{
  "abstract": "Background: Previous studies have explored the independent effects of different movement behaviors on osteoporosis (OP), but limited research on their substitution effects, especially among rural adults in resource-limited areas. This study investigates the associations between hypothetical time reallocations among different movement behaviors and QUS-defined osteoporosis.\n\nMethods: This cross-sectional study included 7368 participants selected from the second wave survey of the Henan Rural Cohort Study. Osteoporosis was defined using calcaneal quantitative ultrasound (QUS), and participants with a QUS T-score ≤ − 2.5 were classified as having QUS-defined osteoporosis. Logistic regression and restricted cubic spline were applied to examine the relationships between movement behaviors and QUS-defined osteoporosis. The isotemporal substitution model was employed to evaluate associations under hypothetical time reallocations among behaviors.\n\nResults: Long nocturnal sleep duration was associated with higher odds of QUS-defined osteoporosis in both sexes, while daytime napping was associated with higher odds in women. Sedentary behavior was associated with higher odds in men ( OR : 1.58, 95% CI : 1.05–2.37), whereas walking was associated with lower odds in both sexes (all P < 0.05). Isotemporal substitution analysis showed that reallocating 30–60 min from nocturnal sleep, sedentary behavior, or moderate-to-vigorous physical activity (MVPA) to walking was associated with lower odds of QUS-defined osteoporosis in both sexes (all P < 0.05). In women, reallocating 30 min of daytime napping to walking was also associated with lower odds of QUS-defined osteoporosis ( OR : 0.90, 95% CI : 0.85–0.95). In addition, reallocating 30 min of nocturnal sleep to MVPA was associated with lower odds of QUS-defined osteoporosis in women ( OR : 0.97, 95% CI : 0.94–0.99).\n\nConclusion: In this cross-sectional study, hypothetical reallocation of 30–60 min from nocturnal sleep, sedentary behavior, or MVPA to walking was associated with lower odds of QUS-defined osteoporosis. In women, reallocating the same duration from nocturnal time to MVPA was also associated with lower odds.\n\nClinical trial registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375 .",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "name": "Haidong Jin"
    },
    {
      "name": "Xueru Shi"
    },
    {
      "name": "Hongfei Zhao"
    },
    {
      "name": "Chengrui Zhang"
    },
    {
      "name": "Chongjian Wang"
    },
    {
      "name": "Fengling Wang"
    },
    {
      "name": "Jun Pan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0vtjybqnexdy8.bib",
  "cited_by": 0,
  "doi": "10.1186/s12889-026-29599-w",
  "fulltext_url": null,
  "id": "0vtjybqnexdy8",
  "issns": [
    "1471-2458"
  ],
  "landing_url": "https://link.springer.com/article/10.1186/s12889-026-29599-w",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2737|Physical Activity and Health"
    ]
  ],
  "openalex": "W7223142262",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-22",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/0vtjybqnexdy8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:54Z",
      "native_id": "10.1186/s12889-026-29599-w",
      "source": "crossref",
      "url": "https://link.springer.com/article/10.1186/s12889-026-29599-w"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Physical Activity and Health",
      "subfield": "physiology"
    }
  ],
  "title": "Sex-stratified associations between movement behaviors and QUS-defined osteoporosis in rural adults: an isotemporal substitution analysis",
  "title_text": "Sex-stratified associations between movement behaviors and QUS-defined osteoporosis in rural adults: an isotemporal substitution analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:54Z",
  "url": "https://research.draconitic.com/paper/0vtjybqnexdy8",
  "venue": "BMC Public Health",
  "versions": []
}