I have focused this story on the long term results of a low carb diet; 10 years on VLC plus now 2 1/2 additional years eating a higher protein, more moderate carb, and lower fat diet. Maintenance of a 22 BMI is easy with a higher protein, nutrient dense plan. At 72, I am now most interested in body composition and bone strength. I had a DEXA Body Composition scan and used the new Spren app (see my journal Post #106, about those results and how to get the app free) to learn about my visceral fat (the more unhealthy type). Since I was overweight and not a healthy BMI before adding high protein, I assume some of this good news is related to all the positive nutrient changes to my LC diet in the past 2 1/2 years. My total body fat percentage, visceral fat volume, and the Android/Gynoid Ratio were all in a healthy/normal range for my age.

The bone mass Z-score total was a positive .2 standard deviations, so my bone density is still better than age-matched norms. My Bone Density scan T score even improved compared to the scan 2 years ago. My current results are from two new radiologists, and my oncologist cautioned that the DEXA machine programs can vary, but they improved. Risk of fracture went down, and according to the radiologist and NIH, they no longer diagnose “osteopenia" but Low Bone Mass. Great change the machine program and the Name.

2 years ago, my probability of fracture, based on FRAX, was 13.2%, now it has decreased to 9.6%. [Having good bone density, plus a good waist to height ratio, not over nor under weight and other results, goes into the FRAX scores] I give credit for at least some of this improvement to more protein, more dietary calcium, more vitamin and minerals supporting bone mass, plus weight bearing exercise…mostly walking and weight machines.

The only body comp marker that was in below normal range was my Lean Mass [but literally at the number where "Healthy" changes to Low.] I think that years of calorie restriction, including protein restriction, carb restriction so low it lead to nutrient insufficiencies, extended fasting for unproven autophagy benefits, and not enough resistance training, all have left me undermuscled. But I think in the past two and half years my strength has increased. My oncologist again said, looking at scans and bloodwork, I am the "healthiest" person in his practice.

Low lean mass makes it harder to maintain weight loss and rebuild strength. As a cancer survivor, I tried a lot of futile dietary changes…especially meat restriction, limiting dairy, and fasting. But cancer is a disease of the genome and the #1 risk factor is obesity. Some cancers relation to obesity is even in a dose-response, that is, for every +5 BMI, the risk increases by x%.

Obesity and Cancer: https://www.cancer.gov/about-cancer...sity-fact-sheet.

Body mass index increases the recurrence risk of breast cancer: a dose-response meta-analysis https://pubmed.ncbi.nlm.nih.gov/35868141/

The importance of protein sources to support muscle anabolism in cancer: An expert group opinion https://pubmed.ncbi.nlm.nih.gov/34891022/

The National Cancer Institute of the NIH is an excellent resource for vetted information on Diet and Cancer. https://www.cancer.gov/about-cancer...ntion/risk/diet
Some well-known cancer hospitals have science-based nutrition programs, Dana-Faber, MSKCancerCenter, MDAnderson, etc.

My goal now is to continue to maintain a 22 BMI through optimal protein, aiming to eat 1g protein per pound of ideal weight usually in three meals within an 8-10 hour period, while also trying to build some lean mass with optimal nutrition and exercise. Pool opens in 2 weeks…then I get about an hour of exercise every day.