Diet and Exercise

The environments where we live, learn, work, and play affect our access to healthy food and opportunities for physical activity which, along with genetic factors and personal choices, shape our health and our risk of being overweight and obese.

Why Are Diet and Exercise Important to Health?

Balanced nutrition and physical activity are essential for health, yet only one-third of adults engage in the recommended amount of weekly physical activity and many American diets exceed calorie recommendations while being insufficient in servings of fruits and vegetables.[1] Poor nutrition can hinder growth and development, while excessive calorie consumption can lead to obesity, especially when paired with too little physical activity. Inadequate physical activity also contributes to increased risk of conditions such as coronary heart disease, diabetes, and some cancers.[2]

When performed routinely, exercise has been shown to lower symptoms of depression, reduce risk of chronic disease and premature death, and delay age-related cognitive decline.[3-5] However, nearly 73% of high school students in the US do not meet the CDC’s recommended physical activity levels.[2]

As of 2013, 29 million Americans lived in a food desert, without access to affordable, healthy food.[6] Poor diet can lead to both malnutrition and obesity. More than two-thirds of American adults and approximately one-third of children and adolescents are overweight or obese. Obesity is one of the biggest drivers of preventable chronic diseases in the US. Being overweight or obese increases the risk for many health conditions, including type 2 diabetes, heart disease, stroke, hypertension, cancer, Alzheimer’s disease, dementia, liver disease, kidney disease, osteoarthritis, and respiratory problems.[6] Adults with more balanced diets are shown to have better mental and physical health outcomes, with recent studies finding similar trends in adolescent mental health.[7]

Unhealthy food intake and insufficient exercise have economic impacts for individuals and communities. Current estimates for obesity-related health care costs in the US range from $147 billion to nearly $210 billion annually, and productivity losses due to obesity-related job absenteeism cost an additional $4 billion each year.[6] Inadequate physical activity results in $117 million annually in additional healthcare costs.[5] 

Increasing opportunities for exercise and access to healthy foods in neighborhoods, schools, and workplaces can help children and adults eat healthy meals and reach recommended daily physical activity levels.

[1] US Department of Health and Human Services. Facts & Statistics. January 26, 2017.
[2] Centers for Disease Control and Prevention. Physical Activity Facts. April 9, 2018. Accessed March 13, 2019.
[3] Stanton R, Reaburn P. Exercise and the treatment of depression: a review of the exercise program variables. Journal of Science and Medicine in Sport. 2014;17(2):177–182.
[4] Deslandes A, Moraes H, Ferreira C, et al. Exercise and mental health: many reasons to move. Neuropsychobiology. 2009;59(4):191–198. 
[5] Centers for Disease Control and Prevention. Physical Activity Builds a Healthy and Strong America. Accessed January 27, 2020.
[6] Christopher G, Harris CM, Spencer T, et al. F as in fat: How obesity threatens America’s future. Washington, DC: Trust for America’s Health (TFAH); 2013.
[7] O'Neil A, Quirk SE, Housden S, et al. Relationship between diet and mental health in children and adolescents: a systematic review. American Journal of Public Health. 2014;104(10):e31–e42. 

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Our Rankings show how healthy a community is as well as indicators for future health. This provides a starting point for action on improving health for all. Dig deeper into the measures below to learn more about our approaches to measuring health.

Percentage of the adult population (age 18 and older) that reports a body mass index (BMI) greater than or equal to 30 kg/m2 (age-adjusted).

When it comes to developing and implementing solutions to problems that affect communities, evidence matters. The strategies below give some ideas of ways communities can harness evidence to make a difference locally. You can learn more about these and other strategies in What Works for Health, which summarizes and rates evidence for policies, programs, and systems changes.

Establish a break from the school day, typically before lunch, that involves planned, inclusive, actively supervised games or activities; also called semi-structured, or structured recess
Offer group educational, social, creative, musical, or physical activities that promote social interactions, regular attendance, and community involvement among older adults
Offer exercise classes (e.g., aerobic dance, yoga, Tai Chi, cycling, etc.) and fitness program support in community, senior, fitness, and community wellness centers
Assign higher costs to non-nutritious foods than nutritious foods via incentives, subsidies, or price discounts for healthy foods and beverages or disincentives or price increases for unhealthy choices
Provide patients with prescriptions for exercise plans, often accompanied by progress checks at office visits, counseling, activity logs, and exercise testing
Offer participants with low incomes matching funds to purchase healthy foods, especially fresh fruits and vegetables; often called bonus dollars, market bucks, produce coupons, or nutrition incentives

The County Health Rankings provide a snapshot of a community’s health and a starting point for investigating and discussing ways to improve health. Select a state below to see what’s happening locally.