International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB)

Quantification of 11 metabolites in rat urine after exposure to organophosphates

BACKGROUND

The aim of the study was to develop a technique for quantitative determination of rat urine metabolites by HPLC-MS/MS, which can be used to search for biomarkers of acute intoxication with organophosphates (OPs).

RESULTS

The content of metabolites in the urine of rats exposed to a single dose of paraoxon (POX1x); interval, twice daily administration of paraoxon (POX2x); exposure to 2-(o-cresyl)-4H-1, 3, 2-benzodioxaphosphorin-2-oxide and paraoxon (CBPOX) was investigated. New data were obtained on the content in the urine of intact rats as well as rats in 3 models of OP poisoning: 3-methylhistidine, threonine, creatine, creatinine, lactic acid, acetylcarnitine, inosine, hypoxanthine, adenine, 3-hydroxymethyl-butyrate and 2-hydroxymethyl-butyrate.

CONCLUSIONS

The proposed assay procedure is a simple and reliable tool for urine metabolomic studies. Within 1-3 days after OP exposure in all three models of acute intoxication, the concentration of metabolites in rat urine, with the exception of adenine, changes similarly and symmetrically, regardless of the method of poisoning modeling, in all three models of acute intoxication. Further studies are needed to determine the specificity and reliability of using urinary metabolite concentration changes as potential biomarkers of acute organophosphate intoxication.

Superior bioavailability of the calcium salt form of β-hydroxy-β-methylbutyrate compared with the free acid form

We investigated the bioavailability of the calcium salt (HMB-Ca) and the free acid (HMB-FA) forms of β-hydroxy-β-methylbutyrate (HMB). Sixteen young individuals received the following treatments on three different occasions in a counterbalanced crossover fashion: (1) HMB-FA in clear capsules; (2) HMB-Ca in gelatine capsules; (3) HMB-Ca dissolved in water. All treatments provided 1 g of HMB. Blood samples were taken before and on multiple time points following ingestion. The following parameters were calculated: peak plasma (Cmax), time to peak (Tmax), slope of HMB appearance in blood, area under the curve (AUC), half-life time (t1/2) and relative bioavailability (HMB-Ca in water set as reference). All treatments led to rapid and large increases in plasma HMB. HMB-Ca in capsules and in water showed similar plasma HMB values across time (p = 0.438). HMB-FA resulted in lower concentrations vs. the other treatments (both p < 0.001). AUC (HMB-Ca in capsules: 50,078 ± 10,507; HMB-Ca in water: 47,871 ± 10,783; HMB-FA: 29,130 ± 12,946 µmol L-1 × 720 min), Cmax (HMB-Ca in capsules: 229.2 ± 65.9; HMB-Ca in water: 249.7 ± 49.7; HMB-FA: 139.1 ± 67.2 µmol L-1) and relative bioavailability (HMB-Ca in capsules: 104.8 ± 14.9%; HMB-FA: 61.5 ± 17.0%) were lower in HMB-FA vs. HMB-Ca (all p < 0.001). HMB-Ca in water resulted in the fastest Tmax (43 ± 22 min) compared to HMB-Ca in capsules (79 ± 40 min) and HMB-FA (78 ± 21 min) (all p < 0.05), while t1/2 was similar between treatments. To conclude, HMB-Ca exhibited superior bioavailability compared to HMB-FA, with HMB-Ca in water showing faster absorption. Elimination kinetics were similar across all forms, suggesting that the pharmaceutical form of HMB affects the absorption rates, but not its distribution or elimination.

Supplementation with β-hydroxy-β-methylbutyrate after resistance training in post-acute care patients with sarcopenia: A randomized, double-blind placebo-controlled trial

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.

Arginine and Lysine Supplementation Potentiates the Beneficial β-Hydroxy ß-Methyl Butyrate (HMB) Effects on Skeletal Muscle in a Rat Model of Diabetes

Skeletal muscle is the key tissue for maintaining protein and glucose homeostasis, having a profound impact on the development of diabetes. Diabetes causes deleterious changes in terms of loss of muscle mass, which will contribute to reduced glucose uptake and therefore progression of the disease. Nutritional approaches in diabetes have been directed to increase muscle glucose uptake, and improving protein turnover has been at least partially an oversight. In muscle, β-hydroxy β-methyl butyrate (HMB) promotes net protein synthesis, while arginine and lysine increase glucose uptake, albeit their effects on promoting protein synthesis are limited. This study evaluates if the combination of HMB, lysine, and arginine could prevent the loss of muscle mass and function, reducing the progression of diabetes. Therefore, the combination of these ingredients was tested in vitro and in vivo. In muscle cell cultures, the supplementation enhances glucose uptake and net protein synthesis due to an increase in the amount of GLUT4 transporter and stimulation of the insulin-dependent signaling pathway involving IRS-1 and Akt. In vivo, using a rat model of diabetes, the supplementation increases lean body mass and insulin sensitivity and decreases blood glucose and serum glycosylated hemoglobin. In treated animals, an increase in GLUT4, creatine kinase, and Akt phosphorylation was detected, demonstrating the synergic effects of the three ingredients. Our findings showed that nutritional formulations based on the combination of HMB, lysine, and arginine are effective, not only to control blood glucose levels but also to prevent skeletal muscle atrophy associated with the progression of diabetes.

Beta-hydroxy-beta-methylbutyrate supplementation preserves fat-free mass in collegiate boxers during acute body mass loss

Acute body mass loss before competitions in combat sports usually leads to loss in fat-free mass. Beta-hydroxy-beta-methylbutyrate (HMB) has been shown to increase skeletal muscle mass and muscle strength in various muscle wasting conditions. This study investigated the effect of HMB supplementation on body composition and sport-specific performance in well-trained boxers consuming a hypocaloric diet. Twelve male college boxers were divided into the HMB and placebo (PLA) groups using a body weight-matched single-blind parallel design. The study comprised a 6-day weight loss period (days 1-6), followed by a 3-day competition period (days 7-9). The participants in both the groups consumed 16 kcal/kg/day, including 1.6-1.7 g/kg of carbohydrates, 1.2-1.3 g/kg of protein, and 0.45-0.5 g/kg of fat during the 9-day period. The HMB group consumed 3 g/day HMB. Body composition measurement, isometric mid-thigh pull (IMTP), and a simulated boxing match were performed at baseline and on days 7, 8, and 9. Fasting blood samples were collected on the day before day 1 and on days 7, 8, and 9. Body mass was significantly decreased after the 6-day weight loss period (HMB group: baseline: 69.4 ± 11.2 kg, day 7: 67.1 ± 11.2 kg; PLA group: baseline: 68.6 ± 12.1 kg, day 7: 65.7 ± 11.5 kg, P < 0.05) while it was unchanged on the 3-day competition period in both the groups. Fat-free mass in the HMB group was maintained throughout the 9-day period (baseline: 56.7 ± 9.3 kg, day 7: 56.3 ± 8.7 kg, day 9: 55.8 ± 9.5 kg) whereas it significantly decreased on days 7 and 9 compared to the baseline in the PLA group (baseline: 55.2 ± 6.4 kg, day 7: 54.1 ± 6.6 kg, day 9: 54.0 ± 6.6 kg, P < 0.05). In the PLA group, the average and maximal heart rates in round 1 and the average heart rate in round 2 on days 8 and 9 were significantly lower than those at baseline, while these parameters were unchanged in the HMB group. The maximal force and the rate of force development in the IMTP remained unchanged among the different timepoints in both the groups. The blood biochemical parameters were similar at any timepoint between the PLA and HMB groups. HMB supplementation during acute weight loss may preserve fat-free mass and maintain heart rate response in subsequent simulated matches in well-trained boxers. In addition, HMB supplementation had a nonsignificant effect on glucose, fat, and protein metabolism during energy restriction.

Advances in nutritional supplementation for sarcopenia management

Sarcopenia is a syndrome characterized by a decline in muscular mass, strength, and function with advancing age. The risk of falls, fragility, hospitalization, and death is considerably increased in the senior population due to sarcopenia. Although there is no conclusive evidence for drug treatment, resistance training has been unanimously recognized as a first-line treatment for managing sarcopenia, and numerous studies have also pointed to the combination of nutritional supplementation and resistance training as a more effective intervention to improve quality of life for people with sarcopenia. People with both malnutrition and sarcopenia have a higher mortality rate, so identifying people at risk of malnutrition and intervening early is extremely important to avoid sarcopenia and its associated problems. This article provides important information for dietary interventions in sarcopenia by summarizing the discoveries and developments of nutritional supplements such as protein, leucine, β-hydroxy-β-methylbutyric acid, vitamin D, vitamin C, vitamin E, omega-3 fatty acids, creatine, inorganic nitrate, probiotics, minerals, collagen peptides, and polyphenols in the management of sarcopenia.

Personalized nutrition therapy in critical care: 10 expert recommendations

Personalization of ICU nutrition is essential to future of critical care. Recommendations from American/European guidelines and practice suggestions incorporating recent literature are presented. Low-dose enteral nutrition (EN) or parenteral nutrition (PN) can be started within 48 h of admission. While EN is preferred route of delivery, new data highlight PN can be given safely without increased risk; thus, when early EN is not feasible, provision of isocaloric PN is effective and results in similar outcomes. Indirect calorimetry (IC) measurement of energy expenditure (EE) is recommended by both European/American guidelines after stabilization post-ICU admission. Below-measured EE (~ 70%) targets should be used during early phase and increased to match EE later in stay. Low-dose protein delivery can be used early (~ D1-2) (< 0.8 g/kg/d) and progressed to ≥ 1.2 g/kg/d as patients stabilize, with consideration of avoiding higher protein in unstable patients and in acute kidney injury not on CRRT. Intermittent-feeding schedules hold promise for further research. Clinicians must be aware of delivered energy/protein and what percentage of targets delivered nutrition represents. Computerized nutrition monitoring systems/platforms have become widely available. In patients at risk of micronutrient/vitamin losses (i.e., CRRT), evaluation of micronutrient levels should be considered post-ICU days 5-7 with repletion of deficiencies where indicated. In future, we hope use of muscle monitors such as ultrasound, CT scan, and/or BIA will be utilized to assess nutrition risk and monitor response to nutrition. Use of specialized anabolic nutrients such as HMB, creatine, and leucine to improve strength/muscle mass is promising in other populations and deserves future study. In post-ICU setting, continued use of IC measurement and other muscle measures should be considered to guide nutrition. Research on using rehabilitation interventions such as cardiopulmonary exercise testing (CPET) to guide post-ICU exercise/rehabilitation prescription and using anabolic agents such as testosterone/oxandrolone to promote post-ICU recovery is needed.

Effects of beta-hydroxy beta-methyl butyrate calcium combined with exercise therapy in patients with cardiac disease: a study protocol for clinical trial

INTRODUCTION

The current treatment for heart disease consists of exercise therapy in addition to pharmacotherapy, nutritional support and lifestyle guidance. In general, nutritional support focuses on protein, salt and energy restrictions, with no active protein or amino acid intake in cases involving moderate or higher renal failure. From this perspective, patients with cardiac disease are at high risk of frailty.Beta-hydroxy beta-methyl butyrate (HMB) is a metabolite of leucine. HMB is widely used for muscle strengthening and can be safely ingested even by patients with renal failure. The proposed study protocol will investigate the effects of HMB-calcium (HMB-Ca) administered in combination with comprehensive cardiac rehabilitation for muscle strength, muscle mass and cardiac function in patients with cardiac disease during the convalescent period. The primary outcome will be knee extensor strength. Secondary outcomes will be gross isometric limb strength and skeletal muscle mass.

METHODS AND ANALYSIS

This study will be a single-blinded, randomised, controlled trial with parallel comparisons between two groups. The study period will be 60 days from the start of outpatient cardiac rehabilitation. Participants will be randomly divided into two groups: an HMB group consuming HMB-Ca one time per day for 60 days; and a Placebo group consuming reduced maltose once one time per day for 60 days. Exercise therapy will be performed by both groups.

ETHICS AND DISSEMINATION

The study protocol will be published in a peer-reviewed journal. Ethics approval was provided by the Showa University Clinical Research Review Board.

TRIAL REGISTRATION NUMBER

jRCTs031220139; Japan Registry of Clinical Trails.

Impact of ß-hydroxy-ß-methylbutyrate (HMB) in critically ill patients on the endocrine axis - A post-hoc cohort study of the HMB-ICU trial

BACKGROUND

β-hydroxy-β-methylbutyrate (HMB) might improve muscle function and maintain its mass in critically ill patients. We aimed to investigate whether the administration of HMB influenced the plasma levels of growth hormone (GH)/insulin-like growth factor-1 (IGF-1), C-peptide, and 25-OH vitamin-D.

METHODS

Post-hoc analysis of the study HMB-ICU, a randomized, placebo-controlled double-blind trial.

INCLUSION CRITERIA

Intensive care unit (ICU) patients depending on mechanical ventilation on day 3 with functional gastrointestinal tract. Patients were randomized to HMB (3 g/day) or placebo (maltodextrin) from day 4 on, for 30 days. Blood samples were collected on days 4 and 15. We determined the GH, C-peptide, 25-OH vitamin-D, and IGF-1. Statistics by ANCOVA.

RESULTS

Blood samples of 26 patients were available on day 4, and 23 on day 15. While age and severity of disease did not differ, diabetes was more frequent in the HMB group (p = 0.041), and obesity was more frequent in the placebo group (p = 0.021). Glucose intake, blood glucose (BG) and amount of insulin to maintain blood glucose between 6 and 8 mM did not differ between groups. There was no difference between groups for C-peptide, GH, IGF-1, and 25-OH vitamin-D. IGF-1 increased significantly from day 4-15 (p = 0.026) in both groups.

CONCLUSION

Subject to possible insufficient power of the study, we did not reach conclusive results. HMB intervention does not affect significantly the plasma concentrations of insulin, GH/IGF axis activity, C-peptide, and 25-OH vitamin-D.

CLINICALTRIALS

GOV IDENTIFIER

NCT03628365.

Sarcopenia and Ageing

Musculoskeletal ageing is a major health challenge as muscles and bones constitute around 55-60% of body weight. Ageing muscles will result in sarcopenia that is characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes. In recent years, a few consensus panels provide new definitions for sarcopenia. It was officially recognized as a disease in 2016 with an ICD-10-CM disease code, M62.84, in the International Classification of Diseases (ICD). With the new definitions, there are many studies emerging to investigate the pathogenesis of sarcopenia, exploring new interventions to treat sarcopenia and evaluating the efficacy of combination treatments for sarcopenia. The scope of this chapter is to summarize and appraise the evidence in terms of (1) clinical signs, symptoms, screening, and diagnosis, (2) pathogenesis of sarcopenia with emphasis on mitochondrial dysfunction, intramuscular fat infiltration and neuromuscular junction deterioration, and (3) current treatments with regard to physical exercises and nutritional supplement.

Dietary methionine restriction improves gut microbiota composition and prevents cognitive impairment in D-galactose-induced aging mice

Dietary methionine restriction (MR) has been shown to delay aging and ameliorate age-related cognitive impairments. We hypothesized that changes in the gut microbiota may mediate these effects. To test this hypothesis, ICR mice subcutaneously injected with 150 mg kg^-1 day^-1D-galactose were fed a normal (0.86% methionine) or an MR (0.17% methionine) diet for 2 months. Multiple behavioral experiments were performed, and the gut microbiota composition, metabolite profiles related to short-chain fatty acids (SCFAs) in the feces, and indicators related to the redox and inflammatory states in the hippocampus were further analyzed. Our results indicated that MR alleviated cognitive impairment (including non-spatial memory deficits, working memory deficits, and hippocampus-dependent spatial memory deficits) and anxiety-like behavior in D-Gal-induced aging mice. Furthermore, MR increased the abundance of putative SCFA-producing bacteria such as Lachnospiraceae, Turicibacter, Roseburia, Ruminococcaceae_UCG-014, Intestinimonas, Rikenellaceae, Tyzzerella, and H₂S-producing bacteria such as Desulfovibrio in feces. Moreover, MR reversed and normalized the levels of intestinal SCFAs (acetate, propionate, and butyrate) and important intermediate metabolites of the SCFAs (pyruvate, lactate, malate, fumarate, and succinate), abolished aging-induced oxidative stress and inflammatory responses, increased the levels of H₂S in the plasma and hippocampus, and selectively modulated the expression of multiple learning- and memory-related genes in the hippocampus. These findings suggest that MR improved the gut microbiota composition and SCFA production and alleviated oxidative stress and inflammatory responses in the hippocampus, which might prevent cognitive impairment in D-galactose-induced aging mice.

Effects of β-hydroxy-β-methylbutyrate supplementation on recovery from exercise-induced muscle damage: a mini-review

PURPOSE

Several studies have reported that β-hydroxy-β-methylbutyrate (HMB) has beneficial effects on exercise-induced muscle damage (EIMD). Here, we examine the effects and mechanisms of HMB supplementation on exercise-induced muscle damage EIMD and provide guidelines for the application of supplementary HMB.

METHODS

For this review, we performed web searches using PubMed, Web of Science, and Wiley Online Library. Keywords used were 'HMB,' 'HMB and EIMD,' 'HMB and recovery,' 'HMB and resistance exercise,' and 'HMB and eccentric muscle contraction.'

RESULTS

Several previous studies have shown that HMB supplementation can reduce EIMD and promote recovery. In particular, reductions were detected in certain markers of muscle membrane damage, including creatine kinase and lactate dehydrogenase. There may be multiple mechanisms in which HMB supplementation reduces EIMD, including reducing muscle-damage-induced inflammation and oxidative stress and promoting cellular cholesterol synthesis by increasing the production of β-hydroxy-β-methylglutaryl-Co-A, a product of HMB metabolism. In general, the suggested daily intake of HMB is 3 g. In addition, the timing and duration of HMB intake can be classified as chronic [≥ 2 weeks, in which a total of 3 g is consumed daily (3 × 1 g taken at breakfast, lunch, and dinner)] or acute (taken 30-60 min before exercise). The timing of intake during exercise may vary depending upon whether the formulation is calcium HMB (60-120 min before exercise) or the free-acid form of HMB (30-60 min before exercise). Notably, the co-administration of HMB and creatine does not appear to be effective in reducing EIMD.

CONCLUSION

HMB supplementation can be considered as an effective nutritional strategy to minimize EIMD.

Natural Compounds That Enhance Motor Function in a Mouse Model of Muscle Fatigue

Musculoskeletal disease can be a serious condition associated with aging that may lead to fractures and a bedridden state due to decreased motor function. In addition to exercise training to increase muscle mass, increasing muscle function with the intake of functional foods is an effective treatment strategy for musculoskeletal disease. Muscle-specific SOD2-deficient mice (muscle-Sod2^-/-) show a severe disturbance in exercise in association with increased mitochondrial reactive oxygen species, as well as mitochondrial dysfunction and muscle damage. In the present study, to develop a therapeutic strategy for musculoskeletal disease, we searched for substances that enhanced motor function among functional compounds by in vivo screening using muscle-Sod2^-/- mice as a muscle fatigue model. We administered 96 compounds, including antioxidants, to muscle-Sod2^-/- mice and assessed their effects on treadmill performance. Among the administered compounds, gossypin, genistein, kaempferol, taxifolin, fumaric acid, β-hydroxy-β-methylbutyrate Ca, and astaxanthin, which are dietary functional food factors, increased forced running time in muscle-Sod2^-/- mice. In addition, troglitazone, tempol, trolox, and MnTE-2-PyP, which are antioxidants, also significantly increased the running ability of muscle-Sod2^-/- mice. These results suggest that the intake of functional foods with antioxidant activity can improve motor function. Muscle-Sod2^-/- mice, as a muscle fatigue model, are suitable for the in vivo screening of functional substances that promote improvements in exercise and muscle performance.

EXERCISE-INDUCED HORMONAL RESPONSES TO HMB ADMINISTRATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

ABSTRACT Introduction: The β-hydroxy β-methyl butyrate (HMB) is an amino acid leucine metabolite with several ergogenic benefits. It is known that it can benefit testosterone and cortisol concentration in athletes. However, no systematic review and meta-analysis has focused on the effects of HMB supplementation on testosterone and cortisol in trained athletes. Objectives: The meta-analysis evaluates the effect of HMB supplementation on testosterone and cortisol in trained athletes and verifies conflicting results between studies. Methods: A systemic review was performed in Scopus, Medline, and Google scholar databases of articles published until August 2021. The Cochrane Collaboration tool was used to assess the risk of bias and assess the quality of the studies. Random effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were used to estimate the overall effect. Results: Although the meta-analysis showed that HMB consumption does not alter cortisol and testosterone concentration, subgroup analysis based on exercise type exhibited a significant decrease in cortisol concentration in resistance training exercises (P<0.05) and a significant increase in testosterone concentration in combined aerobic and anaerobic sports (P<0.05). Conclusion: The results indicate that HMB supplementation in athletes can reduce cortisol concentration in endurance exercise and increase testosterone concentration in combined aerobic and anaerobic exercise. Evidence Level II; Therapeutic Studies – Investigating the results.

Supplementing sows with the leucine metabolite beta-hydroxy-beta-methylbutyrate and vitamin D3 improves piglet birth weights that may lead to increased weaning weights

Previous university studies demonstrated that supplementing sows with calcium beta-hydroxy-beta-methylbutyrate (CaHMB) in late gestation and/or lactation improved piglet weights through weaning. Two studies were conducted at commercial farrowing operations to test if the results would translate to commercial operations. Sows in both trials were randomized to receive either 3 g/day CaHMB plus 500 IU/day vitamin D3 (HMB/D) or a calcium carbonate containing control top-dressed to the feed from day 104 of gestation through weaning. Sows were randomly assigned to either HMB/D (n = 41 trial 1 and n = 26 trial 2) or control (n = 46 trial 1 and n = 26 trial 2). Data were analyzed using a general linear model with main effects of group, treatment, and group by treatment interaction. Treatment with HMB/D had no effect on sow weights, lactational weight loss, and stillborn or mummified piglets. In trial 1, the control group had an increased number of live born piglets, which at 24 h tended to be greater, and no difference in liveborn or 24-h piglet numbers was seen in trial 2. In trial 1, HMB/D increased piglet live birth (P &lt; 0.03) and 24-h weights (1,490 ± 30.1 vs. 1,390 ± 28.8 g in HMB/D and control piglets, respectively, P &lt; 0.02). Farm practices were to equalize piglet numbers across sows by cross-fostering. After cross-fostering, the 24-h average piglet weights were not different, and further advantages to supplementation were not observed (P = 0.21). In trial 2, birth and 24-h weights of the piglets from HMB/D-supplemented sows were increased (P &lt; 0.0001). Piglets from sows supplemented with HMB/D were 9.7% heavier at birth and 9.2% heavier at 24 h (1,549 ± 22.0 and 1,419 ± 21.2 in HMB/D and control, respectively). A difference was observed in weaning age (P &lt; 0.0001), and weaning weights were adjusted to 21-day weights (5,426 ± 103.5 and 5,205 ± 99.5 for HMB/D and control piglets, respectively, P = 0.12). Analysis by group showed that HMB/D tended to increase weaning weights in younger sows (second and third parity), 5,432 ± 150.7 and 5,074 ± 142.7 in HMB/D and control piglets, respectively (P &lt; 0.09). In conclusion, these results agree with previous university studies demonstrating that CaHMB supplementation increased early piglet weights with a tendency to improve weaning weights.

Bibliometric Analysis of the Knowledge Base and Future Trends on Sarcopenia from 1999–2021

Sarcopenia is characterized by progressive loss of muscle mass and function, and it is becoming a serious public health problem with the aging population. However, a comprehensive overview of the knowledge base and future trends is still lacking. The articles and reviews with “sarcopenia” in their title published from 1999 to 2021 in the SCIE database were retrieved. We used Microsoft Excel, VOSviewer, and CiteSpace to conduct a descriptive and bibliometric analysis. A total of 3582 publications were collected, from 4 published in 2000 increasing dramatically to 850 documents in 2021. The USA was the most productive country, with the most citations. The Catholic University of the Sacred Heart and Landi F were the most influential organization and author in this field, respectively. The core journal in this field was the Journal of Cachexia Sarcopenia and Muscle. According to the analysis of keywords and references, we roughly categorized the main research areas into four domains as follows: 1. Definition and diagnosis; 2. Epidemiology; 3. Etiology and pathogenesis; 4. Treatments. Comparing different diagnostic tools and the epidemiology of sarcopenia in different populations are recent hotspots, while more efforts are needed in the underlying mechanism and developing safe and effective treatments. In conclusion, this study provides comprehensive insights into developments and trends in sarcopenia research that can help researchers and clinicians better manage and implement their work.

Testosterone and cortisol responses to ß‐hydroxy ß‐methylbutryate consumption and exercise: A meta‐analysis

Background

β‐hydroxy β‐methylbutryate (HMB) is a metabolite of leucine amino acid and it has several ergogenic benefits. Previous studies also showed that it may affect beneficially the testosterone and cortisol concentration in athletes. Due to the contradiction results between studies, we aimed to conduct this meta‐analysis to assess the HMB supplementation effect on testosterone and cortisol in trained athletes.

Methods

Scopus, Medline, and Google scholar were systematically searched up to August 2021. The Cochrane Collaboration tool for evaluating the risk of bias was applied for assessing the studies' quality. Random‐effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were used for estimating the overall effect. Between‐study heterogeneity was evaluated applying the chi‐squared and I² statistic.

Results

Seven articles were included in the meta‐analysis. Although the meta‐analysis generally showed that HMB consumption did not have any effect on the cortisol and testosterone concentration (p > .05), subgroup analysis based on the exercise type showed a significant decrease in the cortisol concentration in resistance training exercises (WMD = −3.30; 95% CI: −5.50, −1.10; p = .003) and a significant increase in the testosterone concentration in aerobic and anaerobic combined sports (WMD = 1.56; 95% CI: 0.07, 3.05; p = .040).

Conclusion

The results indicate that HMB supplementation in athletes can reduce the concentration of cortisol in resistance exercises and increase the concentration of testosterone in aerobic and anaerobic combined exercises. Nevertheless, more studies are required to confirm these results.

Acute dose toxicity evaluation of the food supplement calcium 3-hydroxy-3-methylbutyrate (HMB) in female Sprague Dawley rats

The leucine metabolite, 3-hydroxy-3-methylbutyrate (HMB), primarily utilized as the calcium salt (CaHMB) has become one of the most widely used supplements and food ingredients to promote muscle health. While both CaHMB and HMB free acid have published sub-chronic toxicity studies, and CaHMB has published studies on genotoxicity, data are lacking on the acute dosing of HMB which is important for regulatory and transportation classification as well as in cases of accidental overconsumption. Therefore, an acute oral toxicity study was conducted with CaHMB following OECD 420 guidelines. One rat was used in the dosage sighting study and four rats were used in the main study. In both studies, rats were given a single oral dose of 2000 mg/kg body weight by gavage and monitored for 14 days following the dosage for changes in body weight, clinical signs as noted in OECD 420, and at the end of the study a necropsy was conducted to determine any gross tissue abnormalities. The dosage of CaHMB administered resulted in no deaths, no significant adverse clinical signs, and no findings of lesions or abnormal tissues. Under the Global Harmonized System of classification, CaHMB was found to be in the least toxic Category 5 or non-toxic.

Impact of Sarcopenia and Myosteatosis in Non-Cirrhotic Stages of Liver Diseases: Similarities and Differences across Aetiologies and Possible Therapeutic Strategies

Sarcopenia is defined as a loss of muscle strength, mass and function and it is a predictor of mortality. Sarcopenia is not only a geriatric disease, but it is related to several chronic conditions, including liver diseases in both its early and advanced stages. Despite the increasing number of studies exploring the role of sarcopenia in the early stages of chronic liver disease (CLD), its prevalence and the relationship between these two clinical entities are still controversial. Myosteatosis is characterized by fat accumulation in the muscles and it is related to advanced liver disease, although its role in the early stages is still under researched. Therefore, in this narrative review, we firstly aimed to evaluate the prevalence and the pathogenetic mechanisms underlying sarcopenia and myosteatosis in the early stage of CLD across different aetiologies (mainly non-alcoholic fatty liver disease, alcohol-related liver disease and viral hepatitis). Secondly, due to the increasing prevalence of sarcopenia worldwide, we aimed to revise the current and the future therapeutic approaches for the management of sarcopenia in CLD.

β-Hydroxy-β-Methylbutyrate Supplementation Promotes Antitumor Immunity in an Obesity Responsive Mouse Model of Pancreatic Ductal Adenocarcinoma

Simple Summary

Pancreatic cancer (PDAC) is a deadly disease, exacerbated by obesity, which lacks effective therapeutic interventions. Most PDAC has a limited response to immune- and chemotherapy. Treating PDAC is made additionally challenging by the rapid emergence of muscle wasting and cachexia, which predict poor response to several therapies. We have found that dietary supplementation with β-hydroxy-β-methylbutyrate promotes immunosurveillance in PDAC tumors and protects muscle. This dietary supplement has the potential to be an important adjuvant in PDAC therapy, opening the doors to immunotherapy response.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related deaths in the United States, and effective therapies for PDAC are currently lacking. Moreover, PDAC is promoted and exacerbated by obesity, while cachexia and sarcopenia are exceptionally common comorbidities that predict both poor survival and treatment response. Managing PDAC with immunotherapies has thus far proven ineffective, partly due to the metabolically hostile tumor microenvironment. β-hydroxy-β-methylbutyrate (HMB), a metabolite of leucine commonly used as a dietary supplement to boost muscle growth and immune function, may be an attractive candidate to augment PDAC therapy. We therefore sought to test the hypothesis that HMB would enhance antitumor immunity while protecting mouse muscle mass. Control and diet-induced obese C57BL/6 male mice bearing subcutaneously injected Panc02 tumors were supplemented with 1% HMB and treated with or without 50 mg/kg gemcitabine (n = 15/group). HMB was associated with reduced muscle inflammation and increased muscle fiber size. HMB also reduced tumor growth and promoted antitumor immunity in obese, but not lean, mice, independent of the gemcitabine treatment. Separately, in lean tumor-bearing mice, HMB supplementation promoted an anti-PD1 immunotherapy response (n = 15/group). Digital cytometry implicated the decreased abundance of M2-like macrophages in PDAC tumors, an effect that was enhanced by anti-PD1 immunotherapy. We confirmed that HMB augments M1-like macrophage (antitumor) polarization. These preclinical findings suggest that HMB has muscle-sparing and antitumor activities against PDAC in the context of obesity, and that it may sensitize otherwise nonresponsive PDAC to immunotherapy.

Femoral µCT Analysis, Mechanical Testing and Immunolocalization of Bone Proteins in β-Hydroxy β-Methylbutyrate (HMB) Supplemented Spiny Mouse in a Model of Pregnancy and Lactation-Associated Osteoporosis

A metabolite of leucine, ß-hydroxy-ß-methylbutyrate (HMB), used as a dietary supplement effects muscle tissue gain and bone tissue quality. Since there are no studies on the effects of HMB during pregnancy yet, the aim of the current study was to determine the effects of HMB supplementation during pregnancy on osteoporotic bone quality postpartum and post-lactation using spiny mice (Acomys cahirinus) as the animal models. The six-month-old dams were divided into four groups: pregnant and lactating controls, and pregnant and lactating HMB-treated (during the second trimester of pregnancy) females. The intensity of the immunoreaction of osteocalcin (OC), osteoprotegerin (OPG), bone morphogenetic protein 2 (BMP-2), tissue inhibitor of metalloproteinases 2 (TIMP-2), matrix metalloproteinase 8 and 13 (MMP-8 and MMP-13) and proteins involved in bone turnover, was measured in femoral trabecular and compact bone, as well as in the hyaline and epiphyseal cartilage of the femora. The analysis of the trabecular bone microarchitecture showed that the administration of HMB to pregnant females, by influencing the proteins responsible for bone cell activity and collagen remodeling, can provide protection from bone loss. Based on the results of the current study it can be assumed that HMB administration to pregnant females has a more positive impact on trabecular than compact bone.

Effects of exercise and/or β-hydroxy-β-methylbutyrate supplementation on muscle mass, muscle strength, and physical performance in older women with low muscle mass: a randomized, double-blind, placebo-controlled trial

BACKGROUND

The interaction between exercise and nutritional supplementation is unclear among older adults at risk of sarcopenia.

OBJECTIVES

We aimed to examine if β-hydroxy-β-methylbutyrate (HMB) supplementation enhances the effects of exercise on muscle mass, strength, and physical performance and observe potential residual effects in older women with low muscle mass.

METHODS

This 12-wk, randomized, double-blind, placebo-controlled, 2 × 2 factorial design (exercise-only, HMB-only, both, and none) trial included 156 women aged 65-79 y with skeletal muscle index <5.7 kg/m2, and was followed by a 12-wk observational period. Resistance training twice weekly or education programs every 2 wk and calcium-HMB (1500 mg) or placebo supplements daily were provided. The primary outcome was the change in muscle mass from baseline to postintervention. Secondary outcomes included changes in muscle strength and physical performance.

RESULTS

In total, 149 and 144 participants completed the assessment at weeks 12 and 24, respectively. ANOVAs based on the intention-to-treat principle showed no significant interactions between exercise and HMB on any primary outcomes. The main-effect analyses revealed that exercise improved the usual and maximal gait speed by 0.16 m/s (95% CI: 0.10, 0.21 m/s) and 0.15 m/s (95% CI: 0.09, 0.22 m/s), respectively; the knee extensor and hip adductor strength by 22.0 N (95% CI: 10.1, 33.9 N) and 21.8 N (95% CI: 12.9, 30.7 N), respectively; and timed up-and-go and sit-to-stand time by -0.5 s (95% CI: -0.7, -0.3 s) and -1.7 s (95% CI: -2.1, -1.3 s), respectively, relative to education. HMB improved usual gait speed by 0.06 m/s (95% CI: 0.01, 0.11 m/s) relative to placebo. Most improvements disappeared during the subsequent 12-wk observation period.

CONCLUSIONS

HMB additively improved gait performance with negligible benefit and provided no enhancements in the effects of exercise on other outcomes. Exercise appeared to be the only effective intervention to improve outcomes in older women with low muscle mass.This trial was registered at www.umin.ac.jp/ctr/as UMIN000028560.

Nutritional interventions to improve muscle mass, muscle strength, and physical performance in older people: an umbrella review of systematic reviews and meta-analyses

CONTEXT

Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased risk of adverse outcomes such as falls, disability, and death. The Belgian Society of Gerontology and Geriatrics has developed evidence-based guidelines for the prevention and treatment of sarcopenia. This umbrella review presents the results of the Working Group on Nutritional Interventions.

OBJECTIVE

The aim of this umbrella review was to provide an evidence-based overview of nutritional interventions targeting sarcopenia or at least 1 of the 3 sarcopenia criteria (ie, muscle mass, muscle strength, or physical performance) in persons aged ≥ 65 years.

DATA SOURCES

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed and Web of Science databases were searched for systematic reviews and meta-analyses reporting the effect of nutritional supplementation on sarcopenia or muscle mass, strength, or physical performance.

DATA EXTRACTION

Two authors extracted data on the key characteristics of the reviews, including participants, treatment, and outcomes. Methodological quality of the reviews was assessed using the product A Measurement Tool to Assess Systematic Reviews. Three authors synthesized the extracted data and generated recommendations on the basis of an overall synthesis of the effects of each intervention. Quality of evidence was rated with the Grading of Recommendations Assessment, Development and Evaluation approach.

DATA ANALYSIS

A total of 15 systematic reviews were included. The following supplements were examined: proteins, essential amino acids, leucine, β-hydroxy-β-methylbutyrate, creatine, and multinutrient supplementation (with or without physical exercise). Because of both the low amount and the low to moderate quality of the reviews, the level of evidence supporting most recommendations was low to moderate.

CONCLUSIONS

Best evidence is available to recommend leucine, because it has a significant effect on muscle mass in elderly people with sarcopenia. Protein supplementation on top of resistance training is recommended to increase muscle mass and strength, in particular for obese persons and for ≥ 24 weeks. Effects on sarcopenia as a construct were not reported in the included reviews.

β-Hydroxy-β-Methylbutyrate (HMB) Supplementation Prevents Bone Loss during Pregnancy-Novel Evidence from a Spiny Mouse (Acomys cahirinus) Model

The aim of this study was to determine the effects of ß-hydroxy-ß-methylbutyrate (HMB) supplementation during pregnancy on postpartum bone tissue quality by assessing changes in trabecular and compact bone as well as in hyaline and epiphyseal cartilage. The experiment was carried out on adult 6-month-old female spiny mice (Acomys cahirinus) divided into three groups: pregnant control (PregCont), pregnant HMB-treated (supplemented with 0.02 g/kg b.w of HMB during the second trimester of pregnancy, PregHMB), and non-pregnant females (NonPreg). Cross-sectional area and cortical index of the femoral mid-shaft, stiffness, and Young modulus were significantly greater in the PregHMB group. Whole-bone mineral density was similar in all groups, and HMB supplementation increased trabecular number. Growth plate cartilage was the thinnest, while the articular cartilage was the thickest in the PregHMB group. HMB supplementation increased the content of proteoglycans in the articular cartilage and the percentage of immature collagen content in metaphyseal trabeculae and compact bone. In summary, dietary HMB supplementation during the second trimester of pregnancy intensifies bone metabolic processes and prevents bone loss during pregnancy.

Why Are Masters Sprinters Slower Than Their Younger Counterparts? Physiological, Biomechanical, and Motor Control Related Implications for Training Program Design

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.

Atherosclerosis Linked to Aberrant Amino Acid Metabolism and Immunosuppressive Amino Acid Catabolizing Enzymes

Cardiovascular disease is the leading global health concern and responsible for more deaths worldwide than any other type of disorder. Atherosclerosis is a chronic inflammatory disease in the arterial wall, which underpins several types of cardiovascular disease. It has emerged that a strong relationship exists between alterations in amino acid (AA) metabolism and the development of atherosclerosis. Recent studies have reported positive correlations between levels of branched-chain amino acids (BCAAs) such as leucine, valine, and isoleucine in plasma and the occurrence of metabolic disturbances. Elevated serum levels of BCAAs indicate a high cardiometabolic risk. Thus, BCAAs may also impact atherosclerosis prevention and offer a novel therapeutic strategy for specific individuals at risk of coronary events. The metabolism of AAs, such as L-arginine, homoarginine, and L-tryptophan, is recognized as a critical regulator of vascular homeostasis. Dietary intake of homoarginine, taurine, and glycine can improve atherosclerosis by endothelium remodeling. Available data also suggest that the regulation of AA metabolism by indoleamine 2,3-dioxygenase (IDO) and arginases 1 and 2 are mediated through various immunological signals and that immunosuppressive AA metabolizing enzymes are promising therapeutic targets against atherosclerosis. Further clinical studies and basic studies that make use of animal models are required. Here we review recent data examining links between AA metabolism and the development of atherosclerosis.

An 1H NMR- and MS-Based Study of Metabolites Profiling of Garden Snail Helix aspersa Mucus

Metabolic profiling based on 1H nuclear magnetic resonance (NMR) spectroscopy was applied with the aim to investigate the functional role of the metabolites in lyophilized mucus from the garden snail Helix aspersa. Twenty metabolites were unambiguously identified by 1H, 1D TOCSY, 2D J-resolved, 2D COSY, and 2D HSQC NMR spectra with water suppression. The metabolic profiles of two fractions with low molecular weight (Mw < 1 kDa and Mw < 3 kDa) are very similar. Metabolites with known antioxidant, antibacterial, and antimicrobial activity were detected by NMR metabolic analysis of mucus samples from Helix aspersa. Some of them were confirmed by mass spectrometric analysis. The primary structure of several peptides was identified in low molecular weight fractions (Mw < 1 kDa) by tandem mass spectrometry.

β-hydroxy-β-methylbutyrate supplementation benefits the effects of resistance training on body fat reduction via increased irisin expression in white adipose tissue

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.

Regulation of Folliculogenesis by Growth Factors in Piglet Ovary Exposed Prenatally to β-Hydroxy-β-Methylbutyrate (HMB)

Β-hydroxy-β-methylbutyrate (HMB) is one of the leucine metabolites with protein anabolic effects which makes it very popular among athletes. Previously, it was shown that HMB administered during the prenatal period reduced the pool of primordial follicles and increased the proportion of developing follicles in newborn piglets. This work is a further step to understand these morphological alterations. Therefore, the aim of this study was to examine the effect of prenatal HMB treatment on the expression of the Kit ligand, BMP-4, bFGF, and the IGF-1/IGF-1R system which are the main growth factors controlling follicular development. Excised ovaries from 12 newborn piglets, originated from the control (n=6) and HMB-treated (n=6) sows were used for immunohistochemical and western-blot analysis. The tested proteins were localized within egg nests and ovarian follicles. Furthermore, the western-blot assay indicated higher BMP-4, Kit ligand, and IGF-1R expression, while the level of bFGF and IGF-1 proteins decreased after HMB dietary treatment. These findings show that HMB included into sow diet can modulate the expression of growth factors and thereby alter ovarian morphology in offspring. Therefore, this study opens a discussion about the benefits and risks of the diet supplemented with HMB and its potential application in medicine and animal husbandry, and further research is necessary in this area.

The Effects of Calcium-β-Hydroxy-β-Methylbutyrate on Aging-Associated Apoptotic Signaling and Muscle Mass and Function in Unloaded but Nonatrophied Extensor Digitorum Longus Muscles of Aged Rats

Beta-hydroxy-beta-methylbutyrate (HMB), a naturally occurring leucine metabolite, has been shown to attenuate plantar flexor muscle loss and increase myogenic stem cell activation during reloading after a period of significant muscle wasting by disuse in old rodents. However, it was less clear if HMB would alter dorsiflexor muscle response to unloading or reloading when there was no significant atrophy that was induced by unloading. In this study, we tested if calcium HMB (Ca-HMB) would improve muscle function and alter apoptotic signaling in the extensor digitorum longus (EDL) of aged animals that were unloaded but did not undergo atrophy. The EDL muscle was unloaded for 14 days by hindlimb suspension (HS) in aged (34-36 mo.) male Fisher 344 × Brown Norway rats. The rats were removed from HS and allowed normal cage ambulation for 14 days of reloading (R). Throughout the study, the rats were gavaged daily with 170 mg of Ca-HMB or water 7 days prior to HS, then throughout 14 days of HS and 14 days of recovery after removing HS. The animals' body weights were significantly reduced by ~18% after 14 days of HS and continued to decline by ~22% during R as compared to control conditions; however, despite unloading, EDL did not atrophy by HS, nor did it increase in mass after R. No changes were observed in EDL twitch contraction time, force production, fatigue resistance, fiber cross-sectional area, or markers of nuclear apoptosis (myonuclei + satellite cells) after HS or R. While HS and R increased the proapoptotic Bax protein abundance, BCL-2 abundance was also increased as was the frequency of TUNEL-positive myonuclei and satellite cells, yet muscle mass and fiber cross-sectional area did not change and Ca-HMB treatment had no effect reducing apoptotic signaling. These data indicate that (i) increased apoptotic signaling preceded muscle atrophy or occurred without significant EDL atrophy and (ii) that Ca-HMB treatment did not improve EDL signaling, muscle mass, or muscle function in aged rats, when HS and R did not impact mass or function.

Nutritional Strategies to Optimize Performanceand Recovery in Rowing Athletes

Rowing is a high-intensity sport requiring a high level of aerobic and anaerobic capacity. Although good nutrition is essential for successful performance in a rowing competition, its significance is not sufficiently established. This review aimed to provide nutritional strategies to optimize performance and recovery in rowing athletes based on a literature review. Following the guidelines given in the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), we performed web searches using online databases (Pubmed, Web of Science, Wiley Online Library, ACS Publications, and SciFinder). Typically, a rowing competition involves a 6–8-min high-intensity exercise on a 2000-m course. The energy required for the exercise is supplied by muscle-stored glycogens, which are derived from carbohydrates. Therefore, rowing athletes can plan their carbohydrate consumption based on the intensity, duration, and type of training they undergo. For effective and safe performance enhancement, rowing athletes can take supplements such as β-alanine, caffeine, β-hydroxy-β-methylbutyric acid (HMB), and beetroot juice (nitrate). An athlete may consume carbohydrate-rich foods or use a carbohydrate mouth rinse. Recovery nutrition is also very important to minimize the risk of injury or unexplained underperformance syndrome (UUPS) from overuse. It must take into account refueling (carbohydrate), rehydration (fluid), and repair (protein). As lightweight rowing athletes often attempt acute weight loss by limiting food and fluid intake to qualify for a competition, they require personalized nutritional strategies and plans based on factors such as their goals and environment. Training and competition performance can be maximized by including nutritional strategies in training plans.

The addition of β-Hydroxy β-Methylbutyrate (HMB) to creatine monohydrate supplementation does not improve anthropometric and performance maintenance across a collegiate rugby season

BACKGROUND

Muscular damage sustained while playing rugby may hinder performance across a season. β-Hydroxy β-Methylbutyrate (HMB) may help attenuate muscle damage and maintain lean mass and performance. This study sought to determine the effect of combining HMB with creatine monohydrate supplementation on measures of stress and muscle damage, body composition, strength and sprinting kinetics throughout a rugby season.

METHODS

This double-blind, cross-over investigation recruited 16 male collegiate rugby players to provide resting blood samples and complete assessments of body composition, strength and sprinting performance prior to their fall season (PREFALL). After testing, the athletes were matched for fat-free mass and assigned to consume one of two supplementation regimens for 6 weeks: 5 g HMB + 5 g creatine per day (HMB-Cr: 20.9 ± 1.1 years; 177 ± 2 cm; 88.4 ± 4.9 kg) or 5 g creatine + 5 g placebo per day (Cr: 21.4 ± 2.1 years; 179 ± 2 cm; 88.3 ± 4.9 kg). After 6 weeks (POSTFALL), PREFALL testing was repeated in 13 of the original 16 athletes before a 10-wk wash-out period. Athletes who returned for the spring season (n = 8) repeated all fall-season procedures and testing prior to (PRESPRING) and following (POSTSPRING) their 6-wk spring season, except they were assigned to the opposite supplementation regimen.

RESULTS

Linear mixed models with repeated measures revealed group x time interactions (p <  0.05) for observed for several measures but did not consistently and positively favor one group. During the fall season, knee extensor peak torque was reduced by 40.7 ± 28.1 Nm (p = 0.035) for HMB-Cr but remained consistent for Cr, and no group differences or changes were noted in the spring. In the spring, greater knee flexor rate of torque development (~ 149 Nm·sec- 1, p = 0.003) and impulse (~ 4.5 Nm·sec, p = 0.022) were observed in Cr at PRESPRING but not at POSTSPRING. Although significant interactions were found for cortisol concentrations, vastus lateralis pennation angle, and sprinting force, post-hoc analysis only revealed differences between fall and spring seasons. No other differences were observed.

CONCLUSIONS

The combination of HMB and creatine monohydrate supplementation does not provide a greater ergogenic benefit compared to creatine monohydrate supplementation alone. Body composition, strength, and sprinting ability did not change across the season with creatine monohydrate supplementation.

Low Dose of β-Hydroxy-β-Methylbutyrate (HMB) Alleviates Muscle Strength Loss and Limited Joint Flexibility following Eccentric Contractions

Objective: The optimal dose of β-hydroxy-β-methylbutyrate (HMB) required for decreasing muscle damage remains unknown. Therefore, this study investigated the supplemental effect of low-dose HMB on muscle damage following eccentric contractions (ECCs) of human elbow flexors.Methods: Twenty untrained men (aged 20-26; height, 169.4 ± 5.7 cm; weight, 68.2 ± 11.3 kg; body mass index, 23.7 ± 3.3) completed the double-blind, placebo-controlled, parallel design study. The subjects were randomly assigned to the ingestion of HMB supplement (HMB, n = 10) or placebo group (PL, n = 10). After the subjects of 1.5 g HMB or placebo pills per day for 2 weeks, they performed six sets of 10 ECCs at 100% maximal voluntary contraction (MVC) using dumbbell. Changes in MVC torque, range of motion (ROM), upper arm circumference, muscle soreness, and muscle stiffness were assessed before, immediately after, 1, 2, 3, 5 days after exercise.Results: MVC torque was significantly higher in the HMB group than in the PL group immediately after (HMB, -56.8%; PL, -67.1%) as well as 3 (HMB: -25.5%, PL: -48.7%) and 5 (HMB: -22.5%, PL: -44.0%) days after performing ECCs (p < 0.05). Additionally, ROM was significantly higher in the HMB group than in the PL group immediately after (HMB, -29.8%; PL, -50.5%) and 5 (HMB: -26.1%, PL: -43.3%) days after performing ECCs (p < 0.05). No between-group differences were observed in other muscle damage markers.Conclusion: The low-dose HMB supplementation demonstrated a moderate overall impact and played a beneficial role in muscle dysfunction and joint flexibility following ECCs.

Combined protein and calcium β-hydroxy-β-methylbutyrate induced gains in leg fat free mass: a double-blinded, placebo-controlled study

Background

The leucine metabolite β-hydroxy-β-methylbutyrate (HMB) is widely used as an ergogenic supplement to increase resistance-training induced gains in fat free mass (FFM) and strength in healthy adults. Recent studies have questioned the effectiveness of HMB, particularly when a high protein diet is habitually consumed. To investigate the additive resistance-training induced effects of HMB and protein in untrained individuals, we conducted a randomized double-blind, placebo-controlled study that compared the effects of combined protein and HMB supplementation to protein supplementation alone on FFM and muscle strength after 12-week resistance training.

Methods

Sixteen healthy men (22 ± 2 yrs) performed a periodized resistance-training program for twelve weeks (four sessions per week). The program comprised two mesocycles, characterized by a linear periodization and non-linear periodization, respectively, and separated by a 1-week tapering period. All participants received 60 g of whey protein on training days and 30 g of whey protein (WP) on non-training days. Participants were randomly assigned to additionally receive 3 g of calcium HMB (WP + HMB) or a placebo (WP + PLA). Body composition and physical fitness were tested before and after the 12-week training program. Whole-body and arm and leg fat free mass (FFM) were assessed by bioimpedance spectroscopy; upper arm and leg fat free cross sectional areas were also quantified using magnetic resonance imaging (MRI); upper and lower body strength were measured by One-repetition maximum (1-RM) bench press and leg press.

Results

Whole-body and segmental FFM increased in both groups (P <  0.001). However, gains in leg FFM were higher in WP + HMB vs. WP + PLA (arm FFM: + 6.1% vs. + 9.2%, P = 0.2; leg FFM: + 14.2% vs. + 7.0%, P <  0.01). No change in fat mass was observed (P = 0.59). 1-RM increased in both groups (P <  0.001).

Conclusions

Combined protein and HMB supplementation resulted in segmental, but not whole-body increases in FFM compared to protein supplementation alone. These findings could explain some of the controversial effects of HMB reported in previous studies and have practical implications for maximizing training-induced gains in FFM and clinical conditions associated with skeletal muscle deconditioning such as aging, sedentary lifestyles, bed rest and spaceflight.

Long-Term Effect of Combination of Creatine Monohydrate Plus β-Hydroxy β-Methylbutyrate (HMB) on Exercise-Induced Muscle Damage and Anabolic/Catabolic Hormones in Elite Male Endurance Athletes

Creatine monohydrate (CrM) and β-hydroxy β-methylbutyrate (HMB) are widely studied ergogenic aids. However, both supplements are usually studied in an isolated manner. The few studies that have investigated the effect of combining both supplements on exercise-induced muscle damage (EIMD) and hormone status have reported controversial results. Therefore, the main purpose of this study was to determine the effect and degree of potentiation of 10 weeks of CrM plus HMB supplementation on EIMD and anabolic/catabolic hormones. This study was a double-blind, placebo-controlled trial where participants (n = 28) were randomized into four different groups: placebo group (PLG; n = 7), CrM group (CrMG; 0.04 g/kg/day of CrM; n = 7), HMB group (HMBG; 3 g/day of HMB; n = 7), and CrM-HMB group (CrM-HMBG; 0.04 g/kg/day of CrM plus 3 g/day of HMB; n = 7). Before (baseline, T1) and after 10 weeks of supplementation (T2), blood samples were collected from all rowers. There were no significant differences in the EIMD markers (aspartate aminotransferase, lactate dehydrogenase, and creatine kinase) among groups. However, we observed significant differences in CrM-HMBG with respect to PLG, CrMG, and HMBG on testosterone (p = 0.006; η2p = 0.454) and the testosterone/cortisol ratio (T/C; p = 0.032; η2p = 0.349). Moreover, we found a synergistic effect of combined supplementation on testosterone (CrM-HMBG = -63.85% vs. CrMG + HMBG = -37.89%) and T/C (CrM-HMBG = 680% vs. CrMG + HMBG = 57.68%) and an antagonistic effect on cortisol (CrM-HMBG = 131.55% vs. CrMG + HMBG = 389.99%). In summary, the combination of CrM plus HMB showed an increase in testosterone and T/C compared with the other groups after 10 weeks of supplementation. Moreover, this combination presented a synergistic effect on testosterone and T/C and an antagonistic effect on cortisol compared with the sum of individual or isolated supplementation.

Effect of Ten Weeks of Creatine Monohydrate Plus HMB Supplementation on Athletic Performance Tests in Elite Male Endurance Athletes

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.

Effect of the Combination of Creatine Monohydrate Plus HMB Supplementation on Sports Performance, Body Composition, Markers of Muscle Damage and Hormone Status: A Systematic Review

Although there are many studies showing the isolated effect of creatine monohydrate (CrM) and β-hydroxy β-methylbutyrate (HMB), it is not clear what effect they have when they are combined. The main purpose of this systematic review was to determine the efficacy of mixing CrM plus HMB in comparison with their isolated effects on sports performance, body composition, exercise induced markers of muscle damage, and anabolic-catabolic hormones. This systematic review was carried out in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines and the PICOS model, for the definition of the inclusion criteria. Studies were found by searching PubMed/MEDLINE, Web of Science (WOS), and Scopus electronic databases from inception to July 3rd 2019. Methodological quality and risk of bias were assessed by two authors independently, and disagreements were resolved by third-party evaluation, in accordance with the Cochrane Collaboration Guidelines samples. The literature was examined regarding the effects of the combination of CrM plus HMB on sport performance using several outcome variables (athletic performance, body composition, markers of muscle damage, and hormone status). This systematic review included six articles that investigated the effects of CrM plus HMB on sport performance (two on strength performance, showing improvements in one of them; three on anaerobic performance, presenting enhancements in two of them; and one on aerobic performance, not presenting improvements), body composition (three on body mass, showing improvements in one of them; two on fat free mass, presenting increases in one of them; and two on fat mass, showing decreases in one of them) and markers of muscle damage and hormone status (four on markers of muscle damage and one on anabolic-catabolic hormones, not showing benefits in any of them). In summary, the combination of 3–10 g/day of CrM plus 3 g/day of HMB for 1–6 weeks could produce potential positive effects on sport performance (strength and anaerobic performance) and for 4 weeks on body composition (increasing fat free mass and decreasing fat mass). However, this combination seems to not show positive effects relating to markers of exercise-induced muscle damage and anabolic-catabolic hormones.

Negligible Effects of β-Hydroxy-β-Methylbutyrate Free Acid and Calcium Salt on Strength and Hypertrophic Responses to Resistance Training: A Randomized, Placebo-Controlled Study

This study evaluated the effects of β-hydroxy-β-methylbutyrate free acid (HMB-FA) and calcium salt (HMB-Ca) on strength, hypertrophy, and markers of muscle damage. In this randomized, double-blind, placebo-controlled study, 44 resistance-trained men (age: 26 ± 4 years; body mass: 84.9 ± 12.0 kg) consuming ≥1.7 g·kg-1·day-1 of protein received HMB-FA (3 g/day; n = 14), HMB-Ca (3 g/day; n = 15), or placebo (PL; cornstarch, 3 g/day; n = 15) for 12 weeks, while performing a periodized resistance training program. Before and after intervention, lean body mass (measured with dual X-ray absorptiometry), maximal dynamic strength (one-repetition maximum), knee extension maximal isometric strength (maximal voluntary isometric contraction [MVIC]), cross-sectional area (measured with ultrasound), and muscle soreness were assessed. MVIC was also measured 48 hr after the first and the last training sessions. All groups increased lean body mass (main time effect: p < .0001; HMB-FA: 1.8 ± 1.8 kg; HMB-Ca: 0.8 ± 1.4 kg; PL: 0.9 ± 1.4 kg), cross-sectional area (main time effect: p < .0001; HMB-FA: 6.6 ± 3.8%; HMB-Ca: 4.7 ± 4.4%; PL: 6.9 ± 3.8%), one-repetition maximum bench press (main time effect: p < .0001; HMB-FA: 14.8 ± 8.4 kg; HMB-Ca: 11.8 ± 7.4 kg; PL: 11.2 ± 6.6 kg), MVIC (main time effect: p < .0001; HMB-FA: 34.4 ± 39.3%; HMB-Ca: 32.3 ± 27.4%; PL: 17.7 ± 20.9%) after the intervention, but no differences between groups were shown. HMB-FA group showed greater leg press strength after the intervention than HMB-Ca and PL groups (Group × Time interaction: p < .05; HMB-FA: 47.7 ± 31.2 kg; HMB-Ca: 43.8 ± 31.7 kg; PL: 30.2 ± 20.9 kg). MVIC measured 48 hr after the first and the last sessions showed no attenuation of force decline with supplementation. Muscle soreness following the first and last sessions was not different between groups. The authors concluded that neither HMB-Ca nor HMB-FA improved hypertrophy or reduced muscle damage in resistance-trained men undergoing resistance training ingesting optimal amounts of protein. HMB-FA but not HMB-Ca resulted in a statistically significant yet minor improvement on leg press one-repetition maximum.

Time-restricted feeding plus resistance training in active females: a randomized trial

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.

Efficacy of Nutritional Interventions as Stand-Alone or Synergistic Treatments with Exercise for the Management of Sarcopenia

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.

Mechanism of Action and the Effect of Beta-Hydroxy-Beta-Methylbutyrate (HMB) Supplementation on Different Types of Physical Performance - A Systematic Review

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.

β-Hydroxy-β-methylbutyrate Suppresses NF-ĸB Activation and IL-6 Production in TE-1 Cancer Cells

BACKGROUND/AIM

Stress reactions, especially those related to surgery, cause poor convalescence of cancer patients. β-Hydroxyβ-methylbutyrate (HMB) is known to regulate excessive inflammation in the body. The objective of this work was to investigate the capacity of HMB to suppress activation of nuclear factor-kappa B (NF-ĸB) and production of interleukin-6 (IL-6) in a human esophageal squamous cell carcinoma cell line (TE-1).

MATERIALS AND METHODS

Cell proliferation was measured using the water-soluble tetrazolium-1 method, while tumor necrosis factor alpha (TNFα)-induced IL-6 production was measured using an enzyme-linked immunosorbent assay (ELISA) assay. Nuclear translocation of NF-ĸB was detected by immunofluorescence staining.

RESULTS

HMB did not affect cell proliferation. However, HMB suppressed the TNFα-induced increase in IL-6 production in TE-1 cells by inhibiting NF-ĸB activation.

CONCLUSION

HMB did not influence TE-1 cell proliferation, but inhibited activation of NF-ĸB and IL-6 production. This result may be useful for improving excessive stress reactions during and after surgery.

Physical exercise, nutrition and hormones: three pillars to fight sarcopenia

BACKGROUND

Sarcopenia is a pathophysiological condition diffused in elderly people; it represents a social issue due to the longer life expectancy and the growing aging population. It affects negatively quality of life and it represents a risk factor for other pathologies, such as diabetes, cardiovascular disease, and obesity. No silver bullet exists to hinder sarcopenia, but it may be counteracted by physical exercise, nutrition, and a proper endocrine milieu. Indeed, we aim to analyze the scientific literature to give to clinician effective advices to counteract sarcopenia. Main text: Physical exercise, proper nutrition, optimized hormonal homeostasis represent the three pillars to fight sarcopenia. Physical exercise represents the most effective remedy to face sarcopenia, in particular if it is combined with a proper diet and with an adequate endocrine milieu. Consistency in training, adequate daily protein intake and eugonadism seems to be the keys to fight sarcopenia. The combination of these three pillars might act synergistically.

CONCLUSIONS

Optimization of these factors may increase their efficiency; however, scientific data may be sometimes confusing so far. Therefore, we aim to give practical advices to clinician to identify and to highlight the most important aspects in each of these three factors that should be addressed.

Eccentric resistance training and β-hydroxy-β-methylbutyrate free acid affects muscle PGC-1α expression and serum irisin, nesfatin-1 and resistin in rats

The hypothalamus controls metabolism and feeding behaviour via several signals with other tissues. Exercise and supplements can change hypothalamic signalling pathways, so the present study investigated the influence of eccentric resistance training and β-hydroxy-β-methylbutyrate free acid supplementation on PGC-1α expression, serum irisin, nesfatin-1 and resistin concentrations. Thirty-two male rats (8 weeks old, 200±17 g body mass) were randomly allocated to control, β-hydroxy-β-methylbutyrate free acid supplementation (HMB), eccentric resistance training (ERT), and β-hydroxy-β-methylbutyrate free acid supplementation plus eccentric resistance training (HMB+ERT) groups. Training groups undertook eccentric resistance training (6 weeks, 3 times a week) and supplement groups consumed β-hydroxy-β-methylbutyrate free acid (HMB-FA) orally (76 mg kg^-1 day^-1). Twenty-four hours after the last training session, serum and triceps brachii muscle samples were collected and sent to the laboratory for analysis. Two-way ANOVA and Pearson correlation were employed (significance level: P<0.05). The results showed that eccentric resistance training increases skeletal muscle PGC-1α gene expression, as well as serum levels of irisin and nesfatin-1 (P=0.001). Eccentric resistance training decreased the serum concentration of resistin (P=0.001). HMB-FA supplementation increased skeletal muscle PGC-1α gene expression (P=0.002), as well as the serum concentration of irisin and nesfatin-1 (P=0.001), but decreased the serum concentration of resistin (P=0.001). Significant correlations were observed between PGC-1α gene expression and serum concentrations of irisin, nesfatin-1 and resistin. HMB-FA supplementation with eccentric resistance training may induce crosstalk between peptide release from other tissues and increases maximal muscle strength. The combination of the two interventions had a more substantial effect than each in isolation.

Dietary Intakes of Professional and Semi-Professional Team Sport Athletes Do Not Meet Sport Nutrition Recommendations-A Systematic Literature Review

Background: to develop sport-specific and effective dietary advice, it is important to understand the dietary intakes of team sport athletes. This systematic literature review aims to (1) assess the dietary intakes of professional and semi-professional team sport athletes and (2) to identify priority areas for dietetic intervention. Methods: an extensive search of MEDLINE, Sports DISCUS, CINAHL, Web of Science, and Scopus databases in April–May 2018 was conducted and identified 646 studies. Included studies recruited team sport, competitive (i.e., professional or semi-professional) athletes over the age of 18 years. An assessment of dietary intake in studies was required and due to the variability of data (i.e., nutrient and food group data) a meta-analysis was not undertaken. Two independent authors extracted data using a standardised process. Results: 21 (n = 511) studies that assessed dietary intake of team sport athletes met the inclusion criteria. Most reported that professional and semi-professional athletes’ dietary intakes met or exceeded recommendations during training and competition for protein and/or fat, but not energy and carbohydrate. Limitations in articles include small sample sizes, heterogeneity of data and existence of underreporting. Conclusions: this review highlights the need for sport-specific dietary recommendations that focus on energy and carbohydrate intake. Further exploration of factors influencing athletes’ dietary intakes including why athletes’ dietary intakes do not meet energy and/or carbohydrate recommendations is required.

Transport Mechanisms for the Nutritional Supplement β-Hydroxy-β-Methylbutyrate (HMB) in Mammalian Cells

PURPOSE

β-Hydroxy-β-methylbutyrate (HMB), a nutritional supplement, elicits anabolic activity in muscle. Here we investigated the mechanism of HMB uptake in muscle cells.

METHODS

Murine muscle cells (C2C12) and human mammary epithelial cells (MCF7) were used for uptake. As HMB is a monocarboxylate, focus was on monocarboxylate transporters, monitoring interaction of HMB with H⁺-coupled lactate uptake, and influence of H⁺ directly on HMB uptake. Involvement of MCT1-4 was studied using selective inhibitors and gene silencing. Involvement of human Na⁺/monocarboxylate transporter SMCT1 was also assessed using Xenopus oocytes.

RESULTS

H⁺-coupled lactate uptake was inhibited by HMB in both mammalian cells. HMB uptake was H⁺-coupled and inhibited by lactate. C2C12 cells expressed MCT1 and MCT4; MCF7 cells expressed MCT1-4; undifferentiated C2C12 cells expressed SMCT1. SMCT1 mediated Na⁺-coupled HMB transport. Inhibitors of MCT1/4, siRNA-mediated gene silencing, and expression pattern showed that MCT1-4 were responsible only for a small portion of HMB uptake in these cells.

CONCLUSION

HMB uptake in C2C12 and MCF7 cells is primarily H⁺-coupled and inhibited by lactate, but MCT1-4 are only partly responsible for HMB uptake. SMCT1 also transports HMB, but in a Na⁺-coupled manner. Other, yet unidentified, transporters mediate the major portion of HMB uptake in C2C12 and MCF7 cells.

β-Hydroxy-β-methylbutyrate and its impact on skeletal muscle mass and physical function in clinical practice: a systematic review and meta-analysis

BACKGROUND

Loss of skeletal muscle mass and muscle weakness are common in a variety of clinical conditions with both wasting and weakness associated with an impairment of physical function. β-Hydroxy-β-methylbutyrate (HMB) is a nutrition supplement that has been shown to favorably influence muscle protein turnover and thus potentially plays a role in ameliorating skeletal muscle wasting and weakness.

OBJECTIVES

The aim of this study was to investigate the efficacy of HMB alone, or supplements containing HMB, on skeletal muscle mass and physical function in a variety of clinical conditions characterized by loss of skeletal muscle mass and weakness.

METHODS

A systematic review and meta-analysis of randomized controlled trials reporting outcomes of muscle mass, strength, and physical function was performed. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment. Outcome data were synthesized through meta-analysis with the use of a random-effects model and data presented as standardized mean differences (SMDs).

RESULTS

Fifteen randomized controlled trials were included, involving 2137 patients. Meta-analysis revealed some evidence to support the effect of HMB alone, or supplements containing HMB, on increasing skeletal muscle mass (SMD = 0.25; 95% CI: -0.00, 0.50; z = 1.93; P = 0.05; I2 = 58%) and strong evidence to support improving muscle strength (SMD = 0.31; 95% CI: 0.12, 0.50; z = 3.25; P = 0.001; I2 = 0%). Effect sizes were small. No effect on bodyweight (SMD = 0.16; 95% CI: -0.08, 0.41; z = 1.34; P = 0.18; I2 = 67%) or any other outcome was found. No study was considered to have low risk of bias in all categories.

CONCLUSION

HMB, and supplements containing HMB, increased muscle mass and strength in a variety of clinical conditions, although the effect size was small. Given the bias associated with many of the included studies, further high-quality studies should be undertaken to enable interpretation and translation into clinical practice. The trial was registered on PROSPERO as CRD42017058517.

Effects of resistance training and/or beta-hydroxy-beta-methylbutyrate supplementation on muscle mass, muscle strength and physical performance in older women with reduced muscle mass: protocol for a randomised, double-blind, placebo-controlled trial

INTRODUCTION

Resistance training (RT) and nutritional supplementation seem to have beneficial effects on muscle properties and physical performance in older adults. However, the reported effects of specific RT programmes and supplementation prescriptions vary among studies. The present study aims to examine the acute and residual effects of RT and/or beta-hydroxy-beta-methylbutyrate (HMB) supplementation on muscle mass, muscle strength and physical performance in older women with reduced muscle mass.

METHODS AND ANALYSIS

This is a randomised, double-blind, placebo-controlled trial. Older women fitting the eligibility criteria were recruited in February 2018 from a population-based sample identified via screening conducted in October 2017. In March 2018, 156 participants were randomly allocated to undergo one of four interventions (RT + HMB, RT + placebo, education + HMB and education + placebo) for 12 weeks. Supervised RT consisted of body weight, elastic band, ankle weight and machine-based exercises two times per week at the Tokyo Metropolitan Institute of Gerontology (TMIG). Each participant ingested HMB (1200 mg) or placebo supplements once daily. Sessions of education not associated with sarcopenia treatment were conducted every 2 weeks. Post-intervention follow-up will be conducted for 12 weeks, until September 2018. The study includes assessments conducted in March (baseline), June (post-intervention) and September 2018 (follow-up). The primary outcome is the longitudinal change in muscle mass. Secondary outcomes include the longitudinal changes in muscle strength, physical performance, muscle thickness, muscle quality, blood counts, blood biochemistry, calf circumference, skin viscoelasticity, habitual dietary intake, habitual physical activity levels, functional capacity and health-related quality of life. Intention-to-treat analyses will be conducted.

ETHICS AND DISSEMINATION

The study protocol was approved by the Ethics Committee of the TMIG, Japan. The study is being conducted according to the principles of the Declaration of Helsinki. The findings will be presented at international academic congresses and published in peer-reviewed international journals.

TRIAL REGISTRATION NUMBER

UMIN000028560; Post-results.

Maternal β-hydroxy-β-methylbutyrate (HMB) supplementation during pregnancy affects early folliculogenesis in the ovary of newborn piglets

Beta-hydroxy-beta-methylbutyrate (HMB) is a leucine metabolite with protein anabolic effects. This study was designed to determine whether prenatal HMB treatment has an effect on oogenesis and folliculogenesis in the ovary of newborn piglets. HMB decreased the number of egg nests and primordial follicles and increased the pool of developing follicles compared to the control group. Although the percentage of TUNEL-positive oocytes within the egg nests was higher in HMB-treated group no increase in the Bax/Bcl-2 ratio and active caspase-3 expression was observed. Moreover, the granulosa cell proliferation index and StAR protein expression were higher in HMB-treated group. In contrast to the control group, the expression of E-cadherins was reduced after the HMB treatment. In addition, a significant increase in the serum level of gonadotropins and steroid hormones was detected in HMB-treated piglets. In conclusion, prenatal HMB treatment dysregulates hormonal homeostasis which impairs early folliculogenesis in piglets.