Cape Town may be the most beautiful city in South Africa, but it also seems to have a higher rate of lifestyle-related illness than most other cities in the country.
This is according to a Men's Health magazine study, which rated the city the second worst for poor lifestyles and bad health.
The two-month study, which sought to determine the healthiest South African city to live in, found Cape Town to have the highest rate of diabetes and the second-highest rate of heart disease and stroke in men.
Nine cities were surveyed and Polokwane in Limpopo came out tops with the least lifestyle-based illnesses.
Deputy editor Adam Cooke, who led the study, said the results were gleaned from death records kept by the police, the health and home affairs departments, the Medical Research Council and Arrive Alive.
"The study was a matter of taking the latest information from different sources and putting it in one document and making it new and relevant. We then put all this information together and, when we scored, we found that Cape Town had shocking health statistics."
Cooke said although the city had lots of gyms and high gym membership, it was evident that many people were still eating very poorly and were not exercising.
Even those who had moved from rural areas were changing their relatively healthy diet to one with less fibre.
"These are diseases of lifestyle," Cooke said.
"One of the clear things we found is that people are eating lots of processed foods.
"Cape Town has also seen an influx of people from rural areas and it is clear that these people change their healthy rural diet drastically once they move to the city. People are eating less fresh produce because it is easier to get processed foods and, probably because of the lack of land, they can't have their own vegetable gardens."
Cooke said the good news was that the city had a low prevalence of HIV compared to the rest of the country.
Commenting on the study, Heart Foundation dietitian Lunelle Arendse said diabetes was often the consequence of not taking responsibility for health and not cultivating healthy lifestyle habits.
The city also had a poor showing when it came to public sports facilities, coming third last in this category.
But it had a reasonable gym score, with fitness regimes revolving around its environment. "Capetonians do a wide variety of outdoor activities," said Mike Finch, editor of Runner's World. "The mountain and sea are part of our lifestyle. People here paddle, cycle, run and surf at any time. Cape Town has more active outdoor people than other cities because it has the natural resources you need.
"Table Mountain National Park attracts four million visitors to the mountain each year, the great majority of them regular visitors who use it as a resource."
The study also found the city has the country's highest burglary rate and the second highest rate of murder and assault with intent.