Note: Descriptions are shown in the official language in which they were submitted.
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HEALTH MANAGEMENT SYSTEM WITH
CONNECTION TO REMOTE COMPUTER SYSTEM
Field of the Invention
The invention relates to health management, in particular to diet management
and
weight control.
Background of the Invention
There are serious problems with conventional weight loss programs. Food
consumption by the person using the weight loss program (the user) is
conventionally
recorded in great detail, allowing an accurate caloric intake to be
determined. However,
weight control is related to the user's net caloric balance, the difference
between caloric
intake and caloric expenditure. Caloric expenditure is usually not known
accurately. It is
possible to estimate the caloric expenditure related to various physical
activities.
However, as discussed by Remmereit in U.S. Patent No. 6,034,132, for a typical
person,
70 percent of total caloric expenditure is due to their resting metabolic rate
(RMR). In a
conventional diet program, RMR is estimated from the height, weight, age, and
gender of
the person, for example using the Harris-Benedict equation. This equation,
well known to
those skilled in the nutritional arts, is given in U.S. Patent No. 5,839,901
to Karkanen,
and in U.S. Patent No. 5,639,471 to Chait et al. There are serious
inadequacies in using
the Harris-Benedict equation (or any similar equation) in a weight loss
program. The
Harris-Benedict equation provides only an estimated RMR, which is an average
value for
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people of similar height, weight, age, and gender. However, due to natural
variations in
physiology, it need not be accurate for a specific individual.
The total caloric expenditure of a person comprises a resting metabolic
component and a physical activity component. Total energy expenditure (TEE) is
the sum
of resting energy expenditure (REE) and activity energy expenditure (AEE),
i.e. TEE
AEE + REE. Weight loss occurs if total caloric expenditure (TEE) exceeds total
caloiic
intake over a given time period. The net caloric balance for a person is the
difference
between caloric expenditure and caloric intake.
Conventional weight loss programs use an estimated TEE based on estimates of
activity levels, and estimates of REE from the Harris-Benedict equation.
However, if
REE is not estimated correctly, the person's caloric balance cannot be known
accurately,
and the outcome of a weight loss program is likely to be unsatisfactory.
It is also known that RMR often falls during a restricted calorie diet. The
Harris-
Benedict equation scales RMR with weight, but does not account for a natural
slowing of
human metabolism in what the body may interpret as partial starvation
conditions.
Physical activity during the restricted calorie diet may cause RMR to fall
further to allow
the body to conserve energy, or, alternatively, it may cause RMR to increase
due to an
increase in muscle mass. Hence, in addition to unpredictable variations in RMR
from
person to person, there are also unpredictable changes in RMR in response to a
weight
control program. The improved weight control system described herein overcomes
these
problems.
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Resting metabolic rate (RMR) can be measured using an indirect calorimeter.
REE corresponds to the value RMR multiplied by an appropriate time period,
usually one
day. (RMR is a rate of energy expenditure whereas REE is a total energy
expenditure
over a given time period, though REE and RMR are sometimes used
interchangeably).
Conventional indirect calorimeters are too large and expensive to be used as
part of a
weight control program. Recently, James R. Mault M.D. et al. invented an
improved
indirect calorimeter, embodiments of which are well suited for applications in
improved
weight control and health management programs. The improved indirect
calorimeter is
more fully described in pending U.S. application Serial No. 09/630,398.
Conventional diet calculators enable food records to be created on a hand-held-
device. However, they do not provide a link to a communications network, and
so cannot
provide feedback generated by a remote computer system, or health professional
with
access to the communications network.
1n U.S. Patent No. 5,839,901, Karkanen describes an integrated weight loss
control method, in which a calorie density is determined by comparing the
actual weight
loss of a dieter to an estimated calorie deficit. This patent does not
describe a system in
which a person has a portable computing device linked to a communications
network.
In U.S. Patent No. 5,639,471, Chait et al. describes the formulation of a
nutritionally balanced diet based on a person's caloric requirements
calculated using the
Harris-Benedict equation. However, this patent does not describe a weight loss
program
with feedback provided to the person over a communications network, or the
determination of a person's caloric balance.
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In U.S. Patent No. .5,933,136, Brown describes the controlled access to an
entertainment program based on the user's compliance with a treatment plan.
However,
this patent does not describe the provision of information so as to help the
user comply
with a weight control program, based on the degree of compliance with the
program.
In U.S. Patent No. 6,039,688, Douglas et al. describes a therapeutic behavior
modification program. However, this patent does not describe the determination
of a
person's caloric balance.
In U.S. Patent No. 4,321,674, Krames describes an electronic diet calculator.
This hand-held device allows a person to record consumption from a limited
selection of
food items. In U.S. Patent No. 4,729,479, Duboff describes a diet calculator
with key
entry, in which consumption is subtracted from target amounts. In U.S. Patent
Nos.
5,704,350 and 4,891,756, Williams et al. describes a diet calculator in which
foods are
grouped by category, and presented to the user using a menu display. In U.S.
Patent No.
5,729,479, Golan describes a multifunctional diet calculator, in which
cumulative food
totals are compared with target amounts. Other diet calculators are described
by Sakai
(4,855,945), Ikemoto (4,894,793), and others.
Summary of the Invention
It is an object of the present invention to provide an improved weight control
system. In a preferred embodiment, the person using the improved weight
control
program (the user) is provided with a portable computing device, such as a
personal
digital assistant (PDA). The PDA has a software application program, which for
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convenience will be called a calorie management program. The calorie
management
program comprises the functionality of diet logging software, and enables the
user to
record food items consumed. The calorie management program preferably has
other
functionality, so as to assist the user to set and achieve weight goals.
Another object of the invention is to provide a weight control system in which
unpredictable variations of resting metabolic rate (RMR) are accounted for.
The user
preferably measures their RMR using a metabolic rate meter, such as an
indirect
calorimeter, and enters this value into the calorie management program. The
user also
enters weight control goals, such as a certain weight loss goal. The calorie
management
program uses the determined value of RMR to estimate total energy expenditure
(TEE),
based on an assumed level of physical activity, and determines a level of
caloric intake
which will enable the weight control goals to be met. During the weight
control program,
the user records weight, food intake using a diet log, activity levels, and
resting metabolic
rate at intervals.
A further object of the invention is to provide improved feedback to the user
over
a communications network. Calorie management data is transmitted from the PDA
to the
remote computer system. The user connects to the remote server at a convenient
time, for
example in the evening, and recorded diet-log data, weight, and activity-
related signals
are transmitted to the remote server and stored in a related database.
Feedback is
generated by the remote computer system, and transmitted back to the portable
computing device of the user.
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Brief Description of the Drawings
Figure 1A illustrates a portable computing device;
Figure 1 B illustrates a system embodiment of the invention;
Figure 2 is illustrates a set-up procedure for a user of calorie management
software;
Figure 3 shows a menu screen on the display of a portable computer, from which
a user selects a food itefn;
Figure 4 illustrates the interactions between a portable computing device and
a
remote computer over a communications network;
Figure 5 is a schematic showing communication between a portable computer and
a remote computer system;
Figure 6 is a schematic showing a community of users interacting with a remote
computer system;
Figure 7 is a schematic illustrating controlled user access to a data relating
to a
community of users;
Figure 8 shows a person breathing through an indirect calorimeter;
Figure 9 shows a cross-section of an indirect calorimeter suitable for use in
embodiments of the present invention;
Figure 10 is a schematic of a weight control system including an indirect
calorimeter;
Figure 11 is a schematic of a weight control system comprising a portable
computer which interfaces with a desktop computer;
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Figure 12 is a schematic of a weight control system in which an indirect
calorimeter is located at a physician's office;
Figure 13 is a schematic of a system in which food data is received during a
purchase transaction;
Figure 14 shows a wrist-mounted device used in embodiments of the present
invention; and
Figure 15 shows a system embodiment using a wrist-mounted device.
Detailed Description of the Invention
Figure 1A shows a handheld microprocessor-based device 10, used in preferred
embodiments of the present invention, having a user display 12 and a user
information
input in the form of data entry buttons 14. The device 10 is a portable
computing device,
preferably a personal digital assistant (PDA), but it can also be a wireless
phone, an
electronic book, a pager, other portable computer, or other portable
electronic device
having computational functionality. For convenience, portable computing device
10 will
be hereinafter referred to as a PDA, though this is non-limiting as other
portable
computing devices can be used. The user may also input data into the PDA using
a
stylus, bar-code reader, finger motion detector, voice recognition method,
track ball, or
any other convenient input method. The PDA has a data transmission and
reception
means for transmitting data to (and receiving data from) a communications
network, for
example; a telephone modem, wireless modem, cable modem, network interface
card, or
other telecommunication transceiver. Preferably, the PDA is connected to the
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communications network using a wireless connection, belt cables, optical
fibers, and other
systems may also be used.
Figure 1 B is a schematic of an improved diet control system. Portable
computing
device 10 is connected to a communications network 20. A remote computer
system 30
is also connected to the communications network, so as to allow data to be
transmitted
between the computing device 10 and the remote computer system 30 over the
communications network 20. The communications network provides a
communications
link between devices connected to the communications network. The portable
computing
device 10 also receives data from a physical activity sensor 16, and body
weight scales
18. The portable computing device also can communicate with a computer 22, the
computer 22 also being connected to the communications network 20.
The communications network 20 is preferably a public network adapted to
receive
data from the PDA, such as digital representations of data stored in the
memory of PDA
10. The communications network 20 is preferably the Internet. The connection
between
1 S the PDA 10 and the communications network 20 is preferably a wireless
connection, such
as a wireless Internet connection, however cables, phone lines, optical fibers
and other
communication links can also be used.
The remote computer system 30 is preferably a server system. The remote
computer 30 is connected to the network 20, and is adapted to receive data
from the PDA
such as digital representations of data stored in the memory of PDA 10. The
remote
computer 30 has an application program for analyzing the user's caloric
consumption,
caloric expenditure, and net caloric balance, and for generating feedback
(such as critical
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messages, other advice, educational content, and the like) to the user, the
messages and
feedback relating to the user's progress toward a weight control goal. The
remote
computer 30 also has transmission circuitry for transmitting messages and
feedback over
the network 20 to the PDA 10. The messages and feedback act to motivate the
user to
make progress towards a weight control goal.
One system embodiment requires only PDA 10, communications network 20,
scales 18, and remote computer system 30. This embodiment will be discussed
first, and
other systems including the activity sensor 16 and computer 22 are discussed
later.
The PDA 10 has a software application program so as to assist the user to set
and
achieve weight goals. The program is adapted to receive user inputs related to
user
caloric intake and user caloric expenditure and to calculate user net caloric
balance on a
daily basis. For convenience, this program running on the PDA 10 will be
called a
calorie management program. The calorie management program comprises the
functionality of diet logging software, and enables the user to record food
items
consumed. The PDA has a memory for storing user inputs related to caloric
intake and
caloric expenditure, and a transmission means for providing digital
representations of the
information stored in the memory.
Diet logging software suitable for adaptation for use in the present invention
has
been described in U.S. provisional application Serial No. 60/240,185,
incorporated herein
in its entirety by reference. Diet logging software is also described in U.S.
Patent Nos.
5,704,350 and 4,891,756 to Williams, incorporated herein in their entirety by
reference.
A calorie management program running on the PDA allows the user to record food
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intake, hence determining their caloric intake. Preferably, a database of food
and drink
items and associated nutritional data (such as caloric values) is stored on
the PDA, and
accessed by the calorie management software to correlate food identities with
nutritional
data. Alternatively, a database of food identities and associated nutritional
data can also
be located on the remote computer system 30. The remote database would
preferably be
more extensive, so as to allow expansion of the local database on the PDA as
needed.
Before the start of the weight control program, the, user completes a set-up
procedure. Figure 2 illustrates an example set-up procedure which the user
completes
before starting a weight control program. Boxes 40-54 in Figure 2 represent
functional
steps provided by the calorie management software running on the PDA 10.
The user enters personal information (box 40), such as their name, alias, e-
mail
address, and a password. This information is used' for communication with the
user, and
sharing data with other users, and other authorized persons such as health
management
workers. This step is only executed on the user's first use of the software,
or if personal
details change. Calorie management software on a single portable device such
as 10 may
support multiple users, for example through different password entry.
The user enters start parameters (box 42), such as starting date, initial
weight, age,
height, body fat percentage, lifestyle activity level, and frame size. If
required, the
software can present a comparison of the user's current weight and body mass
index
against accepted healthy ranges. The user also enters lifestyle information,
such as
occupation, physical activity levels, time at work, and time asleep. This
information is
used to estimate a value for activity energy expenditure AEE.
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Preferably, the user determines their initial resting metabolic rate (RMR)
using an
indirect calorimeter, and enters this value into the calorie management
software. The use
of an indirect calorimeter in an improved weight control system is described
in more
detail later. If the user does not know their RMR, and an indirect calorimeter
is not
available, the Harris-Benedict equation is used to estimate the RMR of the
user. This
equation is described in U.S. Patent No. 5,839,901 to Karkanen, incorporated
herein in its
entirety by reference. However, it is important to note that the Harris-
Benedict equation
provides only an estimate of metabolic rate. (This estimate can be improved by
determination of body fat content, for example using bioelectrical impedance
analysis.)
The software may display the daily values of REE, AEE (as determined from
lifestyle
activity data), and TEE to the user at this point.
The user then enters their goal or goals (box 44), such as a weight goal
(weight
loss, weight gain, or weight maintenance), , fat loss, muscle building, blood
pressure
reduction, blood sugar control, and the like. In this specification, for
convenience, we will
consider the case of a user wishing to lose weight. In this case, the user
enters weight
loss goals, such as a total weight loss over a time period, or a desired
weight loss rate (for
example one pound per week).
The software determines a caloric intake level consistent;~:with the weight
loss
goals (box 48). For weight loss, the caloric intake needs to be lover than
TEE, i.e. the
user's net caloric balance is negative and the user experiences a calbrie
deficit. The user's
weight loss is related to the negative caloric balance (calorie deficit) via a
parameter
termed the calorie density. As discussed by Karkanen in U.S. Patent No.
5,839,901, a
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calorie density of 3500 Cal/lb is conventionally used to predict weight loss
from the
calorie deficit. This implies that a calorie deficit of 3500 Cal/week is
needed to lose one
pound of body weight per week. The nutritional balance of consumed foods (the
actual
mix of carbohydrates, protein, and fat consumed, or planned to be consumed)
recorded by
the calorie management .software can be used to determine a more accurate
value for the
calorie density. (The term calorie density is also used in the nutritional
literature to refer
to the calorie content per unit weight of food items. In this specification,
the term calorie
density is not used in this way, here calorie density refers to the
relationship between
caloric balance and body weight changes.) The software estimates an activity
level and
. corresponding to AEE in calculating TEE, and hence the allowed caloric
intake of the
user.
Using conventional nutritional knowledge, a recommended nutritional balance is
provided consistent with caloric intake goals (box 50). Dietary guidelines are
well known
to those skilled in the nutritional arts. The implementation of diet
guidelines in preparing
a balanced diet program within caloric limits, such as calculated using the
Harris-
Benedict equation, is 'discussed in U.S. Patent No. 5,639,471 to Chait et al.,
incorporated
herein in its entirety by reference. The calorie management software can be
used in meal
planning. The user can enter dietary restrictions, for example allergens, and
other foods to
be avoided, so as fo exclude foods from a planned diet program. Preferred
foods can also
be entered, for example a particular favored breakfast can be entered.
The user is offered the possibility of changing the activity. level, which
changes
AEE and hence the allowed caloric intake (box 52). For example, a user might
prefer to
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exercise more and eat more, while still remaining within a planned calorie
deficit. After
such changes, allowed caloric intake calculations '(box 48) and nutritional
advice
calculations (box 50) are repeated. The user then exits the set-up procedure,
after
confirming the accuracy of entered parameters (box 54), and can then start the
weight
control program.
During the weight control program, the user enters their diet log details into
.the
PDA. As food items are entered into the calorie management software, the
actual
nutritional balance of consumed foods can be compared with target nutrition
goals.
Nutritional supplements or food alternatives are suggested if the diet log
shows a
nutritional imbalance. The calorie management software is adapted to receive
user weight
data at intervals, for example user weight as determined daily using scales
18. The calorie
management software is also adapted to receive data relating to the user's
resting
metabolic rate, for example as determined using an indirect calorimeter. The
use of an
indirect calorimeter in an improved weight control system is described in more
detail
later.
Preferably, the .user selects food items consumed from a menu system presented
on the display 12 of the portable computing device 10, for example as
described in U.S.
Patent Nos. 5,704,350 and 4,891,756 to Williams et al., and in co-pending U.S.
provisional application,. Serial No. 60/240,185. Figure 3 shows an example
menu screen
display from which the user can select food items from within groups.
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If a particular meal is selected a number of times, it can be identified as a
favorite
by the software and presented to the user more prominently, for example at the
top of a
menu display.
The PDA is used to record and display caloric intake and caloric expenditure.
The data may be presented as a conning total in terms, of caloric balance, or
on a daily
basis, indicating the days on which caloric balance goals were achieved.
The PDA can be used to record informal calorie management data, such as voice
memos, images, notes, barcodes, or purchase information, and such informal
data can be
used to construct a full diet log at a later convenient time, using calorie
management
software running either on the PDA or on the remote computer system.
Preferably, the calorie management software running on PDA 10 receives data
related to the physical activity level of the user. The user can enter the
time, duration, and
intensity of exercises or other activities into the calorie management
software. Preferably,
the PDA provides a menu of activities to the user and the user chooses an
activity and
enters a duration.
A button on the PDA 10, activity monitor 16, or other portable electronic
device
can be pressed at the beginning and end of an exercise to provide time and
duration data.
These time stamps can be used at a later time in creation of a detailed
exercise log. Voice
memos can also be recorded using an optical imaging sensor, for example to
record an
image to assist the user or other person to create an exercise log. The PDA
may have an
imaging functionality, or another device-may be used. For example, if an image
of an
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exercise machine is recorded along with time of day and duration data, this
will assist in
the creation of a full exercise log at a later more convenient time.
The user preferably carries a physical activity monitor 16 which provides a
signal
related to physical activity, and preferably this is a body mounted pedometer
comprising
S one or more accelerometers. Other types of activity monitors may be used,
for example
GPS-based monitors as described in U.S. patent applications Serial Nos.
6,148,262 and
6,002,982 to Fry. Physical activity monitors providing a signal correlated
with one or
more physiological parameters, such as heart rate, body temperature,
respiration
frequency, and the like can also be used in system embodiments.
Data can be transferred from the activity monitor 16 to the PDA 10 using a
cable
link, wireless methods (such as the Bluetooth protocol or an IR link), using
the transfer of
memory modules, or by the formation of a data transfer interface between
monitor 16 and
PDA 10. The calorie management software on PDA 10 receives any such activity-
related
data, and processes the data so as to provide an estimate of activity related
data (AEE).
Heart rate and other physiological parameters can also be monitored to provide
a
signal related to physical activity. The PDA can receive data from other
physiological
monitors, for example scales, a body fat meter, a pulse rate meter, a body
temperature
sensor, and the like. The PDA can also be used to predict blood sugar levels
of the
person based on the glycemic index of the foods consumed and activities
planned. Meals
can be planned to avoid blood sugar levels outside of an acceptable range. The
activity
sensor 16 may possess additional functionality so as to act as a physiological
monitor,
physical location monitor, or environmental monitor.
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At intervals, data is transmitted between the PDA 10 and remote computer
system
30 over the communications network 20. Figure 4 illustrates an example
interaction with
the remote computer system. Boxes 60-70 represent functional steps.
The user initiates connection with the remote computer system (box 60), for
example by logging in to a web-site provided by the . remote computer system.
Connections can also be initiated automatically at intervals.
The PDA 10 and remote computer system (server system 30) then enter a data
synchronization step (liox 62). Data recorded by the calorie management
program, and
stored in the memory of PDA 10, is transmitted to the remote computer system
30. This
includes data related to caloric intake, the most recent weight of the user,
physical
activity data, and metabolic rate data (if available). A software program
running on the
remote computer system 30 (server software) receives the data and stores the
newly
receive data on a database, where it is accessible by the server software.
The received data and cumulative stored data are processed by the server
software
(box 66), so as to analyze the data in relation to user goals. The server
software provides
feedback to the user corresponding to the data analysis (box G8). Data
analysis and
feedback are discussed in more detail below.
The server software can present data to the user graphically. The server
generates
visual presentations of data, for example by dynamic generation of a website.
The PDA
is used to display the website to the user by the communications network. The
website
can be password protected, or otherwise only accessible to the user and other
authorized
people.
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The user disconnects from the remote computer system (box 70) after data
transfer steps are coW plete, and the user no longer wishes to view data
representations
generated by the server software. Feedback and critical messages generated by
the server
may be stored in the memory of the PDA 10, where they can be viewed later.
Figure 5 shows a further schematic of one example of how the user can
communicate with the remote computer. Figure 5 shows an application program,
running
on remote computer system 30, in communication with a database 82, a source of
dietary
feedback 84, and a communications interface 86, preferably a web-site based
interface.
For example, the user's identity and password can be embedded in a URL
provided to the
server software. The user's PDA can communicate with the application program
80 via
the web-site 86 over the communications network 20.
The user uses PDA 10 to connect to communication network 20. The user
accesses a web site 86, providing a name and password which is passed to
server program
80. Server program 80 recognizes the user. A synchronization step is
performed, whereby
user-related data stored on the PDA and in database 82 are compared, and in
the case of
inconsistencies, the most recent data is stored in both. For example, the user
may change
weight loss goals using the calorie management software on the PDA, the
changes being
recognized by the server software on connecting to the remote computer, and
the changed
goals stored in database 82. The server software requests data from PDA 10
over the
communications network, and stores the data in appropriate fields of database
82. The
server program 80 compares the recent data with the weight loss goals, and
selects
feedback from the available material provided by feedback source 84.
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In other embodiments; the application software program on the remote computer
(server software) may comprise calorie management functionality such as diet
logging,
and would be adapted to receive data from the PDA 10 such as the times and
locations of
meals. The user would then interact with the server software over the
communications
network, for example using the data entry mechanisms of the PDA to provide
additional
information needed to complete the diet log.
Data analysis by the server software and the provision of feedback to the user
are
now discussed in more detail. The application software on the remote computer
system
(server software) processes the data received from the user over the
communications
network, so as to determine appropriate feedback. The PDA is used to display
audio-
visual feedback received over the communications network for the purpose of
providing
dietary feedback to the user. For example, if the diet is progressing
successfully towards
a weight loss goals, the feedback would praise the user, and offer
encouragement to the
user to continue to succeed.
1 S One or more parameters related to the degree of success of the program can
be
calculated by the server software (or by the calorie management software on
the PDA),
for example based on the calorie management data collected,, current weight of
the user,
and program goals. The following non-limiting _ example illustrates how this
may be
achieved. If half the weight loss goal was achieved over the first half of the
program, the
parameter has the value zero, indicating that the progress is exactly on
track. If no weight
has been lost, the parameter has the value 100. If one quarter of the weight
is lost, the
parameter is 50. If the goal is met in half the required time, the parameter
is (-100). The
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feedback provided to the user is based on the value of this parameter.
Different feedback
is provided over different ranges of the value of this parameter. Other
success parameters,
or combination of parameters can be used. A novel diet success parameter is
discussed in
more detail later. The historical performance is also preferably included in
the selection
of appropriate feedback. For example, if exercise goals are not met during the
first half of
the program, the user is encouraged to exercise more by the provided feedback.
However,
if this feedback has no effect, as shown by subsequent data, the feedback is
modified to
provide stronger encouragement. For example, an appointment with a fitness
consultant
can be made automatically.
In the improved feedback mechanism described here, the nature of the feedback
is
determined by the status of the weight control program. A failure pattern can
be
recognized. For example, if weight has been gained despite a low recorded
caloric
intake, feedback may be provided to discourage the user from under-recording
food
consumption. If the diet log shows a prevalence of snacks recorded at a
certain time of
day, suggestions may be provided towards alternative activities instead of
snacking, for
example to drink water, go for a walk, or something similar. If certain times
of days are
recognized as a problem, the PDA may be used to schedule activities or other
alternatives
to snacking during problem times. An alarm may actually be provided to the
user to
discourage them from snacking at a time that is known to be problematic. If
serious
discrepancies from goals or acceptable healthy lifestyles are detected by the
server
software, a physician or other authorized person may be alerted. Activity
levels, in terms
of activity-related energy expenditure (AEE) or some activity-related
parameter may be
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compared with goals, and used in determining the nature of feedback or
critical
messages.
The planning and organizational functionalities of a conventional PDA can be
effectively used in the improved diet control program described here, for
example in
planning meals and activities during the day.
Feedback can be in the form of video clips, animations, and the like. For
example,
the likeness of a doctor, fitness professional, or other person can be used to
deliver a
motivational or critical message to the user.
The feedback to the user can be adapted to the user's personality. For
example, at
the start of the program the user can indicate which style of feedback they
would prefer,
for example lecturing, aggressive, gentle, or other style. The style can be
adjusted based
on the effectiveness of previous feedback. If gentle feedback is not
effective, then a more
assertive style may be tried.
Feedback can be in the form of educational videos selected on the basis of the
1 S user's progress. For example, if recorded physical activity is lower than
the set goals, a
video of exercises can be provided.
Feedback can be sensed (viewed and/or listened to) by the user on any
appropriate
device having a connection to the communications network 20, such as an
interactive
television, web-TV, Internet appliance, cell phone and the like. The remote
computer may
provide codes to the PDA, which can then be used to access feedback or other
relevant
content via such devices.
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A feature of conventional diet programs is that meetings and communal
weighings at certain physical locations can be used to exert peer pressure on
the user.
The expectations of the group influence the behavior of an individual user,
and give the
user more resolution to succeed than would be the case for a weight control
program
carried out in isolation. This effect is known to be considerable, and in part
justifies the
fees charged by conventional diet businesses.
Figure 6 shows remote' computer system 30 used in the creation of a community
of users (represented by portable computing devices 10, 90, 92) interconnected
by the
communications network 20. In practice, the,community may be considerably
larger than
three users. The results for an individual user can be presented to the rest
of the group
using an alias, or partial identification. Discussion groups can be set up.
Figure 7 shows a schematic of how an individual user receives community data
using the communications link to the remote server. The user, using PDA 10,
connects to
communications network 20, preferably the Internet, and exchanges data with
server
software 80 through website-based interface 86. The user can access all of the
data stored
in database 82, which is associated with the user, and a limited sub-set of
data fields from
other databases related to other community users. For example, a diet success
parameter
and an alias may be accessed. The user may view a graphical presentation of
the other
users' progress towards weight loss goals, which can provide additional
encouragement.
For example, a user may observe that relative success falls for most users
over a holiday
period and then picks up, encouraging the user to continue in a program after
a holiday
period which has involved excessive calorie intake.
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The community can be divided into groups for the purpose of encouraging
competition between groups. Fcjr example, the community can be divided along
lines
such as geographical areas, college alumni, etc. For example, rivalry between
alumni of
historically competing universities, or between supporters of sports teams,
can be used to
generate additional motivation between groups of users. The group can also be
divided
by weight divisions, target weight loss, gender, age, state, or some other
demographic
factor. Users with common health concerns can also be grouped together.
Validation at
the end of a weight loss program is performed if substantial rewards are given
for best
performance. For example, users would report to a given location for an end of
program
weighing.
Studies have shown that a social support network can also be useful in
lowering
the injury rate during a physical activity program. Hence, the community of
users
accessible by the Internet will help encourage a healthy activity program.
Recently, James R. Mault M.D. et al. invented an improved indirect
calorimeter,
well suited for use in an improved weight or health management system. This
device,
sometimes known as the Gas Exchange Monitor (GEM), is preferably used in the
improved weight and health control program described here. In a preferred
embodiment,
the GEM is a handheld indirect calorimeter which determines the user's
metabolic rate by
analyzing the user's inhalations and exhalations to determine oxygen
consumption from
the difference between exhaled and inhaled flow volumes of oxygen. The GEM may
also
be supported by straps around the user's body (for example, around the head),
by a
helmet, or by another support mechanism relative to the user's body. The
improved
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indirect calorimeter is best described in U.S. application Serial No.
09/630,398, which is
incorporated herein in its entirety by reference. A brief description of the
calorimeter
follows.
Referring to Figures 8 and 9, the calorimeter according to U.S. application
Serial
No. 09/630,398 is generally shown at 100. The calorimeter 100 includes a body
102 and
a respiratory connector, such as mask 104, extending from the body 102. In
use, the body
102 is grasped in the hand of a user and the mask 104 is brought into contact
with the
user's face so as to surround their mouth and nose, as best shown in Figure 8.
Optional
straps 105 are also shown in Figure 8. With the. mask 104 in contact with
their face, the
user breathes normally through the calorimeter 100 for a period of time. The
calorimeter
100 measures a variety of factors and calculates one or more respiratory
parameters, such
as oxygen consumption and metabolic rate. A power button 106. is located on
the top
side of the calorimeter 10 and allows the user to control the calorimeter's
functions. A
display screen is disposed behind lens 108 on the side of the calorimeter body
102
1 S opposite the mask 104: Test results are displayed on the screen following
a test. Other
respiratory connectors can be used, for example a mouthpiece.
Figure 9 shows ~a vertical cross section of the calorimeter 100. The flow path
for
respiration gases through the calorimeter 100 is illustrated by arrows A-H. In
use, when
a user exhales, their exhalation passes through the mask 104, through the
calorimeter 100,
and out to ambient air. Upon inhalation, ambient air is drawn into and through
the
calorimeter and through the respiratory connector to the user.
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Exhaled air passes through inlet conduit 110, and enters connected concentric
chamber 112. Excess moisture in a user's exhalations tends to drop out of the
exhalation
flow and fall to the lower end of the concentric chamber 114. Concentric
chamber 112
serves to introduce the respiration gases to the flow path 116 from all radial
directions as
evenly as possible. Exhaled air flows downwardly through a flow path 116
formed by the
inside surface of the flow tube 118. Exhaled air enters outlet flow passage
120, via
concentric chamber 122, and passes through the grill 124 to ambient air.
Flow rates through the flow path 116 are determined using a pair of ultrasonic
transducers 126 and 128. An oxygen sensor 130, in contact with respiratory gas
flow
through opening 132, is used to measure the partial pressure of oxygen in the
gas flow.
Integration of oxygen concentration and flow rate allows inhaled oxygen volume
and
exhaled oxygen volume to be determined. The metabolic rate of the user is
determined
from the net oxygen consumption; the difference between inhaled and exhaled
oxygen
volumes. Metabolic rate is determined using either a measured or assumed
respiratory
quotient (the ratio of oxygen consumption to carbon dioxide production). For a
user at
rest, the RMR (resting metabolic rate) is determined. The RMR value is shown
on display
109, behind window 108
Preferably, the indirect calorimeter used in embodiments of the present
invention
comprises a respiratory connector such as a mask or mouthpiece, so as to pass
respiration
gases as the subject breathes; a~ flow pathway between the respiratory
connector and a
source and sink of respiratory gases (such as the atmosphere) which receives
and passes
the respiration gases; a flow meter configured to generate electrical signals
as a function
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of the instantaneous flow of respiration gases passing through the flow
pathway, such as
an ultrasonic flow meter; and a component gas concentration sensor, such as a
fluorescent
oxygen sensor, which generates electrical signals as a function of the
instantaneous
fraction of gases such as oxygen and/or carbon dioxide in the respiration
gases they pass
through the flow pathway, such as the indirect calorimeter described above.
The user's
resting metabolism can be measured at repeated time intervals using the
indirect
calorimeter. The user breathes a multiple of inhalations and exhalations
through the
indirect calorimeter, so that the inhaled air and exhaled gas passes through
the indirect
calorimeter, the inhaled air volume and the exhaled flow volume are integrated
with the
instantaneous concentration of ~. oxygen, and so the exhaled, inhaled, and
consumed
oxygen are determined. The component gas concentration sensor can be omitted
if the
molecular mass of respired gases is determined using an ultrasound method, in
which
case oxygen volumes consumed can be determined using ultrasound without a
component gas sensor. Other indirect calorimeters can be used in embodiments
of the
present invention, for example such as described in U.S. Patent Nos.
4,917,104;
5,038,792; 5,178,155; 5,179,958; 5,836,300, and 6,135,107 all to Mault, which
are
incorporated herein in their entirety by reference. The indirect calorimeter
can also be a
module which interfaces with the PDA. The display, buttons, and process
capabilities of
the PDA are used to operate ~ he module, display instructions for use of the
indirect
calorimeter, initiate tests, and record data.
Figure 10 shows an improved weight loss program in which an indirect
calorimeter is used to monitor the metabolic rate of the user at intervals.
PDA 10 receives'
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data at intervals from the indirect calorimeter 100, related to the metabolic
rate of the
user. The data can be transferred by a wired or wireless connection, by manual
input, or
by exchange of memoiy modules. PDA 10 receives a signal related to physical
activity
related data from activity sensor 16. The user weighs themselves using scales
18 and
enters or otherwise communicates the data to the PDA 10, for example on, a
daily basis.
The PDA is in communication with a communications network 20 allowing data to
be
exchanged with remote computer system 30, as discussed in detail above.
In the preferred embodiment, the PDA is provided with calorie management
software as described above. Before the start of the weight control program,
the
metabolic rate of the user is measured using the indirect calorimeter,
preferably the gas
exchange monitor invented by James R. Mault, M.D. et al. The user start weight
is also
entered. Goals are entered, for example a planned weight loss rate. Using RMR
and
estimated activity levels, a caloric expenditure is advised. A suggested
level.of activity
related energy expenditure is provided, and converted to a suggested exercise
program,
1 S for example exercises suggested each day or every few days.
Weight loss programs often fail due to the user's fall in resting metabolic
rate in
response to diet. The indirect calorimeter invented by Mault et al. allows a
solution to
this problem to be provided. The user's metabolic rate is measured at
intervals during the
diet program. Experiments have shown that metabolic rate often falls
significantly after
the onset of a diet. Hence, even if caloric intake is decreased, total energy
expenditure
may also fall, leading to,a failure of the weight control program despite good
faith efforts
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of the user. Hence, measurement of resting metabolic rate at intervals is
beneficial in a
weight control program.
It should be noted that the response of resting metabolic rate to diet is
unpredictable, so that it is not accurate to use the Harris=Benedict equation
(or similar
equations based on height, weight, age, and gender) to estimate RMR after the
onset of a
diet. In conventional weight loss schemes, resting metabolic rate is estimated
using the
Harris-Benedict equation, which may indicate a fall in resting metabolic rate
corresponding to a fall in weight of the person. However; weight loss may be
related to
water loss, fat loss, or some other change which is, not correlated with
metabolic rate
changes.
Hence, ~in the improved' weight loss .program described here, resting
metabolic
rate; is measured at intervals, for example every day during the first week of
a weight loss
program. Data is transmitted to the server software over the communications
link, which
processes the data so as to determine appropriate feedback. If collected RMR
data shows
a significant fall during the time of the weight control program (from
historical pre-
program values (or the starting value) to the current value of RMR), it is can
be beneficial
to increase the activity of the person. The server software may provide
suggestions of
how to improve activity related energy expenditure (AEE) to the user over the
communications network. Feedback may advise a further reduction in caloric
intake.
However, both increased activity and reduced caloric intake can initially lead
to a further
reduction in resting metabolic rate. Hence, it is important to monitor RMR
closely, for
example on a daily basis, after a change in dietary or activity parameters. It
may be
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necessary to reduce the weight loss goals of the diet program to avoid failure
and
demoralization of the user. Preferably, a combination of increased activity
and reduced
caloric intake is used to restore the calorie deficit to a required value to
achieve the set
weight loss goals.
Preferably, activity is used to increase TEE if RMR falls. Activity can help
restore REE to previous levels; or even higher. If muscle mass is restored or
increased,
metabolic rate may be returned to the original value or increased.
The calorie management software on the PDA calculates calorie balance using
the
latest measurement of resting, metabolic rate of the user. Data
synchronization with the
server software, over the communications network, is used to provide the
latest calorie
management data to the server software.
The application program on the remote computer (server software) receives the
calorie management data from the PDA at intervals, the data comprising caloric
intake
data, activity data, body weight, and resting metabolic rate of the user. The
server
software analyzes the data in relation to the probability of the user meeting
weight goals,
and provides feedback to the user over the communications network. For
example, if the
resting metabolic rate of the user falls in response to the weight control
program, the
server software will provide feedback to assist the user meet a weight goal in
view of the
changing RMR. No conventional weight control system allows this. For example,
the
caloric intake allowance may be decreased, activity levels increased, weight
goals may be
modified, or some combination suggested. The user may enter an interactive
dialog with
the server software, or a human advisor, over the communications link, so as
to establish
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new diet parameters. A database of previous RMR responses to changed diet
regimens
may be maintained on the remote computer system, allowing the server software
to act as
an expert system. For example, it may be determined that the resting metabolic
rate of
specific demographic groups is likely to respond positively to exercise, so a
user within
those groups would be encouraged to exercise more. Certain compounds are
believed to
increase metabolic rate; such as phosphates (as discussed in U.S. Patent No.
6,113,949 to
Brink), and these may also- be recommended in certain circumstances. Other
compounds
may also be recommended, such as appetite suppressants, diet additives to
impede fat
absorption, stimulants, and the like. The user's response to known and
suspected
metabolism enhancers and other dietary supplements can be quantified using the
GEM,
and the results used in developing a diet program. Medical supervision can be
provided
as necessary. Advantages of the server software system described here include
the ability
of the weight control business administering the program to monitor the effect
of given
advice, continually update advice algorithms based on effectiveness, and the
ability to
alert health professionals if necessary.
The signal provided by physical activity monitor 16, exercise machine data, or
physical activities having defined parameters can be correlated with total
energy
expenditure (TEE) using an indirect calorimeter, and hence with activity
related energy
expenditure (AEE = TEE - REE). This is described more fully in co-pending
application
09/684,440, which is incorporated herein in its entirety by reference. For
example, a
version of the Gas Exchange Monitor equipped with a face mask is worn during
an
activity. AEE is determined using the' indirect calorimeter. For example,
after REE of the
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user is determined, the indirect calorimeter is switched into "activity mode"
in which the
increase in energy expenditure due to activity (AEE) is displayed. AEE is then
correlated
with one or more exercise parameters (such as treadmill speed, treadmill
gradient,
walking speed, running speed, step rate during e.g. running on the spot or
other exercises,
specific exercise repetitions, exercise intensity, and the like), one or more
activity
monitor parameters (such as pedometer signal, accelerometer signal, exercise
machine
data, exercise repetition monitor, signals from multiple devices; and the
like), or with one
or more physiological parameters (such as pulse rate, body temperature,
surface (skin)
temperature, skin conductivity, respiration noise level, respiration
frequency, and the
like). The correlation or correlations determined are then used to determine
AEE during
an activity from one or more measured parameters as discussed above. AEE can
also be
determined for general work or recreational activities, such as typing,
computer work,
driving, or other. user activities.
Figure 11 shows PDA 10 synchronized at intervals with personal computing
device 22. The PDA is docked, wired, interfaced, or otherwise
iriacommunication with '
the computer 22, so that data can be transmitted between the PDA 10 and the
computer
22. Computer 22 is connected. to communications network 20, and is used to
display
audio-visual feedback from content provider (or feedback provider) 140, the
content,
feedback, or other critical messages being provided to the user based on the
user's
progress towards health goals, such as weight loss.
The computer 22 is preferably a conventional desktop personal computer, but it
can also be an entertainment device, a web TV, Internet appliance, interactive
TV, or
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some other electronic device, preferably having display capabilities and a
communications link to communications network 20. Calorie management software
operable on computer 22 may be used to create the diet log for the user. The
PDA 10 can
be used to capture data such as voice records, times of meals, times of
exercise, exercise
nature, exercise intensity, images of food, barcodes, product identification
using optical
character recognition, purchase information, menu descriptions, and the like.
The
improved display capabilities and data entry mechanisms of the computer 22
facilitate
creation of the diet log and collation~of calorie management data. An
activity.log can also
be created on computer 22. Calorie management software running on the PDA is
used to
record the food eaten and activities; for example, this can be achieved by
recording the
times of meals and activities along with possibly an accompanying voice memo
or image,
and the times and accompanying data are then be used as memory prompts when
creating
a full diet log on the computer 22 at a later convenient time.
Data is transferred to the remote computer system 30 at intervals. Data is
then
synchronized between the computer 22, the remote computer system 30, and PDA
10.
Calorie management data, is sent to the server, and revised goals, programs,
activities or
other feedback data are transmitted from the remote computer system 30 to the
computer
22 and PDA 10. The synchronization of data between the computer 22, PDA 10,
and the
remote computer system 30, is an important aspect of this invention. The PDA
10 is
synchronized with the computer 22, so that revised goals are shown on software
running
on the PDA, for example to provide reminders to exercise, reminders of goals,
and meal
plans.
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A conventional diet measures success in terms of weight loss in pounds.
However, the nature of the weight loss is important to the long-term success
of the diet.
For example, if weight loss is achieved through water loss, the water is
replaced quickly
and no long term weight loss is achieved. If muscle tissue is lost, the
situation is even
worse as this causes the user's resting metabolic rate to fall over the long
term, and if the
user returns to pre-diet caloric intake, the weight will be regained and then
additional
weight is likely to be added. This is an extremely unsatisfactory situation
which
commonly occurs with conventional weight loss programs.
Hence, an improved diet success parameter M may be defined which takes into
account the benefits of increased metabolic rate, fat loss, fitness increase,
cardiovascular
health improvement, stamina improvement, strength improvement and the like.
For
example M can be defined as:
M=aW+bR+cF
where W = weight loss, R = resting metabolic rate increase, F = body fat mass
loss, and
a, b, and c are numeric parameters preferably chosen to put M in a convenient
numeric
range such as 0-100.
A diet can be a success even if no weight is lost, for example if body fat is
lost
and the user's metabolic rate increases. In a conventional diet program, a
lack of weight
loss is considered a failure. However, by increasing RMR, a person will then
subsequently lose weight slowly with a caloric intake equal to the level
needed to
maintain weight at the previous RMR.
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RMR is preferably measured using an indirect calorimeter, such as the Gas
Exchange Monitor discussed earlier. An indirect calorimeter is preferably used
in the
weight control systems described here to assist in, determination of caloric
balance. The
indirect calorimeter data can then also be used in the determination of an
improved diet
success parameter.
Body fat percentage can be determined using bioimpedance, for example using
scales available commercially from various sources, such as the Tanita
Corporation of
Japan. Body fat percentage cari also be determined using an indirect
calorimeter. The
RMR of the person is related to their muscle mass, since the fat cells do not
significantly
contribute to the metabolic rate of the person. Hence, body fat percentage can
be
calculated using the user's height, weight, and the user's measured RMR.
Hence, the Gas
Exchange Monitor can be used to track the success of a diet, as well as used
to modify
the weight loss goals of a diet. If needed, the diet success parameter is
calculated by the
calorie management software resident on the PDA.
An indirect calorimeter may be provided at a doctor's office, weight loss
business
office, gym, public location such as a drugstore, and the like.
Figure 12 shows a system configuration suitable for use in situations in which
an
indirect calorimeter is provided at a location such as a doctor's office.
Figure 12 shows an
indirect calorimeter 100 providing data to physician's computer 150. A
physiological
monitor 152 is also connected to physician's computer 150. The user's PDA 10,
user's
personal computer 22, remote computer system 30, and physician's computer 150
are
connected to communications network 20.
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Data from the indirect calorimeter 100 is communicated to a computer 152
located at the doctor's office (the physician's computer). After review and
analysis, the
data is transmitted via the communications network 20 to the remote computer
30.
Synchronization of the PDA 10 with the server 30 over the communications
network 20
allows the RMR data to be updated on software running on the PDA. Other
medical
information can be entered into the physician's computer 150, sent to a
database on
remote computer system 30, and synchronized with the PDA. This system can also
be
used for an improved method of conveying the results of medical tests to a
patient.
Additional physiological data obtained out at the doctor's office, such as
cardiovascular
testing, can be transferred to the database on remote computer system 30.
The PDA can be used in the purchase of goods; such as over a communications
network or at a physical location such as a store. For example, the PDA can,
enable the
purchase of goods or services via the authorized debiting of a bank account.
The PDA
display may provide an image of the user for identification, and the user
could provide an
electronic signature, identification number, or sign on an area of the display
of the PDA.
If the PDA is used to purchase food items, the food identity can then be
stored in the
memory of the PDA, and accessed by calorie management software for the purpose
of
creating a diet log.
Figure 13 shows a purchase system in which PDA 10 communicates with check
out system 162. The PDA 10, check out system 162, remote computer system 30,
and
bank computer 160 are connected to communications network 20, preferably the
Internet.
At the time of purchase, a communication is sent from PDA 10 to bank 160,
authorizing
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the debit of an account associated with the user to pay for the purchased
goods. The
check out system 162 transmits the identities of items purchased to the PDA,
and/or to
the remote computer system 30. The identities of food items are correlated
with
nutritional data, for example using a database on remote computer system 30,
for
S assistance with the creation of.a diet log.
Food items can also be purchased by conventional methods, and the nutrition
content of purchased goods transmitted to the PDA via a wireless method, IR
beam,
cable, optical character recognition, or barcode scanning. The identification
of the
purchased items can be stored on the PDA, or on a remote database, for example
on the
remote computer system 30.
Meals supplied by a vending machine may also be stored on the PDA if the PDA
was used in the purchase process, for example through initiation of food
dispensing and
an account debit. The identity of the chosen item is then subsequently used in
creating a
diet log.
The PDA may also have. a barcode scanner adapted to receive data from scanned
packages. The PDA may also be equipped with a wireless receiver to receive
data from a
food vending machine or a checkout machine at a grocery store.
In a further embodiment,.;the user is provided with a wrist mounted device,
having
a time display and buttons adapted to record the times of meals and
activities. These time
stamps act as a memory prompt at a later time when the user is compiling a
detailed.diet
', log and activity log.
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Figure 14 shows a schematic of a wrist-mounted device for inclusion into an
improved weight control or .health management program. The wrist-mounted
device,
shown generally at 170, has a generally rounded housing 172 in the style of a
wristwatch,
supported on the user's wrist by strap 174. A microphone 176 is contained
within the
housing 172, and provides a method of storing voice records on a memory
contained
within the housing 172. The wrist-mounted device has a mode button 178, a food
flag
button 180, a record/transmit button pair 182 and 184, an IR downlink port
186, a mode
display 188, a time display 190, an activity display (or exercise display)
192, and a food
display 194. A heart rate sensor (not shown) is provided on rear of the
housing, so as to
contact the wrist of the user and provide a signal related to heart rate of
the user.
The mode button 178 is used to switch between operating modes, which might
include time display only, pulse rate, time from the start of an exercise,
food display,
activity level display, combinations of the above, and other information.
The food flag button 180 is pressed when food is eaten. The time stamp (the
time
at which the button was pressed) is, used in creating a diet log at ,a later
date. The time
stamp data may be supplemented by recorded voice memos using the microphone.
The
recorded memos preferably have a time added, for assisting with diet log
creation.
IR downlink port 186 is used for data transfer to another device. This
comprises
an IR emitter and IR detector; so as to communicate with other devices using
an IR beam.
The transmit/record button pair (182 and 184) are pressed to initiate IR
communication
using port 186. Other wireless communications methods such as the Bluetooth
protocol
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can also be used for data transfer. Cable links or memory module transfers can
also be
used.
In the preferred embodiment, photo-plethysmography is used to determine the
heart rate of the user. An IR source is reflected from the wrist and used to
monitor the
heart rate. Other techniques known in the art may be used, for example
pneumatic
plethysmography, in which variations in pressure are monitored, impedance
cardiography, and phonocardiography.
Other physiological monitors which may be incorporated into the wrist-mounted
SAM include a blood glucose .'sensor, a temperature sensor, an accelerometer,
and the
like. An optical imaging device can be provided for recording digital images
of foods
consumed.
Figure 15 shows wrist-mounted device 170 adapted to transfer data to computer
22. Computer 22 is connected through communications network 20 to remote
computer
system 30.
In the improved weight control system, time stamps and voice memos recorded
on device 170 are downloaded to computing device 22, preferably using a cable
connection or IR link, and calorie management software running on computer 22
is used
to create a diet and exercise log using the data transferred from device 170
as memory
prompts. A PDA can be used in place or in addition to computer 22 for creating
diet and
exercise logs. Data communication with remote computer system 30 over network
20, for
assistance in achieving weight control goals, is as discussed above.
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In a business model, a health management company provides a diet logging
device, or diet logging software adapted to run on a device owned by the user.
Preferably, the user has a personal digital assistant (PDA) with diet logging
software
installed. Exercise log software can also be provided so to allow the user to
record time
durations and intensity of exercises performed.
A health management company, such as a weight loss company, supplies the user
with diet logging software, exercise log software, and access to an Internet
site.
Preferably, the user also has access to an indirect calorimeter, allowing the
user to
measure their resting metabolic rate at intervals. The health management
company may
sell the indirect calorimeter to the user; alternatively, it may be provided
as part of a
subscription towards a complete weight management program. The health
management
company may also sell disposables for use in the indirect calorimeter.
The health management business also provides the remote computer 30 and a
website accessible through a communications network. The health management
business
provides a software program running on the remote computer 30 adapted to
receive diet
log and exercise log data relating to the user, and further adapted to provide
feedback to
the user. Preferably, employees of the health management business can access
data
relating to a user for review and further feedback. The feedback to the user
can be
provided in a largely automated process involving a computer expert system.
Preferably,
the feedback is made more user friendly by generating for example an animated
human
face accompanying the audio advice. Appropriate video clips may also be
selected to
provide detailed feedback. Such computationally intense software is presently
better
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suited for running on the remote computer than on a handheld device, however
in the
future it may be possible to generate animations on the handheld device
responsive to
wireless communications from the remote computer. In relating to website
feedback, the
software receives caloric intake, activity related data, arid weight data of
the user. The
software generates a graph of caloric balance, weight, and other health
related parameters
against time. For example, a running caloric balance may be provided to
indicate the
user's success on a diet program. Alternatively, a day-by-day feedback may be
provided
in which days with a positive caloric balance are indicated as good, for
example using
colors or money symbols or weather-related symbols, whereas days with a
negative
caloric balance are shown as bad using appropriate symbols.
Feedback is related to the success of the diet program as shown by the user's
data.
If caloric intake is too high, the feedback may suggest meals which are
appropriate to
meet goals, for example using a database of meals located on server 30. If the
caloric
intake is within the goals of the program, but weight loss has not been
achieved, an
1 S activity schedule is suggested so as to help the user achieve their weight
loss goals. This
may be indicative of a fall in metabolic rate due to the effects of a diet
program on the
user's physiology, and if an indirect calorimeter is available, the feedback
would prompt
the user to measure their metabolic rate at a time in the near future. If
caloric intake is
apparently lower than the goals of the program, the weight gain or no weight
loss is
recorded, the feedback may again suggest measuring metabolic rate but may also
provide
feedback on sources of recording error. For example, the user may be under
recording
their diet, which is a particular problem if a large number of meals are eaten
out. The
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health management business may sell prepackaged meals, or may be affiliated
with a
company that supplies such meals, and the feedback may suggest the user
purchase these
meals in order to record a more accurate diet log. If caloric intake is lower
than the goals
of the program, and excessive weight loss has been achieved, the user will be
provided
with feedback on health risks of an accelerated weight loss program.
Using the communications network, the user can request information from the
server system 30 regarding metabolic rate, diet, nutrition theory, and
physiology. This
information can be provided as text, audio, or combined audiovisual
presentations
supplied from the remote computer system 30 and displayed on the PDA.
Feedback may also be provided using another device accessible by the user, for
example an entertainment device such as an interactive TV, web TV, Internet
appliance,
and the remote computer system will then provide the feedback on the other
device.
Medical information can also be provided by the feedback mechanism. The user's
physician or other authorized medical professional may also monitor the data
recorded in
the diet log and exercise log. The weight control business may supply foods,
advice, diet
plans, exercise programs, or services provided by affiliated companies. For
example,
recipe advice may be combined with automated online ordering of groceries from
an
online retailer of food, allowing the user to plan and order foods for the
next week's
menu. The software running on the remote servei also preferably performs a
nutritional....
analysis of the diet log record relating to the user, and recommends
supplements of
minerals, vitamins, proteins, amino acids, and other nutritional elements, for
example in
affiliation with nutritional supplement retailers.
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The software program on server 30 may also provide culturally sensitive or
allergy related feedback, for example recommending foods consistent with the
user's
chosen lifestyle. For example,.vegetarian meals, peanut free meals, or other
suitable diet
plans may be provided. The website may also be personalized in terms of the
user's
interests, for example providing up-to-date stock market reports or sports
reports to give
the user additional reason to check the site daily.
Software distribution mechanisms include provision of the user with a PDA
having preinstalled software, web download to a computing device already owned
by the
.;
user, distribution of CD-ROMs for installation on a PC and transfer of
software to a
PDA, memory stick or other memory module distribution, or other suitable
mechanism.
A weight control businesses may provide vending machines for prepackaged
meals. The PDA 10 can be used to order the prepackaged meals, providing an
authorization code, and billing the cost of the meal to the program. ; .
A fitness center allows a suitable source of interaction with the user. In the
preferred embodiment, the fitness center provides access to an indirect
calorimeter, such
as the gas exchange monitor. The user pays a subscription to the fitness
center for use of
the facilities, and this subscription can also include use of the indirect
calorimeter at
intervals. Alternatively, the fitness center or a supplier can sell disposable
elements for
use in the indirect calorimeter. ;
An exercise program is devised to improve the fitness, health and perhaps
reduce
the weight of the user. A fitness parameter can be defined and tested over
time. For
example, the use of heart rate response during an exercise routine can be
parameterized
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using one or more variable parameters, and these may be recorded as an
indication of the
fitness level of the user. The fitness level data is stored on the user's PDA,
or recorded in
a computer system provided by the fitness center.
The indirect calorimeter can be connected to the fitness center computer, so
as to
allow metabolic rate data to be stored. The user preferably logs into the
computer
system, so data relating to the user is stored in a local database. A fitness
advisor at the
gym can help set weight and fitness goals.
Health related parameters which can be tracked include body fat percentage,
metabolic rate, pulse rate and its response to exercise, the number of
exercise repetitions
achievable by the user, or some combination of the above or other parameters.
For a different exercise program, an indirect calorimeter adapted to be worn
by
the user during the exercise can be used to calibrate, the energy expenditure
of the user
;:
i.
during the course of the exercise. Equations inay be defined, which may be
individualized for the user, which give caloric expenditure in terms of
duration and
intensity of a particular exercise.
Diet planning can be achieved using a computer expert system or using the
advice
of a nutritionist affiliated with the fitness center.
An activity goal can be used to set the contents of the program. For example,
if
the user is planning to run a marathon at some time in the future, a goal of
improved
cardiovascular efficiency can be defined and progress towards that goal
tracked over
time.
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A respiratory monitor can also be used during exercise to detect respiratory
components indicative of fat metabolism, such as ketones, in particular
acetone. Acetone
production in the breath can be used as an indication of the onset of fat
burning, and can
be used in a weight control program to improve the efficiency of fat burning
in a weight
loss program.
The user accesses the fitness center website to monitor their progress towards
a
goal. The PDA or other hand-held device is carried by the user, and provides
information
so as to assist the user to reach any set goal, and provides advice on
nutrition and exercise
programs which may have previously been set. The conventional organizational
functionalities of the PDA can also be used to schedule appointments with
fitness trainers
and to schedule the start time and duration of planned exercises. The user can
access the
website provided by the fitness center to monitor progress towards their
goals. A fitness
trainer can be provided with a computing device such as a PDA. The device
preferably
runs software which can monitor the progress of several clients towards their
goals.
Software on the computing device allows the fitness trainer to set up
identities for a
number of users. The set up information might include name of ,user, start
weight, goal,
and any medical information relevant to the achievement of the goal. As the
user's
program progresses, data is synchronized to the fitness trainer's PDA,
allowing the
fitness trainer to monitor the progress of the various clients towards their
goal.
While the invention has been described with reference to a number of
embodiments, it will be understood to those skilled in the arts that the
invention is not
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limited thereto. The scope of the invention is to be determined by the
following claims
and their legal equivalents.
I claim:
