(KSNF/KODE) — The holiday season is officially here. It’s a time for festivity, relaxation, and spending time with loved ones, but it’s also when many Americans “fall off the wagon” when it comes to their health.

Whether it’s from the extra eating and drinking, spikes in stress, or accidents and exposure to germs during travel, government studies have shown emergency room visits increase during the holiday season, with New York City doctors estimating a 5-to-12% spike. According to a study from the Journal of the American Heart Association, holiday heart attacks are real, and lead to a 4% increase in heart-related deaths.

In addition to dangerous holiday behaviors, preventive behaviors like exercising and eating well also tend to drop off. To determine which states are keeping their bodies and minds the healthiest as we head into the holiday season, Lifeextension.com (a website offering information on the science of health and wellness) analyzed data from the Centers for Disease Control and Prevention (CDC).

The results show that while Americans in some states keep up their healthy habits year-round, others are less likely to do so — and therefore are more at risk for heart disease and mental health issues.

Best And Worst States

Fortunately, most Americans say their overall health is either good, very good or excellent: 79% in Kentucky are confident in their health status, while up to 88.8% in New Hampshire and Hawaii see themselves as healthy. But when you dive into individual health habits and incidences of physical and mental illness, the numbers tell a somewhat different story, particularly during the holidays.

Averaging out all health factors, Utah comes out on top, followed by Massachusetts, Connecticut, and Maryland. In these top states, adults tend to work out, have low rates of heart disease and smoking, and report being in good health overall.

In contrast, states like Arkansas, Oklahoma, and Missouri landed at the bottom of the list. The reasons: Lower exercise rate, a high share of smokers, and poor nutrition compared with other states. According to CDC data, a below-average rate of heavy drinking also contributed to the Four States region ranking poorly.

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6 Holiday Health Tips

Stress, travel and traditionally big meals are some common obstacles to staying healthy around the holidays — but with some extra planning, you can prioritize your family’s well-being during the festive season and beyond. Here are six holiday health tips provided by lifeextension.com.

DO enjoy the flavors of the season, but to avoid holiday weight gain and/or bloating after a big meal, watch your portions. Also, consider swapping out decadent dishes for ones considered to be on the healthier side. For example, oat cookies instead of sugar cookies, or mashed cauliflower instead of mashed potatoes.DON’T skip the Thanksgiving turkey because you think it makes you tired — this is a myth! In fact, the tryptophan in Turkey offers multiple health benefits, particularly when it comes to mood.DO enjoy Thanksgiving leftovers, especially these 10 healthy turkey options.DON’T get sidelined during the holidays — Keep your immune system strong by taking echinacea (coneflower).DON’T let stress get the upper hand (often easier said than done during this hectic time of year).DON’T skimp on sleep. If you’re having trouble drifting off to dreamland because you’re worried about your to-do list, melatonin can help — just make sure you’re taking the right amount.

You’ll find more information from the lifeextension.com holiday health study, HERE.