Germany's youth city versus rural dwellers engage in more moderate-to-vigorous physical activity.

Rapid urbanization poses the question how city living impacts human physical activity, especially in the population of vulnerable youth. This study aimed to examine urban-rural differences in moderate-to-vigorous physical activity (MVPA) among children and adolescents in Germany in a large German national study, across two independent samples (Discovery study: N = 2734; Replication study: N = 1196) of children and adolescents (6-17 years), with accelerometer-assessed MVPA, and across two different urbanicity assessments. In both studies, city youth engaged in more total MVPA than rural youth and were more likely to comply with the physical activity guidelines of the World Health Organization. While city living and total MVPA were independent of age and gender, age groups differed regarding physical activity guideline compliance. These results point towards a potential positive implication of urbanization for physical activity and suggest actions to target rural areas for physical activity promotion, if findings are validated towards causality in future studies.