Poor diet and physical inactivity contribute to many chronic diseases in the United States each year. Diets low in saturated fatty acids and cholesterol and high in plant foods, i.e., fruits and vegetables, legumes and whole cereals, are protective. Physically active lifestyles are associated with lower risk of cardiovascular diseases, diabetes, obesity and some cancers. To access diet and physical activity levels in West Virginians, we conducted a study which was supported by the West Virginia Bureau for Public Health and the West Virginia University Prevention Research Center (CDC Cooperative Agreement). The purposes of this study were to estimate the proportion of the sample meeting recommendations for chronic disease prevention, and to examine if the individuals who were meeting the Surgeon General's physical activity recommendation for health are also consuming healthier diets. Our results showed that reducing saturated fatty acids and increasing consumption of folate, Vitamin E, calcium and fiber are of prime public health importance in West Virginia. Diet and activity levels were modestly related, suggesting that those who adopt a healthy diet also become more active and vice versa. Due to the cross-sectional nature of this data, it is unknown if single-strategy or dual interventions work best. Prospective studies are needed to determine optimal strategies.