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Friday 30 September 2016
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Profile: Race to the Top

Profile: Race to the Top

Using Formula One technology to help weight loss initiatives, one practice demonstrates how technology can play a crucial role in addressing the relationship between calorie intake and energy expenditure

Celebrated for its culture of innovation, the latest initiative by Stowhealth medical centre makes use of cutting-edge Formula One racing technology to tackle the rapidly increasing obesity problem.  

In a unique collaboration between McLaren Applied Technologies (MAT), Stowhealth and academics at University Campus Suffolk, funded by healthcare provider Simplyhealth, the Helping Health Change study has been launched to see whether understanding the relationship between energy expenditure and calorific intake can help weight loss. 

Executive partner at Stowhealth, and project initiator, GP Dr Simon Rudland, who has worked at the practice for 18 years says: “The project goes back four years ago to an idea I had around trying to provide people with more information to seal the gap between what they know they’ve eaten in terms of calories but actually having very little idea of how much energy they’ve burned during the course of the day, and so you can’t really make any sensible decisions about sustainable weight loss or weight gain for that matter unless you understand that vital balance between what goes in and what goes out. 

“We talk endlessly about calories and food, but what we don’t do, is understand the relationship between energy and activity burn.”

The year-long research study makes use of telemetry technology, inspired by equipment used to collect data about the on-track performance of Vodafone McLaren Mercedes Formula One cars, to monitor activity levels through measuring cardiac activity of overweight people. 

Geoff McGrath, Vice President of MAT, says: ”How we manage the health and performance of a racing car, week in week out, and what doctors are looking to achieve in the monitoring of patients is not that different. 

“We develop systems that collect, transmit and manage vast amounts of data per race to better understand how the car is performing and diagnose any changes that need to be made. We are applying the same approach to this study, but in this instance to help provide an accurate and well-informed picture of an individual’s energy usage…though this joint research project is relatively small-scale at present, it demonstrates how health groups and technology companies can work together to tackle health problems in the future.”

Explaining how the device works, Simon says: “It’s a three lead device that you wear on your chest, what that does is it records your heart rate and uses clever algorithms to make interpretations about how much energy you’re using. 

“Then it talks to another device, which essentially captures all the information and sends it up to a server. The server then sends the information back as a calorie burn, so people can carry around that little detection device and see what their calorie burn looks like.”

The study aims to recruit 90 patients within Stowhealth who will be randomly assigned to three conditions. 

This includes a group who have access to an exercise and education programme and use of the all-active gym at the practice, a group who has access to the exercise and education programme as well as use of the McLaren device, and the control group who gets access to the exercise project after ten weeks. 

To qualify for the study, participants need to be over 18, have a BMI of over 30, or 27 with a long-term condition such as heart disease, diabetes or asthma. Participants are recruited via local community pharmacies, the centre’s long-term condition clinic as well as through mail shots to people who have been recorded as being overweight on their database. 

The study is an extension of a three-month pilot study, which took place about four years ago.

Although the study demonstrated that McClaren technology could be used in primary care to aid weight loss and that people were happy to wear the devices, with only nine people taking part, the results did not have the necessary scientific rigour for the findings to be generalised.

Having now recruited 30 people for the study, they are about a third of way through, and the results are looking promising:

“We have fabulous comments like I’ve cleaned the house and I’ve gone shopping, I’ve burned 300 calories. It’s really insightful stuff,” says Simon who believes that providing people with accurate feedback about their energy expenditure in an understandable format will empower them to achieve more sustainable weight loss.

“For however long they’re wearing it, they will be recording their calorific use. If they want to, they can wear it all day long. You just don’t want to wear it in the bath. They might feel they don’t want all their activity recorded on the device. We’ve had some speculation about some of the variation in activity in different times of the day!”

Participants are given energy expenditure targets to reach, based upon their height and weight, which will hopefully generate the required weight loss.  

Simon says that, unlike a pedometer, the McLaren device has the added advantage of measuring energy usage other than that expended through stepping. 

This includes raising the heart rate through upper body usage such as doing the hoovering or arm exercises. According to Simon, by gauging energy burn from heart rate, a much more accurate reflection of what’s going on is obtained.  

Furthermore, while participants can view their energy expenditure through a mobile device, they also have the option of downloading it through the web portal and seeing it on the computer screen. Talking about the advantages of different display options, Simon says:

“What we do know is how you represent information to people is really important as to how readily they can use that information to motivate themselves. So different people like information in different ways, and that may be something that we can explore as a consequence of the research project.”

With 28% of young people between 2-15 in the UK being either overweight or obese, the outcomes of this study could have far-reaching consequences on reducing incidences of obesity in the UK. 

Simon says: “My dream or vision, which may sound really naïve, is that [as technology evolves] we will be able to produce a simple vest that you can clip to the hip and that vest will talk to their smart phone and it will tell them how much energy they’re using… kids have no idea about the relationship between energy intake and exercise expenditure, so why shouldn’t part of the national curriculum be understanding that relationship… for example, I’ve burned 500 calories because I walked to school, and used a play station. You’ve burned 1,500 calories because you cycled to school and played football. That’s where it‘s going in my mind.”

Well known for its innovative practices, Stowhealth has won several awards including the East Anglia region GP team of the year award last year for their initiatives around an appointment system called Total Telephone Treatment. Since the system has been in place, the practice only experiences three to four missed appointments a month compared to 90 a month.  

The practice also won the Guy Rotheram award in 2006 for their work in managing people with multiple long-term conditions in a standalone clinic. This involved different ways of offering care to people that reduced the number of people they had to come in contact with across the organisation by relying on integrated workings across the practice between practice nurses, doctors and HCAs.

Stowhealth has always had an emphasis on fitness and well-being.  The gym that participants of the McLaren study use as part of the exercise programme has actually been an integral part of the centre for ten years. It’s seen as an additional service to the range of other alternative therapies which the centre has to promote health. 

This includes acupuncture, allergy therapy, aromatherapy, counseling and psychotherapy, hypnotherapy, Indian head massage and Kinesiology. 

As well as being available for commercial use, the gym brings together rehabilitation packages put together by osteopaths, physiotherapists as well as those offering talking therapies who work at the centre. 

“Patients with a mixture of problems including post joint replacement or accidents at work can benefit, and it’s great to have a gym as part of the environment and also health professionals that can support patients in the environment.

 “It’s outrageous we can’t prescribe exercise. It’s such a powerful drug, and there’s so much evidence to support its use. We thought a truly wholistic organisation should focus on wellness versus illness, so we need facilities that help and promote that, and we do what it says on the tin.”