Access to bike lanes and childhood obesity: A systematic review and meta‐analysis

The lack of bike lane access has been a proven risk factor for childhood obesity due to its role in discouraging healthy lifestyles. However, there has not been a systematic review of this important association in the existing literature. This study aims to fill this gap. A literature search was conducted in the Cochrane Library, PubMed, Embase, and Web of Science for studies published from 1 January 2019 onwards that examined the association between bike lane access and weight‐related behaviours and outcomes among children aged <18 years. A total of 21 studies were included in this systematic review. Among them, most of the studies showed that bike lane access was significantly associated with children and adolescents' physical activity (PA), whereas only two studies showed a negative association. Meta‐analysis also supported these findings and showed that bike lane access was significantly associated with children and adolescents' PA (odds ratio [OR] = 1.57, 95% confidence interval [CI]: 1.37–1.81). Additionally, we reviewed how bike lane characteristics and microenvironment variables such as children and adolescents' choice of bicycle travel mode, the degree of separation of cycle path, cycle path unevenness, and street maintenance were associated with adolescents' preferences and intention to cycle. This systematic review and meta‐analysis strongly suggests that bike lane access is associated with children and adolescents' PA. Nonetheless, it was difficult to draw a conclusion on the association between bike lane access and weight‐related outcomes.

[1]  Katherine A. Sauder,et al.  Understanding childhood obesity in the US: the NIH environmental influences on child health outcomes (ECHO) program , 2019, International Journal of Obesity.

[2]  P. Jia,et al.  Street connectivity, physical activity, and childhood obesity: A systematic review and meta‐analysis , 2019, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[3]  Tom Stewart,et al.  The Importance of Pedestrian Network Connectivity for Adolescent Health: A Cross-sectional Examination of Associations between Neighbourhood Built Environments and Metabolic Health in the Pacific Islands Families Birth Cohort Study , 2019, International journal of environmental research and public health.

[4]  Hamish Mackie,et al.  The Pathway to Behaviour Change: Preliminary Findings from Te Ara Mua – Future Streets (High Scoring Researcher Abstract Award Sponsored by the Institute of Transportation Engineers) , 2019, Journal of Transport & Health.

[5]  Yongping Zhang,et al.  Examining and optimizing the BCycle bike-sharing system – A pilot study in Colorado, US , 2019, Applied Energy.

[6]  J. Lakerveld,et al.  Top 10 Research Priorities in Spatial Lifecourse Epidemiology , 2019, Environmental health perspectives.

[7]  Youfa Wang,et al.  Association of neighborhood built environments with childhood obesity: Evidence from a 9-year longitudinal, nationally representative survey in the US. , 2019, Environment international.

[8]  A. Stein,et al.  Earth Observation: Investigating Noncommunicable Diseases from Space. , 2019, Annual review of public health.

[9]  R. Mackett,et al.  Children’s Transport Built Environments: A Mixed Methods Study of Associations between Perceived and Objective Measures and Relationships with Parent Licence for Independent Mobility in Auckland, New Zealand , 2019, International journal of environmental research and public health.

[10]  S. Wen,et al.  Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate in Alzheimer's Disease: A Systematic Review and Meta-Analysis , 2019, Front. Aging Neurosci..

[11]  Alfred Stein,et al.  Spatial Technologies in Obesity Research: Current Applications and Future Promise , 2019, Trends in Endocrinology & Metabolism.

[12]  P. Jia Spatial lifecourse epidemiology. , 2019, The Lancet. Planetary health.

[13]  S. Wen,et al.  Catecholamines in Post-traumatic Stress Disorder: A Systematic Review and Meta-Analysis , 2018, Front. Mol. Neurosci..

[14]  J. Molina-García,et al.  Biking to School: The Role of Bicycle-Sharing Programs in Adolescents. , 2018, The Journal of school health.

[15]  S. Wen,et al.  Salivary cortisol in post-traumatic stress disorder: a systematic review and meta-analysis , 2018, BMC Psychiatry.

[16]  Peng Jia,et al.  Integrating Kindergartener-Specific Questionnaires With Citizen Science to Improve Child Health , 2018, Front. Public Health.

[17]  Ilse de Bourdeaudhuij,et al.  Subgroups of adolescents differing in physical and social environmental preferences towards cycling for transport: A latent class analysis. , 2018, Preventive medicine.

[18]  Craig M. Hales,et al.  Differences in Obesity Prevalence by Demographics and Urbanization in US Children and Adolescents, 2013-2016 , 2018, JAMA.

[19]  J. Jiao,et al.  Promoting active student travel: A longitudinal study , 2018, Journal of Transport Geography.

[20]  D. van Dyck,et al.  Differences in physical environmental characteristics between adolescents’ actual and shortest cycling routes: a study using a Google Street View-based audit , 2018, International Journal of Health Geographics.

[21]  J. Mota,et al.  Environmental perceptions and its associations with physical fitness and body composition in adolescents: longitudinal results from the LabMed Physical Activity Study , 2018, International journal of adolescent medicine and health.

[22]  Gretchen A. Stevens,et al.  Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults , 2017, Lancet.

[23]  Ilse de Bourdeaudhuij,et al.  Which physical and social environmental factors are most important for adolescents’ cycling for transport? An experimental study using manipulated photographs , 2017, International Journal of Behavioral Nutrition and Physical Activity.

[24]  Alfred Stein,et al.  Using remote sensing technology to measure environmental determinants of non-communicable diseases. , 2017, International journal of epidemiology.

[25]  J. Salmon,et al.  Park attributes that encourage park visitation among adolescents: A conjoint analysis , 2017 .

[26]  P Jia,et al.  Applications of geographic information systems (GIS) data and methods in obesity‐related research , 2017, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[27]  Youfa Wang,et al.  Time Trend and Demographic and Geographic Disparities in Childhood Obesity Prevalence in China—Evidence from Twenty Years of Longitudinal Data , 2017, International journal of environmental research and public health.

[28]  John C. H. Spence,et al.  Adolescents' perceptions of cycling versus walking to school: Understanding the New Zealand context , 2017 .

[29]  Jeongjae Yoon,et al.  From sedentary to active school commute: Multi-level factors associated with travel mode shifts. , 2017, Preventive medicine.

[30]  A. Kelly,et al.  Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment , 2017, Mayo Clinic proceedings.

[31]  T. Lobstein,et al.  Planning for the worst: estimates of obesity and comorbidities in school‐age children in 2025 , 2016, Pediatric obesity.

[32]  M. Vrijheid,et al.  The Built Environment and Child Health: An Overview of Current Evidence , 2016, Current Environmental Health Reports.

[33]  M. Kwan,et al.  Natural and built environmental exposures on children's active school travel: A Dutch global positioning system-based cross-sectional study. , 2016, Health & place.

[34]  A. Timperio,et al.  Does parental accompaniment when walking or cycling moderate the association between physical neighbourhood environment and active transport among 10-12 year olds? , 2016, Journal of science and medicine in sport.

[35]  C. Hoppmann,et al.  Ecological Momentary Assessment , 2015 .

[36]  G. Cardon,et al.  Creating Cycling-Friendly Environments for Children: Which Micro-Scale Factors Are Most Important? An Experimental Study Using Manipulated Photographs , 2015, PloS one.

[37]  M. Kamargianni Investigating next generation's cycling ridership to promote sustainable mobility in different types of cities , 2015 .

[38]  A. Timperio,et al.  Bicycles gathering dust rather than raising dust--Prevalence and predictors of cycling among Australian schoolchildren. , 2015, Journal of science and medicine in sport.

[39]  Jun Zhang,et al.  Sustainable bike-sharing systems: characteristics and commonalities across cases in urban China , 2015 .

[40]  G. Cardon,et al.  Assessing cycling-friendly environments for children: are micro-environmental factors equally important across different street settings? , 2015, International Journal of Behavioral Nutrition and Physical Activity.

[41]  P. Bergman,et al.  Neighborhood environment and physical activity among young children: A cross-sectional study from Sweden , 2015, Scandinavian journal of public health.

[42]  R. Puhl,et al.  Stigma and Eating and Weight Disorders , 2015, Current Psychiatry Reports.

[43]  Alan D. Lopez,et al.  Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2014, The Lancet.

[44]  Walter Ricciardi,et al.  Evaluation of the Endorsement of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Statement on the Quality of Published Systematic Review and Meta-Analyses , 2013, PloS one.

[45]  Andrew P. Jones,et al.  A framework for understanding school based physical environmental influences on childhood obesity. , 2012, Health & place.

[46]  K. Lock,et al.  Cycling for transport and public health: a systematic review of the effect of the environment on cycling. , 2011, European journal of public health.

[47]  L. Vartanian,et al.  Internalized Societal Attitudes Moderate the Impact of Weight Stigma on Avoidance of Exercise , 2011, Obesity.

[48]  Willem van Mechelen,et al.  Built Environmental Correlates of Walking and Cycling in Dutch Urban Children: Results from the SPACE Study , 2010, International journal of environmental research and public health.

[49]  J. Kavanagh,et al.  Searching for systematic reviews of the effects of social and environmental interventions: a case study of children and obesity. , 2010, Journal of the Medical Library Association : JMLA.

[50]  D. Hasin,et al.  Associations Between Perceived Weight Discrimination and the Prevalence of Psychiatric Disorders in the General Population , 2009, Obesity.

[51]  K. Pont,et al.  Environmental correlates of children's active transportation: a systematic literature review. , 2009, Health & place.

[52]  Wei Zhang,et al.  The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis , 2009, BMC public health.

[53]  T. Lorenc,et al.  Attitudes to walking and cycling among children, young people and parents: a systematic review , 2008, Journal of Epidemiology & Community Health.

[54]  A. S. Singh,et al.  Tracking of childhood overweight into adulthood: a systematic review of the literature , 2008, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[55]  W. van Mechelen,et al.  Determinants of Activity-Friendly Neighborhoods for Children: Results from the Space Study , 2007, American journal of health promotion : AJHP.

[56]  Mariela Alfonzo,et al.  Evaluation of the California Safe Routes to School legislation: urban form changes and children's active transportation to school. , 2005, American journal of preventive medicine.

[57]  B. Swinburn,et al.  Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. , 1999, Preventive medicine.

[58]  G. Smith,et al.  Bias in meta-analysis detected by a simple, graphical test , 1997, BMJ.

[59]  Blair T. Johnson,et al.  Spatial Lifecourse Epidemiology Reporting Standards (ISLE-ReSt) statement , 2019, Health & place.

[60]  Greet Cardon,et al.  An experimental study using manipulated photographs to examine interactions between micro-scale environmental factors for children's cycling for transport , 2018 .

[61]  Kelly J. Clifton,et al.  Do characteristics of walkable environments support bicycling? Toward a definition of bicycle-supported development , 2016 .

[62]  Janette Sadik-Khan,et al.  Urban Bikeway Design Guide , 2014 .

[63]  Elizabeth R. Pulgarón,et al.  Childhood obesity: a review of increased risk for physical and psychological comorbidities. , 2013, Clinical therapeutics.

[64]  H. Cabral,et al.  The role of recreational spaces in meeting physical activity recommendations among middle school students. , 2011, Journal of physical activity & health.

[65]  Sally F. Kelty,et al.  Encouraging Walking for Transport and Physical Activity in Children and Adolescents , 2009, Sports medicine.

[66]  D. O'Gorman,et al.  International Journal of Behavioral Nutrition and Physical Activity Active Commuting to School: How Far Is Too Far? , 2022 .