Muscle As the Powerful Preventive Tool

The era of “thin equals healthy” is fading. Doctors warn that very low BMI can increase the risk of osteoporosis, fractures and early muscle loss. Bones need resistance to stay strong. Without muscle, density declines faster after 35. The new mantra is clear. Build muscle, not just lose weight.

Orthopaedic experts are seeing younger adults with early bone thinning and stress fractures. The common denominator is low muscle mass from aggressive dieting and lack of strength training.

Extremely low body weight, inadequate muscle mass and aggressive dieting without strength training. At Apollo Hospitals, Dr Deepthi Nandan Reddy, senior consultant orthopaedic surgeon, sees this shift firsthand. “People focus heavily on the number on the scale, but bones respond to strength and load not just leanness,” says Dr Deepthi Nandan Reddy. “If someone is underweight and has low muscle mass, the bones are not being stressed enough. Over time they become fragile.”

Biology we ignored

Dr Deepthi explains that bones are not static scaffolding but living tissue that remodel in response to mechanical stress. Muscle pull, not aesthetics, keeps them dense and resilient. After 35, bone density naturally declines, but chronic calorie restriction, low protein intake and sedentary habits can speed up the loss. While women are more vulnerable after menopause, men with very low BMI are increasingly at risk as well. “Muscle acts like armour and a motor for the skeleton,” says Dr Deepthi. “It improves posture, balance and joint stability. People who maintain muscle mass are less likely to fall, and even if they do, their bones are better protected.” The new orthopaedic consensus is clear: fragility is not just about age. It is about composition.

Sarcopenia wake-up call

Dr Ishani Chaudhary, orthopedic surgeon and a musculoskeletal ultrasound expert, sees what she calls an “invisible epidemic.” Using ultrasound imaging to objectively assess muscle quality, she reports a startling figure, “Nearly 90 percent of urban Indians show signs of sarcopenia, measurable muscle wasting, on sonography.”

For Dr Ishani, the obsession with looking thin has come at a structural cost. “A healthy body isn’t a look. It is what lies inside — balanced muscle, healthy body fat, strong bones and well-functioning organs.” Muscle, she explains, is the body’s built-in anti-ageing system.

“Developing muscle is our ticket to natural anti ageing. Bone responds to mechanical loading brought about by muscle. Resistance training creates osteogenic changes and improves bone density.”

Strong muscles also offload stress from joints, reducing wear and tear that leads to arthritis. They improve balance, lower fall risk and protect against fractures. There is also a beauty dividend. “Strong muscles improve skin elasticity and give a youthful look. Looking toned is a by product of being strong,” says Dr Ishani.

Muscle-first manifesto

Both experts recommend:

· Strength training two to three times a week

· Squats, lunges, resistance bands, light weights, core strengthening

· Gradual load increase over months

· Adequate daily protein intake

· Sufficient calcium and vitamin D