Americans aren’t exercising enough.

Less than a third of U.S. adults meet suggested benchmarks for aerobic and muscle-building activities set out by health officials, according to a new study released on Thursday.

The U.S. Department of Health and Human Services recommends healthy adults spend at least 150 minutes per week—roughly 20 minutes a day—doing moderate-intensity aerobic exercise and at least two days per week doing muscle-strengthening activities.

Only 28% of people in the U.S. are actually following those guidelines, according to the study published by the Centers for Disease Control and Prevention that analyzed more than 30,000 responses from its 2020 National Health Interview Survey. The research from institutions across the country noted that activity could have been dented during the height of the COVID pandemic.

Read More: 9 Ways to Squeeze In More Steps Every Day

People living in rural areas were even less likely to get enough exercise: Only 16% of people outside cities met benchmarks for aerobic and muscle-strengthening activities, compared with 28% in large metropolitan cities areas.

Regional differences emerged as well. People living in the South were less physically active than those in other regions, while people in the West were most active.

Major improvements at the local, state and national level are needed to promote healthy exercise, the authors said, such as sprucing up physical spaces in cities and rural areas to make them more inviting to activity, and encouraging philanthropic investments in research.

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Tanaz Meghjani/Bloomberg

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