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Research Letter
May 2016

Accuracy of Wearable Devices for Estimating Total Energy Expenditure: Comparison With Metabolic Chamber and Doubly Labeled Water Method

Author Affiliations
  • 1Department of Health Promotion and Exercise, National Institute of Health and Nutrition, NIBIOHN, Tokyo, Japan
  • 2Faculty of Sport Sciences, Waseda University, Saitama, Japan
  • 3Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
JAMA Intern Med. 2016;176(5):702-703. doi:10.1001/jamainternmed.2016.0152

Accurate estimation of energy expenditure is a key element in determining the relationships between aspects of human behavior, physical activity, and overall health.1,2 Although wearable devices for estimating energy expenditure are becoming increasingly popular, there is little evidence regarding their validity.3,4 This study was performed to examine the validity of total energy expenditure estimates made by several wearable devices compared with gold standard measurements for a standardized day (metabolic chamber method) and free-living days (doubly labeled water [DLW] method).

All protocols were reviewed and approved by the ethics review board of the National Institute of Health and Nutrition, Tokyo, Japan. Written informed consent was obtained from all participants, who were compenstated for their participation. Participants were 19 healthy adults (9 men and 10 women) aged 21 to 50 years who were not obese and had no problems performing regular daily activities. Total energy expenditure was measured using 12 wearable devices. Eight were consumer devices selected because the manufacturers claim that they measure total energy expenditure and they are popular according to Japanese sales rankings (JAWBONE UP24, Fitbit Flex, Misfit Shine, EPSON PULSENCE PS-100, Garmin Vivofit, TANITA AM-160, OMRON CaloriScan HJA-403C, and Withings Pulse O2). The remaining 4 devices are validated for use in research (OMRON Active style Pro HJA-350IT, Panasonic Actimarker EW4800, SUZUKEN Lifecorder EX, and ActiGraph GT3X). All 12 devices were worn simultaneously at randomly assigned positions on the wrist, chest, or waist as appropriate to minimize possible bias owing to placement (Figure 1).

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