WEBVTT - The Skinny on Diet and Health Apps 0:00:01.160 --> 0:00:03.560 It's almost seven thirty and I just got in from 0:00:03.560 --> 0:00:06.760 my morning walk. Thanks to my fitbit and my phone, 0:00:07.360 --> 0:00:10.000 I know that I'm already more than halfway to hitting 0:00:10.000 --> 0:00:13.560 my ten thousand step target for the day. I have 0:00:14.080 --> 0:00:20.279 my fitbit who says that I have walked seven thousand 0:00:20.400 --> 0:00:24.360 and thirty one steps. And you know what I have 0:00:24.640 --> 0:00:30.319 on my phone as well, another health app, and that 0:00:30.360 --> 0:00:33.920 one says I've done seven thousand, four hundred and eleven steps. 0:00:34.520 --> 0:00:36.839 Now that it's warmer out, I'm on tract to beat 0:00:36.920 --> 0:00:41.040 last week's numbers two. But I'll admit sometimes I wonder 0:00:41.080 --> 0:00:53.800 if my fitbit really makes me any more fit. Welcome 0:00:53.800 --> 0:00:57.280 to Prognosis, Bloomberg's podcast about the interception of health and 0:00:57.320 --> 0:01:01.800 technology and the unexpected places taking us. I'm your host, 0:01:01.920 --> 0:01:05.480 Michelle fe Cortes. Even if you never use it, you 0:01:05.560 --> 0:01:07.880 most likely have a health app installed on your phone. 0:01:08.760 --> 0:01:12.440 Apple Health, which comes with every iPhone, can clock everything 0:01:12.480 --> 0:01:16.360 from steps to sleep. Some three thousand digital health apps 0:01:16.360 --> 0:01:18.440 are competing for a share of the market to help 0:01:18.480 --> 0:01:22.760 you track your calories, watch your blood sugar, guide your workouts, 0:01:23.319 --> 0:01:27.280 or help you meditate. In the last episode, we told 0:01:27.280 --> 0:01:29.920 you what these apps are doing with your data. This time, 0:01:30.280 --> 0:01:33.080 my colleague Naomi Krasky looks into what the health apps 0:01:33.160 --> 0:01:43.960 can do for their users. For us, My app addiction 0:01:44.120 --> 0:01:47.320 started last year when a friend of a friend told 0:01:47.360 --> 0:01:49.600 me he was using an app as a smart alarm 0:01:49.640 --> 0:01:52.680 clock set to ring when he was sleeping most lightly 0:01:52.720 --> 0:01:56.400 in the morning. I was super intrigued. I downloaded the 0:01:56.440 --> 0:01:58.920 app and pretty soon realized it would also grade in 0:01:59.000 --> 0:02:02.600 my sleep on a hundred point scale. I love being 0:02:02.640 --> 0:02:05.720 told whether I'm doing things right, so soon it became 0:02:05.760 --> 0:02:08.520 the first thing I looked at every morning. But that 0:02:08.600 --> 0:02:11.520 wasn't enough. I wanted to know why I was sleeping 0:02:11.520 --> 0:02:14.960 well or poorly, so I caved and bought the premium version. 0:02:15.880 --> 0:02:21.400 That was my first real sign of app addiction. Another 0:02:21.480 --> 0:02:24.239 friend gave me a bunch of recommendations for other apps 0:02:24.280 --> 0:02:28.160 to try. I started using a period tracker and telling 0:02:28.200 --> 0:02:30.840 that app about way more than just my menstrual cycle. 0:02:31.639 --> 0:02:35.600 I recorded gastro intestinal side effects, my moods, my sex life. 0:02:36.120 --> 0:02:39.000 That app knew more about me than most real humans did. 0:02:40.080 --> 0:02:42.360 And at the same time I was researching apps for 0:02:42.400 --> 0:02:46.359 diabetes patients for a magazine article, and then eventually also 0:02:46.440 --> 0:02:49.880 started using a life tracking app linked to my sleep app. 0:02:50.600 --> 0:02:52.920 That one shows you where you are during the day, 0:02:53.520 --> 0:02:57.000 work or shopping or home, et cetera. So I could 0:02:57.040 --> 0:03:00.440 watch how long I spend bicycling to work, walking, or 0:03:00.520 --> 0:03:04.359 at the gym. It felt like being able to watch 0:03:04.480 --> 0:03:07.880 all these elements of my life so closely was giving 0:03:07.919 --> 0:03:11.960 me more control over them somehow. But the big question 0:03:12.720 --> 0:03:17.280 was whether it was actually improving my health. For example, 0:03:17.520 --> 0:03:20.640 the sleep app showed me almost immediately what helps me 0:03:20.680 --> 0:03:25.000 sleep well, things like meditating before bed and working out, 0:03:25.760 --> 0:03:30.280 and what kills my sleep basically booze parties and early 0:03:30.320 --> 0:03:34.320 morning light. But my sleep only really improved after my 0:03:34.400 --> 0:03:37.360 life slowed down. I had just come off a jam 0:03:37.400 --> 0:03:40.240 packed spring and summer in which I had moved, finished 0:03:40.240 --> 0:03:45.840 a big project at work, and gotten married. So I 0:03:45.880 --> 0:03:49.360 figured my next step should be collecting more data, which 0:03:49.360 --> 0:03:52.680 meant downloading more apps. I'm part of a team of 0:03:52.720 --> 0:03:56.560 reporters who write about European health and consumer goods companies, 0:03:56.920 --> 0:04:00.680 so I asked my colleagues for recommendations. The top pick 0:04:01.040 --> 0:04:05.800 was the hugely popular my Fitness Pal app. Sportswear company 0:04:05.920 --> 0:04:09.720 under Armour bought this app in for four hundred and 0:04:09.760 --> 0:04:14.520 seventy five million dollars. Here's Michael Lagardia, under Armour's senior 0:04:14.640 --> 0:04:18.480 vice president of Digital Products, explaining why we look at 0:04:18.480 --> 0:04:22.800 fitness as a holistic activity. That it's about the fuel 0:04:22.839 --> 0:04:26.160 that you put into It's about the activity that you do, 0:04:26.360 --> 0:04:28.960 and my Fitness Pal is there to help you keep 0:04:29.000 --> 0:04:32.800 track of that. The central function of my Fitness Pal, 0:04:33.400 --> 0:04:37.440 like so many other fitness apps, is counting calories in 0:04:37.680 --> 0:04:42.520 calories out Now. I am almost forty years old and had, 0:04:42.720 --> 0:04:45.880 if you believe it, actually never tried to do this 0:04:45.960 --> 0:04:49.200 in a systematic way before. It's not that I didn't 0:04:49.200 --> 0:04:52.920 read food labels or think about calories. It's just that 0:04:52.960 --> 0:04:55.440 I had always been too lazy to write them down 0:04:56.320 --> 0:04:59.680 and had relied on a combination of exercise and metabolism 0:04:59.760 --> 0:05:03.400 to burn them off. But my colleagues assured me that 0:05:03.440 --> 0:05:06.000 I would be able to find the calorie and nutrition 0:05:06.040 --> 0:05:09.520 facts for almost anything in my Fitness Pal. So in 0:05:09.640 --> 0:05:13.159 February one, I logged my first day's worth of meals. 0:05:13.760 --> 0:05:17.520 The app told me I had eaten about calories, about 0:05:17.520 --> 0:05:21.720 a third of which came from snacks, cookies, and peanuts. 0:05:21.760 --> 0:05:24.400 I had eatn in the office and then after work 0:05:24.640 --> 0:05:30.480 bread and patte with a colleague. Oh dear, at least 0:05:30.520 --> 0:05:37.239 I'd skipped having any wine. The app lets you set 0:05:37.240 --> 0:05:39.880 a calorie target based on whether you want to lose, 0:05:40.080 --> 0:05:44.159 maintain or gain weight. I set my target on maintain 0:05:44.440 --> 0:05:47.840 and kept on logging. The easiest things to record were 0:05:47.880 --> 0:05:52.000 straightforward items like pieces of fruit or eggs, but logging 0:05:52.080 --> 0:05:56.760 anything I'd cooked for myself, arguably the healthiest choice, required 0:05:56.800 --> 0:06:00.680 a bit of guesswork to find out what the evidences 0:06:00.800 --> 0:06:04.680 that this app, or any app can improve its users health. 0:06:05.279 --> 0:06:08.839 I called Yucca b am Seran, a doctor and researcher 0:06:08.960 --> 0:06:12.839 at Bond University in Australia. She published one of the 0:06:12.960 --> 0:06:16.800 few overview studies of the effectiveness of digital health apps 0:06:16.960 --> 0:06:20.640 last year. We came to this research as you know, 0:06:20.760 --> 0:06:24.480 just any other twenty one century UM citizen with smartphones, 0:06:24.520 --> 0:06:26.920 and we started seeing a lot of UM news and 0:06:27.040 --> 0:06:31.240 articles on how smartphone apps are treating this thing and 0:06:31.320 --> 0:06:34.360 that thing, and it's you know, being UM taught it 0:06:34.440 --> 0:06:38.040 as the next big thing in health and tech. World. 0:06:38.520 --> 0:06:42.839 Science is very specific about how we know medical treatments work, 0:06:43.680 --> 0:06:47.040 but that's not the case when it comes to consumer products. 0:06:47.040 --> 0:06:51.640 Like most health apps a Yucca started looking for rigorous studies. 0:06:52.240 --> 0:06:57.320 She surveyed almost eight hundred trials of apps conducted between 0:06:57.360 --> 0:07:02.480 two thousand eight and but once she looked more closely, 0:07:03.120 --> 0:07:05.880 she found only a handful of the studies showed the 0:07:05.880 --> 0:07:10.480 apps have some meaningful effect on health outcomes. Since then, 0:07:10.840 --> 0:07:13.880 drugmakers have started looking more at apps that could be 0:07:13.960 --> 0:07:18.160 used as therapies. Swiss Droukes Giant Novardes got US approval 0:07:18.280 --> 0:07:22.480 for one to treat substance abuse last year, But across 0:07:22.520 --> 0:07:27.320 the app world, YUCA says evidence still remains a rare commodity. 0:07:27.960 --> 0:07:30.640 We would estimate that less than one percent of all 0:07:30.680 --> 0:07:34.600 of these apps are actually been tested, and for apps 0:07:34.600 --> 0:07:38.080 that aren't being reviewed by health regulators, just having done 0:07:38.160 --> 0:07:41.200 any kind of test can be a marketing point, no 0:07:41.240 --> 0:07:46.280 matter what the outcome was. The term for this is experrammercial, 0:07:46.760 --> 0:07:52.080 a combination of experiment and commercial. And when the study 0:07:52.120 --> 0:07:54.760 doesn't show any benefit, they don't mention it, but they 0:07:54.760 --> 0:07:57.600 would mention in the app description that our app has 0:07:57.640 --> 0:08:01.320 been scientifically tested, and that kind of gives this false 0:08:01.360 --> 0:08:06.920 notion of legitimacy to the potential customers and consumers. My 0:08:06.960 --> 0:08:09.760 Fitness Pal was among the few apps or Youka found 0:08:09.840 --> 0:08:13.920 that had been tested in an independent clinical trial conducted 0:08:13.960 --> 0:08:17.360 about five years ago in Los Angeles. The study randomly 0:08:17.400 --> 0:08:21.480 assigned two hundred and twelve overweight adults to either use 0:08:21.520 --> 0:08:25.440 the app or to pursue and I quote any activities 0:08:25.520 --> 0:08:29.400 you would like to lose weight. After six months, neither 0:08:29.440 --> 0:08:33.880 group lost much weight. The researchers did speculate, though, that 0:08:34.000 --> 0:08:36.840 the app might be useful for patients who are already 0:08:36.920 --> 0:08:40.680 trying to watch their calorie intake. I asked Michael, the 0:08:40.760 --> 0:08:44.640 under Armour executive, for his thoughts on the results. That's 0:08:44.679 --> 0:08:47.760 absolutely directly in line with our experience with this app. 0:08:48.040 --> 0:08:49.760 You know, like I said, it's not We don't think 0:08:49.760 --> 0:08:51.480 of it as a health to it. We don't think 0:08:51.520 --> 0:08:53.600 of it as something that someone would say, put this 0:08:53.679 --> 0:08:55.800 on your phone, you will get better. But we think 0:08:55.800 --> 0:08:59.320 of it as an integral part in someone's journey when 0:08:59.320 --> 0:09:01.720 they've made the decision I'm going to change my life, 0:09:01.760 --> 0:09:04.280 I'm going to hit some fitness goals. Will be there 0:09:04.280 --> 0:09:07.400 to help. Maybe that was the problem with my diet 0:09:07.400 --> 0:09:11.640 app experiment. I didn't start out with a particular fitness goal. 0:09:12.200 --> 0:09:15.240 I wasn't actually trying to change my body or my life, 0:09:16.040 --> 0:09:20.520 and in fact another force was at work, won a 0:09:20.600 --> 0:09:28.520 lot stronger than willpower or workouts. I was pregnant, and 0:09:28.600 --> 0:09:32.400 so for the first time practically since puberty, my body 0:09:32.480 --> 0:09:36.040 felt like it was careening out of my control. Low 0:09:36.080 --> 0:09:38.800 carb diet hard to handle when you need to eat 0:09:38.840 --> 0:09:41.000 toast practically as soon as you open your eyes in 0:09:41.040 --> 0:09:43.840 the morning in order to settle your stomach, and I 0:09:43.920 --> 0:09:46.440 knew I would have to gain weight, not maintain it, 0:09:46.880 --> 0:09:51.120 let alone lose it. Still, I kept logging my meals 0:09:51.320 --> 0:09:54.599 and my exercise. I started to read more about the 0:09:54.679 --> 0:09:57.920 nutrients I would need for a healthy pregnancy, and I 0:09:57.960 --> 0:10:01.280 started to get a little obsessed of about making sure 0:10:01.320 --> 0:10:06.720 I logged them. When my fitness pal inexplicably didn't record 0:10:06.760 --> 0:10:09.600 the calcium in my brand of yogurt, it felt like 0:10:09.640 --> 0:10:14.160 a personal insult. I started keeping a very very close 0:10:14.240 --> 0:10:17.959 eye on my protein intake, and I started worrying about 0:10:18.000 --> 0:10:21.280 whether I was getting too much vitamin A, something that 0:10:21.360 --> 0:10:24.640 would never have occurred to me before, from eating too 0:10:24.640 --> 0:10:28.120 many a rugulas salads. I started to wonder whether I 0:10:28.200 --> 0:10:32.839 was monitoring myself a little too much. Today we're being 0:10:32.880 --> 0:10:37.679 reminded every single minute of how sub optimized we are 0:10:37.840 --> 0:10:39.920 and what we should be doing in order to be 0:10:40.320 --> 0:10:45.720 more optimized. That's Carl Staderstrom, an associate professor at Stockholm 0:10:45.800 --> 0:10:49.400 Business School. He co wrote a book called The Wellness Syndrome, 0:10:49.840 --> 0:10:52.240 in which he argued that the pressure to become ever 0:10:52.320 --> 0:10:57.560 healthier is actually anything but healthy. For another project, he 0:10:57.640 --> 0:11:01.360 also used himself as a guinea pig. So what I 0:11:01.400 --> 0:11:05.400 did was that I was using an app to log 0:11:05.559 --> 0:11:09.800 everything that I was eating. I was also using one 0:11:09.880 --> 0:11:15.280 of these wearables of rest band that logged my sleeping 0:11:15.400 --> 0:11:18.719 and logged the activity I was doing during the day. 0:11:18.960 --> 0:11:21.680 And then I was spending all my days in the gym, 0:11:21.760 --> 0:11:24.720 and I was over the course of that month gaining 0:11:24.800 --> 0:11:27.560 something like eight kilos. And the month ended with me 0:11:27.640 --> 0:11:32.200 participating in a weightlifting competition which I incidentally ended up 0:11:32.240 --> 0:11:37.160 coming last in. Carl writes about our society's obsession with 0:11:37.280 --> 0:11:41.960 wellness as being part of an individualistic culture where you 0:11:42.000 --> 0:11:45.480 need to demonstrate that you're performing at your peak, where 0:11:45.480 --> 0:11:48.480 there's a moral value linked with how your body looks, 0:11:49.320 --> 0:11:53.160 and also where workers who spend their days emailing and 0:11:53.360 --> 0:11:57.760 organizing seek satisfaction or at least a sense of having 0:11:57.800 --> 0:12:01.120 something to show for their efforts from improving their bodies. 0:12:02.080 --> 0:12:04.520 He says health apps are a lot like an idea 0:12:04.640 --> 0:12:08.839 from Freud, where your conscience prodes you to do what 0:12:08.920 --> 0:12:12.360 you know you should do but don't want to. So 0:12:12.400 --> 0:12:17.680 it is using an app as this little angry man 0:12:17.880 --> 0:12:22.040 sitting on your shoulder constantly telling you that what you 0:12:22.120 --> 0:12:25.520 do is wrong and what you should be doing is 0:12:26.280 --> 0:12:30.520 this or that. And I think it's says something about 0:12:30.600 --> 0:12:33.560 how difficult it is for for all your humans have 0:12:33.640 --> 0:12:38.360 probably always been to live the way that we are 0:12:38.559 --> 0:12:41.760 supposed to be living. And I think to some extent, 0:12:42.280 --> 0:12:45.280 the whole idea of being human is that we are imperfect. 0:12:45.280 --> 0:12:48.520 There's no way of always being able to do everything 0:12:48.600 --> 0:12:51.440 that we're supposed to be doing. But I think what's 0:12:51.480 --> 0:12:55.319 different today than in the past, and the health apps 0:12:55.559 --> 0:12:57.320 are a big part of this, is that we are 0:12:57.360 --> 0:13:02.120 being reminded seven as we're not living up to that 0:13:02.320 --> 0:13:06.600 idealized version of ourselves. Carl argues that this focus on 0:13:06.720 --> 0:13:11.080 self optimization is part of a larger political development in 0:13:11.120 --> 0:13:15.439 which health is viewed more as an individual concern and 0:13:15.640 --> 0:13:20.320 less as a broader social good, and the more society 0:13:20.480 --> 0:13:24.240 moves in that direction, the easier it becomes to demonize 0:13:24.240 --> 0:13:27.400 and ridicule people who do not have the resources to 0:13:27.480 --> 0:13:30.760 look after their own health. Talking to Carl made me 0:13:30.800 --> 0:13:34.160 think about my own app experiments in a different way. 0:13:34.640 --> 0:13:38.880 There I was obsessing about vitamin A and analyzing the 0:13:38.960 --> 0:13:42.840 nutrition content of the free protein bars in the Bloomberg pantry. 0:13:43.760 --> 0:13:52.480 The whole thing seemed so narcissistic. There was one time, though, 0:13:53.120 --> 0:13:56.200 that an app did help me do something that's actually 0:13:56.240 --> 0:14:00.480 objectively healthy. I quit smoking a couple of years ago. 0:14:01.200 --> 0:14:04.840 As any former smoker would know, the way cigarettes fit 0:14:04.880 --> 0:14:07.280 into your daily ritual is one of the things that 0:14:07.320 --> 0:14:10.760 make it super hard to quit. I used to love 0:14:10.840 --> 0:14:13.600 smoking in the late afternoon. It's a little moment to 0:14:13.679 --> 0:14:16.040 rest my brain before the last few hours of my 0:14:16.120 --> 0:14:19.600 work day. So once I quit, I started using a 0:14:19.640 --> 0:14:23.840 meditation app called Headspace as a replacement. I didn't think 0:14:23.840 --> 0:14:26.720 of Headspace at the time as a health app per se. 0:14:27.640 --> 0:14:31.080 It has more than one million paying subscribers and offers 0:14:31.120 --> 0:14:34.240 everything from a cat's and boats soundscape for falling asleep 0:14:34.680 --> 0:14:39.120 to meditation prep for students who are taking exams. But 0:14:39.200 --> 0:14:42.000 when I talked to the apps chief science officer Megan 0:14:42.080 --> 0:14:45.560 Jones bell I found out that they actually do see 0:14:45.600 --> 0:14:49.600 themselves that way. The company says there are sixty seven 0:14:49.680 --> 0:14:54.080 randomized clinical trials being done on its app, including studies 0:14:54.080 --> 0:14:57.760 on everything from quitting smoking to managing stress and pain. 0:14:58.680 --> 0:15:01.680 There are a number of ways that people can use 0:15:01.720 --> 0:15:06.280 meditation to improve their health and happiness, and that can 0:15:06.400 --> 0:15:08.760 range from using it as we think about it as 0:15:08.840 --> 0:15:12.000 kind of a vitamin, which means that you are um 0:15:12.080 --> 0:15:15.920 using it more on a preventative health capacity, such as 0:15:16.040 --> 0:15:19.800 trying to boost your resilience to stress, which is something 0:15:19.800 --> 0:15:22.480 that we have researched in a number of our trials 0:15:22.520 --> 0:15:25.560 and have a number of very rigorous studies underway looking 0:15:25.560 --> 0:15:28.360 at how that actually has proven out in brain changes. 0:15:29.040 --> 0:15:31.680 The company is also working on a separate version of 0:15:31.720 --> 0:15:35.120 its app that doctors could prescribe to their patients like 0:15:35.200 --> 0:15:39.640 a medicine. This is more complicated because Headspace needs to 0:15:39.680 --> 0:15:43.120 figure out with the Food and Drug Administration how best 0:15:43.160 --> 0:15:45.880 to test the new app and regulate it to make 0:15:45.920 --> 0:15:50.120 sure it works. Headspace hasn't started these trials yet and 0:15:50.160 --> 0:15:52.120 it could be a couple of years before the new 0:15:52.120 --> 0:15:56.440 product is approved. I asked Megan why Headspace would spend 0:15:56.480 --> 0:16:00.480 money in the meantime testing its consumer app too, when 0:16:00.480 --> 0:16:04.480 there's no regulator demanding data. I think, because we're really 0:16:04.560 --> 0:16:08.880 playing the long game here, our science strategy is not 0:16:09.120 --> 0:16:13.240 unlike the way that we've approached redefining the brand of meditation. 0:16:13.360 --> 0:16:17.640 You can think about headspaces origins and really changing the 0:16:17.720 --> 0:16:22.920 cultural perception of meditation and mindfulness, and you know, we've 0:16:22.960 --> 0:16:25.760 certainly lifted all ships in the process of doing that 0:16:25.840 --> 0:16:29.080 and really helping create this market and moving it out 0:16:29.160 --> 0:16:32.240 of this kind of more woo woo experience into something 0:16:32.280 --> 0:16:38.280 that is very approachable for a diverse range of of consumers. 0:16:38.680 --> 0:16:41.440 A few studies are also being done on headspaces big 0:16:41.480 --> 0:16:45.560 competitor the app Calm, So when these trials read out, 0:16:45.880 --> 0:16:48.880 assuming the results are published, we should get a better 0:16:48.920 --> 0:16:51.600 idea if at least this particular corner of the app 0:16:51.640 --> 0:16:55.360 market works. Some in the health apps industry think that 0:16:55.440 --> 0:16:59.280 an evidence space will become more necessary across the market 0:16:59.280 --> 0:17:02.000 as a whole, not just for apps that could be 0:17:02.000 --> 0:17:07.120 prescribed as medicines. I talked to Carl Johann Hateroth, CEO 0:17:07.160 --> 0:17:10.040 of sleep Cycle, the alarm clock app that got me 0:17:10.080 --> 0:17:13.600 started on this project it's really really interesting for us. 0:17:14.840 --> 0:17:18.560 I think the whole industry is heading in that direction. 0:17:19.119 --> 0:17:22.840 I think this industry is going to be regulated in 0:17:22.880 --> 0:17:27.560 some way the coming years. I don't know exactly how, 0:17:28.119 --> 0:17:32.800 but I think it will. And I mean, we like that. 0:17:36.680 --> 0:17:40.800 And now I have a confession to make. Like a 0:17:40.800 --> 0:17:43.800 lot of health app users, I wound up using what 0:17:43.960 --> 0:17:48.359 kept me entertained and dropping the rest. I'm still using 0:17:48.359 --> 0:17:51.199 sleep Cycle, partly because I like to compete with my 0:17:51.280 --> 0:17:54.280 husband to see who gets a better night's sleep, and 0:17:54.440 --> 0:17:57.080 because I take a morbid interest in seeing how much 0:17:57.119 --> 0:17:59.159 worse my sleep might get as I get more and 0:17:59.240 --> 0:18:03.679 more pregnant. Well you know what I mean, bigger and bigger. 0:18:05.280 --> 0:18:09.400 But my fitness pal was more complicated. The turning point 0:18:09.520 --> 0:18:11.879 was around the time when I was moving from the 0:18:12.160 --> 0:18:15.359 she ate too many burritos to the is that a 0:18:15.480 --> 0:18:19.119 bump stage of pregnancy. I noticed that on the weekends 0:18:19.200 --> 0:18:22.040 when I would skip the app, I felt so much 0:18:22.080 --> 0:18:25.679 better about my food intake. And during the week when 0:18:25.720 --> 0:18:30.440 I was worrying about protein and calcium and vitamins and calories, 0:18:30.960 --> 0:18:34.040 I felt like I was going crazy. I would look 0:18:34.119 --> 0:18:37.680 up online calculators to reassure myself that my weight gain 0:18:37.800 --> 0:18:41.719 was within normal parameters, and then beat myself up for 0:18:41.760 --> 0:18:45.359 not hitting a nutrient target even though I had exceeded 0:18:45.400 --> 0:18:49.880 my calorie goal for the day. My husband Philip actually 0:18:49.880 --> 0:18:52.880 started to worry about me. I mean, I wouldn't say 0:18:52.880 --> 0:18:54.760 it was crazy. You used the worst crazy before. I 0:18:54.800 --> 0:18:58.800 wouldn't say it was crazy, But definitely you were a 0:18:58.800 --> 0:19:03.360 bit obsessed. I remember you always telling me like not 0:19:03.560 --> 0:19:09.159 to worry so much about weight during pregnancy, and I 0:19:09.200 --> 0:19:12.520 wonder whether some of the experience with this was just 0:19:12.600 --> 0:19:17.960 tied together with that as well. That could definitely be 0:19:17.960 --> 0:19:20.159 the case. I mean, I do remember that you asked 0:19:20.240 --> 0:19:23.040 very often like, oh God, am I too big? Am 0:19:23.040 --> 0:19:26.040 I gaining too much weight? And I then, I mean, 0:19:26.080 --> 0:19:29.720 I even get angry about this question because it's not 0:19:29.840 --> 0:19:33.160 a competition of like who gains more or who gains 0:19:33.240 --> 0:19:36.800 less weight during pregnancy. Your body does. What your body 0:19:36.800 --> 0:19:39.840 does in each pregnancy is difficult different. At some point 0:19:39.880 --> 0:19:42.399 in time, I was afraid that you would, I don't know, 0:19:42.480 --> 0:19:45.960 stop eating when you if you thought that you had 0:19:46.000 --> 0:19:49.680 gained too much weight, which would maybe have been unhealthy 0:19:49.720 --> 0:19:53.040 for you or the baby. And if an app makes 0:19:53.080 --> 0:19:55.480 you even consider something like that, it's definitely not a 0:19:55.520 --> 0:19:59.040 good app. After Philip told me that I quit using 0:19:59.080 --> 0:20:03.440 the app. But not everybody is as neurotic as I am, 0:20:03.480 --> 0:20:06.359 and with so little evidence about health apps and health, 0:20:06.880 --> 0:20:09.160 I think the bottom line here is that you can 0:20:09.200 --> 0:20:12.280 take what's good for you and just leave the rest behind, 0:20:13.160 --> 0:20:16.280 and that sometimes the more you try to control things 0:20:16.800 --> 0:20:20.760 to optimize yourself, as Carl would say, the more you 0:20:20.800 --> 0:20:39.280 eventually realize that you just need to let go. And 0:20:39.359 --> 0:20:43.320 that's it for this week's prognosis. Thanks for listening. Do 0:20:43.359 --> 0:20:45.080 you have a story about health here in the US 0:20:45.400 --> 0:20:47.840 or around the world we want to hear from you. 0:20:48.359 --> 0:20:51.720 Find me on Twitter at bay Cortes or email m 0:20:51.760 --> 0:20:55.320 Cortes a Bloomberg dot net. If you are a fan 0:20:55.400 --> 0:20:57.520 of this episode, please take a minute to rate and 0:20:57.560 --> 0:21:00.440 review us. It really helps new listeners in the show, 0:21:01.040 --> 0:21:04.359 and don't forget to subscribe. This episode was produced by 0:21:04.400 --> 0:21:08.199 Liz Smith and topor Foreheads. Our story editor was Rick 0:21:08.280 --> 0:21:12.959 Shine Francesco Leavie as head of Bloomberg Podcasts. We'll be 0:21:12.960 --> 0:21:16.040 back with our next episode on July four. See you then,