We examined the compositional associations between the intensity spectrum derived from incremental acceleration intensity bands and the body mass index (BMI) z-score in youth, and investigated the estimated differences in BMI z-score following time reallocations between intensity bands. School-aged youth from 63 schools wore wrist accelerometers, and data of 1453 participants (57.5% girls) were analysed. Nine acceleration intensity bands (range: 0−50 mg to ≥700 mg) were used to generate time-use compositions. Multivariate regression assessed the associations between intensity band compositions and BMI z-scores. Compositional isotemporal substitution estimated the differences in BMI z-score following time reallocations between intensity bands. The ≥700 mg intensity bandwas strongly and inversely associated with BMI z-score (p < 0.001). The estimated differences in BMI z-score when 5 min were reallocated to and from the ≥700 mg band and reallocated equally among the remaining bands were −0.28 and 0.44, respectively (boys), and −0.39 and 1.06, respectively (girls). The time in the ≥700 mg intensity band was significantly associated with BMI z-score, irrespective of sex. When even modest durations of time in this band were reallocated, the asymmetrical estimated differences in BMI z-score were clinically meaningful. The findings highlight the utility of the full physical activity intensity spectrum over a priori-determined absolute intensity cut-point approaches.

Alliance for Research in Exercise Nutrition and Activity Allied Health and Human Performance University of South Australia Adelaide SA 5001 Australia

Centre for Adolescent Health Murdoch Children's Research Institute Melbourne VIC 3052 Australia

Department of Applied Health and Social Care and Social Work Faculty of Health Social Care and Medicine Edge Hill University Ormskirk L39 4QP UK

Department of Psychology University of Liverpool Liverpool L69 7ZA UK

Department of Sports Science and Clinical Biomechanics University of Southern Denmark 5230 Odense Denmark

Department of Teacher Education and Outdoor Studies Norwegian School of Sport Sciences 0863 Oslo Norway

Diabetes Research Centre Leicester General Hospital University of Leicester Gwendolen Road Leicester LE5 4PW UK

Faculty of Physical Culture Palacký University Olomouc CZ 779 00 Olomouc Czech Republic

Movement Behaviours Nutrition Health and Wellbeing Research Group Department Sport and Physical Activity Edge Hill University St Helens Road Ormskirk L39 4QP UK

National Institute for Health Research University Hospitals of Leicester NHS Trust and the University of Leicester Leicester LE5 4PW UK

Research Institute of Sport and Exercise Science Liverpool John Moores University Liverpool L3 3AF UK

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