Abstract
BackgroundThe analysis of associations between accelerometer-derived physical activity (PA) intensities and cardiometabolic health is a major challenge due to multicollinearity between the explanatory variables. This challenge has facilitated the application of different analytic approaches within the field. The aim of the present study was to compare association patterns of PA intensities with cardiometabolic health in children obtained from multiple linear regression, compositional data analysis, and multivariate pattern analysis.MethodsA sample of 841 children (age 10.2 ± 0.3 years; BMI 18.0 ± 3.0; 50% boys) provided valid accelerometry and cardiometabolic health data. Accelerometry (ActiGraph GT3X+) data were characterized into traditional (four PA intensity variables) and more detailed categories (23 PA intensity variables covering the intensity spectrum; 0–99 to ≥10,000 counts per minute). Several indices of cardiometabolic health were used to create a composite cardiometabolic health score. Multiple linear regression and multivariate pattern analyses were used to analyze both raw and compositional data.ResultsBesides a consistent negative (favorable) association between vigorous PA and the cardiometabolic health measure using the traditional description of PA data, associations between PA intensities and cardiometabolic health differed substantially depending on the analytic approaches used. Multiple linear regression lead to instable and spurious associations, while compositional data analysis showed distorted association patterns. Multivariate pattern analysis appeared to handle the raw PA data correctly, leading to more plausible interpretations of the associations between PA intensities and cardiometabolic health.ConclusionsFuture studies should consider multivariate pattern analysis without any transformation of PA data when examining relationships between PA intensity patterns and health outcomes.Trial registrationThe study was registered in Clinicaltrials.gov 7th of April 2014 with identification number NCT02132494.
Highlights
The analysis of associations between accelerometer-derived physical activity (PA) intensities and cardiometabolic health is a major challenge due to multicollinearity between the explanatory variables
The children included in the present analyses did not differ from the excluded children (n = 288, 57% boys) with respect to age (p ≥ .689) or anthropometry (p ≥ .166)
We showed that different analytic approaches may lead to different association patterns of PA related to cardiometabolic health and conflicting conclusions regarding the importance of various PA intensities for cardiometabolic health
Summary
The analysis of associations between accelerometer-derived physical activity (PA) intensities and cardiometabolic health is a major challenge due to multicollinearity between the explanatory variables. This challenge has facilitated the application of different analytic approaches within the field. Accelerometer-derived physical activity (PA) is often broadly represented across a spectrum of time spent in different intensities (sedentary (SED), light PA (LPA), moderate PA (MPA), vigorous PA (VPA) and/or moderate-to-vigorous PA (MVPA). Few studies incorporate the entire intensity spectrum This is important as focusing only on selected parts of it leads to a loss of information from accelerometry data and it creates at least two problems for interpretation of study results: 1) It ignores the possible influence of other intensities on health and 2) it increases susceptibility of residual confounding [4,5,6]. Associations across the whole PA intensity spectrum should be examined to obtain a complete picture and to facilitate improved interpretations of how PA relates to health outcomes [4,5,6,7]
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