Effect of beta-hydroxy-beta-methylbutyrate supplementation on muscle loss in older adults: A systematic review and meta-analysis

Wang, Hongmei; Xia, Yang; Jiang, Jin; Du, Huanmin; Guo, Xiaoyan; Liu, Xing; Li, Chunlei; Huang, Guowei; Niu, Kaijun

doi:10.1016/j.archger.2015.06.020

Cited by 121 publications

(123 citation statements)

References 26 publications

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“…In an attempt to meta-analyze the impact of β-HMB on the elderly, Molfino et al (90) concluded, “Meta-analysis was not feasible due to the considerable variation in study design, the type and timing of HMB intervention…” and importantly in the same review, the authors stated, “Quite surprisingly, studies evaluating the effects of HMB alone in old adults were limited.” Thus, the effects of β-HMB in older adults are limited in terms of what can be concluded as to effect of the supplements on LBM and muscle function, a conclusion supported by Fitschen et al (91). Despite the conclusion reached by Molfino et al (90), Wu et al (89) did perform a meta-analysis of β-HMB and its effects in the elderly. These authors included 7 RCTs with 147 older adults receiving β-HMB and 140 receiving a non-caloric or DAA control placebo (89).…”

Section: Adjunctive Ingredientsmentioning

confidence: 94%

“…Despite the conclusion reached by Molfino et al (90), Wu et al (89) did perform a meta-analysis of β-HMB and its effects in the elderly. These authors included 7 RCTs with 147 older adults receiving β-HMB and 140 receiving a non-caloric or DAA control placebo (89). The meta-analysis showed greater muscle mass gain in the β-HMB (standardized mean difference = 352 g; 95% confidence interval: 110–594 g).…”

Section: Adjunctive Ingredientsmentioning

confidence: 94%

“…The discussion here is focused on two ingredients for which there is enough evidence to discuss relevant outcomes: beta-hydroxy-beta-methylbutyrate (β-HMB) and creatine. Humans have a limited capacity to endogenously synthesize β-HMB, a metabolite of the amino acid leucine (89, 90), that has been extensively studied in clinical trials and shown to have small impacts on gains in LBM (89–91). Leucine and β-HMB have parallel modes of action in terms of stimulating MPS (92) and inhibiting MPB (93) although the signaling pathways may be distinct (92).…”

Section: Adjunctive Ingredientsmentioning

confidence: 99%

“…Leucine and β-HMB have parallel modes of action in terms of stimulating MPS (92) and inhibiting MPB (93) although the signaling pathways may be distinct (92). Thus, it would be expected that by comparison to protein that provides leucine, the impact of β-HMB would be minimal; however, in clinical trials, β-HMB has most often been compared to a mixture of dispensable amino acids (DAAs) or a non-caloric placebo (89, 90). In an attempt to meta-analyze the impact of β-HMB on the elderly, Molfino et al (90) concluded, “Meta-analysis was not feasible due to the considerable variation in study design, the type and timing of HMB intervention…” and importantly in the same review, the authors stated, “Quite surprisingly, studies evaluating the effects of HMB alone in old adults were limited.” Thus, the effects of β-HMB in older adults are limited in terms of what can be concluded as to effect of the supplements on LBM and muscle function, a conclusion supported by Fitschen et al (91).…”

Section: Adjunctive Ingredientsmentioning

confidence: 99%

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Current Concepts and Unresolved Questions in Dietary Protein Requirements and Supplements in Adults

Phillips

2017

Front. Nutr.

109

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Protein needs for otherwise healthy individuals older than 19 years are defined by the recommended dietary allowance (RDA) at 0.80 g protein/kg/day. There is no recommendation in the current RDA for subpopulations of older adults or people in various pathological situations. Despite the lack of a separate recommendation, there exists a growing body of evidence that is strongly suggestive of an increased need and/or benefit for protein in older persons. That is, intakes beyond the RDA are, in older persons, associated with benefits. In addition, a number of catabolic states including critical illness also result in a sharp elevation in the needs for protein and amino acids. An underappreciated issue in protein nutrition is the impact of protein quality on clinically relevant outcomes. The introduction of a new protein scoring system—the digestible indispensable amino acid score (DIAAS)—for protein quality has raised a forgotten awareness of protein quality. The DIAAS, which replaces the protein digestibility-corrected amino acid score (PDCAAS), is based on ileal digestibility of protein and a different test protein than PDCAAS and has values greater than 1.0. The aim of this article is a brief review and summary recommendations for protein nutrition and protein requirements in populations who would benefit from more protein than the RDA. The emphasis of the review is on muscle protein turnover, and there is a discussion of the impact of protein quality, particularly as it applies to commercially available protein sources. The evidence for more optimal protein intakes is considered in light of the potential health risks of consumption of protein at levels greater than the RDA.

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Section: Adjunctive Ingredientsmentioning

confidence: 94%

Section: Adjunctive Ingredientsmentioning

confidence: 94%

Section: Adjunctive Ingredientsmentioning

confidence: 99%

Section: Adjunctive Ingredientsmentioning

confidence: 99%

See 2 more Smart Citations

Current Concepts and Unresolved Questions in Dietary Protein Requirements and Supplements in Adults

Phillips

2017

Front. Nutr.

109

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“…Based on the meta‐analysis of seven randomized controlled trials, HMB supplementation can prevent the loss of lean body mass in older adults without causing a significant change in fat mass 72. The rationale for HMB supplementation in ageing subjects is strongly supported by recent findings of a negative correlation between the HMB levels in blood plasma with age and the lower levels of KIC dioxygenase in the livers of old rats than in young rats 73…”

Section: Hmb As a Nutritional Supplementmentioning

confidence: 99%

Beta‐hydroxy‐beta‐methylbutyrate supplementation and skeletal muscle in healthy and muscle‐wasting conditions

Holeček

2017

J cachexia sarcopenia muscle

200

154

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Beta‐hydroxy‐beta‐methylbutyrate (HMB) is a metabolite of the essential amino acid leucine that has been reported to have anabolic effects on protein metabolism. The aims of this article were to summarize the results of studies of the effects of HMB on skeletal muscle and to examine the evidence for the rationale to use HMB as a nutritional supplement to exert beneficial effects on muscle mass and function in various conditions of health and disease.The data presented here indicate that the beneficial effects of HMB have been well characterized in strength‐power and endurance exercise. HMB attenuates exercise‐induced muscle damage and enhances muscle hypertrophy and strength, aerobic performance, resistance to fatigue, and regenerative capacity. HMB is particularly effective in untrained individuals who are exposed to strenuous exercise and in trained individuals who are exposed to periods of high physical stress. The low effectiveness of HMB in strength‐trained athletes could be due to the suppression of the proteolysis that is induced by the adaptation to training, which may blunt the effects of HMB. Studies performed with older people have demonstrated that HMB can attenuate the development of sarcopenia in elderly subjects and that the optimal effects of HMB on muscle growth and strength occur when it is combined with exercise. Studies performed under in vitro conditions and in various animal models suggest that HMB may be effective in treatment of muscle wasting in various forms of cachexia. However, there are few clinical reports of the effects of HMB on muscle wasting in cachexia; in addition, most of these studies evaluated the therapeutic potential of combinations of various agents. Therefore, it has not been possible to determine whether HMB was effective or if there was a synergistic effect. Although most of the endogenous HMB is produced in the liver, there are no reports regarding the levels and the effects of HMB supplementation in subjects with liver disease. Several studies have suggested that anabolic effects of HMB supplementation on skeletal muscle do not occur in healthy, non‐exercising subjects.It is concluded that (i) HMB may be applied to enhance increases in the mass and strength of skeletal muscles in subjects who exercise and in the elderly and (ii) studies examining the effects of HMB administered alone are needed to obtain conclusions regarding the specific effectiveness in attenuating muscle wasting in various muscle‐wasting disorders.

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An umbrella review of systematic reviews of β‐hydroxy‐β‐methyl butyrate supplementation in ageing and clinical practice

Phillips

Lau

D'Souza

et al. 2022

J cachexia sarcopenia muscle

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The compound β-hydroxy-β-methyl butyrate (HMB) is proposed to increase or mitigate the loss of skeletal muscle and improve muscle function. We undertook a review of systematic reviews of HMB supplementation to promote gains or mitigate muscle loss in ageing and clinical populations. Following PRISMA guidelines, we searched for systematic reviews reporting the effect of HMB in our target populations. Dual-energy X-ray absorptiometry (DXA) measured lean soft-tissue mass (LSTM) was accepted as a proxy for muscle. We identified 15 systematic reviews that met our inclusion criteria, which were independently evaluated. The methodological quality of the reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR), and standardized effectiveness statements were generated. Five of 15 studies found some evidence that HMB augmented LSTM; the remaining 10 studies reported some evidence favouring no difference (6/10 studies) or insufficient evidence to determine an effect (4/10 studies). Of the 12 studies that evaluated strength, 4/12 found some evidence, 5/12 found some evidence of no effect with one article finding some evidence in favour of patients in peri-hospitalized and no evidence for those that are community-dwelling, 4/12 had insufficient evidence to determine an effect, and 1/12 had insufficient evidence. No]study reported a positive effect of HMB on physical function; however, 2/10 studies found some evidence favouring no effect, and 7/10 studies reported insufficient evidence to determine an effect. The effectiveness of HMB supplementation in augmenting LSTM was heterogeneous, with most reviews finding no effect or inconclusive evidence to determine an effect. Most reviews concluded that HMB supplementation did not affect strength outcome measures or studies were inconclusive. The current evidence is insufficient to assess the impact of HMB supplementation on functional outcome measures. Our analysis shows minor, inconsistent support for HMB as part of an oral nutritional supplement or as a stand-alone supplement (or combined with other amino acids) to increase or promote retention of LSTM, improve strength, and no evidence that it improves physical function in older persons or clinical populations.

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Effect of beta-hydroxy-beta-methylbutyrate supplementation on muscle loss in older adults: A systematic review and meta-analysis

Cited by 121 publications

References 26 publications

Current Concepts and Unresolved Questions in Dietary Protein Requirements and Supplements in Adults

Current Concepts and Unresolved Questions in Dietary Protein Requirements and Supplements in Adults

Beta‐hydroxy‐beta‐methylbutyrate supplementation and skeletal muscle in healthy and muscle‐wasting conditions

An umbrella review of systematic reviews of β‐hydroxy‐β‐methyl butyrate supplementation in ageing and clinical practice

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