The state's residents remain far too inactive and fat, and too many of us still use tobacco, according to N.C. Prevention Partners, which on Wednesday released a report card grading health and prevention measures.

The state's overall grades were unchanged from the last report card, issued in 2005.

Here's how the state's residents measured up in the subjects of nutrition, exercise and tobacco use:

THE GRADES: Despite some improvement in cutting smoking, the overall numbers did not change enough to raise the state above a "C" grade in that subject. And the news was worse in diet and nutrition, areas that again each garnered "D" grades.

THE GOOD: Tobacco use among middle and high school students plummeted, and most of the state's hospitals have gone tobacco free. More than 80 percent of the state's private health insurers now offer some type of benefit or program aimed at encouraging physical activity. About 70 percent of school districts have adopted healthy dining programs.

THE BAD: The percentage of adults who are obese or overweight increased, and senior citizens and high school students showed no improvement. And there are few signs of change. Fruit and vegetable consumption among youths was actually down, despite unprecedented public attention to healthy diet in recent years. "We're at the bottom, and unfortunately the trend is worsening," said Meg Molloy, executive director of N.C. Prevention Partners.

THE COST: Poor lifestyle choices result in higher rates of diabetes, heart attack, stroke, preventable cancers and other ailments that now cost an estimated $26 billion in North Carolina, according to Molloy. That's double the amount from 2005.

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