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What’s in the Pipeline for NAFLD and NASH Treatment? – Hep Treatment News

Oct, 28th 2020 12:57 pm, Article Recommended by Dr. J. Smith

A wide variety of different therapies are being studied for the management of fatty liver disease and its complications. Several experimental drugs, alone or in combination, were highlighted at the recent 2020 Digital International Liver Congress, convened by the European Association for the Study of the Liver (EASL).

Non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic steatohepatitis (NASH), areresponsible for a growing burden of advanced liver disease worldwide. Over time, thebuildup of fat in the liver triggers inflammation, which can lead to fibrosis (scarring), cirrhosis and liver cancer. A study by Zobair Younossi, MD, MPH, of Inova Health System in Falls Church, Virginia, and colleagues found that NAFLD/NASH is responsible for 26% of liver-related deaths in the United States, second only to alcoholic liver disease.

Developing treatments for NAFLD and NASH has proved challenging. Several drugs that appeared promising in early studies did not show significant benefits in larger clinical trials. With no approved therapies, management currently relies on lifestyle changes, such as weight loss and exercise.

Linked to obesity and diabetes, NAFLD/NASH is increasingly recognized as a manifestation of metabolic syndrome, characterized by abdominal obesity, high blood pressure, elevated blood sugar and abnormal cholesterol or triglyceride levels.

Several treatment approaches aim to improve liver health by targeting metabolic abnormalities associated with fatty liver disease.

Treatments under study for NAFLD and NASH include:

FXR Agonists

Last year, Intercepts FXR agonist Ocaliva (obeticholic acid) was the front-runner in the NASH pack thanks to promising findings from the REGENERATE study. But further results showed that although Ocaliva increased the likelihood of at least a one-stage improvement in fibrosis without worsening of NASHa common primary endpoint in fatty liver disease trialsit failed to meet the other main endpoint of improvement in NASH without worsening fibrosis.

In July, the Food and Drug Administration (FDA) declined to approve Ocaliva for NASH, suggesting its benefits might not outweigh the risks. Intercept argued that the totality of data support the drugs approval. Results presented at the liver congress showed that Ocaliva led to sustained improvement in fibrosis according to newer noninvasive assessments, including the FibroMeter index, FibroMeter plus liver stiffness by transient elastography, and FAST score, which incorporates markers of inflammation.

Also at this years conference, Vlad Ratziu, MD, PhD, of Piti-Salptrire Hospital in Paris, reported that a novel FXR agonist, Enantas EDP-305, showed promising results in the Phase IIa ARGON-1 study.

This study included 132 people with NASH-related fibrosis who had not yet progressed to cirrhosis. The mean body mass index (BMI) was in the range for obesity, and three quarters were being treated for type 2 diabetes. They were randomly assigned to receive 1 milligram or 2.5 mg of EDP-305 or a placebo for 12 weeks.

Participants in the high-dose EDP-305 group saw a significantly greater decrease in liver fat content, with 45% having at least a 30% relative reduction. The high dose led to reductions in ALT and GGT liver enzyme levels and C4, a protein involved in the complement immune response. But it also led to a small rise in harmful LDL cholesterol and a significant drop in beneficial HDL cholesterol.

The most common side effect was pruritus, or itching, which was reported by 51% and led to treatment discontinuation in 21% of participants who received the higher dose of EDP-305.

This trial confirms that FXR agonism is a valuable therapeutic target in NASH with strong antisteatotic effects and the potential to reduce inflammatory injury to the liver, Ratziu said in an EASL press release.

Another FXR agonist, Novartiss nudifexor, also showed promising results in a Phase II trial. This study included 121 people with NASH. The average BMI was in the range for obesity. If participants had diabetes, it had to be controlled with medication. The participants were randomized to receive one of two oral doses of nudifexor (50 or 100 mg) or a placebo.

At week 12, body weight decreased by about three pounds in the low-dose nudifexor group and by about four pounds in the high-dose group. The mean relative reduction in liver fat content was 29% in the low-dose group and 32% in the high-dose group. About 50% and 70% in the two groups saw at least a 30% relative reduction in liver fat. ALT declined significantly more in both nudifexor groups compared with the placebo group. LDL and triglyceride levels did not change significantly, but HDL decreased.

Treatment was generally safe, but side effects were common. About a third of people randomized to the high-dose group reduced their dose or discontinued treatment due to adverse events, but this did not occur in the low-dose group. The most common side effect was pruritus, reported by 30% in the low-dose group and 54% in the high-dose group.

Other Drug Classes

Philip Ambery, MD, of AstraZeneca, presented findings from a Phase IIb clinical trial testing cotadutide, a dual receptor agonist that modifies the activity of both glucagon and GLP-1.

This study included 834 people who had overweight or obesity, type 2 diabetes treated with metformin and evidence of fatty liver disease. They were randomly assigned to receive one of three doses of cotadutide (100, 200 or 300 micrograms) via once-daily injection, the diabetes drug liraglutide (a single-action GLP-1 agonist) or a placebo.

After 54 weeks, people taking cotadutide lost more weight and saw greater improvements in metabolic, cardiovascular and liver fibrosis biomarkers. Cotadutide was generally safe, but 41% of people taking the high dose experienced nausea, and 22% stopped treatment due to adverse events.

Ambery said the improvements in fibrosis are encouraging, noting that a Phase II study of cotadutide for people with obesity and NASH is underway using a higher dose with an optimized titration schedule in an effort to reduce side effects. (Read the full report here.)

Stephen Harrison, MD, of Pinnacle Clinical Research, in San Antonio, and colleagues evaluated aldafermin (NGM282), a genetically engineered fibroblast growth factor (FGF19) analogue from NGM Biopharmaceuticals. This Phase II trial included 77 people with NASH. They were ramdomized to received aldafermin or a placebo as a daily injection.

Aldafermin significantly reduced liver fat content by week 24, with 66% of participants taking the drug showing at least a 30% relative decrease. Whats more, 38% experienced at least a one-stage improvement in fibrosis without worsening of NASH, while 24% experienced NASH resolution without worsening fibrosis. Nearly a quarter (22%) achieved both endpoints.

Aldafermin was generally well tolerated. No one stopped treatment due to side effects, and rates of gastrointestinal symptoms and pruritus were not higher in the aldafermin group compared with the placebo group. (Read the full report here.)

Rohit Loomba, MD, of the University of California at San Diego, and colleagues evaluated TVB-2640, from Sagimet Biosciences, a first-in-class fatty acid synthase inhibitor.

The Phase IIa FASCINATE-1 trial included 99 people with evidence of NAFLD. They were randomized to receive one of two oral doses of TVB-2640 (25 or 50 mg) or a placebo. Median BMI was in the range for obesity; 76% in the low-dose group, 37% in the high-dose group and 55% in the placebo group had type 2 diabetes.

After 12 weeks of treatment, liver fat content declined significantly more in the high-dose TVB-2640 group compared with the placebo group. In the high- and low-dose groups, 61% and 23%, respectively, experienced at least a 30% relative reduction in liver fat compared to baseline levels.

ALT levels also fell, with 58% in the high-dose group achieving ALT normalization. Both LDL and HDL cholesterol dropped significantly in the high-dose group. This group also saw a 24% rise in levels of adiponectin, a hormone that regulates appetite and glucose and fatty acid metabolism. Finally, TVB-2640 led to reductions in biomarkers of fibrosis.

Treatment was generally well tolerated. Only 3% of people taking either dose of TVB-2640 experienced moderate side effects, and there were no severe adverse events. In particular, no one reported pruritus or elevated triglycerides.

Loomba said these findings warrant further studies to examine whether TVB-2640 will lead to NASH resolution and fibrosis improvement in people with biopsy-proven NASH.

Loomba also presented the latest results from a Phase IIa trial of VK2809, a thyroid receptor beta agonist from Viking Therapeutics. This study included 47 people with NAFLD and elevated LDL and triglyceride levels. They were randomly assigned to receive one of three oral regimens of VK2809 (5 or 10 mg every day or 10 mg every other day) or a placebo for 12 weeks.

Last year, Loomba reported that people taking VK2809 experienced significantly greater reductions in liver fat content compared with the placebo group. They also saw declines in LDL and ALT levels. Treatment was generally safe with excellent gastrointestinal tolerability.

This year, he reported that this effect was maintained four weeks after the end of treatment. Altogether, 70% of those taking VK2809 saw at least a 30% reduction in liver fat at week 16.

The consistency and durability of efficacy reported with VK2809 in this trial regardless of therapeutic dose, baseline patient characteristics or underlying NASH risk factors is encouraging, Loomba said in a Viking press release. Particularly noteworthy is that VK2809-treated patients with NASH risk factors, including elevated baseline ALT, obesity and hypertension, experienced reductions in liver fat that were significantly greater than observed among patients receiving placebo.

VK2809 is now being tested for people with biopsy-confirmed NASH and mild to advanced fibrosis in the larger Phase IIb VOYAGE trial.

Combination Treatment

Given the number of different biological processes that play a role in the development of NAFLD and NASH, many experts think optimal treatment may require combining therapies with different mechanisms of action.

Gilead Sciences Phase IIb ATLAS trial evaluated three of the companys fatty liver drug candidates alone and in various combinations in people with advanced fibrosis or compensated cirrhosis due to NASH. Selonsertib (GS-4997) is an ASK1 inhibitor, firsocostat (GS-0976) is an ACC inhibitor and cilofexor (GS-9674) is an FXR agonist.

As previously reported, the Phase III STELLAR-3 and STELLAR-4 trials found that selonsertib alone worked no better than a placebo for improving liver fibrosis or reducing the risk of cirrhosis; the selonsertib monotherapy arm of ATLAS was therefore discontinued.

Last December, Gilead announced that neither firsocostat or cilofexor monotherapy nor any of the two-drug combinations significantly increased the likelihood of achieving at least a one-stage improvement in fibrosis without worsening of NASH.

However, Loomba presented data at the recent conference showing that some of the single agents and combinations did lead to significant improvements in fibrosis and other measures of liver health, despite failing to meet the studys primary endpoint.

After 48 weeks of treatment, 21% of participants assigned to receive firsocostat/cilofexor and 19% of those taking selonsertib/cilofexor had at least a one-stage improvement in fibrosis without worsening of NASH. The likelihood of progression to cirrhosis was lower in all treatment groups compared with the placebo group.

The combination of firsocostat and cilofexor appeared most promising overall, with participants assigned to this regimen seeing improvements in NAFLD activity scores, noninvasive fibrosis tests, ALT and AST levels, insulin levels and body weight. All regimens were generally safe and well tolerated, but 28% of people who used firsocostat/cilofexor reported pruritus. (Read the full report here.)

Another drug that was in the running to be the first approved NASH treatment, Genfits dual PPAR alpha/gamma agonist elafibranor, was halted in July after itfailed to meet the primary endpoint of improving NASH without worsening fibrosis in thePhase III RESOLVE-IT trial.

However, a preclinical study presented at the liver congress showed that combining elafibranor with the GLP-1 diabetes drug semaglutide (Ozempic or Rybelsus) led to improvements in obese mice fed a high-fat diet. Mice that received the combination had decreased NAFLD activity scores, ALT levels and triglycerides in the liver. These effects were not seen when either drug was used alone. About 30% of the mice that received elafibranor showed reduced fibrosis, but this effect was not enhanced by adding semaglutide.

Immune Modulators

Immune-modulating therapies do not directly target metabolic processes involved in the development of fatty liver disease but rather aim to control the inflammation that leads to fibrosis.

Allergans cenicriviroc, which blocks both CCR2 and CCR5 receptors on immune cells, was previously studied as a treatment for HIV. In the Phase IIb CENTAUR trial, cenicriviroc did not lead to a decrease in liver fat or NAFLD activity scores in people with NASH, but it did reduce liver fibrosis significantly more than a placebo over 48 weeks. Long-term safety results presented at the liver congress showed that cenicriviroc continued to be safe and well tolerated for more than four years.

Another mouse study presented at the conference tested a novel dual CCR2/CCR5 blocker (BMS-687681) plus a fibroblast growth factor (FGF21) analogue (BMS-986171) being developed by Bristol-Myers Squibb. The CCR2/CCR5 blocker reduced inflammation and fibrosis; the FGF analogue reduced body weight, triglycerides and liver fat accumulation; and combining the drugs led to additive or even synergistic benefits.

Cenicriviroc is currently being studied as a treatment for people with NASH and moderate to severe fibrosis in the Phase IIIAURORA trial. Primary results are expected next year.

Finally, CytoDyn announced in July that it has launched a Phase II trial of its single-action CCR5 blocker leronlimab (PRO14) as a treatment for NASH, following promising preclinical data. The experimental drug is also being evaluated as a treatment for HIV, cancer and COVID-19.

Click here to learn more about NAFLD and NASH.

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What's in the Pipeline for NAFLD and NASH Treatment? - Hep Treatment News

PharmD Alumnus, Cornelius Toliver, strives to educate his patients on their condition and medication regime | Blogs | Campbell – Campbell University…

Oct, 28th 2020 12:57 pm, Article Recommended by Dr. J. Smith

Alumnus: Cornelius Toliver

Program: Doctor of Pharmacy

Undergraduate Institution: North Carolina A&T State University

Where are you currently employed: AdhereRx

Title: Pharmacy Manager

Tell us a little bit about how amazing your current position is and what you do. I am the pharmacy manager for AdhereRX Pharmacy in Cary, NC. It is the position I dreamed of having. I previously worked as a district lead for Walgreens, where I helped start their immunization program. I then began working at an independent pharmacy, collaborating with a primary care and serving patients through the pharmacy.

My career eventually took me to a 100% clinical position, where I taught diabetes education for over 500 patients. I was able to work as a clinical pharmacist practitioner helping manage my patients medications, while giving them the necessary tools to gain control of their chronic conditions. AdhereRx is a mail to home pharmacy. We deliver to over 40 states throughout the U.S. What makes AdhereRX special is that we focus on patients who currently take 5 or more medications. My goal as the pharmacy manager has been to bring innovation and care management to all our patients across the United States. This includes starting the first immunization program for AdhereRx, bringing compliance packaging for patients, and implementing care management with a team of diverse pharmacist.

The sky is the limit with AdhereRX, and I am energized to lead the charge with my team and build more of a care management pharmacy, focused on education of disease states, medications, and nutrition focused for our patients. Compliance packaging is a huge piece of increasing adherence measures, and the overall goal is to collaborate with providers and manage patients as a team. Transition of care is another piece we want to implement. I am honored to be a pharmacist and a proud Campbell graduate. I want to be a champion for our patients, university, and profession. I am proud to say we have several other Campbell pharmacists that work at AdhereRx who share the same passion.

Why did you choose CPHS and what benefits do you believe you gained from attending Campbell? I chose Campbell Pharmacy because of the small town atmosphere, the generosity of the faculty, and the Baptist based religion belief in which I was raised. I felt like I was a part of a family when I was on campus, and I still communicate with a lot of my faculty and classmates!

Please summarize your personal, business, and academic journey, please be sure to include info about underserved, practicum, awards won, promotions, national organization leadership positions, papers published, etc.

Bachelors of Science: North Carolina A&T State UniversityLettered 2 years: Collegiate Basketball at North Carolina A&TCEO: To-Live-Right Medication Management (This business I am starting) Health and Wellness, DSMME (Disease State Medication Management education) focused. Focused on changing the lives of patients.Pharmacy Manager (AdhereRx Pharmacy) we deliver to 44 states, I hold the pharmacy manager license for 28 of them.CDE: Certified Diabetes Educator LicenseCPP: Clinical Pharmacist PractitionerCNPR: Certified National Association of Pharmaceutical SalesAwards:Walgreens District Customer Service AwardWalgreens District Immunization Lead AwardWalgreens Champion AwardPhi Delta Chi Member

Please summarize any additional accomplishments you would like to highlight: I ran for my district NCBOP position and finished 2nd in the runoff. I plan to continue to run and be an advocate for our profession. I am passionate about patient care. My big drive is diabetes, considering that is a cornerstone of a lot of other chronic conditions such as hypertension and hyperlipidemia. I have developed a method called the Toliver approach, which I hope to publish one day. I believe in teaching the patient about their disease states in a language they understand. Helping them create goals and determine how to reach them is important. I want to motivate patients to want to live a healthier life.

The Toliver approach focuses on teaching the patient about their medication regimen. What does the medication do to help with whats happening with their condition? When you educate the patient first on the condition, and then teach them the medication, the patient is more likely to be adherent. That is the Toliver approach. Another goal I have is to write childrens books that focus on chronic conditions such as diabetes, hypertension, obesity, and hyperlipidemia to name a few. Introducing this at a young age can help kids understand the value of proper nutrition and being physically active.

At Campbell we believe in purposeful lives and meaningful service. What legacy are you leaving? I want to leave a simple legacy: Cornelius Toliver simply loved helping people feel great about themselves and achieve their goals. My goals are geared toward helping other people achieve their goals. That could be helping a patient lose weight, and not having to take as many medications. That could be mentoring a pharmacy school student who wants to become a better leader. That could be me being the best father to my kids so they can have the best life possible.

Reasons why prospective students should choose Campbell over other Graduate and Professional Schools. At Campbell, youre not just a number or a random person, youre family. Your faculty cares about you. I had personal setbacks while I was at Campbell and the Campbell team never once gave up on me. They supported me through those difficult times and I will never forget that. Even when I almost gave up on myself, they never did. That is why Campbell is the best choice: the support system.

Additional Comments: Attending Campbell, was the best decision I ever made. It has made me a better man, father, pharmacist, and friend. I cant say enough about the university and the faculty.

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PharmD Alumnus, Cornelius Toliver, strives to educate his patients on their condition and medication regime | Blogs | Campbell - Campbell University...

Scout Bio Advances Novel Gene Therapy for the Treatment of Feline Diabetes – BioSpace

Oct, 28th 2020 12:57 pm, Article Recommended by Dr. J. Smith

PHILADELPHIA, Oct. 28, 2020 (GLOBE NEWSWIRE) -- Scout Bio, a biotechnology company focused on revolutionizing pet medicine by delivering a pipeline of one-time therapeutics for major chronic pet health conditions, today announced it has initiated two pilot clinical studies to demonstrate effectiveness of an AAV expressing a GLP-1 analog (SB-009) in treating diabetic felines.

Scout Bio envisions two potential therapeutic applications for SB-009. First, to replace daily insulin injections with a single injection of SB-009 to treat feline diabetes and second to significantly increase the percentage of cats entering remission when SB-009 is given with insulin.

The two initiated pilot clinical studies will investigate each of these two potential treatment paradigms.

Mark Heffernan, Ph.D., Chief Executive Officer of Scout Bio remarked, This one-time injectable therapy for feline diabetes has the potential to provide a convenient single treatment that is an alternative to the burden of twice daily insulin injections. We believe SB-009 has the potential to be a blockbuster product for animal health and that our pipeline of gene therapy products for pets will disrupt and grow major markets.

SB-009 was developed under a collaboration between scientists at Scout Bio and the University of Pennsylvanias Gene Therapy Program, where the protein was engineered to improve potency, circulating accumulation kinetics and manufacturability. The design of SB-009 makes the clinical dose both affordable and commercially attractive.

Matthew Wilson, VP Product Discovery and External Innovation said, This is a further example of our strong collaborative relationship with UPenns Gene Therapy Program and Scouts internal capabilities of executing preclinical research to rapidly identify highly potent AAV gene therapies. In less than 12 months after initiating a discovery program, we are now in a position to transition into patients.

Scout Bio has conducted robust preclinical studies with various GLP-1 constructs in rodents and healthy cats. Key findings include:

Dr. Anne Traas, Scout Bios Chief Development Officer reflected, Owners can be devastated to learn their pet has this life-threatening disease and unfortunately, many are unable to give twice daily insulin injections and have to make the difficult choice to euthanize their beloved pet. A one-time safe and efficacious therapy, given by a veterinarian, that eliminates the need for insulin and worry of hypoglycemia, would greatly improve the current treatment paradigm and result in an improved quality of life for diabetic cats and their owners.

Feline diabetes, a severe disease lacking recent innovation, remains a major challenge for veterinarians and owners to safely and effectively manage. Diabetes in most cats is similar to type 2 diabetes in people. Insulin resistance, caused by factors such as obesity, leads to Beta-cell disfunction (the cells that produce insulin). Cats become insulin dependent when blood sugar levels rise, commonly 3-10 times normal, leading to the development of clinical signs which can seriously and negatively impact both the owner and the cat. The most common signs are increased drinking, increased urination and weight loss despite ravenous appetite.

About SB-009 SB-009 is a recombinant AAV gene therapy viral vector utilizing a novel capsid expressing an engineered feline GLP-1 agonist for the treatment of feline diabetes. GLP-1 has been shown to be a safe and highly efficacious molecule in the treatment of humans with type 2 diabetes and SB-009 is the first gene-therapy delivered GLP-1 to be studied in clinical studies in cats with a view to treat the disease.

The expressed feline GLP-1 analog protein functions by stimulating the beta-cells in the pancreas to produce more insulin and may also have an effect in decreasing insulin resistance. GLP-1 receptor agonists do not decrease glucose levels in animals with normal blood glucose, so there is expected to be a very low, or no risk of hypoglycemia.

About Feline DiabetesMost diabetic cats appear to have disease similar to human type 2 diabetes, which is primarily defined as a combined problem with insulin production by the beta-cells in the pancreas, as well as a decrease in the sensitivity to the normal action of insulin (insulin resistance). In cats, one of the most common factors contributing to insulin resistance is obesity which reduces insulin sensitivity.

Lack of insulin production and decreased sensitivity to insulin causes the glucose (sugar) in the blood to become very high leading to the clinical signs. Very high levels of blood glucose also hurt the beta-cells in the pancreas, leading to further reductions in insulin production.

Substantial progress has been made in the treatment of human type 2 diabetes, even in the early stages of the disease. However, insulin therapy remains the only FDA-approved treatment for diabetes in cats.

About Current Treatment | Feline DiabetesCurrent therapy aims to replace the insulin that the cats body no longer makes by injecting insulin twice daily. Giving insulin in the right amounts may bring the blood sugar levels down. If the blood glucose can be brought under control for the majority of a 24-hour period each day, then the clinical signs will be reduced to manageable levels. Too much insulin can cause the blood sugar to drop to dangerous levels (hypoglycemia), so there has to be a careful balance made between maintaining ideal blood glucose levels andadministering too much insulinwhich may result in life threatening low blood sugar levels.

Often owners find the prospect of administering injections to their cats daunting and the strict regimen of twice daily injections and feedings can be difficult to fit into a busy lifestyle. Unfortunately, not treating the cats is simply not a viable option and usually results in a rapid decline in physical health. Even with insulin treatment, some cats diabetes is not well controlled, resulting in the continuation of clinical signs and/or euthanasia.

About Diabetic RemissionGood control of blood glucose may also allow the beta-cells to rest. That rest may increase their capacity to regain some of their insulin-secreting ability. Insulin administration helps to decrease and control the excess blood glucose levels and complement whatever insulin producing ability the cat has left. In some cases, cats regain enough function to allow the insulin injections to stop. This is called diabetic remission. A cat is determined to be in remission when blood sugar is normal and there is complete correction of clinical signs once insulin has been discontinued.

About Scout BioScout Bio is a biotechnology company focused on revolutionizing pet medicine by delivering a pipeline of one-time therapeutics for major chronic pet health conditions. Scout Bios therapeutics are designed to induce long-term expression of therapeutic proteins in pet patients using AAV vector technology. Scout Bio has an exclusive research and development collaboration with the University of Pennsylvanias Gene Therapy Program. Scout Bios innovative partnerships build on a 20-year history with AAV leaders and is complemented by Scout Bios global leaders in gene therapy research and development. Scout Bio is a private company headquartered in Philadelphia, Pennsylvania. For more information, see http://www.scoutbio.coFor further information, please contact:

Investors:Sarah McCabeStern Investor Relations,


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Scout Bio Advances Novel Gene Therapy for the Treatment of Feline Diabetes - BioSpace

Echosens Supports October 2020 Liver Cancer Awareness Month: Cites Link to Nonalcoholic Fatty Liver Disease and Importance of Early Detection -…

Oct, 28th 2020 12:57 pm, Article Recommended by Dr. J. Smith

WALTHAM, Mass.--(BUSINESS WIRE)--Echosens, a high-technology company offering the FibroScan family of products, urges increased awareness of the rise of liver cancer rates, which have more than tripled since 1980, while death rates have more than doubled during this time. About 21,000 Americans are diagnosed with primary liver cancer each yeartwice as common in men than in women. Risk factors include other liver diseases, including cirrhosis, chronic hepatitis B, chronic hepatitis C and non-alcoholic fatty liver disease (NAFLD). NAFLD may be a key driver of increased cancer associated with obesity, while non-alcoholic steatohepatitis (NASH) is the fastest growing cause of liver cancer among transplant candidates.

People with NAFLD have higher rates of several types of cancer, with the greatest increase seen for liver cancer and other gastrointestinal cancers, says Jon Gingrich, CEO, Echosens North America. Point-of-care examinations, monitoring and ongoing assessment of liver fat and stiffness as provided by FibroScan, a rapid, non-invasive point of care examination, can identify individuals who are asymptomatic and undiagnosed for liver damage.

Researchers have found that liver cancer, NAFLD, hepatitis C and liver transplants are prevalent in 40-80% of people who have Type 2 diabetes and in 30-90% of people who are obese. Being overweight or obese is responsible for about 85% of fatty liver disease.

Approximately 30,000 people die from liver cancer each year and these numbers have continued to rise in recent years, says Lynn Gardner Seim, Executive Vice President and Chief Operating Officer, American Liver Foundation. It is essential that patients at risk for liver cancer, including those who have previously been diagnosed with hepatitis C, NAFLD, NASH and other liver diseases, talk with their doctors and have a plan in place for getting screened.

Traditional approaches to assessing liver health, such as liver biopsy and advanced radiological imaging, may not be cost effective nor accessible to the broader at-risk population. FibroScan directly measures physical properties of stiffness and fat liver to provide reproducible results and allow for both diagnosis and monitoring of liver stiffness and liver fat. It is also recognized worldwide as the reference for non-invasive liver diagnosis supported with more than 2,000 medical publications and 40 guideline recommendations.

About Echosens

Echosens, the developer of FibroScan, is an innovative high-technology company offering a full range of products and services supporting physicians in their assessment and management of patients with chronic liver diseases. FibroScan is supported by over 2,500 peer-reviewed publications and examinations are covered by Medicare, Medicaid and many insurance plans. For more information, please visit and follow us on Twitter (@echosensNA).

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Echosens Supports October 2020 Liver Cancer Awareness Month: Cites Link to Nonalcoholic Fatty Liver Disease and Importance of Early Detection -...

Making Gains In The Fitness Industry – Seeking Alpha

Oct, 28th 2020 12:55 pm, Article Recommended by Dr. J. Smith

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No Pain, No Gain? Try No Politics, No Future for the Fitness Industry – Club Industry

Oct, 28th 2020 12:55 pm, Article Recommended by Dr. J. Smith

Warning: If you dont read this blog because its about politics, you are doing a disservice to yourself and your business.

Opinion: The fitness industry must get more politicaland by that, I mean interested in or active in politics.

Truth: The U.S. fitness industry, which generated revenue of $35 billion in 2019 ($96.7 billion worldwide) is not a large industry compared to the pharmaceutical industry (U.S. revenue of $484.8 billion in 2018 and worldwide revenue of $1.2 trillion in 2018) or the health insurance industry (revenue of more than $913 billion in 2019 with profits of $35.7 billion in 2019). We dont have the money they have to curry favor with politicians through campaign contributions. We also dont have the revenue to spend on advertising like pharmaceutical companies docollectively, they spent $6.46 billion on direct to customer advertising in 2018.

But we are part of the first line of defense in this countrythe first line of defense against obesity and the chronic conditions that arise from obesity. Study after study show that exercise can help prevent chronic conditions and help treat many of them.

Plea: I know you are busy trying to keep your clubs open and getting members to return, but this call for you to get political is a part of that fight for your survival.

I spoke with Fitness Formula Clubs CEO Gale Landers yesterday, one of the founders of an alliance of Illinois health club operators, and he shared that the alliance members being part of state COVID-19 task force meetings and inviting politicians into their clubs to see how clubs are cleaning and protecting members were important factors in getting health clubs reopened in the state. Alliances of health club operators have been formed in several states. And they are getting results.

It is a lot of work to set up an alliance, and it takes a lot of time to sit in on task force meetings. Kudos to those of you who have taken this upon yourself. You are warriors for the industry. But for the rest of you, I'd like to remind you that to get results, you have to put in the work. Isnt that what you tell your members? So why would you think you could just sit on your butt and not put in the work to get to know your local and federal legislators, be involved in task force meetings, and lobby your city council members and U.S. reps in order to ensure they know the fitness industry is here and provides a vital service? Thats like expecting to build muscles without ever engaging in strength training.

Help:The lectureis over. Now, let Club Industry provide you with your training plan to build those political muscles. And well do so for free. (Yes, youve always heard that no one values anything they get for free, but consider this a gift. You can send us a thank-you note later as payment.)

Our Future of Fitness virtual event (Nov. 16-18) includes four sessions that will exercise those muscles. One of the sessions focuses on why the industry needs state alliances, and how to join your state alliance or how to form one in your state if it doesnt already exist. The U.S. Health Club Industrys Survival Requires Club Alliances will occur at 12:35 pm Eastern on Nov. 17, featuring three club operators who helped form alliances in their states: the aforementioned Landers, Scott Gillespie of Saco Sport & Fitness in Maine, and JoAnna Masloski of Wellbridge in Colorado. Right after the panel session, which will be moderated by Al Noshirvani, chairman of Motionsoft, the group will break off into a live Zoom Q&A chat so that you can ask them more specifics about alliances, getting involved with your state alliance or creating your own alliance.

The day after this alliance session, we are presenting a panel, The Fitness Industry Needs a Political Movement, with panelists Rodney Steven of Genesis Health Clubs, Chris Craytor of ACAC, and Mark Miller of Merritt Clubs. Moderator Helen Durkin of IHRSA will ask these three politically active health club operators to share their efforts and the results of those efforts. Make sure to attend that at 10:15 a.m. Eastern on Nov. 18.

Part of the problem the industry faces is that it still suffers from a poor reputation due to bad actors of the past. That history has come back to hurt the industry today. So how can we elevate the reputation of the industry? We address that at 8:40 a.m. Eastern on Nov. 17 in How to Improve the Industrys Reputation and Build Confidence in Its Importance. Kevin McHugh of The Atlantic Club and Ori Gorfine of U.S. Fitness Holdings will share their clubs efforts to communicate the professionalism with which health clubs now operate and the value health clubs provide to their communities. Find out how you can do the same by attending this panel, moderated by Maria Turco, CEO of Honor Yoga.

Before all of these sessions occur, however, we kick off the Future of Fitness event at 8 a.m. Eastern on Nov. 16, with David Stalker, president of Europeactive, presenting his keynote on Power Is Local: Influencing Government Strategies. He will share how to influence policies at a local level, including who to talk to and what to say to them to offer clarity around the essential role the fitness industry plays in the health of communities.

If you cant tell, the staff at Club Industry believe members of the fitness industry can no longer sit around and pretend that politics plays no role in the industry. Even after the COVID-19 pandemic is over, other issues will arise as city, county and state politicians deal with the aftereffects of the pandemic on their coffers. The industry must unite to have a strong voice, particularly because the industrys monetary pull is outweighed by other groups. But you know that the benefits of the fitness industry to the communities you serve is just as great if not greater than that of pharma. Its time to join together, bring your members along and be such a resounding chorus that politicians cant ignore the logic of the message we are sending.

Register now for the Future of Fitness virtual event. Even if you cant attend all the sessions live, by registering now, you will receive access to the sessions on-demand.

No Pain, No Gain? Try No Politics, No Future for the Fitness Industry - Club Industry

How To Tell If Fitness Influencers Actually Know What Theyre Talking About – Well+Good

Oct, 28th 2020 12:55 pm, Article Recommended by Dr. J. Smith

Fitness influencers are often motivational, aspirational, andlets be honestpretty darn attractive. But its not always the best idea to follow their advice without first engaging in some little healthy scrutiny. Theres too much information out there that nobodys fact checking, says Katrina Pilkington, a personal trainer certified by the National Academy of Sports Medicine (NASM). You have to be your own fact checker.

Doing background research to vet the content shared by fitness influencers might suck the fun out of following them, but its important for your health if you plan to follow their advice. After all, people arent qualified trainers just because theyve got your dream body. Looks arent everything, says Pilkington. Someone could have a six-pack and a heart problem. They also might not be 100 percent transparent around what theyve done to get their physique. Think of it this way: Jennifer Aniston has done commercials for Aveeno and Smartwater, but you dont assume that her entire beauty routine consists of drinking water and applying lotion, right? Apply that same critical thinking to fitfluencers, and take a few beats before copycatting their moves.

The easiest thing you can do is check the influencers credentials. Pilkington says to see if someone has a masters degree relevant to the advice theyre sharing. Im not saying it completely validates them, but it can be a little more of a credential because it means theyve had continuing education in their field, she says. NASM-certified trainer Tony Ambler-Wrightwho has a masters degree in exercise sciencerefers to this as foundational knowledge and also advises keeping an eye out for it.

You might also want to take a look at trainers professional certifications. Ambler-Wright says hes biased towards his own (NASM) type of certification, but he also recommends trainers who are certified by the National Strength and Conditioning Association, American Council on Exercise, orthe American College for Sports Medicine.

If someone you follow fails to possess any of the above credentials, says Ambler-Wright, that could be a red flag.

Both Pilkington and Ambler-Wright also note that just because someone is credentialed in one area doesnt mean you should follow their advice in other disciplines. The persons training should align with the advice that theyre providing, says Ambler-Wright. One of the things that I think consumers should be wary of is individuals operating outside the scope of their expertise.

For example, dont look to a fitness influencer or certified trainer for credible diet advice unless they have additional credentials as a nutritionist or registered dietician. The nutrition piece is not something that a [non-credentialed] trainer should be touching, says Pilkington. They shouldnt be recommending what you eat or how much you eat, because thats just completely out of their scope and authority. And while she admits she may have been guilty of doling out this sort of advice in the past, now that shes in graduate school for nutrition, she realizes how complicated it is to offer one-size-fits-all advice to a diverse group of people with different medical needs. You have to be extremely careful, she says.

Additionally, if someone is credentialed by a specific studio or discipline, Pilkington and Ambler-Wright say it only makes sense to follow advice related to those specific exercises. Ambler-Wright explains that he wouldnt offer advice on yoga moves, since hes not qualified to teach yoga, but he does think professionals should know where to send their clients looking for additional help. As a professional, I would want to be well-versed in what else is out there, just to be aware and guide individuals who are asking me for advice in the appropriate directions, he says.

Pilkington suggests you should also be wary of personal trainers who claim to be able to diagnose your injuries or give advice on what to do about a certain types of pain if they arent a trained physical therapist or chiropractor.

Another way to vet information shared by influencers is to look for accompanying citations and sources pointing to research or other forms of expertise from which the information was gathered. And if you want to go the extra mile, you can check those sources, too: Is it just another expert without expertise, or is it a scientific study published in a peer-reviewed journal? And if its the latter, what was the study size? Digging into the nitty-gritty is time-consuming, but it can be helpful.

Its one thing to offer exercises and another to offer a training program, says Ambler-Wright, who says that its important to differentiate between the two. I dont think its bad to look to social media for exercise ideas because variability, creativityall of thats important in keeping somebody engaged and getting them to adhere to a program, he says. But exercises dont equal training. A training program needs to take the individual into consideration, and a person on social media doesnt necessarily know their followers capabilities or limitations. In other words, just because youre copying a fitfluencers exercise routine doesnt mean youre being trained, and its unlikely youll see the results you would if you were properly training.

On that note, Ambler-Wright advises caution whenever you encounter too-good-to-be-true claims about an exercise or a programs benefits. If somethings being described as a magic bullet or the best of anything, Id be leery of that, he says.

Just as selfies are filtered, so too is fitness content posted on social media. The impressions they want you to have are not necessarily reality, says Ambler-Wright. They might make batch content where they do days of filming exercises and sequence them in a way that gives the impression that theyre doing it all at one time, in a way that is totally unrealistic for the average person.

Someone who is trained and responsible, says Ambler-Wright, should be cognizant of form and technique. If youre following along with a workout and the fitfluencer isnt narrating proper technique for the moves theyre demonstrating, thats concerning. You want to hear the expert explaining what theyre doing and how to do it safely to minimize stress on the body, he says.

To that end, its important to keep your own conditions, injuries, or limitations in mind when trying to emulate your favorite fitness influencers. Youll want to be aware of who the exercises are designed for and whether or not theyre safe for you to attempt. For example, Pilkington notes that it might be unsafe for someone who is pregnant to do exercises that arent specifically designed for pregnancy.

You may also not quite be up to the level of the fitfluencer youre following, and taking on moves or sequences that are too advanced could lead to bodily stress or injury. If something looks unsafe or risky, then you know its probably not a good idea to try it if youve never done anything like that before, says Ambler-Wright.

Last but certainly not least, it might be best to follow the advice of fitness influencers who make it a point to share the setbacks, challenges, and imperfections of their journeysnot just the good news. Look for them to be authentic and share the reality of what it takes to to get in good shape, and to improve your health and fitness, says Ambler-Wright. Anyone that doesnt talk about the effort it takes to improve ones fitness that would be a red flag in my mind.

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F45 Training Hiits Back At Teen Obesity With New Prodigy Fitness Program – Club Industry

Oct, 28th 2020 12:55 pm, Article Recommended by Dr. J. Smith

Club Industry was not involved in the creation of this content.

Global Fitness Empire F45 Training Creates Fitness Offering for AdolescentsLaunching in Select StudiosNationwide October 24th

(Los Angeles, CA - October 24, 2020). This Fall, F45 launches Prodigy, a specially designed program for adolescents between 11-17 years of age. Prodigy is the latest innovation from F45, one of the worlds fastest growing functional fitness network, which has been designed to deliver a safe, effective and time-efficient form of physical activity for adolescents. Landing in selected studios on October 24th, Prodigy provides adolescents the opportunity to develop both physically and mentally - in a motivating, community environment.

The prevalence of adolescents that are being classified as overweight and obese has reached unprecedented levels. Despite intense clinical and public health focus on obesity and weight-related behaviors during the past decade, obesity prevalence remains high with 1 in 5 children classified as obese according to the CDC. According to the American Council on Exercise, children should participate in a variety of physical activities every day, including active play, non-competitive activities and vigorous exercise, making high intensity interval training (HIIT) a safe form of physical activity for children and adolescents.

With the success of F45, weve specifically developed a Functional HIIT program with the aim to combat the rise of obesity and health related issues in adolescents, said Lee Wallace, F45 Chief Sport Science Officer. F45 Prodigys HIIT workouts have been designed to mimic the nature of childrens day-to-day movements making it more appealing, engaging and enjoyable for kids, compared to other fitness structures, encouraging a lifelong participation in physical exercise.

The F45 Prodigy program will be available in a variety of formats, depending on where you are in the United States. To align with COVID-19 mandates, the F45 Prodigy team have put every parameter in place to ensure the health and safety of members. F45 Prodigy sessions will have reduced class sizes to maintain social distancing guidelines, designated workout stations for adolescents and eliminate person-to-person contact and sharing of equipment. They will also include extended breaks in between the sessions, allowing for the equipment to be properly sanitized. For areas where gyms are mandated closed, F45 Prodigy will be available via live Zoom sessions, run by local F45 Prodigy studios.

Current guidelines recommend that adolescents should participate in 60 minutes of moderate-to-high intensity physical activity every day and also include muscle and bone strengthening exercises at least three times per week (Department of Health [DOH], 2018). Collectively, the regular participation in HIIT workouts in child and adolescent populations has been shown to positively influence both health and fitness markers as well as encourage lifelong participation in physical activity.

The roll-out of Prodigy launched in Australia in April 2019 and due to its success is moving to the US for the Fall 2020 launch.


F45 Training is a global fitness training community specializing in innovative, high-intensity group workouts that are fast, fun and proven to get rapid results for members. F45 Trainings commitment to innovation goes well beyond the gym floor. With an ever-growing suite of proprietary fitness and business technology, F45 Training provides an unprecedented level of insight and control for both clients and franchisees. For more information on F45 Training please visit


Dr. Lee Wallace has had over 16 years experience in the sports science industry. Lee is the Director of Sport and Exercise Science / Management at the University of Technology Sydney. He has completed a PhD in Exercise Physiology with a focus on fatigue and recovery, quantifying training loads and modeling performance in athletes. He is an Accredited Exercise Scientist with an extensive research background and numerous peer-reviewed publications to his name. Lee is also an experienced university lecturer in the areas of Functional Anatomy, Structural Anatomy, Strength and Conditioning, Skill Acquisition and Exercise Prescription.

Alongside the F45 Athletic and F45 Challenge Departments, Lee is dedicated to the research and development of F45 Training workouts. Under the guidance of our CEO, the team is tirelessly investigating current and emerging training concepts as well as tweaking and fine-tuning existing training regimens.

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F45 Training Hiits Back At Teen Obesity With New Prodigy Fitness Program - Club Industry

Global Gyms, Health and Fitness Clubs Market 2020 Key Factors and Emerging Opportunities with Current Trends Analysis 2025 – AlgosOnline

Oct, 28th 2020 12:55 pm, Article Recommended by Dr. J. Smith Adds New Global Gyms, Health and Fitness Clubs Market Report to its research database. The report presents a deep study of the market growth factors and drivers.

As per the Gyms, Health and Fitness Clubs market report, the industry is expected to produce considerable returns while registering a profitable yearly growth rate during the foreseeable years. Revealing the outline of the industry, the report provides important details relatable to the valuation that the market holds currently. The report also offers a detailed breakdown of the Gyms, Health and Fitness Clubs market, as well as the current growth opportunities in the business vertical.

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Best swimming tracker 2020: waterproof fitness trackers for swimming in the pool and open water – T3

Oct, 28th 2020 12:55 pm, Article Recommended by Dr. J. Smith

Taking to the water this summer and wondering how to find the best fitness tracker for swimming? Youre going to need a device that is more than just waterproof. Whether its for open water or in a pool, a wearable with proper swimming tracking will be able to feedback to you vital swim stats - automatically detecting the type of stroke, stroke rate (the number of strokes you swim per length), and split times, for instance.

According to David Tatler, Head Coach at London swim coaching firm DMT Swimming, having this sort of data available while in the water can not only aid swimmers track how many lengths theyre doing or calories theyve burnt, but can help even more seasoned swimmers push beyond their limits.

Seeing where you are slowing down, for instance, will force you to look at every aspect of your stroke and see where improvements are needed in your technique, he explains.

How to choose the best swimming fitness tracker for you

If you're a keen athlete or triathlete serious about swimming, purchasing a good quality fitness wearable boasting some good tracking features is a no brainer. A constant supply of stats will help you keep a watchful eye on how well youre performing day-to-day, where your strengths and weaknesses are, and how to improve your stroke.

Alternatively, if youre not exactly a pro, youre just starting out or you prefer to swim occasionally and arent so interested in closely monitoring detailed swim stats, you might want to go for more of an all-rounder. A multi-sport tracker would therefore be ideal as it will allow you to keep tabs on all kinds of fitness while not feeding back stats that arent so relevant to you. Most smartwatches and activity trackers do this anyway, but not all.

Theres also two main types of tracker to look out for, a full-sized smartwatch or a more slimline fitness band. This is all to do with preference and how comfortable you feel wearing a larger, heavier watch while in the water. Bands are usually lighter and smaller so less noticeable on the arm during your lengths, but these tend to have fewer sensors and therefore are lacking when it comes to detailed stats. On the upside, though, they are usually cheaper, so perhaps best for those more casual swimmers among us.

(Image credit: Garmin)

Blows all other trackers out of the water

Display Size: 1.04"

Estimated Battery Life: 7 days

GPS: Yes

Water resistance: 50m

+Easy to use+Super detailed summary stats+GPS for open water swimming

-Lacks multisport features

Garmin is probably the market leader when it comes to smartwatches and is popular with more serious fitness fanatics and athletes thanks to its in-depth multisport tracking features, robust designs and reliability. The Swim 2 is no exception. With a built in heart rate monitor so that you can see your heart rate on your wrist, with no additional waterproof chest strap needed like you used to, this wearable is a piece of engineering genius. It will also deliver pacing alerts, telling you when to slow down or speed up with Critical Swim Speed, logging drills and everything you need to advance your swim. Its a serious watch for serious swimmers. The only downside? It doesnt track anything else. For that, it might be worth investing in the firms Fenix range.

(Image credit: Polar)

Pricey but impressive

Display Size: 1.2"

Estimated Battery Life: 100 hours

GPS: Yes

Water resistance: 100mm

+Excellent detailed summaries+Great recovery stats and features+Ideal for outdoors swimming

-Pricey if youre only using it for swimming-A little bulky

This watch has a lot to offer. Aimed at anyone with a love for outdoors activities, the rugged Grit X can handle just about anything you throw at it, making it especially useful for open water or competitive swimmers.

At 379.99, its the pricest tracker on our list, but its also one of the most feature-rich. Not only does it track just about every sport you can think of, but when it comes to swimming, the Grit X automatically detects your heart rate, swimming style, distance, pace, strokes and rest times.

The watch also features SWOLF (the swimming efficiency metric) support. This is calculated by adding together your time and the amount of strokes it takes you to swim a pool length. Generally, the lower your SWOLF is for a certain distance and style, the more efficient you are. A great way of motivating you to improve.

(Image credit: Huawei)

Light, slim and excellent value for money

Display Size: 0.95"

Estimated Battery Life: 5 days


Water resistance: 50m

+Cheap as chips at under 50+Hardly noticeable on the wrist

-Tracking is not so detailed-Small display

With a slick AMOLED touchscreen display, the Huawei Band 4 Pro isnt just nice to look at but it looks great in the water, too, being bright and clear enough so you can easily view your real-time data while youre thrashing around in the water.

When it comes to tracking, you can customise training targets (such as distance, duration, calories burnt, reminder interval) or just start swimming and let it monitor what youre doing automatically.

This is all quite surprising when you consider the Huawei BAnd 4 Pros RRP. At under 50, this device is a steal - and that would still be the case even if swimming was its only trackable activity. But infarct, this nifty device can monitor your stats during most major sports.

(Image credit: Apple)

Best for iOS users

Display Size: 1.78

Estimated Battery Life: 18 hours

GPS: Yes

Water resistance: 50m

+Beautiful displayWaterproof speaker+Swim tracking is the tip of the iceberg

-Only works with iOS-Unnecessary feature set for serious swimmers

The Apple Watch Series 5 tracks all the basics distance, lengths and time but ups the ante with automatic stroke recognition, tailored progress reports and advice. It has a surprising number of features that make it a great swim tracker, such as automatic stroke, splits and sets recognition, an Open Water Swim mode that visualises your route on a map, and an active calories, distance and overall pace tracking function. It even has a self-locking mechanism that, once unlocked, expels any water from the speaker.

It is, however, quite a pricey purchase if youre only going to use it for swim tracking, and of course it only works with iOS devices so its definitely not worth investing if you have an Android phone. That said, its one of the best smartwatches out there if youre an iPhone owner, with an endless array of lifestyle features that will help make your life easier.

(Image credit: Fitbit)

Best midrange tracker with plenty of extras

Display size: 1"

Estimated Battery Life: 7 days

GPS: Yes

Water resistance: 50m

+Comfortable and lightweight+Good value for money

-No open water swim tracking-Fitbit app is limited

Another fitness band that comes up trumps for swim tracking is Fitbits Charge 4. With a mid-range price tag (130) its pretty compact but still bursting with features. As you would expect from any Fitbit device, swimming isnt the only activity tracking capability here, but those looking to take this device to the water wont be disappointed in how well it performs.

Thanks to Fitbits relatively new SmartTrack tech, the Charge 4 is able to automatically recognise when you're swimming, meaning you dont have to select the activity option from the menu before diving in; itll capture swim lengths, duration, distance and pace. The annoying thing, though, is that none of that data is viewable in real-time on the device itself, so you'll have to head to Fitbit's companion app later to get your data, and this app isnt exactly the most intuitive out there.

Nevertheless, the Charge 4 to be pretty accurate in the water, proving comfortable and in the most part, enjoyable to use.

The good-looking all-rounder for everyday wear

Best for: All-round fitness gadget

Depth: 40m

Battery Life: 3-4 days

Measures: Goals, time, distance, pace

+Great design+Works with Spotify

-Needs Speedo app

If youre looking for a great fitness tracker under 200, the Samsung Gear Fit2 Pro might be right up your lane. Its a vast improvement on its predecessor the Gear Fit2, not least because its now waterproof to around 40m, bringing it into the list of viable contenders for best swimming fitness tracker.

Its engineered to work with the Speedo app in Speedo Mode, which allows you to set the length of the pool and your goal for that session, and get specs like your pace and duration in return. It also looks great for everyday wear, both in and out of the pool, with its slick integrated screen.

Great all-round tracking with swimming-specific highlights

Best for: Casual swimmers

Depth: 50m

Battery Life: 3 days

Measures: Swim duration, pace, laps, distance, calories burned

+Great inexpensive fitness tracker+Same metrics as more expensive bands

-Accuracy of results can be thrown off

The Fitbit Flex might not be the brands flagship band, but as their first tracker for swimming its still going strong, and deservedly so. It packs in the same swim tracking metrics as the three-times-the-price Ionic, namely pace, distance, laps and time spent in the water.

Some found that stop-start swims could throw off the accuracy of the results reported back, so while its arguably best kept for quieter evenings at the pool, anything that pushes us to keep up the pace is a win in our book. And, with access to Fitbits superior all-round activity tracking, its still among the best in terms of software.

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