JACKSONVILLE, Fla. -

A new study shows that Jacksonville is one of the unhealthiest, least fit cities in the nation.

According to the study from the American College of Sports Medicine, the annual American Fitness Index ranks the city 37th in the nation when it comes to fitness.

Fitness experts say they're not surprised by the not so flattering spot on the list. They say the city doesn't do a good job at promoting exercise and an active lifestyle and say it can improve by becoming more pedestrian and bicycle friendly.

Elmira Adams, 54, says her computer programming job led to a sedentary lifestyle and eventually left her tipping the scales at more than 220 pounds. But after she was diagnosed with diabetes, she decided she had to make a change, and fast.

"It makes you feel a lot better when you're looking in the mirror and you see a different person," Adams said.

She said she still understands why Jacksonville was recently ranked 37th in the nation when it comes to health and fitness. The ranking is based on smoking and obesity rates and environmental factors, including availability to parks, recreational facilities and walking trails.

"Unfortunately, it doesn't surprise me," said Sean Watts, of CrossFit San Marco. "When you look at our city and some of the way it's planned, we're not a pedestrian city. We're not a mass transit city."

Trainers like Watts say the city needs to take this rating to heart and be proactive about health.

"It's kind of like we wait to see who's going to go on the dance floor first, then we'll go out," Watts said. "So once I think we get all of our civic leaders, city leaders, clergymen, our neighbors involved and see it, then we'll be more apt to get out and participate."

Others like David Wells argue the index is off base "because we have a big military presence here in this part of the country, and it seems like everybody is health conscious, at least the people I talk to," he said.

So how does the city improve its position on the list? Watts says it's pretty simple.

"We've got to start paying attention to our own bodies, paying attention to our environment around us and find any opportunity that you can to exercise," he said.

Watts said the best way to make a fitness routine stick and successful is by two things: Choose an exercise you enjoy, whether it's golf, swimming or just walking with a friend, and then make it part of your routine. Just 30 minutes a day can make a big difference.