Associations between the built environment and obesity: an umbrella review

• Published in: International journal of health geographics Vol. 20; no. 1; pp. 7 - 24
• Main Authors: Lam, Thao Minh, Vaartjes, Ilonca, Grobbee, Diederick E., Karssenberg, Derek, Lakerveld, Jeroen
• Format: Journal Article
• Language: English
• Published: London BioMed Central 01.02.2021; BioMed Central Ltd; BMC
• Subjects: Air pollution; Bias; Body weight; Built Environment; Care and treatment; Construction; Cross-Sectional Studies; Diagnosis; Domains; Environment Design; Environments; Epidemiology; Exercise; Fast food; Food; Food environment; Health aspects; Health Informatics; Health Promotion and Disease Prevention; Human Geography; Humans; Influence; Land use; Literature reviews; Medical Geography; Medicine; Medicine & Public Health; Meta-Analysis as Topic; Obesity; Obesity - diagnosis; Obesity - epidemiology; Observational Studies as Topic; Outdoor air quality; Overweight; Physical activity; Physiological aspects; Population; Psychological aspects; Public Health; Review; Risk assessment; Rural environments; Socioeconomics; Systematic Reviews as Topic; Umbrella review; Urban areas; Urban environments; Urban sprawl; Urbanization; Netherlands; Obesity; Obesogenic environment; Physical activity; Food environment; Built environment; Umbrella review; Overweight
• ISSN: 1476-072X; 1476-072X
• DOI: 10.1186/s12942-021-00260-6

Background In the past two decades, the built environment emerged as a conceptually important determinant of obesity. As a result, an abundance of studies aiming to link environmental characteristics to weight-related outcomes have been published, and multiple reviews have attempted to summarise these studies under different scopes and domains. We set out to summarise the accumulated evidence across domains by conducting a review of systematic reviews on associations between any aspect of the built environment and overweight or obesity. Methods Seven databases were searched for eligible publications from the year 2000 onwards. We included systematic literature reviews, meta-analyses and pooled analyses of observational studies in the form of cross-sectional, case–control, longitudinal cohort, ecological, descriptive, intervention studies and natural experiments. We assessed risk of bias and summarised results structured by built environmental themes such as food environment, physical activity environment, urban–rural disparity, socioeconomic status and air pollution. Results From 1850 initial hits, 32 systematic reviews were included, most of which reported equivocal evidence for associations. For food- and physical activity environments, associations were generally very small or absent, although some characteristics within these domains were consistently associated with weight status such as fast-food exposure, urbanisation, land use mix and urban sprawl. Risks of bias were predominantly high. Conclusions Thus far, while most studies have not been able to confirm the assumed influence of built environments on weight, there is evidence for some obesogenic environmental characteristics. Registration : This umbrella review was registered on PROSPERO under ID CRD42019135857.