A Tale of Two Cities: Fattest and Fittest Towns in America

She added that list is "somewhat typical" for Burlington, if not for the rest of the country.

Montstream's philosophy is the fewer ingredients the better, and she looks for local and healthy food choices, even though it can be expensive.

"You just have to look and compare," she said.

In terms of infrastructure, Burlington's downtown shopping district is closed to traffic, forcing shoppers to get out of their cars and walk. The town sits on Lake Champlain, a four-season playground, which abounds with outdoor exercisers.

"With Burlington, we have this amazing lake where we can swim, there's the bike path that people use all year round -- they cross-country ski on it in the winter," Montstream said. "I think we all get inspired by each other and how we eat and how we move our bodies and try to keep active."

Huntington, too, sits next to water, but the Ohio River is a more of a workhorse than a showhorse. Huntington's waterfront has less than a mile of walkable paths along the river bank. On a February afternoon, one lone runner went by.

Dr. Tom Dannals, a family practitioner known locally as an exercise evangelist, wants to make Huntington's riverfront more accessible to exercisers. He is trying to raise money to create the Paul Ambrose Trail for Health, or PATH, named after a beloved local doctor who was killed at the Pentagon on 9/11.

"We want to build a trail on top of the flood wall," he said. "If you live close to a trail then you'll use it. It sounds very simple, but it's absolutely true."

Dannals took "Nightline" on a driving tour of Huntington, pointing out that the town's infrastructure is not conducive to exercising outdoors. He pointed out that most roads have no shoulder for running or biking.

"It's dangerous out here," he said.

The underlying reasons for the differences in the health of the two towns may lie in economics, education and culture, all indicators that favor the Vermonters.

But the residents of Huntington consider the study a wakeup call and are vowing to make changes that will result in a better ranking next year.

'It's Cheap to Be Fat'

Michelle Isenberg is looking to change her family's eating habits after living in Huntington for six years. She said their cabinets used to be "stuffed with two or three bags of chips, and then we would have Oreos -- and there would probably be a couple of those little 90-cent packages of candy bars."

Now, the freezer is stocked with meat and frozen vegetables.

"To get fresh fruits and vegetables in this area is very expensive, so we have a lot of frozen vegetables," she said.

"It's cheap to be fat," she added. "It's expensive to be healthy."

Isenberg said she has also learned an important rule about the layout of grocery stores that she now follows: Shop the outside aisles.

"Fresh fruits and vegetables are on the outside," she said. "Your meats, your dairy -- I call it all the stuff that God created -- is on the outside. All the stuff that man created that sometimes isn't good for you is on the inside."

Back at Christ Temple Church, a large room has been outfitted as a gym, and two nights a week you'll find church members doing aerobics and weight training. They aren't proud of their moniker as the unhealthiest city in the United States.

As one member said, "I'm glad they pointed it out if it is true, because that alone is motivation to change."

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