TUESDAY, May 24 (HealthDay News) -- Exercising more and smoking less are two of the main reasons why residents of Minneapolis-St. Paul find their city is now the top-ranked in the United States for healthy living.

Every year, the American College of Sports Medicine (ACSM) ranks the 50 healthiest and fittest metropolitan areas in the United States, using the American Fitness Index (AFI). Although kicking the habit was a big part of why the Twin Cities unseated Washington D.C. from the No. 1 spot in 2011, moderate-to-low rates of chronic health problems such as obesity, asthma, heart disease and diabetes also factored into the city's high score (77.2 out of 100 possible points).

Moreover, Minneapolis-St. Paul's percentage of park land is above average, as is its share of recreational facilities. More farmers markets also popped up in the city this past year. These trends tend to indicate residents there are moving towards healthier lifestyles and eating habits, the ACSM noted.

Trailing behind Minneapolis-St. Paul to round out the AFI's top five slots are the following cities:

• Washington D.C., with a score of 76.8
• Boston, with a score of 69.1
• Portland, Ore., with a score of 67.7
• Denver, with a score of 67.6

At the opposite end of the index, Memphis, Tenn., Louisville, Ken. and Oklahoma City ranked lowest. The cities received scores of 32.9, 29 and 24.6, respectively.

Still, the report noted that whether they landed at the top of the list or at the bottom, each city had its strengths and weaknesses when it comes to health and fitness.

"The scores and rankings from the report indicate which metro areas are more fit, and which ones are less fit," Walter Thompson, chair of the AFI advisory board, said in an ACSM news release. "Although Minneapolis ranked first, there is room for improvement. At the same time, even the lowest-ranked areas have healthy residents and community resources supporting health and fitness."

Thompson added the report should serve as either a needed wake-up call or a source of positive re-enforcement for city leaders.

"A regular, scientific evaluation of the infrastructure, community assets, policies and opportunities which encourage healthy and fit lifestyles is imperative for cities wishing to provide a high quality of life for residents," Thompson said. "Community health leaders and advocates in each metro area can use the AFI data report to easily identify their strengths and areas of opportunity."

"There are no quick fixes when it comes to improving the health of an entire metro area," Dr. Wesley Wong, a member of the AFI advisory board, said in the news release.

More information

The U.S. Centers for Disease Control and Prevention offers a wide array of tips on healthy living.