The latest findings from Bloomberg have ranked Spain as the healthiest country in the world, largely due to the country’s tendency to consume a Mediterranean diet with extra virgin olive oil and nuts.

The 2019 Bloomberg Healthiest Country Index ranked 169 World Health Organization states for their overall health based on data from the World Health Organization, the United Nations Population Division and the World Bank.

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Data was analyzed in the context of health variables, such as behavior, environment and life expectancy as well as risk factors, such as obesity, high blood pressure and tobacco use.

Spain jumped five places to beat out Italy, formerly the healthiest nation according to the 2017 Bloomberg study. Spain scored an overall health grade of 92.8 out of 100. Other top 10 countries were Iceland, Japan, Switzerland, Sweden, Australia, Singapore, Norway and Israel.

Researchers hypothesized that the exceptional health of Spain’s citizens was largely due to their eating habits. Like Italy, Spain’s adherence to the Mediterranean diet, with a focus on extra virgin olive oil and nuts, has been shown to be healthier than a low-fat diet in protecting against major cardiovascular events.

Bloomberg suggested this might be one reason countries with a low-fat diet, such as Japan, did not score quite as high. The Mediterranean diet has also been linked to healthy brain aging, lower risk of depression, lower risk of stroke in women, a lower risk of obesity and a host of other benefits.

Spain also earned praise for its public health system, notably its emphasis on preventative care for children, women and elderly patients. According to the European Observatory on Health Systems and Policies, the Mediterranean country has seen a decline in cardiovascular diseases and deaths from cancer over the last decade.

According to U.N. data, Spain enjoys the highest life expectancy in the E.U. and the third highest globally, behind Japan and Switzerland. By 2040, it is predicted that the average person born in Spain will have a life expectancy of almost 86 years at birth, which would be the highest in the world.

Canada and the United States came in sixteenth and thirty-fifth in the 2019 Bloomberg Healthiest Country Index, respectively. Meanwhile, Cuba ranked thirtieth, making it the highest-ranking nation that is not considered a “high income” country by the World Bank.

China came in fifty-second and the Asian country is expected to enjoy a higher life expectancy than the United States by the year 2040. Sub-Saharan nations represented 27 of the 30 least healthy nations in the Bloomberg study, along with Haiti, Afghanistan and Yemen.

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