{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T15:18:39Z","timestamp":1778426319119,"version":"3.51.4"},"reference-count":75,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"Intramural Research Program, National Institute on Aging, National Institutes of Health","doi-asserted-by":"publisher","award":["Z01-AG000513"],"award-info":[{"award-number":["Z01-AG000513"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Objective: The aim of this study is to determine if protein intake, diet quality, or engagement in physical activity mediate the relationship between sleep quality or duration and handgrip strength. Methods: The sample consisted of 2171 middle-aged persons examined in the 2013\u20132017 Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) prospective cohort study. Those with sleep apnea (n = 222) and missing data were excluded, resulting in an analytical sample of 1308. Handgrip strength, an objectively measured variable, was determined using a Jamar Hydraulic Hand Dynamometer and expressed relative to body mass index (based on measured height and weight). Sleep quality and duration were measured using the Pittsburgh Sleep Quality Index questionnaire. Protein intake was calculated from two 24 h recalls collected using the USDA Automated Multiple-Pass Method and expressed as g per kg of body weight. Diet quality was assessed using the Healthy Eating Index (HEI) and the energy-adjusted Dietary Inflammatory Index (e-DII). Physical activity was self-reported and expressed as meeting the Life Simple 7 criterion (\u2265150 min\/week, 0\u2013149 min\/week, 0 min\/week). Mediation analysis was conducted using the Hayes PROCESS macro, model #4, for SPSS Version 4.2. Adjustment for the self-reported covariates of age (years); sex at birth (male, female); race (African American, White); poverty status (&lt;125% or &gt;125% US HHS Poverty Guidelines); current cigarette smoker (yes, no); marijuana, opiate, and\/or cocaine user (yes, no); medical conditions including diabetes, hypertension, and\/or metabolic syndrome (yes, no); and mean energy (kcal, only protein model) was performed. Results: Protein intake, expressed as g per kg of body weight, mediated the relationship between sleep quality and sleep duration and handgrip strength (indirect effect = \u22120.0017 \u00b1 0.0006, CI 95% (\u22120.0030, \u22120.0006, p &lt; 0.05); indirect effect = 0.0057 \u00b1 0.0019, CI 95% (0.0023, 0.0098, p &lt; 0.05, respectively)). Diet quality, as measured using the HEI, mediated the relationship between sleep duration and handgrip strength (indirect effect = 0.0013 \u00b1 0.0007, CI 95% (0.0001, 0.0030, p &lt; 0.05). Conclusions: Protein intake and a healthy diet mediate the relationship between sleep and handgrip strength, suggesting that these factors may play a role in preserving muscle strength.<\/jats:p>","DOI":"10.3390\/nu17111900","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T05:09:12Z","timestamp":1748840952000},"page":"1900","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Protein Intake and Diet Quality Mediate the Relationship Between Sleep and Handgrip Strength in Adults in the HANDLS Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6903-3386","authenticated-orcid":false,"given":"Marie Fanelli","family":"Kuczmarski","sequence":"first","affiliation":[{"name":"Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE 19711, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9653-7042","authenticated-orcid":false,"given":"Elizabeth","family":"Orsega-Smith","sequence":"additional","affiliation":[{"name":"Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE 19711, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1050-4523","authenticated-orcid":false,"given":"May A.","family":"Beydoun","sequence":"additional","affiliation":[{"name":"Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele K.","family":"Evans","sequence":"additional","affiliation":[{"name":"Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6523-4778","authenticated-orcid":false,"given":"Alan B.","family":"Zonderman","sequence":"additional","affiliation":[{"name":"Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.5664\/jcsm.9476","article-title":"Sleep is essential to health: An American Academy of Sleep Medicine position statement","volume":"17","author":"Ramar","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"National Center for Health Statistics (2022). QuickStats: Percentage of Adults Aged \u2265 18 Years Who Sleep <7 Hours on Average in a 24-Hour Period, by Sex and Age Group\u2014National Health Interview Survey, United States, 2020. MMWR Morb. Mortal. Wkly. Rep., 71, 393.","DOI":"10.15585\/mmwr.mm7110a6"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101788","DOI":"10.1016\/j.smrv.2023.101788","article-title":"The interrelationship between sleep, diet, and glucose metabolism","volume":"69","author":"Darimont","year":"2023","journal-title":"Sleep Med. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s41043-024-00500-y","article-title":"Hand grip strength as a proposed new vital sign of health: A narrative review of evidences","volume":"43","author":"Vaishya","year":"2024","journal-title":"J. Health Popul. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.diabet.2017.07.005","article-title":"The association between handgrip strength and sleep duration in Japanese patients with type 2 diabetes","volume":"45","author":"Hamasaki","year":"2019","journal-title":"Diabetes Metab."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Liu, J., Zhang, T., Luo, J., Chen, S., and Zhang, D. (2023). Association between Sleep Duration and Grip Strength in U.S. Older Adults: An NHANES Analysis (2011\u20132014). Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20043416"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s41999-020-00399-8","article-title":"Association between muscle strength and sleep quality and duration among middle-aged and older adults: A systematic review","volume":"12","author":"Pana","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"822","DOI":"10.5535\/arm.2018.42.6.822","article-title":"Sleep Quality and Attention May Correlate with Hand Grip Strength: FARM Study","volume":"42","author":"Lee","year":"2018","journal-title":"Ann. Rehabil. Med."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Laredo-Aguilera, J.A., Carmona-Torres, J.M., Cobo-Cuenca, A.I., Garcia-Pinillos, F., and Latorre-Roman, P.A. (2019). Handgrip Strength is Associated with Psychological Functioning, Mood and Sleep in Women over 65 Years. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16050873"},{"key":"ref_10","unstructured":"Watson, R.R., and Preedy, V.R. (2020). Chapter 22\u2014The Influence of Diet on Sleep. Neurological Modulation of Sleep, Academic Press."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1017\/S0029665117003974","article-title":"Sleep and dietary habits in the urban environment: The role of chrono-nutrition","volume":"77","author":"Pot","year":"2018","journal-title":"Proc. Nutr. Soc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101430","DOI":"10.1016\/j.smrv.2021.101430","article-title":"Association between diet and sleep quality: A systematic review","volume":"57","author":"Godos","year":"2021","journal-title":"Sleep Med. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"648","DOI":"10.3945\/an.115.008623","article-title":"Short sleep duration and dietary intake: Epidemiologic evidence, mechanisms, and health implications","volume":"6","author":"Dashti","year":"2015","journal-title":"Adv. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"766","DOI":"10.3945\/ajcn.115.124669","article-title":"Higher-protein diets improve indexes of sleep in energy-restricted overweight and obese adults: Results from 2 randomized controlled trials","volume":"103","author":"Zhou","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/j.jand.2022.01.007","article-title":"Diet Composition and Objectively Assessed Sleep Quality: A Narrative Review","volume":"122","author":"Wilson","year":"2022","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1111\/jhn.12709","article-title":"Diet and sleep health: A scoping review of intervention studies in adults","volume":"33","author":"Burrows","year":"2020","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_17","first-page":"e367","article-title":"Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement from the American Heart Association","volume":"134","author":"Grandner","year":"2016","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.sleh.2022.07.006","article-title":"Association between short sleep duration and intake of sugar and sugar-sweetened beverages: A systematic review and meta-analysis of observational studies","volume":"9","author":"Shahdadian","year":"2023","journal-title":"Sleep Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1007\/s12603-018-1006-8","article-title":"Dietary Protein Intake and Overall Diet Quality Are Associated with Handgrip Strength in African American and White Adults","volume":"22","author":"Pohlig","year":"2018","journal-title":"J. Nutr. Health Aging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1080\/21551197.2022.2070321","article-title":"Intakes of Total and Branched-Chain Essential Amino Acids are Positively Associated with Handgrip Strength in African American and White Urban Younger and Older Adults","volume":"41","author":"Kuczmarski","year":"2022","journal-title":"J. Nutr. Gerontol. Geriatr."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Pikosky, M.A., Cifelli, C.J., Agarwal, S., and Fulgoni III, V.L. (2022). Association of Dietary Protein Intake and Grip Strength Among Adults Aged 19+ Years: NHANES 2011\u20132014 Analysis. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.873512"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Kim, M.H., Choi, M.K., and Bae, Y.J. (2023). Relationship between protein intake and grip strength in qualitative and quantitative aspects among the elderly in Korea: Results from the Korea National Health and Nutrition Examination Survey. BMC Geriatr., 23.","DOI":"10.1186\/s12877-023-04016-8"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3755","DOI":"10.1093\/jn\/nxab288","article-title":"Dietary Protein Intake Is Positively Associated with Appendicular Lean Mass and Handgrip Strength among Middle-Aged US Adults","volume":"151","author":"Jun","year":"2021","journal-title":"J. Nutr."},{"key":"ref_24","first-page":"e43595","article-title":"The Effect of Physical Activity on Sleep Quality and Sleep Disorder: A Systematic Review","volume":"15","author":"Alnawwar","year":"2023","journal-title":"Cureus"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"101426","DOI":"10.1016\/j.smrv.2021.101426","article-title":"Daily associations between sleep and physical activity: A systematic review and meta-analysis","volume":"57","author":"Atoui","year":"2021","journal-title":"Sleep Med. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1007\/s12529-019-09810-6","article-title":"Daily Associations Between Sleep and Physical Activity","volume":"26","author":"Mead","year":"2019","journal-title":"Int. J. Behav. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/jsr.12078","article-title":"Exercise and sleep in community-dwelling older adults: Evidence for a reciprocal relationship","volume":"23","author":"Dzierzewski","year":"2014","journal-title":"J. Sleep Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jbmt.2016.08.017","article-title":"Handgrip strength and associated sociodemographic and lifestyle factors: A systematic review of the adult population","volume":"21","author":"Silva","year":"2017","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1007\/s40279-018-0952-y","article-title":"Handgrip Strength and Health in Aging Adults","volume":"48","author":"McGrath","year":"2018","journal-title":"Sports Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1007\/s10522-015-9631-7","article-title":"Live strong and prosper: The importance of skeletal muscle strength for healthy ageing","volume":"17","author":"McLeod","year":"2016","journal-title":"Biogerontology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1001\/jama.281.6.558","article-title":"Midlife hand grip strength as a predictor of old age disability","volume":"281","author":"Rantanen","year":"1999","journal-title":"JAMA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1159\/000501203","article-title":"Effects of Exercise Training on Handgrip Strength in Older Adults: A Meta-Analytical Review","volume":"65","author":"Labott","year":"2019","journal-title":"Gerontology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"20","DOI":"10.17352\/aggr.000011","article-title":"The influence of physical activity on handgrip strength of elderly","volume":"4","author":"Bilajac","year":"2019","journal-title":"Arch. Gerontol. Geriatr. Res."},{"key":"ref_34","first-page":"267","article-title":"Healthy aging in neighborhoods of diversity across the life span (HANDLS): Overcoming barriers to implementing a longitudinal, epidemiologic, urban study of health, race, and socioeconomic status","volume":"20","author":"Evans","year":"2010","journal-title":"Ethn. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2236551","DOI":"10.1080\/07853890.2023.2236551","article-title":"Relationship between Non-Energy-Adjusted and Energy-Adjusted Dietary Inflammatory Index and the Healthy Eating Index-2015: An analysis of the National Health and Nutrition Examination Survey (NHANES) 2015\u20132018","volume":"55","author":"DiNatale","year":"2023","journal-title":"Ann. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1017\/S1368980013002115","article-title":"Designing and developing a literature-derived, population-based dietary inflammatory index","volume":"17","author":"Shivappa","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"100036","DOI":"10.59717\/j.xinn-med.2023.100036","article-title":"The associations of energy adjusted dietary inflammatory index with brain structure and cognitive function","volume":"1","author":"Zheng","year":"2023","journal-title":"Innov. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"399","DOI":"10.3945\/jn.113.183079","article-title":"The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans","volume":"144","author":"Guenther","year":"2014","journal-title":"J. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1093\/ajcn\/88.2.324","article-title":"The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes","volume":"88","author":"Moshfegh","year":"2008","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_41","unstructured":"US Department of Agriculture (2024, November 03). Food and Nutrient Database for Dietary Studies, Available online: https:\/\/www.ars.usda.gov\/northeast-area\/beltsville-md-bhnrc\/beltsville-human-nutrition-research-center\/food-surveys-research-group\/docs\/fndds-download-databases\/."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1093\/ajcn\/36.5.936","article-title":"A short questionnaire for the measurement of habitual physical activity in epidemiological studies","volume":"36","author":"Baecke","year":"1982","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.jad.2023.04.083","article-title":"Life\u2019s simple 7 and its association with trajectories in depressive symptoms among urban middle-aged adults","volume":"333","author":"Beydoun","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1161\/CIRCULATIONAHA.121.053730","article-title":"American Heart Association\u2019s Life\u2019s Simple 7: Lifestyle Recommendations, Polygenic Risk, and Lifetime Risk of Coronary Heart Disease","volume":"145","author":"Hasbani","year":"2022","journal-title":"Circulation"},{"key":"ref_45","unstructured":"US Department of Health and Human Services (2025, January 20). The 2004 HHS Poverty Guidelines, Available online: https:\/\/aspe.hhs.gov\/2004-hhs-poverty-guidelines."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/j.amepre.2015.05.025","article-title":"Grip Strength as a Marker of Hypertension and Diabetes in Healthy Weight Adults","volume":"49","author":"Mainous","year":"2015","journal-title":"Am. J. Prev. Med."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Wen, Y., Liu, T., Ma, C., Fang, J., Zhao, Z., Luo, M., Xia, Y., Zhao, Y., and Ji, C. (2022). Association between handgrip strength and metabolic syndrome: A meta-analysis and systematic review. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.996645"},{"key":"ref_48","unstructured":"Hayes, A.F. (2022). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach, Guilford Press. [3rd ed.]."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.ausmj.2017.02.001","article-title":"The Analysis of Mechanisms and Their Contingencies: PROCESS versus Structural Equation Modeling","volume":"25","author":"Hayes","year":"2017","journal-title":"Australas. Mark. J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"9","DOI":"10.5664\/jcsm.8112","article-title":"Sleep duration is associated with healthy diet scores and meal patterns: Results from the population-based EpiHealth study","volume":"16","author":"Lemming","year":"2020","journal-title":"J. Clin. Sleep Med."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Stefan, L., Radman, I., Podnar, H., and Vrgoc, G. (2018). Sleep Duration and Sleep Quality Associated with Dietary Index in Free-Living Very Old Adults. Nutrients, 10.","DOI":"10.3390\/nu10111748"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"846","DOI":"10.7326\/0003-4819-141-11-200412070-00008","article-title":"Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite","volume":"141","author":"Spiegel","year":"2004","journal-title":"Ann. Intern. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.psyneuen.2016.09.014","article-title":"Sleep restriction alters plasma endocannabinoids concentrations before but not after exercise in humans","volume":"74","author":"Cedernaes","year":"2016","journal-title":"Psychoneuroendocrinology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"E55","DOI":"10.1002\/oby.20683","article-title":"Short sleep duration is associated with decreased serum leptin, increased energy intake and decreased diet quality in postmenopausal women","volume":"22","author":"Stern","year":"2014","journal-title":"Obesity"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"559","DOI":"10.3945\/ajcn.114.086579","article-title":"Sex and race differences in caloric intake during sleep restriction in healthy adults","volume":"100","author":"Spaeth","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.nutres.2015.11.009","article-title":"Anti-inflammatory Dietary Inflammatory Index scores are associated with healthier scores on other dietary indices","volume":"36","author":"Wirth","year":"2016","journal-title":"Nutr. Res."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Wu, L., Shi, Y., Kong, C., Zhang, J., and Chen, S. (2022). Dietary Inflammatory Index and Its Association with the Prevalence of Coronary Heart Disease among 45,306 US Adults. Nutrients, 14.","DOI":"10.3390\/nu14214553"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s10803-024-06328-z","article-title":"The Association Between Children\u2019s Dietary Inflammatory Index (C-DII) and Nutrient Adequacy with Gastrointestinal Symptoms, Sleep Habits, and Autistic Traits","volume":"55","author":"Zare","year":"2025","journal-title":"J. Autism Dev. Disord."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"107789","DOI":"10.1016\/j.maturitas.2023.107789","article-title":"Handgrip strength, physical activity and incident mild cognitive impairment and dementia","volume":"176","author":"Werneck","year":"2023","journal-title":"Maturitas"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.sleh.2020.10.002","article-title":"Poor sleep quality and physical performance in older adults","volume":"7","author":"Denison","year":"2021","journal-title":"Sleep Health"},{"key":"ref_61","first-page":"1108","article-title":"Current Cigarette Smoking Among Adults\u2014United States, 2005\u20132013","volume":"63","author":"Jamal","year":"2014","journal-title":"Morb. Mortal. Wkly. Rep."},{"key":"ref_62","unstructured":"Food and Nutrition Service (2025, February 13). US Department of Agriculture. Average Healthy Eating Index-2010 Scores for Americans by Age Group, WWEIA-NHANES 2011\u20132012, Available online: https:\/\/www.fns.usda.gov\/sites\/default\/files\/media\/file\/HEI2010_Age_Groups_2011_2012.pdf."},{"key":"ref_63","unstructured":"National Research Council (1989). Recommended Dietary Allowances. Chapter: Protein and Amino Acids, The National Academies Press. [10th ed.]."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Carbone, J.W., and Pasiakos, S.M. (2019). Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients, 11.","DOI":"10.3390\/nu11051136"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"685","DOI":"10.2519\/jospt.2018.7851","article-title":"Hand-Grip Strength: Normative Reference Values and Equations for Individuals 18 to 85 Years of Age Residing in the United States","volume":"48","author":"Wang","year":"2018","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.2147\/CIA.S194543","article-title":"Grip Strength: An Indispensable Biomarker for Older Adults","volume":"14","author":"Bohannon","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Pan, P.J., Hsu, N.W., Lee, M.J., Lin, Y.Y., Tsai, C.C., and Lin, W.S. (2022). Physical fitness and its correlation with handgrip strength in active community-dwelling older adults. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-21736-w"},{"key":"ref_68","first-page":"171","article-title":"The Effect of Gender and Arm Anatomical Position on the Hand Grip Strength and Fatigue Resistance during Sustained Maximal Handgrip Effort","volume":"12","author":"Almashaqbeh","year":"2022","journal-title":"J. Biomed. Phys. Eng."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"afac324","DOI":"10.1093\/ageing\/afac324","article-title":"Grip strength values and cut-off points based on over 200,000 adults of the German National Cohort\u2014A comparison to the EWGSOP2 cut-off points","volume":"52","author":"Huemer","year":"2023","journal-title":"Age Ageing"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2270","DOI":"10.1002\/jcsm.13586","article-title":"Factors associated with handgrip strength across the life course: A systematic review","volume":"15","author":"Ribeiro","year":"2024","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Cho, E., Soh, H.S., Lee, J.R., Yun, J., Bae, W.K., and Lee, H. (2023). Association between smoking status and handgrip strength in Korean male adults: Based on Korea National Health and Nutrition Examination Survey 2016\u20132019. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1212946"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"zsy057","DOI":"10.1093\/sleep\/zsy057","article-title":"Agreement between self-reported and objectively measured sleep duration among white, black, Hispanic, and Chinese adults in the United States: Multi-Ethnic Study of Atherosclerosis","volume":"41","author":"Jackson","year":"2018","journal-title":"Sleep"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jpsychores.2016.03.017","article-title":"Biological and psychological correlates of self-reported and objective sleep measures","volume":"84","author":"Jackowska","year":"2016","journal-title":"J. Psychosom. Res."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Howes, E.M., Parker, M.K., Misyak, S.A., DiFeliceantonio, A.G., Davy, B.M., Brown, L.E.C., and Hedrick, V.E. (2024). The Impact of Weight Bias and Stigma on the 24 h Dietary Recall Process in Adults with Overweight and Obesity: A Pilot Study. Nutrients, 16.","DOI":"10.3390\/nu16020191"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1249\/MSS.0b013e3182a0595f","article-title":"Comparison of self-reported versus accelerometer-measured physical activity","volume":"46","author":"Dyrstad","year":"2014","journal-title":"Med. Sci. Sports Exerc."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/11\/1900\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:44:50Z","timestamp":1760031890000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/11\/1900"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,31]]},"references-count":75,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["nu17111900"],"URL":"https:\/\/doi.org\/10.3390\/nu17111900","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,31]]}}}