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The journal of nutrition, health & aging

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Open Access 01-06-2018

Role of Oral Nutritional Supplements Enriched with B-hydroxy-B-Methylbutyrate in Maintaining Muscle Function and Improving Clinical Outcomes in Various Clinical Settings

Authors: Alejandro Sanz-Paris, M. Camprubi-Robles, J. M. Lopez-Pedrosa, S. L. Pereira, R. Rueda, M. D. Ballesteros-Pomar, J. M. Garcia Almeida, A. J. Cruz-Jentoft

Published in: The journal of nutrition, health & aging | Issue 6/2018

Abstract

Aging and disease-related malnutrition are well associated with loss of muscle mass and function. Muscle mass loss may lead to increased health complications and associated increase in health care costs, especially in hospitalized individuals. High protein oral nutritional supplements enriched with β-hydroxy-β-methylbutyrate (HP-ONS+HMB) have been suggested to provide benefits such as improving body composition, maintaining muscle mass and function and even decreasing mortality rates. The present review aimed to examine current evidence on the effect of HP-ONS+HMB on muscle-related clinical outcomes both in community and peri-hospitalization patients. Overall, current evidence suggests that therapeutic nutrition such as HP-ONS+HMB seems to be a promising tool to mitigate the decline in muscle mass and preserve muscle function, especially during hospital rehabilitation and recovery.

Shiozu H, Higashijima M, Koga T. Association of sarcopenia with swallowing problems, related to nutrition and activities of daily living of elderly individuals. J Phys Ther Sci. 2015;27:393–6.CrossRefPubMedPubMedCentral

Argiles JM, Campos N, Lopez-Pedrosa JM, Rueda R, Rodriguez-Manas L. Skeletal Muscle Regulates Metabolism via Interorgan Crosstalk: Roles in Health and Disease. J Am Med Dir Assoc. 2016.

de Souza Vasconcelos KS, Domingues Dias JM, de Carvalho Bastone A, Alvarenga Vieira R, de Souza Andrade AC, Rodrigues Perracini M, et al. Handgrip Strength Cutoff Points to Identify Mobility Limitation in Community-dwelling Older People and Associated Factors. J Nutr Health Aging. 2016;20:306–15.CrossRef

Deutz NE, Matheson EM, Matarese LE, Luo M, Baggs GE, Nelson JL, et al. Readmission and mortality in malnourished, older, hospitalized adults treated with a specialized oral nutritional supplement: A randomized clinical trial. Clin Nutr. 2016;35:18–26.CrossRefPubMed

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.CrossRefPubMedPubMedCentral

Kamel HK. Sarcopenia and aging. Nutr Rev. 2003;61:157–67.CrossRefPubMed

Hirani V, Blyth F, Naganathan V, Le Couteur DG, Seibel MJ, Waite LM, et al. Sarcopenia Is Associated With Incident Disability, Institutionalization, and Mortality in Community-Dwelling Older Men: The Concord Health and Ageing in Men Project. J Am Med Dir Assoc. 2015;16:607–13.CrossRefPubMed

Elia M, RJ S. Calculating the cost of disease-related malnutrition in the UK in 2007 (public expenditure only) in: Combating Malnutrition: Recommendations for Action. Report from the advisory group on malnutrition. BAPEN. 2009.

Scott D, Park MS, Kim TN, Ryu JY, Hong HC, Yoo HJ, et al. Associations of low muscle mass and the metabolic syndrome in Caucasian and Asian middle-aged and older adults. J Nutr Health Aging. 2016;20:248–55.CrossRefPubMed

10.

Greysen SR, Stijacic Cenzer I, Auerbach AD, Covinsky KE. Functional impairment and hospital readmission in Medicare seniors. JAMA Intern Med. 2015;175:559–65.CrossRefPubMedPubMedCentral

11.

Guest JF PM, Baeyens JP, de Man F, Ljungqvist O, Pichard C, Wait S, Wilson L. Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK. Clin Nutr. 2011;30:422–9.CrossRefPubMed

12.

Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010;58:1734–8.CrossRefPubMed

13.

Cruz-Jentoft AJ, Landi F, Schneider SM, Zuniga C, Arai H, Boirie Y, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014;43:748–59.PubMedPubMedCentral

14.

Wandrag L, Brett SJ, Frost G, Hickson M. Impact of supplementation with amino acids or their metabolites on muscle wasting in patients with critical illness or other muscle wasting illness: a systematic review. J Hum Nutr Diet. 2015;28:313–30.CrossRefPubMed

15.

Witard OC, Wardle SL, Macnaughton LS, Hodgson AB, Tipton KD. Protein Considerations for Optimising Skeletal Muscle Mass in Healthy Young and Older Adults. Nutrients. 2016;8.

16.

Landi F, Calvani R, Tosato M, Martone AM, Ortolani E, Savera G, et al. Protein Intake and Muscle Health in Old Age: From Biological Plausibility to Clinical Evidence. Nutrients. 2016;8.

17.

Molfino A, Gioia G, Rossi Fanelli F, Muscaritoli M. Beta-hydroxy-beta-methylbutyrate supplementation in health and disease: a systematic review of randomized trials. Amino Acids. 2013;45:1273–92.CrossRefPubMed

18.

Standley RA, Distefano G, Pereira SL, Tian M, Kelly OJ, Coen PM, et al. Effects of beta-hydroxy-beta-methylbutyrate (HMB) on skeletal muscle mitochondrial content and dynamics, and lipids after 10 days of bed rest in older adults. J Appl Physiol (1985). 2017:jap 00192 2017.

19.

Fitschen PJ, Wilson GJ, Wilson JM, Wilund KR. Efficacy of beta-hydroxy-betamethylbutyrate supplementation in elderly and clinical populations. Nutrition. 2013;29:29–36.CrossRefPubMed

20.

Cruz-Jentoft AJ. Beta-hydroxy-beta-methyl butyrate (HMB): From experimental data to clinical evidence in sarcopenia. Curr Protein Pept Sci. 2017;18:1–5.

21.

Ekinci O, Yanik S, Terzioglu Bebitoglu B, Yilmaz Akyuz E, Dokuyucu A, Erdem S. Effect of Calcium beta-Hydroxy-beta-Methylbutyrate (CaHMB), Vitamin D, and Protein Supplementation on Postoperative Immobilization in Malnourished Older Adult Patients With Hip Fracture: A Randomized Controlled Study. Nutr Clin Pract. 2016:1–7.

22.

Olveira G, Olveira C, Dona E, Palenque FJ, Porras N, Dorado A, et al. Oral supplement enriched in HMB combined with pulmonary rehabilitation improves body composition and health related quality of life in patients with bronchiectasis (Prospective, Randomised Study). Clin Nutr. 2016;35:1015–22.CrossRefPubMed

23.

Berton L, Bano G, Carraro S, Veronese N, Pizzato S, Bolzetta F, et al. Effect of Oral Beta-Hydroxy-Beta-Methylbutyrate (HMB) Supplementation on Physical Performance in Healthy Old Women Over 65 Years: An Open Label Randomized Controlled Trial. PLoS One. 2015;10:e0141757.CrossRef

24.

Philipson TJ, Snider JT, Lakdawalla DN, Stryckman B, Goldman DP. Impact of oral nutritional supplementation on hospital outcomes. Am J Manag Care. 2013;19:121–8.PubMed

25.

Collins J, Porter J. The effect of interventions to prevent and treat malnutrition in patients admitted for rehabilitation: a systematic review with meta-analysis. J Hum Nutr Diet. 2015;28:1–15.CrossRefPubMed

26.

Graham J, Fan L, Meadows ES, Hang L, Partridge J, Goates S. Addressing malnutrition across the continuum of care: Which Patients Are Likely to Receive Oral Nutritional Supplements. Journal of ageing research and healthcare 2017;1:9.CrossRef

27.

Sauer AC, Alish CJ, Strausbaugh K, West K, B Q. Nurses needed: Identifying malnutrition in hospitalized older adults NursingPlus Open. 2016;2:21–5.CrossRef

28.

Schuetz P. Food for thought: why does the medical community struggle with research about nutritional therapy in the acute care setting? BMC Med. 2017;15:38.CrossRefPubMedPubMedCentral

29.

Baldwin C, Weekes CE. Dietary counselling with or without oral nutritional supplements in the management of malnourished patients: a systematic review and meta-analysis of randomised controlled trials. J Hum Nutr Diet. 2012;25:411–26.CrossRefPubMed

30.

Bally MR, Blaser Yildirim PZ, Bounoure L, Gloy VL, Mueller B, Briel M, et al. Nutritional Support and Outcomes in Malnourished Medical Inpatients: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016;176:43–53.CrossRefPubMed

31.

Elia M, Normand C, Laviano A, Norman K. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings. Clin Nutr. 2016;35:125–37.CrossRefPubMed

32.

Elia M, Normand C, Norman K, Laviano A. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in the hospital setting. Clin Nutr. 2016;35:370–80.CrossRefPubMed

33.

Stratton RJ, Hebuterne X, Elia M. A systematic review and meta-analysis of the impact of oral nutritional supplements on hospital readmissions. Ageing Res Rev. 2013;12:884–97.CrossRefPubMed

34.

Milne AC, Potter J, Vivanti A, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev. 2009:CD003288.

35.

Cawood AL, Elia M, Stratton RJ. Systematic review and meta-analysis of the effects of high protein oral nutritional supplements. Ageing Res Rev. 2012;11:278–96.CrossRefPubMed

36.

Wall BT, van Loon LJ. Nutritional strategies to attenuate muscle disuse atrophy. Nutr Rev. 2013;71:195–208.CrossRefPubMed

37.

Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids. Am J Clin Nutr. 2005;82:1065–73.CrossRefPubMed

38.

Deutz NE, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr. 2014;33:929–36.CrossRefPubMedPubMedCentral

39.

Koretz RL, Avenell A, Lipman TO, Braunschweig CL, Milne AC. Does enteral nutrition affect clinical outcome? A systematic review of the randomized trials. Am J Gastroenterol. 2007;102:412–29; quiz 68.CrossRefPubMed

40.

Wu H, Xia Y, Jiang J, Du H, Guo X, Liu X, et al. Effect of beta-hydroxy-betamethylbutyrate supplementation on muscle loss in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2015;61:168–75.CrossRefPubMed

41.

Flakoll P, Sharp R, Baier S, Levenhagen D, Carr C, Nissen S. Effect of beta-hydroxybeta-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women. Nutrition. 2004;20:445–51.CrossRefPubMed

42.

Stout JR, Smith-Ryan AE, Fukuda DH, Kendall KL, Moon JR, Hoffman JR, et al. Effect of calcium beta-hydroxy-beta-methylbutyrate (CaHMB) with and without resistance training in men and women 65+yrs: a randomized, double-blind pilot trial. Exp Gerontol. 2013;48:1303–10.CrossRefPubMed

43.

Nishizaki K, Ikegami H, Tanaka Y, Imai R, Matsumura H. Effects of supplementation with a combination of beta-hydroxy-beta-methyl butyrate, L-arginine, and L-glutamine on postoperative recovery of quadriceps muscle strength after total knee arthroplasty. Asia Pac J Clin Nutr. 2015;24:412–20.PubMed

44.

Kortebein P, Symons TB, Ferrando A, Paddon-Jones D, Ronsen O, Protas E, et al. Functional impact of 10 days of bed rest in healthy older adults. J Gerontol A Biol Sci Med Sci. 2008;63:1076–81.CrossRefPubMed

45.

Deutz NE, Pereira SL, Hays NP, Oliver JS, Edens NK, Evans CM, et al. Effect of betahydroxy- beta-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Clin Nutr. 2013;32:704–12.CrossRefPubMed

46.

De Luis DA, Izaola O, Bachiller P, Perez Castrillon J. 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. Nutr Hosp. 2015;32:202–7.PubMed

47.

Cramer JT, Cruz-Jentoft AJ, Landi F, Hickson M, Zamboni M, Pereira SL, et al. Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial. J Am Med Dir Assoc. 2016;17:1044–55.CrossRefPubMed

48.

Kuhls DA, Rathmacher JA, Musngi MD, Frisch DA, Nielson J, Barber A, et al. Beta-hydroxy-beta-methylbutyrate supplementation in critically ill trauma patients. J Trauma. 2007;62:125–31; discussion 31-2.CrossRefPubMed

49.

Malafarina V, Uriz-Otano F, Malafarina C, Martinez JA, Zulet MA. Effectiveness of nutritional supplementation on sarcopenia and recovery in hip fracture patients. A multi-centre randomized trial. Maturitas. 2017;101:42–50.CrossRefPubMed

50.

Beck AM, Holst M, Rasmussen HH. Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital: systematic review and metaanalysis of randomized controlled trials. Clin Rehabil. 2013;27:19–27.CrossRefPubMed

51.

Lopez JA, Segurola H, Cardenas G, Giribes M, Ferrer JJ, Rodriguez E, et al. Effect on muscle mass of nutritional intervention with a hypercaloric and hyperproteic diet with HMB in malnourished patients with COPD Nutr Hosp. 2015;31.

52.

Tu MK, Levin JB, Hamilton AM, Borodinsky LN. Calcium signaling in skeletal muscle development, maintenance and regeneration. Cell Calcium. 2016;59:91–7.CrossRefPubMedPubMedCentral

53.

Halfon M, Phan O, Teta D. Vitamin D: a review on its effects on muscle strength, the risk of fall, and frailty. Biomed Res Int. 2015;2015:953241.CrossRefPubMedPubMedCentral

54.

Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck AE, Theiler R, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ. 2009;339:b3692.CrossRefPubMedPubMedCentral

55.

Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28.CrossRefPubMed

Title: Role of Oral Nutritional Supplements Enriched with B-hydroxy-B-Methylbutyrate in Maintaining Muscle Function and Improving Clinical Outcomes in Various Clinical Settings
Authors: Alejandro Sanz-Paris
M. Camprubi-Robles
J. M. Lopez-Pedrosa
S. L. Pereira
R. Rueda
M. D. Ballesteros-Pomar
J. M. Garcia Almeida
A. J. Cruz-Jentoft
Publication date: 01-06-2018
Publisher: Springer Paris
Published in: The journal of nutrition, health & aging / Issue 6/2018
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI: https://doi.org/10.1007/s12603-018-0995-7

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