The influence of geographic life environments on cardiometabolic risk factors: a systematic review, a methodological assessment and a research agenda

Obes Rev. 2011 Mar;12(3):217-30. doi: 10.1111/j.1467-789X.2010.00726.x.


Recent environmental changes play a role in the dramatic increase in the prevalence of cardiometabolic risk factors (CMRFs) such as obesity, hypertension, type 2 diabetes, dyslipidemias and the metabolic syndrome in industrialized countries. Therefore, identifying environmental characteristics that are associated with risk factors is critical to develop more effective public health interventions. We conducted a systematic review of the literature investigating relationships between characteristics of geographic life environments and CMRFs (131 articles). Most studies were published after 2006, relied on cross-sectional designs, and examined whether sociodemographic and physical environmental characteristics, and more recently service environment characteristics, were associated with obesity or, to a lesser extent, hypertension. Only 14 longitudinal studies were retrieved; diabetes, dyslipidemias and the metabolic syndrome were rarely analysed; and aspects of social interactions in the neighbourhood were critically underinvestigated. Environmental characteristics that were consistently associated with either obesity or hypertension include low area socioeconomic position; low urbanization degree; low street intersection, service availability and residential density; high noise pollution; low accessibility to supermarkets and high density of convenience stores; and low social cohesion. Intermediate mechanisms between environmental characteristics and CMRFs have received little attention. We propose a research agenda based on the assessment of underinvestigated areas of research and methodological limitations of current literature.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Exercise / physiology*
  • Heart Diseases / epidemiology*
  • Heart Diseases / etiology
  • Humans
  • Metabolic Diseases / epidemiology*
  • Metabolic Diseases / etiology
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / etiology
  • Obesity / epidemiology*
  • Obesity / etiology
  • Prevalence
  • Risk Factors
  • Social Environment*