Segmented School Physical Activity and Weight Status in Children: Application of Compositional Data Analysis.

The purpose of this study was to apply compositional data analysis (CoDA) for the analysis of segmented school step counts and associate the school step count composition to body mass index (BMI) z-scores in a sample of children. Participants were 855 (51.8% female) children recruited from the fourth and fifth grades from four schools following a 7-h school schedule. Using piezoelectric pedometers, step count data were collected during physical education, recess, lunch, and during academic class time. A multi-level mixed effects model associated the step count composition with BMI z-scores. Compositional isotemporal substitution determined changes in BMI z-scores per reallocation of steps between pairs of school segments. A higher percentage of steps accrued during physical education (b = -0.34, 95%CI: -0.65--0.03, = 0.036) and recess (b = -0.47, 95%CI: -0.83--0.11, = 0.012), relative to other segments, was associated with lower BMI z-scores. Specifically, a 5% to 15% reallocation of steps accrued during lunchtime to either physical education or recess was associated with lower BMI z-scores, ranging from -0.07 to -0.25 standard deviation units. Focusing school-based promotion of physical activity during physical education and recess may have greater relative importance if targeted outcomes are weight-related.