Dr. Ray Chan
Specialist in Internal Medicine
Dr. Ray Chan
Specialist in Internal Medicine
KEY MESSAGES
1. Inadequate nutrient intake and muscle loss are indicators of malnutrition.1,2
2. Muscle loss with decreased muscle function is associated with multiple adverse health outcomes:3
3. Muscle loss is more severe for inactive hospitalized patients, especially as they age.4-9
* The study results were based on Lean Body Mass (LBM) measurements; LBM is made up of 75% muscle
4. Although currently, there is no medication approved by the FDA for sarcopenia, certain strategies can be regarded as useful solutions for muscle loss:10
5. β-hydroxy-β-methyl butyrate (HMB) is derived from leucine, which only takes up about 5% of the downstream metabolite.11
6. Scientific evidence suggests that HMB is associated with the stimulation of protein synthesis in muscle growth.12-14
7. RCT evidence of HMB (NOURISH study): HMB (2 servings of 1.5g CaHMB per day) plus high protein is helpful for malnourished, older, hospitalized adults in reducing mortality rates and improving nutritional status:15,†
Footnotes:
† Study design: The NOURISH study was a multicenter, prospective, randomized, double-blind, placebo-controlled, parallel-group study conducted in the United States between May 2012 and October 2014. Eligible patients were aged 65 years with a recent hospital admission (within 72 h) with a primary diagnosis of CHF, AMI, PNA, or COPD. A total of 622 enrolled patients received their allocated intervention and were included in the final ITT analysis, of whom 313 received standard-of-care plus high protein and 1.5 g HMB supplement 2 servings/day and 309 received standard-of-care with placebo supplement. The primary composite endpoint was the 90-day post-discharge incidence of death or nonelective readmission.15
AMI, acute myocardial infarction; CaHMB, calcium ß-hydroxy-ß-methyl butyrate; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; FDA, Food and Drug Administration; HMB, ß-hydroxy-ß-methyl butyrate; HP-HMB, high protein + ß-hydroxy-ß-methyl butyrate ICU, intensive care unit; ITT, intention-to-treat; LBM, lean body mass; ONS, oral nutritional supplement; PNA, pneumonia; RCT, randomized controlled trial.
References:
HKG.2025.58178.ENS
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