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However, the impact of air pollution on body weight at a population level remains inconclusive. This systematic review and meta-analysis will estimate the association of ambient air pollution with obesity, distribution of ectopic adipose tissue, and the incidence and prevalence of non-alcoholic fatty liver disease among adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for conduct and reporting. The search will include the following databases: Ovid Medline, Embase, PubMed, Web of Science and Latin America and the Caribbean Literature on Health Sciences, and will be supplemented by a grey literature search. Each article will be independently screened by two reviewers, and relevant data will be extracted independently and in duplicate. Study-specific estimates of associations and their 95% Confidence Intervals will be pooled using a DerSimonian and Laird random-effects model, implemented using the RevMan software. The I<jats:sup>2<\/jats:sup> statistic will be used to assess interstudy heterogeneity. The confidence in the body of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>As per institutional policy, ethical approval is not required for secondary data analysis. In addition to being published in a peer-reviewed journal and presented at conferences, the results of the meta-analysis will be shared with key stakeholders, health policymakers and healthcare professionals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42023423955.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-080026","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:26:30Z","timestamp":1708043190000},"page":"e080026","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of ambient air pollution on obesity and ectopic fat deposition: a protocol for a systematic review and meta-analysis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9711-7675","authenticated-orcid":false,"given":"Mehnaz","family":"Munir","sequence":"first","affiliation":[{"name":"Department of Global Health, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandi M","family":"Azab","sequence":"additional","affiliation":[{"name":"Department of Pharmacognosy, Alexandria University, Alexandria, Egypt"},{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shrikant","family":"I Bangdiwala","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Om","family":"Kurmi","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Faculty Research Centre for Healthcare and Communities, Institute of Health and Wellbeing, Coventry University, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dany","family":"Doiron","sequence":"additional","affiliation":[{"name":"Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Brook","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Banfield","sequence":"additional","affiliation":[{"name":"Health Sciences Library, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8945-513X","authenticated-orcid":false,"given":"Russell J","family":"de Souza","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"},{"name":"Department of Global Health & Department of Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"2025101815112194000_14.2.e080026.1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.7243\/2052-5966-2-2","article-title":"Epidemiology of obesity in developing countries: challenges and prevention","volume":"2","author":"Ellulu","year":"2014","journal-title":"Glob Epidemi Obes"},{"key":"2025101815112194000_14.2.e080026.2","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/s12916-020-01666-y","article-title":"The role of overweight and obesity in adverse cardiovascular disease mortality trends: an analysis of multiple cause of death data from Australia and the USA","volume":"18","author":"Adair","year":"2020","journal-title":"BMC Med"},{"key":"2025101815112194000_14.2.e080026.3","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyi272"},{"key":"2025101815112194000_14.2.e080026.4","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1002\/oby.20198","article-title":"Ambient air pollution and the prevalence of obesity in chinese children: the seven northeastern cities study","volume":"22","author":"Dong","year":"2014","journal-title":"Obesity"},{"key":"2025101815112194000_14.2.e080026.5","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2008.102"},{"key":"2025101815112194000_14.2.e080026.6","doi-asserted-by":"publisher","DOI":"10.1177\/1559827608314095"},{"key":"2025101815112194000_14.2.e080026.7","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamainternmed.85"},{"key":"2025101815112194000_14.2.e080026.8","unstructured":"Behan DF , Cox SH , Lin Y , et al . 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