Opinion: AI, Health, and Fashion

HOW SMART WEARABLES ARE REDEFINING DAILY LIFE

INTRODUCTION

In the last decade, consumer-oriented smart wearables have transformed themselves from niche curiosities to essential companions for millions worldwide. What began with simple pedometers and heart-rate monitors has grown into a dynamic ecosystem of intelligent devices. Today, smartwatches that can detect falls and call for help, fitness bands that track blood oxygen in real time, health rings that discreetly monitor sleep, smart socks which can monitor a baby’s health are seamlessly woven into daily life.

This transformation was fueled by miniaturized sensors, high performance but low power consuming processors, and advanced connectivity. As the market expands, people no longer just want a bunch of data; they expect guidance, personalization of their health data, and a connected experience that adapts to them.

EVOLUTION OF SMART WEARABLES WITH ARTIFICIAL INTELLIGENCE

The story of smart wearables is one of the rapid transformations that mankind has witnessed. What began as basic step counters and heart rate monitors in the early 2000s has now evolved into a multi-billion-dollar industry, blending health, communication, and lifestyle into a single wearable. Early pioneers like Fitbit turned everyday activity tracking into a global trend, while other global companies such as Apple, Samsung, and Xiaomi expanded the ecosystem with increasingly powerful and stylish devices. These companies were already a known household name around the world due to their other electronic products.

Over the time, wearables became multi-sensor hubs, integrating GPS, accelerometers, gyroscopes, barometers, and even electrocardiogram (ECG) sensors. This leap made it possible not just to track simply steps or calories, but to monitor and gain personalized insights about sleep cycles, stress levels, oxygen saturation (SpO₂), and overall cardiovascular health.

Today’s wearables extend far beyond fitness; it has become multipurpose. A smartwatch can notify you of emails, guide you with turn-by-turn navigation, make contactless payments while detecting irregular heart rhythms that could indicate atrial fibrillation (AFib). Fitness bands are favored by athletes for precision training metrics, while smart ring has become a discreet tool for tracking recovery and sleep quality.

The latest chapter in this evolution is AI integration. Apple Watch now can detect falls and car crashes1, Fitbit’s algorithm interprets sleep quality2, and Samsung’s Galaxy Watch can coach users on sleeping pattern as well as can detect sever sleep apnea3. Instead of merely collecting data, these devices provide personalized insights and adaptive recommendations, nudging users toward healthier habits.

In short, wearables have journeyed from being passive recorders of activity to becoming active companions – devices that not only monitor but also anticipate, advise, and adapt to the fast pace of everyday life.

NOTABLE EXAMPLES OF SMART WEARABLES

Apple Watch

As mentioned earlier, Apple introduced the “crash detection” with its Apple Watch Series 8. The feature leverages multiple sensors such as accelerometer, gyroscope, barometer, GPS, and microphone to detect severe vehicle collisions. Upon detection, it alerts the user and, if the user does not respond to, the watch then automatically contacts emergency services with the user’s location. There are multiple instances found online where users of Apple Watch have claimed that their lives have been saved due to this feature which alerted the emergency services on time.

A user can also use the ECG App4 with an Apple Watch to create, record, store, transfer, and display a single channel electrocardiogram (ECG), similar to a Lead I ECG. The app can analyze the waveform and determine whether it shows AFib or sinus rhythm. In addition to ECG functionality, the Apple Watch can also measure Oxygen Saturation (SpO2)5,6. The Blood Oxygen feature works through conventional pulse oximetry, shining red and near-infrared (IR) light into blood-perfused tissue to estimate SpO₂ levels.

Apple AirPods

Apple has also introduced a Hearing Aid Feature (HAF), a software-only medical application designed for use with compatible versions of AirPods Pro. This feature employs a self-fitting strategy, allowing users to adjust the settings to their hearing needs without requiring assistance from a hearing professional7. However, Apple has clarified that the feature is intended solely for adults aged 18 years and older with mild to moderate hearing loss8.

TJ Smart Gloves

The TJay smart glove, developed by the Indian startup Terrablue XT9, is a pioneering wearable designed primarily for the early detection and management of epilepsy. According to the company, TJay is “a glove capable of sensing electrical signals from the user’s body, keeping track of health, and providing insights into performance during sleep, work, or daily routines.” The glove integrates embedded sensors in the palm that capture signals and transmit them in real time to the cloud. An AI/ML-based software platform then analyzes this data to predict the onset of epileptic episodes, serving as both an early-warning system for patients and a decision-support tool for healthcare providers.

WHOOP Fitness Band

Founded in 2012, WHOOP Inc. has emerged as a game-changer in the smart wearable industry with its WHOOP Fitness Band. Unlike the Apple Watch, WHOOP Fitness Band does not feature an inbuilt display, instead it relies entirely on its smartphone app. Despite this minimalist design, the band continuously tracks key health metrics such as sleep, heart rate variability (HRV), resting heart rate, and respiratory rate to generate a personalized daily recovery score for users.

One of its most notable applications is the WHOOP Coach, an AI-powered feature built in collaboration with OpenAI. This tool delivers tailored health and fitness guidance, allowing members to ask personalized questions and receive data-driven recommendations for training and overall well-being10. Similar to the Apple Watch, WHOOP Fitness Band also incorporates an ECG function with an equivalent intended use11.

WHOOP has gained significant cultural traction as well, with endorsements from numerous celebrities and professional athletes12. Notably, several members of the Indian National Cricket Team have been seen wearing WHOOP bands, further solidifying its reputation as a premium performance-focused wearable13.

DE BROGLIE HYPOTHESIS

Just as the De Broglie Hypothesis revolutionized physics by demonstrating the wave-particle duality of matter, modern smart wearables are reshaping daily life through a similar duality. On one hand, they act as discrete, data-driven “particles,” meticulously monitoring health metrics such as heart rate, blood oxygen levels, activity patterns, sleep quality, and stress indicators. With the integration of AI algorithms, this data is no longer static: wearables now analyze patterns in real time, anticipate potential health concerns, and deliver personalized guidance – transforming them into intelligent, proactive health companions.

On the other hand, they spread as a fashionable “wave,” seamlessly blending into wardrobes and lifestyle choices. Sleek designs, customizable watch faces, and interchangeable wristbands allow wearables to reflect personal style, elevating them beyond mere gadgets to fashion statements. This fusion of utility, style, and intelligence has propelled smart wearables from niche tools into a global phenomenon shaping not only how we monitor our bodies, but also how we present ourselves to the world.

As the technology continues to advance, the boundaries between health, fashion, and self-expression grow ever more intertwined hinting at a future where wearables are not just instruments, but adaptive extensions of personal identity.

ALL IS NOT WELL!

There is no doubt that smart wearables have revolutionized the world. With the recent AI boom and rapid technological advancements, new opportunities continue to emerge. However, everything is not perfect; smart wearables also introduce numerous challenges into our daily lives.

CYBERSECURITY

The biggest challenge posed by smart wearables is cybersecurity. At the core of these technologies is data, which must be stored either locally on the device (or a paired smartphone) or synced to the cloud. Even when health data is stored locally, analyzing health trends typically requires an app, either provided by the manufacturer or a third-party developer. This process introduces multiple potential vulnerabilities that hackers could exploit to gain access to personal health information. When data is stored in cloud infrastructure, there is also a risk of breaches. While manufacturers generally implement robust cybersecurity measures, the risk can never be zero, and vulnerabilities will always exist.

MISBRANDING

It is not rare to see manufacturers making unapproved claims about their products. Sometimes, this may also stem from a lack of thorough evaluation of regulatory requirements. Two such examples are,

WHOOP Fitness Band for Blood Pressure Insight (BPI):

WHOOP recently received a warning letter from the US FDA14 after marketing the WHOOP Fitness Band as capable of delivering innovative Blood Pressure Insights (BPI) for a deeper understanding of personal well-being. However, such functionalities are classified as medical devices under regulatory frameworks in many countries, including the United States. WHOOP had not obtained prior approval or clearance from the FDA before promoting these features.

OWLET Smart Socks:

In 2021, Owlet Baby Care, Inc. received a US FDA warning letter15 after marketing their OWLET Smart Socks without prior FDA clearance. The product was promoted to track multiple indicators of a baby’s health – such as oxygen levels, heart rate, and total hours slept and provide trend insights. Based on this intended use, the FDA classified the Smart Socks as a medical device. Consequently, Owlet Baby Care had to withdraw the product from the market. Two years later, the company addressed the regulatory requirements and successfully received FDA clearance to sell the Smart Socks as a medical device.

    These examples are not isolated instances. Around the world, there may be several of such cases where companies are marketing products as general consumer applications that would otherwise be classified as medical devices.

    LIMITED ACCESS

    Although hundreds of thousands of smart wearables are available on the market, not all of them are accessible or affordable to everyone. Companies often prioritize launching products in larger markets with straightforward regulatory pathways. Unfortunately, even in the 21st century, regulatory requirements remain inconsistent across countries, limiting access to groundbreaking technologies.

    Additionally, many high-end smart wearables come with a significant price tag, which can be a major barrier in markets like India. While cheaper alternatives may exist, their accuracy and quality are often unverifiable, making it challenging for users to rely on them for health and fitness monitoring.

    FALSE POSITIVE

    It is important to acknowledge that even data from high-end smart wearables may not always be 100% accurate. It is the manufacturer’s responsibility to clearly communicate this limitation to consumers. For example, smartwatches with AFib detection capabilities have occasionally generated false alerts, leading users to seek medical attention unnecessarily16, 17.

    SUSTAINIBILITY

    Technology and fashion are constantly evolving, and most devices are replaceable. For example, the smartwatch you are wearing today may become obsolete or look outdated within a few years due to newer, upgraded models. As a result, consumers are more likely to replace their devices sooner, and older models often end up as electronic waste (e-waste). This cycle drives increased demand for raw materials and manufacturing of new devices, contributing to a larger carbon footprint.

    CONCLUSION

    Smart wearables are undeniably a major innovation, and the AI boom is raising expectations for greater accuracy and precision. Yet many manufacturers remain uncertain about when a wearable falls under medical device regulation. In our view, each market should establish clear criteria defining when a smart wearable is subject to medical device regulations. Manufacturers should also act responsibly on sustainability, and governments should strengthen oversight of smart wearables even when they are marketed primarily as lifestyle or fashion products. Consumers should understand that, in most cases, smart wearables complement rather than replace traditional diagnostic devices. Finally, we would like to note that, over the coming decade(s), the wave of smart wearables as fashion statements may begin to fade, whereas healthcare‑oriented wearables will gain momentum. However, broad affordability and access will remain open questions.

    Disclaimer: Although sources are cited throughout this article, the authors wish to emphasize that it is an opinion piece, not a research article. The views expressed are solely those of the authors and do not necessarily reflect the views of the institutions with which they are affiliated.

    Reference:
    1. https://support.apple.com/en-in/guide/watch/apd3a60b5576/watchos
    2. Haghayegh, S., Khoshnevis, S., Smolensky, M. H., Diller, K. R., & Castriotta, R. J. (2019, November 28). Accuracy of Wristband Fitbit Models in Assessing Sleep: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 21(11), e16273. https://doi.org/10.2196/16273.
    3. https://www.androidcentral.com/wearables/samsung-galaxy-watch/samsung-galaxy-watch-8-series-launch
    4. https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN180044.pdf
    5. https://www.apple.com/healthcare/docs/site/Blood_Oxygen_app_on_Apple_Watch_October_2022.pdf
    6. Windisch, P., Schröder, C., Förster, R., Cihoric, N., & Zwahlen, D. R. (2023, February 23). Accuracy of the Apple Watch oxygen saturation measurement in adults: A systematic review. Cureus, 15(3), e35989. https://doi.org/10.7759/cureus.35989
    7. https://www.fda.gov/news-events/press-announcements/fda-authorizes-first-over-counter-hearing-aid-software
    8. https://support.apple.com/en-us/120992
    9. https://www.teblux.com/tjay.html
    10. https://www.businesswire.com/news/home/20230926899032/en/WHOOP-Unveils-the-New-WHOOP-Coach-Powered-by-OpenAI-the-First-Wearable-to-Deliver-Highly-Individualized-Performance-Coaching-on-Demand
    11. https://www.accessdata.fda.gov/cdrh_docs/pdf24/K243236.pdf
    12. https://www.whoop.com/in/en/
    13. https://www.thecricketpanda.com/fitness-band-cricketers-wear/
    14. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/whoop-inc-709755-07142025
    15. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/owlet-baby-care-inc-616354-10052021
    16. Tran, K.-V., Filippaios, A., Noorishirazi, K., Ding, E., Han, D., Mohagheghian, F., Dai, Q., Mehawej, J., Wang, Z., Lessard, D., Otabil, E. M., Hamel, A., Paul, T., Gottbrecht, M. F., Fitzgibbons, T. P., Saczynski, J., Chon, K. H., & McManus, D. D. (2023). False atrial fibrillation alerts from smartwatches are associated with decreased perceived physical well-being and confidence in chronic symptoms management. Cardiology and Cardiovascular Medicine, 7(1), 97–107. https://doi.org/10.26502/fccm.92920314
    17. Lubitz, S. A., Faranesh, A. Z., Selvaggi, C., & McManus, D. D. (2022). Smartwatch-detected atrial fibrillation: The “value” in the positive predictive value. Circulation, 146(17), 1415–1424. https://doi.org/10.1161/CIRCULATIONAHA.122.062292

    Author

    Monoj Kalita, Ph.D.

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