What is the fittest city in America? The answer has a lot to do with sleep and mental health

Even as the nation moves beyond the COVID-19 pandemic, about half of U.S. adults don’t get enough aerobic activity and fewer than 1 in 4 adults do enough aerobic and strength exercises.

According to the latest fitness ranking of the nation's 100 largest cities, about 51% of adults get American College of Sports Medicine's recommended 150 minutes of moderate intensity aerobic activity every week. Such routine physical activity helps stave off chronic disease and reduces or prevents symptoms of anxiety and depression.

The annual ACSM/Elevance Health Foundation Fitness Index ranks the 100 largest cities and communities using 34 personal and community health indicators.

Arlington, Virginia was the fittest city for the 6th consecutive year. Washington, D.C ranked second, followed by Seattle, Minneapolis and Irvine, California. Oklahoma City had the lowest ranking among the 100 cities. Others in the bottom five include Wichita, Kansas; Bakersfield, California; Louisville, Kentucky and North Las Vegas, Nevada. The full report and scores can be viewed here.

The fitness report gives city and community leaders insight to policy, systems and strategies that can help communities improve health and fitness, according to ACSM.

"We need people to be more physically active," said Stella Volpe, chair of the American Fitness Index Advisory Board and ACSM president-elect. "It doesn't have to be running a marathon. It could be out for a walk with your friends, your dogs, your family."

Mental health, lack of sleep weigh on Americans

This year's report includes new data on mental health concerns as the nation emerges from the COVID-19 pandemic. About 42% of adults reported poor mental health in the past month. Miami residents had the sunniest disposition among the nation's largest cities, with just 27% reporting recent poor mental health. Richmond, Virginia ranked last with 63% reporting recent poor mental health.

The report also said at least 1 in 3 adults in the top 100 cities didn’t get enough sleep − a risk factor for chronic disease such as diabetes, heart disease and obesity. However, the report suggests cities whose residents get enough sleep tend to rank better in overall fitness. Five cities among the Top 10 Most Restful also ranked among the Top 10 Fittest Cities.

San Jose, California and Madison, Wisconsin shared the top spot for sleep with 78.8% of adults getting at least 7 hours each day. Corpus Christi, Texas ranked last with 57% of residents getting enough sleep.

Obesity, heart disease among chronic health woes

The nation's lack of physical activity harms Americans in other ways. About 4 in 10 adults had two or more chronic diseases, which put them at higher risk for COVID-19 complications.

Nearly 31% of residents in the 100 largest cities were obese and 30% have high blood pressure, two chronic health conditions that became more common during the pandemic. Nearly 11% have diabetes.

The report said chronic diseases are often linked to unhealthy behaviors such as smoking ortobacco use, poor diet, alcohol abuse or lack of physical activity. The report said improved physical activity could help people live longer and prevent 1 in 12 cases of diabetes and 1 in 15 cases of heart disease.

Top 10 fittest cities

1. Arlington, Virginia

2. Washington D.C.

3. Seattle

4. Minneapolis

5 Irvine, California

6. Madison Wisconsin

7. San Francisco

8 St. Paul, Minnesota

9 Denver

10 Oakland, California

Bottom 10 cities

91 Kansas City, Missouri

92 Lubbock, Texas

93 Indianapolis, Indiana

94 Tulsa, Oklahoma

95 Memphis, Tennessee

96 North Las Vegas, Nevada

97 Louisville, Kentucky

98 Bakersfield, California

99 Wichita, Kansas

100 Oklahoma City

Source: ACSM/Elevance Health Foundation Fitness Index

This article originally appeared on USA TODAY: The fittest city in America ranks health of the 100 largest cities