Effects of green space on physical activity and body weight status among Chinese adults: a systematic review

BACKGROUND: Green space may provide many benefits to residents’ health behaviors and body weight status, but the evidence is still relatively scattered among Chinese adults. The purpose of this study was to review the scientific evidence on the effects of green space on physical activity (PA) and body weight status among Chinese adults. METHODS: A keyword and reference search was conducted in Pubmed, Web of Science, MEDLINE, and PsycINFO. Studies examining the associations between green space and PA, body mass index (BMI) among Chinese adults were included. The quality of the included literature was evaluated using the National Institutes of Health’s Observational Cohort and Cross-Sectional Study Quality Assessment Tool. RESULTS: A total of 31 studies were included that met the inclusion criteria, including 25 studies with a cross-sectional design, 3 studies with a longitudinal design, and 3 studies with an experimental design. Street-level green view index and green space accessibility were found to be positively associated with PA, but negatively associated with BMI. In most studies, there was a correlation between green space ratio in local areas and BMI. In addition, green space interventions were effective in increasing PA and decreasing BMI among Chinese adults. In contrast, further evidence is needed to support the association between the design characteristics of green space and PA and BMI. CONCLUSION: Preliminary evidence suggests that green space has a positive effect on PA and BMI among Chinese adults. However, there are contradictory findings, and future studies adopting longitudinal and quasi-experimental studies are needed to further explore the causal relationship between green space and PA and BMI to provide a relevant theoretical basis for policymakers.