Global Health Institute, Xi'an Jiaotong University, Xi'an, China.
Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Obes Rev. 2021 Feb;22 Suppl 1(Suppl 1):e13057. doi: 10.1111/obr.13057. Epub 2020 Jul 7.
The lack of access to sidewalks is a barrier for physical activity (PA) and may be a risk factor for childhood obesity. However, previous studies reported mixed findings and the association between sidewalk accessibility and childhood obesity remains unclear. This study systematically examined the evidence on the association between sidewalk accessibility and childhood obesity. PubMed, Cochrane Library, and Web of Science were searched for relevant articles (published before 1 January 2019) that reported on the association between neighborhood sidewalk access and weight-related behaviors and outcomes in children. Seventeen studies conducted in five countries were included. Ten studies used objective measure of access to sidewalks, seven studies measured children's height and weight, and seven studies objectively measured the PA or sedentary behaviors. Ten studies reported on the association of better access to sidewalks with increased PA (β ranging from 0.032 to 2.159; p < 0.05), reduced sedentary behaviors (β ranging from -0.19 to -0.14; p < 0.05), lower body mass index (BMI) (β ranging from -0.261 to -0.144; p < 0.001), or obesity risks (OR ranging from 1.02 to 1.32; p < 0.05); while the remaining seven studies did not report a desirable obesity-sidewalk association. Our findings support the hypothesis that higher sidewalk accessibility is associated with higher PA levels, lower BMI, and obesity risks. Efforts in building healthy environments, including health-promoting city planning, can help minimize the growing obesity epidemic and promote public health.
缺乏人行道的通行可能会阻碍人们进行体育锻炼（PA），并可能成为儿童肥胖的一个风险因素。然而，之前的研究报告结果不一，人行道可达性与儿童肥胖之间的关系仍不清楚。本研究系统地评估了人行道可达性与儿童肥胖之间关联的证据。检索了 PubMed、Cochrane 图书馆和 Web of Science 中截至 2019 年 1 月 1 日之前发表的有关邻里人行道可达性与儿童相关行为和结果之间关联的相关文章。共纳入了五个国家的 17 项研究。其中 10 项研究使用了人行道可达性的客观测量方法，7 项研究测量了儿童的身高和体重，7 项研究客观测量了 PA 或久坐行为。有 10 项研究报告了更好的人行道可达性与增加 PA（β 范围从 0.032 到 2.159；p < 0.05）、减少久坐行为（β 范围从-0.19 到-0.14；p < 0.05）、降低 BMI（β 范围从-0.261 到-0.144；p < 0.001）或肥胖风险（OR 范围从 1.02 到 1.32；p < 0.05）之间的关联；而其余 7 项研究则没有报告理想的肥胖与人行道之间的关联。我们的研究结果支持这样一种假设，即更高的人行道可达性与更高的 PA 水平、更低的 BMI 和肥胖风险有关。为了建设健康环境而做出的努力，包括促进健康的城市规划，可以帮助减少日益严重的肥胖流行趋势，并促进公共健康。
