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Effects of Beta-Hydroxy-Beta-Methylbutyrate Supplementation on Elderly Body Composition and Muscle Strength: A Review of Clinical Trials.
Costa Riela, NA, Alvim Guimarães, MM, Oliveira de Almeida, D, Araujo, EMQ
Annals of nutrition & metabolism. 2021;(1):16-22
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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.
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Benefits of β-hydroxy-β-methylbutyrate supplementation in trained and untrained individuals.
Gepner, Y, Varanoske, AN, Boffey, D, Hoffman, JR
Research in sports medicine (Print). 2019;(2):204-218
Abstract
β-Hydroxy-β-Methylbutyrate (HMB) is a metabolite of the branched-chain amino acid leucine and its ketoacid α-ketoisocaproate. HMB has been widely used as an ergogenic supplement to increase muscle strength, muscle hypertrophy and enhance recovery. The physiological mechanisms that underlie these benefits are related to HMB's ability to stimulate muscle protein synthesis and minimize muscle breakdown. Although evidence supporting the benefits of HMB supplementation is not conclusive, many of these studies have suffered from methodological flaws including different formulations, supplement duration and population studied. HMB in its free acid formulation is suggestive of having a greater potential for efficacy in both trained and untrained populations than its calcium-salt form. However, the evidence regarding HMB's role in limiting muscle degradation and increasing muscle protein synthesis has created an exciting interest in examining its efficacy among untrained individuals. Recent investigations examining intense training have demonstrated efficacy in maintaining muscle mass and attenuating the inflammatory response.
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Effects of beta-hydroxy-beta-methylbutyrate supplementation on strength and body composition in trained and competitive athletes: A meta-analysis of randomized controlled trials.
Sanchez-Martinez, J, Santos-Lozano, A, Garcia-Hermoso, A, Sadarangani, KP, Cristi-Montero, C
Journal of science and medicine in sport. 2018;(7):727-735
Abstract
OBJECTIVES The aim of this meta-analysis was to examine the evidence for the effectiveness of beta-hydroxy-beta-methylbutyrate supplementation interventions on modification in strength and body composition in trained and competitive athletes. DESIGN Systematic review and meta-analysis. METHODS A systematic search was performed using three databases: MEDLINE, EBSCO and Web of Science. The analysis was restricted to randomized controlled trials that examined the effect of HMB supplementation interventions on modification in bench and leg press strength, body mass, fat-free mass and fat mass. Effect sizes (ES) and 95% confidence intervals (CIs) were calculated using a fixed effect meta-analysis due to low value of the heterogeneity. The Egger test was used to determine the presence of publication bias, and the Q and I2 statistics were used to assess heterogeneity among studies. Significance was set at p<0.05. RESULTS Six studies were selected for meta-analysis, as they fulfilled the inclusion criteria (n=193 participants). HMB supplementation interventions present a trivial non-significant ES in all variables studied (bench press ES=0.00, leg press ES=0.09, body mass ES=-0.01, fat-free mass ES=0.16, and fat mass ES=-0.20; all cases p>0.05, and null heterogeneity I2=0.0% p>0.05). These results remained constant even analyzing by subgroups (HMB doses, duration of intervention, training level and diet co-intervention). CONCLUSIONS This meta-analysis found no effect of HMB supplementation on strength and body composition in trained and competitive athletes.
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Role of Oral Nutritional Supplements Enriched with β-Hydroxy-β-Methylbutyrate in Maintaining Muscle Function and Improving Clinical Outcomes in Various Clinical Settings.
Sanz-Paris, A, Camprubi-Robles, M, Lopez-Pedrosa, JM, Pereira, SL, Rueda, R, Ballesteros-Pomar, MD, Garcia Almeida, JM, Cruz-Jentoft, AJ
The journal of nutrition, health & aging. 2018;(6):664-675
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Abstract
Aging and disease-related malnutrition are well associated with loss of muscle mass and function. Muscle mass loss may lead to increased health complications and associated increase in health care costs, especially in hospitalized individuals. High protein oral nutritional supplements enriched with β-hydroxy-β-methylbutyrate (HP-ONS+HMB) have been suggested to provide benefits such as improving body composition, maintaining muscle mass and function and even decreasing mortality rates. The present review aimed to examine current evidence on the effect of HP-ONS+HMB on muscle-related clinical outcomes both in community and peri-hospitalization patients. Overall, current evidence suggests that therapeutic nutrition such as HP-ONS+HMB seems to be a promising tool to mitigate the decline in muscle mass and preserve muscle function, especially during hospital rehabilitation and recovery.
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β-hydroxy-β-methylbutyrate free acid supplementation may improve recovery and muscle adaptations after resistance training: a systematic review.
Silva, VR, Belozo, FL, Micheletti, TO, Conrado, M, Stout, JR, Pimentel, GD, Gonzalez, AM
Nutrition research (New York, N.Y.). 2017;:1-9
Abstract
β-Hydroxy-β-methylbutyrate free acid (HMB-FA) has been suggested to accelerate the regenerative capacity of skeletal muscle after high-intensity exercise and attenuate markers of skeletal muscle damage. Herein a systematic review on the use of HMB-FA supplementation as an ergogenic aid to improve measures of muscle recovery, performance, and hypertrophy after resistance training was conducted. This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We included randomized, double-blinded, placebo-controlled trials investigating the effects of HMB-FA supplementation in conjunction with resistance exercise in humans. The search was conducted using Medline and Google Scholar databases for the terms beta-hydroxy-beta-methylbutyrate, HMB free acid, exercise, resistance exercise, strength training, and HMB supplementation. Only research articles published from 1996 to 2016 in English language were considered for the analysis. Nine studies met the criteria for inclusion in the analyses. Most studies included resistance-trained men, and the primary intervention strategy involved administration of 3g of HMB-FA per day. In conjunction with resistance training, HMB-FA supplementation may attenuate markers of muscle damage, augment acute immune and endocrine responses, and enhance training-induced muscle mass and strength. HMB-FA supplementation may also improve markers of aerobic fitness when combined with high-intensity interval training. Nevertheless, more studies are needed to determine the overall efficacy of HMB-FA supplementation as an ergogenic aid.
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Nutritional interventions in sarcopenia: a critical review.
Hickson, M
The Proceedings of the Nutrition Society. 2015;(4):378-86
Abstract
The aim of the present paper is to critically review the details of the published nutrition intervention trials, with and without exercise, targeting sarcopenia. Sarcopenia is the loss of muscle mass, strength and/or performance with age. Since amino acids and energy are required for muscle synthesis it is possible that nutritional intake influences sarcopenia. Nutritional studies are challenging to carry out because of the complexity of modulating dietary intake. It is very difficult to change one nutrient without influencing many others, which means that many of the published studies are problematic to interpret. The studies included evaluate whole protein, essential amino acids and β-hydroxyl β-methylbutyrate (HMB). Whole-protein supplementation failed to show a consistent effect on muscle mass, strength or function. This can be explained by the variations in study design, composition of the protein supplement and the failure to monitor voluntary food intake, adherence and baseline nutritional status. Essential amino-acid supplements showed an inconsistent effect but there are only two trials that have significant differences in methodology and the supplement used. The HMB studies are suggestive of a beneficial effect on older adults, but larger well-controlled studies are required that measure outcomes relevant to sarcopenia, ideally in sarcopenic populations. The issues of timing and distribution of protein intake, and increased splanchnic amino-acid sequestration are discussed, and recommendations for future trials are made.
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Effect of beta-hydroxy-beta-methylbutyrate supplementation on muscle loss in older adults: a systematic review and meta-analysis.
Wu, H, Xia, Y, Jiang, J, Du, H, Guo, X, Liu, X, Li, C, Huang, G, Niu, K
Archives of gerontology and geriatrics. 2015;(2):168-75
Abstract
BACKGROUND Beta-hydroxy-beta-methylbutyrate (HMB), a metabolite of the branched-chain amino acid leucine, has been investigated as a potential supplement to improve muscle quality; however, whether HMB supplementation has beneficial effects on muscle loss in older adults remains unclear. DESIGN Systematic review with meta-analysis. SETTING PubMed, Medline and EMBASE databases were searched from the earliest possible year to September 2014. PARTICIPANTS Individuals aged 65 years and older that reported absolute changes in body composition with use of HMB. MEASUREMENTS Two review authors working independently reviewed the trials, and standard mean difference was calculated using a fixed effects model. RESULTS A total of seven randomized controlled trials were included, in which 147 older adults received HMB intervention and 140 were assigned to control groups. The meta-analysis showed greater muscle mass gain in the intervention groups compared with the control groups (standard mean difference=0.352kg; 95% confidence interval: 0.11, 0.594; Z value=2.85; P=0.004). There were no significant fat mass changes between intervention and control groups (standard mean difference=-0.08kg; 95% confidence interval: -0.32, 0.159; Z value=0.66; P=0.511). CONCLUSION Beta-hydroxy-beta-methylbutyrate supplementation contributed to preservation of muscle mass in older adults. HMB supplementation may be useful in the prevention of muscle atrophy induced by bed rest or other factors. Further studies are needed to determine the precise effects of HMB on muscle strength and physical function in older adults.
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Nutrition supplements for athletes: potential application to malnutrition.
Mullin, GE
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2014;(1):146-7
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Supplementing with beta-hydroxy-beta-methylbutyrate (HMB) to build and maintain muscle mass: a review.
Alon, T, Bagchi, D, Preuss, HG
Research communications in molecular pathology and pharmacology. 2002;(1-4):139-51
Abstract
Beta-hydroxy-beta-methylbutyrate, more commonly referred to as HMB, is derived from the amino acid, leucine, and its keto acid, alpha-ketoisocaproate. In several studies combining HMB supplementation and resistance exercise, researchers have concluded that HMB may play an important role in reducing protein degradation and/or increasing recovery of damaged muscle cells. These actions could be advantageous to all individuals participating in exercise programs and improve the lives of many by overcoming weakness or frailty.