Skip to main content
Log in

The Effect of β-Hydroxy-β-Methylbutyrate (HMB) on Sarcopenia and Functional Frailty in Older Persons: A Systematic Review

  • Published:
The journal of nutrition, health & aging

Abstract

Background

Beta-hydroxy-beta-methylbutyrate (HMB) has been shown to be effective and superior to other types of protein supplements to attenuate loss of muscle mass, strength and function, however, its benefits in sarcopenic and frail older people remain unclear.

Objective

We seek to determine the effect of HMB on muscle mass, strength and function in older people with sarcopenia or frailty by reviewing results from available randomized controlled trials (RCTs).

Design

This review was registered at PROSPERO (University of York) with registration number CRD42018088462 and conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Using a pre-determined e-search strategy, we searched PubMed, Medline, EMBASE, CINAHL, LILACS, Web of Science, Cochrane and Scopus databases. Our inclusion criteria were RCTs that assessed the effect of HMB on muscle mass, strength and function in older people with sarcopenia and frailty aged ≥60 years. The main outcomes were lean body mass, handgrip, leg press strength, and Short Physical Performance Battery (SPPB) score.

Results

Three studies matched our eligibility criteria which enrolled 203 subjects through a variety of definitions of sarcopenia or frailty. Lean body mass increased and muscle strength and function were preserved following HMB supplementation.

Conclusion

HMB improves lean muscle mass and preserves muscle strength and function in older people with sarcopenia or frailty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1

Similar content being viewed by others

References

  1. He W, Goodkind D, Kowal P. An Aging World: 2015. U.S. Government Publishing Office, Washington, DC: U.S. Census Bureau; 2016.

    Google Scholar 

  2. Fujita S, Volpi E. Nutrition and Sarcopenia of Ageing. Nutrition Research Reviews. 2004;17(1):69–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Rolland Y, Czerwinski S, van Kan GA, Morley JE, Cesari M, Onder G, et al. Sarcopenia: Its Assessment, Etiology, Pathogenesis, Consequences and Future Perspectives. Journal of Nutrition Health and Aging. 2008;12(7):433–50.

    Article  CAS  Google Scholar 

  4. Grimby G, Saltin B. The Ageing Muscle. Clinical Physiology. 1983;3(3):209–18.

    Article  CAS  PubMed  Google Scholar 

  5. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in Older Adults: Evidence for a Phenotype. The Journals of Gerontology Series A, Biological Sciences and Medical Sciences. 2001;56(3):M146–56.

    Article  CAS  PubMed  Google Scholar 

  6. Xue QL. The Frailty Syndrome: Definition and Natural History. Clinics in Geriatric Medicine. 2011;27(1):1–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Topinkova E. Aging, Disability and Frailty. Annals of Nutrition and Metabolism. 2008;52 Suppl 1:6–11.

    Google Scholar 

  8. Wu H, Xia Y, Jiang J, Du H, Guo X, Liu X, et al. Effect of Beta–Hydroxy–Beta–Methylbutyrate Supplementation on Muscle Loss in Older Adults: a Systematic Review and Meta–Analysis. Archives of Gerontology and Geriatrics. 2015;61(2):168–75.

    Article  CAS  PubMed  Google Scholar 

  9. Wall BT, Gorissen SH, Pennings B, Koopman R, Groen BBL, Verdijk LB, et al. Aging Is Accompanied by a Blunted Muscle Protein Synthetic Response to Protein Ingestion. PLoS ONE. 2015;10(11):e0140903.

    Google Scholar 

  10. Welle S, Thornton C, Jozefowicz R, Statt M. Myofibrillar protein synthesis in young and old men. The American journal of physiology. 1993;264(5 Pt 1):E693–8.

    Google Scholar 

  11. Paw M, van Uffelen JGZ, Riphagen I, van Mechelen W. The Functional Effects of Physical Exercise Training in Frail Older People–A Systematic Review. Sports Medicine. 2008;38(9):781–93.

    Article  Google Scholar 

  12. Yarasheski KE, Pak–Loduca J, Hasten DL, Obert KA, Brown MB, Sinacore DR. Resistance Exercise Training Increases Mixed Muscle Protein Synthesis Rate in Frail Women and Men =76 Year Old. American Journal of Physiology. 1999;277(1 Pt 1):E118–25.

    Google Scholar 

  13. Tieland M, van de Rest O, Dirks ML, van der Zwaluw N, Mensink M, van Loon LJC, et al. Protein Supplementation Improves Physical Performance in Frail Elderly People: A Randomized, Double–Blind, Placebo–Controlled Trial. Journal of the American Medical Directors Association. 2012;13(8):720–6.

    Article  PubMed  Google Scholar 

  14. Tieland M, Dirks ML, van der Zwaluw N, Verdijk LB, van de Rest O, de Groot L, et al. Protein Supplementation Increases Muscle Mass Gain During Prolonged Resistance–Type Exercise Training in Frail Elderly People: A Randomized, Double–Blind, Placebo–Controlled Trial. Journal of the American Medical Directors Association. 2012;13(8):713–9.

    Article  PubMed  Google Scholar 

  15. Deutz NE, Pereira SL, Hays NP, Oliver JS, Edens NK, Evans CM, et al. Effect of Beta–Hydroxy–Beta–Methylbutyrate (HMB) on Lean Body Mass during 10 Days of Bed Rest in Older Adults. Clinical Nutrition. 2013;32(5):704–12.

    Article  CAS  PubMed  Google Scholar 

  16. Landi F, Calvani R, Tosato M, Martone AM, Ortolani E, Savera G, et al. Protein Intake and Muscle Health in Old Age: From Biological Plausibility to Clinical Evidence. Nutrients. 2016;8(5):14.

    Article  CAS  Google Scholar 

  17. Cruz–Jentoft AJ, Landi F, Schneider SM, Zúñiga C, Arai H, Boirie Y, et al. Prevalence of and Interventions for Sarcopenia in Ageing Adults: a Systematic Review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age and Ageing. 2014;43(6):748–59.

    PubMed  PubMed Central  Google Scholar 

  18. Wilson JM, Fitschen PJ, Campbell B, Wilson GJ, Zanchi N, Taylor L, et al. International Society of Sports Nutrition Position Stand: Beta–Hydroxy–Beta–Methylbutyrate (HMB). Journal of the International Society of Sports Nutrition. 2013;10:6–.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Baier S, Johannsen D, Abumrad N, Rathmacher JA, Nissen S, Flakoll P. 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. Journal of Parenteral and Enteral Nutrition. 2009;33(1):71–82.

    Article  CAS  PubMed  Google Scholar 

  20. Calvani R, Miccheli A, Landi F, Bossola M, Cesari M, Leeuwenburgh C, et al. Current Nutritional Recommendations and Novel Dietary Strategies to Manage Sarcopenia. Journal of Frailty and Aging. 2013;2(1):38–53.

    PubMed  Google Scholar 

  21. Van Koevering M, Nissen S. Oxidation of leucine and alpha–ketoisocaproate to beta–hydroxy–beta–methylbutyrate in vivo. The American Journal of Physiology. 1992;262(1 Pt 1):E27–31.

    PubMed  Google Scholar 

  22. Wilson GJ, Wilson JM, Manninen AH. Effects of beta–hydroxy–beta–methylbutyrate (HMB) on exercise performance and body composition across varying levels of age, sex, and training experience: A review. Nutrition & Metabolism (Lond). 2008;5:1.

    Article  CAS  PubMed Central  Google Scholar 

  23. Baxter JH, Carlos JL, Thurmond J, Rehani RN, Bultman J, Frost D. Dietary Toxicity of Calcium Beta–Hydroxy–Beta–Methylbutyrate (CaHMB). Food and Chemical Toxicology. 2005;43(12):1731–41.

    Article  CAS  PubMed  Google Scholar 

  24. Durkalec–Michalski K, Jeszka J, Podgórski T. The Effect of a 12–Week Betahydroxy–beta–methylbutyrate (HMB) Supplementation on Highly–Trained Combat Sports Athletes: A Randomised, Double–Blind, Placebo–Controlled Crossover Study. Nutrients. 2017;9(7):1–21.

    Article  CAS  Google Scholar 

  25. Chanet A, Verlaan S, Salles J, Giraudet C, Patrac V, Pidou V, et al. Supplementing Breakfast with a Vitamin D and Leucine–Enriched Whey Protein Medical Nutrition Drink Enhances Postprandial Muscle Protein Synthesis and Muscle Mass in Healthy Older Men. Journal of Nutrition. 2017;147(12):2262–71.

    Article  CAS  PubMed  Google Scholar 

  26. Hung W, Liu T, Chen C, Chang C. Effect of Beta–Hydroxy–Beta–Methylbutyrate Supplementation During Energy Restriction in Female Judo Athletes. Journal of Exercise Science and Fitness. 2010;8(1):50–3.

    Article  Google Scholar 

  27. O’Connor DM, Crowe MJ. Effects of Beta–Hydroxy–Beta–Methylbutyrate and Creatine Monohydrate Supplementation on the Aerobic and Anaerobic Ccapacity of Highly Trained Athletes. Journal of Sports Medicine and Physical Fitness. 2003;43(1):64–8.

    PubMed  Google Scholar 

  28. Silva VR, Belozo FL, Micheletti TO, Conrado M, Stout JR, Pimentel GD, et al. Beta–Hydroxy–Betaβ–Methylbutyrate Free Acid Supplementation May Improve Recovery and Muscle Adaptations After Resistance Training: a Systematic Review. Nutrition Research. 2017;45:1–9.

    Article  CAS  PubMed  Google Scholar 

  29. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [Updated March 2011]. The Cochrane Collaboration; 2011 [cited 15 May 2018]. [Available from http://handbook.cochrane.org].

    Google Scholar 

  30. Ryan R, Hill S. How to GRADE the quality of the evidence Version 1.0: Cochrane Consumers and Communication Group; 2016 [cited 3 June 2018]. [Available at http://cccrg.cochrane.org/author–resources].

    Google Scholar 

  31. Malafarina V, Uriz–Otano F, Malafarina C, Martinez J, Zulet M. Effectiveness of nutritional supplementation on sarcopenia and recovery in hip fracture patients. A multi–centre randomized trial. Maturitas. 2017; 101:[42–50 pp.].

    Google Scholar 

  32. Nissen S, Sharp R, Ray M, Rathmacher JA, Rice D, Fuller JC, Jr., et al. Effect of leucine metabolite beta–hydroxy–beta–methylbutyrate on muscle metabolism during resistance–exercise training. Journal of Applied Physiology (Bethesda, Md: 1985). 1996;81(5):2095–104.

    Article  CAS  Google Scholar 

  33. Beaumier L, Castillo L, Yu YM, Ajami AM, Young VR. Arginine: new and exciting developments for an “old” amino acid. Biomedical and environmental sciences: BES. 1996;9(2–3):296–315.

    CAS  PubMed  Google Scholar 

  34. El–Khoury AE, Pereira PC, Borgonha S, Basile–Filho A, Beaumier L, Wang SY, et al. Twenty–four–hour oral tracer studies with L–[1–13C]lysine at a low (15 mg.kg (–1).d (–1) and intermediate (29 mg.kg (–1).d(–1)) lysine intake in healthy adults. The American Journal of Clinical Nutrition. 2000;72(1):122–30.

    Article  PubMed  Google Scholar 

  35. Rand WM, Young VR. Statistical Analysis of Nitrogen Balance Data with Reference to the Lysine Requirement in Adults. The Journal of Nutrition. 1999;129(10):1920–6.

    Article  CAS  PubMed  Google Scholar 

  36. Gallagher PM, Carrithers JA, Godard MP, Schulze KE, Trappe SW. ß–hydroxy–ßmethylbutyrate ingestion, part II: effects on hematology, hepatic and renal function. Medicine & Science in Sports & Exercise. 2000;32(12):2116–9.

    Article  CAS  Google Scholar 

  37. Sharawy MH, El–Awady MS, Megahed N, Gameil NM. The ergogenic supplement beta–hydroxy–beta–methylbutyrate (HMB) attenuates insulin resistance through suppressing GLUT–2 in rat liver. Canadian Journal of Physiology and Pharmacology. 2016;94(5):488–97.

    Article  CAS  PubMed  Google Scholar 

  38. Gerlinger–Romero F, Guimarães–Ferreira L, Giannocco G, Nunes MT. Chronic supplementation of beta–hydroxy–beta methylbutyrate (HMβ) increases the activity of the GH/IGF–I axis and induces hyperinsulinemia in rats. Growth Hormone &IGF Research. 2011;21(2):57–62.

    Article  CAS  Google Scholar 

  39. Yonamine CY, Teixeira SS, Campello RS, Gerlinger–Romero F, Rodrigues CF, Jr., Guimaraes–Ferreira L, et al. Beta hydroxy beta methylbutyrate supplementation impairs peripheral insulin sensitivity in healthy sedentary Wistar rats. Acta Physiologica (Oxford, England). 2014;212(1):62–74.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gustavo Duque.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oktaviana, J., Zanker, J., Vogrin, S. et al. The Effect of β-Hydroxy-β-Methylbutyrate (HMB) on Sarcopenia and Functional Frailty in Older Persons: A Systematic Review. J Nutr Health Aging 23, 145–150 (2019). https://doi.org/10.1007/s12603-018-1153-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-018-1153-y

Key words

Navigation