Justin J. Lang

Public Health Agency of Canada | PHAC · Health Promotion and Chronic Disease Prevention

Purpose To identify criterion-referenced standards for cardiorespiratory fitness (CRF); to estimate the percentage of children and youth that met each standard; and to discuss strategies to help improve the utility of criterion-referenced standards for population health research. Methods A search of four databases was undertaken to identify papers...

Objective: This systematic review aimed to summarize research that assessed the associations between 20 metre shuttle run test (20mSRT) performance and indicators of physiological, psychosocial and cognitive health among school-aged children and youth. Methods: Five online databases were used to identify peer-reviewed studies published from 1980 to...

We review the evidence that supports cardiorespiratory fitness (CRF) as an important indicator of current and future health among school-aged children and youth, independent of physical activity levels. We discuss the merit of CRF measurement for population health surveillance and propose the development of CRF guidelines to help support regional,...

Objective: We provide our perspective on using cardiorespiratory fitness (CRF) as an objective measure to complement the current Global Action Plan on Physical Activity (GAPPA) evaluation efforts, providing a proximal outcome of physical activity levels in individuals of all ages. Method: We interpret the scientific evidence evaluating associations...

Background: The Global Burden of Disease (GBD) Study represents a large and systematic effort to describe the burden of diseases and injuries over the last three decades. The objective of this study was to summarize the Canadian burden of diseases and injuries using data from the GBD Study. Methods: We summarized data from the 2016 iteration of GB...

Objective: To determine the association between social media use (SMU) and physical activity (PA) among Canadian adolescents. Methods: We used data from 12,358 participants in grades 6 to 10 who responded to the Canadian component of the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey. Social media intensity and problematic SMU...

Objective To estimate health care and health-related productivity costs associated with excessive sedentary behaviour (> 8 h/day and > 9 h/day) in Canadian adults.Methods Three pieces of information were used to estimate costs: (1) the pooled relative risk estimates of adverse health outcomes consistently shown to be associated with excessive seden...

The objective of this study was to estimate health care and health-related productivity costs associated with low cardiorespiratory fitness (CRF) in Canadian adults. We also estimated costs that would be avoided by a 10 percentage point prevalence reduction in low CRF. A prevalence-based approach was used to estimate the economic costs associated w...

Introduction: Associations between physical activity (PA), sedentary behavior (SED), and sleep-24-h movement behaviors (MBs)-and children/youth's mental health (MH) is well-established though often only examined separately. Methods: This scoping review sought to answer the question: What evidence is there on the association between 24-h movement be...

Objective To evaluate current levels of physical activity and sedentary behaviour among pregnant and non-pregnant adults in Canada. Methods We ascertained population-based cross-sectional data from the Canadian Community Health Survey (CCHS), 2015–2019, and from the Canadian Health Measures Survey (CHMS), 2007–2019. We included adults who were ass...

Background: Data on meeting the Canadian 24-Hour Movement Guidelines for adults (24-H Guidelines) and associations with health indicators by body mass index (BMI) class are needed to support public health surveillance. The aim of this study was to describe the proportion of Canadian adults meeting individual and various combinations of the 24-H Gu...

Background: The primary aim was to examine the temporal trends in physical fitness (PF) for Japanese children and adolescents before and during the coronavirus disease (COVID-19) pandemic. The secondary aim was to estimate the concurrent trends in body size (measured as body mass and height) and movement behaviors (exercise, screen, and sleep time...

Introduction: The new Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years and older recommend that adults limit daily sedentary time to eight hours or less, including three hours or less of recreational screen time. The eight-hour recommendation was centred between the evidence from research using self-reported...

Introduction Over the last decade, e-cigarette use has been on the rise but with growing health concerns. The objective of this systematic review was to update findings for chronic health outcomes associated with e-cigarette use from the 2018 National Academies of Sciences, Engineering, and Medicine (NASEM) report. Methods Three bibliographic data...

Background Built environments have been implicated in the development of chronic disease, with physical activity (PA) considered one of the critical mechanisms for this relationship. Substantial growth in research on built environments and PA makes navigating the available evidence challenging. Objective To examine and describe the current state,...

Background The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. Objective This study aimed to produce a list of the top 10 inte...

Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods:...

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally.

Background: Recently, the Canadian 24-Hour Movement Guidelines for Adults were released, and included a revised physical activity (PA) recommendation. The recommendation of 150 minutes per week of moderate-to-vigorous intensity PA (MVPA) was revised, from requiring that MVPA be accrued in bouts of 10 minutes or more (bouted) to having no bout requ...

Background Few studies have investigated the optimal anthropometric index associated with potential cardio-metabolic risk. Using direct measures of standing height, body mass, and waist circumference, we sought to identify the optimal index for detecting cardio-metabolic risk associated with diabetes and hypertension in a nationally representative...

Background: Built environments have shown to be associated with health, with physical activity (PA) considered one of the critical pathways for achieving benefits. Navigating available evidence on the built environment and PA is challenging given the number of reviews. Objective: Examine the current state and quality of research looking at assoc...

Introduction: Handgrip strength (HGS) asymmetry may help identify the functional asymmetries that contribute to mobility limitations. We sought to determine the associations of HGS asymmetry on gait speed and standing balance in older Americans. Materials and Methods: The analytic sample included 8,396 adults aged ≥65-years for the last wave in whi...

Meeting the physical activity (PA) and recreational screen time recommendations for children and young people is associated with several health benefits. The purpose of this study was to compare the odds of meeting PA and recreational screen time recommendations between the Canadian youth living in urban versus rural communities. We analyzed nation...

Handgrip dynamometers are widely used to measure handgrip strength (HGS). HGS is a safe and easy to obtain measure of strength capacity, and a reliable assessment of muscle function. Although HGS provides robust prognostic value and utility, several protocol variants exist for HGS in clinical settings and translational research. This lack of method...

Background Using a nationally representative cohort of Canadian adults, we assessed associations between neighbourhood walkability and cause-specific mortality and investigated whether they differed by socioeconomic status. Methods The study population was drawn from the 2001 Canadian Census Health and Environment Cohort, which contains individual...

Background: The Canadian 24-Hour Movement Guidelines for Adults (18-64 years and 65 years or older) were launched in October 2020 and provide evidence-based recommendations for physical activity, sedentary behaviour and sleep. The purpose of this study was to examine whether meeting the 24-Hour Movement Guidelines overall, and different combinatio...

Regular physical activity prevents several non-communicable chronic conditions and premature mortality. The benefits of physical activity can be achieved through active transport, which refers to non-motorised/active means (e.g. walking, cycling, rollerblading) to move from one place to another. Active transport can be integrated into daily routine...

Background: The fitness levels of Canadian adults declined substantially between 1981 and the years 2007 to 2009, suggesting a reduction in population health. This paper updates the fitness trends of Canadians aged 20 to 69 years by extending the time period to 2017. Data and methods: The Canadian Health Measures Survey is a repeated cross-secti...

Background: Suicide is a leading cause of death, particularly for young adults. Suicide-related behaviours are influenced by a wide-range of personal, social, and cultural factors. Emerging evidence suggests that daily changes in meteorological conditions, including temperature, can increase the risk of suicide. Methods: We conducted a systemati...

Background Cardiorespiratory fitness (CRF), which reflects the overall aerobic capacity of the cardiovascular, respiratory, and muscular systems, is significantly related to health among youth.Objective The aim of this systematic review was to identify health-related criterion-referenced cut-points for CRF among youth aged 5–17 years.MethodsA syste...

Background This study preliminarily examined the relationship between physical activity, sedentary time, and social emotional functioning in children aged 4–6 years. Methods Eighty children attending kindergarden classes in Ottawa, Canada wore Actical accelerometers for 1-week to directly assess their physical activity and sedentary time. Physical...

Introduction: Handgrip strength (HGS) is an important indicator of health. Because HGS is strongly associated with body size, most investigators normalize HGS for some measure of body size as a more sensitive indicator of strength within a population. We aimed to (1) identify the optimal body size dimension to remove (normalize) HGS for difference...

Background Musculoskeletal fitness is an excellent functional measure that is significantly related to health among youth. Objective Our objective was to identify health-related criterion-referenced cut-points for musculoskeletal fitness (MSF) among youth. Methods A systematic search of two electronic databases (MEDLINE and SPORTDiscus) was condu...

Background The standing broad jump (SBJ) is an excellent functional measure of explosive lower-body strength that is significantly related to health among children and adolescents. Objectives The aim of this study was to estimate national (country-level) and international (pooled global data) temporal trends in SBJ performance for children and ado...

Introduction To examine the effectiveness of universal suicide prevention interventions on reducing suicide mortality in high-income Organisation for Economic Co-operation and Development (OECD) member countries. Methods We implemented a comprehensive search strategy across three electronic databases: MEDLINE (Ovid), PsycINFO (Ovid) and Embase (Ov...

Background: Physical fitness is an important indicator of current and future health status. This analysis examines the relationships among child-parent dyads in physical fitness measures. Data and methods: The analysis is based on biological child-parent dyads from three cycles of the Canadian Health Measures Survey (Cycle 1: 2007 to 2009, Cycle...

Background: Handgrip strength (HGS) is an excellent marker of functional capability and health in adults, although little is known about temporal trends in adult HGS. Objectives: The aim of this study was to systematically analyze national (country-level) temporal trends in adult HGS, and to examine the relationships between national trends in a...

Summary Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a sta...

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publ...

Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardise...

Background: The Strengths and Difficulties Questionnaire (SDQ) is a brief measure of children's and adolescents' mental health. There are different versions of the questionnaire: a version for children and adolescents to complete by self-reporting, a version for parents and guardians to complete ("parent-rated"), and a version for teachers to comp...

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

We estimated international/national temporal trends in sit-ups performance for children and adolescents, and examined relationships between national trends in sit-ups performance and national trends in health-related/sociodemographic indicators. Data were obtained by systematically searching studies reporting on temporal trends in sit-ups performan...

Objective To estimate national and international temporal trends in handgrip strength for children and adolescents, and to examine relationships between trends in handgrip strength and trends in health-related and sociodemographic indicators. Methods Data were obtained through a systematic search of studies reporting temporal trends in the handgri...

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant...

Background /Objective. This study examined the validity of the FitnessGram® criterion-reference cut-points for cardiorespiratory fitness (CRF) based on two samples of US adolescents (aged 12–15 years). This study also established the CRF cut-points for metabolically healthy weight status based on a recent national fitness survey for the purposes of...

Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD...

Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD...

Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. methods We reviewed results for injuries from the GBD...

Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD...

Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. methods We reviewed results for injuries from the GBD...

BACKGROUND: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. METHODS: We reviewed results for injuries from the GB...

Background: Suicide is a behaviour that results from a complex interplay of factors, including biological, psychological, social, cultural, and environmental factors, among others. A participatory model building workshop was conducted with fifteen employees working in suicide prevention at a federal public health organization to develop a conceptu...

Objective: This study aimed to develop and validate health-related criterion-referenced cut-points for the modified Canadian Aerobic Fitness Test (mCAFT), a field-based measure to predict cardiorespiratory fitness (CRF) among adults (18-69 years). Methods: Criterion-referenced mCAFT cut-points were developed using nationally representative data...

Background: Criterion-referenced cut-points for field-based aerobic fitness for children and adolescents are lacking. This study aimed to determine the associations between aerobic fitness and obesity to propose criterion-referenced cut-points for boys and girls (6–17 years). Methods: A total of 61,465 children and adolescents aged 11.2 ± 2.0 years...

Background: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods: We reviewed results for injuries from the G...

Introduction The 10-item Social Provisions Scale (SPS-10) has been implemented to measure social support in a number of national surveys in Canada. The objective of this study was to reduce the SPS-10 to a brief, five-item scale (SPS-5), while maintaining adequate measurement properties. Methods Data from individuals aged 18 years and older who re...

Introduction L’Échelle de provisions sociales à 10 items (SPS-10) a été mise en oeuvre dans un certain nombre d’enquêtes nationales canadiennes pour évaluer le soutien social. L’objectif de notre étude était de réduire l’échelle SPS-10 à une échelle à 5 items (SPS-5) tout en conservant des propriétés de mesure adéquates. Méthodologie Nous avons an...

Background: This study developed age- and sex-specific normative-referenced percentile values for five physical fitness tests across a wide age range of Canadians, using a nationally representative sample. Data and methods: The data are from 5,188 Canadians (50.1% female) and were collected as part of cycle 5 of the Canadian Health Measures Surv...

Background: Physical fitness during childhood is an important indicator of current and future health. This paper provides an overview of the fitness of Canadian children and youth aged 6 to 19 years. Data and methods: Data are from three cycles of the Canadian Health Measures Survey (CHMS) spanning a 10-year period: 2007 to 2009 (n = 2,081), 200...