Citation: Souza, A.R.; Bandeira, P.F.R.; da Silva, M.A.C.; da Cunha, G.L.; Pereira, D.F.; Martins, C. Twenty-Four-Hour Movement Behaviors, Fitness, and Adiposity in Preschoolers: A Network Analysis. Obesities 2023, 3, 36–45. https:// doi.org/10.3390/obesities3010004 Academic Editors: Nobuyuki Takahashi and Carmine Finelli Received: 1 October 2022 Revised: 22 December 2022 Accepted: 17 January 2023 Published: 24 January 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). Article Twenty-Four-Hour Movement Behaviors, Fitness, and Adiposity in Preschoolers: A Network Analysis Alyce Rodrigues Souza 1 , Paulo Felipe Ribeiro Bandeira 2,3, * , Morgana Alves Correia da Silva 2 , Glacithane Lins da Cunha 2 , Daniel Fernandes Pereira 2 and Clarice Martins 1,4, * 1 Federal University of Paraíba, Cidade Universitária, João Pessoa 58000-000, Brazil 2 Federal University of Vale do São Franciso, Petrolina 56304-917, Brazil 3 Regional University of Cariri, Crato 63105-000, Brazil 4 Laboratory for Integrative and Translational Research in Population Health (ITR), Research Centre of Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, 4500 Porto, Portugal * Correspondence: paulo.bandeira@urca.br(P.F.R.B.); claricemartinsufpb@gmail.com (C.M.) Abstract: The present study aimed to verify the associations between compliance with the 24-h move- ment behavior recommendations, fitness, and adiposity markers in preschoolers, considering the non-linear nature of these associations. The sample was comprised of 253 preschoolers. Preschoolers were assessed for anthropometric data and wore an accelerometer for seven consecutive days. Screen time and sleep duration were parent-reported in a face-to-face interview. The PREFIT test battery was used to assess physical fitness components (lower-body strength, cardiorespiratory fitness, and speed/agility). Descriptive statistics were used to describe the variables, and a network analysis was conducted to assess the emerging pattern of associations between the variables. Preschoolers’ greatest compliance with recommendations was observed for physical activity, while the lowest compliance was observed for the screen time recommendation. Among children aged three years, only 2.2% complied with all recommendations; only 1.0% of the four-year-olds and 1.3% of the five-year-olds complied with all recommendations. The results of the network analysis and cen- trality measures emphasized that cardiorespiratory fitness (CRF) and compliance with movement behavior recommendations were the most critical variables to address in preschoolers, reinforcing the importance of intervention programs focused on intense activities. Keywords: children; obesity; complexity 1. Introduction Childhood adiposity constitutes a global health problem [1]. Between 1980 and 2013, the prevalence of obesity among children increased by 47.1% [2], and according to the World Health Organization (WHO) [3], by 2025, the number of children with overweight and obesity can reach 75 million. This evidence becomes even more relevant when considering that the obesity epidemic has direct implications for public health; in addition, it leads to a considerable increase in health costs [4]. Obesity has been previously linked to at least 100 associated factors of different natures [5], including movement behaviors (physical activity (PA), sedentary behavior, and sleep). When analyzing the association between each movement behavior and adiposity, evidence has indicated a negative association between PA time and adiposity [6,7]. Previ- ous studies have also shown that sleep duration in children is inversely associated with adiposity [8–10], while short sleep duration is associated with a higher body mass index (BMI) and waist circumference (WC) [11]. Moreover, regardless of PA levels, sedentary behavior, especially the time exposed to screens, is associated with an increased risk for adi- posity and low physical fitness levels [12]. Physical fitness indicates the ability to engage in daily physical activity (PA) without excessive fatigue, respond to environmental demands, and maintain and improve health [13]. Physical fitness components play a protective role Obesities 2023, 3, 36–45. https://doi.org/10.3390/obesities3010004 https://www.mdpi.com/journal/obesities