Muscle Mass Maintenance Strategies on a Low Carb Diet

Understanding Muscle Loss in Cancer

Gradual loss of muscle mass or sarcopenia is a natural occurrence with aging. Cancer, its therapies, and therapeutic dietary strategies can accelerate this loss. Nutritional strategies for cancer are under study, but severe weight loss and wasting or cachexia are responsible for 20 to 30% of cancer-related deaths. 

Nutritional Approaches to Combat Muscle Loss

All chronic disease outcomes correlate favorably with maintaining favorable muscle measures like percent muscle mass, standards of muscle quality, and function. Part of this benefit may be from muscles’ ability to take up blood glucose through membrane glucose transporters independent of insulin and insulin growth factors. Muscles are the biggest organ in the body and play a significant role in stabilizing blood sugar swings and, thus, insulin spikes that trigger cellular proliferation. Muscles are your silent friend to foster metabolic health, carry your suitcase on your next vacation, or help you lift your grandchild on their next birthday. There are many reasons to keep these structures healthy, not to mention the myokines produced during work that help the immune system fight disease. 

Low Carb Diet for Cancer Patients

Many patients use strategies to impact their cancer by mistakenly avoiding fats and proteins and limiting carbohydrates. This starvation strategy challenges the body with ultimate rapid weight loss, diminished organ function, and failure of therapies. I frequently remind patients they cannot get in “a game of chicken” with their own body. Our body needs healthy fats and protein to maintain baseline operations and can get by well on reduced carbohydrates.

Intermittent Fasting for Cancer Patients

Generally, we at MMC suggest avoiding significant intermittent fasting (IF) or tight eating windows if one is in the danger zone of their BMI or ideal weight. Although there are always exceptions, below a BMI of 17 is of concern (BMI Calculator). We suggest a stacking approach to muscle activation for those in the safe zone, using modified keto diets or low carbohydrate approaches coupled with some IF to stress cancer cells and aid ketosis before treatments. 

Resistance Training and Amino Acid Supplementation

Stacking means activating through resistance training like a quick 10 to 20-minute multi-site dumbbell or stretchy band workout or picking your favorite safe but aggressive program immediately after or just before loading your system with 10 to 20 grams of amino acids. Remember you must include the bigger muscles of the legs and push to the point of adaptation or pain. This point is somewhat nebulous but is the level at which things start to get hard, and our level 1 fibers recruit the level 2 fibers to get the job done but trigger growth-promoting cell messengers to make the job easier next time (through muscle and mitochondrial growth). Exercise will only succeed by also providing the building blocks of protein or amino acids.  Doing this in proximity to your workout preferentially serves the muscles and, less likely, other cellular proliferation activities like cancer growth

Sticking to this resistance training routine and protein supplementation three times a week should diminish or minimize muscle loss. These strategies are crucial when cancer therapies knock out androgens (testosterone) in men and sometimes women and further threaten muscle mass that can lead to cachexia. 

As we age, our bodies become less efficient at using protein, so it is vital to increase our intake. Aim to consume 1.2-1.7 grams of protein per kilogram of body weight each day. Good protein sources include lean meat, poultry, fish, eggs, dairy products, legumes, and nuts.

Other essential nutrients for muscle health include vitamin D, omega-3 fatty acids, and creatine supplements (5-10 grams per day). Vitamin D helps with muscle protein synthesis, omega-3 fatty acids reduce inflammation, and creatine helps muscle cells produce more energy.

Recommended Tools & Resources

Here are some of my favorite products to support these strategies (I have no affiliation with any of them but have used them):

Essential Amino Acids

Perfect Aminos – vegan sources eight essential amino acids that the body doesn’t make in tablet or powder form. I suggest pills make them easy to consume on the fly. Each tablet is one gram.  – Perfect Amino Online site

Kion Aminos Another option to shop for the eight amino acids or protein building blocks one does not make in the body from other amino acids- therefore essential. Plant proteins are lower in essential amino acids than animal proteins. It is somewhat sweeter in the powder form, which is challenging on the modified keto-groomed palate. See All – Kion (

Collagen Protein

This low-cost protein additive nicely blends into many liquids and soups and can add a good protein source to many options (coffee, soups, electrolyte combinations, smoothies). One scoop is 10 grams and is not likely to trigger insulin or break a fast; thus, it works nicely in the morning electrolyte hydration step or coffee while fasting till lunch.

Bulletproof Unflavored Organic Collagen Bulletproof Collagen Protein Unflavored — 14.3 oz – Vitacost

Great Lakes Wellness Premium Collagen Peptides | Great Lakes Wellness

More Muscle Mass Maintenance Tools & Resources

Creatine Monohydrate – 5 grams daily helps maintain and build muscle mass while supporting brain and immune health. See this Consumer Report write-up on selecting options: Consumer Review | What Is The Best Creatine Powder On The Market? (

“Fitness” on YouTube channel by Dr. Meakin on five major muscle group exercises with a stretchy band – Fitness – YouTube

Other Resources