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


Pan X(1)(2), Zhao L(2)(3)(4), Luo J(1)(2), Li Y(3), Zhang L(2)(5)(6), Wu T(2)(7), Smith M(2)(8), Dai S(2)(9), Jia P(2)(9)(10).
Author information:
(1)Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China.
(2)International Institute of Spatial Lifecourse Epidemiology
(ISLE), Hong Kong, China.
(3)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
(4)Research Center for Healthy City Development, Sichuan University, Chengdu, China.
(5)Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
(6)Victorian Comprehensive Cancer Centre, The University of Melbourne Centre for Cancer Research, Melbourne, Victoria, Australia.
(7)Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China.
(8)School of Nursing, The University of Auckland, Auckland, New Zealand.
(9)Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.
(10)Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, the Netherlands.


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.