Street connectivity, physical activity, and childhood obesity: A systematic review and meta‐analysis

Abstract

Street connectivity, as a neighbourhood built environmental factor, may affect indi-vidual physical activity (PA) and subsequently weight status. However, these associa-tions remain inconclusive. This study aimed to systematically review the associationbetween street connectivity and childhood obesity. A literature search was con-ducted in the Cochrane Library, PubMed, and Web of Science for articles publishedbefore January 1, 2019. All original studies that investigated the association betweenstreet connectivity and weight‐related behaviours or outcomes among children andadolescents were included. Forty‐seven articles were identified, including eight longi-tudinal and 41 cross‐sectional studies conducted in eight countries. The sample sizeranged from 88 to 46 813. Street intersection density (SID), measured by GeographicInformation Systems in 36 studies and reported in 13 studies, was the main indicatorused to represent street connectivity. Forty‐four studies examined the associationbetween SID and weight‐related behaviours, including overall PA (n = 15),moderate‐to‐vigorous PA (n = 13), active transport (n = 12), dog walking (n = 1), walk-ing (n = 1), sedentary behaviours (n = 2), and TV viewing (n = 1). Fifteen studiesfocused on the association between SID and weight‐related outcomes. Overall, evi-dence from this systematic review and meta‐analyses suggested a positive associa-tion between street connectivity and PA. However, it was difficult to draw aconclusion on the association between street connectivity and BMI. More longitudi-nal evidence is needed to confirm the causal association between street connectivityand weight status.