Health Benefits of β-Hydroxy-β-Methylbutyrate (HMB) Supplementation in Addition to Physical Exercise in Older Adults: A Systematic Review with Meta-Analysis

Javier Courel-Ibáñez, Tomas Vetrovsky, Klara Dadova, Jesús G Pallarés, Michal Steffl, Javier Courel-Ibáñez, Tomas Vetrovsky, Klara Dadova, Jesús G Pallarés, Michal Steffl

Abstract

Both regular exercise training and beta-hydroxy-beta-methylbutyrate (HMB) supplementation are shown as effective treatments to delay or reverse frailty and reduce cognitive impairment in older people. However, there is very little evidence on the true benefits of combining both strategies. The aim of this meta-analysis was to quantify the effects of exercise in addition to HMB supplementation, on physical and cognitive health in older adults. Data from 10 randomized controlled trials (RCTs) investigating the effect of HMB supplementation and physical function in adults aged 50 years or older were analyzed, involving 384 participants. Results showed that HMB supplementation in addition to physical exercise has no or fairly low impact in improving body composition, muscle strength, or physical performance in adults aged 50 to 80 years, compared to exercise alone. There is a gap of knowledge on the beneficial effects of HMB combined with exercise to preserve cognitive functions in aging and age-related neurodegenerative diseases. Future RCTs are needed to refine treatment choices combining HMB and exercises for older people in particular populations, ages, and health status. Specifically, interventions in older adults aged 80 years or older, with cognitive impairment, frailty, or limited mobility are required.

Keywords: elderly; leucine; neuromuscular function; nutrition; resistance training; sarcopenia.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart illustrating the different phases of the search and study selection, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statements.
Figure 2
Figure 2
Effects meta-analysis of HMB on handgrip strength. Squares are effect sizes. The area of each square is proportional to the study’s weight in the meta-analysis. Vertical line and diamond indicate the overall measure of effects and confidence intervals.
Figure 3
Figure 3
Effects meta-analysis of HMB on leg strength. Squares are effect sizes. The area of each square is proportional to the study’s weight in the meta-analysis. Vertical line and diamond indicate the overall measure of effects and confidence intervals.
Figure 4
Figure 4
Effects meta-analysis of HMB on muscle mass. Squares are effect sizes. The area of each square is proportional to the study’s weight in the meta-analysis. Vertical line and diamond indicate the overall measure of effects and confidence intervals.
Figure 5
Figure 5
Effects meta-analysis of HMB on fat mass. Squares are effect sizes. The area of each square is proportional to the study’s weight in the meta-analysis. Vertical line and diamond indicate the overall measure of effects and confidence intervals.
Figure 6
Figure 6
Effects meta-analysis of HMB on muscle mass and strength. Squares are effect sizes. The area of each square is proportional to the study’s weight in the meta-analysis. Vertical line and diamond indicate the overall measure of effects and confidence intervals.

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