Cited by 133Muscle metabolism and nutritionNutrition and Health in AgingMuscle Physiology and Disorders

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Year‐long Changes in Protein Metabolism in Elderly Men and Women Supplemented With a Nutrition Cocktail of β‐Hydroxy‐β‐methylbutyrate (HMB), L‐Arginine, and L‐Lysine

Baier, Shawn, Johannsen, Darcy, Abumrad, Naji, Rathmacher, John A., Nissen, Steven, Flakoll, Paul·2009·Journal of Parenteral and Enteral Nutrition

DOI 10.1177/0148607108322403

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Abstract

Background: A major contributing factor to the loss of mobility in elderly people is the gradual and continuous loss of lean body mass. Objectives: To determine whether supplementation of an amino acid cocktail daily for 1 year could improve the age‐associated changes in protein turnover and lean body mass in elderly people. Design: Elderly (76± 1.6 years) women (n = 39) and men (n = 38) were recruited for a double‐blinded controlled study. Study participants were randomly assigned to either an isonitrogenous control‐supplement (n = 37) or a treatment‐supplement (HMB/Arg/Lys) consisting of β‐hydroxy‐β‐methylbutyrate, L‐arginine, and L‐lysine (n = 40) for the 1‐year study. Lean tissue mass was measured using both bioelectrical‐impedance analysis (BIA) and dual energy x‐ray absorptiometry (DXA). Rates of whole‐body protein turnover were estimated using primed/intermittent oral doses of 15 N‐glycine. Results: In subjects taking the HMB/Arg/Lys supplement, lean tissue increased over the year of study while in the control group, lean tissue did not change. Compared with control, HMB/Arg/Lys increased body cell mass (BIA) by 1.6% (P = .002) and lean mass (DXA) by 1.2% (P = .05). The rates of protein turnover were significantly increased 8% and 12% in the HMB/Arg/Lys‐supplemented group while rates of protein turnover decreased 11% and 9% in the control‐supplemented subjects (P < .01), at 3 and 12 months, respectively. Conclusions: Consumption of a simple amino acid‐related cocktail increased protein turnover and lean tissue in elderly individuals in a year‐long study.

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Background
Relative differences in strength and power from slow to fast isokinetic velocities may reflect dynapenia
Jenkins, N. D. M., Housh, T. J., Palmer, T. B., Cochrane, K. C., Bergstrom, H. C., Johnson, G. O., Schmidt, R. J., & Cramer, J. T. (2014) · Muscle & Nerve · doi:10.1002/mus.24505 · Cited by 26
Subtotal stomach in esophageal reconstruction surgery achieves an anastomotic leakage rate of less than 1%
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Investigation of the Presence of β-Hydroxy-β-methylbutyric Acid and α-Hydroxyisocaproic Acid in Bovine Whole Milk and Fermented Dairy Products by a Validated Liquid Chromatography–Mass Spectrometry Method
Ehling, S., & Reddy, T. M. (2014) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf500026s · Cited by 20
Benefits of β-hydroxy-β-methylbutyrate supplementation in trained and untrained individuals
Gepner, Y., Varanoske, A. N., Boffey, D., & Hoffman, J. R. (2018) · Research in Sports Medicine · doi:10.1080/15438627.2018.1533470 · Cited by 20
“conjunction with arginine, lysine, and ascorbic acid for a year resulted in no significant changes in renal function or blood chemistry in senior citizens (Baier et al., 2009).”
BackgroundInfluential
Using Global Criteria to Detect Malnutrition: Application in Disease States
Kirsch, R., Matthews, K., & Williams, V. (2019) · Nutrition in Clinical Practice · doi:10.1002/ncp.10444 · Cited by 18
Elderly Persons With ICU‐Acquired Weakness
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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
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Nutritional Strategies for Frail Older Adults
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“When older adults consumed nutrition supplements with HMB, their function, strength, and leanbodymass improved,(53) aswell as their protein turnover.(54) Supplementing the dietwithwhey protein is beneficial because whey protein delivers the correct amino acids in proportion to the ratio of skeletal muscle.”
Background
Effects of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and glutamine supplementation on cardiac surgery: A randomized controlled trial
Ogawa, M., Satomi‐Kobayashi, S., Yoshida, N., Komaki, K., Hirabayashi, T., Wakida, K., Saitoh, S., Inoue, T., Yamashita, T., Sakai, Y., et al. (2024) · Clinical Nutrition · doi:10.1016/j.clnu.2024.12.030 · Cited by 14
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Arginine and Lysine Supplementation Potentiates the Beneficial β-Hydroxy ß-Methyl Butyrate (HMB) Effects on Skeletal Muscle in a Rat Model of Diabetes
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“This result would agree with previous studies where the nutritional supplementation of the combination of HMB, Lys, and Arg in elderly healthy people increased protein turnover and lean tissue [53,54], as well as showed a beneﬁcial effect on muscle functionality [55].”
Tratamento medicamentoso da sarcopenia
de Souza, C. G. (2020) · Revista Brasileira de Ortopedia · doi:10.1055/s-0040-1709732 · Cited by 19
EFFECT ON QUALITY OF LIFE AND HANDGRIP STRENGTH BY DYNAMOMETRY OF AN ENTERAL SPECIFIC SUPLEMENTS WITH BETA-HYDROXY-BETA-METHYLBUTYRATE AND VITAMIN D IN ELDERLY PATIENTS.
de Luis, D. A., Izaola, O., Bachiller, P., & Castrillon, J. P. (2015) · PubMed · doi:10.3305/nh.2015.32.1.9083 · Cited by 12
Clinical Manifestations and Pathophysiology of Sarcopenia
Yakabe, M., Ogawa, S., & Akishita, M. (2015) · doi:10.11648/j.bs.20150102.11 · Cited by 12
Expert opinion on the current conceptual, clinical and therapeutic aspects of disease related malnutrition and muscle loss: a multidisciplinary perspective
Doğanay, M., Halil, M. G., Kaymak, Ç., Selek, U., Topçuoğlu, M. A., & Yalçın, Ş. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1509689 · Cited by 12
Study protocol: High-protein nutritional intervention based on β-hydroxy-β-methylbutirate, vitamin D3 and calcium on obese and lean aged patients with hip fractures and sarcopenia. The HIPERPROT-GER study
Malafarina, V., Úriz‐Otano, F., Gil‐Guerrero, L., Iniesta, R. R., Zulet, M. Á., & Martínez, J. A. (2013) · Maturitas · doi:10.1016/j.maturitas.2013.06.016 · Cited by 11
Genotoxicity assessment of calcium β-hydroxy-β-methylbutyrate
Pitchford, L. M., Fuller, J. C., & Rathmacher, J. A. (2018) · Regulatory Toxicology and Pharmacology · doi:10.1016/j.yrtph.2018.10.016 · Cited by 11
Self-citation
β-Hydroxy-β-Methylbutyrate Supplementation May Not Enhance Additional Effects of Exercise on Muscle Quality in Older Women
Osuka, Y., Kojima, N., Nishihara, K., Sasai, H., Wakaba, K., Tanaka, K., & Kim, H. (2021) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002836 · Cited by 11
The role of vitamin D on rotator cuff tear with osteoporosis
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Direct Determination of β-Hydroxy-β-Methylbutyrate (HMB) in Liquid Nutritional Products
Baxter, J. H., Phillips, R. R., Dowlati, L., Goehring, K. C., & Johns, P. W. (2010) · Food Analytical Methods · doi:10.1007/s12161-010-9173-1 · Cited by 10
“A series of research studies has associated physiological benefits—most notably an increase in lean body mass, a decrease in muscle damage, and the stimulation of protein synthesis—with a daily administration of 3 g of β-hydroxyβ-methylbutyrate (HMB) (Berk et al. 2008; Wilson et al. 2008; Baier et al. 2009; Kraemer et…”
BackgroundMethod
Nutritional approaches to the management of sarcopenia
Greig, C. A. (2013) · Nutrition Bulletin · doi:10.1111/nbu.12046 · Cited by 11
Functional Nutrients to Ameliorate Neurogenic Muscle Atrophy
Moresi, V., Renzini, A., Cavioli, G., Seelaender, M. C. L., Coletti, D., Gigli, G., & Cedola, A. (2022) · Metabolites · doi:10.3390/metabo12111149 · Cited by 10
Effects of oral supplementation of β -hydroxy-β -methylbutyrate on muscle mass and strength in individuals over the age of 50: a meta-analysis
Li, N., Chen, S., He, Y., Chen, Y., Duan, X., He, W., Wang, Q., Liu, S., Liu, T., & Fang, H. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1522287 · Cited by 8
Physiological Benefits, Applications, and Future Directions of β-Hydroxy-β-Methylbutyrate (HMB) in Food and Health Industries
Zhou, S., Liu, G., Wang, Z., Lei, Z., Chen, W., & Wang, C. (2025) · Foods · doi:10.3390/foods14081294 · Cited by 9
“Panton et al., noted that supplementation of 3.0 g/day of HMB during resistance training led to more pronounced increases in upper body strength, fat-free weight, and a reduction in fat percentage [59].”
Influential
Sarcopenia, Diabetes, and Nutritional Intervention
Wicks, S. M., Саламон, І., Calderón, Á. I., de Blanco, E. J. C., & Mahady, G. B. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-812019-4.00023-4 · Cited by 8
β-Hydroxy-β-Methylbutyrate (HMB) Supplementation Prevents Bone Loss during Pregnancy—Novel Evidence from a Spiny Mouse (Acomys cahirinus) Model
Tomaszewska, E., Donaldson, J., Kosiński, J., Dobrowolski, P., Tomczyk‐Warunek, A., Hułas‐Stasiak, M., Lamorski, K., Laskowska-Woźniak, D., Muszyński, S., Blicharski, R., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22063047 · Cited by 8
The Role of Amino Acid Supplementation in Orthopaedic Surgery
Jazayeri, R., Anil, U., & Zuckerman, J. D. (2023) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-23-00300 · Cited by 6
Obesity and Musculoskeletal Health of Young and Older Malaysian Women: A Cross-Sectional Study
Abidin, N. Z. (2023) · Malaysian Journal of Medical Sciences · doi:10.21315/mjms2023.30.1.12 · Cited by 5
Does β-Hydroxy-β-Methylbutyrate Have Any Potential to Support the Treatment of Duchenne Muscular Dystrophy in Humans and Animals?
Gorji, A. E., Ostaszewski, P., Urbańska, K., & Sadkowski, T. (2023) · Biomedicines · doi:10.3390/biomedicines11082329 · Cited by 6
Sheer drop ahead: reviewing sarcopenia outcomes in elderly patients undergoing bariatric surgery
Stumpf, M. A. M., Cercato, C., de Melo, M. E., & Mancini, M. C. (2025) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-025-09946-9 · Cited by 4
Urinary Titin N-Fragment Evaluation in a Randomized Controlled Trial of Beta-Hydroxy-Beta-Methylbutyrate for Acute Mild Trauma in Older Adults
Nakano, H., Hashimoto, H., Mochizuki, M., Naraba, H., Takahashi, Y., Sonoo, T., Matsuishi, Y., Ogawa, Y., Shimojo, N., Inoue, Y., et al. (2021) · Nutrients · doi:10.3390/nu13030899 · Cited by 4
“Studies on the long-term administration of HMB to healthy elderly subjects reported muscle mass gain after 12–48 weeks of treatment [18,19].”
Background
Acute dose toxicity evaluation of the food supplement calcium 3-hydroxy-3-methylbutyrate (HMB) in female Sprague Dawley rats
Fuller, J. C., & Rathmacher, J. A. (2022) · Regulatory Toxicology and Pharmacology · doi:10.1016/j.yrtph.2022.105133 · Cited by 4
Self-citation
Reduced Skeletal Muscle Mass and Lifestyle
Scott, D. S. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-810422-4.00002-6 · Cited by 4
Can Dietary Supplements Support Muscle Function and Physical Activity? A Narrative Review
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Effective Nutritional Supplement Combinations
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Potential Modulatory Effects of β-Hydroxy-β-Methylbutyrate on Type I Collagen Fibrillogenesis: Preliminary Study
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“Studies in ageing and wound healing models have shown that HMB supplementation can accelerate collagen deposition and improve matrix remodelling [28].”
β-Hydroxy-β-methylbutyrate enhances fast-twitch muscle and mitochondrial function, histopathology and mTORC1 signalling in the mdx dystrophic mouse
Giourmas, N., Lalunio, H., Wu, C., Bagaric, R. M., Calzoni, M., Goodman, C. A., & Hayes, A. W. (2025) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.00722.2025 · Cited by 2
Molecular Mechanisms and Nutritional Modulation in Sarcopenia: A Narrative Review
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Sarcopenia
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Comparison of Muscle, Bone and Fat Indices between Stages of Sarcopenia in Postmenopausal Malaysian Women
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“It is well established that muscle mass and strength decrease with ageing, although more prominent after the age of 40 years old (37, 38).”
Background

Authors: Baier, S., Johannsen, D., Abumrad, N., Rathmacher, J. A., Nissen, S., & Flakoll, P.
Affiliations: Iowa State University (US)
Vanderbilt University Medical Center (US)
Corresponding author: Nissen, Steven
ORCID: Johannsen, Darcy
Abumrad, Naji
Rathmacher, John A.
Venue: Journal of Parenteral and Enteral Nutrition
Publisher: Wiley
Published: 2008-10-02
Volume: 33
Issue: 1
Pages: 71-82
ISSN: 0148-6071 (ISSN-L)
1941-2444
DOI: 10.1177/0148607108322403
OpenAlex: W2047767140
Cited by: 133
References: 61
Citations by year: 2026: 5 · 2025: 9 · 2024: 6 · 2023: 9 · 2022: 9 · 2021: 6 · 2020: 8 · 2019: 6 · 2018: 10 · 2017: 6 · 2016: 9 · 2015: 12 · 2014: 7 · 2013: 12 · 2012: 8
FWCI: 1.61
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Parenteral and Enteral Nutrition (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r44ag020897-03)
National Institute on Aging (R44AG20897)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
Keywords: protein metabolism, protein turnover, lean body mass, older adults, beta-hydroxy-beta-methylbutyrate, L-arginine, L-lysine, amino acid supplementation, sarcopenia, body cell mass, aging
MeSH terms: Aged, Aged, 80 and over, Aging, Arginine, Body Composition, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Lysine, Male, Patient Compliance, Proteins, Surveys and Questionnaires, Valerates, Muscle, Skeletal, Dietary Supplements

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Year‐long Changes in Protein Metabolism in Elderly Men and Women Supplemented With a Nutrition Cocktail of β‐Hydroxy‐β‐methylbutyrate (HMB), L‐Arginine, and L‐Lysine

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