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Effects of oral administration of β-hydroxy β-methylbutyrate on lean body mass in older adults: a systematic review and meta-analysis

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Key summary points

AbstractSection Aim

This systematic review and meta-analysis aim to explore the effects of HMB on body composition in older adults.

AbstractSection Finding

Available evidence suggests that HMB supplementation in older adults can promote increased muscle mass but may not be effective in reducing fat mass. The results of subgroup analysis indicated that exercise might limit the effect of HMB supplementation in older people, but this did not indicate that exercise did not help the muscle mass and function of older people.

AbstractSection Message

This study not only illustrates that HMB supplementation is an effective way to improve sarcopenia in older people but also highlights the urgent need to develop rational exercise programs to meet the needs of older people.

Abstract

Objective

Beta-hydroxy beta-methylbutyrate (HMB), a metabolite of leucine, is currently widely used in athletes to increase muscle mass and strength and has also been used as a nutritional supplement in recent years to maintain muscle mass in muscular atrophic diseases of older people. However, the effects of HMB supplementation on muscle mass, muscle strength, and physical function in older people remain controversial. The purpose of this review was to explore the effects of HMB on body composition in older adults.

Methods

The PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases were searched to obtain the randomized controlled trials needed as a basis for systematic review and meta-analysis.

Result

A total of 9 studies (448 participants) were eventually found eligible. The pooled results showed that HMB supplementation significantly increased fat-free mass in older people compared with the control group (effect size: 0.37; 95% Cl 0.16, 0.58; Z value = 3.47, P = 0.001; Fixed-effect model). But it had no effect on fat mass (effect size: − 0.04 95% CI − 0.26, 0.18; Z value = 0.36, P = 0.716, fixed-effect model). Subgroup analysis of HMB supplementation alone showed a significant improvement in fat-free mass in older people (effect size: 0.59; 95% CI 0.32, 0.87; Z = 4.24, P < 0.001; fixed-effect model), whereas HMB supplementation combined with exercise intervention showed no additional fat-free mass change (effect size: 0.06; 95% CI − 0.26, 0.38; Z = 0.38, P = 0.705; Fixed-effect model).

Conclusion

HMB supplementation is beneficial for improving body composition in older people. However, the effect of HMB supplementation combined with exercise therapy to improve muscle mass is not obvious. Exercise programs need to be designed according to the different physical health of older people.

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References

  1. Rosenberg IH (1989) Summary comments. Am J Clin Nutr 50(5):1231–1233. https://doi.org/10.1093/ajcn/50.5.1231

    Article  Google Scholar 

  2. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 39(4):412–423. https://doi.org/10.1093/ageing/afq034

    Article  PubMed  PubMed Central  Google Scholar 

  3. Dodds RM, Roberts HC, Cooper C, Sayer AA (2015) The Epidemiology of Sarcopenia. J Clin Densitometry 18(4):461–466. https://doi.org/10.1016/j.jocd.2015.04.012

    Article  Google Scholar 

  4. Fujita S, Volpi E (2006) Amino acids and muscle loss with aging. J Nutr 136(1 Suppl):277s–s280. https://doi.org/10.1093/jn/136.1.277S

    Article  CAS  PubMed  Google Scholar 

  5. Ellis AC, Hunter GR, Goss AM, Gower BA (2019) Oral supplementation with beta-hydroxy-beta-methylbutyrate, arginine, and glutamine improves lean body mass in healthy older adults. J Diet Suppl 16(3):281–293. https://doi.org/10.1080/19390211.2018.1454568

    Article  CAS  PubMed  Google Scholar 

  6. Weihrauch M, Handschin C (2018) Pharmacological targeting of exercise adaptations in skeletal muscle: benefits and pitfalls. Biochem Pharmacol 147:211–220. https://doi.org/10.1016/j.bcp.2017.10.006

    Article  CAS  PubMed  Google Scholar 

  7. Durkalec-Michalski K, Jeszka J, Podgórski T (2017) The effect of a 12-week beta-hydroxy-beta-methylbutyrate (HMB) supplementation on highly-trained combat sports athletes: a randomised, double-blind, placebo-controlled crossover study. Nutrients. https://doi.org/10.3390/nu9070753

    Article  PubMed  PubMed Central  Google Scholar 

  8. Teixeira FJ, Matias CN, Monteiro CP, Valamatos MJ, Reis JF, Batista A et al (2019) No effect of HMB or α-HICA supplementation on training-induced changes in body composition. Eur J Sport Sci 19(6):802–810. https://doi.org/10.1080/17461391.2018.1552723

    Article  PubMed  Google Scholar 

  9. Teixeira FJ, Matias CN, Monteiro CP, Valamatos MJ, Reis JF, Tavares F et al (2019) Leucine metabolites do not enhance training-induced performance or muscle thickness. Med Sci Sports Exerc 51(1):56–64. https://doi.org/10.1249/mss.0000000000001754

    Article  CAS  PubMed  Google Scholar 

  10. Vukovich MD, Stubbs NB, Bohlken RM (2001) Body composition in 70-year-old adults responds to dietary beta-hydroxy-beta-methylbutyrate similarly to that of young adults. J Nutr 131(7):2049–2052. https://doi.org/10.1093/jn/131.7.2049

    Article  CAS  PubMed  Google Scholar 

  11. Stout JR, Smith-Ryan AE, Fukuda DH, Kendall KL, Moon JR, Hoffman JR et al (2013) Effect of calcium β-hydroxy-β-methylbutyrate (CaHMB) with and without resistance training in men and women 65+ years: a randomized, double-blind pilot trial. Exp Gerontol 48(11):1303–1310. https://doi.org/10.1016/j.exger.2013.08.007

    Article  CAS  PubMed  Google Scholar 

  12. May PE, Barber A, D'Olimpio JT, Hourihane A, Abumrad NN (2002) Reversal of cancer-related wasting using oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine. Am J Surg 183(4):471–479. https://doi.org/10.1016/s0002-9610(02)00823-1

    Article  CAS  PubMed  Google Scholar 

  13. Flakoll P, Sharp R, Baier S, Levenhagen D, Carr C, Nissen S (2004) Effect of beta-hydroxy-beta-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women. Nutrition 20(5):445–451. https://doi.org/10.1016/j.nut.2004.01.009

    Article  CAS  PubMed  Google Scholar 

  14. Deutz NE, Pereira SL, Hays NP, Oliver JS, Edens NK, Evans CM et al (2013) Effect of beta-hydroxy-beta-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Clin Nutr 32(5):704–712. https://doi.org/10.1016/j.clnu.2013.02.011

    Article  CAS  PubMed  Google Scholar 

  15. Berton L, Bano G, Carraro S, Veronese N, Pizzato S, Bolzetta F et al (2015) Effect of oral beta-hydroxy-beta-methylbutyrate (HMB) supplementation on physical performance in healthy old women over 65 years: an open label randomized controlled trial. PLoS ONE. https://doi.org/10.1371/journal.pone.0141757

    Article  PubMed  PubMed Central  Google Scholar 

  16. Baier S, Johannsen D, Abumrad N, Rathmacher JA, Nissen S, Flakoll P (2009) Year-long changes in protein metabolism in elderly men and women supplemented with a nutrition cocktail of beta-hydroxy-beta-methylbutyrate (HMB), l-arginine, and l-lysine. JPEN J Parenter Enteral Nutr 33(1):71–82. https://doi.org/10.1177/0148607108322403

    Article  CAS  PubMed  Google Scholar 

  17. Wu H, Xia Y, Jiang J, Du H, Guo X, Liu X et al (2015) Effect of beta-hydroxy-beta-methylbutyrate supplementation on muscle loss in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr 61(2):168–175. https://doi.org/10.1016/j.archger.2015.06.020

    Article  CAS  PubMed  Google Scholar 

  18. Stahn AC, Maggioni MA, Gunga HC, Terblanche E (2020) Combined protein and calcium β-hydroxy-β-methylbutyrate induced gains in leg fat free mass: a double-blinded, placebo-controlled study. J Int Soc Sports Nutr 17(1):16. https://doi.org/10.1186/s12970-020-0336-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Tritto AC, Bueno S, Rodrigues RMP, Gualano B, Roschel H, Artioli GG (2019) Negligible effects of β-hydroxy-β-methylbutyrate free acid and calcium salt on strength and hypertrophic responses to resistance training: a randomized, placebo-controlled study. Int J Sport Nutr Exerc Metab 29(5):505–511. https://doi.org/10.1123/ijsnem.2018-0337

    Article  CAS  PubMed  Google Scholar 

  20. Dutt V, Gupta S, Dabur R, Injeti E, Mittal A (2015) Skeletal muscle atrophy: potential therapeutic agents and their mechanisms of action. Pharmacol Res 99:86–100. https://doi.org/10.1016/j.phrs.2015.05.010

    Article  CAS  PubMed  Google Scholar 

  21. Wilkinson DJ, Hossain T, Hill DS, Phillips BE, Crossland H, Williams J et al (2013) Effects of leucine and its metabolite β-hydroxy-β-methylbutyrate on human skeletal muscle protein metabolism. J Physiol 591(11):2911–2923. https://doi.org/10.1113/jphysiol.2013.253203

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Cruz-Jentoft AJ (2018) Beta-hydroxy-beta-methyl butyrate (HMB): from experimental data to clinical evidence in sarcopenia. Curr Protein Pept Sci 19(7):668–672. https://doi.org/10.2174/1389203718666170529105026

    Article  CAS  PubMed  Google Scholar 

  23. Kaczka P, Michalczyk MM, Jastrząb R, Gawelczyk M, Kubicka K (2019) Mechanism of action and the effect of beta-hydroxy-beta-methylbutyrate (HMB) supplementation on different types of physical performance—a systematic review. J Hum Kinet 68:211–222. https://doi.org/10.2478/hukin-2019-0070

    Article  PubMed  PubMed Central  Google Scholar 

  24. Courel-Ibáñez J, Vetrovsky T, Dadova K, Pallarés JG, Steffl M (2019) Health benefits of β-hydroxy-β-methylbutyrate (HMB) supplementation in addition to physical exercise in older adults: a systematic review with meta-analysis. Nutrients. https://doi.org/10.3390/nu11092082

    Article  PubMed  PubMed Central  Google Scholar 

  25. Nunan D, Howatson G, van Someren KA (2010) Exercise-induced muscle damage is not attenuated by beta-hydroxy-beta-methylbutyrate and alpha-ketoisocaproic acid supplementation. J Strength Cond Res 24(2):531–537. https://doi.org/10.1519/JSC.0b013e3181c4d370

    Article  PubMed  Google Scholar 

  26. Paddon-Jones D, Keech A, Jenkins D (2001) Short-term beta-hydroxy-beta-methylbutyrate supplementation does not reduce symptoms of eccentric muscle damage. Int J Sport Nutr Exerc Metab 11(4):442–450. https://doi.org/10.1123/ijsnem.11.4.442

    Article  CAS  PubMed  Google Scholar 

  27. Giallauria F, Cittadini A, Smart NA, Vigorito C (2016) Resistance training and sarcopenia. Monaldi Arch Chest Dis 84(1–2):738. https://doi.org/10.4081/monaldi.2015.738

    Article  PubMed  Google Scholar 

  28. Fielding RA, Meredith CN, O'Reilly KP, Frontera WR, Cannon JG, Evans WJ (1991) Enhanced protein breakdown after eccentric exercise in young and older men. J Appl Physiol (1985) 71(2):674–9. https://doi.org/10.1152/jappl.1991.71.2.674

    Article  CAS  Google Scholar 

  29. Holeček M (2017) Beta-hydroxy-beta-methylbutyrate supplementation and skeletal muscle in healthy and muscle-wasting conditions. J Cachexia Sarcopenia Muscle 8(4):529–541. https://doi.org/10.1002/jcsm.12208

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wang J, Cui C, Chim YN, Yao H, Shi L, Xu J et al (2020) Vibration and β-hydroxy-β-methylbutyrate treatment suppresses intramuscular fat infiltration and adipogenic differentiation in sarcopenic mice. J Cachexia Sarcopenia Muscle 11(2):564–577. https://doi.org/10.1002/jcsm.12535

    Article  PubMed  PubMed Central  Google Scholar 

  31. Pencharz PB, Elango R, Ball RO (2220s) Determination of the tolerable upper intake level of leucine in adult men. J Nutr 142(12):2220s–s2224. https://doi.org/10.3945/jn.112.160259

    Article  CAS  PubMed  Google Scholar 

  32. Fuller JC Jr, Arp LH, Diehl LM, Landin KL, Baier SM, Rathmacher JA (2014) Subchronic toxicity study of β-hydroxy-β-methylbutyric free acid in Sprague-Dawley rats. Food Chem Toxicol 67:145–153. https://doi.org/10.1016/j.fct.2014.02.025

    Article  CAS  PubMed  Google Scholar 

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Funding

This work was supported by the National Natural Science Foundation of China [no. 31871182].

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Authors and Affiliations

  1. Department of Geriatric Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No. 76, Linjiang Road, Chongqing, 400010, China

    Lin Zebin, Zhao Yipin & Chen Qingwei

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  1. Lin Zebin
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  2. Zhao Yipin
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by LZ, ZY and CQ. The first draft of the manuscript was written by LZ and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. We all agree to publish this article.

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Correspondence to Lin Zebin.

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This systematic literature review was performed following the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines.

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This is a review, for this type of study, no informed consent is required.

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Lin, Z., Zhao, Y. & Chen, Q. Effects of oral administration of β-hydroxy β-methylbutyrate on lean body mass in older adults: a systematic review and meta-analysis. Eur Geriatr Med 12, 239–251 (2021). https://doi.org/10.1007/s41999-020-00409-9

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