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Impact of built environment on physical activity and obesity among children and adolescents in China: A narrative systematic review
Open accessAbstract
BACKGROUND: Neighborhood built environment may profoundly influence children's physical activity (PA) and body weight. This study systematically reviewed scientific evidence regarding the impact of built environment on PA and obesity among children and adolescents in China. METHODS: A keyword and reference search was conducted in Active Living Research, Cochrane Library, PubMed, and Web of Science. Studies that met all of the following criteria were included in the review: (1) study designs-experimental studies, observational studies, and qualitative studies; (2) study subjects-Chinese children and/or adolescents aged ≤17 years; (3) exposures-neighborhood built environment; (4) outcomes-PA and/or body weight status; (5) article type-peer-reviewed publications; (6) time window of search-from the inception of an electronicbibliographic database to May 31, 2018; (7) country-China; and (8) language-articles written in English. RESULTS: A total of 20 studies, including 16 cross-sectional studies, 3 longitudinal studies, and 1 descriptive study, met the predetermined selection criteria and were included in the review. A total of 13 studies adopted subjective built environment measures reported by parents and/or children,2 adopted objective measures (e.g., geographical information system, field observations), and 5 adopted both objective and subjective measures. PA behaviors included PA, physical inactivity, sedentary behavior, active/passive commuting from/to school, and park visits. Among the 16 studies that provided some quantitative estimates of the influence of built environment on PA and body weight status, all reported a statistically significant relationship in the expected direction. Availability and accessibility in proximity to greenspaces, parks, recreational facilities, and sidewalks were found to be associated with increased PA levels, reduced sedentary behaviors, and/or active commuting among Chinese childrenand adolescents. In contrast, the absence of bike lanes and living in higher density residential areas were associated with increased likelihood of childhood overweight and obesity. CONCLUSION: Neighborhood built environment plays an important role in Chinese children's PA engagement and weight outcomes. Building new exercise facilities and enhancing the accessibility of existing facilities hold the potential to enhance PA engagement among Chinese children and adolescents. In addition, urban designs that incorporate sidewalks, bike lanes, walking paths, less motorized traffic, and lower residential density are likely to promote PA and prevent childhood obesity in China.
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“Evidence from China indicates that built environmental features in the community, such as availability and accessibility of open space, recreational facilities and walkable sidewalks, are likely to facilitate increased physical activity and active commuting, as well as reduced sedentary behaviours among Chinese children and adolescents.”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [109]
In the citing paper
“There is consistent evidence of various environmental influences on the physical activity levels of children and adolescents.109–112”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [109]
In the citing paper
“Commonly reported factors influencing physical activity levels include socioeconomic status (income and education), the physical environment (ambient air and water) and the built environment (neighbourhood design, parks and recreational facilities, green space, safety, access to physical activity facilities and street connectivity).”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [109]
In the citing paper
“In contrast, features such as the lack of bike lanes and high residential density are likely to be associated with childhood overweight and obesity.109”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [109]
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Cites
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“The relationship between built environment and PA among children in general has been extensively documented.(16,17) Accumulating evidence suggests that the availability of parks, playgrounds, gyms, and other facilities, as well as other neighborhood features such as walkability and safety, profoundly shape children’s…”
BackgroundAnnual Medical Spending Attributable To Obesity: Payer-And Service-Specific Estimates
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Global prevalence and trends of overweight and obesity among preschool children
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Neighborhood Environment and Physical Activity Among Youth
Ding, D., Sallis, J. F., Kerr, J., Lee, S., & Rosenberg, D. E. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.06.036 · Cited by 914 · cited 1×
“Accumulating evidence suggests that the availability of parks, playgrounds, gyms, and other facilities, as well as other neighborhood features such as walkability and safety, profoundly shape children’s daily PA patterns.(18,19) Roemmich et al.”
BackgroundThe Role of Built Environments in Physical Activity, Eating, and Obesity in Childhood
Sallis, J. F., & Glanz, K. (2006) · The Future of Children · doi:10.1353/foc.2006.0009 · Cited by 755 · cited 1×
“Two systematic reviews have investigated the associations between various built environment attributes and childhood obesity.(56,58) Neighborhood features such as walkability, bikeability, and proximity to parks and recreational facilities were found to be associated with increased PA and active commuting.”
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Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)
Chen, P., Wang, D., Shen, H., Yu, L., Gao, Q., Mao, L., Jiang, F., Luo, Y., Xie, M., Zhang, Y., et al. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-102261 · Cited by 225
“109”
Zhu, Z., Tang, Y., Zhuang, J., Liu, Y., Wu, X., Cai, Y., Wang, L., Cao, Z., & Chen, P. (2019) · BMC Public Health · doi:10.1186/s12889-019-6515-9 · Cited by 209
Dixon, B. N., Ugwoaba, U. A., Brockmann, A. N., & Ross, K. M. (2020) · Obesity Reviews · doi:10.1111/obr.13171 · Cited by 159
Yang, L., Yang, H., Yu, B., Lü, Y., Cui, J., & Lin, D. (2023) · Travel Behaviour and Society · doi:10.1016/j.tbs.2023.100673 · Cited by 149
Liu, H., Zhang, M., Ma, Q., Tian, B., Nie, C., Chen, Z., & Li, J. (2020) · Food & Function · doi:10.1039/d0fo00855a · Cited by 123
Metadata
- Authors
- An, R., Shen, J., Yang, Q., & Yang, Y.
- Affiliations
- University of Illinois Urbana-Champaign (US)
- Beijing Sport University (CN)
- East China Normal University (CN)
- Corresponding author
- An, Ruopeng
- Venue
- Journal of Sport and Health Science
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 8
- Issue
- 2
- Pages
- 153-169
- ISSN
- 2213-2961 (ISSN-L)
- 2095-2546
- PMC
- PMC6451055
- OpenAlex
- W2901880988
- Cited by
- 172
- References
- 60
- Citations by year
- 2026: 19 · 2025: 24 · 2024: 31 · 2023: 26 · 2022: 22 · 2021: 25 · 2020: 18 · 2019: 7
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Journal of sport and health science/Journal of Sport and Health Science (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Transportation › Urban Transport and Accessibility
- Social Sciences › Urban Studies › Urban Green Space and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- built environment, physical activity, childhood obesity, adolescents, sedentary behavior, active commuting, park accessibility, green spaces, recreational facilities, bicycle lanes, housing density, urban design, China
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