Reduce Obesity Levels Research Articles

Socio-demographic predictors of obesity among women in Mukono Central Division in Central Uganda: a cross-sectional study

BackgroundThere is a steadily increasing trend in obesity globally and in Sub-Saharan Africa that disproportionately affects women in most places. This is not different in Uganda, where the Uganda Demographic and Health Survey indicated an increase in obesity among women of reproductive age as measured by the body mass index (BMI). However, studies on the predictors of obesity in women are still limited. Particularly, studies using specific indicators of body fat are scant. This study explored the socio-demographic predictors of obesity as indicated by total body fat percentage among women in the age range of 18 to 69 years old living in Mukono Central Division in Central Uganda.MethodsA cross sectional study design using quantitative methods was employed. A total of 384 women between 18 and 69 years old from Mukono Central Division in Central Uganda were randomly recruited. A structured questionnaire was used to collect socio-demographic data including age, level of education, marital status, childbearing status, household expenditure, household size and employment status. Total body fat percentage, the indicator for obesity was measured using the body composition meter from TANITA. The data was analyzed using multinomial logistic regression analysis using SPSS version 20.Results155 women, nearly two fifths (40.4% CI 95% 38.4–42.4) were classified as obese. Age, marital status, childbearing status, and employment status were the factors that were associated with obesity among these women. Employment status was the only variable that remained significantly associated with obesity among the women after adjusting for other factors. Unemployed women were nearly two times more likely to be obese than the employed women (AOR 1.9; 95% CI 1.1–3.1). The prevalence of obesity among the unemployed and employed women was 48.2% and 34.4% respectively.ConclusionsObesity in women was predicted by employment status. An in-depth study on factors that predispose unemployed women to obesity, will be instrumental in guiding interventions to curb the emerging obesity epidemic in Uganda. In the same vein, strategies to reduce levels of unemployment among women living in urban Uganda are essential for protecting public health from the dimension of reducing obesity levels.

Domains of Capacity Building in Whole-Systems Approaches to Prevent Obesity-A "Systematized" Review.

Despite increased awareness of its risks, for the most part, contemporary efforts for obesity prevention have been patchy at best. As such, the burgeoning interest in whole-systems approaches (WSAs) that acknowledge the complex, dynamic nature of overweight and obesity and operate across multiple levels of society is particularly timely. Many components of “community capacity building” (CB), an essential but often neglected aspect of obesity prevention, overlap with “best practice principles” in effective/optimal community-based obesity-prevention initiatives. Rhetoric urging WSAs and community CB in public health abounds although operative and efficacious contemporary examples of these approaches to reducing obesity levels are scarce. The aim of this investigation was to undertake a systematized review of the level of capacity building incorporated in published literature on WSAs targeting obesity to better understand how domains of CB have been incorporated. A PubMed search and a recently published systematic review were utilized to identify WSAs to obesity prevention between 1995–2020. A team-based approach to qualitative thematic data analysis was used to systematically assess and describe each intervention regarding explicit capacity-building practice. Despite not being specifically designed for building capacity, a significant proportion of the WSAs studied in the current report had implemented several CB domains.

Using Economics to Impact Local Obesity Policy: Introducing the UK Centre for Economics of Obesity (CEO).

Worldwide, population obesity levels are at their highest recorded levels, having nearly tripled between 1975 and 2016. This leads to substantial pressure on health systems, a negative impact on economic development, and results in adverse physical and mental health outcomes. There are many economic reasons why reducing population obesity should be a priority, and global targets have been set with many governments pledging to reduce obesity levels by 2030. To achieve these targets, a ‘system-wide’ approach has been widely advocated in direct recognition of the wide-ranging complex interacting determinants of the disease. This system approach requires action at all levels, including at the local government level, to use all fiscal and non-fiscal levers to bring about local system change that promotes healthier population behaviours. Like many country contexts, in England, local resources for achieving this system change have been drastically reduced in recent years. Economic evaluation offers a formal explicit framework to support local decision making but, to date, there has been a disconnect between national guidance on cost-effectiveness and how that informs local action. A new Centre for Economics of Obesity has been purposively developed to work closely with local government to adapt methods to help achieve efficiency and equity gains. By working across six workstreams to begin with, this Centre will use economics to inform policy action on different but interrelated parts of the obesity system and act as a training hub for health economists working in obesity policy.

Examining the policy process of sugar-sweetened beverage taxation in Ireland

Sugar sweetened beverages (SSBs) are a growing source of weight gain, obesity, and type 2 diabetes that contain high added sugar amounts and provide minimal nutritional benefit. Taxing SSBs are effective in reducing sugar consumption and increasing awareness about health effects. The 2014 European Union Action Plan on Childhood Obesity combined with neighboring SSB tax proposals in the U.K. and France helped stimulate political discussions in Ireland. Following this momentum, in 2015, public health groups lead by the Irish Heart Foundation proposed an SSB tax with earmarked funds for public health and worked with the Irish Health Department through a whole-of-government approach to convince the Finance Department to introduce an SSB tax. These efforts resulted in the Finance Department proposing the Sugar Sweetened Drinks Tax (SSDT) in September 2016, which taxes non-alcoholic, water-based and juice-based drinks, which have an added sugar content of 5g per 100mL and above. Opposing stakeholders including the Irish Beverage Council and Food & Drink Industry Ireland argued that the tax would not decrease consumption of SSBs or impact obesity, disproportionately impact individuals with a low socioeconomic background, and create illicit trade. However, health groups argued the tax would reduce sugar consumption, encourage consumers to purchase healthier options, and help reduce obesity levels. These efforts with political will helped Ireland become the 36th country in the world (9th in Europe) to implement an SSB tax policy in May 2018. While the government reportedly raised €16.5 million (20.012 million USD) in 2018 and €33 million (40.024 million USD) in 2019 from the SSDT, the tax was not earmarked for public health purposes nor has it been evaluated despite multiple requests by public health groups representing an important missed opportunity. While other countries should follow Ireland's lead in enacting an SSB tax, it is important to evaluate the tax's impact on reducing sugar consumption and ensure the tax has earmarked funds for public health to further maximize the impact of reducing sugar consumption, promoting health equity and helping curb the NCD epidemic.

Weight stigma in Mexico and front-of-package labeling. A systemic review

Background. Front-of-package food labeling is a public health strategy implemented to reduce the consumption of processed food to decrease the incidence of obesity in Mexico. Although there is an increasing focus among public health officials on implementing policies designed to address obesity, much less attention has been paid to how these policies could impact those with disordered eating, despite the fact that millions suffer from such illnesses. Objective. The aim of this article is to present scientific literature related to front-of-package labeling and its impact on obesity and eating disorders. Method. Papers related to nutrition labels and obesity and eating disorders were reviewed. Results. The papers reviewed found no significant improvement regarding the consumption of processed food. Other measurements, including nutritional education, availability, physical education, and body-image acceptance, have a better impact on nutritional health. Discussion and conclusion. Front-of-package labeling is regarded as an important measure in the attempt to reduce obesity levels. However, there is insufficient scientific evidence to suggest that this type of labeling reduces the consumption of processed foods in patients with obesity.

The Association of Healthy Lifestyle Behaviors with Overweight and Obesity among Older Adults from 21 Countries.

This study aimed to analyze the association of healthy lifestyle behaviors with overweight and obesity among Europeans aged 65+ years. Data were from the 2014 European Social Survey, analyzing 21 countries. Five lifestyle behaviors (physical activity, fruit and vegetable consumption, sleep quality, drinking alcohol, and smoking) were analyzed. Binary logistic regressions were performed. A total of 8938 participants (4099 men) 65 years and older, mean age—73.6 (SD: 6.6) presented prevalence of overweight of 42.3% (95% CI: 41.3 to 43.3) and obesity of 20.9% (95% CI: 20.1 to 21.8). Adopting five healthy behaviors was associated with lower odds of obesity (OR = 0.50, 95% CI: 0.39 to 0.63), but not overweight (OR: 0.93; 95% CI: 0.79 to 1.10). Physical activity (≥5 days/week) was the most protective behavior, reducing by 42% the odds of obesity. Sex moderated the association of fruits and vegetables consumption, alcohol use, and smoking with obesity. Strategies aiming to reduce obesity levels in older adults should focus on the promotion of multiple lifestyle health behaviors, particularly physical activity in order to decrease vulnerability risk in old age.

Impact of sin taxes on consumption volumes of sweetened beverages and soft drinks in Saudi Arabia

Background: The consumption of sweetened drinks plays a major role in increasing the burden of diseases such as obesity and cardiovascular diseases. The prevalence rate of obesity and overweight individuals in Saudi Arabia has increased alarmingly among children over the past decade, revealing a crucial need the initiate and monitor effective prevention measures of obesity. Hence, this paper aims to measure the impact of sin taxes of sugar-sweetened beverages on the consumption level of such beverages in Saudi Arabia. Building enough evidence to guide other countries in the Eastern Mediterranean Region (EMR) on how to reduce the level of sugar intake consumption to reduce obesity and malnutrition has an impact on the economy as a whole. Methods: The excise taxes on sugar-sweetened beverages were applied in 2017. The impact of this was measured using a time series data set that covered sales volumes of soft drinks in Saudi Arabia from 2010 to 2020. Results: Sin taxes had a significant negative impact on the sales volume over the years. A significance level of <1% was found as sales volume of soft drinks decreased by 57.64% from 2010 to 2017 when sin taxes were applied on energy and soft drinks. Conclusions: Sin tax policy is recommended to other countries in the EMR to reduce obesity levels among children. These recommendations advocate the recommended priority actions by the World Health Organization for the strategy on nutrition for the EMR 2020-2030.

Impact of sin taxes on consumption volumes of sweetened beverages and soft drinks in Saudi Arabia

Background: The consumption of sweetened drinks plays a major role in increasing the burden of diseases such as obesity and cardiovascular diseases. The prevalence rate of obesity and overweight individuals in Saudi Arabia has increased alarmingly among children over the past decade, revealing a crucial need the initiate and monitor effective prevention measures of obesity. Hence, this paper aims to measure the impact of sin taxes of sugar-sweetened beverages on the consumption level of such beverages in Saudi Arabia. Building enough evidence to guide other countries in the Eastern Mediterranean Region (EMR) on how to reduce the level of sugar intake consumption to reduce obesity and malnutrition has an impact on the economy as a whole. Methods: The excise taxes on sugar-sweetened beverages were applied in 2017. The impact of this was measured using a time series data set that covered sales volumes of soft drinks in Saudi Arabia from 2010 to 2020. Results: Sin taxes had a significant negative impact on the sales volume over the years. A significance level of <1% was found as sales volume of soft drinks decreased by 57.64% from 2010 to 2017 when sin taxes were applied on energy and soft drinks. Conclusions: Sin tax policy is recommended to other countries in the EMR to reduce obesity levels among children. These recommendations advocate the recommended priority actions by the World Health Organization for the strategy on nutrition for the EMR 2020-2030.

Impact of sin taxes on consumption volumes of sweetened beverages and soft drinks in Saudi Arabia.

Background: The consumption of sweetened drinks plays a major role in increasing the burden of diseases such as obesity and cardiovascular diseases. The prevalence rate of obesity and overweight individuals in Saudi Arabia has increased alarmingly among children over the past decade, revealing a crucial need the initiate and monitor effective prevention measures of obesity. Hence, this paper aims to measure the impact of sin taxes of sugar-sweetened beverages on the consumption level of such beverages in Saudi Arabia. Building enough evidence to guide other countries in the Eastern Mediterranean Region (EMR) on how to reduce the level of sugar intake consumption to reduce obesity and malnutrition has an impact on the economy as a whole. Methods: The excise taxes on sugar-sweetened beverages were applied in 2017. The impact of this was measured using a time series data set that covered sales volumes of soft drinks in Saudi Arabia from 2010 to 2020. Results: Sin taxes had a significant negative impact on the sales volume over the years. A significance level of <1% was found as sales volume of soft drinks decreased by 57.64% from 2010 to 2017 when sin taxes were applied on energy and soft drinks. Conclusions: Sin tax policy is recommended to other countries in the EMR to reduce obesity levels among children. These recommendations advocate the recommended priority actions by the World Health Organization for the strategy on nutrition for the EMR 2020-2030.

The impact of obesity on absenteeism among working adults in Portugal and its costs

Abstract Background Obesity leeds to poor health and may afffect work productivity. We aim to investigate the association between obesity and absenteeism and its indirect costs. Methods Individuals employeed and actively working at baseline form the EpiDoC Cohort, a large portuguese population-based prospective study analized from 2011 to 2016. Body mass index was assessed during baseline appointment. Follow-up assessment was performed through a phone interview and self reported absenteeism defined by the question”did you have a sick leave in previous 12 months? yes/no”, followed by the number of days missed work due to sickness in the previous twelve months.(1) Negative Binomial Regression model estimated the association between obesity and absenteeism. Indirect costs were computed using the human-capital method. Results EpiDoC cohort had 4338 participants who were working adults at baseline. The prevalence of obesity among working adults was 15.2% and of absenteeism was 29.4%. Obesity was associated with an increase in absenteeism incidence rate ratio by 31% (p &amp;lt; 0.01). Obese individual miss 3.9 days per year (95% CI 3.1-4.5). This number is higher in women, 4.6 days per year (95% CI 3.6-5.6) and according to the professional categories women with white collar professions were 82% (p &amp;lt; 0.01) more likely to miss work than peers with their normal weight. Extrapolating for the entire working population, absenteeism due to obesity has an estimated cost of 236€ million per year. Conclusions Obesity is an independent risk factor for absenteeism among working adults wich leads to high societal burden in terms of costs. Food and nutrition policies are needed in order improve food patterns and reduce obesity levels among south european population. Key messages Obesity is an independent risk factor for absenteeism among working adults. Obesity increases absenteeism mainly in women and has a major impact on economies.

Simulations of future cardiometabolic disease and life expectancy under counterfactual obesity reduction scenarios

The aim of this study was to provide decision makers with an assessment of potential future health effects of interventions against overweight and obesity (OWOB). By means of the DYNAMO-HIA tool we conducted a health impact assessment simulating future prevented disease (ischemic heart disease (IHD), diabetes, stroke, and multi morbidity) incidence, prevalence and life expectancy (LE) related to a scenario where OWOB is reduced by 25% and a scenario where obesity is eliminated. The study covered projected number of persons living in Copenhagen, Denmark during year 2014-2040 (n 2040=742,129). Reducing the proportion of men/women with OWOB with 25% will increase population LE by 2.4/1.2months and at the same time decrease LE with diabetes by 3.1/2.2months. As a result of eliminating obesity, total LE will increase by 6.0/3.6months and LE with diabetes will decrease with 9.8/10.3months for men/women. We found no important effects on LE with IHD and stroke. This illustrates that the positive effects of lowering OWOB levels on IHD and stroke incidence is offset due to increasing total LE. Although the population of Copenhagen is relatively lean, reducing obesity levels will result in significant benefits for population cardiometabolic health status and LE. Future public health prevention programs may use the results as reference data for potential impact of reductions in OWOB.

Consumers’ Purchasing Decisions for Confectionery and Savoury Snack Food Items on and off Promotion

Food retail outlets, by making food accessible, available and affordable, contribute significantly to consumers’ food choices, including snack food choices, and ultimately their longer-term health status. Therefore, the food retail environment may represent an opportune place to harness marketing power to implement anti-obesity measures. The study aimed to understand consumers’ purchasing decisions for confectionery and savoury snack food items both on and off promotion. Associated objectives sought to identify what influences consumers’ food buying decisions and understand if these differ by food product category or promotional status, particularly in respect of single versus multi-pack confectionery/savoury snack food items, to inform retail promotional strategies and anti-obesity policymaking. In order to gain an insight into consumers’ motivations, attitudes and behaviours, an ethically compliant, quantitative survey was designed which collected data from 302 respondents aged 18-75. Three-quarters (76%) of those surveyed believed promotions are more prevalent for less healthy foods compared to healthy foods. Promotions were found to have a significant impact on consumer behaviour, causing 64% to purchase greater volume of an item and 76.5% to purchase confectionery and savoury snacks more readily. Respondents made unintended purchases regularly with the highest incidence among those shopping four to six times per week, while 72% of all unintended purchases were attributed to promotional activity. Findings highlight the clear effect promotions have on consumers’ buying behaviour. The main enabler reported to encourage consumers to make healthier food choices was “if healthy food was cheaper”. Additionally, the findings also suggest that increasing the price of less healthy foods (such as confectionery and savoury snacks) could also impact positively on consumers’ purchasing behaviours. The research indicates the potential for future supermarket health promotion initiatives to encourage consumers to make healthier food choices which could play a vital role in improving public health and subsequently reduce obesity levels.

Exploring the acceptability and usability of a novel social innovation to encourage physical activity: The iStep prototype.

This study explored the acceptability and usability of the iStep prototype a novel social innovation to encourage intergenerational physical activity (PA) to help reduce obesity levels in older age. Obesity is a major public health issue and physical inactivity is one of the many factors that influence this, especially in childhood and later life. iStep (a pedometer and interactive website) sought to increase PA levels across the life course through intergenerational partnerships participating in walking challenges together. This was a qualitative mixed methods study involving 130 participants from two different settings. Pupils and teachers from a local secondary school (n=120) tested the iStep prototype over two separate 2-week periods. Pupil and teacher partnerships engaged in a walking challenge using pedometers and the website platform. In addition, 10 retirement age women were involved in a modified co-operative evaluation of the prototype. Two focus groups with pupils (n=9 and 20), semistructured interviews with teachers (n=5), and one dyadic interview (pupil/teacher) were undertaken. Data were analysed using an iterative thematic approach. Five themes were identified: perceptions of the technology, attitudes towards the walking challenge, attitudes to the intergenerational partnership, competition versus collaboration and promoting PA. The pedometer was a useful motivational tool which raised awareness of PA levels. The website was thought to be simple and easy to use. Walking was deemed inclusive and accessible to all age groups and setting a target goal was considered beneficial. Engaging in PA with a partner was regarded as a good way to provide support and encouragement. Overall, this early prototype evaluation showed that iStep has potential to be an innovative and engaging way to encourage increased PA across generations. It may positively contribute towards reducing obesity levels in older age but outcomes that effectively measure this need to be incorporated in any future iStep testing.

Obesity Prevention: Strategies and Challenges in Latin America.

The purpose of this study is to present changes of policies and norms aimed to reduce obesity levels that have been adopted in some Latin American countries. The global increase of the excess weight within the population has been demanding governmental actions aimed at preventing health impacts generated by obesity. Over recent years, many Latin American countries have established a number of regulations aimed at reducing weight in the population using interventions that could effectively prevent childhood obesity, including the taxation of sugar-sweetened beverages (SSBs), increasing physical activity in open spaces, and, especially, front-of-package labeling. Some strategies are part of the Action Plan for Prevention of Child and Adolescence Obesity signed by all countries in Latin America, which currently have among the highest prevalence of childhood obesity in the world. Among them are the implementation of fiscal policies on energy-dense and nutrient-poor foods and taxes on SSBs; improvements in nutrition labeling, highlighting the front-of-package (FOP) labeling to promote the choice of healthier products at the time of purchase; and promotion of an active lifestyle, such as encouraging the use of bicycle paths or physical activity programs at school. The real impact of these prevention strategies implemented in Latin America on the prevalence of obesity is still unknown.

Obesity: problem to consider in public health

Overweight is an increase in body mass; Obesity is the increase in the size or quantity of fat cells sufficient to damage the health of the individual. It is the world millennium pandemic, which affects all types of population, does not discriminate between age, race, sex, social position or religion, according to the World Health Organization is considered obese to people with a higher body mass index or equal to 30 Kg / m2. It has been shown that through good advice can be remedied with this acute physical problem and that often leads to self-esteem and mental problems. The work is supported in the investigation of the phenomenon of obesity, its causes, and consequences for human health in the parish March 12, in the city of Portoviejo in the province of Manabi. The results of a survey carried out on a sample of 97 adults residing in the parish are exposed, showing the high level of obesity that exists in the population, as well as the inadequate eating habits and the sedentary lifestyle that accompanies this problem. Health. It is evident that the fundamental causes of obesity consist of a well-localized group of inadequate food practices and the lack of physical exercise, a situation that can be combated from social work where the factors and the society of the community can be compromised, aimed at reducing obesity levels and increasing the health of the population.

Assessing the causal relationship between obesity and venous thromboembolism through a Mendelian Randomization study.

Observational studies have shown an association between obesity and venous thromboembolism (VTE) but it is not known if observed associations are causal, due to reverse causation or confounding bias. We conducted a Mendelian Randomization study of body mass index (BMI) and VTE. We identified 95 single nucleotide polymorphisms (SNPs) that have been previously associated with BMI and assessed the association between genetically predicted high BMI and VTE leveraging data from a previously conducted GWAS within the INVENT consortium comprising a total of 7507 VTE cases and 52,632 controls of European ancestry. Five BMI SNPs were associated with VTE at P<0.05, with the strongest association seen for the FTO SNP rs1558902 (OR 1.07, 95% CI 1.02-1.12, P=0.005). In addition, we observed a significant association between genetically predicted BMI and VTE (OR=1.59, 95% CI 1.30-1.93 per standard deviation increase in BMI, P=5.8×10-6). Our study provides evidence for a causal relationship between high BMI and risk of VTE. Reducing obesity levels will likely result in lower incidence in VTE.

Childhood obesity

Essential facts Nearly one third of children aged 2-15 in England are overweight or obese. Younger generations are becoming obese at earlier ages and staying so for longer. Reducing obesity levels is a major public health challenge as the condition doubles the risk of dying prematurely. Obese adults are more likely to develop health conditions such as heart disease, type 2 diabetes and depression. Treating conditions related to obesity is a major financial burden on the NHS, costing more than £5 billion a year.

The Role of Male Closeness on Black Adolescent Male Weight Status in Father‐Present Versus Male‐Kinship Households

Black males from the ages of 12‐19 years olds are the only adolescent group in the United States to experience a significant increase in obesity rates from 1999‐2010. This rise translates into an increase in the odds of obesity prevalence of 1.05 annually. This study used the National Survey of American Life‐Adolescent, a nationally representative sample of African American and Caribbean Black adolescents (n=434), to examine the relationship between male closeness and BMI in father‐present and male‐kinship households among Black adolescents. Obesity levels were similar between father‐present (19%) and kinship households (20%). However, a greater percentage of adolescent males in male‐kinship homes (68%) were normal weight than in father‐present homes (60%). Male‐kinship homes reported higher percentages of male closeness (49%) in comparison to father‐present homes (46%). Ethnic differences were not present between households. In the initial bivariate analysis, Paternal Closeness Scores were negatively correlated with BMI in adolescent males who reported excellent relationship with a male in their life (p=.05). Yet, after accounting for age, household income, ethnicity, and participation in sports, higher male closeness was only predictive of lower BMI in kinship homessage (p=&lt;.01). Family structure has a macro level role on obesity in Black adolescent males. Future interventions among Black adolescents should focus on male bonding as a way to reduce obesity levels.

Association of gestational diabetes and breastfeeding on obesity prevalence in predominately Hispanic low-income youth.

The goal of this study was to examine if breastfeeding duration by gestational diabetes mellitus status impacted the prevalence of obesity in offspring. Data were obtained from a 2011 phone survey with caregivers of low-income children (2-4 years) participating in the Women, Infants and Children programme in Los Angeles County. The final sample included 2295 children, 84% Hispanic and 48% female. Chi-square and binary logistic regression were used to assess gestational diabetes status and breastfeeding duration on the prevalence of obesity, with the following a priori covariates: child's ethnicity, birth weight, age in months and sex. Breastfeeding and gestational diabetes were significantly associated with obesity prevalence (P < 0.01). Using gestational diabetes mellitus and no breastfeeding as the referent category, gestational diabetes mellitus offspring who were breastfed ≥12 months had a 72% decrease in obesity prevalence (adjusted odds ratio = 0.28, confidence interval 0.89-0.03, P = 0.05). These findings suggest that > 12 months of breastfeeding duration in the gestational diabetes mellitus group and any duration of breastfeeding in the non-gestational diabetes mellitus mothers is needed to reduce obesity levels in a primarily Hispanic population.

What Are the Health Benefits of Active Travel? A Systematic Review of Trials and Cohort Studies

BackgroundIncreasing active travel (primarily walking and cycling) has been widely advocated for reducing obesity levels and achieving other population health benefits. However, the strength of evidence underpinning this strategy is unclear. This study aimed to assess the evidence that active travel has significant health benefits.MethodsThe study design was a systematic review of (i) non-randomised and randomised controlled trials, and (ii) prospective observational studies examining either (a) the effects of interventions to promote active travel or (b) the association between active travel and health outcomes. Reports of studies were identified by searching 11 electronic databases, websites, reference lists and papers identified by experts in the field. Prospective observational and intervention studies measuring any health outcome of active travel in the general population were included. Studies of patient groups were excluded.ResultsTwenty-four studies from 12 countries were included, of which six were studies conducted with children. Five studies evaluated active travel interventions. Nineteen were prospective cohort studies which did not evaluate the impact of a specific intervention. No studies were identified with obesity as an outcome in adults; one of five prospective cohort studies in children found an association between obesity and active travel. Small positive effects on other health outcomes were found in five intervention studies, but these were all at risk of selection bias. Modest benefits for other health outcomes were identified in five prospective studies. There is suggestive evidence that active travel may have a positive effect on diabetes prevention, which may be an important area for future research.ConclusionsActive travel may have positive effects on health outcomes, but there is little robust evidence to date of the effectiveness of active transport interventions for reducing obesity. Future evaluations of such interventions should include an assessment of their impacts on obesity and other health outcomes.