These are the healthiest cities in America

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One of the healthiest cities in America is right in the nation's capital. 

For the third year in a row, Washington, D.C. earned the title of America's fittest city, according to the ninth annual American Fitness Index from the American College of Sports Medicine.

The survey, released on Tuesday, compares the 50 largest metropolitan areas in the country based on factors like walkability, school physical education requirements, the number of recreational facilities like parks and swimming pools, and obesity, diabetes and smoking rates.

Cities near the top of the list have "more strengths and resources that support healthy living and fewer challenges that hinder it," researchers wrote in the report.

Eighty percent of people in the Washington area who responded claimed that they exercised in the last 30 days, one of the factors that contributed to the region's top rank.

In the Midwest, things aren't looking quite so hot. Indianapolis came in last for the second straight year. Just 45.6% of residents there were deemed to be in "excellent or very good health."

The survey also revealed some encouraging trends for the US as a whole. About 12% more Americans have exercised in the past 30 days compared to last year's report, while the number of smokers dropped about 5%. Diabetes death rates dropped about 7%.

On the downside, the US is still one of the most overweight countries in the world.

See the full list here.

Here's a selection of the top cities:

1. Washington, D.C.

2. Minneapolis

3. Denver