America's fittest city is Arlington, Virginia – for the fourth straight year, study finds

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Americans were shut out of gyms and other indoor exercise venues for much of last year as COVID-19 raged and leaders locked down group gatherings.

The annual ranking of the fittest U.S. cities released Tuesday shows Americans’ options to stay physically fit during the pandemic hinged on geography. Those who lived in communities with walkable neighborhoods, trails and bike paths had more ways to stay active and stave off high blood pressure, obesity or heart disease.

The American College of Sports Medicine and the Anthem Foundation publishes the annual American Fitness Index ranking the nation’s 100 most populous cities by 34 variables of personal health behaviors, outcomes and community indicators such as air quality and walkability. The report aims to evaluate a community’s strengths and resources to bolster healthy living and barriers that prevent people from staying fit.

Communities with safe and open spaces where people could exercise, walk, bike or play ball fared better and stayed active during the pandemic, said Stella L. Volpe, who chairs the American Fitness Index advisory board.

“Even in the lockdown, when people felt safe or could do so, physical activity increased a bit,” Volpe said. “People were going out and walking with their families and being safe with distancing.”

Stella Volpe, American Fitness Index Chair
Stella Volpe, American Fitness Index Chair

Arlington, Virginia, where nearly 86% of adults reported exercising within the past month, was named America’s fittest city for the fourth consecutive year, followed by Minneapolis; Seattle; Denver; and Madison, Wisconsin.

Oklahoma City's fitness ranked last among the nation's 100 most populous cities. Also in the bottom 5: Tulsa, Oklahoma; North Las Vegas, Nevada; Indianapolis; and Wichita, Kansas.

The report found most Americans didn't meet Centers for Disease Control and Prevention recommendations of 150 minutes of moderate or 75 minutes of vigorous aerobic activity a week, as well as muscle strengthening twice each week.

Fewer than 1 in 4 adults reported performing any exercise in the past month. About 1 in 3 adults in the largest cities are obese and 14% smoke, according to the report.

Cleveland ranks last for sleep quality; St. Louis has highest food insecurity

The fitness ranking, which has been published for 14 years, included two new measurements this year – sleep quality and food insecurity, both stressors for families and individuals during the pandemic.

Volpe said the report highlights sleep as one of four personal health behaviors to prevent chronic disease. Others are maintaining a healthy weight, regular exercise and not smoking. The report listed alcohol consumption as another personal health behavior, but it was not included in the community's overall ranking.

More than one-third of Americans in the 100 largest cities did not get adequate sleep of seven hours or more per day.

About 78% of residents had adequate daily sleep in Lubbock, giving the Texas city the highest score on the quality sleep measure. Cleveland ranked last in sleep, with just 53% of residents getting enough sleep, according to the report.

Many Americans struggled with sleep during the pandemic as families adjusted to work and school at home. Lack of sleep is linked to ill health effects such as slower metabolism, poor heart health, obesity and cancer as well as lack of productivity and focus, said National Sleep Foundation Chair Lauren Hale.

“If you’ve got an acute stress like the pandemic disrupting everything in your life, it is likely to have a negative effect on your sleep,” said Hale, a professor of public health at Stony Brook University.

But Hale said many Americans who worked remotely slept a bit more because they avoided long commutes and spent less time on morning routines. For those Americans, the pandemic was restful.

“People are going to bed later, waking up later, but in general getting more sleep,” Hale said. But “a subset of the population experienced increase insomnia symptoms due to a range of anxiety caused by the pandemic."

Volpe said food insecurity is a critical measure of a community's health because families who don't have a reliable source of nutritious food are more likely to suffer chronic diseases. And with more than 50 million Americans facing food insecurity in 2020 as a result of poverty and job loss, Volpe said it's a challenge nationwide.

People who live in poorer communities might not have a nearby grocer and must rely on convenience stores that don't stock fresh fruits and vegetables, Volpe said.

St. Louis ranked as the city with the highest food insecurity, with 18.2% of residents concerned about accessing nutritious food. New Orleans and Baltimore had slightly lower rates of food insecurity.

Meredith Knopp, president and CEO of the St. Louis Area Foodbank, said her organization coordinates with dozens of community partners to distribute millions of free meals to those in need.

Knopp said up to 70% of people her organization served last year were seeking assistance for the first time. Most have returned to work and fewer are seeking help now, but Knopp said community assistance is still vital. She said it took a decade for the community's appetite for food assistance to wane following the Great Recession.

"We are working very hard to ensure it doesn't take 10 years for people to get back on their feet," Knopp said.

Ken Alltucker is on Twitter as @kalltucker or can be emailed at

This article originally appeared on USA TODAY: American Fitness Index: Arlington, Virginia, No. 1; Oklahoma City last