Special Report

Cities With the Worst Diets

Mumemories / Getty Images

Americans have a global reputation for unhealthy eating habits that have led to a national obesity rate of nearly 40%. The situation seems to only be getting worse.

Healthy eating was at its lowest level in 2016, the latest year for which data is available. About 63.3% of U.S. adults reported eating healthy all day the previous day, surpassing the previous low of 67.7% in 2010, according to a Gallup poll. This meant an increase of more than 10 million American adults with poor diets.

Gallup asked tens of thousands of Americans in 189 communities in all 50 states, “Did you eat healthy all day yesterday?” And the answers varied from city to city. 24/7 Tempo reviewed the cities with the highest shares of residents reporting unhealthy eating habits.

Of the 40 cities with the highest share of residents eating unhealthy diets, all but four are either in the South or the Midwest. In the metro area with the worst diet in the nation only slightly more than half of adult residents reported healthy eating. By contrast, in the region with the best diet 75.3% of adults said they are eating healthy.

With information on nutritious foods only a click away, it’s not hard to find examples of what to eat in order to be healthy. Most people already know fruits and vegetables are preferable and junk food should be avoided. For somewhat of a balance, here are several healthy versions of old-school unhealthy snacks.

But eating decisions are impacted by other factors, including money and availability of healthy food options. More than half of the 40 metro areas where people have the worst eating habits have more fast-food restaurants per 100,000 people than the national average of 73 per 100,000 people.

Income may partly explain eating choices. Produce and high-quality meat tend to be more expensive than cheeseburgers and fries, which are among the unhealthiest items in every fast-food chain. The median household income in 33 of the 40 cities with the worst diets is lower than the national median of $60,366 annually. In addition, in just over half of the 40 cities a higher share of households receives food stamps than across the United States as a whole.

In the metro areas where residents reported eating unhealthy, poor health outcomes are a lot more common than in the rest of the United States as a whole. Take obesity, for example. All but three of the 40 cities with the worst diets have a greater adult obesity rate than the national average.  

Click here to see the 40 cities with the worst diets.

To identify the 40 cities with the worst diets, 24/7 Tempo reviewed the metro areas where less than 60% of adults reported eating a healthy diet all day, according to Gallup and Sharecare’s 2016 Community Rankings for Healthy Eating report. Population and median household income data was obtained from the U.S. Census Bureau’s 2017 American Community Survey. Obesity rates and percentage of adults reporting fair or poor health came from the 2019 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program.

Source: Public Domain / Wikimedia Commons

40. Provo-Orem, Utah
> Adults who do not eat healthy: 40.1%
> Fast-food restaurants: 66.9 per 100,000 people
> Adult obesity rate: 25.4%
> Median household income: $70,196
> Adults who report poor or fair health: 11.9%
> Population: 617,678

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Source: DenisTangneyJr / Getty Images

39. Lansing-East Lansing, Michigan
> Adults who do not eat healthy: 40.1%
> Fast-food restaurants: 73.1 per 100,000 people
> Adult obesity rate: 32.9%
> Median household income: $56,440
> Adults who report poor or fair health: 15.9%
> Population: 477,656

Source: pakaloeff / Flickr

38. Fort Wayne, Indiana
> Adults who do not eat healthy: 40.1%
> Fast-food restaurants: 64.9 per 100,000 people
> Adult obesity rate: 31.8%
> Median household income: $52,908
> Adults who report poor or fair health: 14.5%
> Population: 434,617

Source: Spatms / Wikimedia Commons

37. Baton Rouge, Louisiana
> Adults who do not eat healthy: 40.2%
> Fast-food restaurants: 76.5 per 100,000 people
> Adult obesity rate: 33.2%
> Median household income: $57,401
> Adults who report poor or fair health: 18.8%
> Population: 834,159

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Source: Mshake / Getty Images

36. Toledo, Ohio
> Adults who do not eat healthy: 40.2%
> Fast-food restaurants: 88.1 per 100,000 people
> Adult obesity rate: 33.9%
> Median household income: $50,389
> Adults who report poor or fair health: 17.4%
> Population: 603,668

Source: fstop123 / Getty Images

35. Beaumont-Port Arthur, Texas
> Adults who do not eat healthy: 40.3%
> Fast-food restaurants: 64.4 per 100,000 people
> Adult obesity rate: 33.7%
> Median household income: $49,875
> Adults who report poor or fair health: 17.6%
> Population: 411,339

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Source: benkrut / Getty Images

34. Akron, Ohio
> Adults who do not eat healthy: 40.3%
> Fast-food restaurants: 84.2 per 100,000 people
> Adult obesity rate: 29.4%
> Median household income: $56,106
> Adults who report poor or fair health: 15.2%
> Population: 703,505

Source: jmoor17 / Getty Images

33. Chico, California
> Adults who do not eat healthy: 40.4%
> Fast-food restaurants: 68.9 per 100,000 people
> Adult obesity rate: 25.4%
> Median household income: $49,061
> Adults who report poor or fair health: 16.3%
> Population: 229,294

Source: DenisTangneyJr / Getty Images

32. Flint, Michigan
> Adults who do not eat healthy: 40.5%
> Fast-food restaurants: 77.8 per 100,000 people
> Adult obesity rate: 32.4%
> Median household income: $46,298
> Adults who report poor or fair health: 19.9%
> Population: 407,385

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Source: Chris Pruitt / Wikimedia Commons

31. Huntsville, Alabama
> Adults who do not eat healthy: 40.5%
> Fast-food restaurants: 84.5 per 100,000 people
> Adult obesity rate: 32.2%
> Median household income: $61,331
> Adults who report poor or fair health: 15.5%
> Population: 455,448

Source: dougtone / Flickr

30. Binghamton, New York
> Adults who do not eat healthy: 40.6%
> Fast-food restaurants: 73.9 per 100,000 people
> Adult obesity rate: 29.2%
> Median household income: $50,545
> Adults who report poor or fair health: 16.8%
> Population: 242,217

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Source: Morgan Riley / Wikimedia Commons

29. Richmond, Virginia
> Adults who do not eat healthy: 40.6%
> Fast-food restaurants: 72.1 per 100,000 people
> Adult obesity rate: 29.9%
> Median household income: $67,633
> Adults who report poor or fair health: 15.2%
> Population: 1,301,540

Source: Brian Stansberry / Wikimedia Commons

28. Knoxville, Tennessee
> Adults who do not eat healthy: 40.7%
> Fast-food restaurants: 75.5 per 100,000 people
> Adult obesity rate: 32.3%
> Median household income: $51,848
> Adults who report poor or fair health: 18.8%
> Population: 877,874

Source: Sami99tr / Wikimedia Commons

27. Nashville-Davidson–Murfreesboro–Franklin, Tennessee
> Adults who do not eat healthy: 41.0%
> Fast-food restaurants: 79.7 per 100,000 people
> Adult obesity rate: 31.7%
> Median household income: $63,939
> Adults who report poor or fair health: 16.4%
> Population: 1,904,226

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Source: Hanyou23 / Wikimedia Commons

26. Lincoln, Nebraska
> Adults who do not eat healthy: 41.2%
> Fast-food restaurants: 93.2 per 100,000 people
> Adult obesity rate: 27.7%
> Median household income: $60,057
> Adults who report poor or fair health: 11.1%
> Population: 331,592

Source: Public Domain / Wikimedia Commons

25. Columbus, Ohio
> Adults who do not eat healthy: 41.3%
> Fast-food restaurants: 80.9 per 100,000 people
> Adult obesity rate: 30.0%
> Median household income: $63,764
> Adults who report poor or fair health: 15.1%
> Population: 2,078,725

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Source: UrbanTallahassee / Wikimedia Commons

24. Tallahassee, Florida
> Adults who do not eat healthy: 41.3%
> Fast-food restaurants: 75.8 per 100,000 people
> Adult obesity rate: 31.5%
> Median household income: $50,825
> Adults who report poor or fair health: 16.1%
> Population: 385,473

Source: JonClee86 / Wikimedia Commons

23. Omaha-Council Bluffs, Nebraska-Iowa
> Adults who do not eat healthy: 41.4%
> Fast-food restaurants: 69.3 per 100,000 people
> Adult obesity rate: 31.0%
> Median household income: $65,619
> Adults who report poor or fair health: 13.7%
> Population: 934,184

Source: Kruck20 / Getty Images

22. Columbia, South Carolina
> Adults who do not eat healthy: 41.5%
> Fast-food restaurants: 72.6 per 100,000 people
> Adult obesity rate: 32.7%
> Median household income: $54,480
> Adults who report poor or fair health: 16.3%
> Population: 825,004

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Source: zrfphoto / Getty Images

21. Erie, Pennsylvania
> Adults who do not eat healthy: 41.5%
> Fast-food restaurants: 69.2 per 100,000 people
> Adult obesity rate: 33.6%
> Median household income: $50,614
> Adults who report poor or fair health: 15.0%
> Population: 274,541

Source: Daniel Schwen / Wikimedia Commons

20. Indianapolis-Carmel-Anderson, Indiana
> Adults who do not eat healthy: 41.5%
> Fast-food restaurants: 78.3 per 100,000 people
> Adult obesity rate: 31.5%
> Median household income: $59,566
> Adults who report poor or fair health: 15.5%
> Population: 2,027,059

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Source: Ed Schipul / Flickr

19. Killeen-Temple, Texas
> Adults who do not eat healthy: 41.6%
> Fast-food restaurants: 63.7 per 100,000 people
> Adult obesity rate: 31.8%
> Median household income: $53,303
> Adults who report poor or fair health: 18.7%
> Population: 442,693

Source: NatalieMaynor from Jackson, Mississippi, United States. / Wikimedia Commons

18. Jackson, Mississippi
> Adults who do not eat healthy: 41.8%
> Fast-food restaurants: 93.6 per 100,000 people
> Adult obesity rate: 36.1%
> Median household income: $52,434
> Adults who report poor or fair health: 19.5%
> Population: 578,794

Source: benkrut / Getty Images

17. Canton-Massillon, Ohio
> Adults who do not eat healthy: 41.9%
> Fast-food restaurants: 85.0 per 100,000 people
> Adult obesity rate: 32.5%
> Median household income: $51,198
> Adults who report poor or fair health: 16.4%
> Population: 399,927

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Source: DenisTangneyJr / Getty Images

16. Lafayette, Louisiana
> Adults who do not eat healthy: 42.0%
> Fast-food restaurants: 70.6 per 100,000 people
> Adult obesity rate: 34.9%
> Median household income: $47,848
> Adults who report poor or fair health: 18.9%
> Population: 491,558

Source: katsrcool / Wikimedia Commons

15. Oklahoma City, Oklahoma
> Adults who do not eat healthy: 42.2%
> Fast-food restaurants: 79.4 per 100,000 people
> Adult obesity rate: 32.1%
> Median household income: $56,260
> Adults who report poor or fair health: 16.4%
> Population: 1,383,737

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Source: texasbackroads / Flickr

14. Shreveport-Bossier City, Louisiana
> Adults who do not eat healthy: 42.3%
> Fast-food restaurants: 80.1 per 100,000 people
> Adult obesity rate: 37.3%
> Median household income: $38,627
> Adults who report poor or fair health: 19.6%
> Population: 440,933

Source: Jose Kevo / Wikimedia Commons

13. Springfield, Missouri
> Adults who do not eat healthy: 42.3%
> Fast-food restaurants: 75.6 per 100,000 people
> Adult obesity rate: 34.8%
> Median household income: $48,151
> Adults who report poor or fair health: 19.0%
> Population: 461,469

Source: Chris Pruitt / Wikimedia Commons

12. Montgomery, Alabama
> Adults who do not eat healthy: 42.5%
> Fast-food restaurants: 80.8 per 100,000 people
> Adult obesity rate: 36.9%
> Median household income: $49,123
> Adults who report poor or fair health: 20.6%
> Population: 373,889

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Source: DXR / Wikimedia Commons

11. Augusta-Richmond County, Georgia-South Carolina
> Adults who do not eat healthy: 42.6%
> Fast-food restaurants: 67.8 per 100,000 people
> Adult obesity rate: 31.8%
> Median household income: $50,492
> Adults who report poor or fair health: 18.1%
> Population: 600,600

Source: Caleb Long / Wikimedia Commons

10. Tulsa, Oklahoma
> Adults who do not eat healthy: 42.8%
> Fast-food restaurants: 74.4 per 100,000 people
> Adult obesity rate: 31.2%
> Median household income: $52,275
> Adults who report poor or fair health: 16.1%
> Population: 990,773

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Source: Sean Pavone / Getty Images

9. Little Rock-North Little Rock-Conway, Arkansas
> Adults who do not eat healthy: 42.9%
> Fast-food restaurants: 76.0 per 100,000 people
> Adult obesity rate: 34.4%
> Median household income: $53,173
> Adults who report poor or fair health: 19.0%
> Population: 738,082

Source: davidwilson1949 / Flickr

8. Topeka, Kansas
> Adults who do not eat healthy: 43.0%
> Fast-food restaurants: 78.1 per 100,000 people
> Adult obesity rate: 35.7%
> Median household income: $56,834
> Adults who report poor or fair health: 14.4%
> Population: 233,149

Source: gograffer / Flickr

7. Wichita, Kansas
> Adults who do not eat healthy: 43.1%
> Fast-food restaurants: 85.5 per 100,000 people
> Adult obesity rate: 33.9%
> Median household income: $54,432
> Adults who report poor or fair health: 14.8%
> Population: 646,542

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Source: Britt Selvitelle (w:Flickr user Another Britt) / Wikimedia Commons

6. Lexington-Fayette, Kentucky
> Adults who do not eat healthy: 43.1%
> Fast-food restaurants: 85.2 per 100,000 people
> Adult obesity rate: 30.0%
> Median household income: $58,069
> Adults who report poor or fair health: 18.2%
> Population: 512,650

Source: DenisTangneyJr / Getty Images

5. Clarksville, Tennessee-Kentucky
> Adults who do not eat healthy: 43.3%
> Fast-food restaurants: 64.1 per 100,000 people
> Adult obesity rate: 33.4%
> Median household income: $54,667
> Adults who report poor or fair health: 20.3%
> Population: 285,602

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Source: Ken Thomas / Wikimedia Commons

4. Hickory-Lenoir-Morganton, North Carolina
> Adults who do not eat healthy: 43.6%
> Fast-food restaurants: 70.7 per 100,000 people
> Adult obesity rate: 31.8%
> Median household income: $48,079
> Adults who report poor or fair health: 17.5%
> Population: 366,534

Source: Public Domain / Wikimedia Commons

3. Cincinnati, Ohio
> Adults who do not eat healthy: 43.7%
> Fast-food restaurants: 73.2 per 100,000 people
> Adult obesity rate: 31.7%
> Median household income: $61,653
> Adults who report poor or fair health: 15.5%
> Population: 2,180,746

Source: Nclauzing / Getty Images

2. Memphis, Tennessee
> Adults who do not eat healthy: 44.1%
> Fast-food restaurants: 72.0 per 100,000 people
> Adult obesity rate: 35.1%
> Median household income: $50,984
> Adults who report poor or fair health: 19.4%
> Population: 1,346,626

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Source: DenisTangneyJr / Getty Images

1. Lubbock, Texas
> Adults who do not eat healthy: 46.2%
> Fast-food restaurants: 85.2 per 100,000 people
> Adult obesity rate: 32.2%
> Median household income: $47,276
> Adults who report poor or fair health: 18.0%
> Population: 318,011

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