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

Abstract

Although older people are particularly liable to sarcopenia, limited research is available on beta-hydroxy-beta-methylbutyrate (HMB) supplementation in this population, particularly in healthy subjects. In this parallel-group, randomized, controlled, open-label trial, we aimed to evaluate whether an oral supplement containing 1.5 g of calcium HMB for 8 weeks could improve physical performance and muscle strength parameters in a group of community-dwelling healthy older women. Eighty healthy women attending a twice-weekly mild fitness program were divided into two equal groups of 40, and 32 of the treated women and 33 control completed the study. We considered a change in the Short Physical Performance Battery (SPPB) score as the primary outcome and changes in the peak torque (PT) isometric and isokinetic strength of the lower limbs, 6-minute walking test (6MWT), handgrip strength and endurance as secondary outcomes. Body composition was assessed with dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computerized tomography (pQCT). The mean difference between the two groups on pre-post change were finally calculated (delta) for each outcome. After 8 weeks, there were no significant differences between the groups’ SPPB, handgrip strength or DXA parameters. The group treated with HMB scored significantly better than the control group for PT isokinetic flexion (delta = 1.56±1.56 Nm; p = 0.03) and extension (delta = 3.32±2.61 Nm; p = 0.03), PT isometric strength (delta = 9.74±3.90 Nm; p = 0.02), 6MWT (delta = 7.67±8.29 m; p = 0.04), handgrip endurance (delta = 21.41±16.28 s; p = 0.02), and muscle density assessed with pQCT. No serious adverse effects were reported in either group. In conclusion, a nutritional supplement containing 1.5 g of calcium HMB for 8 weeks in healthy elderly women had no significant effects on SPPB, but did significantly improve several muscle strength and physical performance parameters.Trial RegistrationClinicalTrials.gov NCT02118181

Poor Physical Performance Predicts Future Onset of Depression in Elderly People: Progetto Veneto Anziani Longitudinal Study

“…The cutoffs for dividing the sample into tertiles were 10 and 11 points in men, and 9 and 11 points in women. Since the 4 m walking speed and five times sit-to-stand test are independent predictors of several negative outcomes in older people 24,25 , these parameters were also considered as separate items in this analysis. The cutoffs used for the 4 m gait speed were 0.83 and 0.98 m/s in males, and 0.72 and 0.85 m/s in females; for the five times sit-to-stand test, the corresponding cut-offs were 11.2 and 9.4 in males, and 10.2 and 12.6 s in females.…”

Cellular and Physiological Effects of Dietary Supplementation with β-Hydroxy-β-Methylbutyrate (HMB) and β-Alanine in Late Middle-Aged Mice

“…HMB has since been demonstrated to promote muscle mass, strength, power, or physical performance or reduce skeletal muscle atrophy in elderly subjects [ 40 – 44 ]. HMB supplementation also prevented the loss of lean mass in a human study of 10 days of bed rest [ 45 ], and has shown similar efficacy in experimental models of cancer cachexia [ 37 , 46 – 48 ]. On the other hand, several studies, namely in strength-trained athletes, do not support these results and may reflect differences in dose and duration of HMB supplementation or total protein intake [ 49 – 51 ].…”

Role of Oral Nutritional Supplements Enriched with B-hydroxy-B-Methylbutyrate in Maintaining Muscle Function and Improving Clinical Outcomes in Various Clinical Settings

“…Berton et al ( 23 ) aimed at evaluating whether HP-ONS+HMB given as 1 serving/day for 8 weeks together with a mild fitness program could improve physical performance, muscle strength and body composition parameters. This open labeled RCT was conducted in a group of healthy community dwelling women (aged ≥ 65 years) attending a mild fitness program including mainly aerobic exercise and some resistance exercise.…”

“…Recently, HMB has been added to high protein ONS as a means to target muscle loss in context of an optimized nutrition supplement that provides macro and micronutrients to meet the daily requirements of patients with nutritional insufficiencies/deficiencies. Administration of these high protein HMB-enriched oral nutritional supplements (HP-ONS+HMB) has shown promise in helping adults maintain muscle mass and function in hospital and community settings ( 4 , 21 - 23 ). Therefore, the purpose of this review is to summarize and discuss the current evidence that examined nutritional support, mainly through HP-ONS+HMB on muscle function and clinical outcomes in adults with, or at risk of, malnutrition, and both in community and peri-hospitalization settings.…”