LVL is a hydration monitor from BSX, You might know that name from the company’s first product, the Insight lactate threshold monitor.
Why Monitor Hydration?
Think of LVL as the evolution of that technology, says BSX co-founder Dustin Freckleton, MD. “Lactate threshold was always a mid-range goal on the way to what we truly wanted to do, which was measure hydration,” he says. Freckleton’s interest is partly personal: in the midst of studying for med school exams, he suffered a stroke partly brought on by dehydration. Once recovered from the partial paralysis that resulted, he became intensely interested in the subject.
Past Freckleton’s own harrowing experience, BSX points to its own research that shows some significant declines in cognitive function and performance with as little as one or two percent dehydration (as a percentage of total body weight). It’s easy to write that off as bespoke research intended to buttress the company’s claims, but there’s a significant reservoir of independent clinical research that backs up the notion.
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Studies have correlated even mild dehydration—the same level that BSX focused on—to drops in short-term memory, reaction time, motor skills—even mood. But the methodologies and definitions within these studies differ, and the evidence is not uniform, skeptics point out. For example, there’s no single standard measurement for “dehydration”; total body water and plasma osmolality are two, but they’re not entirely interchangeable. Also, many of the studies focus on the effect of dehydration after a workout, not necessarily in everyday life.
But neither is anyone claiming dehydration is good for you. And, for many of us, exercise is a part of everyday life, and mild dehydration is a common effect of exercise. There, the science is a little more clear: dehydration has been strongly correlated with lower athletic performance, including faster time to exhaustion. So even if the science isn’t in total agreement, there is general consensus that being hydrated is generally better than the alternative.
BSX
How LVL Works
How does LVL work to quantify that? It’s similar to other fitness wearable technology like from FitBit or Garmin in that it operates via optical sensors. But most fitness wearables use sensing technology called photoplethysmography (PPG), based on an LED light that’s green in the visible spectrum. (It’s similar to the technology currently used in pulse oximetry.) But as a recent lawsuit against FitBit shows, there are concerns about whether it’s as reliably accurate as conventional heart rate straps, which measure electrical activity like an electrocardiogram.
LVL uses a technology called NIRS: near-infrared spectroscopy, which, like PPG, is also used in medical imaging. One key difference is that the red visible light that NIRS uses to penetrate the skin goes deeper into the body than PPG, which BSX says essentially produces better signal strength, for better accuracy.
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BSX says another benefit of that is it can allow LVL to monitor more physiological parameters, including hydration. So LVL is a hydration monitor, but it’s not meant to run alongside your current wearable, but rather replace it: LVL will also monitor heart rate, step count (via accelerometers, like other wearables) and sleep. BSX also hints at more capabilities not currently built into LVL, like respiratory rate and muscle oxygenation.
Is LVL Accurate?
That leaves two major questions, which won’t be answered at least until we get our hands on one and maybe some time after. First: is LVL accurately and reliably measuring hydration? Since there’s no single gold standard for how to measure hydration, LVL has to essentially pick a method of measurement—in this case, plasma osmolality—and then assign relative values off of that. Are you properly hydrated or dehydrated? If so, by how much? LVL shows that in a simple graphical readout on the unit, and pairs to a mobile-based app with a dashboard showing sleep and activity stats, as well as hydration recommendations.
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For this to work practically for users, the data has to be within a consistent range of error, and correlate to other measurements. (BSX says that in lab testing and development, it’s correlated the plasma osmolality measurement it takes with other methods, including lean body water, urine osmolality and body weight change.) For what it’s worth, BSX’s Insight lactate threshold monitor, which uses the same NIRS technology, was tested independently at Central Queensland University and found to be reliable, and the highly regarded DC Rainmaker blog also favorably reviewed it.
A cose-up of the LVL hydration monitoring system.
BSX
Is Hydration Data Useful?
The second question is far more open: we’ve never really been able to reliably measure hydration on broad terms, only in limited lab situations. What do we do with that information? The human body is roughly 60 percent water, but recommendations on how much we should drink to stay properly hydrated are typically vague, ranging from “drink when you’re thirsty” to the old eight-glasses-a-day chestnut.
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If LVL can accurately measure hydration, then there’s the very real question of how we begin to use that information. A parallel is the advent of power meters that offered independent left leg/right leg measurement. Coaches and fitters are still figuring out what that means on a practical level for training and bike fit, let alone utilizing the wealth of data that comes with something like Pioneer’s power meter that offers force vector data at 12 points on each pedal stroke. Hydration, thankfully, may be more simple: you’re either hydrated, or over-hydrated or dehydrated to some extent. The complexity comes in what that might mean.
If LVL can do what BSX claims, then it opens up an opportunity for researchers to dive in with a relatively low-cost way to study the issue, help define those terms, and offer some practical insight into what it means. And, if LVL works as advertised and proves to be more accurate, the technology it uses could have a significant effect on other wearables, which is estimated to become anywhere from an $18Bn to $34Bn market by 2020 (that’s a larger market than just fitness wearables, but does include the category). BSX will sell the LVL at launch for $199, in range of many current fitness wearables; backers of the current Kickstarter program get a discount, as is common with crowdfunding campaigns.
In touting the potential physiological parameters its NIRS sensing technology can monitor, BSX obviously has designs on firmware updates and subsequent products that could deepen the pool of data available to wearables users while also increasing accuracy. If LVL works, which of course we have to learn, then the self-examined life just got a closer examination.