1
|
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.
Collapse
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
| |
Collapse
|
2
|
Riviati N, Legiran L, Saleh I, Indrajaya T, Ali Z, Irfannuddin, Probosuseno. Ophiocephalus striatus Extract Supplementation Decreases Serum IL-6 Levels in Older People with Sarcopenia-A Single-Center Experience. Geriatrics (Basel) 2024; 9:35. [PMID: 38525752 PMCID: PMC10961775 DOI: 10.3390/geriatrics9020035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/26/2024] Open
Abstract
Sarcopenia, a condition characterized by muscle loss and decreased function in older adults, is a growing public health concern. This study aimed to investigate the effects of Ophiocephalus striatus extract on insulin-like growth factor-1 serum, interleukin-6 serum levels, and sarcopenia-related parameters in older adults with sarcopenia. This double-blind randomized controlled trial included 80 older adults with sarcopenia. Participants were randomly assigned to receive Ophiocephalus striatus extract or a placebo for two weeks. The IGF-1 serum and IL-6 serum levels were assessed as primary outcomes. The Ophiocephalus striatus extract intervention resulted in a significant reduction in serum IL-6 levels. Although the IGF-1 levels did not show significant changes, there was an increase for the intervention group. This study demonstrated that a 2-week intervention with Ophiocephalus striatus extract positively impacted the serum IL-6 levels in older adults with sarcopenia. While the IGF-1 levels did not change significantly in this short intervention period, the observed improvements in IGF-1, calf circumference, muscle mass, and muscle strength are promising. The findings suggest that Ophiocephalus striatus extract may offer a valuable intervention for managing sarcopenia, particularly in regions with abundant Ophiocephalus striatus production, such as South Sumatera. This study was registered with trial number NCT05869383.
Collapse
Affiliation(s)
- Nur Riviati
- Internal Medicine Department, Medical Faculty, Sriwijaya University, Palembang 30126, Indonesia
| | - Legiran Legiran
- Biomedicine Department, Dr. Mohammad Hoesin Hospital, Faculty of Medicine, Sriwijaya University, Palembang 30139, Indonesia;
| | - Irsan Saleh
- Pharmacology Department, Dr. Mohammad Hoesin Hospital, Faculty of Medicine, Sriwijaya University, Palembang 30139, Indonesia;
| | - Taufik Indrajaya
- Internal Medicine Department, Dr. Mohammad Hoesin Hospital, Faculty of Medicine, Sriwijaya University, Palembang 30139, Indonesia; (T.I.); (Z.A.)
| | - Zulkhair Ali
- Internal Medicine Department, Dr. Mohammad Hoesin Hospital, Faculty of Medicine, Sriwijaya University, Palembang 30139, Indonesia; (T.I.); (Z.A.)
| | - Irfannuddin
- Physiology Department, Dr. Mohammad Hoesin Hospital, Faculty of Medicine, Sriwijaya University, Palembang 30139, Indonesia;
| | - Probosuseno
- Internal Medicine Department, Faculty of Medicine, Gajah Mada University, Yogyakarta 55281, Indonesia;
| |
Collapse
|
3
|
Voulgaridou G, Tyrovolas S, Detopoulou P, Tsoumana D, Drakaki M, Apostolou T, Chatziprodromidou IP, Papandreou D, Giaginis C, Papadopoulou SK. Diagnostic Criteria and Measurement Techniques of Sarcopenia: A Critical Evaluation of the Up-to-Date Evidence. Nutrients 2024; 16:436. [PMID: 38337720 PMCID: PMC10856900 DOI: 10.3390/nu16030436] [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: 01/02/2024] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Sarcopenia, a geriatric syndrome characterized by progressive skeletal muscle mass and function decline, poses a significant health risk among the elderly, contributing to frailty, falls, hospitalization, loss of independence and mortality. The prevalence of sarcopenia varies significantly based on various factors, such as living status, demographics, measurement techniques and diagnostic criteria. Although the overall prevalence is reported at 10% in individuals aged 60 and above, disparities exist across settings, with higher rates in nursing homes and hospitals. Additionally, the differences in prevalence between Asian and non-Asian countries highlight the impact of cultural and ethnic factors, and variations in diagnostic criteria, cut-off values and assessment methods contribute to the observed heterogeneity in reported rates. This review outlines diverse diagnostic criteria and several measurement techniques supporting decision making in clinical practice. Moreover, it facilitates the selection of appropriate tools to assess sarcopenia, emphasizing its multifactorial nature. Various scientific groups, including the European Working Group of Sarcopenia in Older People (EWGSOP), the International Working Group on Sarcopenia (IWGS), the Asian Working Group on Sarcopenia (AWGS), the American Foundation for the National Institutes of Health (FNIH) and the Sarcopenia Definition and Outcomes Consortium (SDOC), have published consensus papers outlining diverse definitions of sarcopenia. The choice of diagnostic criteria should be aligned with the specific objectives of the study or clinical practice, considering the characteristics of the study population and available resources.
Collapse
Affiliation(s)
- Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Stefanos Tyrovolas
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA;
- WHOCC Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, Athanassaki 2, 11526 Athens, Greece
| | - Despoina Tsoumana
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Mariella Drakaki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | | | - Dimitrios Papandreou
- Department of Clinical Nutrition & Dietetics, College of Health, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece;
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| |
Collapse
|
4
|
Rodrigues Junior CF, Murata GM, Gerlinger-Romero F, Nachbar RT, Marzuca-Nassr GN, Gorjão R, Vitzel KF, Hirabara SM, Pithon-Curi TC, Curi R. Changes in Skeletal Muscle Protein Metabolism Signaling Induced by Glutamine Supplementation and Exercise. Nutrients 2023; 15:4711. [PMID: 38004105 PMCID: PMC10674901 DOI: 10.3390/nu15224711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
AIM To evaluate the effects of resistance exercise training (RET) and/or glutamine supplementation (GS) on signaling protein synthesis in adult rat skeletal muscles. METHODS The following groups were studied: (1) control, no exercise (C); (2) exercise, hypertrophy resistance exercise training protocol (T); (3) no exercise, supplemented with glutamine (G); and (4) exercise and supplemented with glutamine (GT). The rats performed hypertrophic training, climbing a vertical ladder with a height of 1.1 m at an 80° incline relative to the horizontal with extra weights tied to their tails. The RET was performed three days a week for five weeks. Each training session consisted of six ladder climbs. The extra weight load was progressively increased for each animal during each training session. The G groups received daily L-glutamine by gavage (one g per kilogram of body weight per day) for five weeks. The C group received the same volume of water during the same period. The rats were euthanized, and the extensor digitorum longus (EDL) muscles from both hind limbs were removed and immediately weighed. Glutamine and glutamate concentrations were measured, and histological, signaling protein contents, and mRNA expression analyses were performed. RESULTS Supplementation with free L-glutamine increased the glutamine concentration in the EDL muscle in the C group. The glutamate concentration was augmented in the EDL muscles from T rats. The EDL muscle mass did not change, but a significant rise was reported in the cross-sectional area (CSA) of the fibers in the three experimental groups. The levels of the phosphorylated proteins (pAkt/Akt, pp70S6K/p70S6K, p4E-BP1/4E-BP1, and pS6/S6 ratios) were significantly increased in EDL muscles of G rats, and the activation of p4E-BP1 was present in T rats. The fiber CSAs of the EDL muscles in T, G, and GT rats were increased compared to the C group. These changes were accompanied by a reduction in the 26 proteasome activity of EDL muscles from T rats. CONCLUSION Five weeks of GS and/or RET induced muscle hypertrophy, as indicated by the increased CSAs of the EDL muscle fibers. The increase in CSA was mediated via the upregulated phosphorylation of Akt, 4E-BP1, p70S6k, and S6 in G animals and 4E-BP1 in T animals. In the EDL muscles from T animals, a decrease in proteasome activity, favoring a further increase in the CSA of the muscle fibers, was reported.
Collapse
Affiliation(s)
- Carlos Flores Rodrigues Junior
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-220, Brazil; (C.F.R.J.); (T.C.P.-C.); (R.C.)
| | - Gilson Masahiro Murata
- Divisions of Nephrology and Molecular Medicine, LIM-29, Department of Medicine, University of São Paulo, São Paulo 05508-220, Brazil;
| | | | - Renato Tadeu Nachbar
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-220, Brazil; (C.F.R.J.); (T.C.P.-C.); (R.C.)
| | - Gabriel Nasri Marzuca-Nassr
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco 4811230, Chile;
- Interuniversity Center for Healthy Aging (Code RED21993), Talca 3460000, Chile
| | - Renata Gorjão
- Interdisciplinary Post-graduate Program in Health Sciences, Universidade Cruzeiro do Sul, São Paulo 01506-000, Brazil;
| | - Kaio Fernando Vitzel
- School of Health Sciences, Massey University (University of New Zealand), Auckland 0745, New Zealand;
| | - Sandro Massao Hirabara
- Interdisciplinary Post-graduate Program in Health Sciences, Universidade Cruzeiro do Sul, São Paulo 01506-000, Brazil;
| | - Tania Cristina Pithon-Curi
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-220, Brazil; (C.F.R.J.); (T.C.P.-C.); (R.C.)
- Interdisciplinary Post-graduate Program in Health Sciences, Universidade Cruzeiro do Sul, São Paulo 01506-000, Brazil;
| | - Rui Curi
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-220, Brazil; (C.F.R.J.); (T.C.P.-C.); (R.C.)
- Interdisciplinary Post-graduate Program in Health Sciences, Universidade Cruzeiro do Sul, São Paulo 01506-000, Brazil;
- Butantan Institute, São Paulo 05585-000, Brazil
| |
Collapse
|
5
|
Kisil I, Gimelfarb Y. Long-term supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine for pressure ulcer in sedentary older adults: a retrospective matched case-control study. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2023; 40:364-372. [PMID: 36796413 PMCID: PMC10626290 DOI: 10.12701/jyms.2022.00899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Growing evidence suggests that beta-hydroxy-beta-methylbutyrate (HMB), arginine (Arg), and glutamine (Gln) positively affect wound recovery. This study investigated the effects of long-term administration of HMB/Arg/Gln on pressure ulcer (PU) healing in sedentary older adults admitted to geriatric and rehabilitation care facilities. METHODS This was a pilot retrospective case (standard of care and HMB/Arg/Gln)-control (standard of care alone) clinical study. Outcome measures were relative healing rates and Pressure Ulcer Scale for Healing (PUSH) scores (calculated after 4, 8, 12, 16, and 20 weeks) and time to healing. RESULTS The study subpopulation was comprised of 14 participants (four males, 28.6%) with the median age of 85.5 years (interquartile range [IQR], 82.0-90.2 years). The control subpopulation was comprised of 31 participants (18 males, 58.1%) with the median age of 84.0 years (IQR, 78.0-90.0 years). At the beginning of follow-up, there were no statistically significant demographic (sex and age) and clinical (main diagnosis, baseline area, and PU perimeter) differences between the groups. During the study period, there were no significant differences in the relative healing rates and PUSH scores between the subpopulations. The median time to complete healing in the study and control populations was 170.0 days (95% confidence interval [CI], 85.7-254.3) and 218.0 days (95% CI, 149.2-286.7) (log-rank, chi-square=3.99; p<0.046), respectively. CONCLUSION More than 20 weeks of HMB/Arg/Gln supplementation had a positive effect on difficult PU healing in older adults with multiple comorbidities.
Collapse
Affiliation(s)
- Igor Kisil
- Medical – Care Hospital, Bat Yam, Israel
| | - Yuri Gimelfarb
- AMHC, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Bat Yam, Israel
| |
Collapse
|
6
|
Gorji AE, Ostaszewski P, Urbańska K, Sadkowski T. Does β-Hydroxy-β-Methylbutyrate Have Any Potential to Support the Treatment of Duchenne Muscular Dystrophy in Humans and Animals? Biomedicines 2023; 11:2329. [PMID: 37626825 PMCID: PMC10452677 DOI: 10.3390/biomedicines11082329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Skeletal muscle is the protein reservoir of our body and an important regulator of glucose and lipid homeostasis. The dystrophin gene is the largest gene and has a key role in skeletal muscle construction and function. Mutations in the dystrophin gene cause Duchenne and Becker muscular dystrophy in humans, mice, dogs, and cats. Duchenne muscular dystrophy (DMD) is an X-linked neuromuscular condition causing progressive muscle weakness and premature death. β-hydroxy β-methylbutyrate (HMB) prevents deleterious muscle responses under pathological conditions, including tumor and chronic steroid therapy-related muscle losses. The use of HMB as a dietary supplement allows for increasing lean weight gain; has a positive immunostimulatory effect; is associated with decreased mortality; and attenuates sarcopenia in elderly animals and individuals. This study aimed to identify some genes, metabolic pathways, and biological processes which are common for DMD and HMB based on existing literature and then discuss the consequences of that interaction.
Collapse
Affiliation(s)
- Abdolvahab Ebrahimpour Gorji
- Department of Physiological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (A.E.G.); (P.O.)
| | - Piotr Ostaszewski
- Department of Physiological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (A.E.G.); (P.O.)
| | - Kaja Urbańska
- Department of Morphological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-776 Warsaw, Poland;
| | - Tomasz Sadkowski
- Department of Physiological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (A.E.G.); (P.O.)
| |
Collapse
|
7
|
Norikura T, Sasaki Y, Kojima-Yuasa A, Kon A. Glyoxylic Acid, an α-Keto Acid Metabolite Derived from Glycine, Promotes Myogenesis in C2C12 Cells. Nutrients 2023; 15:nu15071763. [PMID: 37049603 PMCID: PMC10096605 DOI: 10.3390/nu15071763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/07/2023] Open
Abstract
α-Keto acids may help prevent malnutrition in patients with chronic kidney disease (CKD), who consume protein-restricted diets, because they serve as amino acid sources without producing nitrogenous waste compounds. However, the physiological roles of α-keto acids, especially those derived from non-essential amino acids, remain unclear. In this study, we examined the effect of glyoxylic acid (GA), an α-keto acid metabolite derived from glycine, on myogenesis in C2C12 cells. Differentiation and mitochondrial biogenesis were used as myogenesis indicators. Treatment with GA for 6 d resulted in an increase in the expression of differentiation markers (myosin heavy chain II and myogenic regulatory factors), mitochondrial biogenesis, and intracellular amounts of amino acids (glycine, serine, and alanine) and their metabolites (citric acid and succinic acid). In addition, GA treatment suppressed the 2.5-µM dexamethasone (Dex)-induced increase in mRNA levels of ubiquitin ligases (Trim63 and Fbxo32), muscle atrophy markers. These results indicate that GA promotes myogenesis, suppresses Dex-induced muscle atrophy, and is metabolized to amino acids in muscle cells. Although further in vivo experiments are needed, GA may be a beneficial nutrient for ameliorating the loss of muscle mass, strength, and function in patients with CKD on a strict dietary protein restriction.
Collapse
Affiliation(s)
- Toshio Norikura
- Department of Nutrition, Faculty of Health Science, Aomori University of Health and Welfare, Aomori 030-8505, Japan
| | - Yutaro Sasaki
- Department of Nutrition, Graduate School of Human Life and Ecology, Osaka Metropolitan University, Osaka 558-8585, Japan
| | - Akiko Kojima-Yuasa
- Department of Nutrition, Graduate School of Human Life and Ecology, Osaka Metropolitan University, Osaka 558-8585, Japan
| | - Atsushi Kon
- Department of Nutrition, Faculty of Health Science, Aomori University of Health and Welfare, Aomori 030-8505, Japan
| |
Collapse
|
8
|
Increasing Muscle Mass in Elders through Diet and Exercise: A Literature Review of Recent RCTs. Foods 2023; 12:foods12061218. [PMID: 36981144 PMCID: PMC10048759 DOI: 10.3390/foods12061218] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/23/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
This study aimed to review the current evidence on the independent and combined effects of diet and exercise and their impact on skeletal muscle mass in the elderly population. Skeletal muscle makes up approximately 40% of total body weight and is essential for performing daily activities. The combination of exercise and diet is known to be a potent anabolic stimulus through stimulation of muscle protein synthesis from amino acids. Aging is strongly associated with a generalized deterioration of physiological function, including a progressive reduction in skeletal muscle mass and strength, which in turn leads to a gradual functional impairment and an increased rate of disability resulting in falls, frailty, or even death. The term sarcopenia, which is an age-related syndrome, is primarily used to describe the gradual and generalized loss of skeletal muscle mass (mainly in type II muscle fibers) and function. Multimodal training is emerging as a popular training method that combines a wide range of physical dimensions. On the other hand, nutrition and especially protein intake provide amino acids, which are essential for muscle protein synthesis. According to ESPEN, protein intake in older people should be at least 1 g/kgbw/day. Essential amino acids, such as leucine, arginine, cysteine, and glutamine, are of particular importance for the regulation of muscle protein synthesis. For instance, a leucine intake of 3 g administered alongside each main meal has been suggested to prevent muscle loss in the elderly. In addition, studies have shown that vitamin D and other micronutrients can have a protective role and may modulate muscle growth; nevertheless, further research is needed to validate these claims. Resistance-based exercise combined with a higher intake of dietary protein, amino acids, and/or vitamin D are currently recognized as the most effective interventions to promote skeletal muscle growth. However, the results are quite controversial and contradictory, which could be explained by the high heterogeneity among studies. It is therefore necessary to further assess the impact of each individual exercise and nutritional approach, particularly protein and amino acids, on human muscle turnover so that more efficient strategies can be implemented for the augmentation of muscle mass in the elderly.
Collapse
|
9
|
Jang YJ. The Effects of Protein and Supplements on Sarcopenia in Human Clinical Studies: How Older Adults Should Consume Protein and Supplements. J Microbiol Biotechnol 2023; 33:143-150. [PMID: 36474318 PMCID: PMC9998208 DOI: 10.4014/jmb.2210.10014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022]
Abstract
Sarcopenia is a condition in which muscle mass, strength, and performance decrease with age. It is associated with chronic diseases such as diabetes, cardiovascular disease, and hypertension, and contributes to an increase in mortality. Because managing sarcopenia is critical for maintaining good health and quality of life for the elderly, the condition has sparked concern among many researchers. To counteract sarcopenia, intake of protein is an important factor, while a lack of either protein or vitamin D is a major cause of sarcopenia. In addition, essential amino acids, leucine, β-hydroxy β-methylbutyrate (HMB), creatine, and citrulline are used as supplements for muscle health and are suggested as alternatives for controlling sarcopenia. There are many studies on such proteins and supplements, but it is necessary to actually organize the types, amounts, and methods by which proteins and supplements should be consumed to inhibit sarcopenia. In this study, the efficacy of proteins and supplements for controlling sarcopenia according to human clinical studies is summarized to provide suggestions about how the elderly may consume proteins, amino acids, and other supplements.
Collapse
Affiliation(s)
- Young Jin Jang
- Major of Food Science and Technology, Seoul Women's University, Seoul 01797, Republic of Korea
| |
Collapse
|
10
|
Effects of Whey Protein, Leucine, and Vitamin D Supplementation in Patients with Sarcopenia: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:nu15030521. [PMID: 36771225 PMCID: PMC9920795 DOI: 10.3390/nu15030521] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/04/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023] Open
Abstract
(1) Background: In this study, a meta-analysis was performed to investigate the effects of whey protein, leucine, and vitamin D in sarcopenia; (2) Methods: We searched PubMed, Cochrane Library, Embase, and Scopus databases and retrieved studies published until 5 December 2022. Randomized controlled trials were included to evaluate muscle mass, strength, and function, after using whey protein, leucine, and vitamin D supplementation in patients with sarcopenia; (3) Results: A total of three studies including 637 patients reported the effectiveness of using whey protein, leucine, and vitamin D supplementation in patients with sarcopenia. Without considering whether or not a physical exercise program was combined with nutritional supplementation, no significant differences in grip strength or short physical performance battery (SPPB) scores between the experimental and control groups were noted. However, appendicular muscle mass significantly improved in the experimental group compared to the control group. The results were analyzed according to the presence or absence of a concomitant physical exercise program. With the use of a concomitant physical exercise program, handgrip strength and SPPB scores in the experimental group significantly improved when compared to the control group. In contrast, when physical exercise was not combined, there was no significant improvement in the handgrip strength and SPPB scores of patients with sarcopenia. In addition, the appendicular muscle mass significantly increased regardless of the presence of a concomitant physical exercise program; (4) Conclusions: Whey protein, leucine, and vitamin D supplementation can increase appendicular muscle mass in patients with sarcopenia. In addition, combining a physical exercise program with whey protein, leucine, and vitamin D supplementation can improve muscle strength and function.
Collapse
|
11
|
Hou V, Madden K. Assessing the Effects of Dietary Protein Supplementation on Sarcopenia in Community-Dwelling Older Adults. Can Geriatr J 2022; 25:390-403. [PMID: 36505918 PMCID: PMC9684029 DOI: 10.5770/cgj.25.608] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Sarcopenia, an age-associated skeletal muscle disorder characterized by muscle loss, is associated with disability in elderly populations. This literature review summarizes the impact of protein intake and supplementation on the indicators of severe sarcopenia-muscle mass, muscle strength, and physical function in community-dwelling older adults. We performed a literature search on PubMed, EMBASE, and MedLine, and included studies that evaluated the effects of protein intake with or without exercise intervention and on sarcopenia in community-dwelling older adults. Information regarding study participants, protein intervention, and sarcopenia-related outcomes were collected. Protein supplementation with or without exercise positively improves muscle mass, and aspects of muscle strength and physical function in sarcopenic and pre-frail older adults, while it elicited inconclusive effects in healthy populations. Greater dietary animal-based and soy-based protein diets can improve muscle mass in older adults. In conclusion, protein supplementation can improve muscle mass and reduce the risk of sarcopenia in sarcopenia and pre-frail older adults, while future studies should continue to investigate the effects of protein supplementation on indicators of sarcopenia in healthy older adults.
Collapse
Affiliation(s)
- Vincent Hou
- Department of Medicine, The University of British Columbia, Vancouver, BC
| | - Kenneth Madden
- Department of Medicine, The University of British Columbia, Vancouver, BC,Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, BC,Gerontology and Diabetes Research Laboratory, Vancouver Coastal Health Research Institute, Vancouver, BC
| |
Collapse
|
12
|
Han Z, Ji NN, Ma JX, Dong Q, Ma XL. Effect of Resistance Training Combined with Beta-Hydroxy-Beta-Methylbutyric Acid Supplements in Elderly Patients with Sarcopenia after Hip Replacement. Orthop Surg 2022; 14:704-713. [PMID: 35195339 PMCID: PMC9002065 DOI: 10.1111/os.13208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives To evaluate the efficacy of resistance training (RT) combined with beta‐hydroxy‐beta‐methylbutyric acid (HMB) in the treatment of elderly patients with sarcopenia after hip replacement. Methods From January 1, 2018 to December 31, 2018, 200 elderly patients (68 men, mean age 76.3 years and 137 women, mean age 79.1 years) who experienced femoral neck fracture with sarcopenia after hip arthroplasty were assigned to four groups: RT + HMB group, RT group, HMB group, and negative control group. Baseline data, body composition, grip strength, Barthel index (BI), Harris hip score (HHS), and visual analog scale score (VAS) were compared among the four groups before and 3 months after surgery. Results A total of 177 participants completed the trial, including 43 in the HMB + RT group, 44 in the HMB group, 45 in the RT group, and 45 in the negative control group. At the 3‐month follow‐up, the body composition and grip strength of the HMB + RT group and RT group were significantly improved compared with those before operation. The HMB group had no significant change, while the measures in the negative control group significantly decreased. Postoperative BI and HSS did not reach pre‐injury levels in any of the four groups, but postoperative VAS score was significantly improved. However, there was no significant difference in BI, HSS, or VAS among the four groups. Conclusion RT, with or without HMB supplementation, can effectively improve body composition and grip strength in elderly patients with sarcopenia after hip replacement at short‐term follow‐up. Simultaneously, use of exclusive HMB supplementation alone may also help to prevent decreases in muscle mass and grip strength in these patients.
Collapse
Affiliation(s)
- Zhe Han
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China.,Department of Hip Trauma, Tianjin Hospital, Tianjin, China
| | - Neng-Neng Ji
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jian-Xiong Ma
- Institute of Orthopaedics, Tianjin Hospital, Tianjin, China
| | - Qiang Dong
- Department of Hip Trauma, Tianjin Hospital, Tianjin, China
| | - Xin-Long Ma
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China.,Institute of Orthopaedics, Tianjin Hospital, Tianjin, China.,Department of Orthopaedics, Tianjin Hosptial, Tianjin, China
| |
Collapse
|
13
|
Kositsawat J, Duque G, Kirk B. Nutrients with anabolic/anticatabolic, antioxidant, and anti-inflammatory properties: Targeting the biological mechanisms of aging to support musculoskeletal health. Exp Gerontol 2021; 154:111521. [PMID: 34428477 DOI: 10.1016/j.exger.2021.111521] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/12/2021] [Accepted: 08/15/2021] [Indexed: 12/25/2022]
Abstract
Old age is associated with declines in bone density and muscle mass and function, which predisposes to mobility disability, falls, and fractures. Poor nutritional status, a risk factor for several age-related pathologies, becomes prevalent in old age and contributes to the structural and functional changes of the musculoskeletal system that increases the risk of osteoporosis, sarcopenia, osteosarcopenia, and physical frailty. The biological mechanisms underpinning these pathologies often overlap and include loss of proteostasis, impaired redox functioning, and chronic low-grade inflammation. Thus, provision of nutrients with anabolic/anticatabolic, antioxidant, and anti-inflammatory properties may be an effective strategy to offset these age-related pathologies. We searched PUBMED for pre-clinical and clinical work examining the effects of nutrients with a combined effect on muscle and bone. This review summarizes recent evidence on the mechanisms of action and potential clinical use of nutrients that concomitantly improve muscle and bone health in older persons.
Collapse
Affiliation(s)
- Jatupol Kositsawat
- Center on Aging, University of Connecticut Health Center, Farmington, CT, USA
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC 3021, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC 3021, Australia
| | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC 3021, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC 3021, Australia.
| |
Collapse
|
14
|
Ersöz H, Ağababaoğlu İ, Taylan İ, Çakır E, Aksun S, Güneli E. Do oral amino acid supplements facilitate the healing of rat lung injuries? Eur J Cardiothorac Surg 2021; 58:983-990. [PMID: 32783058 DOI: 10.1093/ejcts/ezaa206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/23/2020] [Accepted: 05/09/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Prolonged air leaks following lung injury cause extended hospital stays. This study investigated the effect of nutritional supplements containing arginine, glutamine and β-hydroxy β-methyl butyrate, which were theoretically proven to accelerate wound healing, on air leak and wound healing parameters in a rat lung injury model. METHODS Twenty-eight female rats were randomly divided into 4 groups. Experimental groups were given glutamine (Resource Glutamine®) or a mixture of arginine, glutamine and β-hydroxy β-methyl butyrate (Abound®) as a dietary supplement at isonitrogenous and isocaloric doses. On day 3, standard sized lung injuries were created in all rats except the sham group. The rats were sacrificed on day 6, and the lungs were removed for air-leak threshold pressure measurement and histopathological and biochemical analyses. RESULTS Loss of body mass was greater in the glutamine group than in the other groups (P = 0.004). Rats that received the amino acid mixture had better results for mature collagen fibre density (P = 0.002) and inflammation suppression (P = 0.003). The sham group had higher values for air-leak threshold pressure and all other histochemical parameters compared to the other groups. Hydroxyproline level did not differ significantly in any of the groups. CONCLUSIONS Our results indicated that an oral amino acid mixture was effective in the healing of lung injuries. Isolated glutamine supplementation had an adverse impact on body mass. Randomized clinical studies including larger series are needed. Hydroxyproline does not seem to be a suitable marker for this purpose.
Collapse
Affiliation(s)
- Hasan Ersöz
- Department of Thoracic Surgery, Izmir Katip Celebi University, Ataturk Training and Research Hospital, İzmir, Turkey
| | - İsmail Ağababaoğlu
- Department of Thoracic Surgery, Yıldırım Beyazıd University, Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - İbrahim Taylan
- Department of Thoracic Surgery, Izmir Katip Celebi University, Ataturk Training and Research Hospital, İzmir, Turkey
| | - Ebru Çakır
- Department of Medical Pathology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, İzmir, Turkey
| | - Saliha Aksun
- Department of Medical Biochemistry, Izmir Katip Celebi University, Ataturk Training and Research Hospital, İzmir, Turkey
| | - Ensari Güneli
- Dokuz Eylül University, İzmir Biomedicine and Genome Center, İzmir, Turkey.,Department of Laboratory Animal Science, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| |
Collapse
|
15
|
Martin-Cantero A, Reijnierse EM, Gill BMT, Maier AB. Factors influencing the efficacy of nutritional interventions on muscle mass in older adults: a systematic review and meta-analysis. Nutr Rev 2021; 79:315-330. [PMID: 33031516 PMCID: PMC7876433 DOI: 10.1093/nutrit/nuaa064] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Context Nutritional interventions stimulate muscle protein synthesis in older adults. To optimize muscle mass preservation and gains, several factors, including type, dose, frequency, timing, duration, and adherence have to be considered. Objective This systematic review and meta-analysis aimed to summarize these factors influencing the efficacy of nutritional interventions on muscle mass in older adults. Data Sources A systematic search was performed using the electronic databases MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus from inception date to November 22, 2017, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria included randomized controlled trials, mean or median age ≥65 years, and reporting muscle mass at baseline and postintervention. Exclusion criteria included genetically inherited diseases, anabolic drugs or hormone therapies, neuromuscular electrical stimulation, chronic kidney disease, kidney failure, neuromuscular disorders, and cancer. Data Extraction Extracted data included study characteristics (ie, population, sample size, age, sex), muscle mass measurements (ie, method, measure, unit), effect of the intervention vs the control group, and nutritional intervention factors (ie, type, composition, dose, duration, frequency, timing, and adherence). Data Analysis Standardized mean differences and 95%CIs were calculated from baseline to postintervention. A meta-analysis was performed using a random-effects model and grouped by the type of intervention. Conclusions Twenty-nine studies were included, encompassing 2255 participants (mean age, 78.1 years; SD, 2.22). Amino acids, creatine, β-hydroxy-β-methylbutyrate, and protein with amino acids supplementation significantly improved muscle mass. No effect was found for protein supplementation alone, protein and other components, and polyunsaturated fatty acids. High interstudy variability was observed regarding the dose, duration, and frequency, coupled with inconsistency in reporting timing and adherence. Overall, several nutritional interventions could be effective to improve muscle mass measures in older adults. Because of the substantial variability of the intervention factors among studies, the optimum profile is yet to be established. Systematic Review Registration PROSPERO registration no. CRD42018111306.
Collapse
Affiliation(s)
- Aitana Martin-Cantero
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin M T Gill
- Department of Clinical Nutrition, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| |
Collapse
|
16
|
Kaczka P, Kubicka K, Batra A, Maciejczyk M, Kopera E, Bira J, Zając T. Effects of Co-Ingestion of β-Hydroxy-β-Methylbutyrate and L-Arginine α-Ketoglutarate on Jump Performance in Young Track and Field Athletes. Nutrients 2021; 13:nu13041064. [PMID: 33805883 PMCID: PMC8064357 DOI: 10.3390/nu13041064] [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: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 01/15/2023] Open
Abstract
The aim of the study was to determine the effect of simultaneous supplementation of β-hydroxy-β-methylbutyrate and L-Arginine α-ketoglutarate on lower limb power and muscle damage in medium distance runners aged 15.3 (±0.9) years old. Methods: The study group consisted of 40 volunteers aged 14–17 years practicing medium distance running for at least two years. The study lasted 12 days and followed a randomized, double-blind, placebo-controlled, parallel design. All subjects attended a familiarization session on day 0 before the test. The subjects were randomly divided into two groups: supplements and placebo group. The same training cycle protocol was used in both groups during the 12-day training period. Morning warm-up involved 10 min jogging at 60–75% of maximal heart rate and countermovement jump height measurement. Main training units were carried out for both groups with the same volume. Training load assessment (the daily session Rating of Perceived Exertion (s-RPE) method) method takes into consideration the intensity and the duration of the training session to calculate the “training load” (TL). Results: At the end of the training cycle, a significant (p = 0.002) decrease in the countermovement jump (CMJ) height was found in the placebo group when compared to the baseline. In the supplement group, there was no decrease in the countermovement jump height. Creatine kinase and lactate dehydrogenase concentration increased during the training days similarly in both groups and decreased on rest days. There were no differences between groups in enzymes concentration. The research results indicate that the supplement combination used in the supplements group prevented a reduction in the CMJ values. In contrast to the supplements group, in the placebo group, the CMJ changes were statistically significant: a noticeable (p = 0.002) decrease in CMJ was noted between the baseline measurement and the 6th measurement. The well-being of the subjects from both groups changed significantly during the training period, and the intergroup differences in the mood level were similar and not statistically significant. Conclusions: The results of this study indicate that the daily co-supplementation with calcium salt of β-hydroxy-β-methylbutyrate (7.5 g) and L-Arginine α-ketoglutarate (10 g) during training might help to prevent decline in jump performance. No influence on muscle damage markers or mood was shown.
Collapse
Affiliation(s)
- Piotr Kaczka
- Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (K.K.); (A.B.); (E.K.); (J.B.); (T.Z.)
- Correspondence:
| | - Katarzyna Kubicka
- Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (K.K.); (A.B.); (E.K.); (J.B.); (T.Z.)
| | - Amit Batra
- Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (K.K.); (A.B.); (E.K.); (J.B.); (T.Z.)
| | - Marcin Maciejczyk
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University of Physical Education in Krakow, Jana Pawła II 78, 31-571 Kraków, Poland;
| | - Edyta Kopera
- Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (K.K.); (A.B.); (E.K.); (J.B.); (T.Z.)
| | - Justyna Bira
- Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (K.K.); (A.B.); (E.K.); (J.B.); (T.Z.)
| | - Tomasz Zając
- Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (K.K.); (A.B.); (E.K.); (J.B.); (T.Z.)
| |
Collapse
|
17
|
Costa Riela NDA, Alvim Guimarães MM, Oliveira de Almeida D, Araujo EMQ. Effects of Beta-Hydroxy-Beta-Methylbutyrate Supplementation on Elderly Body Composition and Muscle Strength: A Review of Clinical Trials. ANNALS OF NUTRITION AND METABOLISM 2021; 77:16-22. [PMID: 33709969 DOI: 10.1159/000514236] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 01/06/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aging process has great impact on body composition, such as the increase of adipose tissue in abdominal region, and the decrease of lean body mass, due to skeletal muscle loss. A reduction in muscle mass is associated to high risk of fractures and falls, loss of mobility, and increased number of hospitalizations. Beta-hydroxy-beta-methylbutyrate (HMB) is a biological substance derived from leucine metabolism, with anabolic and anticatabolic properties. Some HMB effects are tissue repair stimulation and protein anabolism. AIMS We aimed to evaluate the effects of HMB supplementation on body composition and muscle strength in elderly, as well as to identify the efficient dosages to reach these effects. METHODS This review included studies that evaluated muscle mass and muscle strength, associated or not with physical exercise and diet in elderly people. Only studies published from 2008 to 2019 were selected for analysis. RESULTS Six articles were included in the review. The used doses varied from 1.5 to 3 g. In 5 studies, HMB supplementation was associated with calcium; only 1 study did not use the oral administration route. Two studies used 4 g of maltodextrin as a vehicle; 1 used HMB with a hypercaloric and hyperproteic supplement; 1 associated HMB with lysine and arginine; and 1 with arginine and glutamine. Supplementation of 3 g of HMB has shown to be most beneficial in improving strength and body composition in people over 65 years, especially in bed rest and untrained conditions. CONCLUSION Our findings suggest that HMB has a positive effect on body composition and strength, especially in bedridden or sedentary elderly, due to its anticatabolic properties.
Collapse
Affiliation(s)
| | | | - Daniela Oliveira de Almeida
- Life Sciences Department, Nucleus of Research and Extension in Nutritional Genomics and Metabolic Dysfunctions (GENUT), University of The State of Bahia (UNEB), Salvador, Brazil.,Professor of undergraduate medical course, UniFTC, Salvador, Brazil
| | - Edilene Maria Queiroz Araujo
- Life Sciences Department, Nucleus of Research and Extension in Nutritional Genomics and Metabolic Dysfunctions (GENUT), University of The State of Bahia (UNEB), Salvador, Brazil, .,Life Sciences Department/UNEB, Health Sciences Institute/UFBA, Coordinator of Nutrition Course and GENUT, Professor at Post-Graduation Program Interactive Process of Organs and Systems, Salvador, Brazil,
| |
Collapse
|
18
|
Bear DE, Cruz-Jentoft AJ, Stout JR. β-hydroxy-β-methylbutyrate supplementation in older persons - an update. Curr Opin Clin Nutr Metab Care 2021; 24:48-52. [PMID: 33148945 DOI: 10.1097/mco.0000000000000713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW The interest in the use of beta-hydroxy-beta-methylbutyrate (HMB) as an intervention to prevent and treat sarcopenia has increased over recent years. The purpose of this review is to explore recent evidence pertaining to the mechanism of action of HMB and how this may influence changes in lean mass and strength in older persons who are both hospitalized and living in the community. RECENT FINDINGS No new studies have been published over the last 2 years investigating the effect of HMB in older persons who are hospitalized, aside from one posthoc analysis of a randomized controlled trial exploring the effect of a high protein oral nutrition supplement containing HMB on handgrip strength and nutritional status. Three studies recruiting community-dwelling older adults have been published, but results are influenced by suboptimal methodological quality. SUMMARY Recent data suggest the need for high-quality studies investigating the effectiveness of HMB to improve outcomes related to sarcopenia in both hospitalized and community-dwelling older persons.
Collapse
Affiliation(s)
- Danielle E Bear
- Departments of Nutrition and Dietetics and Critical Care, Guy's and St Thomas' NHS Foundation Trust
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | | | - Jeffrey R Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida, USA
| |
Collapse
|
19
|
Effects of oral administration of β-hydroxy β-methylbutyrate on lean body mass in older adults: a systematic review and meta-analysis. Eur Geriatr Med 2020; 12:239-251. [PMID: 33034021 DOI: 10.1007/s41999-020-00409-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Beta-hydroxy beta-methylbutyrate (HMB), a metabolite of leucine, is currently widely used in athletes to increase muscle mass and strength and has also been used as a nutritional supplement in recent years to maintain muscle mass in muscular atrophic diseases of older people. However, the effects of HMB supplementation on muscle mass, muscle strength, and physical function in older people remain controversial. The purpose of this review was to explore the effects of HMB on body composition in older adults. METHODS The PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases were searched to obtain the randomized controlled trials needed as a basis for systematic review and meta-analysis. RESULT A total of 9 studies (448 participants) were eventually found eligible. The pooled results showed that HMB supplementation significantly increased fat-free mass in older people compared with the control group (effect size: 0.37; 95% Cl 0.16, 0.58; Z value = 3.47, P = 0.001; Fixed-effect model). But it had no effect on fat mass (effect size: - 0.04 95% CI - 0.26, 0.18; Z value = 0.36, P = 0.716, fixed-effect model). Subgroup analysis of HMB supplementation alone showed a significant improvement in fat-free mass in older people (effect size: 0.59; 95% CI 0.32, 0.87; Z = 4.24, P < 0.001; fixed-effect model), whereas HMB supplementation combined with exercise intervention showed no additional fat-free mass change (effect size: 0.06; 95% CI - 0.26, 0.38; Z = 0.38, P = 0.705; Fixed-effect model). CONCLUSION HMB supplementation is beneficial for improving body composition in older people. However, the effect of HMB supplementation combined with exercise therapy to improve muscle mass is not obvious. Exercise programs need to be designed according to the different physical health of older people.
Collapse
|
20
|
Nutritional Intervention to Prevent the Functional Decline in Community-Dwelling Older Adults: A Systematic Review. Nutrients 2020; 12:nu12092820. [PMID: 32942634 PMCID: PMC7551991 DOI: 10.3390/nu12092820] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023] Open
Abstract
Aging is a global public health concern. From the age of 50, muscle mass, muscle strength and physical performance tend to decline. Sarcopenia and frailty are frequent in community-dwelling older adults and are associated with negative outcomes such as physical disability and mortality. Therefore, the identification of therapeutic strategies to prevent and fight sarcopenia and frailty is of great interest. This systematic review aims to summarize the impact of nutritional interventions alone or combined with other treatment(s) in older community-dwelling adults on (1) the three indicators of sarcopenia, i.e., muscle mass, muscle strength and physical performance; and (2) the hospitalization and readmission rates. The literature search was performed on Medline and included studies published between January 2010 and June 2020. We included randomized controlled trials of nutritional intervention alone or combined with other treatment(s) in community-living subjects aged 65 or older. In total, 28 articles were retained in the final analysis. This systematic review highlights the importance of a multimodal approach, including at least a combined nutritional and exercise intervention, to improve muscle mass, muscle strength and physical performance, in community-dwelling older adults but especially in frail and sarcopenic subjects. Regarding hospitalization and readmission rate, data were limited and inconclusive. Future studies should continue to investigate the effects of such interventions in this population.
Collapse
|