Interchangeability of research and commercial wearable device data for assessing associations with cardiometabolic risk markers

Introduction: While there is evidence on agreement, it is unknown whether commercial wearables can be used as surrogates for research-grade devices when investigating links with markers of cardiometabolic risk. Therefore, the aim of this study was to investigate whether data from a commercial wearable device could be used to assess associations between behavior and cardiometabolic risk markers, compared with physical activity from a research-grade monitor. Methods: Forty-five adults concurrently wore a wrist-worn Fitbit Charge 2 and a waist-worn ActiGraph wGT3X-BT during waking hours over 7 consecutive days. Log-linear regression models were fitted, and predictive fit via a one-out cross-validation was performed for each device between behavioral (steps, and light and moderate-to-vigorous physical activity) and cardiometabolic variables (body mass index, weight, body fat percentage, systolic and diastolic blood pressure, glycated haemoglobin, grip strength, estimated maximal oxygen uptake, and waist circumference). Results: Overall, step count was the most consistent predictor of cardiometabolic risk factors, with negative associations across both Fitbit and ActiGraph devices for body mass index (−0.017 vs. −0.020, p < .01), weight (−0.014 vs. −0.017, p < .05), body fat percentage (−0.021 vs. −0.022, p < .01), and waist circumference (−0.013 vs. −0.015, p < .01). Neither device was found to provide a consistently better prediction across all included cardiometabolic risk markers. Conclusions: Step count data from a commercial-grade wearable device showed similar associations and predictive relationships with cardiometabolic risk markers compared with a research-grade wearable device, providing preliminary support for their use in health research.