Early muscle strength impairment among young adults in an urban population and its association with lifestyle factors

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Urban lifestyles characterized by physical inactivity, prolonged sedentary behavior, inadequate sleep, and suboptimal nutrition may predispose young adults to early muscle dysfunction before overt muscle mass loss occurs. Objectives To determine the prevalence of early muscle strength impairment (early sarcopenia phenotype) among adults aged 18–40 years and to evaluate its association with selected modifiable lifestyle factors. Methods A cross-sectional study was conducted among 400 young adults recruited from an urban population. Lifestyle exposures were assessed using a structured questionnaire. Muscle strength was measured using handgrip dynamometry. Early sarcopenia was operationally defined as low muscle strength with or without impaired physical performance. Associations were examined using chi-square tests and multivariable logistic regression. Results Early sarcopenia was identified in 17.0% of participants. Low physical activity (adjusted OR 2.21, 95% CI 1.32–3.69), prolonged daily screen time > 6 hours (adjusted OR 1.74, 95% CI 1.05–2.89), and short sleep duration < 6 hours/night (adjusted OR 2.09, 95% CI 1.24–3.52) were independently associated with early sarcopenia. Conclusions Early muscle strength impairment affects a substantial proportion of young adults and is strongly associated with modifiable lifestyle behaviors. These findings support a life-course approach to sarcopenia prevention and highlight the need for early screening and lifestyle-based interventions as public health priorities. Sarcopenia muscle strength young adults lifestyle factors physical activity sedentary behavior sleep duration urban health public health Introduction Sarcopenia is a progressive skeletal muscle disorder characterized by declines in muscle strength, muscle mass, and physical performance and has long been considered a condition predominantly affecting older adults [ 1 , 2 ]. Contemporary consensus frameworks emphasize muscle strength as the earliest and most clinically relevant marker of sarcopenia-related risk [ 1 – 3 ]. Muscle strength follows a life-course trajectory, peaking in early adulthood and declining thereafter. Early deficits in muscle strength predict adverse outcomes, including functional limitation, cardiometabolic disease, disability, and premature mortality [ 4 , 5 ]. Rapid urbanization has altered behavioral patterns among young adults. Academic and occupational demands, prolonged screen exposure, sedentary work environments, and irregular sleep schedules are increasingly prevalent in metropolitan settings and may contribute to early neuromuscular vulnerability [6–8]. Physical inactivity and sedentary behavior are distinct exposures; both have been linked to poorer metabolic health and reduced muscle function [6–9]. Sleep duration and quality also influence muscle recovery, endocrine regulation, and muscle protein synthesis, and recent evidence supports an association between aberrant sleep duration and sarcopenia-related outcomes [10–12]. Data on early muscle strength impairment in young adults—particularly from low- and middle-income settings—remain limited. Understanding the prevalence and modifiable determinants of early sarcopenia phenotypes may inform screening and preventive public health strategies. This study aimed to assess the prevalence of early muscle strength impairment among young adults and evaluate its association with selected lifestyle factors in an urban population. Objectives Primary objective: • To determine the prevalence of early sarcopenia among adults aged 18–40 years. Secondary objectives: • To assess the association between early sarcopenia and physical activity levels. • To evaluate relationships between early sarcopenia and sedentary behavior and sleep characteristics. Methods Study design and setting: A single-center cross-sectional observational study was conducted at a tertiary care academic center in an urban metropolitan region. The manuscript is reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Study population: Adults aged 18–40 years were recruited from a mixed urban population comprising university students, corporate employees, and community residents. Sample size: Sample size was calculated using n = Z²pq/d². Assuming a prevalence of 15%, absolute precision of 4%, and 95% confidence level, the minimum required sample size was 319. To improve precision and account for non-response, the target sample size was increased to 400 participants. Eligibility criteria: Inclusion criteria were age 18–40 years, provision of written informed consent, and apparently healthy status. Exclusion criteria were neuromuscular disorders, chronic systemic diseases affecting muscle function, pregnancy, major surgery or musculoskeletal trauma in the preceding 6 months, and long-term systemic corticosteroid therapy. Data collection: Lifestyle factors were assessed using a structured questionnaire. Domains included physical activity, sedentary behavior (screen time), sleep duration, and related metropolitan lifestyle exposures. Assessment of muscle strength: Handgrip strength of the dominant hand was measured using a calibrated dynamometer following standardized technique. Sex-specific cut-offs from consensus recommendations were applied to define low muscle strength [ 1 – 3 ]. Definition of early sarcopenia: Early sarcopenia was operationally defined as low muscle strength with or without impaired physical performance. The intent was to identify early functional muscle impairment rather than to establish a formal clinical diagnosis requiring imaging-based muscle mass estimation. Statistical analysis: Descriptive statistics summarized baseline characteristics. Associations were evaluated using chi-square tests. Variables associated with early sarcopenia in univariate analysis were entered into multivariable logistic regression models adjusted for age, sex, body mass index, and occupation. Statistical significance was set at p < 0.05. Clinical trial number: not applicable. Ethics Approval and Consent to Participate : The study protocol was reviewed and approved by the Institutional Ethics Committee, Malla Reddy Vishwavidyapeeth, Hyderabad, Telangana, India. Written informed consent was obtained from all participants prior to enrollment. All procedures involving human participants were performed in accordance with the ethical standards of the Institutional Ethics Committee and with the Declaration of Helsinki (as revised in 2013). Results A total of 400 participants were included. The mean age was 26.8 ± 5.4 years, and 56.0% were female. Students constituted 47.5% of the sample, followed by corporate employees (32.0%) and community participants (20.5%). Normal body mass index was observed in 61.5% of participants. Table 1. Baseline characteristics of study participants (n = 400). Variable Category n (%) Sex Male 176 (44.0) Female 224 (56.0) Occupation Student 190 (47.5) Corporate worker 128 (32.0) Community 82 (20.5) BMI Normal 246 (61.5) Overweight/Obese 154 (38.5) Early sarcopenia was identified in 68 participants, yielding a prevalence of 17.0%. Prevalence was higher among females (19.6%) than males (13.6%) and was highest among students (20.0%). Early sarcopenia was significantly more common among individuals reporting low physical activity, daily screen time exceeding 6 hours, and sleep duration less than 6 hours per night. Table 2. Multivariable logistic regression analysis for predictors of early sarcopenia. Variable Adjusted OR 95% CI p-value Low physical activity 2.21 1.32–3.69 0.002 Screen time >6 h/day 1.74 1.05–2.89 0.031 Sleep <6 h/night 2.09 1.24–3.52 0.004 Discussion This study demonstrates that early muscle strength impairment affects nearly one in six young adults and is independently associated with modifiable lifestyle behaviors. These findings reinforce a life-course perspective of sarcopenia, suggesting that neuromuscular vulnerability may originate decades before traditionally recognized clinical disease [1–5]. Low physical activity emerged as a key predictor, consistent with evidence linking lower muscular strength with adverse cardiometabolic outcomes across the life-course [4,5]. Excess sedentary time and screen exposure may further contribute through reduced muscle activation and metabolic dysregulation [6–9]. Short sleep duration was independently associated with early sarcopenia. Recent meta-analytic evidence supports associations between aberrant sleep duration and sarcopenia-related outcomes [10]. Large population-based data also demonstrate a U-shaped relationship between sleep duration and sarcopenia prevalence [11], supporting the relevance of sleep hygiene within prevention strategies. From a public health perspective, these results support integrating simple handgrip strength assessment into university health programs and workplace wellness initiatives, particularly in metropolitan settings. Early identification of young adults with low strength could enable targeted lifestyle interventions—promoting resistance training, reducing sedentary time, and optimizing sleep—to reduce longer-term burden of disability and non-communicable disease. Strengths of this study include an objective muscle strength measure, a sufficient sample size, and assessment of multiple lifestyle domains. Limitations include cross-sectional design (precluding causal inference), self-reported exposures, and lack of direct muscle mass measurement. Longitudinal studies incorporating objective activity measurement and imaging-based muscle mass assessment are warranted. Conclusions and Public Health Implications Early muscle strength impairment affects a meaningful subset of young adults living in metropolitan environments and is strongly associated with modifiable lifestyle behaviors. These findings challenge the perception of sarcopenia as an exclusively geriatric issue and support a life-course approach to prevention. Incorporating handgrip strength assessment into young-adult screening programs and implementing population-level interventions to increase physical activity, reduce sedentary time, and improve sleep hygiene may help prevent progression to clinically significant sarcopenia and reduce the future burden of disability and cardiometabolic disease. Declarations Clinical trial number: not applicable. Funding: No external funding was received for this study. Conflicts of Interest: The authors declare no competing interests. Ethics Approval and Consent to Participate: The study protocol was reviewed and approved by the Institutional Ethics Committee, Malla Reddy Vishwavidyapeeth, Hyderabad, Telangana, India. Written informed consent was obtained from all participants prior to enrollment. All procedures involving human participants were performed in accordance with the ethical standards of the Institutional Ethics Committee and with the Declaration of Helsinki (as revised in 2013). Data Availability: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. Author Contributions (CRediT): All authors have made equal and significant contribution in all aspects of the study. References Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. https://doi.org/10.1093/ageing/afy169 . Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300–e3072. https://doi.org/10.1016/j.jamda.2019.12.012 . Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–62. https://doi.org/10.1136/bjsports-2020-102955 . Fraser BJ, Blizzard L, Buscot MJ, et al. Muscular strength measured across the life-course and the metabolic syndrome. Nutr Metab Cardiovasc Dis. 2022;32(5):1131–7. https://doi.org/10.1016/j.numecd.2022.01.018 . Wen Y, Liu T, Ma C, et al. Association between handgrip strength and metabolic syndrome: a meta-analysis and systematic review. Front Nutr. 2022;9:996645. https://doi.org/10.3389/fnut.2022.996645 . Li X, He J, Sun Q. Sleep Duration and Sarcopenia: An Updated Systematic Review and Meta-Analysis. J Am Med Dir Assoc. 2023;24(8):1193–e12065. https://doi.org/10.1016/j.jamda.2023.04.032 . Zhang G, Zhang Y, et al. Association of sleep duration and prevalence of sarcopenia: A large cross-sectional study. Prev Med Rep. 2024;42:102741. https://doi.org/10.1016/j.pmedr.2024.102741 . Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8684418","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":596942943,"identity":"35038b20-cd40-49b7-9d8d-6e055c18adef","order_by":0,"name":"Nishanth Muppa","email":"data:image/png;base64,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","orcid":"","institution":"Malla Reddy Vishwavidyapeeth","correspondingAuthor":true,"prefix":"","firstName":"Nishanth","middleName":"","lastName":"Muppa","suffix":""},{"id":596942944,"identity":"f65a91db-1c0a-4278-8442-06fdc3385456","order_by":1,"name":"Syeda Maariya Quadri","email":"","orcid":"","institution":"Malla Reddy Vishwavidyapeeth","correspondingAuthor":false,"prefix":"","firstName":"Syeda","middleName":"Maariya","lastName":"Quadri","suffix":""},{"id":596942947,"identity":"dfbef5bb-6da8-4dc9-b21c-1b10fdf2e9d4","order_by":2,"name":"Kasturi Santosh Ghag","email":"","orcid":"","institution":"Malla Reddy Vishwavidyapeeth","correspondingAuthor":false,"prefix":"","firstName":"Kasturi","middleName":"Santosh","lastName":"Ghag","suffix":""},{"id":596942949,"identity":"37d723b1-c96b-4d6c-94bb-78322cb9ba34","order_by":3,"name":"Sowmika Busireddy","email":"","orcid":"","institution":"Malla Reddy Vishwavidyapeeth","correspondingAuthor":false,"prefix":"","firstName":"Sowmika","middleName":"","lastName":"Busireddy","suffix":""},{"id":596942950,"identity":"6adbdccd-db94-4df2-b11f-ea9f3ffa2a7c","order_by":4,"name":"Sreeja Namilakonda","email":"","orcid":"","institution":"Malla Reddy Vishwavidyapeeth","correspondingAuthor":false,"prefix":"","firstName":"Sreeja","middleName":"","lastName":"Namilakonda","suffix":""}],"badges":[],"createdAt":"2026-01-24 06:53:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8684418/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8684418/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105886549,"identity":"2e634d61-13b5-487e-a464-907a8179e515","added_by":"auto","created_at":"2026-04-01 07:29:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":415967,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8684418/v1/157f6663-9e08-4b00-90ca-c40b570ba7f1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Early muscle strength impairment among young adults in an urban population and its association with lifestyle factors","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSarcopenia is a progressive skeletal muscle disorder characterized by declines in muscle strength, muscle mass, and physical performance and has long been considered a condition predominantly affecting older adults [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Contemporary consensus frameworks emphasize muscle strength as the earliest and most clinically relevant marker of sarcopenia-related risk [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMuscle strength follows a life-course trajectory, peaking in early adulthood and declining thereafter. Early deficits in muscle strength predict adverse outcomes, including functional limitation, cardiometabolic disease, disability, and premature mortality [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRapid urbanization has altered behavioral patterns among young adults. Academic and occupational demands, prolonged screen exposure, sedentary work environments, and irregular sleep schedules are increasingly prevalent in metropolitan settings and may contribute to early neuromuscular vulnerability [6\u0026ndash;8].\u003c/p\u003e \u003cp\u003ePhysical inactivity and sedentary behavior are distinct exposures; both have been linked to poorer metabolic health and reduced muscle function [6\u0026ndash;9]. Sleep duration and quality also influence muscle recovery, endocrine regulation, and muscle protein synthesis, and recent evidence supports an association between aberrant sleep duration and sarcopenia-related outcomes [10\u0026ndash;12].\u003c/p\u003e \u003cp\u003eData on early muscle strength impairment in young adults\u0026mdash;particularly from low- and middle-income settings\u0026mdash;remain limited. Understanding the prevalence and modifiable determinants of early sarcopenia phenotypes may inform screening and preventive public health strategies. This study aimed to assess the prevalence of early muscle strength impairment among young adults and evaluate its association with selected lifestyle factors in an urban population.\u003c/p\u003e\n\u003ch3\u003eObjectives\u003c/h3\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePrimary objective:\u003c/h2\u003e \u003cp\u003e\u0026bull; To determine the prevalence of early sarcopenia among adults aged 18\u0026ndash;40 years.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSecondary objectives:\u003c/h3\u003e\n\u003cp\u003e\u0026bull; To assess the association between early sarcopenia and physical activity levels.\u003c/p\u003e\u003cp\u003e\u0026bull; To evaluate relationships between early sarcopenia and sedentary behavior and sleep characteristics.\u003c/p\u003e "},{"header":"Methods","content":"\u003cp\u003e Study design and setting: A single-center cross-sectional observational study was conducted at a tertiary care academic center in an urban metropolitan region. The manuscript is reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.\u003c/p\u003e \u003cp\u003eStudy population: Adults aged 18\u0026ndash;40 years were recruited from a mixed urban population comprising university students, corporate employees, and community residents.\u003c/p\u003e \u003cp\u003eSample size: Sample size was calculated using n\u0026thinsp;=\u0026thinsp;Z\u0026sup2;pq/d\u0026sup2;. Assuming a prevalence of 15%, absolute precision of 4%, and 95% confidence level, the minimum required sample size was 319. To improve precision and account for non-response, the target sample size was increased to 400 participants.\u003c/p\u003e \u003cp\u003e Eligibility criteria: Inclusion criteria were age 18\u0026ndash;40 years, provision of written informed consent, and apparently healthy status. Exclusion criteria were neuromuscular disorders, chronic systemic diseases affecting muscle function, pregnancy, major surgery or musculoskeletal trauma in the preceding 6 months, and long-term systemic corticosteroid therapy.\u003c/p\u003e \u003cp\u003eData collection: Lifestyle factors were assessed using a structured questionnaire. Domains included physical activity, sedentary behavior (screen time), sleep duration, and related metropolitan lifestyle exposures.\u003c/p\u003e \u003cp\u003eAssessment of muscle strength: Handgrip strength of the dominant hand was measured using a calibrated dynamometer following standardized technique. Sex-specific cut-offs from consensus recommendations were applied to define low muscle strength [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDefinition of early sarcopenia: Early sarcopenia was operationally defined as low muscle strength with or without impaired physical performance. The intent was to identify early functional muscle impairment rather than to establish a formal clinical diagnosis requiring imaging-based muscle mass estimation.\u003c/p\u003e \u003cp\u003eStatistical analysis: Descriptive statistics summarized baseline characteristics. Associations were evaluated using chi-square tests. Variables associated with early sarcopenia in univariate analysis were entered into multivariable logistic regression models adjusted for age, sex, body mass index, and occupation. Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003cp\u003eClinical trial number: not applicable.\u003c/p\u003e\n\u003cp\u003eEthics Approval and Consent to Participate :\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study protocol was reviewed and approved by the Institutional Ethics Committee,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMalla Reddy Vishwavidyapeeth, Hyderabad, Telangana, India.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all participants prior to enrollment.\u003c/p\u003e\n\u003cp\u003eAll procedures involving human participants were performed in accordance with the ethical standards of the Institutional Ethics Committee and with the Declaration of Helsinki (as revised in 2013).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 400 participants were included. The mean age was 26.8 \u0026plusmn; 5.4 years, and 56.0% were female. Students constituted 47.5% of the sample, followed by corporate employees (32.0%) and community participants (20.5%). Normal body mass index was observed in 61.5% of participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Baseline characteristics of study participants (n = 400).\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"609\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e176 (44.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e224 (56.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e190 (47.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eCorporate worker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e128 (32.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eCommunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e82 (20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e246 (61.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eOverweight/Obese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e154 (38.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eEarly sarcopenia was identified in 68 participants, yielding a prevalence of 17.0%. Prevalence was higher among females (19.6%) than males (13.6%) and was highest among students (20.0%).\u003c/p\u003e\n\u003cp\u003eEarly sarcopenia was significantly more common among individuals reporting low physical activity, daily screen time exceeding 6 hours, and sleep duration less than 6 hours per night.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Multivariable logistic regression analysis for predictors of early sarcopenia.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"610\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eAdjusted OR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eLow physical activity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1.32\u0026ndash;3.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eScreen time \u0026gt;6 h/day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1.05\u0026ndash;2.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eSleep \u0026lt;6 h/night\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1.24\u0026ndash;3.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study demonstrates that early muscle strength impairment affects nearly one in six young adults and is independently associated with modifiable lifestyle behaviors. These findings reinforce a life-course perspective of sarcopenia, suggesting that neuromuscular vulnerability may originate decades before traditionally recognized clinical disease [1\u0026ndash;5].\u003c/p\u003e\n\u003cp\u003eLow physical activity emerged as a key predictor, consistent with evidence linking lower muscular strength with adverse cardiometabolic outcomes across the life-course [4,5]. Excess sedentary time and screen exposure may further contribute through reduced muscle activation and metabolic dysregulation [6\u0026ndash;9].\u003c/p\u003e\n\u003cp\u003eShort sleep duration was independently associated with early sarcopenia. Recent meta-analytic evidence supports associations between aberrant sleep duration and sarcopenia-related outcomes [10]. Large population-based data also demonstrate a U-shaped relationship between sleep duration and sarcopenia prevalence [11], supporting the relevance of sleep hygiene within prevention strategies.\u003c/p\u003e\n\u003cp\u003eFrom a public health perspective, these results support integrating simple handgrip strength assessment into university health programs and workplace wellness initiatives, particularly in metropolitan settings. Early identification of young adults with low strength could enable targeted lifestyle interventions\u0026mdash;promoting resistance training, reducing sedentary time, and optimizing sleep\u0026mdash;to reduce longer-term burden of disability and non-communicable disease.\u003c/p\u003e\n\u003cp\u003eStrengths of this study include an objective muscle strength measure, a sufficient sample size, and assessment of multiple lifestyle domains. Limitations include cross-sectional design (precluding causal inference), self-reported exposures, and lack of direct muscle mass measurement. Longitudinal studies incorporating objective activity measurement and imaging-based muscle mass assessment are warranted.\u003c/p\u003e"},{"header":"Conclusions and Public Health Implications","content":"\u003cp\u003eEarly muscle strength impairment affects a meaningful subset of young adults living in metropolitan environments and is strongly associated with modifiable lifestyle behaviors. These findings challenge the perception of sarcopenia as an exclusively geriatric issue and support a life-course approach to prevention. Incorporating handgrip strength assessment into young-adult screening programs and implementing population-level interventions to increase physical activity, reduce sedentary time, and improve sleep hygiene may help prevent progression to clinically significant sarcopenia and reduce the future burden of disability and cardiometabolic disease.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eClinical trial number: not applicable.\u003c/p\u003e\n\u003cp\u003eFunding: No external funding was received for this study.\u003c/p\u003e\n\u003cp\u003eConflicts of Interest: The authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eEthics Approval and Consent to Participate: The study protocol was reviewed and approved by the Institutional Ethics Committee,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMalla Reddy Vishwavidyapeeth, Hyderabad, Telangana, India.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all participants prior to enrollment.\u003c/p\u003e\n\u003cp\u003eAll procedures involving human participants were performed in accordance with the ethical standards of the Institutional Ethics Committee and with the Declaration of Helsinki (as revised in 2013).\u003c/p\u003e\n\u003cp\u003eData Availability: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003eAuthor Contributions (CRediT): All authors have made equal and significant contribution in all aspects of the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16\u0026ndash;31. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1093/ageing/afy169\u003c/span\u003e\u003cspan address=\"10.1093/ageing/afy169\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300\u0026ndash;e3072. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.jamda.2019.12.012\u003c/span\u003e\u003cspan address=\"10.1016/j.jamda.2019.12.012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451\u0026ndash;62. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1136/bjsports-2020-102955\u003c/span\u003e\u003cspan address=\"10.1136/bjsports-2020-102955\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFraser BJ, Blizzard L, Buscot MJ, et al. Muscular strength measured across the life-course and the metabolic syndrome. Nutr Metab Cardiovasc Dis. 2022;32(5):1131\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.numecd.2022.01.018\u003c/span\u003e\u003cspan address=\"10.1016/j.numecd.2022.01.018\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWen Y, Liu T, Ma C, et al. Association between handgrip strength and metabolic syndrome: a meta-analysis and systematic review. Front Nutr. 2022;9:996645. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fnut.2022.996645\u003c/span\u003e\u003cspan address=\"10.3389/fnut.2022.996645\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi X, He J, Sun Q. Sleep Duration and Sarcopenia: An Updated Systematic Review and Meta-Analysis. J Am Med Dir Assoc. 2023;24(8):1193\u0026ndash;e12065. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.jamda.2023.04.032\u003c/span\u003e\u003cspan address=\"10.1016/j.jamda.2023.04.032\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang G, Zhang Y, et al. Association of sleep duration and prevalence of sarcopenia: A large cross-sectional study. Prev Med Rep. 2024;42:102741. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.pmedr.2024.102741\u003c/span\u003e\u003cspan address=\"10.1016/j.pmedr.2024.102741\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sarcopenia, muscle strength, young adults, lifestyle factors, physical activity, sedentary behavior, sleep duration, urban health, public health","lastPublishedDoi":"10.21203/rs.3.rs-8684418/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8684418/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSarcopenia has traditionally been regarded as a geriatric condition; however, emerging evidence indicates that impairments in muscle strength and physical performance may begin much earlier in life. Urban lifestyles characterized by physical inactivity, prolonged sedentary behavior, inadequate sleep, and suboptimal nutrition may predispose young adults to early muscle dysfunction before overt muscle mass loss occurs.\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eTo determine the prevalence of early muscle strength impairment (early sarcopenia phenotype) among adults aged 18\u0026ndash;40 years and to evaluate its association with selected modifiable lifestyle factors.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted among 400 young adults recruited from an urban population. Lifestyle exposures were assessed using a structured questionnaire. Muscle strength was measured using handgrip dynamometry. Early sarcopenia was operationally defined as low muscle strength with or without impaired physical performance. Associations were examined using chi-square tests and multivariable logistic regression.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eEarly sarcopenia was identified in 17.0% of participants. Low physical activity (adjusted OR 2.21, 95% CI 1.32\u0026ndash;3.69), prolonged daily screen time\u0026thinsp;\u0026gt;\u0026thinsp;6 hours (adjusted OR 1.74, 95% CI 1.05\u0026ndash;2.89), and short sleep duration\u0026thinsp;\u0026lt;\u0026thinsp;6 hours/night (adjusted OR 2.09, 95% CI 1.24\u0026ndash;3.52) were independently associated with early sarcopenia.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eEarly muscle strength impairment affects a substantial proportion of young adults and is strongly associated with modifiable lifestyle behaviors. These findings support a life-course approach to sarcopenia prevention and highlight the need for early screening and lifestyle-based interventions as public health priorities.\u003c/p\u003e","manuscriptTitle":"Early muscle strength impairment among young adults in an urban population and its association with lifestyle factors","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-26 10:19:31","doi":"10.21203/rs.3.rs-8684418/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7d54932a-4ae9-4edc-9804-75c17ceaa402","owner":[],"postedDate":"February 26th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-01T07:29:43+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-26 10:19:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8684418","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8684418","identity":"rs-8684418","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}