The Twin cities, which include Minneapolis and St. Paul, are the fittest cities in the U.S. for the third year in a row according to the annual American Fitness Index from the American College of Sports Medicine. Washington, D.C., Portland, and San Francisco also topped the list this year.
The report analyzes smoking, exercise, obesity rates, chronic health problems and health care access of the largest metropolitan areas in the U.S. It also looks at the environment of the city including recreational facilities, parks and walking trails.
RELATED: The Fittest Cities for Men
Minneapolis offers more recreational activities and parks and spends double the money on parks per person than some of the other cities. Cities at the bottom of the list don’t spend as much money on parks and recreational activities and have higher smoking and death rates.
Oklahoma City, which is recovering from the destructive tornado that hit one of its metro areas, was last on the list. Detroit and San Antonio also came in at the bottom.