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Impact of Policy and Built Environment Changes on Obesity-related Outcomes: A Systematic Review of Naturally-Occurring Experiments
Journal article   Open access   Peer reviewed

Impact of Policy and Built Environment Changes on Obesity-related Outcomes: A Systematic Review of Naturally-Occurring Experiments

Stephanie L Mayne, Amy H Auchincloss and Yvonne L Michael
Obesity reviews, v 16(5), pp 362-375
May 2015
PMID: 25753170
url
https://doi.org/10.1111/obr.12269View
Published, Version of Record (VoR) Open

Abstract

diet Natural Experiments physical activity Obesity
Policies and changes to the built environment are promising targets for obesity prevention efforts and can be evaluated as “natural”- or “quasi”-experiments. This systematic review examined the use of natural- or quasi-experiments to evaluate the efficacy of policy and built environment changes on obesity-related outcomes (body mass index, diet, or physical activity). PubMed (Medline) was searched for studies published 2005–2013; 1,175 abstracts and 115 articles were reviewed. Of the 37 studies included, 18 studies evaluated impacts on nutrition/diet, 17 on physical activity, and 3 on body mass index. Nutrition-related studies found greater effects due to bans/restrictions on unhealthy foods, mandates offering healthier foods, and altering purchase/payment rules on foods purchased using low-income food vouchers compared to other interventions (menu labeling, new supermarkets). Physical activity-related studies generally found stronger impacts when the intervention involved improvements to active transportation infrastructure, longer follow-up time, or measured process outcomes (e.g., cycling rather than total physical activity) compared to other studies. Only three studies directly assessed body mass index or weight, and only one (installing light-rail system) observed a significant effect. Studies varied widely in the strength of their design and studies with weaker designs were more likely to report associations in the positive direction.

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Endocrinology & Metabolism
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