Meeting Physical Activity Guidelines and Their Association With Cardiometabolic Indicators in Adolescents With Different Weight Status

Evidence on the association between meeting both aerobic physical activity (PA) and muscle-strengthening activity (MSA) guidelines with mortality in individuals with hypertension is scarce. We included 34,990 adults from the 2007 to 2013 Korea National Health and Nutrition Examination Survey, linking mortality follow-up data until 2019. Adherence to PA guidelines was assessed based on the current PA guidelines using a self-reported questionnaire and categorized as follows: meeting MSA only, aerobic PA only, both MSA and aerobic PA, or neither. Associations of hypertension and adherence to PA guidelines with all-cause and cardiovascular disease (CVD) mortality were examined using Cox proportional hazard models. Over 9.2 years, 1948 participants died from any cause and 419 from CVD. Meeting both PA guidelines was associated with the lowest risk of all-cause and CVD mortalities in the total sample regardless of hypertension status. In individuals with hypertension, meeting aerobic PA guidelines only had a 24% lower risk of both all-cause and CVD mortality, and meeting both PA guidelines further reduced risks by 40% and 43%, respectively; however, meeting MSA guidelines only was not associated with either all-cause or CVD mortality. In individuals without hypertension, only meeting both MSA and aerobic PA guidelines, but not meeting either MSA or aerobic PA guidelines, showed reduced risk of CVD mortality. In Korean population, non-hypertensive individuals who met both guidelines had a lower risk of CVD mortality. However, hypertensive individuals showed a reduced risk of both all-cause and CVD mortality when meeting aerobic PA or both guidelines, but not MSA alone.

The current study aimed to examine the adherence trend for aerobic and muscle-strengthening physical activity (PA) guidelines among Korean adults using the Korea National Health and Nutritional Examination Survey from 2014 to 2019. Korean adults (N = 2642) were included in the current study to examine the trend of PA adherence from 2014 to 2019. The PA guidelines are: (a) aerobic activity (a minimum of 150 min moderate to vigorous PA weekly) and (b) muscle-strengthening activity (a minimum of two days weekly). Self-report questionnaires in the survey measured both activities. The adherence to PA guidelines by survey year was examined using a multivariable logistic regression analysis adjusted for covariates. There was a significant decreasing trend in which the adherence rate to aerobic PA guidelines changed from 57.0% in 2014 to 45.6% in 2019 (p < 0.001). On the other hand, the trend in adherence rate to muscle-strengthening activity was not significant (p = 0.976). The adherence rate to muscle-strengthening activity guideline was slightly increased but still low from 20.8% to 23.3% during 2014–2019. The aerobic PA guidelines are significantly decreasing, and more than half of the Korean adults in 2019 have not followed the guidelines. In addition, there has been a slight increase in muscle-strengthening activity; however, the adherence rate is meager. Therefore, this study suggests that Korean adults’ aerobic and muscle-strengthening PA participation is necessary for their low adherence rate and decline tendency.

Introduction: Latino cancer survivors engage in less physical activity than non-Latino cancer survivors. Previous research has shown that higher acculturation is associated with higher leisure-time physical activity among foreign-born Latinos. However, there is limited research on the association of acculturation with leisure-time aerobic and muscle-strengthening activity among foreign-born Latino cancer survivors, for whom the acculturation and physical activity association may be influenced by lifestyle changes related to cancer survivorship. Therefore, we examined whether acculturation was associated with aerobic and muscle-strengthening physical activity among Latino cancer survivors. Methods: We used cross-sectional data from the 2008-2015 National Health Interview Survey (n=1,293). Participants were individuals that self-identified as Latino, ≥20 years old, and not pregnant. Cancer diagnosis was assessed by the survey variable, “Ever told by a doctor you have cancer?” Nativity (US-born, foreign-born) and years living in the US (&amp;lt;10 years living in US, ≥10 years living in US) were used as proxies of acculturation. Aerobic physical activity was measured based on self-reported minutes of moderate-to-vigorous aerobic physical activity engaged in per week, then categorized into none, some activity, and meeting the aerobic activity guideline. Muscle-strengthening activity was measured based on self-reported frequency of muscle-strengthening activity per week, then categorized into meeting and not meeting the muscle-strengthening guideline. Cutoffs for meeting the aerobic and muscle-strengthening guidelines were based on the 2018 Physical Activity Guidelines for Americans. Logistic regression models were used to examine the association of acculturation with aerobic and muscle-strengthening activity among Latino cancer survivors. Models were adjusted for age, sex, education, and Hispanic subgroup. Results: Approximately 33% of the sample reported meeting the aerobic activity guideline, and 15% reported meeting the muscle-strengthening guideline. Foreign-born cancer survivors living in the US &amp;lt;10 years were significantly less likely to meet the aerobic physical activity guideline (Odds Ratio [OR]: 0.26, 95% Confidence Interval: 0.10-0.67) and to engage in some aerobic activity (OR: 0.38, 95% CI: 0.16-0.89), compared with US-born Latino cancer survivors. There was no significant association between acculturation and muscle-strengthening activity. Conclusion: Recent Latino immigrants with a history of cancer are less likely to engage in aerobic physical activity compared with their US-born counterparts. Research is warranted on the barriers to aerobic physical activity among recent Latino immigrant cancer survivors. Citation Format: Shreya Desai, Mariana Vazquez, Daphne C Hernandez, Lorraine R Reitzel, Rosenda Murillo. Lower acculturation is associated with lower aerobic physical activity among recent Latino immigrant cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D102.

Background: Physical activity (PA) and risk of obesity are inversely related in adult populations. However, the extent to which meeting different PA guidelines influence body mass index (BMI) is less known. The aim of this research was to examine how different PA guideline parameters affect BMI in adults. Methods: The Montana Behavioral Risk Factor Surveillance System (BRFSS, 2019) was used for this study. Four different PA guideline variables were used and included 1) 2-level aerobic PA (APA) (met APA or did not meet APA), 2) 2-level muscle strengthening activity (MSA) (met MSA or did not meet MSA), 3) 4-level PA (met both APA and MSA, met APA only, met MSA only, or met neither), and 4) 3-level APA categories (active, insufficiently active, or inactive). BMI was calculated from self-reported height and weight (kg/m2). Multiple linear regression was used to examine the effect of each PA guideline parameter on BMI while controlling for sociodemographic variables. Results: Findings showed that meeting the 2-level APA (slope (b) = -0.74 kg/m2, p < .0001) or the 2-level MSA (b = -0.75 kg/m2, p < .0001) guideline was associated with lower mean BMI. In the 4-level PA model, as compared to meeting neither guideline, meeting APA only (b = -0.58 kg/m2, p = .0119) or meeting both APA and MSA (b = -1.32 kg/m2, p < .0001) was associated with lower mean BMI. Meeting MSA only did not show significantly (p = .1748) different BMI from those meeting neither guideline. In the 3-level APA model, as compared to those categorized as inactive, those categorized as active (b = -0.91 kg/m2, p < .0001) had lower mean BMI. Those categorized as insufficiently active did not have significantly (p = .1748) different BMI from those categorized as inactive. Furthermore, the 4-level PA guidelines × sex interaction was significant (p = .030) and indicated lower mean BMI for females meeting either MSA only (b = -1.05 kg/m2, p = .0215), APA only (b = -1.14 kg/m2, p = .0014), or both APA and MSA (b = -1.84 kg/m2, p < .0001) guideline (p for trend < .0001). Whereas for males, only meeting both APA and MSA was associated with lower mean BMI (b = -0.77 kg/m2, p = .0077). Conclusion: This study found that meeting either APA or MSA guideline is associated with lower BMI in adults. However, sex-specific analyses indicate that this is true for females only and in dose-response fashion. Lower BMI in males is only associated with meeting both APA and MSA guidelines. Health promotion specialists concerned with obesity should understand the influence that each PA guideline has on relative body weight. Physical activity programming should promote both APA and MSA among adults in Montana.

HIV and its treatment with antiretroviral therapy increase the risk of noncommunicable diseases (NCDs) tied to physical inactivity. Older African American men are also at high risk for NCDs. We tested the efficacy of a theory-based intervention to increase adherence to federal aerobic and muscle-strengthening physical activity (PA) guidelines among African American men aged 40 years and older living with HIV. We randomized African American men aged 40 years and older living with HIV to a three-session social cognitive theory-informed health promotion intervention targeting PA or a one-session health awareness control condition. The primary outcome was PA guideline adherence assessed (self-reported) preintervention, immediate postintervention, and 3, 6, and 12 months postintervention. Secondary outcomes were the number of days on which participants reported moderate-intensity aerobic PA, vigorous-intensity aerobic PA, and muscle-strengthening PA in the past 7 days. Of 302 participants, 255 completed the 12-month postintervention measures. Generalized estimated equation logistic regression indicated that the health promotion intervention participants had higher odds of meeting PA guidelines than health awareness control participants, adjusting for baseline adherence (p = 0.011). Health promotion intervention participants also reported more muscle-strengthening PA (p = 0.001), vigorous-intensity aerobic PA (p = 0.049), and moderate-intensity aerobic PA (p = 0.010) than control participants. The rise in self-reported adherence to PA guidelines and improvements in muscle-strengthening and aerobic PA considered separately suggest that a relatively brief behavioral intervention can increase PA among African American men aged 40 years and older living with HIV and potentially curb their risk of NCDs that PA can prevent.

Physical activity and body mass index were interactively related to health-related quality of life among older adults

Sedentary behavior may not differ between individuals meeting and not meeting physical activity guidelines (PAGs); however, sedentary behavior has been associated with lower levels of health-related quality of life (HRQoL). The purpose of this study was to investigate the influence of sedentary behavior on HRQoL across young adults in three physical activity engagement groups (i.e., did not meet aerobic or muscle-strengthening PAGs; met either aerobic PAGs or muscle-strengthening PAGs; and met both aerobic and muscle-strengthening PAGs) using moderation analyses. Participants were 427 young adults (<i>M</i><SUB>age</SUB> = 19.15 ± 0.77) from Southwestern U.S. public university. Participants completed an online survey assessing sedentary behavior, physical activity profile, and HRQOL. On average, participants who did not meet aerobic or muscle-strengthening PAGs reported the lowest physical and psychosocial HRQoL and highest screen-time sedentary behavior, while participants who met both aerobic and muscle-strengthening PAGs reported the highest physical and psychosocial HRQoL and lowest screen-time sedentary behavior. Moderation analyses indicated meeting both aerobic and muscle-strengthening PAGs significantly buffered the negative influence of screen-time sedentary behavior on physical HRQoL. Meanwhile, meeting only one of the PAGs (i.e., aerobic or muscle-strengthening) did not significantly buffer the negative influence of screen-time sedentary behavior on physical HRQoL. Considering the current trends of sedentary behavior, the current study provided support in promoting regularly engaging in both aerobic and muscle-strengthening activity. Moreover, it provided evidence supporting the position that interventions designed to improve HRQoL should include both aerobic and muscle-strengthening activity.

Introduction: There is well-known inverse dose-response relationship between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease and all-cause mortality. However, only recently is the entire spectrum of HDL-C being examined with mortality. A similar dose-response relationship with mortality exists with physical activity (PA). Engaging in regular PA has consistently been shown to lower both CVD and all-cause mortality by 20-30%. This study examined the association between HDL-C and mortality by PA categories created around the current federal PA guidelines for United States Adults. Hypothesis: Level of PA participation will modify mortality risk across a spectrum of HDL-C levels. Methods: The study sample (n=8,535) included participants (age 20-79 years) from the 1999-2006 National Health and Nutrition Examination Survey. PA was classified into three distinct categories: Those meeting neither of the PA guidelines (category 1), those meeting only the aerobic PA guideline (category 2), and those meeting both the aerobic PA and muscular strengthening activity guidelines (category 3). HDL-C was categorized into eight groups (≤30, 31-40, 41-50, 51-60 [referent group], 61-70, 70-80, and &gt;80 mg/dL). All-cause mortality served as the dependent variable in this study. Cox proportional hazard models were used for all analyses. Results: Among those in PA category 1, a statistically significant increase in all-cause mortality risk was found for those with an HDL-C of 71-80 (HR 1.94, 95% CI 1.14-3.32) and &gt;80 mg/dL (HR 2.18, 95% CI 1.25-3.79). In those with an HDL-C &lt;30 mg/dL, a borderline significant increase in all-cause mortality risk was found (HR 1.67, 95% CI 0.96-2.89, p=0.06) Among those in PA categories 2 and 3, no significant increases in all-cause mortality risk were found. Conclusions: Results suggest that meeting at least the aerobic PA guideline mitigates the increased risk for all-cause mortality in those with very high HDL-C and potentially very low HDL-C. Future studies are warranted to investigate the effects of PA on mortality across measures of HDL-C.

ImportanceApproximately 80% of US adults and adolescents are insufficiently active. Physical activity fosters normal growth and development and can make people feel, function, and sleep better and reduce risk of many chronic diseases.ObjectiveTo summarize key guidelines in the Physical Activity Guidelines for Americans, 2nd edition (PAG).Process and Evidence SynthesisThe 2018 Physical Activity Guidelines Advisory Committee conducted a systematic review of the science supporting physical activity and health. The committee addressed 38 questions and 104 subquestions and graded the evidence based on consistency and quality of the research. Evidence graded as strong or moderate was the basis of the key guidelines. The Department of Health and Human Services (HHS) based the PAG on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report.RecommendationsThe PAG provides information and guidance on the types and amounts of physical activity to improve a variety of health outcomes for multiple population groups. Preschool-aged children (3 through 5 years) should be physically active throughout the day to enhance growth and development. Children and adolescents aged 6 through 17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. They should also do muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week. Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities. Recommendations emphasize that moving more and sitting less will benefit nearly everyone. Individuals performing the least physical activity benefit most by even modest increases in moderate-to-vigorous physical activity. Additional benefits occur with more physical activity. Both aerobic and muscle-strengthening physical activity are beneficial.Conclusions and RelevanceThe Physical Activity Guidelines for Americans, 2nd edition, provides information and guidance on the types and amounts of physical activity that provide substantial health benefits. Health professionals and policy makers should facilitate awareness of the guidelines and promote the health benefits of physical activity and support efforts to implement programs, practices, and policies to facilitate increased physical activity and to improve the health of the US population.

Objectives Latinos engage in high levels of occupational physical activity, yet low levels of leisure-time physical activity. Limited research has examined specific work-based activities that may contribute to leisure-time physical activity for meeting current physical activity recommendations among Latinos. The purpose of our study was to examine associations between frequency of work-related exertion and standing/walking with meeting the aerobic and muscle-strengthening physical activity guidelines among Latinos and whether associations varied by nativity. Design We used cross-sectional 2015 National Health Interview Survey data on Latinos ≥18 years of age (n = 3162). Logistic regression models were used to estimate associations between the frequency of work-related activities with meeting the aerobic and muscle-strengthening physical activity guidelines. Models were adjusted for age, sex, education, Latino subpopulation, shift work, and nativity. We also examined whether associations varied by nativity. Results In adjusted models, compared with those never engaging in exertion at work, participants always exerting themselves were significantly less likely to meet the aerobic activity guideline (Odds Ratio [OR]: 0.66, 95% Confidence Interval [CI]: 0.51–0.87). Compared with those never standing/walking at work, participants seldom standing/walking were also less likely to meet the aerobic activity guideline (OR: 0.57, 95% CI: 0.34, 0.95). Models were adjusted for age, sex, education, Latino subpopulation, shift work, and nativity. When stratified by nativity, the patterns in the strength of the associations were similar, while differences were observed in the associations of work-related activities with meeting guidelines. Conclusion Our findings suggest that engaging in higher frequency of exertion and standing/walking at work are associated with being less likely to meet the aerobic physical activity guideline during leisure time among Latinos, with variation observed in meeting guidelines by nativity. Insight into physical activities performed at work could inform efforts aimed at promoting recommended levels of physical activity among Latinos.

Introduction: Latino men are more likely to report never participating in aerobic and muscle-strengthening physical activity compared to non-Latino white men. Previous research suggests that spouses/partners can play an important role in promoting healthy behaviors in Latino men. However, limited research has examined the association of marital status with aerobic (e.g., walking, running) and muscle-strengthening physical activity in Latino men. Hypothesis: We hypothesized those that were married/living with a partner would be more likely to meet aerobic and muscle-strengthening physical guidelines. Methods: We used cross-sectional 2016-2018 National Health Interview Survey data on Latino men ≥18 years of age (n=5,592). Participants were asked to self-report their marital status and responses were categorized into married/living with a partner and never married/widowed/divorced/separated. Aerobic physical activity was measured based on minutes of moderate-to-vigorous leisure-time physical activity per week and categorized into 1) meeting the guideline (≥150 min of moderate-vigorous activity or ≥75 min of vigorous activity or 150 min of moderate activity/week), and 2) not meeting guideline (&gt;0 min/week of activity but less than the recommendation). Muscle-strengthening physical activity was categorized as 1) meeting guideline (muscle-strengthening activity ≥ 2 times per week), and 2) not meeting guideline (muscle-strengthening physical activity less than twice a week, never, or were unable). Logistic regression analyses were used to estimate associations of marital status with meeting aerobic and muscle-strengthening activity guidelines. Models were adjusted for age, education, employment status, and nativity. Results: In adjusted models, compared with being never married/widowed/divorced/separated, those that were married/living with a partner were significantly more likely to meet the aerobic physical activity guideline (Odds Ratio [OR]: 1.17, 95% Confidence Interval [CI]: 1.02-1.34). Marital status was not associated with meeting the muscle-strengthening guideline (OR: 0.99, 95% CI: 0.83-1.18). Conclusions: Among Latino men, being married/living with a partner is associated with meeting the aerobic activity guideline, but not the muscle-strengthening recommendation. Given the importance placed on family in Latino culture, the role of spouses/partners should be considered in physical activity promotion among Latino men.

BackgroundStudies have shown that aerobic and muscle-strengthening physical activities reduce mortality risk. However, little is known about the joint associations of the two activity types and whether other type of physical activity, such as flexibility activity, can provide similar mortality risk reduction.ObjectivesWe examined the independent associations of aerobic, muscle-strengthening, and flexibility physical activities with all-cause and cause-specific mortality in a population-based prospective cohort of Korean men and women. We also examined the joint associations of aerobic and muscle-strengthening activities, the two physical activity types that are recommended by the current World Health Organization physical activity guidelines.DesignThis analysis included 34,379 Korea National Health and Nutrition Examination Survey 2007–2013 participants (aged 20–79 years) with mortality data linkage through December 31, 2019. Engagement in walking, aerobic, muscle-strengthening, and flexibility physical activities was self-reported at baseline. Cox proportional hazards model was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders.ResultsFlexibility physical activity (≥ 5 vs. 0 d/wk) was inversely associated with all-cause (HR [95% CI] = 0.80 [0.70–0.92]; P-trend < 0.001) and cardiovascular mortality (0.75 [0.55–1.03], P-trend = 0.02). Moderate- to vigorous-intensity aerobic physical activity (≥ 50.0 vs. 0 MET-h/wk) was also associated with lower all-cause (HR [95% CI] = 0.82 [0.70–0.95]; P-trend < 0.001) and cardiovascular mortality (0.55 [0.37–0.80]; P-trend < 0.001). Similar inverse associations were observed with total aerobic physical activity, including walking. Muscle-strengthening activity (≥ 5 vs. 0 d/wk) was inversely associated with all-cause mortality (HR [95% CI] = 0.83 [0.68–1.02]; P-trend = 0.01) but was not associated with cancer or cardiovascular mortality. Compared to participants meeting the highest guidelines for both moderate- to vigorous-intensity aerobic and muscle-strengthening physical activities, those not meeting in any guideline were associated with higher all-cause (1.34 [1.09–1.64]) and cardiovascular mortality (1.68 [1.00-2.82]).ConclusionsOur data suggest that aerobic, muscle-strengthening, and flexibility activities are associated with lower risk of mortality.

This study examined the association between adherence to aerobic physical activity (PA) and muscle-strengthening activity (MSA) guidelines with all-cause mortality (ACM) and cardiovascular disease-related (CVD) mortality in individuals with and without type 2 diabetes (T2D). Data from 31,802 participants aged ≥ 30 years were analyzed from the Korea National Health and Nutrition Examination Survey (2007-2013). T2D status was determined using standardized criteria, and PA levels were assessed using the International Physical Activity Questionnaire Short Form. Participants were categorized into four groups: neither PA type, MSA only, aerobic PA only and both. Cox proportional hazard models were used to estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for ACM and CVD-related mortality, adjusting for potential confounders: age, sex, body mass index, household income, smoking status, alcohol consumption, marital status, education level, hypertension and dyslipidemia. Median follow-up of 11.5 years of follow-up, 3,600 participants died from all causes, and 766 from CVD-related. Compared to individuals with T2D who did not meet either PA guidelines, those with T2D who adhered to PA guidelines (≥ 500 MET-min/week for aerobic PA and ≥ 2 days/week for MSA) had a lower risk of ACM (HR: 0.65; 95% CI: 0.53-0.80). Additionally, meeting both PA guidelines was associated with a reduced risk of CVD-related mortality (HR: 0.50; 95% CI: 0.32-0.87). Findings highlight the benefits of combined PA for reducing mortality risk and emphasize the importance of integrated exercise interventions in T2D management and prevention. Further research is needed to determine optimal exercise regimens.

BackgroundThe World Health Organization’s ‘Global Recommendations on Physical Activity for Health’ state that adults should engage in regular moderate-to-vigorous intensity aerobic physical activity (MVPA; e.g. walking, running, cycling) and muscle-strengthening activity (MSA; e.g. strength/resistance training). However, assessment of both MVPA and MSA is rare in physical activity surveillance. The aim of this study is to describe the prevalence, correlates and chronic health conditions associated with meeting the combined MVPA-MSA guidelines among a population representative sample of U.S. adults.MethodsIn this cross-sectional study, data were drawn from the U.S. 2015 Behavioral Risk Factor Surveillance System. During telephone interviews, MVPA and MSA were assessed using validated questionnaires. We calculated the proportions meeting both the global MVPA and MSA physical activity guidelines (MVPA ≥150 min/week and MSA ≥2 sessions/week). Poisson regressions with a robust error variance were used to assess: (i) prevalence ratios (PR) for meeting both guidelines across sociodemographic factors (e.g. age, sex, education, income, race/ethnicity); and (ii) PRs of 12 common chronic health conditions (e.g. diabetes, coronary heart disease, hypertension, depression) across different categories of physical activity guideline adherence (met neither [reference]; MSA only; MVPA only; met both).ResultsAmong 383,928 adults (aged 18–80 years), 23.5% (95% CI: 20.1, 20.6%) met the combined MVPA-MSA guidelines. Those with poorer self-rated health, older adults, women, lower education/income and current smokers were less likely to meet the combined guidelines. After adjustment for covariates (e.g. age, self-rated health, income, smoking) compared with meeting neither guidelines, MSA only and MVPA only, meeting the combined MVPA-MSA guidelines was associated with the lowest PRs for all health conditions (APR range: 0.44–0.76), and the clustering of ≥6 chronic health conditions (APR = 0.33; 95% CI: 0.31–0.35).ConclusionsEight out of ten U.S. adults do not meet the global physical activity guidelines. This study supports the need for comprehensive health promotion strategies to increase the uptake and adherence of MVPA-MSA among U.S. adults. Large-scale interventions should target specific population sub-groups including older adults, women, those with poorer health and lower education/income.

Background: Health-related quality of life (HRQOL) is an important concept related to how health status affects a person’s life. Engaging in physical activity (PA) and maintaining healthy body weight are each linked to favorable HRQOL. However, the extent to which PA and body weight independently influence HRQOL is less known. The aim of this research was to examine how meeting PA guidelines and body mass index (BMI) affect a measure of HRQOL in adults. Methods: The Montana Behavioral Risk Factor Surveillance System (BRFSS, 2019) was used for this study. Three different PA guideline variables were used and included a two-level aerobic PA (APA) (met APA or did not meet APA) measure, a two-level muscle strengthening activity (MSA) (met MSA or did not meet MSA) measure, and a two-level PA guidelines (APA/MSA) (met both APA and MSA or did not meet both) measure. BMI was calculated from self-reported height and weight (kg/m2). HRQOL was assessed from a question asking participants to rate their general health with the following response options: “excellent”, “very good”, “good”, “fair” or “poor”. Multinomial logistic regression was used to examine the independent effects of PA and BMI on each HRQOL rating (relative to excellent) while controlling for sociodemographic variables. Results: Differences in HRQOL prevalence was seen within all sociodemographic variables except sex. Additionally, BMI was significantly (p Mean = 30.30, SE = 0.32) compared to those reporting excellent, very good or good health (Mean = 27.28, SE = 0.09), with a similar trend seen across all sociodemographic groups. The fully adjusted regression model including APA/MSA showed decreased odds of very good (OR = 0.75, 95% CI: 0.60 – 0.92), good (OR = 0.61, 95% CI: 0.49 – 0.78), fair (OR = 0.56, 95% CI: 0.40 – 0.78), and poor health (OR = 0.44, 95% CI: 0.28 – 0.69) (relative to excellent health) for adults meeting both APA and MSA. In the same model, increased odds was seen for very good (OR = 1.08, 95% CI: 1.06 – 1.10), good (OR = 1.15, 95% CI: 1.13 – 1.18), fair (OR = 1.19, 95% CI: 1.16 – 1.23), and poor health (OR = 1.16, 95% CI: 1.12 – 1.21) (relative to excellent health) for each 1-unit increase in BMI (1.00 kg/m2). Similar findings were seen in the separate APA model but not the MSA model. Conclusion: This study found that meeting PA guidelines and BMI were both independently related to HRQOL in adults. However, meeting MSA showed lower effects and inconsistent effects on HRQOL. Health promotion specialists concerned with improving HRQOL should promote both APA and MSA guidelines along with healthy body weight behavior. Physical activity programming should consider APA a priority over MSA for improving HRQOL in Montana adults.