Differences in Physical Activity and Diet Patterns between Non-Rural and Rural Adults

Background: It is unclear how rural occupations and lifestyles may play a role in shaping physical activity and diet behaviors that contribute to the rural–urban obesity disparity. Methods: Data come from the prospective and observational South Dakota Rural Bone Health Study, which included adults aged 20–66 years in three groups: (1) non-rural non-Hutterite, (2) rural non-Hutterite, and (3) rural Hutterite. Physical activity data were collected using 7-day physical activity questionnaires, and hours per day in physical activity categories are reported. Diet data were collected using food frequency questionnaires, and food group servings per day (svg/day) are reported. Mixed models were generated to determine group differences in physical activity and diet outcomes, and marginal group means are presented. Results: Among females, both rural groups spent more time in moderate activity (4.8 ± 0.13 h/day and 4.7 ± 0.09 h/day vs. 3.5 ± 0.11 h/day, both p < 0.001) and vigorous activity (0.58 ± 0.03 h/day and 0.53 ± 0.02 h/day vs. 0.43 ± 0.03 h/day, both p < 0.01) and less time sitting (4.4 ± 0.13 h/day and 4.3 ± 0.09 h/day vs. 5.0 ± 0.11 h/day, both p < 0.001) on weekdays than non-rural groups. Hutterite females spent fewer hours in moderate activity (2.6 ± 0.08 h/day vs. 4.5 ± 0.11 h/day, p < 0.001) and vigorous activity (0.18 ± 0.02 h/day vs. 0.46 ± 0.02 h/day, p < 0.001) on weekend days compared to rural females. Hutterite females consumed more fruits (2.2 ± 0.06 svg/day vs. 1.7 ± 0.10 svg/day, p < 0.001) and vegetables (3.6 ± 0.08 svg/day vs. 2.7 ± 0.12 svg/day, p < 0.001) than rural females. Among males, both rural groups spent more time in moderate activity (4.9 ± 0.13 h/day and 6.1 ± 0.12 h/day vs. 3.0 ± 0.16 h/day, both p < 0.001) and less time sitting (4.1 ± 0.13 h/day and 3.4 ± 0.12 h/day vs. 6.0 ± 0.15 h/day, both p < 0.001) on weekdays compared to non-rural groups. Hutterite males spent less time in moderate activity (2.1 ± 0.10 h/day vs. 4.1 ± 0.11 h/day, p < 0.001) and vigorous activity (0.15 ± 0.04 h/day vs. 0.74 ± 0.04 h/day, p < 0.001) on weekend days compared to rural males. Hutterite males consumed more vegetables (3.0 ± 0.10 svg/day vs. 2.0 ± 0.11 svg/day, p < 0.001) than rural males. Conclusions: A rural occupation and lifestyle appear to contribute to differences in physical activity, while traditional rural lifestyle practices contribute to differences in diet.