Minneapolis-St. Paul is the nation’s fittest big city, with San Francisco fourth and Sacramento sixth, according to the latest rankings from the American College of Sports Medicine. Los Angeles, despite its well known worship of the tan, fit body, was only 38th of the 50 big cities in the rankings.

The report, known as the American Fitness Index, reflects a composite of “preventive health behaviors, levels of chronic disease conditions, health care access and community resources and policies that support physical activity,” according to the college.

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