a multi-organ scan where I collect information about brain size, gray matter, body composition, heart, lungs, kidneys, liver and pancreas.

It looks like the digital twin study will be popular with participants. How many people do you follow so far?

We’ve deliberately kept it small, and it’s in its early stages. We can’t scale yet due to the cost of doing all the measurements. Eventually, we may learn that not all of these measurements are sensitive or useful, and thus we may delete them. But first I want to put everything in, and then little by little as I learn, take things out.

Right now, we have enough money to do at least 20 people. By the end of this year and next, we should be able to expand to over 100 people. I would like to do this with 10,000 people, but it would cost billions of dollars.

How do you think studies like yours, combined with digital technology, will change health care in five or ten years?

To be bold, I think the way the hospital will change is that we will see the hospital at home. Physical sites like Mount Sinai will be where people come to make interventions. I truly believe that everything in the future will depend on the things you can do remotely. Little by little, we are starting to see great development in sensors that are becoming specific to the biomarkers we care about, such as diabetes or heart health. Being able to measure it frequently will help you see early changes. It will be a new way to analyze and understand biomarkers. We’re working on prototypes for some of them, I’m working on sweat markers for inflammation, for example. I think this is the next generation.