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Wu TT, Li CX, Zhuang YN, Luo CJ, Chen JM, Li Y, Xiong J, Jin S, Li H. Resistance training combined with β-hydroxy β-methylbutyrate for patients with critical illness: A four-arm, mixed-methods, feasibility randomised controlled trial. Intensive Crit Care Nurs 2024; 82:103616. [PMID: 38246040 DOI: 10.1016/j.iccn.2023.103616] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVES This study aimed to assess the feasibility, safety, acceptability, and potential effectiveness of resistance training (RT) with or without β-Hydroxy β-Methylbutyrate (HMB) intervention program for ICU patients. DESIGN Open-label, parallel group, mixed method, randomized controlled trial. SETTINGS A tertiary general hospital in Fuzhou, China. METHODS Participants were randomly allocated to one of four groups. The RT group received supervised multilevel resistance training (RT) using elastic bands, administered by trained ICU nurses. The HMB group received an additional daily dose of 3.0 g HMB. The combination group underwent both interventions concurrently, while the control group received standard care. These interventions were implemented throughout the entire hospitalization period. Primary outcomes included feasibility indicators such as recruitment rate, enrollment rate, retention rate, and compliance rate. Secondary outcomes covered adverse events, acceptability (evaluated through questionnaires and qualitative interviews), and physical function. Quantitative analysis utilized a generalized estimation equation model, while qualitative analysis employed directed content analysis. RESULTS All feasibility indicators met predetermined criteria. Forty-eight patients were randomly assigned across four arms, achieving a 96% enrollment rate. Most patients adhered to the intervention until discharge, resulting in a 97.9% retention rate. Compliance rates for both RT and HMB interventions approached or exceeded 85%. No adverse events were reported. The intervention achieved 100% acceptability, with a prevailing expression of positive experiences and perception of appropriateness. The RT intervention shows potential improvement in physical function, while HMB does not. CONCLUSIONS Implementing nurse-led resistance training with elastic bands with or without HMB proved to be feasible and safe for ICU patients. IMPLICATIONS FOR CLINICAL PRACTICE A large-scale, multicenter clinical trials are imperative to definitively assess the impact of this intervention on functional outcomes in this population.
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Affiliation(s)
- Ting-Ting Wu
- Shengli Clinical College of Fujian Medical University, Fuzhou, China; School of Nursing, Fujian Medical University, Fuzhou, China; Department of Nursing, Fujian Provincial Hospital, Fuzhou, China
| | - Chang-Xin Li
- Intensive Care Unit, First Hospital of NanPing City, Nanping, China
| | - Yao-Ning Zhuang
- Respiratory and Intensive Care Unit, Affiliated Hospital of Putian University, Putian, China
| | - Chen-Juan Luo
- Intensive Care Unit, First Hospital of NanPing City, Nanping, China
| | - Ji-Min Chen
- Emergency Intensive Care Unit, Fujian Provincial Hospital, Fuzhou, China
| | - Yun Li
- Internal Medicine Intensive Care Unit, Fujian Provincial Hospital, Fuzhou, China
| | - Jing Xiong
- Operating Room, Second Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Shuang Jin
- Department of Nursing, Fujian Provincial Hospital, Fuzhou, China.
| | - Hong Li
- School of Nursing, Fujian Medical University, Fuzhou, China.
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Gutiérrez-Reguero H, Buendía-Romero Á, Franco-López F, Martínez-Cava A, Hernández-Belmonte A, Courel-Ibáñez J, Ara I, Alcazar J, Pallarés JG. Effects of multicomponent training and HMB supplementation on disability, cognitive and physical function in institutionalized older adults aged over 70 years: a cluster-randomized controlled trial. J Nutr Health Aging 2024; 28:100208. [PMID: 38489992 DOI: 10.1016/j.jnha.2024.100208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES To investigate the synergist effects of exercise and β-hydroxy β-methylbutyrate (HMB) supplementation on disability, cognitive and physical function, and muscle power in institutionalized older people. DESIGN Cluster-randomized controlled trial. PARTICIPANTS Seventy-two institutionalized older adults (age = 83 ± 10 years old; 63% women) were randomized in four groups: exercise plus placebo (EX), HMB supplementation, EX plus HMB supplementation (EX + HMB), and control (CT). INTERVENTION The exercising participants completed a 12-week tailored multicomponent exercise intervention (Vivifrail; 5 days/week of an individualized resistance, cardiovascular, balance and flexibility program), whereas the HMB groups received a drink containing 3 g/day of HMB. MEASUREMENTS Participants were assessed Pre and Post intervention for disability and cognitive function (validated questionnaires), physical function (short physical performance battery, SPPB), handgrip strength and sit-to-stand relative muscle power. Linear mixed-effect models were used to compare changes among groups. RESULTS Compared to baseline, both EX and EX + HMB improved cognitive function (+2.9 and +1.9 points; p < 0.001), SPPB score (+2.9 points and +2.4 points; p < 0.001) and relative muscle power (+0.64 and +0.48 W·kg-1; p < 0.001), while CT and HMB remained unchanged (p > 0.05). Significant between-group differences were noted between CT, EX and EX + HMB for cognitive function (p < 0.01), between CT and EX + HMB for physical function (p = 0.043), and between CT, EX and EX + HMB for relative muscle power (p < 0.001). CONCLUSION The Vivifrail exercise program was effective in improving cognitive and physical function, and muscle power in nursing home residents, while HMB supplementation did not provide additional benefits when combined with exercise. These results emphasize the importance of physical exercise interventions in very old people as an essential basis for improving their overall health and quality of life.
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Affiliation(s)
- Héctor Gutiérrez-Reguero
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Ángel Buendía-Romero
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Francisco Franco-López
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | - Alejandro Martínez-Cava
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | | | - Javier Courel-Ibáñez
- Department of Physical Education and Sport, University of Granada, Granada, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain.
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Meza-Valderrama D, Sánchez-Rodríguez D, Messaggi-Sartor M, Muñoz-Redondo E, Morgado-Pérez A, Tejero-Sánchez M, De Jaime-Gil E, Leiva-Banuelos N, Marco E. Supplementation with β-hydroxy-β-methylbutyrate after resistance training in post-acute care patients with sarcopenia: A randomized, double-blind placebo-controlled trial. Arch Gerontol Geriatr 2024; 119:105323. [PMID: 38171034 DOI: 10.1016/j.archger.2023.105323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES This study aimed to evaluate the efficacy of adding β-hydroxy-β- methylbutyrate (HMB) supplementation to a 12-week exercise-based rehabilitation program in older adults with sarcopenia after discharge from a post-acute geriatric rehabilitation unit. STUDY DESIGN A randomized, double-blind, placebo-controlled trial with two parallel groups. The intervention group received 3 g/day of Ca-HMB and participated in a 12- week resistance training program (3 sessions/week). The control group received a placebo and followed the same training program. MAIN OUTCOME MEASURES The primary outcomes were the improvements of handgrip strength and physical performance assessed through the Short Physical Performance Battery (SPPB) and 4-meter gait speed; and handgrip strength. All variables were assessed at baseline, post-intervention, and 1-year follow-up. RESULTS After completing the 12-week exercise program, the intervention group showed significant improvements in SPPB-Balance (1.3, 95 %CI 0.3 to 2.4) and total SPPB score (2.2, 95 %CI 0.4 to 4.0). Intra-group analysis demonstrated gains in the SPPB-Chair Stand (0.7 points, 95 %CI 0.0 to 1.4) and total SPPB score (2.1 points, 95 %CI 0.3 to 3.9) in the intervention group. Improvements in handgrip strength were observed in women (3.7 kg, 95 %CI: 0.2 to 7.3) at the end of the intervention, and persisted at the 1-year follow-up. CONCLUSIONS Our findings suggest that the supplementation of 3 g/day of Ca-HMB with resistance exercise may significantly enhance muscle strength and physical performance among older women with sarcopenia after recent hospitalization. Given this study's limitations, the intervention's effectiveness cannot be drawn, and further studies are needed.
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Affiliation(s)
- Delky Meza-Valderrama
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation, Vía Centenario, 0819 Panamá City, Panamá; Sistema Nacional de Investigación- Secretaria Nacional de Ciencia e Investigación, Clayton Ciudad del Saber Edificio 205, 0819 Panamá City, Panamá.
| | - Dolores Sánchez-Rodríguez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A.Van Gehuchten 4, 1020 Brussels, Belgium; WHO Collaborating Center for Public Health aspects of musculoskeletal health and ageing. Division of Public Health, Epidemiology and Health Economics, University of Liège, Pl. du Vingt Août 7, 4000, Liège, Belgium
| | - Monique Messaggi-Sartor
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Elena Muñoz-Redondo
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Andrea Morgado-Pérez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Marta Tejero-Sánchez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Elisabet De Jaime-Gil
- Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019, Barcelona, Catalonia, Spain
| | - Nuria Leiva-Banuelos
- Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019, Barcelona, Catalonia, Spain
| | - Ester Marco
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain; Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Dr Aiguader Building (Mar Campus), Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain
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Rokkam MP, Gora O, Konda MR, Koushik A. A proprietary blend of Sphaeranthus indicus flower head and Mangifera indica bark extracts increases muscle strength and enhances endurance in young male volunteers: a randomized, double-blinded, placebo-controlled trial. Food Nutr Res 2023; 67:8972. [PMID: 36794013 PMCID: PMC9899043 DOI: 10.29219/fnr.v67.8972] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 12/01/2022] [Accepted: 12/16/2022] [Indexed: 01/28/2023] Open
Abstract
Background The demand for safe and efficacious botanical formulations to increase muscle mass, strength, and stamina is increasing among athletes and the general population. The nutraceutical supplements of medicinal plant origin exert minimal health concern. Objective This randomized, double-blind, placebo-controlled study was aimed to evaluate the ergogenic potential of a proprietary, standardized formulation (LI12542F6) of Sphaeranthus indicus flower head and Mangifera indica stem bark extracts. Methods Forty male participants 18-40 years of age were assigned to receive either a placebo (n = 20) or 650 mg/day LI12542F6 (n = 20) for 56 days. All participants performed a fixed set of resistance exercises during the intervention. The primary endpoint was the change from baseline muscle strength, assessed by one-repetition maximum (1-RM) bench and leg presses, and handgrip strength. The secondary endpoints included cable pull-down repetitions, time to exhaustion on a treadmill, mid-upper arm circumference (MUAC), body composition using dual-energy x-ray absorptiometry (DEXA), and free testosterone and cortisol levels in serum. Results Fifty-six days supplementation of LI12542F6 significantly improved baseline bench press (P < 0.0001), leg press (P < 0.0001), handgrip strength (P < 0.0006), number of repetitions (P < 0.0001), and time to exhaustion (P < 0.0008), compared to placebo. Post-trial, the LI12542F6 group also showed significantly increased MUAC and improved body composition and serum hormone levels. The participants' hematology, clinical chemistry, and vital signs were within the normal range. No adverse events were observed. Conclusion This study demonstrates that LI12542F6 supplementation significantly increases muscle strength and size and improves endurance in healthy men. Also, LI12542F6 is well-tolerated by the participants.
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Affiliation(s)
- Meher Prasanna Rokkam
- Department of Orthopedics, Meher Hospital, Vijayawada, India;,Meher Prasanna Rokkam Department of Orthopedics, Meher Hospital, Gandhinagar, Vijayawada-520003, Andhra Pradesh, India.
| | - Olos Gora
- Department of Physiotherapy, Vijaya Institute Medical Sciences College of Physiotherapy, NTR University of Health Sciences, Vijayawada, India
| | | | - Ajay Koushik
- Department of Orthopedics, Mysore Medical College & Research Institute, Mysuru, India
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Yang C, Song Y, Li T, Chen X, Zhou J, Pan Q, Jiang W, Wang M, Jia H. Effects of Beta-Hydroxy-Beta-Methylbutyrate Supplementation on Older Adults with Sarcopenia: A Randomized, Double-Blind, Placebo-Controlled Study. J Nutr Health Aging 2023; 27:329-339. [PMID: 37248756 DOI: 10.1007/s12603-023-1911-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/24/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Sarcopenia is recognized as a major public health concern because of its association with several adverse health events. Beta-hydroxy-beta-methylbutyrate (HMB) supplementation reportedly delays the loss of muscle mass and function; however, the effect of HMB on sarcopenia remains inconclusive. We aimed to evaluate the impact of HMB intervention on muscle strength, physical performance, body compositions, and inflammatory factors in older adults with sarcopenia. DESIGN Randomized, double-blind, placebo-controlled trial. SETTING AND PARTICIPANTS This study included subjects aged ≥60 years with sarcopenia which were assigned to the HMB group (HMBG, n=18) and the placebo group (PG, n=16). INTERVENTION The HMBG and PG were supplied with HMB and placebo products twice daily for 12 weeks, and both received resistance exercise training twice a week in 12 weeks. MEASUREMENTS Hand grip strength was selected as the primary outcome; gait speed, five-time chair stand test, body composition and inflammatory indicators were selected as the secondary outcomes. The differences in changes from baseline between the two groups were analyzed using the analysis of covariance(ANCOVA). RESULTS After the 12-week intervention, the HMBG demonstrated significantly greater improvements in handgrip strength (4.61(95%CI:2.93,6.28) kg, P<0.001), gait speed (0.11(95%CI:0.02,0.20)m/s, P=0.014), five-time chair stand test (-3.65 (95%CI:-5.72, -1.58)s, P=0.001), muscle quality (2.47(95%CI:1.15,3.80),kg.kg-1 P=0.001) and tumor necrosis factor-like weak inducer of apoptosis (-15.23(95%CI:-29.80,-0.66)pmol/mL, P=0.041) compared with the PG; no significant differences in skeletal muscle mass, skeletal muscle index, and other body composition parameters were found between the two groups. CONCLUSION In older adults with sarcopenia, HMB significantly enhance the effect of resistance exercise training on muscle strength, physical performance, muscle quality, and reduced inflammatory factors. Therefore, HMB supplementation could be an effective treatment for sarcorpenia. The trial protocol was registered at http://www.chictr.org.cn/showproj.aspx?proj=47571 as ChiCTR2000028778.
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Affiliation(s)
- C Yang
- Hong Jia, School of Public Health, Southwest Medical University, Luzhou City, Sichuan Province, China,
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Nilsson MI, Crozier M, Di Carlo A, Xhuti D, Manta K, Roik LJ, Bujak AL, Nederveen JP, Tarnopolsky MG, Hettinga B, Meena NK, Raben N, Tarnopolsky MA. Nutritional co-therapy with 1,3-butanediol and multi-ingredient antioxidants enhances autophagic clearance in Pompe disease. Mol Genet Metab 2022; 137:228-240. [PMID: 35718712 DOI: 10.1016/j.ymgme.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 10/18/2022]
Abstract
Alglucosidase alpha is an orphan drug approved for enzyme replacement therapy (ERT) in Pompe disease (PD); however, its efficacy is limited in skeletal muscle because of a partial blockage of autophagic flux that hinders intracellular trafficking and enzyme delivery. Adjunctive therapies that enhance autophagic flux and protect mitochondrial integrity may alleviate autophagic blockage and oxidative stress and thereby improve ERT efficacy in PD. In this study, we compared the benefits of ERT combined with a ketogenic diet (ERT-KETO), daily administration of an oral ketone precursor (1,3-butanediol; ERT-BD), a multi-ingredient antioxidant diet (ERT-MITO; CoQ10, α-lipoic acid, vitamin E, beetroot extract, HMB, creatine, and citrulline), or co-therapy with the ketone precursor and multi-ingredient antioxidants (ERT-BD-MITO) on skeletal muscle pathology in GAA-KO mice. We found that two months of 1,3-BD administration raised circulatory ketone levels to ≥1.2 mM, attenuated autophagic buildup in type 2 muscle fibers, and preserved muscle strength and function in ERT-treated GAA-KO mice. Collectively, ERT-BD was more effective vs. standard ERT and ERT-KETO in terms of autophagic clearance, dampening of oxidative stress, and muscle maintenance. However, the addition of multi-ingredient antioxidants (ERT-BD-MITO) provided the most consistent benefits across all outcome measures and normalized mitochondrial protein expression in GAA-KO mice. We therefore conclude that nutritional co-therapy with 1,3-butanediol and multi-ingredient antioxidants may provide an alternative to ketogenic diets for inducing ketosis and enhancing autophagic flux in PD patients.
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Affiliation(s)
- Mats I Nilsson
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Exerkine Corporation, McMaster University, Hamilton, Ontario, Canada
| | - Michael Crozier
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Alessia Di Carlo
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Donald Xhuti
- Exerkine Corporation, McMaster University, Hamilton, Ontario, Canada
| | - Katherine Manta
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Liza J Roik
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Adam L Bujak
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Joshua P Nederveen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | | | - Bart Hettinga
- Exerkine Corporation, McMaster University, Hamilton, Ontario, Canada
| | - Naresh K Meena
- Cell and Developmental Biology Center, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA
| | - Nina Raben
- Cell and Developmental Biology Center, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA
| | - Mark A Tarnopolsky
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Exerkine Corporation, McMaster University, Hamilton, Ontario, Canada.
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Lv X, Zhou C, Yan Q, Tan Z, Kang J, Tang S. Elucidating the underlying mechanism of amino acids to regulate muscle protein synthesis: impact on human health. Nutrition 2022; 103-104:111797. [DOI: 10.1016/j.nut.2022.111797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 10/31/2022]
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Randomized Clinical Trial: Effects of β-Hydroxy-β-Methylbutyrate (HMB)-Enriched vs. HMB-Free Oral Nutritional Supplementation in Malnourished Cirrhotic Patients. Nutrients 2022; 14:nu14112344. [PMID: 35684144 PMCID: PMC9183090 DOI: 10.3390/nu14112344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/17/2022] Open
Abstract
β-Hydroxy-β-methylbutyrate (HMB) supplementation increases muscle and strength mass in some muscle-wasting disorders. Malnutrition and sarcopenia are often present in liver cirrhosis. We aimed to investigate the effects of oral HMB supplementation on changes in body composition and liver status in patients with cirrhosis and malnutrition. In a randomized, controlled, double-blind trial, 43 individuals were randomized to receive twice a day and for 12 weeks an oral nutritional supplement (ONS) enriched with 1.5 g of calcium HMB per bottle or another supplement with similar composition devoid of HMB. Inclusion criteria were liver cirrhosis with at least one previous decompensation and clinical malnutrition. Liver function, plasma biochemistry analyses, and physical condition assessment were carried out at baseline, then after six and 12 weeks of supplementation. A total of 34 patients completed the clinical trial. An improvement in liver function and an increase in fat mass index were observed in both groups. None of the two ONS changed the fat-free mass. However, we observed an upward trend in handgrip strength and a downward trend in minimal hepatic encephalopathy in the HMB group. At the end of the trial and regardless of the supplement administered, fat mass content increased with no change in fat-free mass, while liver function scores and nutritional analytic markers also improved.
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Espina S, Gonzalez-Irazabal Y, Sanz-Paris A, Lopez-Yus M, Garcia-Sobreviela MP, del Moral-Bergos R, Garcia-Rodriguez B, Fuentes-Olmo J, Bernal-Monterde V, Arbones-Mainar JM. Amino Acid Profile in Malnourished Patients with Liver Cirrhosis and Its Modification with Oral Nutritional Supplements: Implications on Minimal Hepatic Encephalopathy. Nutrients 2021; 13:nu13113764. [PMID: 34836020 PMCID: PMC8617874 DOI: 10.3390/nu13113764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 02/07/2023] Open
Abstract
Low plasma levels of branched chain amino acids (BCAA) in liver cirrhosis are associated with hepatic encephalopathy (HE). We aimed to identify a metabolic signature of minimal hepatic encephalopathy (MHE) in malnourished cirrhotic patients and evaluate its modification with oral nutritional supplements (ONS) enriched with ß-Hydroxy-ß-methylbutyrate (HMB), a derivative of the BCAA leucine. Post hoc analysis was conducted on a double-blind placebo-controlled trial of 43 individuals with cirrhosis and malnutrition, who were randomized to receive, for 12 weeks, oral supplementation twice a day with either 220 mL of Ensure® Plus Advance (HMB group, n = 22) or with 220 mL of Ensure® Plus High Protein (HP group, n = 21). MHE evaluation was by psychometric hepatic encephalopathy score (PHES). Compared to the HP group, an HMB-specific treatment effect led to a larger increase in Val, Leu, Phe, Trp and BCAA fasting plasma levels. Both treatments increased Fischer’s ratio and urea without an increase in Gln or ammonia fasting plasma levels. MHE was associated with a reduced total plasma amino acid concentration, a reduced BCAA and Fischer´s ratio, and an increased Gln/Glu ratio. HMB-enriched ONS increased Fischer´s ratio without varying Gln or ammonia plasma levels in liver cirrhosis and malnutrition, a protective amino acid profile that can help prevent MHE.
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Affiliation(s)
- Silvia Espina
- Gastroenterology Department, University Hospital Miguel Servet, 50009 Zaragoza, Spain; (S.E.); (J.F.-O.); (V.B.-M.)
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
| | - Yolanda Gonzalez-Irazabal
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
- Clinical Biochemistry Department, University Hospital Miguel Servet, 50009 Zaragoza, Spain
| | - Alejandro Sanz-Paris
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
- Nutrition Department, University Hospital Miguel Servet, 50009 Zaragoza, Spain
| | - Marta Lopez-Yus
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragones de Ciencias de la Salud (IACS), University Hospital Miguel Servet, 50009 Zaragoza, Spain
| | - Maria Pilar Garcia-Sobreviela
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragones de Ciencias de la Salud (IACS), University Hospital Miguel Servet, 50009 Zaragoza, Spain
| | - Raquel del Moral-Bergos
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragones de Ciencias de la Salud (IACS), University Hospital Miguel Servet, 50009 Zaragoza, Spain
| | - Beatriz Garcia-Rodriguez
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
- Clinical Biochemistry Department, University Hospital Miguel Servet, 50009 Zaragoza, Spain
| | - Javier Fuentes-Olmo
- Gastroenterology Department, University Hospital Miguel Servet, 50009 Zaragoza, Spain; (S.E.); (J.F.-O.); (V.B.-M.)
| | - Vanesa Bernal-Monterde
- Gastroenterology Department, University Hospital Miguel Servet, 50009 Zaragoza, Spain; (S.E.); (J.F.-O.); (V.B.-M.)
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
| | - Jose M. Arbones-Mainar
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain; (Y.G.-I.); (A.S.-P.); (M.L.-Y.); (M.P.G.-S.); (R.d.M.-B.); (B.G.-R.)
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragones de Ciencias de la Salud (IACS), University Hospital Miguel Servet, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain
- Correspondence:
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Produced β-hydroxybutyrate after β-hydroxy-β-methylbutyrate (HMB) administration may contribute HMB function in mice. Biochem Biophys Rep 2021; 27:101097. [PMID: 34401533 PMCID: PMC8358161 DOI: 10.1016/j.bbrep.2021.101097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
β-Hydroxy-β-methylbutyrate (HMB) is an intermediate in the metabolism of the branched-chain amino acid leucine. HMB has several demonstrated effects on skeletal muscle function, some of which are contradictory. In addition, the effect of exogenous HMB intake on the levels of intermediate metabolites is not known. Therefore, we investigated changes in HMB metabolites after oral HMB administration in mice. First, ICR mice were treated with either distilled water or HMB (0.215 g/10 mL/kg). Sampling was performed at 0, 1, 6, 12, and 24 h after administration. Next, ICR mice were given distilled water or HMB (0.215 g/10 mL/kg/d) for 10 d. Mice given HMB shown a significant increase in liver β-methylcrotonyl-CoA and increased β-hydroxybutyrate in plasma and the gastrocnemius muscle 1 h after HMB administration. Mice administered HMB for 10 d showed significantly decreased food intake and body weight; however, the relative weight of the gastrocnemius muscle was significantly increased. These results may be attributed to an increase in β-hydroxybutyrate resulting from exogenous HMB, since β-hydroxybutyrate inhibits food intake and suppresses skeletal muscle catabolism. In conclusion, β-hydroxybutyrate, a metabolite of HMB, was found to play an important role in the function of HMB. β-Hydroxybutyrate levels in plasma and gastrocnemius were enhanced by HMB. HMB increases in tissues and plasma returned to original levels within 6 h. HMB treatment for 10 d suppressed food intake and decreased body weight. Gastrocnemius weight was increased despite deceased body weight in HMB-treated mice.
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Inhibitors of the PI3K/Akt/mTOR Pathway in Prostate Cancer Chemoprevention and Intervention. Pharmaceutics 2021; 13:pharmaceutics13081195. [PMID: 34452154 PMCID: PMC8400324 DOI: 10.3390/pharmaceutics13081195] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023] Open
Abstract
The phosphatidylinositol 3-kinase (PI3K)/serine-threonine kinase (Akt)/mammalian target of the rapamycin (mTOR)-signaling pathway has been suggested to have connections with the malignant transformation, growth, proliferation, and metastasis of various cancers and solid tumors. Relevant connections between the PI3K/Akt/mTOR pathway, cell survival, and prostate cancer (PC) provide a great therapeutic target for PC prevention or treatment. Recent studies have focused on small-molecule mTOR inhibitors or their usage in coordination with other therapeutics for PC treatment that are currently undergoing clinical testing. In this study, the function of the PI3K/Akt/mTOR pathway, the consequence of its dysregulation, and the development of mTOR inhibitors, either as an individual substance or in combination with other agents, and their clinical implications are discussed. The rationale for targeting the PI3K/Akt/mTOR pathway, and specifically the application and potential utility of natural agents involved in PC treatment is described. In addition to the small-molecule mTOR inhibitors, there are evidence that several natural agents are able to target the PI3K/Akt/mTOR pathway in prostatic neoplasms. These natural mTOR inhibitors can interfere with the PI3K/Akt/mTOR pathway through multiple mechanisms; however, inhibition of Akt and suppression of mTOR 1 activity are two major therapeutic approaches. Combination therapy improves the efficacy of these inhibitors to either suppress the PC progression or circumvent the resistance by cancer cells.
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Gala K, Desai V, Liu N, Omer EM, McClave SA. How to Increase Muscle Mass in Critically Ill Patients: Lessons Learned from Athletes and Bodybuilders. Curr Nutr Rep 2021; 9:369-380. [PMID: 33098051 DOI: 10.1007/s13668-020-00334-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Decades of research on nutrition and exercise on athletes and bodybuilders has yielded various strategies to promote anabolism and improve muscle health and growth. We reviewed these interventions in the context of muscle loss in critically ill patients. RECENT FINDINGS For critically ill patients, ensuring optimum protein intake is important, potentially using a whey-containing source and supplemented with vitamin D and leucine. Agents like hydroxyl β-methylbutyrate and creatine can be used to promote muscle synthesis. Polyunsaturated fatty acids stimulate muscle production as well as have anti-inflammatory properties that may be useful in critical illness. Adjuncts like oxandralone promote anabolism. Resistance training has shown mixed results in the ICU setting but needs to be explored further with specific outcomes. Critically ill patients suffer from severe proteolysis during hospitalization as well as persistent inflammation, immunosuppression, and catabolism syndrome after discharge. High protein supplementation, ergogenic aids, anti-inflammatories, and anabolic adjuncts have shown potential in alleviating muscle loss and should be used in intensive care units to optimize patient recovery.
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Affiliation(s)
- Khushboo Gala
- Department of Internal Medicine, University of Louisville, 550 S Jackson Street, 3rd Floor, Ambulatory Care Building, Louisville, KY, 40202, USA.
| | - Viral Desai
- Department of Internal Medicine, University of Louisville, 550 S Jackson Street, 3rd Floor, Ambulatory Care Building, Louisville, KY, 40202, USA
| | - Nanlong Liu
- Department of Gastroenterology and Hepatology, University of Louisville, Louisville, KY, USA
| | - Endashaw M Omer
- Department of Gastroenterology and Hepatology, University of Louisville, Louisville, KY, USA
| | - Stephen A McClave
- Department of Gastroenterology and Hepatology, University of Louisville, Louisville, KY, USA
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Peripheral Blood T Cell Gene Expression Responses to Exercise and HMB in Sarcopenia. Nutrients 2021; 13:nu13072313. [PMID: 34371826 PMCID: PMC8308783 DOI: 10.3390/nu13072313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/21/2021] [Accepted: 06/30/2021] [Indexed: 01/06/2023] Open
Abstract
Background: Sarcopenia is a major health problem in older adults. Exercise and nutrient supplementation have been shown to be effective interventions but there are limited studies to investigate their effects on the management of sarcopenia and its possible underlying mechanisms. Here, we studied T cell gene expression responses to interventions in sarcopenia. Methods: The results of this study were part of a completed trial examining the effectiveness of a 12-week intervention with exercise and nutrition supplementation in community-dwelling Chinese older adults with sarcopenia, based on the available blood samples at baseline and 12 weeks from 46 randomized participants from three study groups, namely: exercise program alone (n = 11), combined-exercise program and nutrition supplement (n = 23), and waitlist control group (n = 12). T cell gene expression was evaluated, with emphasis on inflammation-related genes. Real-time PCR (RT-PCR) was performed on CD3 T cells in 38 selected genes. Correlation analysis was performed to relate the results of gene expression analysis with lower limb muscle strength performance, measured using leg extension tests. Results: Our results showed a significant improvement in leg extension for both the exercise program alone and the combined groups (p < 0.001). Nine genes showed significant pre- and post-difference in gene expression over 12 weeks of intervention in the combined group. Seven genes (RASGRP1, BIN1, LEF1, ANXA6, IL-7R, LRRN3, and PRKCQ) showed an interaction effect between intervention and gene expression levels on leg extension in the confirmatory analysis, with confounder variables controlled and FDR correction. Conclusions: Our findings showed that T cell-specific inflammatory gene expression was changed significantly after 12 weeks of intervention with combined exercise and HMB supplementation in sarcopenia, and that this was associated with lower limb muscle strength performance.
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Why Are Masters Sprinters Slower Than Their Younger Counterparts? Physiological, Biomechanical, and Motor Control Related Implications for Training Program Design. J Aging Phys Act 2021; 29:708-719. [PMID: 33450731 DOI: 10.1123/japa.2020-0302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/08/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022]
Abstract
Elite sprint performances typically peak during an athlete's 20s and decline thereafter with age. The mechanisms underpinning this sprint performance decline are often reported to be strength-based in nature with reductions in strength capacities driving increases in ground contact time and decreases in stride lengths and frequency. However, an as-of-yet underexplored aspect of Masters sprint performance is that of age-related degradation in neuromuscular infrastructure, which manifests as a decline in both strength and movement coordination. Here, the authors explore reductions in sprint performance in Masters athletes in a holistic fashion, blending discussion of strength and power changes with neuromuscular alterations along with mechanical and technical age-related alterations. In doing so, the authors provide recommendations to Masters sprinters-and the aging population, in general-as to how best to support sprint ability and general function with age, identifying nutritional interventions that support performance and function and suggesting useful programming strategies and injury-reduction techniques.
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15
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The 4R's Framework of Nutritional Strategies for Post-Exercise Recovery: A Review with Emphasis on New Generation of Carbohydrates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010103. [PMID: 33375691 PMCID: PMC7796021 DOI: 10.3390/ijerph18010103] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022]
Abstract
Post-exercise recovery is a broad term that refers to the restoration of training capacity. After training or competition, there is fatigue accumulation and a reduction in sports performance. In the hours and days following training, the body recovers and performance is expected to return to normal or improve. ScienceDirect, PubMed/MEDLINE, and Google Scholar databases were reviewed to identify studies and position declarations examining the relationship between nutrition and sports recovery. As an evidence-based framework, a 4R’s approach to optimizing post-exercise recovery was identified: (i) Rehydration—a fundamental process that will depend on the athlete, environment and sports event; (ii) Refuel—the consumption of carbohydrates is not only important to replenish the glycogen reserves but also to contribute to the energy requirements for the immune system and tissue reparation. Several bioengineered carbohydrates were discussed but further research is needed; (iii) Repair—post-exercise ingestion of high-quality protein and creatine monohydrate benefit the tissue growth and repair; and (iv) Rest—pre-sleep nutrition has a restorative effect that facilitates the recovery of the musculoskeletal, endocrine, immune, and nervous systems. Nutritional consultancy based on the 4R’s is important for the wise stewardship of the hydration, feeding, and supplementation strategies to achieve a timely recovery.
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LÓpez-Laval I, Mielgo-Ayuso J, Terrados N, Calleja-GonzÁlez J. Evidence-based post exercise recovery in combat sports: a narrative review. J Sports Med Phys Fitness 2020; 61:386-400. [PMID: 33092328 DOI: 10.23736/s0022-4707.20.11341-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Some methods such as ergo nutritional aids, cooling or massage among others could improve recovery in combat sports (CS). The effects, doses, duration, and timing of these methods remains unknown. Nowadays, there is no clear consensus regarding the recovery strategies and it is necessary to understand the type of fatigue induced in CS and its underlying mechanisms. The main aim of this article is to review the update literature related to recovery strategies in CS. EVIDENCE ACQUISITION A literature search was conducted following preferred reporting items for review statement on the topic of: "combat sports," "recovery," "nutrition," "fatigue," "ergogenic aids," "weight cutting" and "hydration." EVIDENCE SYNTHESIS The initial search of the literature detected 369 articles about CS. Later, 307 were excluded after being determined unrelated to recovery or after failure to fulfill the inclusion criteria. Of the 80 included articles, 19 satisfied the final inclusion criteria. CONCLUSIONS To optimize CS performance, adequate recovery is required during training and competition processes. Traditional ergo nutritional supplementation of carbohydrates and proteins combined. Besides, the consumption of evidence supported supplementation (green tea, beetroot gels, creatine or alkaline water) improve recovery processes. Further methods of recovery including physical (cold water immersion, massage or photobiomodulation) and physiological (types of active recovery, sleep and rest) therapies have also been shown useful. This narrative review elucidates the important role of recovery techniques in CS.
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Affiliation(s)
- Isaac LÓpez-Laval
- Department of Physiatry and Nursing, Faculty of Health and Sport Science, University of Zaragoza, Huesca, Spain -
| | - Juan Mielgo-Ayuso
- Department of Biochemistry and Physiology, School of Physical Therapy, University of Valladolid, Soria, Spain
| | - Nicolás Terrados
- Department of Health Sciences, University of Burgos, Burgos, Spain
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Tobias DK, Hazra A, Lawler PR, Chandler PD, Chasman DI, Buring JE, Lee IM, Cheng S, Manson JE, Mora S. Circulating branched-chain amino acids and long-term risk of obesity-related cancers in women. Sci Rep 2020; 10:16534. [PMID: 33024201 PMCID: PMC7539150 DOI: 10.1038/s41598-020-73499-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/28/2020] [Indexed: 02/07/2023] Open
Abstract
Obesity is a risk factor for > 13 cancer sites, although it is unknown whether there is a common mechanism across sites. Evidence suggests a role for impaired branched-chain amino acid (BCAAs; isoleucine, leucine, valine) metabolism in obesity, insulin resistance, and immunity; thus, we hypothesized circulating BCAAs may be associated with incident obesity-related cancers. We analyzed participants in the prospective Women’s Health Study without a history of cancer at baseline blood collection (N = 26,711, mean age = 54.6 years [SD = 7.1]). BCAAs were quantified via NMR spectroscopy, log-transformed, and standardized. We used Cox proportional regression models adjusted for age, race, smoking, diet, alcohol, physical activity, menopausal hormone use, Body Mass Index (BMI), diabetes, and other risk factors. The endpoint was a composite of obesity-related cancers, defined per the International Agency for Research on Cancer 2016 report, over a median 24 years follow-up. Baseline BMI ≥ 30 kg/m2 compared with BMI 18.5–25.0 kg/m2 was associated with 23% greater risk of obesity-related cancers (n = 2751 events; multivariable HR 1.23, 95% CI 1.11–1.37). However, BCAAs were not associated with obesity-related cancers (multivariable HR per SD = 1.01 [0.97–1.05]). Results for individual BCAA metabolites suggested a modest association for leucine with obesity-related cancers (1.04 [1.00–1.08]), and no association for isoleucine or valine (0.99 [0.95–1.03] and 1.00 [0.96–1.04], respectively). Exploratory analyses of BCAAs with individual sites included positive associations between leucine and postmenopausal breast cancer, and isoleucine with pancreatic cancer. Total circulating BCAAs were unrelated to obesity-related cancer incidence although an association was observed for leucine with incident obesity-related cancer.
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Affiliation(s)
- Deirdre K Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Aditi Hazra
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Patrick R Lawler
- Peter Munk Cardiac Centre, University Health Network, and Heart and Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada
| | - Paulette D Chandler
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan Cheng
- Division of Cardiovascular Medicine, Department of Medicine, Center for Lipid Metabolomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Barbra Streisand Women's Heart Center and Smidt Heart Institute at Cedars-Sinai, Los Angeles, CA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Mary Horrigan Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Samia Mora
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02215, USA.,Division of Cardiovascular Medicine, Department of Medicine, Center for Lipid Metabolomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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β-hydroxy-β-methylbutyrate supplementation benefits the effects of resistance training on body fat reduction via increased irisin expression in white adipose tissue. Biol Sport 2020; 38:113-121. [PMID: 33795920 PMCID: PMC7996383 DOI: 10.5114/biolsport.2020.97671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 05/01/2020] [Accepted: 07/21/2020] [Indexed: 12/25/2022] Open
Abstract
The effects of resistance training (RT) associated with calcium β-hydroxyβ-methylbutyrate (CaHMB) supplementation on the body composition and gene expression of cytokines related to skeletal muscle hypertrophy and adipose tissue metabolism were studied in rats. Male Wistar rats were divided into four groups of 12 animals: sedentary control (SC); sedentary supplemented (SS); resistance training control (RTC) and resistance training supplemented (RTS). Rats from RTC and RTS groups were submitted to an RT programme and those from SS and RTS groups received 1 mL of CaHMB (320 mg kg-1 day-1) by gavage, for 8 weeks. We evaluated: body composition; plasma lipid profile; the gene expression of interleukin (IL)-6, IL-10, IL-15 and fibronectin type III domain-containing protein 5 (FNDC-5) in skeletal muscle, and IL-6, mitochondrial uncoupling protein 1 (UCP-1) in white adipose tissue (WAT); and the concentration of irisin in WAT. Compared to RTC alone, the combination of CaHMB with RT (RTS) further reduced abdominal circumference (5.3%), Lee index (2.4%), fat percentage (24.4%), plasma VLDL cholesterol (16.8%) and triglycerides (17%) and increased the gene expression of FNDC-5 (78.9%) and IL-6 (47.4%) in skeletal muscle and irisin concentration (26.9%) in WAT. Neither RT nor CaHMB affected the protein percentage or the gene expression of IL-6 and UCP-1 in WAT and IL-10, IL-15 in skeletal muscle. In conclusion, CaHMB supplementation increased the beneficial effects of RT on body fat reduction and was associated with muscular genic expression of IL-6 and FNDC-5 and irisin concentration in WAT, despite the lack of change in protein mass and maximal strength.
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Jakubowski JS, Nunes EA, Teixeira FJ, Vescio V, Morton RW, Banfield L, Phillips SM. Supplementation with the Leucine Metabolite β-hydroxy-β-methylbutyrate (HMB) does not Improve Resistance Exercise-Induced Changes in Body Composition or Strength in Young Subjects: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12051523. [PMID: 32456217 PMCID: PMC7285233 DOI: 10.3390/nu12051523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 01/11/2023] Open
Abstract
β-hydroxy-β-methylbutyrate (HMB) is a leucine metabolite that is purported to increase fat-free mass (FFM) gain and performance in response to resistance exercise training (RET). The aim of this systematic review and meta-analysis was to determine the efficacy of HMB supplementation in augmenting FFM and strength gains during RET in young adults. Outcomes investigated were: total body mass (TBM), FFM, fat mass (FM), total single repetition maximum (1RM), bench press (BP) 1RM, and lower body (LwB) 1RM. Databases consulted were: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica database (Embase), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SportDiscus. Fourteen studies fit the inclusion criteria; however, 11 were analyzed after data extraction and funnel plot analysis exclusion. A total of 302 participants (18-45 y) were included in body mass and composition analysis, and 248 were included in the strength analysis. A significant effect was found on TBM. However, there were no significant effects for FFM, FM, or strength outcomes. We conclude that HMB produces a small effect on TBM gain, but this effect does not translate into significantly greater increases in FFM, strength or decreases in FM during periods of RET. Our findings do not support the use of HMB aiming at improvement of body composition or strength with RET.
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Affiliation(s)
- Josephine S. Jakubowski
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.S.J.); (E.A.N.); (V.V.); (R.W.M.)
| | - Everson A. Nunes
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.S.J.); (E.A.N.); (V.V.); (R.W.M.)
- Department of Physiological Sciences, Federal University of Santa Catarina, Florianópolis, SC 88040-900, Brazil
| | - Filipe J. Teixeira
- CBIOS—Universidade Lusófona’s Research Center for Biosciences and Health Technologies, Campo Grande, 1749 024 Lisboa, Portugal;
| | - Victoria Vescio
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.S.J.); (E.A.N.); (V.V.); (R.W.M.)
| | - Robert W. Morton
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.S.J.); (E.A.N.); (V.V.); (R.W.M.)
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Stuart M. Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.S.J.); (E.A.N.); (V.V.); (R.W.M.)
- Correspondence: ; Tel.: +1-905-525-9140 (ext. 24465)
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Gonzalez AM, Church DD, Townsend JR, Bagheri R. Emerging Nutritional Supplements for Strength and Hypertrophy: An Update of the Current Literature. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Fernández-Landa J, Fernández-Lázaro D, Calleja-González J, Caballero-García A, Córdova Martínez A, León-Guereño P, Mielgo-Ayuso J. Effect of Ten Weeks of Creatine Monohydrate Plus HMB Supplementation on Athletic Performance Tests in Elite Male Endurance Athletes. Nutrients 2020; 12:nu12010193. [PMID: 31936727 PMCID: PMC7019716 DOI: 10.3390/nu12010193] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 01/09/2023] Open
Abstract
Creatine monohydrate (CrM) and β-hydroxy β-methylbutyrate (HMB) are common ergogenic aids in the field of sports and are frequently used in an isolated way. However, there are a few studies that have investigated the effect of combining both supplements on different variables related to performance, with controversial results. Therefore, the main purpose of this study was to determine the efficacy and the degree of potentiation of 10 weeks of CrM plus HMB supplementation on sports performance, which was measured by an incremental test to exhaustion in elite male traditional rowers. In this placebo-controlled, double-blind trial, 10-week study, participants (n = 28) were randomized to a placebo group (PLG; n = 7), CrM group (0.04 g/kg/day of CrM; n = 7), HMB group (3 g/day of HMB; n = 7) and CrM-HMB group (0.04 g/kg/day of CrM plus 3 g/day of HMB; n = 7). Before and after 10 weeks of different treatments, an incremental test was performed on a rowing ergometer to calculate the power that each rower obtained at the anaerobic threshold (WAT), and at 4 mmol (W4) and 8 mmol (W8) of blood lactate concentration. There were no significant differences in WAT and W4 among groups or in body composition. However, it was observed that the aerobic power achieved at W8 was significantly higher in the CrM-HMB group than in the PLG, CrM and HMB groups (p < 0.001; η2p = 0.766). Likewise, a synergistic effect of combined supplementation was found for the sum of the two supplements separately at WAT (CrM-HMBG = 403.19% vs. CrMG+HMBG = 337.52%), W4 (CrM-HMBG = 2736.17% vs. CrMG+HMBG = 1705.32%) and W8 (CrM-HMBG = 1293.4% vs. CrMG+HMBG = 877.56%). In summary, CrM plus HMB supplementation over 10 weeks showed a synergistic effect on aerobic power (measured as WAT, W4, and W8) during an incremental test but had no influence muscle mass.
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Affiliation(s)
- Julen Fernández-Landa
- Laboratory of Human Performance, Department of Physical Education and Sport, Faculty of Education, Sport Section, University of the Basque Country, 01007 Vitoria, Spain; (J.F.-L.); (J.C.-G.)
| | - Diego Fernández-Lázaro
- Department of Cellular Biology, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, Campus de Soria, 42003 Soria, Spain;
| | - Julio Calleja-González
- Laboratory of Human Performance, Department of Physical Education and Sport, Faculty of Education, Sport Section, University of the Basque Country, 01007 Vitoria, Spain; (J.F.-L.); (J.C.-G.)
| | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, University of Valladolid, Campus de Soria, 42003 Soria, Spain;
| | - Alfredo Córdova Martínez
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, University of Valladolid, Campus de Soria, 42003 Soria, Spain;
| | - Patxi León-Guereño
- Faculty of Psychology and Education, University of Deusto, Campus of Donostia-San Sebastián, 20012 San Sebastián, Guipúzcoa, Spain;
| | - Juan Mielgo-Ayuso
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, University of Valladolid, Campus de Soria, 42003 Soria, Spain;
- Correspondence: ; Tel.: +34-975-129-187
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22
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Watkins BA. Nutrition Research: new direction and scope are refining the Journal. Nutr Res 2020; 71:1-7. [PMID: 31896395 DOI: 10.1016/j.nutres.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 12/11/2018] [Accepted: 12/20/2018] [Indexed: 11/17/2022]
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23
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Holland BM, Roberts BM, Krieger JW, Schoenfeld BJ. Does HMB Enhance Body Composition in Athletes? A Systematic Review and Meta-analysis. J Strength Cond Res 2019; 36:585-592. [DOI: 10.1519/jsc.0000000000003461] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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24
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Tinsley GM, Moore ML, Graybeal AJ, Paoli A, Kim Y, Gonzales JU, Harry JR, VanDusseldorp TA, Kennedy DN, Cruz MR. Time-restricted feeding plus resistance training in active females: a randomized trial. Am J Clin Nutr 2019; 110:628-640. [PMID: 31268131 PMCID: PMC6735806 DOI: 10.1093/ajcn/nqz126] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/10/2019] [Accepted: 05/31/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND A very limited amount of research has examined intermittent fasting (IF) programs, such as time-restricted feeding (TRF), in active populations. OBJECTIVE Our objective was to examine the effects of TRF, with or without β-hydroxy β-methylbutyrate (HMB) supplementation, during resistance training (RT). METHODS This study employed a randomized, placebo-controlled, reduced factorial design and was double-blind with respect to supplementation in TRF groups. Resistance-trained females were randomly assigned to a control diet (CD), TRF, or TRF plus 3 g/d HMB (TRFHMB). TRF groups consumed all calories between 1200 h and 2000 h, whereas the CD group ate regularly from breakfast until the end of the day. All groups completed 8 wk of supervised RT and consumed supplemental whey protein. Body composition, muscular performance, dietary intake, physical activity, and physiological variables were assessed. Data were analyzed prior to unblinding using mixed models and both intention-to-treat (ITT) and per protocol (PP) frameworks. RESULTS Forty participants were included in ITT, and 24 were included in PP. Energy and protein intake (1.6 g/kg/d) did not differ between groups despite different feeding durations (TRF and TRFHMB: ∼7.5 h/d; CD: ∼13 h/d). Comparable fat-free mass (FFM) accretion (+2% to 3% relative to baseline) and skeletal muscle hypertrophy occurred in all groups. Differential effects on fat mass (CD: +2%; TRF: -2% to -4%; TRFHMB: -4% to -7%) were statistically significant in the PP analysis, but not ITT. Muscular performance improved without differences between groups. No changes in physiological variables occurred in any group, and minimal side effects were reported. CONCLUSIONS IF, in the form of TRF, did not attenuate RT adaptations in resistance-trained females. Similar FFM accretion, skeletal muscle hypertrophy, and muscular performance improvements can be achieved with dramatically different feeding programs that contain similar energy and protein content during RT. Supplemental HMB during fasting periods of TRF did not definitively improve outcomes. This study was prospectively registered at clinicaltrials.gov as NCT03404271.
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Affiliation(s)
- Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA,Address correspondence to GMT (e-mail: )
| | - M Lane Moore
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Austin J Graybeal
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Youngdeok Kim
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Joaquin U Gonzales
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - John R Harry
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Devin N Kennedy
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Megan R Cruz
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
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25
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Efficacy of Nutritional Interventions as Stand-Alone or Synergistic Treatments with Exercise for the Management of Sarcopenia. Nutrients 2019; 11:nu11091991. [PMID: 31443594 PMCID: PMC6770476 DOI: 10.3390/nu11091991] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/20/2019] [Accepted: 08/20/2019] [Indexed: 12/13/2022] Open
Abstract
Sarcopenia is an age-related and accelerated process characterized by a progressive loss of muscle mass and strength/function. It is a multifactorial process associated with several adverse outcomes including falls, frailty, functional decline, hospitalization, and mortality. Hence, sarcopenia represents a major public health problem and has become the focus of intense research. Unfortunately, no pharmacological treatments are yet available to prevent or treat this age-related condition. At present, the only strategies for the management of sarcopenia are mainly based on nutritional and physical exercise interventions. The purpose of this review is, thus, to provide an overview on the role of proteins and other key nutrients, alone or in combination with physical exercise, on muscle parameters.
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26
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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 2019; 68:211-222. [PMID: 31531146 PMCID: PMC6724588 DOI: 10.2478/hukin-2019-0070] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Beta-hydroxy-beta-methylbutyrate (HMB) has been used extensively as a dietary supplement for athletes and physically active people. HMB is a leucine metabolite, which is one of three branched chain amino acids. HMB plays multiple roles in the human body of which most important ones include protein metabolism, insulin activity and skeletal muscle hypertrophy. The ergogenic effects of HMB supplementation are related to the enhancement of sarcolemma integrity, inhibition of protein degradation (ubiquitin pathway), decreased cell apoptosis, increased protein synthesis (mTOR pathway), stimulation of the growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis and enhancement of muscle stem cells proliferation and differentiation. HMB supplementation has been carried out with various groups of athletes. In endurance and martial arts athletes, HMB supplementation revealed positive effects on specific aerobic capacity variables. Positive results were also disclosed in resistance trained athletes, where changes in strength, body fat and muscle mass as well as anaerobic performance and power output were observed. The purpose of this review was to present the main mechanisms of HMB action, especially related to muscle protein synthesis and degradation, and ergogenic effects on different types of sports and physical activities.
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27
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Teixeira FJ, Matias CN, Monteiro CP, Valamatos MJ, Reis JF, Tavares F, Batista A, Domingos C, Alves F, Sardinha LB, Phillips SM. Leucine Metabolites Do Not Enhance Training-induced Performance or Muscle Thickness. Med Sci Sports Exerc 2019; 51:56-64. [PMID: 30102677 DOI: 10.1249/mss.0000000000001754] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Leucine metabolites, α-hydroxyisocaproic acid (α-HICA) and β-hydroxy-β-methylbutyrate (calcium, HMB-Ca and free acid, HMB-FA), have been proposed to augment resistance training-induced changes in body composition and performance. PURPOSE We aimed to conduct a double-blind randomized controlled pragmatic trial to evaluate the effects of off-the-shelf leucine metabolite supplements of α-HICA, HMB-FA, and HMB-Ca on resistance training-induced changes in muscle thickness and performance. METHODS Forty men were randomly assigned to receive α-HICA (n = 10, fat-free mass [FFM] = 62.0 ± 7.1 kg), HMB-FA (n = 11, FFM = 62.7 ± 10.5 kg), HMB-Ca (n = 9, FFM = 65.6 ± 10.1 kg), or placebo (PLA; n = 10, FFM = 64.2 ± 5.7 kg). The training program consisted of whole body thrice weekly resistance training for 8 wk (seven exercises per session, three to four sets per session, at 70%-80% one repetition maximum). Skeletal muscle thickness by ultrasound, performance measures, and blood measures (creatine kinase, insulin-like growth factor 1, growth hormone, cortisol, and total testosterone) were evaluated at baseline and at the end of weeks 4 and 8. RESULTS Time-dependent changes were observed for muscle thickness (P < 0.001), one repetition maximum bench press and squat (P < 0.001), Wingate peak power (P = 0.02), countermovement jump height (P = 0.03), power (P = 0.006), creatine kinase, insulin-like growth factor-1, growth hormone, and cortisol (all P < 0.001). No significant between-group or time-group interactions were observed. CONCLUSIONS No leucine metabolite resulted in any ergogenic effects on any outcome variable. Supplementation with leucine metabolites-α-HICA, HMB-FA, or HMB-Ca-is not a supplementation strategy that improves muscle growth and strength development in young adult men.
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Affiliation(s)
- Filipe J Teixeira
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL
| | - Catarina N Matias
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL.,Laboratory of Exercise and Health, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL.,Center for the Study of Human Performance, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL
| | - Cristina P Monteiro
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL.,Center for the Study of Human Performance, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL
| | - Maria J Valamatos
- Center for the Study of Human Performance, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL.,Neuromuscular Research Lab, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL
| | - Joana F Reis
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL.,Center for the Study of Human Performance, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL.,Faculty of Health and Sports, Universidade Europeia, Laureate International Universities, Lisboa, PORTUGAL
| | - Francisco Tavares
- Faculty of Health, Sport and Human Performance, The University of Waikato, Hamilton, NEW ZEALAND
| | - Ana Batista
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL
| | - Christophe Domingos
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL
| | - Francisco Alves
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL.,Center for the Study of Human Performance, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL
| | - Luís B Sardinha
- Laboratory of Exercise and Health, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL.,Center for the Study of Human Performance, Faculty of Human Kinetics, Universidade de Lisboa, Cruz Quebrada, PORTUGAL
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, CANADA
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Oktaviana J, Zanker J, Vogrin S, Duque G. The Effect of β-hydroxy-β-methylbutyrate (HMB) on Sarcopenia and Functional Frailty in Older Persons: A Systematic Review. J Nutr Health Aging 2019; 23:145-150. [PMID: 30697623 DOI: 10.1007/s12603-018-1153-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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.
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Affiliation(s)
- J Oktaviana
- Prof. Gustavo Duque, MD, Ph.D., FRACP, FGSA, Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, Australia 3021,Tel: +61 3 8395 8121,
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29
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Landi F, Calvani R, Picca A, Marzetti E. Beta-hydroxy-beta-methylbutyrate and sarcopenia: from biological plausibility to clinical evidence. Curr Opin Clin Nutr Metab Care 2019; 22:37-43. [PMID: 30489401 DOI: 10.1097/mco.0000000000000524] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Given the role of leucine as a major regulator of muscle protein turnover, the consumption of protein sources enhanced with this essential amino acid, or its metabolite beta-hydroxy-beta-methylbutyrate (HMB), is assumed to give the greatest benefit in terms of maintenance of muscle mass and function during aging. The aim of this review is to discuss recent literature about HMB metabolism, its pharmacokinetics compared with the metabolite leucine, effectiveness of HMB to improve outcomes in older adults, and novel approaches for HMB use. RECENT FINDINGS Overall, this review article highlights the potential relationship between HMB dietary supplementation and parameters related to maintenance of muscle mass and strength in older people. However, there are limitations in the studies conducted so far, including low number of participants per study group, heterogeneity of study designs, methodologies, and outcomes. The combination of HMB with other amino acids or supplements limits the ability to determine the direct impact of HMB alone. SUMMARY It is proposed that HMB may be utilized to protect or rebuild muscle mass in older people with reduced lean body mass.
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Affiliation(s)
- Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Teaching Hospital 'Fondazione Policlinico Agostino Gemelli' IRCCS at the Catholic University of the Sacred Heart, Rome, Italy
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30
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Teixeira FJ, Matias CN, Monteiro CP, Valamatos MJ, Reis JF, Batista A, Oliveira AC, Alves F, Sardinha LB, Phillips SM. No effect of HMB or α-HICA supplementation on training-induced changes in body composition. Eur J Sport Sci 2018; 19:802-810. [PMID: 30588860 DOI: 10.1080/17461391.2018.1552723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
β-hydroxy-β-methylbutyrate (calcium: HMB-Ca and free acid: HMB-FA) and α-hydroxyisocaproic acid (α-HICA) are leucine metabolites that have been proposed to improve body composition and strength when combined with resistance exercise training (RET). In this double-blind randomized controlled pragmatic trial, we evaluated the effects of off-the-shelf supplements: α-HICA, HMB-FA and HMB-Ca, on RET-induced changes in body composition and performance. Forty men were blocked randomized to receive α-HICA (n = 10, fat-free mass [FFM] = 62.0 ± 7.1 kg), HMB-FA (n = 11, FFM = 62.7 ± 10.5 kg), HMB-Ca (n = 9, FFM = 65.6 ± 10.1 kg) or placebo (PLA; n = 10, FFM = 64.2 ± 5.7 kg). The training protocol consisted of a whole-body resistance training routine, thrice weekly for 8 weeks. Body composition was assessed by dual-energy x-ray absorptiometry (DXA) and total body water (TBW) by whole-body bioimpedance spectroscopy (BIS), both at baseline and at the end of weeks 4 and 8. Time-dependent changes were observed for increase in trunk FFM (p < 0.05). No statistically significant between-group or group-by-time interactions were observed. Supplementation with HMB (FA and Ca) or α-HICA failed to enhance body composition to a greater extent than placebo. We do not recommend these leucine metabolites for improving body composition changes with RET in young adult resistance trained men.
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Affiliation(s)
- Filipe J Teixeira
- a Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal
| | - Catarina N Matias
- a Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal.,b Laboratory of Exercise and Health, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal.,d Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal
| | - Cristina P Monteiro
- a Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal.,d Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal
| | - Maria J Valamatos
- c Neuromuscular Research Lab, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal.,d Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal
| | - Joana F Reis
- a Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal.,d Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal.,e Universidade Europeia , Lisboa , Portugal
| | - Ana Batista
- a Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal
| | - Ana C Oliveira
- f Nutrition Department , Instituto Superior de Ciências da Saúde Egas Moniz , Almada , Portugal
| | - Francisco Alves
- a Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal.,d Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal
| | - Luís B Sardinha
- b Laboratory of Exercise and Health, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal.,d Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics , Universidade de Lisboa , Cruz Quebrada , Portugal
| | - Stuart M Phillips
- g Department of Kinesiology , McMaster University , Hamilton , Canada
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31
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McIntosh ND, Love TD, Haszard JJ, Osborne HR, Black KE. Response to Effects of Reactiv "Maximum Beta-Hydroxy Beta-Methylbutyrate" on Body Mass and Performance in Elite Male Rugby Players. J Strength Cond Res 2018; 32:e59. [PMID: 30480656 DOI: 10.1519/jsc.0000000000002921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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32
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Gepner Y, Varanoske AN, Boffey D, Hoffman JR. Benefits of β-hydroxy-β-methylbutyrate supplementation in trained and untrained individuals. Res Sports Med 2018; 27:204-218. [PMID: 30348016 DOI: 10.1080/15438627.2018.1533470] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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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Affiliation(s)
- Yftach Gepner
- a Institute of Exercise Physiology and Wellness, Sport and Exercise Science , University of Central Florida , Orlando , FL , USA
| | - Alyssa N Varanoske
- a Institute of Exercise Physiology and Wellness, Sport and Exercise Science , University of Central Florida , Orlando , FL , USA
| | - David Boffey
- a Institute of Exercise Physiology and Wellness, Sport and Exercise Science , University of Central Florida , Orlando , FL , USA
| | - Jay R Hoffman
- a Institute of Exercise Physiology and Wellness, Sport and Exercise Science , University of Central Florida , Orlando , FL , USA
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33
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Arazi H, Taati B, Suzuki K. A Review of the Effects of Leucine Metabolite (β-Hydroxy-β-methylbutyrate) Supplementation and Resistance Training on Inflammatory Markers: A New Approach to Oxidative Stress and Cardiovascular Risk Factors. Antioxidants (Basel) 2018; 7:antiox7100148. [PMID: 30347824 PMCID: PMC6210682 DOI: 10.3390/antiox7100148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/03/2018] [Accepted: 10/18/2018] [Indexed: 01/03/2023] Open
Abstract
β-hydroxy β-methylbutyrate (HMB) is a bioactive metabolite formed from the breakdown of the branched-chain amino acid, leucine. Given the popularity of HMB supplements among different athletes, specifically, those who participate in regular resistance training, this review was performed to summarize current literature on some aspects of HMB supplementation that have received less attention. Because of the small number of published studies, it has not been possible to conclude the exact effects of HMB on cardiovascular parameters, oxidative stress, and inflammatory markers. Thus, the interpretation of outcomes should be taken cautiously. However, the data presented here suggest that acute HMB supplementation may attenuate the pro-inflammatory response following an intense bout of resistance exercise in athletes. Also, the available findings collectively indicate that chronic HMB consumption with resistance training does not improve cardiovascular risk factors and oxidative stress markers greater than resistance training alone. Taken together, there is clearly a need for further well-designed, long-term studies to support these findings and determine whether HMB supplementation affects the adaptations induced by resistance training associated with the body’s inflammatory condition, antioxidative defense system, and cardiovascular risk factors in humans.
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Affiliation(s)
- Hamid Arazi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht 4199843653, Iran.
| | - Behzad Taati
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht 4199843653, Iran.
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan.
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Kerksick CM, Wilborn CD, Roberts MD, Smith-Ryan A, Kleiner SM, Jäger R, Collins R, Cooke M, Davis JN, Galvan E, Greenwood M, Lowery LM, Wildman R, Antonio J, Kreider RB. ISSN exercise & sports nutrition review update: research & recommendations. J Int Soc Sports Nutr 2018; 15:38. [PMID: 30068354 PMCID: PMC6090881 DOI: 10.1186/s12970-018-0242-y] [Citation(s) in RCA: 375] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/17/2018] [Indexed: 12/18/2022] Open
Abstract
Background Sports nutrition is a constantly evolving field with hundreds of research papers published annually. In the year 2017 alone, 2082 articles were published under the key words ‘sport nutrition’. Consequently, staying current with the relevant literature is often difficult. Methods This paper is an ongoing update of the sports nutrition review article originally published as the lead paper to launch the Journal of the International Society of Sports Nutrition in 2004 and updated in 2010. It presents a well-referenced overview of the current state of the science related to optimization of training and performance enhancement through exercise training and nutrition. Notably, due to the accelerated pace and size at which the literature base in this research area grows, the topics discussed will focus on muscle hypertrophy and performance enhancement. As such, this paper provides an overview of: 1.) How ergogenic aids and dietary supplements are defined in terms of governmental regulation and oversight; 2.) How dietary supplements are legally regulated in the United States; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of nutritional approaches to augment skeletal muscle hypertrophy and the potential ergogenic value of various dietary and supplemental approaches. Conclusions This updated review is to provide ISSN members and individuals interested in sports nutrition with information that can be implemented in educational, research or practical settings and serve as a foundational basis for determining the efficacy and safety of many common sport nutrition products and their ingredients.
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Affiliation(s)
- Chad M Kerksick
- Exercise and Performance Nutrition Laboratory, School of Health Sciences, Lindenwood University, St. Charles, MO, USA.
| | - Colin D Wilborn
- Exercise & Sport Science Department, University of Mary-Hardin Baylor, Belton, TX, USA
| | | | - Abbie Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Rick Collins
- Collins Gann McCloskey and Barry PLLC, Mineola, NY, USA
| | - Mathew Cooke
- Department of Health and Medical Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jaci N Davis
- Exercise & Sport Science Department, University of Mary-Hardin Baylor, Belton, TX, USA
| | - Elfego Galvan
- University of Texas Medical Branch, Galveston, TX, USA
| | - Mike Greenwood
- Exercise & Sports Nutrition Lab, Human Clinical Research Facility, Texas A&M University, College Station, TX, USA
| | - Lonnie M Lowery
- Department of Human Performance & Sport Business, University of Mount Union, Alliance, OH, USA
| | | | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL, USA
| | - Richard B Kreider
- Exercise & Sports Nutrition Lab, Human Clinical Research Facility, Texas A&M University, College Station, TX, USA.
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Correia ALM, de Lima FD, Bottaro M, Vieira A, da Fonseca AC, Lima RM. Pre-exercise β-hydroxy-β-methylbutyrate free-acid supplementation improves work capacity recovery: a randomized, double-blinded, placebo-controlled study. Appl Physiol Nutr Metab 2018; 43:691-696. [PMID: 29420925 DOI: 10.1139/apnm-2017-0867] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The purpose of this study was to investigate the effects of a single-dose of β-hydroxy-β-methylbutyrate free acid (HMB-FA) supplementation on muscle recovery after a high-intensity exercise bout. Twenty-three trained young males were randomly assigned to receive either a single-dose supplementation of 3 g of HMB-FA (n = 12; age, 22.8 ± 3.0 years) or placebo (PLA; n = 11; age, 22.9 ± 3.1 years). A muscle damage protocol was applied 60 min after supplementation, and consisted of 7 sets of 20 drop jumps from a 60-cm box with 2-min rest intervals between sets. Muscle swelling, countermovement jump (CMJ), maximal voluntary isometric torque (MVIT), and work capacity (WC) were measured before, immediately after, and 24, 48, and 72 h after the exercise protocol. Muscle swelling, CMJ, and MVIT changed similarly in both groups after the exercise protocol (p < 0.001), but returned to pre-exercise levels after 24 h in both groups. WC decreased similarly in both groups after the exercise protocol (p < 0.01). For HMB-FA, WC returned to pre-exercise level 24 h after exercise protocol. However, for PLA, WC did not return to pre-exercise level even 72 h after the exercise protocol. In summary, a single-dose of HMB-FA supplementation improved WC recovery after a high-intensity exercise bout. However, HMB-FA did not affect the time-course of muscle swelling, MVIT, and CMJ recovery.
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Affiliation(s)
| | - Filipe Dinato de Lima
- b College of Health Sciences, University of Brasília, Brasília - DF, 70910-900, Brazil
| | - Martim Bottaro
- a College of Physical Education, University of Brasília, Brasília - DF, 70910-900, Brazil
| | - Amilton Vieira
- a College of Physical Education, University of Brasília, Brasília - DF, 70910-900, Brazil
| | | | - Ricardo Moreno Lima
- a College of Physical Education, University of Brasília, Brasília - DF, 70910-900, Brazil
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Effects of β-Hydroxy-β-methylbutyrate-free Acid Supplementation on Strength, Power and Hormonal Adaptations Following Resistance Training. Nutrients 2017; 9:nu9121316. [PMID: 29207472 PMCID: PMC5748766 DOI: 10.3390/nu9121316] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 11/26/2017] [Accepted: 11/29/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND β-Hydroxy-β-methylbutyrate-free acid (HMB-FA) has been ingested prior to exercise to reduce muscle damage, however the effects of HMB-FA supplementation on hormonal, strength and power adaptation are unclear. METHODS Sixteen healthy men were matched and randomized into two groups and performed six-week resistance training while supplementing with either HMB-FA or placebo (3 g per day). The subjects were evaluated for 1 repetition maximum (1RM) bench press and leg press and vertical jump (VJ) prior to and after training intervention. In addition, blood samples were obtained before and after resistance training to evaluate resting growth hormone (GH), insulin like growth factor 1 (IGF-1), testosterone (TEST), cortisol (CORT), and adrenocorticotropic hormone (ACTH) responses. The HMB-FA supplementation group showed greater gains compared with the placebo group in peak power (effect size ES = 0.26 vs. 0.01) and 1RM leg press (ES = 1.52 vs. 0.96). In addition, the HMB-FA supplementation group indicated greater decrements in ACTH and CORT responses to training in comparison to the placebo group (p < 0.05). Likewise, in GH (ES = 1.41 vs. 0.12) and IGF-1 (ES = 0.83 vs. 0.41), the HMB-FA indicated greater training effects when compared with the placebo group. CONCLUSIONS These findings provide further support for the potential anabolic benefits associated with HMB-FA supplementation.
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