Bloomberg on Monday released its 2019 edition of the Bloomberg Healthiest Country Index, ranking the Jewish State at No. 10.

Israel was ranked No. 9 in 2017.

According to the report, Spain ranked No. 1, becoming the world’s healthiest country. In 2017, Spain ranked No. 6.

Bloomberg ranks 169 countries according to the factors that contribute to overall health, such as life expectancy, obesity and access to clean water and sanitation.

The top 10 countries are Spain, Italy, Iceland, Japan, Switzerland, Sweden, Australia, Singapore, Norway and Israel.

Researchers say eating habits may provide a clue to the health levels enjoyed by Spain and Italy, which are similar to the eating habits of Israelis. These countries eat a mostly plant-based Mediterranean diet, lots of whole grains, legumes and nuts, and generally use olive or canola oils over butter or other fats.

America ranked lower in the index at No. 35. Part of the reason, according to Bloomberg, is that life expectancy has decreased in the U.S. largely due to drug overdoses and suicides.

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The final index only included nations with at least 0.3 million population and sufficient data.