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These questions recorded the amount of time and frequency of moderate and vigorous activity and were used to assess whether or not respondents met current physical activity guidelines.The exact methodology for collecting these data, as well as the physical activity guidelines used by BRFSS to define “sufficiently” active, changed in the 2011 survey compared to earlier years.We calculated body mass index (BMI) from self-reported weight and height in the BRFSS and adjusted for self-reporting bias using NHANES.We calculated self-reported physical activity—both any physical activity and physical activity meeting recommended levels—from self-reported data in the BRFSS.We used validated small area estimation methods to generate estimates of obesity and physical activity prevalence for each county annually for 2001 to 2011.Our results showed an increase in the prevalence of sufficient physical activity from 2001 to 2009.Thus sufficient physical activity is defined as reporting 150 total minutes of moderate activity per week, the equivalent in vigorous activity, or combination of moderate and vigorous activity (1 minute vigorous activity = 2 minutes moderate activity).

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We used data from the examination portion of the NHANES in the years 1999 to 2010, which produces national-level estimates every two years. Self-reported weight and height were assessed by asking respondents, “About how much do you weigh without shoes? ” To assess the prevalence of any leisure time physical activity, the BRFSS asked respondents, “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?

” In odd-numbered years the BRFSS included more detailed questions, which allows for distinguishing between insufficiently active and sufficiently active respondents.

We used the Behavioral Risk Factor Surveillance System (BRFSS), a state-based random-digit telephone survey that covers the majority of United States counties, and the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US civilian noninstitutionalized population.

About 3.7 million adults aged 20 years or older participated in the BRFSS from 2000 to 2011, and 30,000 adults aged 20 or older participated in NHANES from 1999 to 2010.

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Indeed, the rise in physical activity levels will have a positive independent impact on the health of Americans as it will reduce the burden of cardiovascular diseases and diabetes.

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