Boston and San Francisco Most 'Active Living Cities' in the U.S., Report Finds

— -- To combat the growing obesity epidemic in the U.S., cities across the country have been promoting more physical activity among city residents with bike paths, sidewalks and green spaces.

Cites in various parts of the country may pride themselves on having the "best" bikes lanes, public transportation systems or park spaces, but a new report ranked which cities have been most successful in helping residents live active lives.

Researchers from Gallup in partnership with Healthways, a company that says it uses science to encourage healthier behavior, examined infrastructure data from 48 U.S. cities and their surrounding areas.

They assessed which cities had the highest "active living environments," by measuring bike lanes, parks, public transit and the degree to which each city was walkable. In reviewing the 149,938 telephone interviews that Gallup conducted with U.S. adults, they also looked at corresponding health effects of those environments.

It turns out that wintery Boston and its surrounding suburbs have earned the title of being the top "active living community" in the U.S., as a result of investments in public areas like bike lanes and parks, according to the report published today by Gallup.

The top five cities included three East Coast metro areas, one Midwest and one West Coast city.

• 1. Boston–Cambridge–Newton, MA–NH
• 2. San Francisco–Oakland–Hayward, CA
• 3. Chicago–Naperville–Elgin, IL–IN–WI
• 4. New York–Newark–Jersey City, NY–NJ–PA
• 5. Washington–Arlington–Alexandria, DC–VA–MD–WV

The lowest scorers included metro areas in the South and Midwest, including Fort Wayne, Indianapolis, Oklahoma City and Tulsa. Cities with the lowest scores were found to have higher rates of negative health conditions including depression, obesity, diabetes, hypertension, high cholesterol and smoking.

Specifically, the report found that "bike and park scores have stronger correlations with lower obesity, diabetes, and blood pressure." A better public transport system was associated with "lower daily physical pain," according to the report.

Report authors used four community examples to highlight how changes infrastructure is associated with better health for residents. In one city, Albert Lea, Minnesota, the community undertook multiple measures to improve health including adding 10 miles of bike lanes and sidewalks, policies to reduce tobacco use and enlisting grocery stores and restaurants to help customers make healthier choices.

From 2014 to 2016 smoking dropped in the Alberta Lea from more than 18.5 percent to under 15 percent, and the number of residents who ate the recommended amounts of fresh produce at least most days of each week rose to 62 percent from 57.5 percent, which is the national average.

Some improvements didn't involve direct health measurements; the improvements contributed to community pride, which surged seven points from 61 percent to 68.7 percent.

The report shows how even small changes can have a big impact on health, according to experts.

"Once again it confirms that lifestyle as medicine is truly the best and most reliable strategy approach to health and well-being," Dr. Roy Buchinsky, director of Wellness at University Hospitals Cleveland Medical Center, who was not involved in the report, told ABC News.

"Clearly it has an affect on many issues we are faced with today including obesity, diabetes, high blood pressure," Buchinksy said, adding that he hoped this report can show why rethinking the development in our cities and metro areas can be key to improving the health of the country.

"It truly shows that evidence-based changes to the environment and to our daily lifestyle can make small little changes," he said, which "can make a huge impact."