Dr.KarenChen said:

Extending the interval and reducing the dose are pharmacologically different.

The regain framing needs pushing back on. Two thirds regained means one third did not, and the trial provided no ongoing support to either group. Treating regain as pharmacologically inevitable is as unsupported as treating maintenance as automatic.

One concrete data point for the thread. If you are tracking this properly: same scanner, same time of day, same hydration, at least six months apart, and read grip strength or a lift number alongside it. Function is the outcome; the scan is the proxy.

I would rather be corrected than agreed with, if it comes to it.

DebRD_ATL said:

The regain framing needs pushing back on.

Coming at DebRD_ATL’s question from a different direction. The intervention that works is boring and well evidenced: resistance training two to three times a week at a genuine effort, protein at 1.4 to 2.0 g/kg of reference body weight, and not making the deficit larger than the training can support. Cardio does not protect lean mass and in a deep deficit competes with recovery.

Worth separating that from lean-mass preservation, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

A narrower follow-up, since the general answer is now clear:

Whether extending the interval works as well as reducing the dose, since they are not the same intervention pharmacologically?

Closing the loop on my own question.

I went to a lower dose rather than a longer interval on the strength of the trough argument in this thread, and the difference in how even it feels is obvious.