Standing, fidgeting, coffee all good for you; sitting is still killing you

image via Lifehacker.com

Did you know that standing instead of sitting for just three hours per workday burns the same number of calories in a year as running ten marathons? That’s 30,000 calories or about eight pounds of fat. And that’s got to be the easiest way ever to keep the belly fat and love handles at bay.

It turns out that fidgeting is good for you as well according to a recent article in Michigan Today. Scientifically termed “nonpurposeful movement,” fidgeting generates nonexercise activity thermogenesis (NEAT for short), a fancy way of saying that you burn calories when you fidget – as many as 800 per day! So go ahead and ignore your parents, your teachers, and all of those other authority figures in your life who sternly admonished you to sit quietly and stop fidgeting.

Even though researchers have been back and forth on this one for years, the evidence is mounting that coffee is good for you too. I’m fairly sure the research is about plain old coffee, not the sugar and fat-laden confectionery treats Starbucks specializes in. According to a 2005 study, Americans get more antioxidants from coffee than from anything else in their diets. Actually, dates have more antioxidants than anything but we just don’t eat that many dates.

More coffee consumption benefits: a study published in 2006 that tracked 125,000 people over 22 years showed that those who drink at least one cup of coffee a day were 20 percent less likely to develop liver cirrhosis. And according to a study from The American Chemical Society, people who drink four or more cups of coffee a day reduce their chances of developing Type 2 diabetes by 50 percent. With every additional cup, the risk gets lowered by 7 percent.

In a development of particular interest to baby boomers, researchers from the University of South Florida and the University of Miami found that people older than 65 who had higher blood levels of caffeine developed Alzheimer’s disease two to four years later than others with lower caffeine.

Finally, according to The New York Times, coffee can make you a better athlete. Caffeine increases the number of fatty acids in the bloodstream, allowing athletes’ muscles to absorb and burn those fats for fuel. The body’s small reserves of carbohydrates are saved for later on in the exercise.

Update Feb. 13, 2015: Here’s a fascinating article on an incredible number of health benefits of coffee: 51 Scientific Reasons Coffee is Healthy (#49 is Life-Changing)

So much for things that can make you healthier. One of the single biggest activities (or inactivities) that negatively affects our health is the simple act of sitting. This infographic from MedicalBillingandCoding.org details the many ways that sitting is bad for you and in fact, is killing you. A few examples:

  • Sitting for more than 6 hours per day makes you more 40% more likely to die within 15 years than someone who sits less than 3 hours per day. That holds true even if you exercise.
  • Obese people sit for 2 1/2 hours per day more than thin people. Sitting burns zero calories.  One of every three Americans is clinically obese. You see where this is leading, don’t you?
  • People with sitting jobs have twice the rate of cardiovascular disease as people with standing jobs.
  • The human body has not evolved and is not designed for long periods of sitting.

Takeaway: Get on your feet, grab some coffee, and fidget away!

Read more:

BBC News – Calorie burner: How much better is standing up than sitting?

You are about to have a moving experience! | Michigan Today.

11 Reasons Why You Should Drink Coffee Every Day.

Sitting is Killing You – MedicalBillingAndCoding.org.

How many calories were in that cheeseburger?

CheeseburgerA Canadian startup has developed technology that may disrupt the mobile health tracking market. Airo Health is commercializing a nutrition tracker that can passively detect and inform the wearer exactly how many calories were consumed in the user’s last meal.

The nutrition tracker uses a light emitter and detector in a wristband and fairly sophisticated software in a smartphone app to measure metabolites in the bloodstream. The metabolites are released during and after the user’s meal.

The Airo device also detects the user’s heartbeat and uses that information to assess activity and fitness levels. All of this analysis starts with sensors in a small, unobtrusive wristband.

According to the company co-founder, Abhilash Jayakumar, Airo received US$81,400 in seed funding from the Canadian federal government and the University of Waterloo. The company says it is planning a commercial launch in the fall of 2014 – that’s just a year or so away. Airo has not yet built production prototypes, so their launch date is most likely optimistic.

In an interview with MobiHealthNews, Jayakumar said the sensor bracelet is detecting accurate calorie intakes about 80% of the time. That’s an exciting development, but the lead times for consumer electronics make a full commercial launch in a year improbable at best.

The fledgling startup has done impressive work with very little funding. They are taking digital health and the “quantified self” movement to a new level. Competitors are no doubt already starting development of their own passive calorie tracking technology. What would really be disruptive is an app to make you not eat that cheeseburger in the first place!

Takeaways: Mobile health sensors and applications are getting progressively more sophisticated. It remains to be seen if there is a sizeable market for these devices and apps but they are capable of measuring things in real time that were previously available only in a doctor’s office by appointment. The commercial availability of a Star Trek-like Tricorder device may be only a few years away.

Most of the personal fitness devices are targeted at healthy people. There is a large opportunity as well in monitoring people with chronic diseases or those recovering from surgery.

Read more:

AIRO ups the ante with passive nutrition tracking

 

Cheney’s Defibrillator: Life Imitates Art, or Vice Versa?

http://graphics8.nytimes.com/images/2013/10/28/world/29heart2/29heart2-articleLarge.jpg
image via nytimes.com

Former U.S. Vice President Dick Cheney revealed in an interview with the CBS news magazine program 60 Minutes that he had his implantable cardioverter defibrillator (ICD) modified after implantation to turn off the wireless remote programming feature.

 

The skeptic in me wants to believe that Mr. Cheney was just drumming up publicity on his nationwide press tour to promote his latest book. Recent events in cyberspace, however, including the news that the U.S. National Security Agency has the ability to eavesdrop on the mobile phone conversations of the leaders of other countries has caused my to revise my beliefs. There are untold numbers of hackers around the world, all looking for a way to disrupt the status quo. So there is no shortage of motives for someone to try to hack the VP’s defibrillator.

[SPOILER ALERT] In the second season of the hit Showtime cable TV series Homeland (I’m a big fan, by the way), Nicholas Brody, the ex-prisoner-of-war/Marine Sergeant/Congressman/semi-terrorist cooperates with a Bin Laden-like figure to assassinate the Cheney-like Vice President by remotely manipulating his implanted defibrillator.

After Cheney made his revelation, there was much discussion about whether such an action was technically possible. The jury seems to be divided. It’s at least plausible enough to be the major plot point of Season 2 of Homeland. And apparently the possibility of hacker bad guys doing harm was the motivation for Cheney to deactivate the function in his device.

In the Homeland episode, Brody had to find a device code unique to the Vice President, then relay that to a remote hacker. The hacker executed some code that disrupted the device. The audience was not informed as to exactly how the bad code made its way to the implanted device. In real life, experts say that a programmer device must be in close proximity to the patient in order to wirelessly access the defibrillator. Apparently, Vice President Cheney wasn’t taking any chances!

Mr. Cheney had his defibrillator modified in 2007 while he was still in office. He has since undergone a heart transplant and presumably had the defibrillator removed.

Takeaways: As medical devices become increasingly complicated, the opportunities for negative outcomes – accidental and malicious – increase proportionally. Notwithstanding the dangers to the patient, this sort of negative publicity can have devastating consequences for a company, particularly an early stage company.

An ICD with wireless remote access obviously has the power to kill but other devices can be just as deadly. Be sure to conduct a thorough Failure Mode and Effects Analysis (FMEA) during the development process. Seriously consider involving computer experts, including security consultants, as additional resources. You should also consult key opinion leader physicians and patient groups to get objective third party viewpoints about risks and mitigations.

Lastly, have a disaster plan in effect for unthinkable scenarios like the one in Homeland. And make sure the CEO reviews and approves the plan.

Read more: 

Of Fact, Fiction and Cheney’s Defibrillator | The New York Times

Homeland | Showtime

“Dick Cheney’s Heart” |60 Minutes 

 

MedTech Startup Red Flags to Watch Out For and to Guard Against

Red flagIn an amusing series of articles and blog posts last week, biotech veterans and observers traded their favorite red flags that investors must watch for when considering biotech investment.

Most of these caveats also apply to medical device companies. On the flip side, startup CEOs should be forewarned and forearmed to not make the same mistakes when pitching and/or structuring their companies. They are on to you…

Here are a few of my favorite caveats:

[from Luke Timmerman at Xconomy]
  • Watch out for weak science or results that can’t be reproduced by third party researchers.
  • The company story is too complicated and can’t be reduced to an elevator pitch.
  • “There is no competition.”
  • No plan to demonstrate outcomes or show clinical and financial benefits to the healthcare system.
  • “Rent-a-luminaries” make up the Medical/Clinical/Scientific Advisory Boards.
[from David Sable, physician and venture capitalist]
  • CEO is clueless around investors
  • CEO is inflexible and won’t deviate from the rehearsed pitch
[from Christopher Henney, co-founder of Immunex, Icos, and Dendreon]
  • Too many VCs on the board
  • Family members in key management or board positions

I’m sure these three veterans have seen and/or interviewed dozens, if not hundreds of startup CEOs and their pitches.

Takeaways: Simple is best. Use a template to develop your pitch – they are easily found. Don’t deviate (at least not too much) from standard practices for startups in your industry segment and in your geographic area. It’s easier than ever to get a negative reputation. You may be able to get past one round with a sketchy pitch or objectionable governance. The stakes keep going up, however, and you risk everything by not being able to secure financing all the way to market launch. Do yourself and all of your stakeholders a huge favor and address the red flags before the investors see them.

Read more:

21 Red Flags to Watch for in a Biotech Company | Xconomy.

Six Red Flags to Watch Out For in a Biotech, From Dendreon Co-Founder Chris Henney | Xconomy.

A few more biotech red flags (h/t @ldtimmerman) – David Sable .

Verizon is a serious player in digital health

http://www.verizon.com/cs/groups/public/documents/adacct/logo_landing.pngIf you are a digital health entrepreneur, it can’t be good news that Verizon, one of the world’s largest telecommunications companies, has entered the healthcare market with a second FDA-cleared digital health product.

According to MedCity News, Verizon’s enterprise solutions division just announced its Converged Health Management platform after receiving FDA 510(k) marketing clearance in August.

The Converged Health Management platform will be marketed as a “B2B to C” product. Verizon says it will be white-labeled, meaning it will be sold to providers like hospitals and healthcare systems, payers, and large self-insured corporations and then marketed to consumers under the brands of the healthcare systems, etc.

Verizon also has an e-prescribing platform already on the market being sold in a similar way. That product is in use and growing rapidly. According to Dr. Peter Tippet, Verizon’s chief medical officer, the e-prescription platform has already transacted 40 million prescriptions this year. He also said that the e-prescription volume is doubling every 6 months, an impressive growth rate.

Verizon’s Converged Health Management platform will collect data from wireless medical devices – initially four types of devices: a blood pressure cuff, a scale, pulse oximeters and blood glucose meters. The data is sent automatically to cloud servers that are secure and HIPAA-compliant.

The patient can connect to the wireless medical devices with a smartphone, tablet, or PC. That’s important because they can be mobile and maintain their preferred lifestyles while remaining connected to the Verizon healthcare cloud.

Verizon has built algorithms into the platform to keep watch for patient health trends. Doctors can use the capabilities of real-time data access and two-way communications to express concerns or send reminders directly to the patient.

According to Verizon, the platform has been designed to work with or without biometric data. When used without real-time data, the platform can be used to manage chronic conditions like Crohn’s disease. It also has the ability to provide patients with a reward and even has elements of gamification. They seem to have anticipated a broad range of conditions and healthcare scenarios.

Additionally, Verizon implied that the platform will eventually connect to personal wellness devices like the trendy Fitbit and Jawbone products. According to the MedCity News article, Verizon purposely focused on achieving FDA clearance for the platform’s treatment capability first, reasoning that a treatment indication was more challenging to receive regulatory clearance than a wellness indication would be. Next step will be to get the platform cleared for wellness applications.

Verizon seems to be open to external apps running on its platform. Hospitals and device companies could find this to be valuable real estate.

The platform seems to be highly configurable and flexible to accommodate a broad range of customer and user preferences. Verizon really did its homework in product development.

Takeaways: The digital health market is a land grab scenario right now. Big companies like Verizon have the resources and market heft to occupy a large portion of the land. Medical device companies developing digital health products or startups with a single digital health offering in development must be nimble, flexible, and move quickly. It would also be prudent to approach Verizon and its big customers to find out if you can get your product into their platform ecosystem.

Read more:

Verizon launches FDA-approved platform to take over the patient engagement market – MedCity News.

Verizon demo video

Riboflavin: not just for breakfast anymore

image via wikipedia

Riboflavin, also known as vitamin B2, is a micronutrient and food additive commonly found in breakfast cereals and other processed foods. It’s yellow or yellowish orange in color and is sometimes used as a food coloring. Now it’s being researched for use as a biocompatible “ink” ingredient for 3D printed implants and other structures to be placed in the human body.

3D printing has enormous potential to enable mass customization of medical products. Think of having an implant crafted to fit you and only you. How about 3D printing structures on demand rather than ordering from a manufacturer?

Conformis, an othopedic medical device company, makes individualized metal joint implants from imaging studies using a milling machine. The milling machine creates a custom-made prosthesis for knee replacement surgery. Patients have to wait about 7 weeks for their prosthesis to be made, however. 3D printing promises to be much faster since the machines are small and relatively inexpensive.

One issue has been the biological incompatibility of most of the polymers used in 3D printing. In typical use, a spool of polymer “ink” in the form of a long thread is fed through a 3D printer nozzle. Tiny dots of polymer are melted and laid down on a two dimensional surface and built up vertically until the piece being manufactured is complete.

Now according to Fierce Medical Devices, researchers at North Carolina State University, the University of North Carolina at Chapel Hill, and Laser Zentrum Hannover have used riboflavin as a nontoxic polymerization agent to 3D print structures that could one day become implantable medical devices.

While there is much more research and development to be done before this becomes a practical commercial technique, the technology is possible today. Next step is for a hungry startup or tech-savvy medical device company to commercialize this work. Perhaps when you have a surgery performed in 5-10 years, there will be a 3D printer in the next room churning out an implant “just for you.”

Takeaways: trends like mass customization and technologies like 3D printing are converging. Even in the relatively slow-moving healthcare industry with FDA regulation, there is a need for new, different, better ways of treating patients. 3D printed devices are yet another disruptive technology. At first, they will be crude and not very useful. As time goes on and the technologies evolve, however, they will have a significant effect.

Read more:

Study Finds Natural Compound Can Be Used for 3-D Printing of Medical Implants – FierceMedicalDevices.

Vitamin B2 may help build a safer 3-D medical implant – FierceMedicalDevices 

Knee Replacement, Knee Pain, Customized Knee | ConforMIS.

 Riboflavin – Wikipedia, the free encyclopedia.