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Cited by 25Urban Green Space and HealthUrban Transport and AccessibilityPhysical Activity and Health

Association of greenspaces exposure with cardiometabolic risk factors: a systematic review and meta-analysis

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Sharifi, Yasaman, Sobhani, Sahar, Ramezanghorbani, Nahid, Payab, Moloud, Ghoreshi, Behnaz, Djalalinia, Shirin, Nouri Ghonbalani, Zahra, Ebrahimpur, Mahbube +2 more·2024·BMC Cardiovascular Disorders
DOI 10.1186/s12872-024-03830-1PMC PMC10953288
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Abstract

Background: Cardiometabolic conditions are major contributors to the global burden of disease. An emerging body of evidence has associated access to and surrounding public open spaces (POS) and greenspace with cardiometabolic risk factors, including obesity, body mass index (BMI), hypertension (HTN), blood glucose (BG), and lipid profiles. This systematic review aimed to synthesize this evidence. Methods: This systematic review was conducted based on the PRISMA guidelines. Four electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for eligible articles published until July 2023. All observational studies which assessed the association of greenspace and POS with cardiometabolic risk factors including obesity, BMI, HTN, BG, and lipid profiles were included and reviewed by two authors independently. Heterogeneity between studies was assessed using the I 2 index and Cochrane’s Q test. Random/fixed effect meta-analyses were used to combine the association between greenspace exposure with cardiometabolic risk factors. Results: Overall, 118 relevant articles were included in our review. The majority of the articles were conducted in North America or Europe. In qualitative synthesis, access or proximity to greenspaces or POS impacts BMI and blood pressure or HTN, BG, and lipid profiles via various mechanisms. According to the random effect meta-analysis, more access to greenspace was significantly associated with lower odds of HTN (odds ratio (OR): 0.81, 95% confidence intervals (CIs): 0.61–0.99), obesity (OR: 0.83, 95% CIs: 0.77–0.90), and diabetes (OR:0.79, 95% CI: 0.67,0.90). Conclusions: Findings of this systematic review and meta-analysis suggested that greenspace accessibility is associated with some cardiometabolic risk factors. Improving greenspace accessibility could be considered as one of the main strategies to reduce cardiometabolic risk factors at population level.

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  • Pregnancy-specific greenspace exposure definitions were not consistent, so the evidence should be positioned as contextual support rather than direct proof of effects limited to pregnancy.

    “For the built environment, a large meta-analysis reported that greater greenspace exposure is associated with lower odds of hypertension, obesity, and diabetes, but pregnancy-specific exposure definitions were not consistent, and the evidence should be positioned as contextual support rather than direct proof of effects limited to pregnancy [96].”

    From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [96]

    The Discussion (Limitations and strengths; page not provided) says exposure definitions and measurements varied substantially across the included studies, and that only one blood-pressure study involved pregnant women. This supports treating the review as contextual rather than direct proof of pregnancy-specific effects, but it does not establish that exposure definitions were inconsistent specifically among pregnancy studies. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Greater greenspace exposure is associated with lower odds of hypertension, obesity, and diabetes in a large meta-analysis.

    “For the built environment, a large meta-analysis reported that greater greenspace exposure is associated with lower odds of hypertension, obesity, and diabetes, but pregnancy-specific exposure definitions were not consistent, and the evidence should be positioned as contextual support rather than direct proof of effects limited to pregnancy [96].”

    From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [96]

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Authors
Sharifi, Y., Sobhani, S., Ramezanghorbani, N., Payab, M., Ghoreshi, B., Djalalinia, S., Nouri Ghonbalani, Z., Ebrahimpur, M., Eslami, M., & Qorbani, M.
Affiliations
  • Iran University of Medical Sciences (IR)
  • Alborz University of Medical Sciences (IR)
  • Ministry of Health and Medical Education (IR)
  • Endocrinology and Metabolism Population Sciences Institute (IR)
  • Islamic Azad University, Tehran (IR)
  • Endocrinology and Metabolism Clinical Sciences Institute (IR)
Corresponding author
Qorbani, Mostafa
ORCID
Venue
BMC Cardiovascular Disorders
Publisher
Springer Science and Business Media LLC
Published
2024-03-20
Volume
24
Issue
1
Pages
170-170
ISSN
1471-2261 (ISSN-L)
DOI
10.1186/s12872-024-03830-1
PMC
PMC10953288
OpenAlex
W4393004120
Cited by
25
References
171
Citations by year
2026: 12 · 2025: 11 · 2024: 2
FWCI
1.07
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Cardiovascular Disorders (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Alborz University of Medical Sciences
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
  • Social Sciences › Transportation › Urban Transport and Accessibility
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
green space exposure, public open space, cardiometabolic risk factors, obesity, body mass index, hypertension, blood glucose, lipid profile, diabetes mellitus, green space accessibility, built environment
MeSH terms
Parks, Recreational, Cardiometabolic Risk Factors, Adult, Aged, Blood Glucose, Blood Pressure, Cardiovascular Diseases, Female, Humans, Hypertension, Lipids, Male, Middle Aged, Obesity, Residence Characteristics, Risk Factors, Body Mass Index, Risk Assessment, Young Adult, Protective Factors

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