In 2016, a study published in Mayo Clinic Proceedings culled data from the 2003 to 2006 National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention. Using data from 5,000 U.S. adults, it is one of the largest surveys of its kind.
Looking at four good-for-you lifestyle behaviors – eating well, exercising, and managing body fat – the study revealed that only 2.7% of those surveyed reported following all four standards. Diving deeper into the results, the report found that 38% ate healthy, 47% were active, but a mere 10% had a normal body fat level.
Another survey, this one conducted in 2019 by MedicareAdvantage (and based on a small sample size of 500), revealed a disconnect between Americans’ perception of their health and what they actually do to stay healthy. For example, nearly half of those who say they’re healthier compared to previous generations are in fact overweight. Meanwhile, 87% of those who never or infrequently consume fruits and vegetables believe they are in “good” or “excellent” health. Similarly, 77% who said they never or infrequently work out say they are in “good,” “very good,” or “excellent” health. And 85% of regular tobacco or e-cigarette users think they are in better health than the average American.
To determine the fittest and fattest states, 24/7 Tempo developed an index of various health behaviors and access to locations for physical activity. Data on the number of fitness and recreational sports centers per 10,000 establishments and the number of specialty food stores – a proxy for health food stores – per 10,000 establishments was calculated using data from the U.S. Census Bureau’s 2020 County Business Patterns and were included in the index at full weight.
Data on the percentage of adults who consume two or more fruits and three or more vegetables daily and the percentage of adults who regularly exercise – meeting meet federal activity guidelines or 150 minutes of moderate or 75 minutes of vigorous aerobic activity and two days of muscle strengthening per week – came from the CDC’s 2019 Behavioral Risk Factor Surveillance System and were both included in the index at double weight. (These are the cities where the fewest people exercise.)
Five-year data on the percentage of commuters who bike or walk to work came from the U.S. Census Bureau’s 2020 American Community Survey and were included in the index at full weight.
Click here to see the states with the most (and least) healthy-conscious residents
By these standards, Vermonters are the healthiest people in the country. They rank the highest for working out and eating fruits and vegetables. The unhealthiest? Kentuckians, where fewer than 5% consume fruits and vegetables and only 15.3% exercise regularly – both the lowest scores in the U.S. (These are the states with the most unreliable access to healthy foods.)
50. Kentucky
> Adults who regularly exercise: 15.3% (the lowest)
> Adults who consume fruits and vegetables: 4.7% (the lowest)
> Commuters who walk or bike to work: 2.3% (13th lowest)
> Fitness and recreation centers: 40.3 per 10,000 establishments (13th lowest)
> Health food stores: 17.6 per 10,000 establishments (6th lowest)
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49. West Virginia
> Adults who regularly exercise: 17.1% (5th lowest)
> Adults who consume fruits and vegetables: 5.2% (3rd lowest)
> Commuters who walk or bike to work: 2.9% (24th highest)
> Fitness and recreation centers: 35.1 per 10,000 establishments (2nd lowest)
> Health food stores: 16.1 per 10,000 establishments (the lowest)
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48. Mississippi
> Adults who regularly exercise: 15.7% (3rd lowest)
> Adults who consume fruits and vegetables: 6.3% (9th lowest)
> Commuters who walk or bike to work: 1.4% (3rd lowest)
> Fitness and recreation centers: 42.6 per 10,000 establishments (17th lowest)
> Health food stores: 16.8 per 10,000 establishments (4th lowest)
47. Oklahoma
> Adults who regularly exercise: 15.6% (2nd lowest)
> Adults who consume fruits and vegetables: 5.1% (2nd lowest)
> Commuters who walk or bike to work: 1.9% (9th lowest)
> Fitness and recreation centers: 38.2 per 10,000 establishments (7th lowest)
> Health food stores: 16.7 per 10,000 establishments (3rd lowest)
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46. Alabama
> Adults who regularly exercise: 17.6% (6th lowest)
> Adults who consume fruits and vegetables: 5.9% (6th lowest)
> Commuters who walk or bike to work: 1.2% (the lowest)
> Fitness and recreation centers: 43.7 per 10,000 establishments (18th lowest)
> Health food stores: 19.2 per 10,000 establishments (11th lowest)
45. Missouri
> Adults who regularly exercise: 17.1% (5th lowest)
> Adults who consume fruits and vegetables: 6.1% (7th lowest)
> Commuters who walk or bike to work: 2.1% (12th lowest)
> Fitness and recreation centers: 42.1 per 10,000 establishments (14th lowest)
> Health food stores: 20.6 per 10,000 establishments (13th lowest)
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44. Arkansas
> Adults who regularly exercise: 19.3% (7th lowest)
> Adults who consume fruits and vegetables: 8.0% (25th highest)
> Commuters who walk or bike to work: 1.8% (6th lowest)
> Fitness and recreation centers: 36.7 per 10,000 establishments (4th lowest)
> Health food stores: 16.6 per 10,000 establishments (2nd lowest)
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43. Louisiana
> Adults who regularly exercise: 19.7% (8th lowest)
> Adults who consume fruits and vegetables: 6.9% (15th lowest)
> Commuters who walk or bike to work: 2.3% (14th lowest)
> Fitness and recreation centers: 46.2 per 10,000 establishments (23rd lowest)
> Health food stores: 26.9 per 10,000 establishments (21st highest)
42. North Dakota
> Adults who regularly exercise: 20.1% (11th lowest)
> Adults who consume fruits and vegetables: 5.8% (5th lowest)
> Commuters who walk or bike to work: 3.6% (14th highest)
> Fitness and recreation centers: 39.6 per 10,000 establishments (10th lowest)
> Health food stores: 23.3 per 10,000 establishments (21st lowest)
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41. Ohio
> Adults who regularly exercise: 20.9% (15th lowest)
> Adults who consume fruits and vegetables: 6.3% (9th lowest)
> Commuters who walk or bike to work: 2.5% (21st lowest)
> Fitness and recreation centers: 49.3 per 10,000 establishments (18th highest)
> Health food stores: 26.9 per 10,000 establishments (20th highest)
40. Nevada
> Adults who regularly exercise: 20.0% (10th lowest)
> Adults who consume fruits and vegetables: 5.4% (4th lowest)
> Commuters who walk or bike to work: 1.9% (7th lowest)
> Fitness and recreation centers: 47.9 per 10,000 establishments (23rd highest)
> Health food stores: 22.8 per 10,000 establishments (20th lowest)
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39. Iowa
> Adults who regularly exercise: 20.0% (10th lowest)
> Adults who consume fruits and vegetables: 7.1% (18th lowest)
> Commuters who walk or bike to work: 3.5% (15th highest)
> Fitness and recreation centers: 46.9 per 10,000 establishments (24th lowest)
> Health food stores: 19.2 per 10,000 establishments (9th lowest)
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38. Tennessee
> Adults who regularly exercise: 21.8% (21st lowest)
> Adults who consume fruits and vegetables: 8.6% (18th highest)
> Commuters who walk or bike to work: 1.4% (3rd lowest)
> Fitness and recreation centers: 49.1 per 10,000 establishments (20th highest)
> Health food stores: 19.2 per 10,000 establishments (8th lowest)
37. Kansas
> Adults who regularly exercise: 20.8% (13th lowest)
> Adults who consume fruits and vegetables: 8.6% (18th highest)
> Commuters who walk or bike to work: 2.5% (21st lowest)
> Fitness and recreation centers: 38.7 per 10,000 establishments (9th lowest)
> Health food stores: 23.9 per 10,000 establishments (24th lowest)
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36. South Carolina
> Adults who regularly exercise: 23.0% (25th highest)
> Adults who consume fruits and vegetables: 7.2% (19th lowest)
> Commuters who walk or bike to work: 2.1% (12th lowest)
> Fitness and recreation centers: 45.6 per 10,000 establishments (21st lowest)
> Health food stores: 23.4 per 10,000 establishments (22nd lowest)
35. South Dakota
> Adults who regularly exercise: 21.8% (21st lowest)
> Adults who consume fruits and vegetables: 6.7% (12th lowest)
> Commuters who walk or bike to work: 3.8% (13th highest)
> Fitness and recreation centers: 42.6 per 10,000 establishments (16th lowest)
> Health food stores: 25.7 per 10,000 establishments (23rd highest)
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34. Indiana
> Adults who regularly exercise: 21.1% (16th lowest)
> Adults who consume fruits and vegetables: 9.1% (8th highest)
> Commuters who walk or bike to work: 2.5% (21st lowest)
> Fitness and recreation centers: 47.3 per 10,000 establishments (25th lowest)
> Health food stores: 22.6 per 10,000 establishments (19th lowest)
33. Nebraska
> Adults who regularly exercise: 20.9% (15th lowest)
> Adults who consume fruits and vegetables: 7.3% (20th lowest)
> Commuters who walk or bike to work: 2.8% (25th lowest)
> Fitness and recreation centers: 50.7 per 10,000 establishments (13th highest)
> Health food stores: 21.5 per 10,000 establishments (17th lowest)
32. Michigan
> Adults who regularly exercise: 23.3% (24th highest)
> Adults who consume fruits and vegetables: 6.5% (10th lowest)
> Commuters who walk or bike to work: 2.6% (22nd lowest)
> Fitness and recreation centers: 38.4 per 10,000 establishments (8th lowest)
> Health food stores: 39.2 per 10,000 establishments (4th highest)
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31. North Carolina
> Adults who regularly exercise: 21.6% (17th lowest)
> Adults who consume fruits and vegetables: 8.2% (23rd highest)
> Commuters who walk or bike to work: 1.9% (9th lowest)
> Fitness and recreation centers: 56.1 per 10,000 establishments (7th highest)
> Health food stores: 21.2 per 10,000 establishments (15th lowest)
30. Georgia
> Adults who regularly exercise: 24.1% (18th highest)
> Adults who consume fruits and vegetables: 7.6% (24th lowest)
> Commuters who walk or bike to work: 1.7% (5th lowest)
> Fitness and recreation centers: 47.3 per 10,000 establishments (25th highest)
> Health food stores: 18.7 per 10,000 establishments (7th lowest)
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29. Wyoming
> Adults who regularly exercise: 24.5% (16th highest)
> Adults who consume fruits and vegetables: 6.9% (15th lowest)
> Commuters who walk or bike to work: 4.5% (8th highest)
> Fitness and recreation centers: 37.7 per 10,000 establishments (6th lowest)
> Health food stores: 17.0 per 10,000 establishments (5th lowest)
28. Idaho
> Adults who regularly exercise: 21.7% (18th lowest)
> Adults who consume fruits and vegetables: 8.3% (22nd highest)
> Commuters who walk or bike to work: 3.3% (19th highest)
> Fitness and recreation centers: 37.1 per 10,000 establishments (5th lowest)
> Health food stores: 27.5 per 10,000 establishments (16th highest)
27. Maine
> Adults who regularly exercise: 20.2% (12th lowest)
> Adults who consume fruits and vegetables: 9.2% (7th highest)
> Commuters who walk or bike to work: 4.0% (10th highest)
> Fitness and recreation centers: 39.6 per 10,000 establishments (11th lowest)
> Health food stores: 33.6 per 10,000 establishments (6th highest)
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26. Pennsylvania
> Adults who regularly exercise: 21.8% (21st lowest)
> Adults who consume fruits and vegetables: 7.0% (16th lowest)
> Commuters who walk or bike to work: 4.0% (11th highest)
> Fitness and recreation centers: 52.8 per 10,000 establishments (10th highest)
> Health food stores: 35.0 per 10,000 establishments (5th highest)
25. New Mexico
> Adults who regularly exercise: 25.7% (8th highest)
> Adults who consume fruits and vegetables: 6.6% (11th lowest)
> Commuters who walk or bike to work: 2.5% (21st lowest)
> Fitness and recreation centers: 44.0 per 10,000 establishments (19th lowest)
> Health food stores: 28.2 per 10,000 establishments (13th highest)
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24. Illinois
> Adults who regularly exercise: 23.4% (23rd highest)
> Adults who consume fruits and vegetables: 6.9% (15th lowest)
> Commuters who walk or bike to work: 3.4% (18th highest)
> Fitness and recreation centers: 48.6 per 10,000 establishments (21st highest)
> Health food stores: 25.7 per 10,000 establishments (22nd highest)
23. Texas
> Adults who regularly exercise: 24.3% (17th highest)
> Adults who consume fruits and vegetables: 9.6% (6th highest)
> Commuters who walk or bike to work: 1.7% (5th lowest)
> Fitness and recreation centers: 48.1 per 10,000 establishments (22nd highest)
> Health food stores: 19.2 per 10,000 establishments (10th lowest)
22. Delaware
> Adults who regularly exercise: 23.8% (22nd highest)
> Adults who consume fruits and vegetables: 8.4% (21st highest)
> Commuters who walk or bike to work: 2.4% (16th lowest)
> Fitness and recreation centers: 60.8 per 10,000 establishments (5th highest)
> Health food stores: 26.9 per 10,000 establishments (19th highest)
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21. Virginia
> Adults who regularly exercise: 22.7% (25th lowest)
> Adults who consume fruits and vegetables: 8.8% (14th highest)
> Commuters who walk or bike to work: 2.8% (25th lowest)
> Fitness and recreation centers: 55.2 per 10,000 establishments (8th highest)
> Health food stores: 24.1 per 10,000 establishments (25th lowest)
20. Utah
> Adults who regularly exercise: 24.9% (12th highest)
> Adults who consume fruits and vegetables: 7.4% (21st lowest)
> Commuters who walk or bike to work: 2.9% (24th highest)
> Fitness and recreation centers: 36.5 per 10,000 establishments (3rd lowest)
> Health food stores: 22.1 per 10,000 establishments (18th lowest)
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19. Maryland
> Adults who regularly exercise: 24.0% (21st highest)
> Adults who consume fruits and vegetables: 8.0% (25th highest)
> Commuters who walk or bike to work: 2.4% (16th lowest)
> Fitness and recreation centers: 49.9 per 10,000 establishments (16th highest)
> Health food stores: 27.6 per 10,000 establishments (15th highest)
18. Wisconsin
> Adults who regularly exercise: 24.7% (15th highest)
> Adults who consume fruits and vegetables: 7.5% (23rd lowest)
> Commuters who walk or bike to work: 3.5% (16th highest)
> Fitness and recreation centers: 55.0 per 10,000 establishments (9th highest)
> Health food stores: 30.6 per 10,000 establishments (10th highest)
17. Florida
> Adults who regularly exercise: 27.0% (4th highest)
> Adults who consume fruits and vegetables: 7.1% (18th lowest)
> Commuters who walk or bike to work: 2.0% (10th lowest)
> Fitness and recreation centers: 44.7 per 10,000 establishments (20th lowest)
> Health food stores: 24.9 per 10,000 establishments (25th highest)
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16. Arizona
> Adults who regularly exercise: 25.5% (10th highest)
> Adults who consume fruits and vegetables: 10.2% (5th highest)
> Commuters who walk or bike to work: 2.5% (21st lowest)
> Fitness and recreation centers: 50.4 per 10,000 establishments (14th highest)
> Health food stores: 23.5 per 10,000 establishments (23rd lowest)
15. Minnesota
> Adults who regularly exercise: 25.5% (10th highest)
> Adults who consume fruits and vegetables: 8.5% (20th highest)
> Commuters who walk or bike to work: 3.2% (21st highest)
> Fitness and recreation centers: 50.1 per 10,000 establishments (15th highest)
> Health food stores: 28.0 per 10,000 establishments (14th highest)
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14. Alaska
> Adults who regularly exercise: 25.6% (9th highest)
> Adults who consume fruits and vegetables: 8.1% (24th highest)
> Commuters who walk or bike to work: 8.4% (the highest)
> Fitness and recreation centers: 39.7 per 10,000 establishments (12th lowest)
> Health food stores: 21.2 per 10,000 establishments (16th lowest)
13. California
> Adults who regularly exercise: 22.6% (24th lowest)
> Adults who consume fruits and vegetables: 8.7% (16th highest)
> Commuters who walk or bike to work: 3.3% (19th highest)
> Fitness and recreation centers: 52.3 per 10,000 establishments (11th highest)
> Health food stores: 28.5 per 10,000 establishments (12th highest)
12. Montana
> Adults who regularly exercise: 28.3% (2nd highest)
> Adults who consume fruits and vegetables: 7.5% (23rd lowest)
> Commuters who walk or bike to work: 5.7% (4th highest)
> Fitness and recreation centers: 47.6 per 10,000 establishments (24th highest)
> Health food stores: 21.0 per 10,000 establishments (14th lowest)
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11. New Hampshire
> Adults who regularly exercise: 26.4% (5th highest)
> Adults who consume fruits and vegetables: 9.1% (8th highest)
> Commuters who walk or bike to work: 2.8% (25th lowest)
> Fitness and recreation centers: 69.9 per 10,000 establishments (3rd highest)
> Health food stores: 25.6 per 10,000 establishments (24th highest)
10. Oregon
> Adults who regularly exercise: 24.9% (12th highest)
> Adults who consume fruits and vegetables: 9.0% (11th highest)
> Commuters who walk or bike to work: 5.6% (5th highest)
> Fitness and recreation centers: 45.8 per 10,000 establishments (22nd lowest)
> Health food stores: 29.9 per 10,000 establishments (11th highest)
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9. Hawaii
> Adults who regularly exercise: 24.8% (14th highest)
> Adults who consume fruits and vegetables: 9.1% (8th highest)
> Commuters who walk or bike to work: 5.4% (7th highest)
> Fitness and recreation centers: 27.3 per 10,000 establishments (the lowest)
> Health food stores: 40.5 per 10,000 establishments (3rd highest)
8. Rhode Island
> Adults who regularly exercise: 24.1% (18th highest)
> Adults who consume fruits and vegetables: 10.4% (4th highest)
> Commuters who walk or bike to work: 3.4% (17th highest)
> Fitness and recreation centers: 58.8 per 10,000 establishments (6th highest)
> Health food stores: 32.5 per 10,000 establishments (7th highest)
7. Washington
> Adults who regularly exercise: 25.9% (7th highest)
> Adults who consume fruits and vegetables: 8.7% (16th highest)
> Commuters who walk or bike to work: 4.4% (9th highest)
> Fitness and recreation centers: 51.3 per 10,000 establishments (12th highest)
> Health food stores: 31.0 per 10,000 establishments (9th highest)
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6. Colorado
> Adults who regularly exercise: 27.4% (3rd highest)
> Adults who consume fruits and vegetables: 9.0% (11th highest)
> Commuters who walk or bike to work: 3.9% (12th highest)
> Fitness and recreation centers: 49.6 per 10,000 establishments (17th highest)
> Health food stores: 20.3 per 10,000 establishments (12th lowest)
5. New Jersey
> Adults who regularly exercise: 21.9% (22nd lowest)
> Adults who consume fruits and vegetables: 8.9% (13th highest)
> Commuters who walk or bike to work: 2.9% (23rd highest)
> Fitness and recreation centers: 66.3 per 10,000 establishments (4th highest)
> Health food stores: 49.4 per 10,000 establishments (2nd highest)
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4. Massachusetts
> Adults who regularly exercise: 22.2% (23rd lowest)
> Adults who consume fruits and vegetables: 8.8% (14th highest)
> Commuters who walk or bike to work: 5.6% (6th highest)
> Fitness and recreation centers: 70.5 per 10,000 establishments (the highest)
> Health food stores: 31.5 per 10,000 establishments (8th highest)
3. Connecticut
> Adults who regularly exercise: 26.1% (6th highest)
> Adults who consume fruits and vegetables: 11.3% (2nd highest)
> Commuters who walk or bike to work: 2.9% (22nd highest)
> Fitness and recreation centers: 70.4 per 10,000 establishments (2nd highest)
> Health food stores: 27.5 per 10,000 establishments (17th highest)
2. New York
> Adults who regularly exercise: 24.1% (18th highest)
> Adults who consume fruits and vegetables: 11.0% (3rd highest)
> Commuters who walk or bike to work: 6.6% (2nd highest)
> Fitness and recreation centers: 49.1 per 10,000 establishments (19th highest)
> Health food stores: 50.1 per 10,000 establishments (the highest)
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1. Vermont
> Adults who regularly exercise: 28.5% (the highest)
> Adults who consume fruits and vegetables: 14.1% (the highest)
> Commuters who walk or bike to work: 6.0% (3rd highest)
> Fitness and recreation centers: 42.4 per 10,000 establishments (15th lowest)
> Health food stores: 27.3 per 10,000 establishments (18th highest)
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