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Introduction: Previous studies have reported a higher prevalence of obesity among rural Americans. However, it is not clear whether obesity-related behaviors can explain the higher level of obesity among rural adults. The purpose of this study was to examine the differences in obesity-related behaviors across rural-urban adult populations in the USA.

Methods: Data were obtained from the 1999-2006 National Health and Nutrition Examination Survey, restricted to 14 039 participants aged 20 years or more. Body mass index (BMI) was calculated using measured height and weight, and individuals with BMI;30 kg/m2 were categorized as obese. Physical activity recommendations were used to define participants' physical activity levels: no leisure-time physical activity, less than, meeting, and exceeding the recommended levels. Sedentary behaviors were measured by hours sitting and watching TV or videos or using …