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. 2021 Feb 1;20(1):7.
doi: 10.1186/s12942-021-00260-6.

Associations between the built environment and obesity: an umbrella review

Thao Minh Lam  1   2   3 , Ilonca Vaartjes  4   5   6 , Diederick E Grobbee  4   7 , Derek Karssenberg  8   5 , Jeroen Lakerveld  4   5   9
Affiliations

Associations between the built environment and obesity: an umbrella review

Thao Minh Lam et al. Int J Health Geogr. .

Abstract

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.

Keywords: Built environment; Food environment; Obesity; Obesogenic environment; Overweight; Physical activity; Umbrella review.

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Conflict of interest statement

Dr. Lakerveld reports grants from The Netherlands Organisation for Health Research and Development during the conduct of the study; grants from The Netherlands Organisation for Health Research and Development and grants from Netherlands Heart Foundation outside the submitted work. The other authors declare they have no actual or potential competing financial interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of selected studies
See this image and copyright information in PMC

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