Why Indians Lose Muscle Faster, and What the Science Says You Can Do About It
Ramesh is 51 years old, works with a logistics firm based in Pune, and is relatively active since he averages around 6,000 steps per day. Despite this, his metabolic health may already be at risk. Lately, however, when he climbs up to the third floor of his office, he becomes tired. When carrying groceries out of the car seems like heavy work, he puts it down to being stressed, working long hours, or just “getting older”. At his last scheduled visit, his Doctor told Ramesh that all of his blood tests were within acceptable limits (BMI normal, blood pressure fine, cholesterol borderline), but did not mention anything about his muscle loss.
The thing Ramesh does not understand, nor does the majority of the Indian population aged 40-50, is the fact that he could already be experiencing a clinically meaningful loss of his muscle mass. This is not due to his age but rather the fact that this loss began years ago and has been overlooked.
Sarcopenia is defined as an age-related or chronic progressive loss of muscle mass (or type II fibers) with associated loss of strength and physical performance. Sarcopenia is a relatively common diagnosis. Approximately 40% of elderly Indians are affected by sarcopenia. More recently, studies have shown that the prevalence of sarcopenia among middle-aged Indian men is equivalent to that found in Western countries among elderly individuals.
Furthermore, researchers have found that sarcopenia is also associated with increased risk of developing other serious health conditions such as diabetes, heart disease, fractures, disability, and premature mortality.
Yet despite these alarming findings, it rarely surfaces during a typical medical visit.
In this article, we will explore how this can change and what you can do today to combat this issue regardless of your current age.
Sarcopenia isn’t just an aging disease
It’s common to believe that growing weaker as we get older is an inevitability of aging. But science now says otherwise.
What you’re experiencing, feeling tired from little effort, having trouble standing up from a sitting position (like a low stool), and so on, is likely not just because of how old you are. These may be symptoms of Sarcopenia, a medical term for the loss of muscle mass and function. Sarcopenia literally means “flesh” (sarx) plus “loss” (penia).
In medical terms, Sarcopenia is described as a continuous decrease in muscle mass, strength, and physical performance. It’s not one process failing; it’s the failure of three processes occurring over a long period of time, typically years, before someone realizes there is anything wrong.
The reason why Sarcopenia matters if you are 40+ is that Sarcopenia does not start when you are 60. Medical literature clearly indicates that muscle mass reaches its peak in individuals’ late 20s to early 30s. Following that peak, muscle mass will begin to decline by approximately 1-2% each year. Muscle strength declines much more quickly than muscle mass. Muscle strength declines at about 1.5% each year.
Declines in muscle strength accelerate very rapidly after age 60. Most people do not realize that they have suffered a clinically meaningful reduction in muscle until it is too late. That is, by the time the majority of individuals recognize that they have a problem with muscle (typically by the time they are complaining of being weak), they have lost a clinically significant amount of muscle.
However, the implications of Sarcopenia go well beyond the feeling of being weak. Studies indicate that Sarcopenia is independently associated with type 2 diabetes, heart disease, fractures due to falls, poorer surgical outcomes, cognitive impairment, and earlier death. Therefore, Sarcopenia is not merely a matter of being out of shape. Rather, Sarcopenia represents a systemic health crisis masked as typical aging.
In addition to all other populations studied previously, new studies indicate that indian middle-aged individuals are developing Sarcopenia at a rate that is similar to that reported in elderly Western populations. Specifically, a study conducted on both urban and rural adults near Pune indicated that while those subjects had a mean age of 53 years, they were also suffering from high rates of Sarcopenia – rates that would normally be expected in individuals aged 10 years or more in Western countries.
Sarcopenia is not something to wait for your 60s; it is something to address immediately, ideally in your 40s, prior to the point where the rate of loss accelerates.
The problem described here is a specific body shape that is widespread throughout urban India. At first glance, individuals who have this body shape may appear to be very slender (or even underweight when compared to what is considered healthy in Western countries) and have a BMI that is within the normal range (sometimes actually below the normal range). They get a clean bill of health from their physician every year during their annual examination. However, despite appearing to be completely normal in terms of their physical appearance, many of these individuals are carrying extremely dangerous levels of visceral fat surrounding their internal organs and alarmingly low levels of muscle mass.
Researchers refer to this phenomenon as the “thin-fat phenotype” and refer to it as “normal” by the general public in India.
One of the largest and most significant blind spots regarding public health in India today involves the use of BMI (the measurement used by doctors to determine if an individual is a healthy weight), which was developed based on the body compositions of populations in Western societies. The BMI calculation takes into account the individual’s weight in relation to their height; however, it does not take into consideration where the majority of the weight lies in terms of being either fat or lean muscle.
In terms of body composition, studies repeatedly demonstrate that populations in South Asia possess significantly less muscle mass and greater amounts of body fat at the same BMI level than those found in Western society. An example of this disparity is evident in that while a person might have a perfectly acceptable BMI score of 22, they could also be suffering from severe protein deficiency and muscle depletion.
In its 2025 report, The Lancet Commission on Obesity stated that a reliance on BMI for diagnoses was no longer sufficient and advocated for the inclusion of measurements of body fat – a recommendation that carries tremendous implications for India.
A major factor contributing to this issue is the diet. The classic Indian platter of rice, roti, and vegetables is full of calories but low in protein. Furthermore, not only is the amount of protein lacking in these food groups, but so too is the quality of the protein. Protein from cereals lacks certain key essential amino acids, including lysine, needed to create and repair muscle.
According to a nationwide survey conducted in 2024, approximately 59% of urban Indians fail to consume protein-rich foods each day, and an astonishing 74% failed to provide accurate information regarding the recommended daily protein intake for an average adult. The reason behind this is not due to a lack of availability of protein-rich food sources, but rather it stems from a lack of knowledge and education.
Additionally, the existence of diabetes accelerates this situation. With over 77 million Indians living with Type II Diabetes – the greatest burden of any single nation – there exists a catastrophic cycle of loss of muscle and worsening diabetes. As insulin resistance causes decreased ability to synthesize muscle protein, loss of muscle increases the body’s site of glucose absorption, thereby increasing insulin resistance even further. One condition fuels the other through a slow self-feeding loop.
A 2024 Indian study demonstrated that sarcopenia afflicted 60% of diabetics, double the percentage found in nondiabetic adults of similar ages.
Another layer that exists is the urban/rural divide. Middle-aged rural Indians were shown to experience sarcopenia at rates over 100% higher than their urban counterparts, primarily as a result of lower protein consumption, lower socio-economic status, and limited access to healthcare that would diagnose the condition earlier. Urban Indians, however, face unique risks: sedentary office work, poor sleep resulting from chronic stress, and diets heavy in refined carbs that increase insulin resistance and muscle breakdown.
In summary, regardless of whether you reside in a small village in Bihar or a high-rise apartment building in Bengaluru, there exist structural factors for rapid muscle loss. The thin-fat paradox is not the fault of any one person; it represents the expected outcome of dietary patterns and lifestyles that have never provided support for maintaining muscle health.
It is easier to explain why muscle loss becomes stronger as time goes by (and why people in India have a high risk) once we think about what happens at the biological level.
We need to recognize that muscle tissue is constantly being rebuilt, i.e., proteins are being broken down and replaced. A person who is healthy, adequately nourished, and physically active will maintain this balance. However, because of several factors that occur disproportionately among people in the Indian population, the scale tips heavily against rebuilding.
Firstly, the lack of adequate protein. Muscle building through protein synthesis needs a continuous flow of essential amino acids – especially leucine; leucine is a direct stimulator for the mTOR pathway, which leads to muscle growth. Once a diet lacks sufficient amounts of protein (as most Indians diets do), the body cannot provide the needed materials to repair what it loses. Therefore, the muscle breaks down, and protein synthesis stops. As time passes, this creates a compounding effect of losing muscle.
Secondly, insulin resistance. Insulin has two jobs in a healthy individual. One is to help manage blood sugar levels. The other job is to send signals to muscle cells to take up amino acids and produce protein. If insulin sensitivity deteriorates (i.e., develops insulin resistance), the second job is severely impaired. Therefore, muscle cells are less receptive to glucose and to the protein that the body is attempting to give them. This is why the diabetic-sarcopenic cycle is so vicious: diabetics do not merely eat inadequately or fail to engage in enough physical activity. Their own disease process at a cellular level causes damage to the exact mechanisms that allow muscle repair.
Thirdly, chronic low-level inflammation is more commonly recognized as a major contributor to accelerated aging in South Asians. Inflammation-related cytokines directly impair muscle protein synthesis and increase muscle protein breakdown. Because Indians experience a greater burden of metabolic disorders from an earlier age, and they consume diets that promote increased inflammation levels relative to other cultures, they experience a larger amount of inflammatory load throughout their lives.
A significant clinical gap existed until recent times. Diagnostic criteria for identifying sarcopenia had been determined primarily based on studies conducted on Western and East Asian populations. Thus, these diagnostic criteria would not be applicable to Indian physiology. That changed in March 2025, when an expert panel consisting of 13 Indian specialists representing the disciplines of Endocrinology, Gerontology/Sports Medicine/Dietetics/Critical Care created the first Indian Consensus on Sarcopenia via the Modified-Delphi Method.
For the first time, diagnostic cut-offs specific to Indians were developed – Hand Grip Strength <27.5kg in males and <18kg in females was designated as Low Muscle Strength for the Indian Population. The Panel also stated that individuals with co-morbidities (e.g., Diabetes/Hypertension/CKD/Pulmonary Disease, etc.) should be proactively evaluated for Sarcopenia as opposed to waiting for clinical manifestations of Sarcopenia.
You may perform a simple test at home today that provides some indication that you may want to discuss your results with your physician. Determine your calf circumference measurement at its greatest width. The SWAG-SARCO group (South-Asian Working Action Group on Sarcopenia) has indicated that Calf Circumference <33cm in Women and <34cm in Men could indicate decreased muscle mass in South Asians.
It is NOT a diagnosis; however, if your numbers are near or lower than those listed above, then you should consider discussing your results with your Physician regarding further evaluation.
One fact is clear: according to the scientific literature, the sooner sarcopenia is diagnosed, the more reversible it is. Waiting until Sarcopenia presents symptomatically, e.g., weakness/frailty/inability to arise from a seated position, is waiting too long.
The good news is unambiguously good: sarcopenia is largely preventable, even reversible when you act early. The 2025 indian consensus points to three evidence-based interventions. All is inexpensive equipment, and a radical lifestyle overhaul is free.
Lever #1: Protein
Double the quantity of protein, compared to what you’re eating now.
The Indian Council of Medical Research (ICMR) recommends that healthy adults consume 0.83 grams of protein per kilogram of body weight daily. However, researchers have shown that anyone who has any chronic conditions, diabetes, or those over 40 should eat between 1.2-1.5 grams of protein per kg of body weight. So, for a 70-kilogram adult, that would mean approximately 84 – 105 grams of protein consumed daily, roughly twice what many Indians currently consume.
The distribution of protein matters as much as quantity. Simply put, spreading out protein across all three meals rather than the typical indian pattern of front-loading carbohydrates and only consuming protein at dinner, will significantly improve muscle protein synthesis.
Ranking the best sources of protein available in India by amino acid quality and practicability:
Eggs (the most bioavailable whole food protein available),
Chicken and fish (complete proteins – ideal at 25–30 grams per serving),
Paneer and full-fat curd (good leucine content – convenient options for Vegetarians),
Soy (tofu, soy milk, edamame) (only plant protein with a complete amino acid profile – underutilized in indian kitchens),
Dal and legumes (valuable but not complete – pair with grain or dairy to improve amino acid coverage),
Whey protein (a convenient, evidence-based supplement option when dietary options fall short).
Vegetarians must be extra mindful. While there is one plant source that provides high amounts of each essential amino acid, no single plant food provides adequate quantities of all essential amino acids. Combination is key – dal with curd, soy with vegetables, paneer across multiple meals.
Lever #2: Resistance Training – The Non-Negotiable
Walking is not enough. Yoga, while valuable for flexibility and stress, does not provide the mechanical load that signals muscle tissue to grow and maintain itself. The stimulus for muscle protein synthesis is resistance, progressively challenging your muscles against load.
The minimum effective dose, per current evidence: two to three sessions per week of resistance exercise, targeting all major muscle groups. This does not require a gym. Bodyweight squats, lunges, push-ups, and resistance band exercises are all clinically validated. What matters is progressive overload, gradually increasing difficulty over time. A physiotherapist or certified trainer can design a programme appropriate for any age or fitness level, including those with joint issues.
Lever #3: Screen Early – Know Your Number
Ask your doctor to assess your muscle health, not just your weight. If you are over 40, diabetic, sedentary, or have any chronic condition, request a formal sarcopenia screening. At a minimum, measure your calf circumference at home. Track your grip strength if a dynamometer is accessible at a clinic. These are simple, inexpensive tests that can catch a problem years before it becomes a crisis.
Muscle loss can largely be prevented. That is why we have to act today.
India is in the beginning stages of its massive elderly boom. In India, it is expected that by 2051, one out of every five people will be 60 years old. This generation of men and women aged 40-55 has the ability to decide how that demographic transition turns out, either as a crisis for public health or as a model for longevity and functionality.
Sarcopenia (the progressive degeneration of skeletal muscle) does not get a lot of media attention like diabetes or cardiovascular disease does. Sarcopenia develops gradually, over several years. A person knows they have sarcopenia when they can no longer climb stairs as easily, struggle to open jars, and need more time in the morning to begin their day. However, this late recognition comes after significant structural changes to muscle cells have occurred.
However, due to the fact that there are very few chronic diseases that respond to interventions (in this case, increased protein consumption combined with resistance training), this creates a level of empowerment for the field of research. Many studies have shown that older adults (up to and including those in their 70’s) can gain substantial amounts of muscle mass with adequate protein consumption and resistance training. There is a “forgiving” nature to the biological process; however, it needs the correct inputs early in life.
The request is simple: increase quality protein intake through all meals. At least two times per week, pick up something heavy. When you go to visit your physician, ask them about your muscle health – not just your cholesterol levels. Your long-term health span, mobility, and independence may rely much more on that conversation than on most other things you do in a given year.
For more insights on nutrition and how it impacts muscle health, explore our dedicated section: Nutrition Blogs. This resource provides practical diet strategies, protein guidance, and lifestyle tips to complement muscle health awareness.
