Effects of oral supplementation of β -hydroxy-β -methylbutyrate on muscle mass and strength in individuals over the age of 50: a meta-analysis
Open accessAbstract
Background: β-Hydroxy β-Methylbutyrate (HMB) has shown potential in improving muscle protein turnover, which may be important for preventing muscle degradation in aging populations. The aim of this meta-analysis is to clarify the impact of HMB oral supplementation on muscle-related indicators and discover the interaction between dosage and duration. The findings will provide a scientific basis for the use of HMB oral supplementation in the management of muscle attenuation. Methods: A computer systems-based search for articles of randomized controlled trial (RCT) in the PubMed, Cochrane Library, Web of Science, ScienceDirect, EBSCO English databases and China Journal Full-Text Database (CNKI), Wan Fang Chinese databases, was conducted up to October 2023. Data were pooled using weighted mean difference (WMD) and 95% confidence intervals (95% CI). Results: A total of 21 RCTs were included, involving 1935 participants, all of them were > 50 years old. Results showed a positive impact of HMB oral supplementation in improving muscle mass (appendicular skeletal muscle mass: WMD = 1.56 kg, 95% CI: 0.03–3.09 kg and lean mass: WMD = 0.28 kg, 95% CI: 0.16–0.41 kg), strength (handgrip strength: WMD = 0.54 kg, 95% CI: 0.04–1.04 kg and five-time chair stand test: WMD = –0.73 s, 95% CI: –1.35, –0.11 s), and physical function (gait speed: WMD = 0.06 m/s, 95% CI: 0.01–0.10 m/s). Subgroup analysis revealed that the effect of a dosage of 3 g/d had significant improvement, and the effect of supplementation duration lasting > 12 weeks had significant improvement, and a dosage of 3g/day for more than 12 weeks was recommended. Conclusion: HMB oral supplementation can improve muscle mass, strength, and physical function. We recommend to implement supplementation at a dosage of 3 g for a duration exceeding 12 weeks to achieve optimal benefits. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/login, identifier 42024518958.
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The leucine metabolite β-Hydroxy-β-methylbutyrate has been shown to promote anabolism and limit muscle catabolism.
“The leucine metabolite, β-Hydroxy-β-methylbutyrate has been shown to promote anabolism and limit muscle catabolism [52, 53].”
From Muscle loss and GLP-1R agonists use (2025) · cites this paper as [53]
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Cites
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,577 · see citing works
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.006 · Cited by 10,578 · see citing works
Sarcopenia in Asia: Consensus Report of the Asian Working Group for Sarcopenia
Chen, L.-K., Liu, L.-K., Woo, J., Assantachai, P., Auyeung, T.-W., Bahyah, K. S., Chou, M.-Y., Chen, L.-Y., Hsu, P.-S., Krairit, O., et al. (2014) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.11.025 · Cited by 4,051 · see citing works
The underappreciated role of muscle in health and disease
Wolfe, R. R. (2006) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/84.3.475 · Cited by 1,561 · see citing works
Aging of skeletal muscle: a 12-yr longitudinal study
Frontera, W. R., Hughes, V. A., Fielding, R. A., Fiatarone, M. A., Evans, W. J., & Roubenoff, R. (2000) · Journal of Applied Physiology · doi:10.1152/jappl.2000.88.4.1321 · Cited by 1,443 · see citing works
Sarcopenia with limited mobility: an international consensus
Morley, J. E., Abbatecola, A. M., Argiles, J. M., Baracos, V., Bauer, J., Bhasin, S., Cederholm, T., Stewart Coats, A. J., Cummings, S. R., Evans, W. J., et al. (2011) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2011.04.014 · Cited by 1,125 · see citing works
Clinical definition of sarcopenia.
Santilli, V., Bernetti, A., Mangone, M., & Paoloni, M. (2014) · CLINICAL CASES IN MINERAL AND BONE METABOLISM · doi:10.11138/ccmbm/2014.11.3.177 · Cited by 722 · see citing works
Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis
Xu, J. J., Wan, C. S., Ktoris, K., Reijnierse, E. M., & Maier, A. B. (2021) · Gerontology · doi:10.1159/000517099 · Cited by 433 · see citing works
Nissen, S., Sharp, R., Ray, M., Rathmacher, J. A., Rice, D., Fuller, J. C., Connelly, A. S., & Abumrad, N. (1996) · Journal of Applied Physiology · doi:10.1152/jappl.1996.81.5.2095 · Cited by 393 · see citing works
Hong, S.-H., & Choi, K. M. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21020494 · Cited by 390 · see citing works
Sarcopenia and mortality among a population‐based sample of community‐dwelling older adults
Brown, J. C., Harhay, M. O., & Harhay, M. N. (2015) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12073 · Cited by 354 · see citing works
Deutz, N. E. P., Pereira, S. L., Hays, N. P., Oliver, J. S., Edens, N. K., Evans, C. M., & Wolfe, R. R. (2013) · Clinical Nutrition · doi:10.1016/j.clnu.2013.02.011 · Cited by 287 · see citing works
Implications of low muscle mass across the continuum of care: a narrative review
Prado, C. M., Purcell, S. A., Alish, C., Pereira, S. L., Deutz, N. E., Heyland, D. K., Goodpaster, B. H., Tappenden, K. A., & Heymsfield, S. B. (2018) · Annals of Medicine · doi:10.1080/07853890.2018.1511918 · Cited by 286 · see citing works
Flakoll, P. J., Sharp, R. L., Baier, S. M., Levenhagen, D. K., Carr, C., & Nissen, S. (2004) · Nutrition · doi:10.1016/j.nut.2004.01.009 · Cited by 262 · see citing works
Vukovich, M. D., Stubbs, N. B., & Bohlken, R. M. (2001) · The Journal of Nutrition · doi:10.1093/jn/131.7.2049 · Cited by 222 · see citing works
International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB)
Wilson, J. M., Fitschen, P. J., Campbell, B., Wilson, G. J., Zanchi, N., Taylor, L., Wilborn, C., Kalman, D. S., Stout, J. R., Hoffman, J. R., et al. (2013) · Journal of the International Society of Sports Nutrition · doi:10.1186/1550-2783-10-6 · Cited by 196 · see citing works
Bear, D. E., Langan, A., Dimidi, E., Wandrag, L., Harridge, S. D. R., Hart, N., Connolly, B. A., & Whelan, K. (2018) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqy373 · Cited by 167 · see citing works
Wu, H., Xia, Y., Jiang, J., Du, H., Guo, X., Liu, X., Li, C., Huang, G., & Niu, K. (2015) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2015.06.020 · Cited by 157 · see citing works
Prevalence of sarcopenia in healthy community-dwelling elderly in an urban area of Barcelona (Spain)
Masanés, F., Culla, A., Navarro-González, M., Navarro-López, M., Sacanella, E., Torres, B., & López‐Soto, A. (2011) · The journal of nutrition health & aging · doi:10.1007/s12603-011-0108-3 · Cited by 136 · see citing works
Baier, S., Johannsen, D., Abumrad, N., Rathmacher, J. A., Nissen, S., & Flakoll, P. (2009) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607108322403 · Cited by 133 · see citing works
Malafarina, V., Uriz-Otano, F., Malafarina, C., Martinez, J. A., & Zulet, M. A. (2017) · Maturitas · doi:10.1016/j.maturitas.2017.04.010 · Cited by 131 · see citing works
MUSCLE DISUSE AS A PIVOTAL PROBLEM IN SARCOPENIA-RELATED MUSCLE LOSS AND DYSFUNCTION
Bell, K. E., von Allmen, M., Devries, M. C., & Phillips, S. M. (2016) · The Journal of Frailty & Aging · doi:10.14283/jfa.2016.78 · Cited by 127 · see citing works
Stout, J. R., Smith‐Ryan, A. E., Fukuda, D. H., Kendall, K. L., Moon, J. R., Hoffman, J. R., Wilson, J. M., Oliver, J. S., & Mustad, V. A. (2013) · Experimental Gerontology · doi:10.1016/j.exger.2013.08.007 · Cited by 124 · see citing works
Slater, G., Jenkins, D., Logan, P., Lee, H., Vukovich, M., Rathmacher, J. A., & Hahn, A. G. (2001) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.11.3.384 · Cited by 122 · see citing works
Slater, G. J., & Jenkins, D. (2000) · Sports Medicine · doi:10.2165/00007256-200030020-00004 · Cited by 120 · see citing works
Molfino, A., Gioia, G., Fanelli, F. R., & Muscaritoli, M. (2013) · Amino Acids · doi:10.1007/s00726-013-1592-z · Cited by 99 · see citing works
Efficacy of β-hydroxy-β-methylbutyrate supplementation in elderly and clinical populations
Fitschen, P. J., Wilson, G. J., Wilson, J. M., & Wilund, K. R. (2013) · Nutrition · doi:10.1016/j.nut.2012.05.005 · Cited by 97 · see citing works
Chew, S. T. H., Tan, N. C., Cheong, M., Oliver, J. S., Baggs, G. E., Choe, Y. S., How, C. H., Chow, W. L., Tan, C. Y. L., Kwan, S. C., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.10.015 · Cited by 93 · see citing works
Holeček, M., Muthný, T., Kovařík, M., & Šišpera, L. (2008) · Food and Chemical Toxicology · doi:10.1016/j.fct.2008.11.021 · Cited by 91 · see citing works
Oktaviana, J., Zanker, J., Vogrin, S., & Duque, G. (2018) · The journal of nutrition health & aging · doi:10.1007/s12603-018-1153-y · Cited by 84 · see citing works
Hoffman, J. R., Cooper, J., Wendell, M., Im, J., & Kang, J. (2004) · The Journal of Strength and Conditioning Research · doi:10.1519/13973.1 · Cited by 77 · see citing works
Thomson, J. S., Watson, P. E., & Rowlands, D. S. (2009) · Journal of Strength and Conditioning Research · doi:10.1519/jsc.0b013e3181a00d47 · Cited by 72 · see citing works
Courel-Ibáñez, J., Vetrovsky, T., Dadova, K., Pallarés, J. G., & Steffl, M. (2019) · Nutrients · doi:10.3390/nu11092082 · Cited by 69 · see citing works
Deutz, N. E., Ziegler, T. R., Matheson, E. M., Matarese, L. E., Tappenden, K. A., Baggs, G. E., Nelson, J. L., Luo, M., Hegazi, R., & Jonnalagadda, S. S. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2020.08.031 · Cited by 63 · see citing works
Berton, L., Bano, G., Carraro, S., Veronese, N., Pizzato, S., Bolzetta, F., RUI, M. D., Valmorbida, E., Ronch, I. D., Perissinotto, E., et al. (2015) · PLoS ONE · doi:10.1371/journal.pone.0141757 · Cited by 62 · see citing works
Fuller, J. C., Baier, S. M., Flakoll, P. J., Nissen, S., Abumrad, N. N., & Rathmacher, J. A. (2011) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607111413903 · Cited by 59 · see citing works
Olveira, G., Olveira, C., Doña, E., Palenque, F. J., Porras, N., Dorado, A., Godoy, A., Rubio-Martínez, E., Rojo‐Martínez, G., & Martín‐Valero, R. (2015) · Clinical Nutrition · doi:10.1016/j.clnu.2015.10.001 · Cited by 57 · see citing works
Osuka, Y., Kojima, N., Sasai, H., Wakaba, K., Miyauchi, D., Tanaka, K., & Kim, H. (2021) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqab176 · Cited by 53 · see citing works
Yang, C., Song, Y., Li, T., Chen, X., Zhou, J., Pan, Q., Jiang, W., Wang, M., & Jia, H. (2023) · The journal of nutrition health & aging · doi:10.1007/s12603-023-1911-1 · Cited by 53 · see citing works
Peng, L., Cheng, Y., Yu, P.-C., Lee, W., Lin, M.-H., & Chen, L. (2021) · The journal of nutrition health & aging · doi:10.1007/s12603-021-1621-7 · Cited by 49 · see citing works
Hsieh, L.-C., Chow, C.-J., Chang, W.-C., Liu, T., & Chang, C. (2010) · PubMed · Cited by 47 · see citing works
Self-citationLattanzi, B., Bruni, A., Cola, S. D., Molfino, A., Santis, A. D., Muscaritoli, M., & Merli, M. (2021) · Nutrients · doi:10.3390/nu13072296 · Cited by 38 · see citing works
Lattanzi, B., Giusto, M., Albanese, C. V., Mennini, G., D’Ambrosio, D., Farcomeni, A., Corradini, S. G., Rossi, M., & Merli, M. (2019) · Nutrients · doi:10.3390/nu11092259 · Cited by 37 · see citing works
Ellis, A. C., Hunter, G. R., Goss, A. M., & Gower, B. A. (2018) · Journal of Dietary Supplements · doi:10.1080/19390211.2018.1454568 · Cited by 35 · see citing works
Rathmacher, J., Pitchford, L. M., Khoo, P., Angus, H. F., Lang, J., Lowry, K., Ruby, C., Krajek, A., Fuller, J., & Sharp, R. (2020) · The journals of gerontology. Series A, Biological sciences and medical sciences · doi:10.1093/gerona/glaa218 · Cited by 34 · see citing works
Jakubowski, J., Nunes, E. A., Teixeira, F. J., Vescio, V., Morton, R. W., Banfield, L. E., & Phillips, S. M. (2020) · Nutrients · doi:10.3390/nu12051523 · Cited by 31 · see citing works
Lin, Z., Zhao, A., & He, J. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.914866 · Cited by 29 · see citing works
Yoon, Y., Ko, Y., Kim, K. W., Kang, D., Ahn, J., Ko, E., Park, H., Cho, S., Kim, H. J., Kim, J. B., et al. (2020) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2020.10.039 · Cited by 27 · see citing works
Wu, T., Chen, Q., Lin, X., Xu, M., Chen, X., Luo, C.-J., Zhuang, Y., Wei, Y.-Q., Wu, J.-B., Xiong, J., et al. (2023) · Critical Care · doi:10.1186/s13054-023-04698-x · Cited by 26 · see citing works
Fairfield, W. D., Minton, D. M., Elliehausen, C. J., Nichol, A. D., Cook, T. L., Rathmacher, J. A., Pitchford, L. M., Paluska, S. A., Kuchnia, A. J., Allen, J. M., et al. (2022) · Nutrients · doi:10.3390/nu14214674 · Cited by 13 · see citing works
Dunsmore, K., Lowery, R. P., Duncan, N., Davis, G., Rathmacher, J., Baier, S., Sikorski, E. M., Morrison, T., Naimo, M., Walters, J., et al. (2012) · Journal of the International Society of Sports Nutrition · doi:10.1186/1550-2783-9-s1-p5 · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 4
- [8]Wu J Li J. Prevalence of sarcopenia in the community-dwelling elder people in China: A systematic review and meta-analysi. Modern Prevent. Med. (2019) 46: 4109– 12.
- [32]Hua C Chen G Wen X. HMB intervention of muscle loss in community-dwelling elders with malnutrition. Electron J Metab Nutr Cancer. (2017) 4: 72– 7. 10.16689/j.cnki.cn11-9349/r.2017.01.015 · DOI
- [34]Yu J Chai L. HMB improves postoperative malnutrition status in patients with lower extremity fracture. Electron J Metab Nutr Cancer. (2018) 5: 165– 9. 10.16689/j.cnki.cn11-9349/r.2018.02.011 · DOI
- [56]Zhang Y He J Feng X Zhang Y. Effect of beta-hydroxyl-beta-methyl butyrate on fall risk in the elderlypatients undergoing total hip arthroplasty. Parent. Enteral Nutr. (2018) 25: 218– 22. 10.16151/j.1007-810x.2018.04.007 · DOI
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- Authors
- Li, N., Chen, S., He, Y., Chen, Y., Duan, X., He, W., Wang, Q., Liu, S., Liu, T., & Fang, H.
- Affiliations
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Shandong Academy of Agricultural Sciences (CN)
- Northwest A&F University (CN)
- University of Jinan (CN)
- Chinese PLA General Hospital (CN)
- Corresponding author
- Liu, Tongbo
- Fang, Haiqin
- Venue
- Frontiers in Nutrition
- Publisher
- Frontiers Media SA
- Published
- 2025-04-03
- Volume
- 12
- Pages
- 1522287-1522287
- ISSN
- 2296-861X (ISSN-L)
- PMC
- PMC12003145
- OpenAlex
- W4409105972
- Cited by
- 8
- References
- 52
- Citations by year
- 2026: 5 · 2025: 3
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Nutrition (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- beta-hydroxy-beta-methylbutyrate, HMB supplementation, muscle mass, muscle strength, sarcopenia, aging, older adults, appendicular skeletal muscle mass, lean body mass, grip strength, physical function, walking speed, muscle protein turnover, muscle atrophy prevention, dietary supplementation, creatine supplementation, protein supplementation, exercise training, resistance training
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