NEW YORK (REUTERS) - US cities that provide parks, walking trails, playing fields and running tracks are setting standards for the country's healthiest urban areas and showing that if they build fitness opportunities, residents will come.
A new ranking of the 50 healthiest US cities weighs "community indicators" that include everything from obesity rates and percentage of smokers to the number of baseball diamonds and tennis courts.
"Community indicators and personal health pretty much follow each other," said Walter Thompson, the chairman of the American College of Sports Medicine's American Fitness Index Advisory Board, which compiled the report.
Despite its bone-chilling winters, Minneapolis-St. Paul topped the list for the third year in a row.
High obesity and smoking rates placed Oklahoma City at the bottom.
Minnesota's Twin Cities understand that at certain times of year they will be buried in snow, and so they have created lots of places to exercise indoors, Thompson said.
The report also notes Minneapolis-St. Paul's generous per-capita number of dog parks, golf courses and baseball diamonds.
More than 76 per cent of Minneapolis-St. Paul residents reported exercising in the past 30 days.
Minnesota is sometimes referred to as the land of 10,000 lakes, and the natives appear to use every one of them.
"We have a lot of triathlons because we have so many lakes," said Minneapolis-based fitness expert Chris Freytag.
"There is a lake every 5 miles, so you can't get far from a lake with biking paths, windsurfers, kayaks. Water is a motivator."
The index relied on information from municipalities and federal government data, such as Centers for Disease Control and US Census reports.
Washington D.C., Portland, Oregon; San Francisco and Denver scored well in the fitness stakes, while Memphis, Tennessee; Louisville, Kentucky; San Antonio, Detroit and Oklahoma City were the least healthy.
Robust park-related spending helped Portland spring to third place from seventh in 2012 and Denver move to fifth position from ninth.
Anne Graves, director of health initiatives and partnerships for the YMCA of Greater Indianapolis, sees her city's 45th place ranking as a challenge and an opportunity.
"We use AFI as our guide," said Graves, adding that the YMCA has convened a coalition of community partners to focus on AFI points, from increasing the number of farmers' markets and bicycle lanes to encouraging physicians to emphasize the importance of exercise.
The California cities of San Francisco, Sacramento and San Jose fell within the top 10 on the list.
American Council on Exercise spokeswoman Jessica Matthews said California's beautiful weather, daily farmers' markets and abundance of parkland were only part of the story.
"California public schools have pretty high standards for physical education," said Matthews, a former physical education teacher living in 14th-ranked San Diego, California. "Great habits are instilled at a young age."