The Potential of β-Hydroxy-β-Methylbutyrate as a New Strategy for the Management of Sarcopenia and Sarcopenic Obesity

Abstract

Sarcopenia is defined as an age-related loss of skeletal muscle mass and function and is recognized as a major clinical problem for older people. Essential amino acid supplementation, particularly β-hydroxy-β-methylbutyrate (HMB), a metabolite of leucine that is produced in skeletal muscle, has been evaluated in several studies as a nutritional approach to enhancing muscle protein synthesis in healthy or frail elderly subjects. Studies performed in in vitro conditions show that HMB may be effective in the treatment of muscle wasting, increasing myogenesis, reducing muscle apoptosis, and having a positive effect on muscle protein turnover; however, studies of the effects of HMB conducted in old animals have reported conflicting results. Clinical trials performed in older adults confirm that HMB can attenuate the progression of sarcopenia in elderly subjects. HMB supplementation results in an increase in skeletal muscle mass and strength in the elderly and its effect is even greater when combined with physical exercise. The role of HMB in sarcopenic obesity management is still under debate and a general lack of intervention studies in this population must be recognized. In conclusion, HMB appears to be effective for enhancing muscle mass and strength in the elderly. Less certain is the role of HMB supplementation in reducing fat mass and, thus, in the treatment of sarcopenic obesity.

Is β-hydroxy β-methylbutyrate an effective anabolic agent to improve outcome in older diseased populations?

“…HMB in combination with resistance exercise resulted in (relative) lower values for whole body fat (29, 34, 46) and in decreased adipose fat mass in older adult men (47). No positive effects of HMB supplementation on abdominal fat mass or fat area in muscle have however been found in other studies (31, 32), indicating the use of HMB to reduce fat mass particularly in the treatment of abdominal obesity is less certain (48).…”

Vibration and β‐hydroxy‐β‐methylbutyrate treatment suppresses intramuscular fat infiltration and adipogenic differentiation in sarcopenic mice

“…reported that percentage fat mass was significantly reduced by 1.1 ± 0.2% in the HMB supplementation group in 75 adults of both genders . In contrast, Rossi's review conveyed that the role of HMB in sarcopenic obesity management is still controversial . Therefore, HMB should contribute more on muscle improvement, while its effect on fat reduction is not very notable.…”

Sarcopenia in patients with non‐alcoholic fatty liver disease: is it a clinically significant entity?

“…This implies that an inadequate intake of calories and/or proteins might result in both the loss of muscle mass and the formation of steatosis. Omega 3 fatty acids or β‐hydroxy‐β‐methylbutyrate supplementation might improve muscle mass and function .…”