The 2019 Bloomberg Healthiest Country Index has been released, and Italy is the second healthiest country in the world. “The boot,” which was ranked no. 1 in 2017 in the biannual index, only fell one slot (Spain took top honors).

Researchers attribute part of the positive health trend to a Mediterranean diet, supplemented with extra-virgin olive oil or nuts. The index also took into account smoking and obesity as well as the environment, according to euobserver.com.