Abstract
National estimates of physical activity are used to evaluate population behavior and inform public health guidelines. However, estimates may vary depending on whether physical activity is assessed using self-reported surveys or accelerometer-based measures. PURPOSE: This cross-sectional study was to characterize population-level estimates of weekly moderate-to-vigorous physical activity (MVPA) and physical activity guideline adherence (≥ 150 min/week) among U.S. adults across multiple nationally representative U.S. population-based physical activity data sources. METHODS: A PubMed literature search revealed five databases: NHANES, NHIS, BRFSS, Add Health, and All of Us, using the most recent survey cycles from each database and accelerometer-based physical activity data, with direct survey-accelerometer comparisons available in earlier NHANES cycles. Population level descriptive statistics of weekly MVPA minutes and percentage meeting the aerobic physical activity guidelines of adults over ≥ 18 years were estimated using survey-weighted analyses, excluding missing physical activity data, and applying established accelerometer wear-time criteria. RESULTS: Sample sizes across databases ranged from approximately 3,500 to 433,000. Survey-based estimates were high: Guideline adherence ranged from 89.5% in NHANES 2003-2006, 83.5% in NHANES 2021-2023, 86.3% in NHIS 2020-2024, 71.0% in BRFSS 2023, and 87.1% Add Health 2022-2025 with mean MVPA ranged from 545.6 to 1,726.6 min/week, and median MVPA ranged from 280 to 961 min/week. In contrast, accelerometer-based estimates were low across national databases. Guideline adherence ranged from 15.5% in NHANES 2003-2006, and 56.4% in All of Us 2017-2025 with mean MVPA ranged from 121.2 to 280.6 min/week, and median MVPA ranged from 4.96 to 187 min/week. In a within-person sub-analysis restricted to the paired NHANES 2003-2006 sample, survey-based estimates revealed 74 percentage points more adults as meeting aerobic guidelines than accelerometer-based estimates (88.8% vs 14.8%; p<0.001), yielding survey-based adherence estimates nearly six times higher than accelerometer-based estimates, with median and mean within-person differences of 900 and 1538 min/week. Mean MVPA ranged from 128 (accelerometer) to 1,666 (survey) min/week and median MVPA ranged from 14 (accelerometer) to 900 min/week (survey). CONCLUSION: Estimates of physical activity among U.S. adults vary substantially across national datasets depending on survey or accelerometer usage, making it difficult to define a single, definitive estimates of how physically active the United States is.
Recommended Citation
Choung, Jinwon and Letsinger, Ayland
(2026)
"How Physically Active Are U.S. Adults?: Comparing National EstimatesPhysical Activity Levels of U.S. Adults Across Multiple National Datasets,"
International Journal of Exercise Science: Conference Proceedings: Vol. 2:
Iss.
18, Article 147.
Available at:
https://digitalcommons.wku.edu/ijesab/vol2/iss18/147