If I had my choice of any smartwatch, I’d go for the Apple Watch. But I don’t have that option because it requires an iPhone and I use an Android. I was certainly impressed when I reviewed the Series 4 Apple watch back in 2018 when they first introduced the ability to do an on-the-wrist electrocardiogram (abbreviated as ECG or EKG), and I have no doubt that the newer models are even better.
But there are now some excellent alternatives that may not have as big an eco-system of available apps, but nevertheless deliver important features, including the ability to track key health and fitness data which is especially important in the midst of a pandemic.
At the moment, I’m wearing a $299 Fitbit Sense, but I recently had a chance to test the $228 Fitbit Versa 3, the $219 Samsung Galaxy Watch Active 2 and the much less expensive $54 Amazfit Bip U Health Fitness Smartwatch. All prices are current Amazon prices.
All of these watches can also display notifications, track a variety of exercise routines, and provide you with a sleep report analyzing the quality of your sleep and the amount of time spent in REM (light) sleep, deep sleep and time awake.
All of them can also track your heart rate, analyze the quality of your sleep and your blood oxygen — a measurement commonly referred to as Spo2 or oxygen saturation. Spo2 has become increasingly important since the start of COVID-19 because a low Spo2 can be an indication of respiratory problems associated with COVID. But there are plenty of other reasons why an Spo2 could fall below normal levels, according to the Mayo Clinic (tinyurl.com/spo2causes.
Like the newer Apple Watch, the Samsung and Amafit measure your Spo2 on demand while the two Fitbit models I tested measure it while you sleep, reporting each night’s low, high and average Spo2.
I liked the Samsung watch but some of its features only work with Samsung phones unless you’re willing to do some cumbersome hacks to make them work with other Android phones like my Google Pixel 5.
The other watches I tested work with nearly all Android phones as well as iPhones.
Like some versions of the Apple Watch, the Samsung and Fitbit Sense have the ability to take an ECG, a feature that’s not on the less expensive Fitbit Versa 3 or the Amazafit watch.
Fitbit Sense health features
I had trouble testing the ECG on the Samsung but found it easy to use on the Fitbit Sense. Simply run the app on the watch and place your index finger on the upper left side of the watch’s steel casing and your thumb on the lower right side. Sit still and you have your results in just over 30 seconds right on your watch with detailed analysis on the Fitbit phone app.
While it’s convenient to be able to take an ECG from your watch, the $84 Kardia Mobile Personal EKG is an affordable alternative. It’s small and pocketable and is FDA approved for EKG, atrial fibrillation, Bradycardia (slow heart rate), Tachycardia (fast rate) and normal heart rhythm in 30 seconds.
The Fitbit Sense also tracks your skin temperature each night to show how it varies from your personal baseline though I’m having trouble figuring out how this correlates to general health and fitness.
It also measures your breathing rate and Spo2 while you sleep.
Spo2 while you sleep
As I mentioned, all of the watches I tested measure Spo2 but, while the Apple, Samsung and Amazafit measure it on demand, the Fitbit Sense only measures it while you sleep. I first considered that to be a limitation but — if you need to measure Spo2 on demand, you can easily do so with an inexpensive pulse oximeter like the $18 Zacurate 500BL Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor, which is very easy to use and — as far as I can tell — accurate. I brought it with me to a doctor’s appointment and its measure was very close to what the nurse recorded on her device.
The advantage to the Fitbit’s overnight measurement is that it gives you data that you can’t easily get with a pulse oximeter that’s not designed to work while you sleep. Either way, it gives you a picture of your respiratory health. Overnight Spo2 is often lower than during waking hours.
The Sense also measures stress, though I didn’t find the feature all that useful. There is a passive measurement that is automatically reported in the app as well as the ability to actively take a measurement which requires you placing your palm over the watch face for at least two minutes — a process that found to be a bit stressful.
Fitbit Versa 3
The Fitbit Versa 3 looks and works very much like the more expensive Sense but lacks the ability to do an ECG or the stress analysis. The designs of the two watches are very similar and they are the same size. The Versa 3 also lacks the ability to do a stress analysis but — after using it on the Sense, I’m not sure it’s all that useful. Both the Versa 3 and Sense do a good job when it comes to tracking and recording sleep.
Premium and Google Fit
While you get basic information from any Fitbit, some of the data is only available to Premium users who pay $9.99 a month or $79.99 a year after a 3 month free trial, though there are programs where you can get it for free, including members of AARP’s Medicare program.
I wish the premium features were included at no charge and am hoping that it will after Google, which acquired Fitbit recently, fully integrates Fitbit into its offerings. What I’m hoping for is tight integration between Fitbit and Google’s free Fit app which already provides considerable data for users and could benefit from direct integration into data collected from Fitbit smart watches. I’m also hoping that Google — with its deep pocket — invests resources into transforming at least some Fitbit models into full-fledged smartwatches that can compete with the Apple Watch in terms of features and an app ecosystem.