How Physically Active Are U.S. Adults?: Comparing National EstimatesPhysical Activity Levels of U.S. Adults Across Multiple National Datasets

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