Where do all the fit people live?

We’ll admit up front that states don’t go to the gym or sit like a couch potato in front of the television for hours on end. But their residents do. And some states are far better than others at keeping a fit and healthy population.

Nursa, a per diem health care staffing platform, ranked the 50 U.S. states on fitness using publicly available information. The survey includes information on a state’s smoking rates, diet, walking and hiking routes, aerobic activity and obesity, among other metrics.

The fittest state, as ranked by Nursa, is … Vermont.  It’s followed closely by Massachusetts and then Washington state. Unfortunately, many of the least-fit states are in the South, with Louisiana ranked No. 50. Mississippi is just ahead, followed by West Virginia. Florida is in 38th place.

Why does Vermont do so well? It starts with getting a good night’s sleep. Fewer than a third of Vermonters reported snoozing less than seven hours a night. That’s the lowest rate in the nation.

Just 16% of the state’s residents report being inactive outside of work. Vermont also rates highly in the fruits and vegetables its residents eat. The state also has 19 fast-food restaurants per 100,000 residents, one of the lowest rates in the country. The national average is 24.

Why is Louisiana ranked worst? It has the fewest gyms per capita, at 2.8 per 100,000 people. Its obesity and smoking rates are among the worst in the nation. And 28% of residents say they are inactive outside of work.

No worries if you live in a state that fared poorly. Nobody is doomed by their geography.

So, conduct a frank assessment of your state of health. And get busy exercising.

All of us sleep. It’s a biological imperative. But do we all need to hit the snooze button five times when the morning alarm goes off?

Snoozing involves setting consecutive alarms, usually at about 10-minute intervals, to allow for just a few more minutes of shuteye.

Few scientific studies have measured whether using a snooze alarm is a positive or negative habit for sleepers, and there is little consensus. One thing is clear: Plenty of us do it.

In a recent Harvard University study that used smartphones to track the sleep habits of more than 21,000 adults around the world, researchers found that participants hit the snooze button an average 2.4 times before getting up.

The researchers used the Sleep Cycle app to track more than 3 million sleep sessions from participants in the United States, the United Kingdom, Japan, Australia and Germany. When participants logged a sleep session, they hit the snooze bar or button more than 55% of the time.

Notably, there was more snooze alarm use during the work week than on weekends.

The little research out there suggests that the answer to whether hitting ‘snooze’ is good or bad depends on why someone does it. Is it because they didn’t go to bed early enough to get seven to nine hours of rest? Or are they naturally more night owl than early bird, and 10 minutes helps them ease into the day?

Snooze alarms get a knock from some sleep specialists because if you set an alarm early so you can hit snooze multiple times, you could interfere with the most restful part of the sleep cycle.

The bottom line for snoozers: If lack of sleep is making you drag yourself out of bed, don’t just hit snooze — talk to your doctor.

How nice would it be to make a healthy change to your diet without realizing it?

Two new research studies show how tiny, almost unnoticeable changes could lower sodium levels in packaged and prepackaged goods. These changes could lead to heart healthy improvements for many people and prevent large numbers of heart attacks, strokes and premature deaths.

In France, researchers found that cutting salt in baguettes and other widely eaten breads could lower daily sodium intake by about thirty-five hundredths of a gram per person. Over time, that invisible change could prevent more than 1,000 deaths.

In the United Kingdom, a separate study estimated that meeting the country’s 2024 sodium-reduction goals could reduce an average person’s daily salt intake by 17.5%. That could prevent about 100,000 cases of ischemic heart disease over a 20-year period.

In the U.K. study, researchers analyzed survey data to estimate how much salt people consume from packaged foods and takeout meals. Then, they calculated how much sodium intake would drop if all relevant food categories met the 2024 sodium targets. They measured 84 grocery food categories, including bread, cheeses and snacks.

Consuming too much salt is a big contributor to high blood pressure. It raises the risk of serious conditions like heart attacks, stroke and more.

Because the problem is so dire, reducing salt intake at a population level — rather than asking individuals to cut down on their own — is viewed as one feasible way to improve long-term health while lowering health care costs.

Until such changes come, we’ll have to make smart choices. Watch labels for sneaky sodium and do your best to avoid the salt shaker.

If we’re lucky, most of us will notice our bodies aging gracefully. But new research suggests we might have more factors to contend with than just the ravages of time.

A new study published in Frontiers in Aging found that certain per- and polyfluoroalkyl substances [per- and poly-floor-oh-AL-kill], or PFAS [PEA-fass], can accelerate the “true” physical age of our bodies.

Middle-aged men are the most vulnerable group.

These forever chemicals contain bits found in everyday, manufactured items like non-stick cooking pans, food packaging, water-resistant clothing and more. Their molecular makeup makes them extremely resistant to degradation — hence the use of “forever.”

They’re also everywhere.

Research has linked them to everything from cancer to obesity to hormone disruption. When the team looked at data from more than 300 adults and measured their body’s age on a cellular level, they found that two PFAS in particular were linked to accelerated aging in men between 50 and 64 years old.

Authors pointed out that not all PFAS affect the body the same, as no others were observed to have the same association. This was also not observed in women, and overall levels did not differ between the groups.

One reason middle-aged men were the most impacted could be due to middle age itself, authors said, as it is a “sensitive” window where the body is more susceptible to stressors.

Just because these forever chemicals are abundant doesn’t mean there’s nothing you can do to limit your exposure, however. Experts say to avoid microwaving fast food containers and eat fewer packaged foods.

There’s always a little something you can do.

If you experience osteoarthritis, you’re in good — and widespread — company.

By 2050, millions of people are slated to experience joint pain. The privilege of growing older and wiser comes with a common side effect of aches and pains. Typically, standard treatments include different kinds of medications, or even a surgery … or two.

Now, new research from Ireland suggests that the best treatment is one we microdosed in gym class or dabbled in after a New Year’s resolution: exercise.

Here’s why: The movement feeds our cartilage. This kind of tissue doesn’t come with its own supply of blood, so it relies on our movement to keep working optimally. This movement of fluid and lubrication brings in nutrients to the cartilage. Across the body, exercise dials down inflammation and alters the mechanisms driving damage to our joints. It slows progression. It reduces pain.

One of the earliest signs of osteoarthritis is muscle weakness. Targeted resistance training can help to reverse it, and there are special programs tailored to a variety of neuromuscular exercises aimed at doing just that.

In fact, research shows exercise is one of the most effective means of dealing with long-term joint pain. Regular movement is often an effective stop before surgery — and could even delay its necessity, period.

Researchers analyzed studies and found that the number of people referred to exercise programs is less than 50%. Forty percent are pointed toward surgical options before less invasive ones have been explored.

Hip replacement surgery has come a long way, but so has what we know about exercise.

An obsession can be a bad thing, even if it masquerades as something laudable.

And that is what makes orthorexia nervosa one of the trickiest eating disorders to contend with. In a new study, a team of British and Greek researchers analyzed 16 previous studies that focused on the disorder.

Orthorexia nervosa is an obsession with healthy eating accompanied by restrictive behavior. The attempt to attain perfect health through a pure diet, however, can lead to malnourishment, lost relationships and a sad life.

The person might turn down the office birthday cake every time. Their rigid meal-preparation social media posts are positively reinforced by followers.

And it frequently goes undiagnosed because society, writ large, sees such a diet as virtuous — something we all should be doing. A person with the disorder is continually applauded for the very behavior that is harmful to them.

Imagine you were to try to quit smoking cigarettes, but everywhere you went, people talked about how wonderful it is that you smoke.

The study’s authors say their findings point to a more critical and compassionate approach to health; one that understands the increasingly blurred line between health and disorder, and that resists reinforcing harmful ideals about self-control, food restriction and moralized eating.

Some scholars suggest orthorexia may be a cultural evolution of anorexia nervosa, an obsessive pursuit of thinness that is more widely known. A pursuit of health through clean eating may be more praiseworthy than simply being thin.

Just remember: What looks like self-care on the outside could still be harmful on the inside.

High anxiety is a modern scourge. Part of it stems from the outrage manufactured by social media and the 24/7 news cycle. We can seldom outrun the reach of our smartphones. Coping in the 21st century requires thick skin and Herculean focus.

But now, Brazilian researchers have discovered a medication-free way to deal with the stresses of daily life — stay fit.

Their recent study found that people who have poor cardiorespiratory fitness were nearly eight times more likely to experience high anxiety in stressful situations. That’s compared to fit individuals.

Cardiorespiratory fitness describes how well the heart, lungs and blood deliver oxygen to our muscles.

Researchers also found an association with fitness and anger, with couch potatoes more likely to fume over something than fit counterparts. The study also found that they struggled to control their anger.

Anxiety is a vicious loop. The study shows that high anxiety also tends to reduce physical activity.

Scientists measured this phenomenon by showing a group of healthy young adults a series of photos with disturbing images. Those depicted violence and accidents. They are the sort of images one might find while scrolling through a social media feed.

Then they measured how the viewer’s emotions changed.

Investigators say their findings show that exercise does more than strengthen our muscles. It appears to help rewire our brains to better handle the challenges of daily life.

Americans spend billions on mental health care and medications. But the study suggests that a little exercise might do what a pharmacy sometimes can’t — better control anxiety and anger.

Researchers have long told us that green spaces are healthy. And who could argue that spending time in a woodsy place is better than a stroll along a crowded city street?

A recent study led by a University of California scientist suggests that there might be one exception to the greenery rule: grass.

Investigators tracked nearly 90,000 nurses across the United States for nearly two decades while tracking cardiovascular problems with the group. Those include strokes and heart attacks.

The study found that trees are far more beneficial to health than grass. And the difference is startling.

People living in neighborhoods with more visible trees had a 4% lower rate of cardiovascular disease. Meantime, those living in areas with more grass had a 6% higher rate of cardiovascular disease.

Researchers used data from the Nurses’ Health Study. That study tracked nurses’ health across a wide range of locales, including cities, suburban areas and rural towns.

The team also analyzed 350 million Google Street View photos to measure green spaces.

Scientists suggest that trees can do things for our health that grass just can’t. A tree canopy keeps a neighborhood cooler, which is especially nice in a heat wave. Trees and their branches muffle traffic sounds, which other research has shown can increase risks to the heart. And people walk more often in tree-lined areas.

Now, consider grass. A lawn must be mowed. That creates noise and air pollution. Perhaps most importantly, grassy areas are more common in car-dependent areas. And cars, of course, pollute.

So, next time you look for a new home, check for trees … and maybe don’t worry about the lack of a lawn.

Waking up with a yawn, you wonder what on earth possessed you to dream you were in a kennel. Then, your better half asks if you heard the neighbor’s dogs barking all night.

Now, scientists are using that trick to goad us into creativity.

A new study from Northwestern University shows it is possible to influence what a person dreams about. And they found that REM sleep — that rapid eye movement stage when our most detailed, realistic dreams occur — might help us solve problems.

The scientists used a technique called targeted memory reactivation in a study involving 20 participants who had experienced lucid dreaming. That means they were sometimes aware they were dreaming as they slept.

Each participant was asked to solve a series of tough brain teasers, with three minutes allotted per puzzle. Each puzzle had its own distinctive soundtrack.

Later, when participants were asleep in the lab, researchers recorded their brain activity and other physiological signals. During REM sleep, scientists again played the soundtracks linked to half the unsolved puzzles.

Here’s what they found: 75% of the participants reported dreams that included ideas or facets of the unsolved puzzles. After they woke, participants solved 42% of the puzzles they dreamed about, compared with 17% of the ones they didn’t.

The researchers said their findings don’t necessarily mean you will solve every problem that finds its way into a dream, let alone those that only make sense in a dream-like scenario. But it helps expand what we know about human creativity and tells us sound can influence dreams.

So the next time a problem weighs heavily on your mind? Sleep on it.

Is using a robot pal to talk about your worries or ask for advice a good idea?

A new study from researchers in Denmark suggests those questions may have troubling answers, though they are far from definitive.

A chatbot is a software application that simulates human conversation. You might text and ask it to suggest a hairstyle. Or prompt it to write a poem. Some people use them as companions.

With more than 1.3 billion downloads since 2022, ChatGPT is now widely used.

The Danish researchers wanted to test what had only been reported anecdotally. They searched more than 10.7 million psychiatric patient records for clinical notes that mentioned “ChatGPT,” “chatbot” or had a related spelling.

They found 38 cases in which chatbot use appeared to have potentially added to mental harm, such as feeding delusions, suicidal thoughts, eating disorders and obsessive-compulsive disorder.

In 11 cases, chatbots reinforced a patient’s false beliefs. Six patients showed signs of self-harm tied to chatbot interactions. For five patients with eating disorders, chatbots enabled calorie-counting or food restriction.

While those aren’t large numbers, researchers say the true numbers are likely much higher. Most clinicians do not consistently ask patients about chatbot use. And if they do, it might not end up in a patient’s chart. The researchers asked only about ChatGPT, not its many competitors.

For now, the researchers suggest that mental health professionals talk to patients about their chatbot use, because some would benefit from either reducing their reliance on them or skipping them entirely.