Impact of built environment on physical activity and obesity among children and adolescents in China: A narrative systematic review

•We systematically reviewed evidence regarding the impact of built environment on physical activity and obesity among children and adolescents in China.•Twenty studies, including 16 cross-sectional, 3 longitudinal, and 1 descriptive studies, met the predetermined selection criteria and were included in the review.•Availability and accessibility in proximity to greenspace, park, recreational facility, and sidewalks were found to be associated with increased physical activity level, reduced sedentary behavior, and/or active commuting among Chinese children and adolescents.•In contrast, lacking bike lanes and living in higher residential density area were associated with an increased likelihood of childhood overweight and obesity. Neighborhood built environment may profoundly influence children's physical activity (PA) and body weight. This study systematically reviewed scientific evidence regarding the impact of built environment on PA and obesity among children and adolescents in China. A keyword and reference search was conducted in Active Living Research, Cochrane Library, PubMed, and Web of Science. Studies that met all of the following criteria were included in the review: (1) study designs—experimental studies, observational studies, and qualitative studies; (2) study subjects—Chinese children and/or adolescents aged ≤17 years; (3) exposures—neighborhood built environment; (4) outcomes—PA and/or body weight status; (5) article type—peer-reviewed publications; (6) time window of search—from the inception of an electronicbibliographic database to May 31, 2018; (7) country—China; and (8) language—articles written in English. A total of 20 studies, including 16 cross-sectional studies, 3 longitudinal studies, and 1 descriptive study, met the predetermined selection criteria and were included in the review. A total of 13 studies adopted subjective built environment measures reported by parents and/or children,2 adopted objective measures (e.g., geographical information system, field observations), and 5 adopted both objective and subjective measures. PA behaviors included PA, physical inactivity, sedentary behavior, active/passive commuting from/to school, and park visits. Among the 16 studies that provided some quantitative estimates of the influence of built environment on PA and body weight status, all reported a statistically significant relationship in the expected direction. Availability and accessibility in proximity to greenspaces, parks, recreation