Physical activity and sedentary behaviour are closely linked to health and the risk of developing various diseases. Therefore, monitoring these behaviours in the population is crucial. To obtain accurate data on both, appropriate measurement tools must be used. Consequently, we conducted a validation study of the measurement characteristics of three of the most commonly used physical activity questionnaires in Europe, involving a sample of 306 healthy adults: the International Physical Activity Questionnaire – Short Form (IPAQ), the Global Physical Activity Questionnaire (GPAQ), and the European Health Interview Survey – Physical Activity Questionnaire (EHIS-PAQ). We compared these questionnaires to the UKK RM42 accelerometer, which participants wore for one week. The reliability and validity results were similar to previous findings and were moderate for reliability and concurrent validity (between questionnaires), but low for concurrent validity between questionnaires and accelerometer (Spearman's ρ between 0.179 and 0.454). On average, participants overestimated their physical activity and underestimated their sitting time by about 2 hours per day. Furthermore, we evaluated the validity of the instruments by physical fitness groups, involving 179 healthy adults. The validity of the questionnaires was highest in the high fitness group (Spearman's ρ for moderate to vigorous physical activity between 0.396 and 0.407). Equivalence testing revealed significant differences between the questionnaires and the accelerometer, and the results were generally not equivalent. However, the EHIS-PAQ's assessment of moderate to vigorous physical activity was entirely equivalent in the high fitness group and comparable in the moderate and low fitness groups. In the Slovenian sample, the reliability and validity of the questionnaires were generally low to moderate. It is important to note that accelerometers and questionnaires are not equivalent, as they do not measure the same dimensions of physical activity. Physical activity and sedentary behaviour are complex behaviours influenced by various factors, and the choice of the most suitable method depends on the purpose of the assessment. It is crucial to critically evaluate the results, considering the strengths and limitations of each method used.
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