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

Danielle E. Bear*, Anne Langan, Eirini Dimidi, Liesl Wandrag, Stephen D.R. Harridge, Nicholas Hart, Bronwen Connolly, Kevin Whelan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

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; 2I = 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.
Original languageEnglish
Pages (from-to)1119-1132
Number of pages14
JournalAmerican Journal of Clinical Nutrition
Volume109
Issue number4
DOIs
Publication statusPublished - 15 Apr 2019

Keywords

  • Cancer cachexia
  • Critical illness
  • HMB
  • Malnutrition
  • Muscle
  • Nutrition
  • Sarcopenia
  • Strength
  • β-hydroxy-β-methylbutyrate

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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