Xconomist of the Week: Larry Smarr’s Quest for ‘Quantified Health’
A couple of months ago, the publisher and CEO of the weekly Strategic News Service Newsletter introduced an article by San Diego Xconomist Larry Smarr, saying, “This issue may be the most important Special Letter we have ever published.”
Smarr’s 23-page article, which takes up the newsletter’s entire Sept. 26 issue, is part scientific paper and part personal odyssey into what Smarr calls his “Quantified Health.” In the 10 years since he moved to San Diego to become founding director of the UC system’s California Institute for Telecommunications and Information Technology (CalIT2), Smarr has scrupulously measured and analyzed his own biological data. In his paper, Smarr writes, “What I have learned about myself both illustrates and foreshadows the ongoing digital transformation of medicine.”
Xconomy Biotech Editor Luke Timmerman previewed this personal experiment last year after Smarr gave a presentation in Seattle. Smarr tells me he initially began by simply charting his weight. “I really wasn’t paying attention to my weight and general health until I came to San Diego from Illinois in 2000,” he says. “Once I looked around at all the fit people here I realized I better pay attention or I might get sent back to the Midwest!”
Through the years, however, Smarr has expanded his survey to include regular blood tests to monitor more than 60 biochemical markers. He now keeps meticulous notes on his diet, exercise, and supplemental vitamins, saying, “I routinely use food and supplements to ‘tune my numbers’ to more optimal levels.” Smarr says he uses the BodyMedia armband and the Fitbit clip to measure his physical activity, caloric burn, and sleep efficiency. He uses the Zeo device to monitor his sleep patterns and the HeartMath‘s emWave Desktop program to measure his stress and train himself to relax.
In 2005, when Smarr detected unusually high levels of a key blood marker for inflammation, his scientific quest escalated to a whole new level of detail—one that included tracking multiple biomarkers in his own stool samples and even obtaining an analysis of his DNA. “Yet this is precisely what the digital revolution in healthcare is all about,” Smarr writes. “The combination of trend-revealing graphs of time series of individual biochemical markers, with population-wide comparisons to people with different health outcomes is transforming biomedical research and ultimately clinical care, into an entirely new paradigm. In this new world, we become personally responsible for monitoring our bodies, noticing deviations from trends, and making appropriate changes.”
I’ve heard Smarr describe CalIT2 as a “time machine” that offers a peek at the future of what IT technologies will be like in 10 years. Now he is providing a similar view into the future of digitally enabled genomic medicine with what he calls “a 10-year detective story of quantifying my body.” He recently agreed to answer a few questions about it.
Xconomy: You didn’t begin this as a scientific odyssey. Yet the extraordinary lengths and level of detail you’ve gone through is amazing. Was it a purely scientific inquiry, or did you feel a personal imperative to find answers to questions about your own health?
Larry Smarr: I really just followed my nose step by step. I started by getting a UCSD trainer and getting back into exercise, which I had neglected for 25 years. Then I read 30 or 40 diet books to better understand nutrition. Once I read Barry Sears, a PhD biochemist and author of the Anti-Aging Zone and related books, I began to realize there was a science of how your body works. That is what began my scientific odyssey.
X: You describe a series of revelations about key blood markers that to you were early warning signals, but were not embraced by your doctors. You also raise serious questions in your paper about the wisdom of taking powerful antibiotics. What were the most significant findings to you?
LS: It never occurred to me that you could easily follow dozens of chemical levels in your blood on a regular basis. Of the 60 or so I track, only one was way out of range, 5 times higher than the recommended upper limit. This was the complex reactive protein (CRP), which is a generic measure of inflammation. What struck me is that I was on a very low inflammatory diet and so how could my CRP be that high? Then I started taking stool samples as well, mainly just to get different chemicals to track. Imagine my surprise when I found my fecal Lactoferrin was 25 times higher than the recommended upper limit! I didn’t know what Lactoferrin was, but thanks to Google, I quickly found out that it was the definitive marker to determine if you had inflammatory bowel disease. When the CRP and Lactoferrin both lined up behind chronic inflammation, I knew I was onto something important.
X: You dryly note that a couple of your doctors called your findings “academic.” But there are no clinical studies that show charting CRP would be an early warning signal for anyone else, right? So how should we think about this?
LS: These are early days in the digital transformation of medicine. Fortunately, medical devices are getting much cheaper and more sensitive, so over the next few years it should become much easier for the average citizen to afford to track their key blood markers. It may well be that we see commercial startups arise that provide Internet consulting services on the type of questions you could ask your doctor given your blood screen results. Right now, many of my blood and stool tests are done through www.yourfuturehealth.com. I take my own stool samples and FedEx them in to a lab, then get the results over the Internet. The key is to track multiple markers and to combine the results in order to create a synthetic view of the functioning of your biochemical systems.
X: There is so much conflicting information online. How can ordinary people tell the difference between good healthcare advice and bad healthcare advice?
LS: This is certainly a real problem. However, like everything on the Web, branding is one of the solutions. When I want authoritative advice about medical issues I go to the Mayo Clinic, Cleveland Clinic, or the National Institutes of Medicine web sites. That gives me enough general knowledge that I am prepared to meet with my doctors and ask intelligent questions.
X: We seem to be moving into an era in which connectivity is everywhere and computing power is infinite. These are the technologies that help to make the “quantified self” possible, right? But how infinite can these IT resources really be?
LS: Right now there are probably 10 million processors in the Internet “clouds” of Amazon, Google, Microsoft, Yahoo, and Apple. My guess is that this will grow at least 100-fold in the next decade. In comparison the fastest supercomputer in the world today has only about a half-million processors. Also there are vast amounts of storage space co-located with the computing.
X: Can you recommend any readings in this area?
The Program: The Brain-Smart Approach to the Healthiest You by Kelly Traver and Betty Kelly Sargent
Fantastic Voyage: Live Long Enough to Live Forever by Ray Kurzweil and Terry Grossman
In Defense of Food: An Eater’s Manifesto by Michael Pollan
Superhealth by Steven Pratt, M.D.
The Anti-Aging Zone by Barry Sears