The 10-Year Gap: Why Indians Spend a Decade in Decline Others Spend in Their Prime — 5 Fixable Reasons

By Dr. Narayan Rout | Author | Researcher |    Holistic Health Series  ·  36 min read  ·  Published: August 29, 2026

Contents of This Research Pillar

Table of Contents

1. Introduction
2. The viral video paradox, and why it deserves a real answer instead of a genetic excuse
3. What HALE actually measures, and why it matters more than life expectancy alone
4. The real gap: India’s decade of decline starts twenty years earlier than Japan’s
5. The LASI numbers: what a nationally representative study actually found
6. Bone health: a steep, steady, and largely preventable decline
7. Why this isn’t genetics: the case against the easiest excuse
8. The five real, fixable reasons behind the gap
9. The Ayurveda twist: classical tradition never dropped exercise, modern culture did
10. Ghee versus other oils: what a fat actually needs to contribute, and what ghee doesn’t
11. Infrastructure and policy: what other countries built that India mostly hasn’t
12. Honest complication: the viral clips aren’t even representative of the West
13. Genuine remedies: what actually works, starting now
14. Quest Sage Insight
15. What You Can Do With This
16. Conclusion
17. Frequently Asked Questions
18. References and Sources
19. Further Reading On Thequestsage.com

A video comparing a 70-year-old American finishing a marathon to a 60-year-old Indian who can’t stand up without support has been making the rounds, and the comment sections fill up predictably: genetics, foreign diets, packaged food versus traditional food. This article set out to check those explanations against the actual data, and found something more useful than either defence: a real, well-documented, entirely fixable gap that has nothing to do with ancestry.

Using WHO Healthy Life Expectancy figures, the Longitudinal Ageing Study in India, and Indian bone-density and nutrition research, this piece lays out exactly how large the gap is, exactly which five habits explain it, and exactly what the evidence says actually works to close it, at any age.

One finding surprised even the research behind this article: classical Ayurveda never endorsed the diet-only approach so often used to defend the status quo. The Charaka Samhita prescribed daily exercise as essential, using logic strikingly close to what modern exercise science recommends today. What follows is the full picture, numbers, causes, and genuine remedies, not another comment-section argument.

Section	What it covers	Why it matters to you
1. The real gap	Indians and the Japanese lose roughly the same number of healthy years, but India’s decade of decline starts 20+ years earlier.	This reframes the viral-video comparison as a real, measurable, fixable gap, not a genetic mystery.
2. Frailty by the numbers	Nearly 1 in 3 Indians over 60 meets the clinical definition of frailty, per LASI data.	This is population-level data, not anecdote or viral-video selection bias.
3. Grip strength matters most for men	79% of Indian men over 60 have weak grip strength, the single strongest frailty predictor.	A simple, testable marker most people have never had checked.
4. Activity matters most for women	Over 81% of Indian women over 60 report inadequate physical activity, the strongest frailty marker for women.	Interventions for men and women may need genuinely different emphasis.
5. Bone loss is steep and steady	Osteoporosis in Indian women climbs from 3.4% in the 40s to over 36% past 70.	This is preventable territory, not an inevitability of ageing.
6. It’s not the sunlight	70-90% of Indians are Vitamin D deficient despite abundant sunshine, due to low sun exposure and diet.	A fixable behavioural and dietary gap, not a geographic disadvantage.
7. Calcium intake has fallen, not risen	Indian dietary calcium intake dropped over 50 years even as the RDA increased.	The gap between need and intake has widened from both directions.
8. Ayurveda never dropped exercise	Classical texts prescribed daily exercise as essential, using logic remarkably close to modern exercise science.	The ‘our traditional lifestyle is healthiest’ defence only holds if you keep the whole tradition.

Clips of 70-year-old Americans running marathons and 80-year-olds cycling circulate constantly, while in many Indian households complaints about knee pain start by 60, and the usual explanations, genetics, foreign diets, are worth checking against actual data rather than accepting on instinct.

You’ve almost certainly seen the clips: a 75-year-old deadlifting at the gym, an 80-year-old finishing a hiking trail, a 70-year-old crossing a marathon finish line. Set that against a familiar pattern in many Indian households: knee pain complaints starting around 60, difficulty with stairs by 65, trouble rising from the floor unassisted by 70.

Two explanations tend to come up automatically. “It’s their genetics, or their diet, they eat different food.” Or, defensively, the opposite: “Our traditional diet of milk, ghee, and millet is the healthiest in the world, foreigners eat packaged food.” Neither of these fully survives contact with the actual data, and this article exists to walk through what does.

Worth saying plainly before anything else: the viral clips themselves are not representative even of the countries they come from. As this article will show later, the United States, source of many of these videos, has the lowest Healthy Life Expectancy of any wealthy nation. This isn’t a story about the West doing everything right and India doing everything wrong. It’s a story about specific, measurable, fixable gaps in India’s own public health data, gaps that have nothing to do with genetics and everything to do with habits, infrastructure, and a tradition that got followed by half.

Healthy Life Expectancy (HALE), the World Health Organization’s measure of how many years a person can expect to live in full health without disability or dependency, tells a very different story than raw life expectancy, and the gap between the two numbers is where this entire article lives.

Life expectancy answers one question: how long, on average, does a person in a given country live. It doesn’t say anything about the quality of those years. HALE answers a more useful question: of those years, how many are spent in full health, free of significant disability or dependency on others, and how many are spent in decline.

The gap between a country’s life expectancy and its HALE is, in effect, a measure of how many years its population spends unwell before death, whatever the cause, chronic disease, frailty, disability, cognitive decline. That gap is the number worth paying attention to, because it’s the part of the story that’s genuinely actionable, unlike raw lifespan, which is shaped by many factors outside any individual’s control.

Country/Region	Life expectancy	HALE (healthy years)	Years in decline
Japan	~84 years	73.4 years	~10.6 years, starting around 73
Singapore	~83 years	73.6 years	~9.4 years, starting around 74
South Korea	~83 years	72.5 years	~10.5 years, starting around 72
Global average	~73 years	63.7 years	~9.3 years
United States	~78 years	63.9 years	~14 years — lowest HALE among wealthy nations
India	~70 years	~60 years	~10 years, starting around 60

Japan’s roughly 84-year life expectancy against a HALE of 73.4 means about 10.6 years are spent in decline, arriving at the very end of a long life; India’s roughly 70-year life expectancy against a HALE of about 60 means a similar decade of decline, but one that begins more than two decades earlier in the lifespan.

This is the single most important reframing this article can offer. The total number of years lost to poor health, roughly a decade, is actually fairly similar between India and Japan. What differs dramatically is when those years arrive. In Japan, the decline decade arrives after 73 years of largely healthy life. In India, it begins around 60, meaning an Indian in their early 60s is, on average, entering the same physical territory a Japanese person doesn’t reach until their mid-70s.

That’s not a story about India simply dying younger. Life expectancy figures already capture that. This is a story specifically about healthy years, the years a person can expect to remain independent, mobile, and free of significant disability, and it’s the reason this article focuses on frailty, muscle strength, and bone health rather than mortality statistics alone.

The Longitudinal Ageing Study in India, surveying tens of thousands of adults aged 45 and above across every Indian state, found frailty affecting roughly 30% of adults over 60, with weak grip strength as the strongest predictor for men and low physical activity as the strongest predictor for women.

LASI is India’s first and largest study of its kind, a nationally representative survey covering all 35 states and union territories, assessing older Indians against internationally validated clinical measures rather than self-report alone. Using Fried’s frailty phenotype, a five-component clinical scale combining exhaustion, unintentional weight loss, weak grip strength, low physical activity, and slow walking speed, LASI researchers found frailty prevalence of approximately 30% among adults 60 and above.

The gender breakdown is worth sitting with, because it changes what an effective response should actually target. Among men, weak grip strength was the single strongest, most discriminant predictor of frailty, present in 79.1% of men over 60, rising to roughly 95% past age 75. Among women, low physical activity was the strongest predictor instead, affecting over 81% of women over 60. These aren’t interchangeable findings. A strength-training programme aimed only at grip and muscle would address the sharper edge of the problem for men while missing the bigger lever for women, who may need better access to safe, regular physical activity more than they need a gym membership specifically.

Measure (adults 60+)	India	Notes
Overall frailty prevalence (LASI, Fried’s phenotype)	~30%	Regional Indian studies (2016-2020) range 20-29%; China reported just 3.9% in a comparable 2017 study
Weak grip strength, men	79.1%	The single most discriminant marker of frailty among Indian men in LASI data
Weak grip strength, men 75+	~95%	Rises sharply with age
Average grip strength, men	32.26 kg	Below international reference benchmarks for healthy older men
Average grip strength, women	23.70 kg	Below international reference benchmarks
Inadequate physical activity, women	81.6%	The most discriminant frailty marker among Indian women
Recent falls reported	~11.5%	Falls are both a marker and a consequence of frailty and low bone density

Osteoporosis prevalence in Indian women rises from around 3.4% in their 40s to over 36% past age 70, a trajectory driven substantially by two well-documented, correctable factors, Vitamin D deficiency affecting 70-90% of Indian adults, and a dietary calcium intake that has actually fallen over the past 50 years even as recommended intake rose.

Bone density loss doesn’t happen suddenly. It accumulates, decade by decade, and Indian data shows this acceleration clearly: from a relatively low baseline in the 40s, osteoporosis prevalence roughly quadruples by the 50s and continues climbing through the 60s and 70s. Individual community studies in specific Indian populations have found even starker figures, some reporting osteoporosis at some skeletal site in 40 to 50% of postmenopausal women.

Two factors dominate the explanation, and both are correctable rather than fixed. Vitamin D deficiency sits at 70-90% across multiple independent Indian studies, despite India’s abundant sunlight, a gap researchers attribute to limited direct sun exposure, covered clothing, indoor work, sunscreen, air pollution, rather than any shortage of sunshine itself. Without sufficient Vitamin D, the body cannot properly absorb the calcium it does consume, regardless of diet. And dietary calcium intake itself has moved the wrong direction over time: pooled Indian nutrition survey data shows average intake falling from around 606 mg per day in the late 1970s to roughly 433 mg by 2011-12, even as the official recommended daily allowance was revised upward from 400 mg to 600 mg over the same period. The gap between what’s needed and what’s consumed has widened from both ends simultaneously.

Age group (women)	Osteoporosis prevalence	Context
40s	~3.4%	Baseline, pre-menopausal
50s	~14.3%	Peri- to post-menopausal transition
60s	~18.6%	Post-menopausal bone loss accelerating
70+	~36.4%	More than 1 in 3
Postmenopausal women overall (multiple Indian studies)	40-50% at some skeletal site	Vitamin D deficiency and low dietary calcium consistently identified as leading risk factors

Genetics doesn’t shift meaningfully across one or two generations, and Indian-origin populations that relocate abroad don’t carry India’s frailty and bone-density statistics with them, which is strong evidence that environment and behaviour, not ancestry, are driving the gap this article has documented.

“It’s genetics” is the single most common explanation offered for this gap, and it’s worth addressing directly rather than dismissing without argument. Human genetics simply doesn’t change fast enough to explain a population-level health gap that has emerged and shifted within living memory, alongside rapid changes in diet, work patterns, and urbanisation. If genetics were the primary driver, Indian-origin populations who have lived abroad for a generation or two, in the UK, the US, Canada, wouldn’t show meaningfully different frailty and bone-density outcomes from India’s domestic population. In practice, health researchers studying migrant populations generally find outcomes tracking much more closely with the adopted environment, diet, and activity patterns of the new country than with ancestral genetics, exactly the pattern you’d expect if environment and behaviour, not genes, are doing most of the work.

There’s a second, simpler argument too. If genetics explained this gap, it should have looked roughly the same a century ago as it does today. It hasn’t. India’s dietary calcium and milk consumption have measurably declined over just the past 50 years, urbanisation and sedentary work have expanded dramatically within a single generation, and disease patterns have shifted accordingly. A population’s genetic code doesn’t move at that speed. Its habits, diet, and daily physical demands do.

Failure to build peak muscle and bone mass in youth, the absence of a strength-training culture, a diet still built for agrarian labour most people no longer perform, severe and widespread micronutrient deficiency, and a well-meaning cultural habit of protecting elders from physical exertion together explain far more of this gap than ancestry ever could.

Reason one: most Indians never build peak reserves in the first place. The human body builds its peak muscle mass and bone density by roughly age 25 to 30, after which it gradually draws down that reserve for the rest of life. In India, those exact years are typically dominated by academic pressure, competitive exams, and early career stress, with physical conditioning treated as optional or actively deprioritised. Studies indicate roughly 71% of Indians aged 30-55 already show poor muscle health, meaning many enter older age with a depleted starting reserve rather than a healthy one to draw down slowly.

Reason two: India has a strong walking culture, but not a strength-training one. Walking offers genuine cardiovascular benefit, and it’s rightly the most common form of exercise across Indian age groups. What it does not do is build or preserve muscle mass, which requires progressive resistance, lifting, pushing, pulling against increasing load over time. Older adults are frequently actively discouraged from resistance training out of fear of injury, even though the global research consensus runs the opposite direction: resistance training becomes more essential, not less, with age, specifically to prevent falls, protect joints, and preserve bone density.

Reason three: traditional diets were built for a different body, doing different work. Diets rich in ghee, whole milk, and high carbohydrate staples were calibrated for physically demanding agrarian labour, ploughing fields, manual harvesting, walking long distances daily, work that burned through the calories and fuelled the energy those foods provide. Ghee itself supplies fat-soluble vitamins and quick energy, but negligible protein or calcium, meaning it cannot, on its own, build or maintain muscle or bone regardless of quantity consumed. Eating the same calorie-dense traditional diet while living a largely sedentary, desk-bound, motorised daily life converts much of that excess fuel into visceral fat rather than physical capacity, contributing to India’s rising obesity and diabetes rates alongside its frailty numbers.

Reason four: micronutrient and protein deficiency is severe and widespread, not marginal. Vitamin D deficiency sits at 70-90% of Indian adults, as covered above. Protein tells a similarly stark story: average Indian daily protein intake is commonly reported around 47 grams, against a global average closer to 68 grams, a gap that matters enormously for muscle maintenance specifically, since insufficient dietary protein directly limits the body’s ability to build or even preserve existing muscle tissue, regardless of activity level.

Reason five: and perhaps the most culturally specific: the well-intentioned habit of treating rest as respect. In many Indian families, showing respect and care for an elder frequently means actively stopping them from doing physical chores, carrying items, or climbing stairs unassisted. The intention is kind. The physiological consequence works directly against it: muscle that isn’t used atrophies, joints that aren’t moved regularly stiffen, and prolonged inactivity accelerates exactly the loss of balance and independent mobility the well-meaning intervention was meant to prevent.

The Charaka Samhita, Ayurveda’s foundational medical text, prescribes daily exercise (Vyayama) as an essential pillar of health using logic strikingly close to modern exercise science, which means the popular defence of ghee-and-milk diets as “our traditional lifestyle” only accounts for half the actual tradition.

Here’s where this article’s research turned up something genuinely worth sitting with, not manufactured to sound impressive, but real, specific, and directly relevant. The Charaka Samhita’s Sutrasthana 7.31-33 defines Vyayama as bodily movement performed specifically to build strength and stability, prescribed daily (nityam), practised up to “half capacity” (ardha shakti, a caution against overexertion, not a licence to skip it), with explicitly named benefits including lightness of body, increased working capacity, endurance, reduction of excess fat (doshakshaya), and improved digestive strength (agnivriddhi). The Sushruta Samhita goes further, calling Vyayama “ekanta pathyatama”, one of the single best practices available for preserving health, full stop.

This matters directly for the cultural defence mentioned at this article’s opening: “our traditional diet is the healthiest.” Classical Ayurveda never actually endorsed diet alone as sufficient. Dinacharya, the daily routine texts prescribe, treats exercise and diet as equally essential, mutually necessary pillars, not a menu where one could be kept and the other quietly dropped. What changed over recent generations wasn’t a faithful continuation of ancient practice, it was a partial one: the ghee, the milk, and the high-carbohydrate staples stayed. The daily Vyayama that was always meant to sit alongside them didn’t.

Ghee provides genuine, well-documented benefits, fat-soluble vitamins and a high smoke point suited to Indian cooking methods, but it contributes negligible protein or calcium, meaning it cannot build or preserve muscle and bone on its own, a distinction worth understanding through direct comparison rather than treating any single fat as uniquely healthy or unhealthy.

No single fat or oil is a complete nutritional solution, and comparing them side by side is more useful than either defending or condemning any one of them in isolation. Ghee earns its traditional prominence honestly: it carries fat-soluble vitamins A, D, E, and K, offers a high smoke point well suited to Indian cooking temperatures, and has a long culinary and digestive tradition behind it. What it does not offer, in any meaningful quantity, is protein or calcium, the two nutrients this article has repeatedly identified as most critical to the muscle and bone gap in Indian ageing.

Mustard oil, by comparison, brings a considerably more favourable omega-3 to omega-6 ratio alongside a high smoke point, making it a genuinely useful complement in North and East Indian cooking traditions. Sesame oil, traditional to South Indian cooking, contributes antioxidant lignan compounds. Olive oil offers strong monounsaturated fat and polyphenol content but a lower smoke point, better suited to finishing dishes or lower-heat cooking than to deep frying.

The practical conclusion isn’t to abandon ghee, which remains a reasonable part of a varied diet, but to stop treating any single fat as capable of solving a protein-and-calcium shaped nutritional gap. That gap needs to be closed with actual protein and calcium sources, not a different cooking medium.

Fat/Oil	Saturated fat	Smoke point	Omega-3:6 ratio	What it does and doesn’t offer for muscle/bone
Ghee (clarified butter)	~62-65%	High (~250°C)	Poor (very low omega-3)	Fat-soluble vitamins A, D, E, K and quick energy; negligible protein or calcium — cannot build muscle or bone on its own
Mustard oil	~12%	High (~250°C)	Good (~1:2, relatively favourable)	Meaningful omega-3 content and monounsaturated fat; traditional to North/East Indian cooking
Groundnut (peanut) oil	~17%	Moderate-high (~230°C)	Poor (omega-6 dominant)	Good for high-heat cooking; contributes negligible omega-3
Sesame oil	~14%	Moderate (~210°C)	Moderate	Contains lignans with antioxidant properties; traditional to South Indian cooking
Olive oil (extra virgin)	~14%	Lower (~190-210°C)	Moderate-good	Rich in monounsaturated fat and polyphenols; best used for lower-heat cooking or finishing, not deep frying

Countries with stronger HALE outcomes for older adults, including Japan and much of Europe, have paired individual behaviour change with public infrastructure, hiking clubs, cycling networks, government-supported senior strength programmes, that India has not yet built at comparable scale, meaning some of this gap is a policy and infrastructure question, not only a personal one.

It would be incomplete to place the entirety of this gap on individual choices without acknowledging the environment those choices are made within. Countries that show consistently strong healthy-ageing outcomes have generally paired public health messaging with real physical infrastructure: accessible, safe walking and cycling paths, publicly supported senior fitness and strength programmes, community hiking and activity clubs specifically organised around older adults, and healthcare systems that screen proactively for frailty, bone density, and Vitamin D status rather than waiting for a fracture or fall to intervene.

India’s equivalent infrastructure remains inconsistent and geographically uneven, strong in some urban centres and largely absent elsewhere. This isn’t offered as an excuse, individual behaviour change remains genuinely powerful and doesn’t need to wait for policy to catch up, but it is a genuine, honest part of the picture: a population is more likely to build and sustain healthy habits when the physical and institutional environment around it makes those habits easy and normal, rather than requiring individual willpower to swim against the current.

The United States, source of many of the viral fitness videos that inspired this comparison, has the lowest Healthy Life Expectancy of any wealthy nation, at 63.9 years, with Americans spending an average of 12.5 years living with chronic disease, a reminder that curated online clips represent exceptional individuals, not national averages, anywhere.

It would undercut this entire article’s credibility to leave this out. The 70-year-old marathon runner and the 80-year-old weightlifter in viral videos are real people, and their fitness is genuinely admirable, but they are not representative of their countries’ populations any more than any single extraordinary individual represents a national average. The United States, in fact, has the lowest Healthy Life Expectancy among wealthy developed nations, just 63.9 years, with Americans living an average of 12.5 years with chronic disease before death, a considerably worse ratio than several of the other countries in this article’s HALE comparison table.

This matters for how the whole comparison should be read. India’s frailty and bone-density statistics represent genuine, well-documented, population-level public health challenges, that part of the argument doesn’t weaken. But the implicit comparison many viral videos invite, “they’ve solved ageing and we haven’t”, isn’t accurate either. Every country in this article’s data, including the wealthiest ones, has real work to do. India’s specific gap is real, well-documented, and worth taking seriously on its own terms, not because the West has some solved formula worth envying uncritically.

Muscle and bone tissue remain responsive to the right stimulus at any age, meaning resistance training two to three times a week, meeting daily protein targets, and correcting Vitamin D and calcium status through testing rather than guesswork are the three concrete, evidence-based actions available to almost anyone, regardless of current age or fitness level.

The genuinely encouraging finding underlying all of this research is that muscle is adaptive tissue capable of responding to the right stimulus even in a person’s 70s, 80s, or 90s, meaning none of the statistics in this article describe an irreversible fate. Three concrete actions carry the strongest evidence behind them.

Resistance training, two to three sessions a week, is the single most impactful addition most Indians in their 50s and beyond could make. This doesn’t require a gym membership: light hand weights, resistance bands, or bodyweight exercises like supported sit-to-stands from a chair all count as genuine resistance training, and starting under the guidance of a trainer or doctor is a reasonable, low-risk approach, especially for anyone managing an existing health condition.

Daily protein intake needs to rise, and needs to be spread across meals rather than concentrated in one sitting, since ageing bodies require more protein per kilogram of body weight than younger ones to stimulate the same degree of muscle protein synthesis. Practical, widely available Indian sources include lentils and dals, paneer, milk and curd, and eggs for those who eat them, with the goal of including a meaningful protein source at each meal rather than only at dinner.

Vitamin D and bone density should be tested, not assumed. Given that 70-90% of Indian adults are deficient, testing serum Vitamin D levels is a reasonable, low-cost first step for most adults over 40, and bone mineral density screening is specifically worth prioritising for postmenopausal women given the sharp rise in osteoporosis risk this article’s data shows beginning in that decade.

What strikes me most, working through this research, is how the popular defence of Indian tradition, “our diet is the healthiest”, accidentally proves the opposite of what it intends. It’s true that ghee, milk, and whole grains have real nutritional value. It’s also true that Charaka never prescribed them alone. He prescribed them alongside Vyayama, daily, without exception, as an equally essential pillar. Somewhere across recent generations, one half of that prescription got quietly dropped while the other half got defended as sacred.

That’s not a story about tradition failing modern India. It’s a story about modern India not fully practising the tradition it invokes. Picking the convenient half of an inheritance while leaving the demanding half behind isn’t continuity. It’s selective memory wearing tradition’s name.

• If you’re over 40, ask your doctor for a Vitamin D test at your next check-up, don’t assume sunlight alone has covered it.
• Add one resistance-based movement to your week this week, a resistance band, light weights, or simply supported sit-to-stands from a chair, all genuinely count.
• Check whether your own diet includes a real protein source at every meal, not just dinner, lentils, paneer, curd, milk, and eggs are all practical, widely available options.
• If you’re caring for an older relative, notice whether ‘helping’ them by doing everything physical for them might be accelerating the exact decline you’re trying to prevent.
• Share the HALE and LASI numbers in this article with anyone still defending inactivity as ‘just how ageing works’, the data says otherwise, and so did Charaka.

Return to the video that started this comparison: a 70-year-old running, a 60-year-old struggling to stand. The honest data behind that gap has nothing to do with genetics. India loses roughly the same decade to physical decline that Japan does, the difference is that decade arrives twenty years earlier, driven by five specific, well-documented, entirely ordinary habits: unbuilt peak strength in youth, a walking culture without a strength-training one, a diet still calibrated for agrarian labour, severe micronutrient deficiency, and a well-meaning cultural instinct to protect elders from the exact movement that would help them most.

None of these five are permanent. Muscle responds to resistance at any age. Bone density can be protected, tested, and treated. And the tradition so often invoked to defend the status quo, read honestly, was never on the side of inactivity to begin with. Charaka prescribed exercise daily, without exception, as the equal partner to diet, not its optional accessory. Closing this gap doesn’t require abandoning Indian tradition. It requires actually finishing it.

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4. Socioeconomic vulnerability and frailty among community-dwelling older adults: cross-sectional findings from LASI, 2017-18. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8919576/

5. Handgrip strength cut off value estimation in Indian older adults using LASI-1 dataset. Indian Journal of Physiology and Pharmacology. https://ijpp.com/handgrip-strength-cut-off-value-estimation-in-indian-older-adults-using-lasi-1-dataset/

6. The Association Between Grip Strength and Depression Among Adults Aged 60 Years and Older: LASI. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9269105/

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8. Prevalence of osteoporosis and osteopenia in an apparently healthy Indian population — a cross-sectional retrospective study. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC6362954/

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10. Bone Health after Fifth Decade in Rural Ambulatory South Indian Postmenopausal Women. PubMed. https://pubmed.ncbi.nlm.nih.gov/31602103/

11. Associations of bone health biomarkers and bone mineral density with dietary intakes in vitamin D deficient women. Scientific Reports / Nature. https://www.nature.com/articles/s41598-025-27321-1

12. Modern India and the Tale of Twin Nutrient Deficiency — Calcium and Vitamin D — Nutrition Trend Data 50 Years. Frontiers in Endocrinology. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00493/full

13. Vyayama — Charaka Samhita Online. https://www.carakasamhitaonline.com/index.php/Vyayama

14. Vyayama (व्यायामम्). Dharmawiki. https://dharmawiki.org/index.php/Vyayama_(%E0%A4%B5%E0%A5%8D%E0%A4%AF%E0%A4%BE%E0%A4%AF%E0%A4%BE%E0%A4%AE%E0%A4%AE%E0%A5%8D)

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17. World Health Organization — Healthy Life Expectancy (HALE) at birth, Global Health Observatory data.

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