OBJECTIVES: The aim of this cross-sectional study is to investigate the association between long-term air pollution (AP) exposure and adiposity, primarily visceral fat and secondary body fat in runners and inactive participants. METHODS: This study included 945 individuals (male n = 505 and female n = 440). These included both active (runners: run ≥ 10 km/week) and inactive (did not follow the WHO 2020 PA recommendations) individuals. Dependent variables were body composition parameters fat mass index (FMI) and visceral fat (VFA), measured using dual-emission X-ray absorptiometry (DXA). A Hologic QDR (Horizon) bone densitometer was used for the measurement. Independent variables were AP values (PM10, PM2.5, NO2, BaP), for which lifetime exposure (LCxp) was calculated. Volume physical activity (PA), eating habits, and cardiorespiratory fitness (V̇O2peak) were analyzed as covariates. RESULTS: The results showed that long-term exposure to AP was not associated with increased adiposity (p > 0.05). However, age (p = 0.000), sex (p = 0.000), and V̇O2peak (p = 0.000) were associated with VFA. Values for VFA increased with age, males had higher VFA than females, and VFA values decreased with increasing V̇O2peak (p < 0.05) values. Furthermore, higher V̇O2peak values were strongly associated with lower FMI (p = 0.000). CONCLUSIONS: Adiposity was not associated with AP in the studied population. Adiposity was affected mainly by lifestyle and associated cardiorespiratory fitness presented by V̇O2peak values.

Application Centre BALUO Faculty of Physical Culture Palacky University Olomouc Czech Republic

Centre for Epidemiological Research Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Epidemiology and Public Health Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Human Movement Studies Faculty of Education University of Ostrava Ostrava Czech Republic

Department of Physiology and Pathophysiology Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Sports Studies Faculty of Education University of South Bohemia Ceske Budejovice Czech Republic

Faculty of Education Charles University Praha Czech Republic

Institute for Research and Applications of Fuzzy Modeling University of Ostrava Ostrava Czech Republic

School of Human Sciences The University of Western Australia Perth Australia

Zobrazit více v PubMed

Agustiyawan, A. 2022. “Hubungan Visceral Fat Dengan VO2Max Pada Pemain Sepak Bola Muda Laki‐Laki.” Jurnal Keperawatan Muhammadiyah 7, no. 4: 17–20. 10.30651/jkm.v7i4.13988. DOI

Alpízar, M. , Frydman T. D., de Reséndiz‐Rojas J. J., Trejo‐Rangel M. A., and de Aldecoa‐Castillo J. M.. 2020. “Fat Mass Index (FMI) as a Trustworthy Overweight and Obesity Marker in Mexican Pediatric Population.” Children 7, no. 3: 19. 10.3390/children7030019. PubMed DOI PMC

An, R. , Zhang S., Ji M., and Guan C.. 2018. “Impact of Ambient Air Pollution on Physical Activity Among Adults: A Systematic Review and Meta‐Analysis.” Perspectives in Public Health 138, no. 2: 111–121. 10.1177/1757913917726567. PubMed DOI

Astrand, P. , Rodahl K., Peterson T. R., and LeCheminant J. D.. 2003. Physiological Bases of Exercise. 4th ed. Human Kinetics.

Bailey, B. W. , Tucker L. A., Peterson T. R., and LeCheminant J. D.. 2007. “A Prospective Study of Physical Activity Intensity and Change in Adiposity in Middle‐Aged Women.” American Journal of Health Promotion 21, no. 6: 492–497. 10.4278/0890-1171-21.6.492. PubMed DOI

Bartoskova Polcrova, A. , Ksinan A. J., González‐Rivas J. P., Bobak M., and Pikhart H.. 2024. “The Explanation of Educational Disparities in Adiposity by Lifestyle, Socioeconomic and Mental Health Mediators: A Multiple Mediation Model.” European Journal of Clinical Nutrition 78, no. 5: 376–383. 10.1038/s41430-024-01403-1. PubMed DOI PMC

Bloemsma, L. D. , Wijga A. H., Klompmaker J. O., et al. 2019. “The Associations of Air Pollution, Traffic Noise and Green Space With Overweight Throughout Childhood: The PIAMA Birth Cohort Study.” Environmental Research 169: 348–356. 10.1016/j.envres.2018.11.026. PubMed DOI

Bostan, P. 2022. “Health Effects of Outdoor Air Pollutants.” World Journal of Environmental Research 12, no. 2: 70–81. 10.18844/wjer.v12i2.8095. DOI

Bowe, B. , Gibson A. K., Xie Y., et al. 2021. “Ambient Fine Particulate Matter Air Pollution and Risk of Weight Gain and Obesity in United States Veterans: An Observational Cohort Study.” Environmental Health Perspectives 129, no. 4: EHP7944. 10.1289/EHP7944. PubMed DOI PMC

Bowe, B. , Xie Y., Gibson A. K., et al. 2021. “Ambient Fine Particulate Matter Air Pollution and the Risk of Hospitalization Among COVID‐19 Positive Individuals: Cohort Study.” Environment International 154: 106564. 10.1016/j.envint.2021.106564. PubMed DOI PMC

Bray, G. A. , Kim K. K., and Wilding J. P. H.. 2017. “Obesity: A Chronic Relapsing Progressive Disease Process. A Position Statement of the World Obesity Federation.” Obesity Reviews 18, no. 7: 715–723. 10.1111/obr.12551. PubMed DOI

Cai, M. , Li H., Wu Y., et al. 2022. “Ambient Air Pollution Associated With Body Fat Percentages at Different Body Compartments: A Cohort Study of UK Biobank Participants.” Environmental Health Perspectives 130, no. 6: 67702. 10.1289/EHP10920. PubMed DOI PMC

Chen, J.‐C. , and Schwartz J.. 2008. “Metabolic Syndrome and Inflammatory Responses to Long‐Term Particulate Air Pollutants.” Environmental Health Perspectives 116, no. 5: 612–617. 10.1289/ehp.10565. PubMed DOI PMC

Chen, Z. , Herting M. M., Chatzi L., et al. 2019. “Regional and Traffic‐Related Air Pollutants Are Associated With Higher Consumption of Fast Food and Trans Fat Among Adolescents.” American Journal of Clinical Nutrition 109, no. 1: 99–108. 10.1093/ajcn/nqy232. PubMed DOI PMC

CHI . n.d. “Air Pollution and Atmospheric Deposition in Data, the Czech Republic, ISKO.” Accessed May 2, 2024. https://www.chmi.cz/files/portal/docs/uoco/isko/tab_roc/tab_roc_CZ.html.

Chooi, Y. C. , Ding C., and Magkos F.. 2019. “The Epidemiology of Obesity.” Metabolism 92: 6–10. 10.1016/j.metabol.2018.09.005. PubMed DOI

Chuang, K.‐J. , Chan C.‐C., Su T.‐C., Lee C.‐T., and Tang C.‐S.. 2007. “The Effect of Urban Air Pollution on Inflammation, Oxidative Stress, Coagulation, and Autonomic Dysfunction in Young Adults.” American Journal of Respiratory and Critical Care Medicine 176, no. 4: 370–376. 10.1164/rccm.200611-1627OC. PubMed DOI

Cipryan, L. , Kutac P., Dostal T., et al. 2020. “Regular Running in an Air‐Polluted Environment: Physiological and Anthropometric Protocol for a Prospective Cohort Study (Healthy Aging in Industrial Environment Study—Program 4).” BMJ Open 10, no. 12: 1–8. 10.1136/bmjopen-2020-040529. PubMed DOI PMC

Cipryan, L. , Litschmannova M., Barot T., et al. 2024. “Air Pollution, Cardiorespiratory Fitness and Biomarkers of Oxidative Status and Inflammation in the 4HAIE Study.” Scientific Reports 14, no. 1: 9620. 10.1038/s41598-024-60388-w. PubMed DOI PMC

Czech Republic . 2012. “Act on Air Protection Pub. L. No. Act n. 201/2012 Sb 2012.”

Demerath, E. W. , Sun S. S., Rogers N., et al. 2007. “Anatomical Patterning of Visceral Adipose Tissue: Race, Sex, and Age Variation.” Obesity 15, no. 12: 2984–2993. 10.1038/oby.2007.356. PubMed DOI PMC

Deschenes, O. , Wang H., Wang S., and Zhang P.. 2020. “The Effect of Air Pollution on Body Weight and Obesity: Evidence From China.” Journal of Development Economics 145: 102461. 10.1016/j.jdeveco.2020.102461. DOI

Elavsky, S. , Jandačková V., Knapová L., et al. 2021. “Physical Activity in an Air‐Polluted Environment: Behavioral, Psychological and Neuroimaging Protocol for a Prospective Cohort Study (Healthy Aging in Industrial Environment Study—Program 4).” BMC Public Health 21, no. 1: 126. 10.1186/s12889-021-10166-4. PubMed DOI PMC

Eurostat . 2022. “Body Mass Index (BMI) by Sex, Age and Country of Citizenship.” Eurostat Data Browser. https://ec.europa.eu/eurostat/databrowser/view/HLTH_EHIS_BM1C__custom_3982835/default/table?lang=en.

Fernández‐Sánchez, A. , Madrigal‐Santillán E., Bautista M., et al. 2011. “Inflammation, Oxidative Stress, and Obesity.” International Journal of Molecular Sciences 12, no. 5: 3117–3132. 10.3390/ijms12053117. PubMed DOI PMC

Furlong, M. A. , and Klimentidis Y. C.. 2020. “Associations of Air Pollution With Obesity and Body Fat Percentage, and Modification by Polygenic Risk Score for BMI in the UK Biobank.” Environmental Research 185: 109364. 10.1016/j.envres.2020.109364. PubMed DOI PMC

Gába, A. , and Přidalová M.. 2014. “Age‐Related Changes in Body Composition in a Sample of Czech Women Aged 18–89 Years: A Cross‐Sectional Study.” European Journal of Nutrition 53, no. 1: 167–176. 10.1007/s00394-013-0514-x. PubMed DOI PMC

Greendale, G. A. , Sternfeld B., Huang M., et al. 2019. “Changes in Body Composition and Weight During the Menopause Transition.” JCI Insight 4, no. 5: e124865. 10.1172/jci.insight.124865. PubMed DOI PMC

Han, S. , Zhang F., Yu H., et al. 2022. “Systemic Inflammation Accelerates the Adverse Effects of Air Pollution on Metabolic Syndrome: Findings From the China Health and Retirement Longitudinal Study (CHARLS).” Environmental Research 215, no. 1: 114340. 10.1016/j.envres.2022.114340. PubMed DOI

Heindel, J. J. , and vom Saal F. S.. 2009. “Role of Nutrition and Environmental Endocrine Disrupting Chemicals During the Perinatal Period on the Aetiology of Obesity.” Molecular and Cellular Endocrinology 304, no. 1–2: 90–96. 10.1016/j.mce.2009.02.025. PubMed DOI

Higgins, S. , Zemel B. S., Khoury P. R., Urbina E. M., and Kindler J. M.. 2022. “Abstract MP70: Differing Age, Sex, and Ancestry‐Related Trends in Visceral Fat Between Youth With Healthy Weight, Obesity, and Type 2 Diabetes.” Circulation 145, no. 1: AMP70. 10.1161/circ.145.suppl_1.MP70. DOI

Huang, S. , Zhang X., Huang J., Lu X., Liu F., and Gu D.. 2020. “Ambient Air Pollution and Body Weight Status in Adults: A Systematic Review and Meta‐Analysis.” Environmental Pollution 265: 114999. 10.1016/j.envpol.2020.114999. PubMed DOI

Hůnová, I. 2020. “Ambient Air Quality in The Czech Republic: Past and Present.” Atmosphere 11, no. 2: 214. 10.3390/atmos11020214. DOI

James, P. , Kioumourtzoglou M.‐A., Hart J. E., Banay R. F., Kloog I., and Laden F.. 2017. “Interrelationships Between Walkability, Air Pollution, Greenness, and Body Mass Index.” Epidemiology 28, no. 6: 780–788. 10.1097/EDE.0000000000000724. PubMed DOI PMC

Jandacka, D. , Uchytil J., Zahradnik D., et al. 2020. “Running and Physical Activity in an Air‐Polluted Environment: The Biomechanical and Musculoskeletal Protocol for a Prospective Cohort Study 4HAIE (Healthy Aging in Industrial Environment—Program 4).” International Journal of Environmental Research and Public Health 17, no. 23: 9142. 10.3390/ijerph17239142. PubMed DOI PMC

Jung, S. H. , Ha K. H., and Kim D. J.. 2016. “Visceral Fat Mass Has Stronger Associations With Diabetes and Prediabetes Than Other Anthropometric Obesity Indicators Among Korean Adults.” Yonsei Medical Journal 57, no. 3: 674–680. 10.3349/ymj.2016.57.3.674. PubMed DOI PMC

Jusof, W. H. W. , and Ramli N. M.. 2019. “Relationship Between Dietary Patterns, Lifestyle Habits and Total Body Fat Composition Among University Students.” International Journal of Research in Pharmaceutical Sciences 10, no. 1. 10.26452/ijrps.v10iSPL1.1682. DOI

Kachur, S. , Lavie C. J., de Schutter A., Milani R. V., and Ventura H. O.. 2017. “Obesity and Cardiovascular Diseases.” Minerva Medica 108, no. 3: 212–228. 10.23736/S0026-4806.17.05022-4. PubMed DOI

Kim, Y.‐J. 2016. “The Long‐Run Effect of Education on Obesity in the US.” Economics and Human Biology 21: 100–109. 10.1016/j.ehb.2015.12.003. PubMed DOI

Kohl, H. W. , Blair S. N., Paffebarger R. S., Macera C. A., and Kronenfeld J. J.. 1988. “Mail Survey of Physical Activity Habits as Related to Measured Physical Fitness.” American Journal of Epidemiology 127, no. 6: 1228–1239. 10.1093/oxfordjournals.aje.a114915. PubMed DOI

Korsić, M. , Fister K., Ivanković D., and Jelcić J.. 2011. “Visceral Obesity.” Lijec̆nic̆ki Vjesnik 133, no. 7–8: 284–287. PubMed

Kutac, P. , Bunc V., Buzga M., Krajcigr M., and Sigmund M.. 2023. “The Effect of Regular Running on Body Weight and Fat Tissue of Individuals Aged 18 to 65.” Journal of Physiological Anthropology 42, no. 1: 28. 10.1186/s40101-023-00348-x. PubMed DOI PMC

Kutáč, P. , Bunc V., and Sigmund M.. 2019. “Whole‐Body Dual‐Energy X‐Ray Absorptiometry Demonstrates Better Reliability Than Segmental Body Composition Analysis in College‐Aged Students.” PLoS One 14, no. 4: 1–15. 10.1371/journal.pone.0215599. PubMed DOI PMC

Kutac, P. , Jandacka D., Elavsky S., et al. 2024. “The Effect of Regular Running on the Bone Tissue of Middle‐Aged Men and Women.” Journal of Sports Medicine and Physical Fitness 64, no. 5: 455–464. 10.23736/S0022-4707.23.15279-0. PubMed DOI

Kutac, P. , Buzga M., Elavsky S., Bunc V., Jandacka D., and Krajcigr M.. 2021. “The Effect of Regular Physical Activity on Muscle and Adipose Tissue in Premenopausal Women.” Applied Sciences 11, no. 18: 8655. 10.3390/app11188655. DOI

Lederer, A. M. , Fredriksen P. M., Nkeh‐Chungag B. N., et al. 2021. “Cardiovascular Effects of Air Pollution: Current Evidence From Animal and Human Studies.” American Journal of Physiology—Heart and Circulatory Physiology 320, no. 4: H1417–H1439. 10.1152/ajpheart.00706.2020. PubMed DOI

Lin, X. , and Li H.. 2021. “Obesity: Epidemiology, Pathophysiology, and Therapeutics.” Frontiers in Endocrinology 12: 706978. 10.3389/fendo.2021.706978. PubMed DOI PMC

Liu, C. , Xu X., Bai Y., et al. 2014. “Air Pollution–Mediated Susceptibility to Inflammation and Insulin Resistance: Influence of CCR2 Pathways in Mice.” Environmental Health Perspectives 122, no. 1: 17–26. 10.1289/ehp.1306841. PubMed DOI PMC

Liu, P. , Ma F., Lou H., and Liu Y.. 2013. “The Utility of Fat Mass Index vs. Body Mass Index and Percentage of Body Fat in the Screening of Metabolic Syndrome.” BMC Public Health 13: 629. 10.1186/1471-2458-13-629. PubMed DOI PMC

Liu, X. , Tu R., Qiao D., et al. 2020. “Association Between Long‐Term Exposure to Ambient Air Pollution and Obesity in a Chinese Rural Population: The Henan Rural Cohort Study.” Environmental Pollution 260: 114077. 10.1016/j.envpol.2020.114077. PubMed DOI

Lubis, A. I. , Putri S. E., Safrida S., Ayunda H. M., and Iskandar A.. 2021. “Relationship Between Body Mass Index and Visceral Fat of Participants EXPO 2021 Universitas Teuku Umar.” Journal of Nutritional Science 2, no. 2: 48. 10.35308/jns.v2i2.4377. DOI

Machaczka, O. , Jiřík V., Janulková T., et al. 2023. “Comparisons of Lifetime Exposures Between Differently Polluted Areas and Years of Life Lost due to All‐Cause Mortality Attributable to Air Pollution.” Environmental Sciences Europe 35, no. 1: 73. 10.1186/s12302-023-00778-5. DOI

Mark, A. E. , and Janssen I.. 2011. “Influence of Movement Intensity and Physical Activity on Adiposity in Youth.” Journal of Physical Activity & Health 8, no. 2: 164–173. 10.1123/jpah.8.2.164. PubMed DOI

Marmot, M. , and Bell R.. 2019. “Social Determinants and Non‐Communicable Diseases: Time for Integrated Action.” BMJ 364: l251. 10.1136/bmj.l251. PubMed DOI PMC

Meyler, S. , Bottoms L., and Muniz‐Pumares D.. 2021. “Biological and Methodological Factors Affecting V̇O2max Response Variability to Endurance Training and the Influence of Exercise Intensity Prescription.” Experimental Physiology 106, no. 7: 1410–1424. 10.1113/EP089565. PubMed DOI

Michalik, J. , Machaczka O., Jirik V., Heryan T., and Janout V.. 2022. “Air Pollutants Over Industrial and Non‐Industrial Areas: Historical Concentration Estimates.” Atmosphere 13, no. 3: 455. 10.3390/atmos13030455. DOI

Montone, R. A. , Rinaldi R., Bonanni A., et al. 2023. “Impact of Air Pollution on Ischemic Heart Disease: Evidence, Mechanisms, Clinical Perspectives.” Atherosclerosis 366: 22–31. 10.1016/j.atherosclerosis.2023.01.013. PubMed DOI

Najjar, R. S. , and Feresin R. G.. 2019. “Plant‐Based Diets in the Reduction of Body Fat: Physiological Effects and Biochemical Insights.” Nutrients 11, no. 11: 2712. 10.3390/nu11112712. PubMed DOI PMC

Ng, M. , Fleming T., Robinson M., et al. 2014. “Global, Regional, and National Prevalence of Overweight and Obesity in Children and Adults During 1980–2013: A Systematic Analysis for the Global Burden of Disease Study 2013.” Lancet 384, no. 9945: 766–781. 10.1016/S0140-6736(14)60460-8. PubMed DOI PMC

Panchu, P. , Bahuleyan B., Babu R., and Vijayan V.. 2019. “Age and Sex Variation in Visceral Adipose Tissue.” International Journal of Advances in Medicine 6, no. 1: 101. 10.18203/2349-3933.ijam20190113. DOI

Parikh, S. , Shah H., and Singh S.. 2017. “Does Visceral Fat Affect Aerobic Fitness in Indian Adolescents of 18–19 Years' Age Group?” National Journal of Physiology, Pharmacy and Pharmacology 1: 1. 10.5455/njppp.2018.8.0830905092017. DOI

Pereira‐da‐Silva, L. , Dias M. P.‐G., Dionísio E., et al. 2016. “Fat Mass Index Performs Best in Monitoring Management of Obesity in Prepubertal Children.” Jornal de Pediatria 92, no. 4: 421–426. 10.1016/j.jped.2015.11.003. PubMed DOI

Peterson, R. A. 2021. “Finding Optimal Normalizing Transformations via bestNormalize.” R Journal 13, no. 1: 310. 10.32614/RJ-2021-041. DOI

Peterson, R. A. , and Cavanaugh J. E.. 2020. “Ordered Quantile Normalization: A Semiparametric Transformation Built for the Cross‐Validation Era.” Journal of Applied Statistics 47, no. 13–15: 2312–2327. 10.1080/02664763.2019.1630372. PubMed DOI PMC

Pikhart, H. , Bobak M., Malyutina S., Pajak A., Kubínová R., and Marmot M.. 2007. “Obesity and Education in Three Countries of the Central and Eastern Europe: The HAPIEE Study.” Central European Journal of Public Health 15, no. 4: 140–142. 10.21101/cejph.a3452. PubMed DOI

Raj, K. 2020. “Air Pollution and Respiratory Health.” Journal of Advanced Pediatrics and Child Health 3, no. 1: 32–37. 10.29328/journal.japch.1001015. DOI

Roosz, A. , Bahls M., Ulbricht S., et al. 2025. “Movement Behaviors and Cardiorespiratory Fitness ‐ a Cross‐Sectional Compositional Data Analysis Among German Adults.” BMC Sports Science, Medicine and Rehabilitation 17, no. 1: 63. 10.1186/s13102-025-01112-7. PubMed DOI PMC

Safaei, M. , Sundararajan E. A., Driss M., Boulila W., and Shapi'i A.. 2021. “A Systematic Literature Review on Obesity: Understanding the Causes and Consequences of Obesity and Reviewing Various Machine Learning Approaches Used to Predict Obesity.” Computers in Biology and Medicine 136: 104754. 10.1016/j.compbiomed.2021.104754. PubMed DOI

Samet, J. M. 2019. “Pollution.” In Urban Health, 112–128. Oxford University Press. 10.1093/oso/9780190915858.003.0013. DOI

Schwendinger, F. , Infanger D., Lichtenstein E., et al. 2025. “Intensity or Volume: The Role of Physical Activity in Longevity.” European Journal of Preventive Cardiology 32, no. 1: 10–19. 10.1093/eurjpc/zwae295. PubMed DOI

Sokolov, E. I. , and Pisarevskaia A. L.. 2007. “Visceral Obesity as a Pathogenetic Factor of Ischemic Heart Disease.” Kardiologiia 47, no. 1: 11–15. PubMed

Sram, R. J. , Binkova B., Dostal M., et al. 2013. “Health Impact of Air Pollution to Children.” International Journal of Hygiene and Environmental Health 216, no. 5: 533–540. 10.1016/j.ijheh.2012.12.001. PubMed DOI

Stafoggia, M. , Oftedal B., Chen J., et al. 2022. “Long‐Term Exposure to Low Ambient Air Pollution Concentrations and Mortality Among 28 Million People: Results From Seven Large European Cohorts Within the ELAPSE Project.” Lancet Planetary Health 6, no. 1: e9–e18. 10.1016/S2542-5196(21)00277-1. PubMed DOI

System Air Quality Information . 2018. “Air Pollution in the Czech Republic 2018.” https://www.chmi.cz/files/portal/docs/uoco/isko/grafroc/18groc/gr18cz/PrilohaII_CHMU2018.pdf.

Tang‐Péronard, J. L. , Andersen H. R., Jensen T. K., and Heitmann B. L.. 2011. “Endocrine‐Disrupting Chemicals and Obesity Development in Humans: A Review.” Obesity Reviews 12, no. 8: 622–636. 10.1111/j.1467-789X.2011.00871.x. PubMed DOI

The National Institute of Public Health (NIPH) . 2003. “Study HELEN 2003—Summary of Monitored Cities.” http://www.szu.cz/topics/environmental‐health/environmental‐health‐monitoring.

Tiotiu, A. I. , Novakova P., Nedeva D., et al. 2020. “Impact of Air Pollution on Asthma Outcomes.” International Journal of Environmental Research and Public Health 17, no. 17: 6212. 10.3390/ijerph17176212. PubMed DOI PMC

Wallwork, R. S. , Colicino E., Zhong J., et al. 2017. “Ambient Fine Particulate Matter, Outdoor Temperature, and Risk of Metabolic Syndrome.” American Journal of Epidemiology 185, no. 1: 30–39. 10.1093/aje/kww157. PubMed DOI PMC

Wang, J. , Ma T., Ma D., et al. 2021. “The Impact of Air Pollution on Neurodegenerative Diseases.” Therapeutic Drug Monitoring 43, no. 1: 69–78. 10.1097/FTD.0000000000000818. PubMed DOI

Wee, S. , Tanaka K., Nakata V., Lee D., Ohkawara K., and Fujimura M.. 2004. “Effects of Diet Plus Exercise on Visceral Fat in Obese Women: With Special Reference to the Increase in VO2max.” Japanese Journal of Physical Fitness and Sports Medicine 53, no. 3: 311–319. 10.7600/jspfsm1949.53.311. DOI

White, L. F. , Jerrett M., Yu J., Marshall J. D., Rosenberg L., and Coogan P. F.. 2016. “Ambient Air Pollution and 16‐Year Weight Change in African‐American Women.” American Journal of Preventive Medicine 51, no. 4: e99–e105. 10.1016/j.amepre.2016.03.007. PubMed DOI PMC

WHO . 2020. “WHO Guidelines on Physical Activity and Sedentary Behaviour.” WHO. Licence: CC BY‐NC‐SA 3.0 IGO.

WHO . 2021a. “Obesity and Overwight.” https://www.who.int/news‐room/fact‐sheets/detail/obesity‐and‐overweight.

WHO . 2021b. “WHO Global Air Quality Guidelines: Particulate Matter (PM PubMed

WHO . 2022. “WHO European Regional Obesity Report 2022.” https://www.who.int/europe/publications/i/item/9789289057738.

Wong, J. C. , O'Neill S., Beck B. R., Forwood M. R., and Khoo S. K.. 2021. “Comparison of Obesity and Metabolic Syndrome Prevalence Using Fat Mass Index, Body Mass Index and Percentage Body Fat.” PLoS One 16, no. 1: e0245436. 10.1371/journal.pone.0245436. PubMed DOI PMC

Xu, Z. , Xu X., Zhong M., et al. 2011. “Ambient Particulate Air Pollution Induces Oxidative Stress and Alterations of Mitochondria and Gene Expression in Brown and White Adipose Tissues.” Particle and Fibre Toxicology 8, no. 1: 20. 10.1186/1743-8977-8-20. PubMed DOI PMC

Žejglicová, K. , Kratěnová J., Lustigová M., and Malý M.. 2016. “Trends in Health Indicators in the Urban Middle‐Aged Population in The Czech Republic in 1998–2010.” Public Health 137: 81–87. 10.1016/j.puhe.2015.11.022. PubMed DOI

Zhang, Z. , Dong B., Chen G., et al. 2021. “Ambient Air Pollution and Obesity in School‐Aged Children and Adolescents: A Multicenter Study in China.” Science of the Total Environment 771: 144583. 10.1016/j.scitotenv.2020.144583. PubMed DOI