Story highlights Washington tops the list for the third year in a row

Indianapolis is at the bottom of the list of 50 metropolitan areas

For the third year in a row, Washington, D.C., has nabbed the top spot in the annual American Fitness Index (PDF), which ranks the 50 biggest metropolitan areas in the country.

The AFI report, which is put out by the American College of Sports Medicine, takes into account factors including residents' mental health, diet, mortality rate, and more. It also looks at the resources available to locals, like walking trails, rec centers, and farmer's markets.

Washington D.C. finds itself at no. 1 thanks to a low smoking rate, high activity levels (especially among commuters that tend to, say, bike or walk to work), and the easy access the city offers to a multitude of recreational facilities and parks.

Rounding out the top five after the nation's capital are Minneapolis-St. Paul, Denver, Portland (Oregon), and San Francisco.