Is tracking our health healthy?

If you've ever gone down a calorie counting rabbit hole, you will understand that it can get you results but it can also be exhausting, even dangerous.

I dabbled in the keto diet to drop some of the baby weight I put on after my first child. Going keto (short for ketosis, a state where your body burns fat rather than glucose) involves restricting your carbohydrate intake to less than 10 percent of calories, about 60 percent calories from fat and about 30 percent from protein.

Each evening, I diligently planned my calories and macronutrients (fats, carbs and proteins) for the next day. My app allowed me to subtract calories burned through exercise so I began doing that too.

It was oddly satisfying to track and encouraging to hit my daily goal. And it worked.

But it also made me fearful of carbs for years to come. By carbs, I mean nutrient-rich foods like carrots, potatoes and legumes, as well as bread, rice and croissants. After a few months, the admin went from satisfying to stressful so I stopped and some of the weight I lost came back on.

There's a lot we can count these days. A fitness tracker can tell you the steps you've taken each day and estimate the calories you've burned. Gadgets can provide feedback on your sleep quality each morning.

We can count calories, macronutrients and even tap into our blood supply with a continuous glucose monitor for real time data on our blood sugar levels (these devices were designed for diabetics, but some wellness influencers are using them to optimise health).

But is all this data making us healthier? We talked to experts in nutrition, fitness and sleep to learn how tracking can help and hinder our health.

Measuring sleep

Tracking the quality of your sleep at home can be done through a smartwatch or you can get far more data with an Oura ring, which costs about $800. Both devices will tell you something about your sleep to various degrees of accuracy, according to Dr Alex Bartle, from New Zealand's Sleep Well Clinic.

Understanding how you slept is one thing, but knowing what to do about it is another.

"Knowing what's going on is really interesting," he says, "but if you're expecting it to actually help you sleep better, if you think you sleep lousy, you need to see someone who deals with sleep."

Sometimes patients will come into the clinic with reams of sleep data, but a better gauge of your sleep is how you feel when you wake up or whether you constantly feel tired during the day, Bartle says.

Some sleep devices can offer valuable information about how to sleep better including limiting blue light exposure (ironically, often from devices such as a smartphone) or laying off the caffeine earlier.

For those who fail to see improvements, finding medical or expert help with sleep can be difficult because "there aren't that many people around who actually do sleep stuff," Bartle says.

Counting nutrition

Calorie counting for weight loss has been around since the 1920s. This was around the same time that bathroom scales became a thing.

As we learn more about nutrition, counting what we eat has dialled into those macronutrients of carbs, protein and fats. Scanning nutritional information on food packets through apps on our phones has made this easier and more accessible.

Continuous glucose monitors provide instant feedback on how your body responds to different foods through a tiny filament inserted in the skin.

But reaching holistic health doesn't need to come through tracking apps or scales, says Lisa Bojarski, an Auckland-based therapist who focuses on eating psychology and intuitive eating.

"How can information about nutrition and wellness go beyond this old story that we've talked about for so long, that it's all calories in versus calories out," she says.

A number of Bojarski's clients have come to her in a tangle of counting apps and at-home scales that are robbing them of the joys of food while losing touch with their body's natural cues when it comes to food.

"I prefer to work on my clients creating a genuine awareness of their bodies, their feelings, their needs, their hunger and fullness cues," Bojarski says.

Like sleep monitoring, there can be benefits with learning healthier habits and motivations through counting nutrition or monitoring weight. However, too often the result is self-loathing, punishment and deprivation, Bojarski says.

Counting calories or macronutrients or some other measure also strips food and eating of its cultural and social value, says Professor Carol Wham, from Massey University and the NZ Nutrition Foundation.

"[Eating] forms our identities. It strengthens our social relationships. Eating together is really important," she says.

Brittany McNabb, a personal trainer with a background in psychotherapy, does calorie tracking with clients with a focus on protein intake until they reach their health goals. McNabb's clients are primarily women on a fat loss journey.

She says the education that can come from calorie or macronutrient counting can inform better decisions. For example, one of her clients had a daily drink from a smoothie chain. Despite the smoothie's aura of health, the calories equalled a typical fast food meal.

"My goal for my clients is for them to build up enough knowledge and awareness of calories that they start making decisions on the fly because that is freedom and that is what I do," she says.

Exercise

On the extreme end of the scale, counting calories and measuring our exercise can be a gateway into an eating disorder for some. It even has a name: technorexia, the compulsive behavior normalised by the popularity of health technology.

McNabb is well aware of this. She was severely bulimic in her teenage years. Some of her clients have crossed over into obsessive exercise tracking and she's worked with them to pull them back.

A big red flag is if a client "slips off plan and you just cascade into shame, guilt, self-attacking", McNabb says.

"I always remind my clients that slipping off track is part of the plan."

Many of her clients come to her already tracking their steps and she works with that. Tracking steps is a form of non-exercise activity thermogenesis, or NEAT, which is a long winded way of describing spontaneous physical activities that don't reach the bar of intentional exercise.

Taking 10,000 steps a day has become a popular goal for many people, with a 2022 study finding it was ideal for cardiovascular and brain health. If a client comes to McNabb with an average of 3000 daily steps, they gradually increase that number over time.

Measuring steps and meeting small goals "puts deposits into their self-confidence basket like, 'I can do that and I can therefore pump it up over time'."

While smart devices are accurate at measuring steps, they're not quite as clever when it comes to measuring calories burned, McNabb says.

"Fitness trackers overestimate calories burned hugely."

If you or someone you know is experiencing some troubling behaviour around tracking, food or wellbeing reach out to Eating Disorder Association of New Zealand 0800 2 EDANZ or (09) 5222 679