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Effect of HMB/Arg/Gln on the prevention of radiation dermatitis in head and neck cancer patients treated with concurrent chemoradiotherapy.
Imai, T, Matsuura, K, Asada, Y, Sagai, S, Katagiri, K, Ishida, E, Saito, D, Sadayasu, R, Wada, H, Saijo, S
Japanese journal of clinical oncology. 2014;(5):422-7
Abstract
OBJECTIVE This prospective randomized Phase II study was designed to evaluate the preventive effect of an oral nutrition supplement composed of beta-hydroxy-beta-methylbutyrate, arginine and glutamine (beta-hydroxy-beta-methylbutyrate/arginine/glutamine) on radiation dermatitis in head and neck cancer patients. METHODS Forty patients with histologically proven head and neck cancer, treated with concurrent chemoradiotherapy involving cisplatin were recruited. They were randomly assigned to the beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplement treatment group (Group A) or the control group that received no supplement (Group B). The primary endpoint of this study was the percentage of patients developing ≥Grade 3 dermatitis. The secondary endpoints were the percentage of patients developing ≥Grade 2 dermatitis, and the duration of each grade of dermatitis relative to the observation period. RESULTS The incidence of ≥Grade 3 dermatitis did not differ between the two groups. However, as secondary endpoints of this study, the incidence of ≥Grade 2 dermatitis was lower in Group A than B (62.6 vs. 94.4%; P < 0.05), and the duration of ≥Grade 1 dermatitis was shorter in Group A than B (44.8 vs. 56.7%; P < 0.01), as was the duration of ≥Grade 2 dermatitis (16.5 vs. 26.5%; P < 0.05). CONCLUSIONS Our study indicated that beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplementation was potentially effective in the prevention of radiation dermatitis in head and neck cancer patients.
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A randomized, double-blind, placebo-controlled trial of a beta-hydroxyl beta-methyl butyrate, glutamine, and arginine mixture for the treatment of cancer cachexia (RTOG 0122).
Berk, L, James, J, Schwartz, A, Hug, E, Mahadevan, A, Samuels, M, Kachnic, L, ,
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2008;(10):1179-88
Abstract
PURPOSE Cancer cachexia is a common problem among advanced cancer patients. A mixture of beta-hydroxyl beta-methyl butyrate, glutamine, and arginine (HMB/Arg/Gln) previously showed activity for increasing lean body mass (LBM) among patients with cancer cachexia. Therefore a phase III trial was implemented to confirm this activity. MATERIALS AND METHODS Four hundred seventy-two advanced cancer patients with between 2% and 10% weight loss were randomized to a mixture of beta-hydroxyl beta-methyl butyrate, glutamine, and arginine or an isonitrogenous, isocaloric control mixture taken twice a day for 8 weeks. Lean body mass was estimated by bioimpedance and skin-fold measurements. Body plethysmography was used when available. Weight, the Schwartz Fatigue Scale, and the Spitzer Quality of Life Scale were also measured. RESULTS Only 37% of the patients completed protocol treatment. The majority of the patient loss was because of patient preference (45% of enrolled patients). However, loss of power was not an issue because of the planned large target sample size. Based on an intention to treat analysis, there was no statistically significant difference in the 8-week lean body mass between the two arms. The secondary endpoints were also not significantly different between the arms. Based on the results of the area under the curve (AUC) analysis, patients receiving HMB/Arg/Gln had a strong trend higher LBM throughout the study as measured by both bioimpedance (p = 0.08) and skin-fold measurements (p = 0.08). Among the subset of patients receiving concurrent chemotherapy, there were again no significant differences in the endpoints. The secondary endpoints were also not significantly different between the arms. CONCLUSION This trial was unable to adequately test the ability of beta-hydroxy beta-methylbutyrate, glutamine, and arginine to reverse or prevent lean body mass wasting among cancer patients. Possible contributing factors beyond the efficacy of the intervention were the inability of patients to complete an 8-week course of treatment and return in a timely fashion for follow-up assessment, and because the patients may have only had weight loss possible not related to cachexia, but other causes of weight loss, such as decreased appetite. However, there was a strong trend towards an increased body mass among patients taking the Juven compound using the secondary endpoint of AUC.
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Dietary treatment of rheumatoid cachexia with beta-hydroxy-beta-methylbutyrate, glutamine and arginine: a randomised controlled trial.
Marcora, S, Lemmey, A, Maddison, P
Clinical nutrition (Edinburgh, Scotland). 2005;(3):442-54
Abstract
BACKGROUND & AIMS Rheumatoid arthritis (RA) is complicated by cytokine-driven alterations in protein and energy metabolism and consequent muscle wasting (cachexia). The aim of this randomised controlled trial was to investigate the efficacy of a mixture of beta-hydroxy-beta-methylbutyrate, glutamine and arginine (HMB/GLN/ARG) as nutritional treatment for rheumatoid cachexia. METHODS Forty RA patients supplemented their diet with either HMB/GLN/ARG or a nitrogen (7.19 g/day) and calorie (180 kcal/day) balanced mixture of alanine, glutamic acid, glycine, and serine (placebo) for 12 weeks. Body composition and other outcomes were assessed at baseline and follow-up, and analysed by mixed ANOVA. RESULTS Dietary supplementation with HMB/GLN/ARG was not superior to placebo in the treatment of rheumatoid cachexia (groupxtime interactions P>0.05 for all outcomes). Both amino acid mixtures significantly increased (main effect of time) fat-free mass (727+/-1186 g, P<0.01), total body protein (719+/-1703 g, P=0.02), arms (112+/-183 g, P<0.01) and legs (283+/-534 g, P<0.01) lean mass, and some measures of physical function. No significant adverse event occurred during the study, but patients in the HMB/GLN/ARG group reported fewer gastrointestinal complaints compared to placebo. CONCLUSIONS Dietary supplementation with HMB/GLN/ARG is better tolerated but not more effective in reversing cachexia in RA patients compared to the mixture of other non-essential amino acids used as placebo. Further controlled studies are necessary to confirm the beneficial anabolic and functional effects of increased nitrogen intake in this population.
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Effects of beta-hydroxy beta-methylbutyrate on power performance and indices of muscle damage and stress during high-intensity training.
Hoffman, JR, Cooper, J, Wendell, M, Im, J, Kang, J
Journal of strength and conditioning research. 2004;(4):747-52
Abstract
Twenty-six members of a collegiate football team were randomly assigned to either a supplement (S) (3 g of beta-hydroxy beta-methylbutyrate [HMB] per day) or placebo (P) group. Testing occurred before (PRE) and at the end of 10 days of preseason football training camp (POST). During each testing session, subjects performed an anaerobic power test, and blood samples were obtained for testosterone, cortisol, creatine kinase, and myoglobin analysis. No differences in anaerobic power were seen between PRE and POST in either group. Cortisol concentrations were significantly decreased from PRE (333 +/- 81 nmol.L(-1)) to POST (246 +/- 79 nmol.L(-1)), and a sixfold increase was seen in creatine kinase concentrations at POST. However, no significant differences between the groups were seen. No significant time or group effects were observed in testosterone or myoglobin concentrations. Results suggest that short duration HMB supplementation does not provide any ergogenic benefit in collegiate football players during preseason training camp.
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The effect of beta-hydroxy beta-methylbutyrate on muscular strength and body composition in collegiate football players.
Ransone, J, Neighbors, K, Lefavi, R, Chromiak, J
Journal of strength and conditioning research. 2003;(1):34-9
Abstract
This study assesses the effects of daily beta-hydroxy beta-methylbutyrate (HMB) supplementation on muscular strength (bench press, squats, and power cleans) and body composition (body weight and body fat) among collegiate football players undergoing a strenuous exercise program. Subjects were collegiate football players (n = 35) training under the supervision of certified strength coaches averaging 20 hours of weekly exercise. In the first supplementation period, 16 of the 35 subjects were supplemented with 3 g of HMB per day for 4 weeks; the other 19 received a placebo followed by a 1-week washout period and then a second supplementation period in a randomized double-blind crossover, placebo design. There were no significant changes (p > 0.05) in muscular strength, including bench press, squats, and power cleans, among the subjects. There were also no significant changes (p > 0.05) in body composition, including body fat and body weight. Very little clinical evidence exists for supplementing HMB in athletic populations.
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Effects of beta-hydroxy-beta-methylbutyrate and creatine monohydrate supplementation on the aerobic and anaerobic capacity of highly trained athletes.
O'Connor, DM, Crowe, MJ
The Journal of sports medicine and physical fitness. 2003;(1):64-8
Abstract
AIM: The aim of this study was to investigate the effects of 6 wks oral supplementation of beta-hydroxy-beta-methylbutyrate (HMB) and a mixture of HMB and creatine monohydrate (HMBCr) on aerobic and anaerobic capacity in highly trained athletes. It was hypothesised that HMB and HMBCr would have positive effects on aerobic and anaerobic power. METHODS A prospective study involving a repeated measures design was utilised where subjects underwent testing prior to, and immediately after, a 6 wks supplementation period. Elite, male rugby league players (n=27) were divided into 3 groups, a control group (n=6), a HMB group (3 g/d; n=10) and a HMBCr group (3 g/d HMB + 3 g/d Cr; n=11). Testing involved a multistage fitness test to determine aerobic power and a 60 sec maximal cycle test to determine anaerobic capacity. Peak power, total work and peak lactate levels were measured in the anaerobic cycle test. RESULTS Two-way repeated measures ANOVA revealed no effect of HMB or HMBCr on any of the measured parameters in comparison to the control group. CONCLUSION Aerobic and anaerobic ability of highly trained male athletes is unaffected by 6 wks oral supplementation with HMB or a combination of HMB and creatine monohydrate.
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The effects of beta-hydroxy-beta-methylbutyrate (HMB) and HMB/creatine supplementation on indices of health in highly trained athletes.
Crowe, MJ, O'Connor, DM, Lukins, JE
International journal of sport nutrition and exercise metabolism. 2003;(2):184-97
Abstract
This study aimed to investigate the effects of 6 wk oral supplementation of beta-hydroxy-beta-methylbutyrate (HMB) and HMB combined with creatine monohydrate (HMBCr) on indices of health in highly trained athletes. Elite, male rugby league players (n=28) were allocated to 1 of 3 groups: a control group (n=6), a HMB group (3 g/d; n=11), or a HMBCr group (3 g/day HMB, 3 g/d Cr; n=11). Testing prior to, and immediately following, supplementation included a full blood count, plasma testosterone and cortisol, blood electrolytes, lipids, urea and glucose, sperm count and motility, and assessment of psychological state. A 3 x 2 factorial ANOVA revealed no effect of HMB or HMBCr on any of the measured parameters except minor changes in blood bicarbonate and blood monocyte and lymphocyte counts. Blood bicarbonate was significantly decreased in the HMB post-supplementation sample compared to the control and HMBCr groups. Blood monocyte and lymphocyte counts showed no within-group changes for HMB or HMBCr supplementation but were significantly different from the control. However, the majority of these readings remained within normal range. HMB and HMBCr were concluded to have no adverse effects on the parameters evaluated in this study when taken orally by highly trained male athletes over a 6-wk period.
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Marginal biotin deficiency during normal pregnancy.
Mock, DM, Quirk, JG, Mock, NI
The American journal of clinical nutrition. 2002;(2):295-9
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Abstract
BACKGROUND Biotin deficiency is teratogenic in several mammalian species. Approximately 50% of pregnant women have an abnormally increased urinary excretion of 3-hydroxyisovaleric acid (3-HIA), which probably reflects decreased activity of the biotin-dependent enzyme methylcrotonyl-CoA carboxylase. However, increased 3-HIA excretion could result from pregnancy per se (eg, from an effect of pregnancy on renal handling of organic acids). OBJECTIVE We tested the hypothesis that biotin supplementation significantly decreases 3-HIA excretion in pregnant women with abnormally increased 3-HIA excretion. DESIGN Twenty-six pregnant women with increased 3-HIA excretion were studied in a randomized, placebo-controlled trial; 10 women were studied during early pregnancy (6-17 wk gestation) and 16 women during late pregnancy (21-37 wk gestation). Urine samples were collected before and after 14 d of supplementation with 300 microg (1.2 micromol) biotin/d or placebo. RESULTS In the early-pregnancy group, 3-HIA excretion decreased (P < 0.006) by 11.7 +/- 3.6 mmol/mol creatinine (mean +/- SEM) in the 5 women who received biotin supplements, whereas 3-HIA excretion increased by 1.6 +/- 0.6 mmol/mol creatinine in the 5 women who received placebo. In the late-pregnancy group, 3-HIA excretion decreased (P < 0.002) by 7.1 +/- 1.2 mmol/mol creatinine in the 8 women who received biotin supplements, whereas 3-HIA excretion increased by 0.9 +/- 1.8 mmol/mol creatinine in the 8 women who received placebo. CONCLUSIONS This study provides evidence that the increased excretion of 3-HIA seen frequently in normal pregnancy reflects reduced biotin status. The conclusion that marginal biotin deficiency occurs frequently in the first trimester further raises concern about potential human teratogenicity.
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Short-term beta-hydroxy-beta-methylbutyrate supplementation does not reduce symptoms of eccentric muscle damage.
Paddon-Jones, D, Keech, A, Jenkins, D
International journal of sport nutrition and exercise metabolism. 2001;(4):442-50
Abstract
PURPOSE We examined the effects of short-term beta-hydroxy-beta-methylbutyrate (HMB) supplementation on symptoms of muscle damage following an acute bout of eccentric exercise. METHODS Non-resistance trained subjects were randomly assigned to a HMB supplement group (HMB, 40mg/kg bodyweight/day, n = 8) or placebo group (CON, n = 9). Supplementation commenced 6 days prior to a bout of 24 maximal isokinetic eccentric contractions of the elbow flexors and continued throughout post-testing. Muscle soreness, upper arm girth, and torque measures were assessed pre-exercise, 15 min post-exercise, and 1, 2, 3, 4, 7, and 10 days post-exercise. RESULTS No pre-test differences between HMB and CON groups were identified, and both performed a similar amount of eccentric work during the main eccentric exercise bout (p > .05). HMB supplementation had no effect on swelling, muscle soreness, or torque following the damaging eccentric exercise bout (p > .05). CONCLUSION Compared to a placebo condition, short-term supplementation with 40mg/kg bodyweight/day of HMB had no beneficial effect on a range of symptoms associated with eccentric muscle damage. If HMB can produce an ergogenic response, a longer preexercise supplementation period may be necessary.
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Body composition in 70-year-old adults responds to dietary beta-hydroxy-beta-methylbutyrate similarly to that of young adults.
Vukovich, MD, Stubbs, NB, Bohlken, RM
The Journal of nutrition. 2001;(7):2049-52
Abstract
Studies in young adults have demonstrated that beta-hydroxy-beta-methylbutyrate (HMB) can increase gains in strength and fat-free mass during a progressive resistance-training program. The purpose of this study was to determine whether HMB would similarly benefit 70-y-old adults undergoing a 5 d/wk exercise program. Thirty-one men (n = 15) and women (n = 16) (70 +/- 1 y) were randomly assigned in a double-blind study to receive either capsules containing a placebo or Ca-HMB (3 g/d) for the 8-wk study. Skin fold estimations of body composition as well as computerized tomography (CT) and dual X-ray absorptiometry (DXA) scans were measured before the study and immediately after the 8-wk training program. HMB supplementation tended to increase fat-free mass gain (HMB, 0.8 +/- 0.4 kg; placebo, -0.2 +/- 0.3 kg; treatment x time, P = 0.08). Furthermore, HMB supplementation increased the percentage of body fat loss (skin fold: HMB, -0.66 +/- 0.23%; placebo, -0.03 +/- 0.21%; P = 0.05) compared with the placebo group. CT scans also indicated a greater decrease in the percentage of body fat with HMB supplementation (P < 0.05). In conclusion, changes in body composition can be accomplished in 70-y-old adults participating in a strength training program, as previously demonstrated in young adults, when HMB is supplemented daily.