ARLINGTON, Va. (7News) — Two DMV cities were again ranked top among the nation’s fittest cities at a time when more Americans are walking and biking to work, but struggling to maintain healthy sleep and mental well-being, per the American College of Sports Medicine (ACSM).

Arlington, Virginia, and D.C. topped the ACSM American Fitness Index for another year; Arlington ranked number one for its environmental indicators and for having the highest exercise and longest sleeping rate among its residents in the previous month.

D.C. ranked second on the list but had the highest rate of residents eating two or more fruits a day and the second highest rate of residents eating three or more vegetables, according to the index. Seattle, Washington residents ranked third overall but stood at number one in personal health, a category that Arlington placed fourth in.

Ranks were based on 33 factors, including public transportation and walking infrastructure, food security, mental health, and community services among others. Many of the nation’s 100 largest cities since the pandemic have not met the ACSM’s minimum standard for exercise, and have seen a decrease in sleeping hours, a decrease in reports of “excellent/very good health” and an increase in poor mental health, officials said.

Many of the cities on the ACSM list were ranked drastically lower on the personal health rank when compared to their community health rank.

“[L]ocal community leaders must step up and make bold spending choices, policy decisions and infrastructure changes to increase opportunities for residents to be physically active and healthy,” said Dr. Stella Volpe, ACSM President, in a statement. The Fitness Index is a trusted road map showing sound strategies for communities to improve. By embracing collaborative advocacy and leveraging data-driven insights, we can collectively move toward a healthier future for America, one city at a time.”

The ACSM recommends people get at least 22 minutes of aerobic exercise a day and at least take part in muscle-strengthening activity twice a week.

Richmond, Virginia residents ranked 28 out of 100, and cities like Norfolk, Virginia Beach, and Chesapeake ranked below 40. Baltimore, Maryland residents ranked 58 on the list, a drop from previous years.