These are the 10 healthiest countries in the world

• Six of the top 10 healthiest countries are in Europe in 2019, according to the Bloomberg Healthiest Country Index.
• Spain knocked Italy off top spot in 2019 jumping from 6th to take number one in this year's gauge.
• The US didn't even make the top 30 and came in at 35th in the rankings.  

Europe is leading the world's health standings with Mediterranean nations atop the list for 2019 .

In new rankings, Europe takes up six of the top 10 spots with North American countries struggling. The US placed lower at 35th for 2019, five places behind Cuba which was the highest ranked non "high income" country on the list. 

Studies have suggested that a "Mediterranean diet" supplemented with foods like extra-virgin olive oil and nuts, had a lower rate of major cardiovascular events than others, giving added significance to a country's geography on the rankings. 

Asian countries improved their rankings generally with South Korea improving seven places while China rose to 52nd in the world, according to the Bloomberg Healthiest Country Index.

The study took into account 169 countries and graded nations on factors like life expectancy but also penalised tobacco use and obesity. Bloomberg's rankings also considered environmental factors such as sanitation and clean water.

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10. Israel

Israel comes in at number 10 with the country's Mediterranean diet standing it in good stead within the Middle Eastern nation dropping one place from the previous rankings. Alongside great dietary trends Israel also has a comparatively high life expectancy, 82.9 years according to 2017 World Health Organisation data, the world's eighth highest.

9. Norway

The land of Fjords is the first of six European nations in the top ten and the second from the Nordic world. As of 2015, Norway had the highest number of nurses and midwives per capita in Europe, although the country has the highest drug overdose and suicide rate amongst Nordic countries for under-49s. 

8. Singapore

The tiny city-state of Singapore comes eighth in this year's rankings, dropping four places and losing its position as the healthiest Asian nation. The country has one of the highest life expectancies in the region and a well-regarded healthcare system.