Discussion
muscle mass, depressive, PTSD, cardiovascular diseases
CARDIOVASCULAR DISEASES
The key findings of the present study are that in a diverse sample of forcibly displaced people living in a Greek refugee camp, grip strength was positively associated with percentage muscle mass, whereas a negative association existed for percentage body fat. No statistically significant associations occurred between grip strength and cardiovascular risk markers. In contrast, we found that participants with higher normalized grip strength reported higher levels of PTSD and depressive symptoms.Five hypotheses were formulated, and each of these will now be discussed separately. Our first hypothesis claimed that men would report higher grip strength than women. In line with previous researchIn contrast, our second hypothesis, which suggested a curvilinear relationship between grip strength and age with a peak around the age of 40 years, was not supported by our empirical data. This contrasts with previous research in younger populations showing that muscle strength increases from childhood to younger adulthood due to changes in muscle mass and muscle fiber sizeOur third hypothesis assumed a weak positive association between grip strength and cardiorespiratory fitness. This hypothesis was supported in the sense that higher VOOur fourth hypothesis focused on the association between grip strength and the various health outcomes. Our findings were mixed and did not fully support a general relation between these variables. Expectedly, higher grip strength was associated with higher relative muscle mass. This is in line with previous investigations showing that grip strength is a good indicator of both whole- and upper-body muscular strengthThe fact that we did not observe any statistically significant associations between grip strength and the cardiovascular risk markers was unexpected and contrasts with a relatively large body of previous studies, in which higher grip strength scores were associated with more favourable cardiovascular risk profiles, fewer cardiovascular diseases and lower risk of cardiovascular mortalityFinally, prior investigations have shown close links between grip strength and mental health outcomes, indicating that people with higher grip strength report better general health perceptionsOur fifth hypothesis was generally supported. Thus, the relationships between grip strength and the various health outcomes pointed in the same direction independent on whether absolute or normalized grip strength were used, or whether comparisons were made between participants with weak versus higher grip strength. In line with previous researchThe strengths of our paper are that we focused on a so-far under-researched vulnerable population, that both physical and mental health outcomes were addressed, and that grip strength was assessed repeatedly with both the dominant and non-dominant hand. Potential limitations are that some possible influences were not assessed, which were associated with grip strength in prior studies. These factors include socioeconomic statusFrom a practical point of view, measuring muscle strength in large populations can be complex and costly