It’s trendy in some circles to bash government guidelines related to exercise and nutrition. After all, if obesity rates are rising and the physical fitness levels of the population are declining with each generation, the guidelines must be bad…right?

There’s an obvious flaw in this line of thinking: public health guidelines and recommendations don’t determine health and fitness outcomes. The best recommendations in the world wouldn’t improve health outcomes if no one followed them. So, that begs the question: how many people actually meet government exercise guidelines? Dietary guidelines are a topic for another day.

A recent meta-analysis by Garcia-Hermoso and colleagues sought to evaluate the proportion of individuals adhering to government guidelines for aerobic and muscle-strengthening activities (1). To be included in the meta-analysis, a study needed to examine individuals who were at least 5 years old, and assess adherence to guidelines for both aerobic exercise and muscle-strengthening activities via either questionnaires or accelerometry. Ultimately, 21 studies met these inclusion criteria, evaluating 3,390,001 individuals from 32 countries.

Adherence rates varied country-to-country, from a high of 53.4% in Iceland, to a low of 0.5% in Romania (6). However, the pooled average was 17.3% (Figure 1). Sub-analyses found that men were a bit more likely to adhere to both guidelines (aerobic and strength exercise) than women, older adults were a bit less likely to adhere to both guidelines than younger, adherence was nonlinearly related to BMI status, and adherence was positively associated with education level (Figure 2).