WASHINGTON – It may be pretty obvious from a glance at runners on the National Mall, but D.C. is among the healthiest and most fit metropolitan areas in the nation.

The American College of Sports Medicine has released its annual American Fitness Index. It ranks the Twin Cities area of Minneapolis and St. Paul as the healthiest in the nation for the third year in a row.

The D.C. area ranked second, Baltimore ranked 17th, Virginia Beach ranked 18th and Richmond placed 20th.

USA Today reports the index ranks areas by looking at health factors like smoking, obesity and exercise, as well as factors like the amount of parks and trails in a community.

Among D.C.’s “Areas of Excellence,” according to the index:

• Lower death rate for cardiovascular disease
• Lower percent of days when mental health was not good during the past 30 days
• Higher percent city land area as parkland
• More swimming pools per capita
• More dog parks per capita

Portland, San Francisco and Denver round out the top five.

See the full list here.

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