Effects of Beta-Hydroxy-Beta-Methylbutyrate Supplementation on Elderly Body Composition and Muscle Strength: A Review of Clinical Trials

Abstract

Background: The aging process has great impact on body composition, such as the increase of adipose tissue in abdominal region, and the decrease of lean body mass, due to skeletal muscle loss. A reduction in muscle mass is associated to high risk of fractures and falls, loss of mobility, and increased number of hospitalizations. Beta-hydroxy-beta-methylbutyrate (HMB) is a biological substance derived from leucine metabolism, with anabolic and anticatabolic properties. Some HMB effects are tissue repair stimulation and protein anabolism. Aims: We aimed to evaluate the effects of HMB supplementation on body composition and muscle strength in elderly, as well as to identify the efficient dosages to reach these effects. Methods: This review included studies that evaluated muscle mass and muscle strength, associated or not with physical exercise and diet in elderly people. Only studies published from 2008 to 2019 were selected for analysis. Results: Six articles were included in the review. The used doses varied from 1.5 to 3 g. In 5 studies, HMB supplementation was associated with calcium; only 1 study did not use the oral administration route. Two studies used 4 g of maltodextrin as a vehicle; 1 used HMB with a hypercaloric and hyperproteic supplement; 1 associated HMB with lysine and arginine; and 1 with arginine and glutamine. Supplementation of 3 g of HMB has shown to be most beneficial in improving strength and body composition in people over 65 years, especially in bed rest and untrained conditions. Conclusion: Our findings suggest that HMB has a positive effect on body composition and strength, especially in bedridden or sedentary elderly, due to its anticatabolic properties.

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

“…In a meta‐analysis by Lin et al ., 18 the pooled results of eight articles (nine studies), found HMB supplementation to have a favourable effect on FFM (ES = 0.37; 95% Cl: 0.16, 0.58; z = 3.47; P = 0.001); however, subgroup analysis revealed that this significant effect was only present with HMB supplementation alone (ES = 0.59; 95% CI: 0.32, 0.87; z = 4.24; P < 0.001) and not when HMB was combined with an exercise intervention (ES = 0.06; 95% CI: −0.26, 0.38; z = 0.38; P = 0.705; QoE: level 3). Consistent with the results from other reviews, 18,19,24,26 Costa Riela et al 15 . too found that HMB supplementation significantly increased lean mass in 3/4 of their included studies (QoE: level 1).…”

“…The original search yielded 230 articles in August 2021, which, when screened by title and abstract, yielded 34 reports. These papers were retrieved and reviewed in greater detail yielding 14 systematic reviews ( Figure 1 ) pertinent to the research question 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 25 , 26 and according to the PICOS statement ( Table 1 ). One additional study was added, 24 totalling 15 studies.…”

Role of muscle-targeted nutritional therapy: new data

“…In the first months of 2021, two reviews addressing evidence from efficacy trials conducted up to the end of 2020 have been published [16 ▪ ,17 ▪ ]. Both have highlighted that data suggest its use as a promising strategy but also that there is a lack of substantial evidence from high-quality trials addressing the most appropriate study populations.…”

Rehabilitation nutrition for individuals with frailty, disability, sarcopenic dysphagia, or sarcopenic respiratory disability

“…Recent systematic review showed that HMB supplementation significantly increased fat-free mass in older people in older people [ 49 ]. Furthermore, supplementation of 3 g of HMB was beneficial in improving muscle strength and body composition, especially in bedridden or frail older people [ 50 ]. On the other hand, recommendation for protein supplementation to increase muscle mass was weaker than for leucine [ 48 ].…”