Sex-stratified compositional analysis of 24-h movement behaviors and their relationship with selective attention and cognitive flexibility in socioeconomically vulnerable children

Introduction: The 24-h movement behavior framework, which integrates physical activity (PA), sedentary behavior, and sleep, acknowledges the co-dependent nature of time-use behaviors within a finite day. While these behaviors have been linked to cognitive performance in children, few studies have applied compositional data analysis (CoDA), and none have examined potential sex differences. Objective: To explore sex-specific associations between 24-h movement behavior compositions and selective attention and cognitive flexibility in a sample of socioeconomically vulnerable Chilean children using CoDA. Methods: Baseline data from 161 children (8-10 years old) participating in the Active-Start trial were analyzed. Movement behaviors were assessed via 9-day wrist-worn accelerometers. Selective attention was assessed using the d2 Test of Attention, and cognitive flexibility was measured with the Design Fluency Test. A non-significant association was observed linking sedentary behavior with cognitive performance in both sexes. Conclusion: These findings highlight potential sex-specific benefits of MVPA and support the use of CoDA in understanding how daily time use relates to cognitive performance in children.