Issue No. 223: Apple's Metabolic Health Moonshot

Apple is pursuing a metabolic health moonshot.

Top Secret

Pushing deeper into healthcare, the tech giant is developing a needleless system for tracking blood glucose.

A secret project 12 years in the making, the company has made strides toward bringing glucose monitoring to Apple Watch, according to Bloomberg.

Smart sensors. Essential for diabetes management, continuous glucose monitors (CGM) are quarter-size sensors affixed to the body by a tiny needle. Measuring blood glucose just beneath the skin, data is sent to an app for real-time tracking.

An improvement upon cumbersome methods like finger pricks, CGMs still have limitations, including accuracy, cost, and lifespan (devices are replaced every 7–14 days).

Lab-on-chip. Apple’s noninvasive CGM trades needles for new tech.

In short, the device beams wavelengths of light into the body. Any light not absorbed by glucose returns to the sensor, where an algorithm determines blood glucose levels.

Although an iPhone-sized prototype is in the works, perfecting a system small enough to fit in an Apple Watch is likely years away. In the meantime, tech innovation in diabetes care is heating up.

Metabolic Dysfunction

We’re in the midst of a metabolic health crisis.

One in 10 adults worldwide has diabetes, accounting for $966B of health expenditures in 2021.
93% of Americans are metabolically unhealthy, and up to 37% suffer from metabolic syndrome.
More than 120M US adults have diabetes or prediabetes, with rates of type 2 diabetes among children expected to rise 700% by 2060.

A positive step, technology has revolutionized diabetes care, introducing new methods for measuring blood sugar and administering insulin.

But, in a study of diabetes patients over the last 30 years, Johns Hopkins epidemiology professor Michael Fang found that innovation hasn’t produced better health outcomes.

In addition to lifestyle behaviors, insulin costs, and health insurance status, Fang speculated that tech advancements “aren’t getting into the hands of people who need them.”

All-access. Part of a broader healthcare strategy, Apple is evolving its smartwatch from an activity tracker into a medical device.

Similar to its built-in, FDA-approved ECG and AFib History features, by launching a noninvasive CGM, the company envisions an accessible, preventative approach to diabetes care.

Not alone, consumer startups like Levels, Signos, and Supersapiens tap CGMs for health optimization, weight loss, and sports performance. But, most CGM upstarts are simply a software layer reliant on an Abbott- or Dexcom-made device.

Focusing on hardware, a new crop of CGMs wants to dethrone the duopoly.

Publicly traded Know Labs uses radio wave technology to measure blood glucose via a palm scanner and wrist wearable.
HAGAR received breakthrough status from the FDA for its noninvasive radiofrequency (RF) GWave device in 2021.
GraphWear’s nanotechnology-based approach uses an electric field to detect glucose levels without breaking the skin.

Elsewhere… Biolinq has raised ~$200M for its glucose-sensing biowearable, and smart ring maker Movano teased proprietary glucose monitoring tech. But, noninvasive tech developer Rockley Photonics recently filed for bankruptcy.

A word of caution: According to analytical chemist and former Lifescan chief scientific officer John L. Smith, needleless CGMs still have a ways to go:

“To be quite candid, I don’t see anything that shows any greater promise than I saw 40 years ago, or 20 years ago, right now, in the optical measurement and spectroscopy areas.”

Looking ahead: In “leaking” this news, Apple is signaling its healthcare ambitions, challenging Big Tech counterparts on a new playing field. But, addressing the root causes, experts recently told Congress solving healthcare inequities and a broken food system should be the primary focus in the fight against diabetes.

🎙 On the Podcast

Ro co-founder & CEO Zachariah “Z” Reitano discusses the company’s path from selling ED pills to building a comprehensive DTC health platform.

We also cover: Ro’s new Body Program for obesity and the debate over prescription weight loss drugs.

Welcome aboard: The Fitt Insider Podcast is now presented by Jack Taylor, our exclusive PR partner.

Listen to today’s episode here

🏓 Developers can’t build pickleball courts fast enough

Pickleball’s growth is off the charts, and real estate developers are staking their claim.

A recent APP report estimated 36.5M adults played pickleball in 2022, up from 4.8M in 2021.
More conservatively, the SFIA’s report put the number at 8.9M players.

An area of agreement, despite 130 new courts opening each month, demand for the sport is outstripping the supply of venues — so increasing access is a top priority.

Game on. Wilson signed up as the title sponsor of Swing Racquet + Paddle, a 45-acre “Sportstainment” complex in North Carolina for tennis, pickleball, and padel. In addition to hosting more players, the equipment maker will test new AR/VR gameplay experiences.

The latest in a flurry of activity, companies are scaling up to capitalize on the pickleball gold rush.

YouFit Gyms partnered with pickleball matchmaking platform Break the Love to manage in-club booking, while Pickleheads added funding to develop the “OS for pickleball.”
Toss & Spin, provider of curated pickleball and tennis experiences, launched pickleball clubs for Shake Shack in Chicago and LA this year.
In March, the LA Galaxy will open a public multi-use recreational park on its stadium’s campus for 5v5 soccer, futsal, pickleball, and padel.

Not to be outdone, Life Time’s pickleball bet is panning out; the health club will host nine professional tournaments this year while seeking to operate 1K permanent courts by the end of 2024.

Punchline: A hit among first-timers and pros alike, pickleball’s popularity isn’t just good for business, it’s great for public health. As expansion continues, all signs point toward more growth ahead.

📈 Planet Fitness tops 17M members in latest earnings report

Announcing Q4 and full-year ’22 earnings, the budget gym chain notched big sales and membership gains:

Q4 revenue was $281.3M (+53.2%) with net income at $36.3M, a $30M YoY improvement.
Total annual revenue jumped 59.6% to $936.8M, with systemwide sales up 11.4%.
Planet Fitness opened 158 gyms, reaching 2.4K across the US, Canada, Panama, Mexico, and Australia.
As of year-end, total membership reached 17M, a 1.8M increase from 2021.

Talking growth. CEO Chris Rondeau said 6% of Americans over age 15 are now Planet Fitness members, a number he plans to double going forward.

Budget-friendly. The chain’s inflation-proof $10 membership has fared well amid cost-of-living increases. Following a similar playbook, other high-volume, low-cost (HVLP) chains, including Anytime Fitness, Snap Fitness, and Crunch Fitness have rebounded post-pandemic.

Back to business. According to Placer.ai data, it’s not a blip. In January, gyms saw a 23.3% YoY increase in traffic as consumers continue to prioritize personal health.

Of note, this trend extends beyond budget gyms, with other fitness operators like Xponential Fitness seeing similar boosts, despite higher prices.

Takeaway: At this rate, Planet Fitness is on pace to top $1B in revenue next year. But, as its bottom line grows, it will be interesting to see how many members actually show up… because the chain collects dues either way.

📰 News & Notes

Nix brings hydration-tracking app to Garmin devices.
Independent running brands Janji and Oiselle merged.
Wellness-obsessed travelers fuel a sleep tourism boom.
Fitt Jobs: Land your dream job in the health & fitness industry.
Pokémon gamifies sleep, readies sync with signature AR game.
Therabody launches wearable compression/vibration recovery sleeve.
Athletic Brewing, Super Coffee pioneer caffeinated pre-workout “beer”.
NCL taps Wahoo for athletes’ training. [Re-read: NCL Shakes Up Cycling]
Peoplehood, a relationship wellness studio from SoulCycle’s co-founders, is open.
Startup Q&A: Zen CEO Daniel James on achieving wellness through better posture.

💰 Money Moves

Headway, a marketplace for therapists, is in talks to raise ~$100M at a $1B valuation.
Sleep care company BetterNight raised $33M in a funding round led by NewSpring.
More from Fitt Insider: The Sleep Economy
BelliWelli, maker of gut-friendly snack bars, closed a $15.4M Series A round led by The Invus Group.
More from Fitt Insider: Our conversation with BelliWelli CEO Katie Wilson
Better-for-you beverage maker Remedy Drinks closed an undisclosed Series B round co-led by L Catterton and Kin Group.
More from Fitt Insider: Functional Beverage Boom
Digital fitness technology company Wexer acquired online fitness class platform Intelivideo.
More from Fitt Insider: Wexer Targets Hybrid Fitness
Health & nutrition school Institute of Integrative Nutrition (IIN) acquired Begin to Heal, a digital platform for holistic wellness and alternative medicine practitioners.
More from Fitt Insider: The Everything Coach
Vertical farming company Plenty landed $1B from REIT Realty Income to scale its physical footprint.
Healium, a stress and meditation tool leveraging VR, AR, and generative AI, raised $3.6M in a seed round.
CPG investor Starco Brands acquired plant-based meal replacement brand Soylent.
More from Fitt Insider: Meal Replacement Shakeup
DICK’S Sporting Goods acquired outdoor gear retailer Moosejaw from Walmart.
Pureboost, a clean-label energy drink mix, raised over $2.5M in crowdfunding.
More from Fitt Insider: Liquid Gold
DIH, developer of VR technology for physical rehabilitation, will go public via SPAC merger with Aurora Technology Acquisition Corp.
Indian DTC meat and fish marketplace FreshToHome secured $104M in a Series D round led by Amazon’s Smbhav Venture Fund.
Vytalize Health, a value-based care company for seniors, landed $100M in a Series B round.
Transcend Therapeutics, a mental health-focused biotech company, closed a $40M Series A led by Alpha Wave Global and Integrated Investment Partners.

Today’s newsletter was brought to you by Anthony Vennare, Joe Vennare, and Ryan Deer.