The lack of neighbourhood aesthetics (e.g. public art and well-maintained properties) may reduce walkability in the neighbourhood and increase the risk of childhood obesity. In this study, a literature search was conducted in the Cochrane Library, PubMed and Web of Science for articles published before January 1, 2019 to analyse the associations between neighbourhood aesthetics and weight-related behaviours and outcomes among children and adolescents aged <18. One cohort study and 24 cross-sectional studies, conducted in 10 countries with a median sample size of 1124 were identified. Neighbourhood aesthetics was more commonly assessed by self-reported or parent-reported perceptions than objective measurements. Eighteen of the 25 included studies analysed physical activity (PA) as the outcome of interests, eight studies analysed active transport to school (ATS), and eight studies analysed weight status, including body mass index and overweight/obesity status. About two-thirds of studies reported non-significant associations when using PA and weight status as outcomes, and half of studies showed that neighbourhood aesthetics is associated with increased use of ATS. The rest of the studies reported mixed findings with slightly more studies showing neighbourhood aesthetics may promote PA or reduce weight. Better designed studies are necessary to achieve a robust understanding of this epidemiological relationship in the future.
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