Walkability, Overweight, and Obesity in Adults: A Systematic Review of Observational Studies

João Paulo dos Anjos Souza Barbosa, Paulo Henrique Guerra, Crislaine de Oliveira Santos, Ana Paula de Oliveira Barbosa Nunes, Gavin Turrell and Alex Antonio Florindo
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João Paulo dos Anjos Souza Barbosa: Nutrition Department, Graduate Program in Public Health Nutrition, School of Public Health, University of São Paulo, Sao Paulo City 01246-904, Brazil
Paulo Henrique Guerra: Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo City 03828-000, Brazil
Crislaine de Oliveira Santos: Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo City 03828-000, Brazil
Ana Paula de Oliveira Barbosa Nunes: Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo City 03828-000, Brazil
Gavin Turrell: Centre for Urban Research, School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC 3000, Australia
Alex Antonio Florindo: Nutrition Department, Graduate Program in Public Health Nutrition, School of Public Health, University of São Paulo, Sao Paulo City 01246-904, Brazil

IJERPH, 2019, vol. 16, issue 17, 1-17

Abstract: We conducted a systematic review to describe and summarize possible associations between the walkability index, overweight, and obesity. Systematic searches using seven electronic databases and reference lists were conducted to identify papers published until December 2017. Observational studies, describing associations using regression-based statistical methods, published in English and Portuguese, reporting markers of overweight and obesity, and involving adults (≥18 years) were included. Of the 2469 references initially retrieved, ten were used for the descriptive synthesis. Seven studies showed significant inverse associations between walkability and overweight and obesity, however, all were cross-sectional studies. High risk of bias scores were observed in “selection bias” and “withdrawals and dropouts”. All studies were published in high-income countries with sample sizes ranging among 75 to 649,513 participants. Weight and height as measures for determining BMI tended to be self-reported. Indicators of walkability, such as land-use mix, street connectivity and residential density were used as components of the indices. Based on this review, more studies should be conducted in low, middle, and middle-high income countries, using longitudinal designs that control neighborhood self-selection; other indicators of the neighborhood environment, such as food access, physical activity facilities, sidewalks, and safety and crime prevention should be considered.

Keywords: walkability; environment; overweight; obesity; review (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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