Improving the identification of bone‐specific physical activity using wrist‐worn accelerometry: A cross‐sectional study in 11–12‐year‐old Australian children

Physical activity (PA) during childhood and adolescence is important for the accrual of maximal peak bone mass. The precise dose that benefits bone remains unclear as methods commonly used to analyze PA data are unsuitable for measuring bone‐relevant PA. Using improved accelerometry methods, this study identified the amount and intensity of PA most strongly associated with bone outcomes in 11–12‐year‐olds. Participants ( n = 770; 382 boys) underwent tibial peripheral quantitative computed tomography to assess trabecular and cortical density, endosteal and periosteal circumference and polar stress‐strain index. Seven‐day wrist‐worn raw acceleration data averaged over 1‐s epochs was used to estimate time accumulated above incremental PA intensities (50 milli‐gravitational unit (m g ) increments from 200 to 3000 m g ). Associations between time spent above each 50 m g increment and bone outcomes were assessed using multiple linear regression, adjusted for age, sex, height, weight, maturity, socioeconomic position, muscle cross‐sectional area and PA below the intensity of interest. There was a gradual increase in mean R 2 change across all bone‐related outcomes as the intensity increased in 50 m g increments from >200 to >700 m g . All outcomes became significant at >700 m g ( R 2 change = 0.6%–1.3% and p = 0.001–0.02). Any further increases in intensity led to a reduction in mean R 2 change and associations became non‐significant for all outcomes >1500 m g . Using more appropriate accelerometry methods (1‐s epochs; no a priori application of traditional cut‐points) enabled us to identify that ∼10 min/day of PA >700 m g (equivalent to running ∼10 km/h) was positively associated with pQCT‐derived measures of bone density, geometry and strength in 11–12‐year‐olds.