T Nation

MSN/Men's Health Ranks the Cities


#1

Ranks best/worst places for general health, surviving a heart attack, who lifts the most/least iron, where all the single girls are, etc.

It also recommends to the citizens of Montgomery, AL (city with most "spare tires") to call Dr. Berardi for help.

TEY

Best & Worst Cities for Men
Our fifth annual survey of U.S. cities reveals the most healthy and least healthy cities to live in

By: Matthew Link, Edited by: Mike Zimmerman
Posted on 12/22/2005

Just what, exactly, were the city fathers thinking when they played papa to your town? Nice plot of land. Fertile. Defensible. Wet (for fish and ships). "Here," they said, "we can build a future." Then they rolled up their sleeves for the original American workout: making something.

We've come a long way since. But that doesn't mean we've taken a step forward. Now, men can be as large and lazy as they want and still see many winters -- but fewer than they might. Certain cities have more than their share of these men dying of heart disease, diabetes, and all manner of cancers. Yet other towns pulse with that wild energy of yore, which keeps their male denizens slim, strong, and motivated.

Our fifth annual survey of the 100 healthiest (and unhealthiest) cities for men throws several thousand chunks of data into a statistical melting pot to figure out why some towns thrive and others fail. The best part: No matter where you live, you'll find enough strategies in these pages to view your hometown just as its city fathers did centuries ago: as a precinct brimming with possibilities, where a motivated man can enjoy every last day of a long life.

Healthiest City in America 2005: San Francisco, CA

Under the rust-colored arc of the Golden Gate Bridge, in the perfect California sunlight, runner after runner comes up to the base of the monument and engages in an odd ritual: Each person high-fives impressions of hands cast in a copper plaque. According to the inscription, these are "Hopper's Hands," and the chain-link fence from which they hang is the turnaround on the long path from downtown.

So why the tribute? As the story goes, a longtime bridge iron worker named Hopper (who is credited with talking down as many as 30 suicidal people from the rails of the Golden Gate over the years) would see all those joggers smacking the fence. So he put up something for them to hit.

Only in San Francisco. And only here would you have a constant stream of joggers running several miles round-trip just to smack a fence. Then again, only in San Francisco would you find the 75,500-acre Golden Gate Recreation Area -- one of the world's largest national parks in an urban setting. Or a city council that hated smoking so much, it banned it in all outdoor public spaces.

It's no surprise, then, that San Francisco is our Healthiest City of 2005 -- scoring big-time grades in prostate cancer (fourth), diabetes (ninth), and heart disease (15th). Only Orlando scored better in average body- mass index (BMI). And only San Jose had more people hitting the gym. If you're not fortunate enough to call San Fran (never "Frisco") home, you can still share in its healthiest secrets, such as imbibing red wine (no city sips more) and swearing off sugar (no one eats less). Here are a few more. . . .

Make fitness fun again. This city's fitness groups inject hilarity into exercise. Note the annual Bay to Breakers 12-K run, which looks like a Halloween parade (participants wear costumes). And the San Francisco Bicycle Coalition is known for "goofball trips like full-moon rides, where you end up at the beach sharing a beer," says Andrew Thornley, program director for the group. The point is to find people who want to break a fun sweat and hang out after. "There's no better way to feel like a 6-year-old again," says Thornley.

Become a master of detection. There is currently no cure for cancer, but there are dozens of treatments that can save lives -- if they're employed early enough. This philosophy of prevention by detection helps explain San Francisco's low cancer death rates. "A lot of people here, especially young people, are well informed about health issues. That makes them more likely to get screened early," says Maxwell Meng, M.D., a urologist at the University of California at San Francisco. As you age, pay attention to the phases in a man's life when certain cancers are most prone to hit: testicular cancer in your 20s, skin cancer in your 30s, colon and prostate cancers in your 50s. If you have a family history, start looking 10 years earlier.

Give yourself a choice. San Francisco is a world leader in food variety, says Eliseo Perez-Stable, M.D., a professor of medicine at the University of California at San Francisco. The city is home to more than 20 vegetarian restaurants and 30-plus health-food stores. It has a dozen year-round farmer's markets selling organic produce. That's the beauty of having so many choices: It's much easier to make the correct ones. Even your town has a grocery store with a produce section, a meat-and-fish counter, and spices. You can find tasty ways to combine all these ingredients here.

The find out the unhealthiest city for men in America, go on to the next page...

Unhealthiest City in America 2005: Charleston, WV

"What form of Satan brought you to Charleston?" a bearded man with a trucker's hat asks me at one of the local bars. "This isn't a place anyone chooses to come to." Well, I didn't choose. The numbers sent me -- and Charleston's combined scores in health, fitness, and quality of life dropped it to the bottom of this year's Healthiest Cities survey.

Case in point: One of the first things you notice at Charleston's Yeager Airport -- besides an impressive American flag covering an entire wall -- is a bright neon sign for Biscuit World. There you can order everything from shaved ham to fried apples in a fluffy biscuit. A trek through West Virginia's state capital reveals that there are actually two competing Biscuit World chains here. No wonder Charleston ranks in the bottom 10 percent of our survey for BMI and diabetes. It also has the 12th-largest percentage of men with high blood pressure. The news isn't better when you look at lung cancer (96th), colon cancer (91st), and heart disease (72nd). And, like most losing teams, Charleston has a lot of men leaving the game early -- it has the worst male suicide rate.

The city does have open spaces for running and cycling, but the paths along the Kanawha River are empty -- as is the wooded Kanawha State Park -- even on this pleasant Sunday in October. The numbers bear this out. Charleston ranked last in the nation for men who jog.

So how do men survive, and even thrive, not just in the unhealthiest city in America, but in the hundreds of towns that share the same bad habits? Some helpful hints . . .

Try conscious eating. Gregory Rosencrance, M.D., has lived in Charleston all his life, and he's well aware of the food culture. Sure, everything's breaded, fried, and covered in gravy. "But the real culprits are the huge portions," says the associate professor of internal medicine at West Virginia University. He points to the French's approach to eating as a desirable role model: lots of sauces and fat, but smaller portions, and taking 3 hours for dinner. The French are conscious of the meal as pleasure and don't "gulp it down" the way we do, says Dr. Rosencrance. Try this: Next time you fill your plate, count to 10 before you dig in. Give each pile of food a once-over. How much should you really eat? Pausing to be conscious of the food will make you more likely to eat it in an intelligent way.

Make exercise your good deed. "Heart disease is the number one killer in Kanawha County," says 40-year-old Tom Light. He should know -- he's a Charleston-based programmer for the West Virginia Health Statistics Center and also has a family history of heart problems. That's why he lost 35 pounds over the past 2 years, trimming down to 175. What's his cardio secret in this land of the heart attack? "I referee at the local high-school football and basketball games," he says. And that makes Light a one-man town-renewal crew. See, volunteering your energy -- as a ref, a coach, a Scout leader, anything active -- is no-lose all around, because you get the exercise, the kids get the activity, and the community gets the positive outcome. Plus, who can skip a workout when all those people depend on you?

Unleash your inner competitor. Json Gladwell, a goateed, twentysomething exercise physiologist, sees the end results of Charleston's health crisis. The gym where he works, Nautilus Fitness Center, adjoins the Charleston Area Medical Center rehab office for postsurgery heart patients, one of whom is Gladwell's client. For his money, Charleston's problem isn't laziness, but apathy. "People don't just pop up and get going," he says. "There's not a lot of motivation here." Well, maybe a little competition would add some motivation. Tomorrow, try to beat everyone to the gym. Try to run a little faster than the guy on the next treadmill. Try for one more rep than the guy before you on the lat machine. Winning these secret battles will go a long way toward winning the war.

To find out which city has the smartest single women and the city with the most spare tires, go on to the next page...

Strength: City with the Most Iron Men

San Jose, CA

Least muscular: Charleston, WV

"Silicon Valley is the computer center of the world," says Greg Payne, PED, chairman of the kinesiology department at San Jose State University. That means that the hypercompetitive men here aren't the skinny geeks people envision. How important is weight training to overall health? Consider that 41 percent more men lift in San Jose than in Charleston. San Jose finished second in our overall rankings; Charleston, dead last.

How men in Charleston can catch up: Use your 25th hour. We all have it. You just need to find that dispensable activity -- the latest episode of Lost, a few quarters of Madden NFL. "If you substitute exercise for something else, you're out of excuses," says Men's Health exercise advisor Michael Mejia, C.S.C.S. Once you find that time, plug the workout into your calendar (use the reminder function on your cellphone) and tear out the Malegrams 15-Minute Workout in every issue of Men's Health.

Strongest Cities: 1. San Jose, CA; 2. Anchorage, AK; 3. Washington, DC; 4. Atlanta, GA; 5. Anaheim, CA

High Blood Pressure: Where the Pressure's Killing Them

Durham, NC

Lowest BP: Toledo, OH

An astounding 41 percent of men in Durham have been told by a health professional that they have high blood pressure. "Hypertension is a big problem in the Southeast," says Thomas Coffman, M.D., chief of nephrology at Durham's Duke University medical center. "You can know that you have it but not suffer the consequences until after you've had a heart attack."

How men in Durham can catch up: Eat celery. Research has shown that pthalide, the compound that gives celery its taste and smell, has antioxidant properties that may relax blood vessels. When test animals were injected with the celery compound, their blood pressure dropped by 13 percent. Try four celery stalks a day, the human equivalent of what the animals received. And no, this is not an excuse to order buffalo wings.

Tops in Low BP: 1. Toledo, OH; 2. Colorado Springs, CO; 3. El Paso, TX; 4. Austin, TX; 5. Anaheim, CA

Smart Single Women: Where the Wild Things Are

Washington, DC

Practically deserted: Phoenix, AZ

Power may indeed be the ultimate aphrodisiac: D.C. is the nation's capital of available women for the second straight year. We combined desirable female stats from the U.S. Census (single, age 25–34, holding a bachelor's degree or higher) with the girl-to-guy ratios of 100 cities and found the best place for men to do some heavy lobbying.

How men in Phoenix can catch up: Men have a tendency to go to places that interest them -- the ballgame, the usual bar -- and wonder where all the women are. Instead, go to places that interest women. Try a Major League Soccer game -- 47 percent of the crowd will be female, more than with most sports. Try a higher-end bar near the courthouse to meet a cute lawyer or paralegal. And how about that Japanese lounge near the hospital, where all the nurses and radiologists go for sushi and sake?

Deepest Dating Pools: 1. Washington, DC; 2. Pittsburgh, PA; 3. Richmond, VA; 4. Raleigh, NC; 5. Boston, MA

Obesity: City with Spare Tires to Spare

Montgomery, AL

Leanest: Orlando, FL

We doubt it's a coincidence that the city with the highest percentage of men with diabetes is also home to the heaviest. With an average BMI of 30.2, Montgomery outweighs the fit and trim Orlando by more than 5 points. Traditional southern cooking may be to blame. "It's a cultural thing," says Scott Bell, M.D., a Montgomery-based physician. "People always put ham or other kinds of fatty meat in any kind of vegetable they cook."

How men in Montgomery can catch up: Pick up the phone and ask for help dropping the pounds. Researchers at the University of Kansas recently had 96 overweight people follow weight-loss counseling programs and discovered that the programs conducted by telephone were just as effective as face-to-face clinical counseling. On average, members of both groups lost 28 pounds in 26 weeks. "Telephone-based programs have the benefits of convenience, lower transportation costs, and accountability with anonymity," says study author Joseph E. Donnelly, Ph.D. Our pick: the phone program offered by John Berardi, Ph.D., C.S.C.S., coauthor of Scrawny to Brawny. Go to johnberardi.com and receive a Men's Health reader discount.

Slimtowns, USA: 1. Orlando, FL; 2. San Francisco, CA; 3. Richmond, VA; 4. Baltimore, MD; 5. Honolulu, HI

To find out the city that exercises the most and the most high-tech hospitals, go on to the next page...

Exercise: Where They're Breakin' a Sweat

Sacramento, CA

Couchbound: Louisville, KY

With an average summer temperature of 74°F, 67 gyms, 192 parks, and a 32-mile bike and jogging trail winding around the city, it's easy for Sacramento men to break a sweat. "With so many opportunities to exercise, everyone finds time for something," says Fred D. Baldini, Ph.D., chairman of kinesiology and health science at California State University at Sacramento.

How men in Louisville can catch up: Challenge a buddy to some one-on-one -- hoops, street hockey, Frisbee, anything sweaty. Ohio State University researchers tracked 350 college students and found that exercising with a friend increased the likelihood of vigorous physical activity by 31 percent.

The Cardio Capitals: 1. Sacramento, CA; 2. Bakersfield, CA; 3. Jacksonville, FL; 4. San Diego, CA; 5. Grand Rapids, MI

Heart Disease: Worst Place to Have a Heart

New York, NY

Fewest heart fatalities: Minneapolis, MN

New York City men are nearly three times more likely to die of heart disease than the boys in Minneapolis. "New York's fast pace increases stress," says Juan Badimon, Ph.D., a professor of cardiology at Manhattan's Mount Sinai School of Medicine. "And commuters are exposed to air pollutants every day, which can lead to arterial inflammation."

How men in New York City can catch up: More dairy. According to a study in the American Journal of Clinical Nutrition, consuming three or more servings of dairy per day can slash your risk of heart disease by 31 percent. "We don't know exactly how dairy lowers heart-disease risk, but other studies show that the calcium and magnesium in it can lower blood pressure," says study author Donna Spiegelman, Sc.D., a professor of epidemiology at the Harvard school of public health. Want even more protection? Seek products fortified with vitamin D. British researchers found that daily D supplements lower blood levels of C-reactive protein, a marker of arterial inflammation, by 23 percent.

Healthiest Hearts: 1. Minneapolis, MN; 2. Salt Lake City, UT; 3. St. Paul, MN; 4. Honolulu, HI; 5. Colorado Springs, CO

High-Tech Hospitals: Where the Doctors Are Wired

New York, NY

Old-school healing: Washington, DC

A 2005 Hospitals & Health Networks survey of 44 U.S. cities found that the medical centers using the most computer technology to improve patient care had 7.2 percent fewer deaths. "Being wired reduces errors, especially with look-alike, sound-alike drugs," says Allan Strongwater, M.D., chairman of orthopedic surgery at Maimonides Medical Center, in Brooklyn, one of the nation's most tech-savvy hospitals. "Paperwork for a simple test used to take hours or days. Now it can be authorized online and viewed instantly from any terminal in the hospital." Go to hhnmostwired.com/05 for a list of the 100 most wired hospitals.

How men in D.C. can catch up: Until more hospitals upgrade, the next-best way to eliminate errors and improve care is to bring someone with you who knows your medical history, says Dr. Strongwater. "Having someone there who's not under the influence of medication or distracted by pain will cut down on physician error," he says. "The doctor will have to explain things -- and that will ensure everything is being thought through."

Wired Hospitals: 1. New York, NY; 2. Boston, MA; 3. Houston, TX; 4. Cincinnati, OH; 5. Chicago, IL

To find out the city with the most male deaths and the city with the most cases of prostate cancer, go on to the next page...

Colon Cancer: City with Its Butt on the Line

Louisville, KY

Most intestinal fortitude: Madison, WI

In the land of fried chicken and gravy, Louisville boys enjoy a smorgasbord of colon-clogging foods. But it's not just the buffet line, says Kristine Krueger, M.D., medical director of the digestive-health center at the University of Louisville. "Folks here smoke, don't exercise, and don't get screened." That's three strikes for Louisville's sluggers.

How men in Louisville can catch up: Drink decaf coffee. A recent study at the Harvard medical school surveyed the tea and coffee consumption of men and women for 18 years -- and showed that drinking 2 or more cups of decaf coffee per day can slash colon-cancer risk by 52 percent. Decaf coffee may have a positive effect on bowel motility -- meaning it keeps things moving -- an effect that the caffeine in regular coffee may cancel out.

Best Rear Guard: 1. Madison, WI; 2. Aurora, CO; 3. San Jose, CA; 4. Fargo, ND; 5. Seattle, WA

Lung Cancer: Where Men Take Their Dying Breaths

Norfolk, VA

Breathing easy: Salt Lake City, UT

Norfolk's military community may protect America's shores, but it's also sinking residents' health. Lung cancer kills three times as many men in Norfolk as it does in Salt Lake City, and we know the likely culprit. According to the Department of Defense, 36 percent of sailors and 39 percent of Marines smoke, compared with 15 percent of Salt Lake City residents.

How men in Norfolk can catch up: Go spit. A 2005 study in the British Medical Journal found that smokers who saw their results from a saliva-based nicotine test were 17 percent more likely to quit. The test, which involves spitting in a cup and measuring the amount of tobacco-derived toxins in the saliva, was used in conjunction with antismoking counseling. Researchers believe that being able to see progress in the quest to quit -- in much the same way one can see the results of a cholesterol-lowering regimen -- helped motivate the participants. Check a local drugstore for NicAlert, a saliva-based nicotine test ($15, also available at www.nymox.com).

Lungs of Iron: 1. Salt Lake City, UT; 2. San Jose, CA; 3. Burlington, VT; 4. Honolulu, HI; 5. Albuquerque, NM

Prostate Cancer: City with the Most Gland Mines

Norfolk, VA

Fewest: Honolulu, HI

Smoking burns Norfolk again, as research shows that lighting up increases a man's risk of prostate cancer. But before you buy a one-way ticket to Honolulu, which has the lowest death rate from prostate cancer, consider: Honolulu's magic bullet may not be the men's lifestyle, but their genes. "Rates of prostate cancer vary widely among ethnic groups," says Laurence Kolonel, M.D., deputy director of the cancer research center at the University of Hawaii in Honolulu. "The population of Honolulu has high numbers of Asians and Pacific Islanders, who also have the lowest risk."

How men in Norfolk can catch up: Pretend you're trying to prevent a heart attack and pop a low-dose aspirin every day. Spanish researchers recently discovered that taking 75 milligrams of aspirin daily lowers the risk of developing prostate cancer by 30 percent. Seems salicylic acid may inhibit the production of COX-2, an enzyme that increases tumor growth. But always talk to your doctor before beginning any aspirin regimen.

Cancer-Proof Prostates: 1. Honolulu, HI; 2. St. Louis, MO; 3. Modesto, CA;

  1. San Francisco, CA; 5. San Jose, CA