Fight Sarcopenia with Exercise & Nutrition


Exercise, specifically strength and resistance training, can assist in fighting the negative effects of sarcopenia and lean body mass loss. A number of studies have shown the positive impact of exercise in older populations, with improvement in muscle strength and size and physical performance.1


Proper nutrition, with a focus on protein consumption, may reduce the risk and moderate the effects of sarcopenia. Increased protein intake has been shown to2,3:

  • Preserve muscle mass
  • Increase strength
  • Improve physical function
  • Slow rates of functional decline

Another important element of proper nutrition is HMB (β-hydroxy- β-methylbutyrate). HMB is a metabolite of leucine, a branched-chain amino acid consumed from the diet that can help fight lean body mass loss.

  • Slows down muscle loss during periods of immobility4
  • Inhibits muscle proteolysis and modulates protein turnover5-8
  • Helps maintain nitrogen balance—the availability of protein for the body’s use9,10

HMB occurs naturally in human muscle cells and is found in foods such as avocado, cauliflower, alfalfa, and catfish.11 But it is extremely difficult to obtain the recommended amount supported by research (3g) and to impact muscle health through food alone.

Commercially available HMB, such as the nutritional supplement CaHMB, allows individuals to obtain the recommended daily serving of 3 grams. It can help those suffering from lean body mass loss and has been shown (in combination with other amino acids) to rebuild lean body mass in older adults and patients suffering from cancer or AIDS.12-14

Research shows that HMB alone or in combination with amino acids may improve:

  • Body composition and functionality in healthy elderly men and women14,15
  • Protein synthesis in patients in the ICU and critical care unit16,17
  • LBM in patients with Stage-IV Cancer and AIDS- associated wasting12,13
Clinical Evidence Supports that HMB Preserves Lean Body Mass in Healthy Older Adults.10

Clinical Evidence Supports that HMB Preserves Lean Body Mass in Healthy Older Adults.10

Clinical Evidence Supports that HMB Preserves Lean Body Mass in Healthy Older Adults.10

HMB Graph

The study tested the efficacy of HMB supplementation on muscle mass declines that occur over 10 days of bed rest. Results based on a prospective, randomized, double-blinded, placebo-controlled trial designed to study the impact of HMB on lean body mass during 10 days of bed rest in older adults.10 Patients were not tested for sarcopenia diagnosis.


In a clinical setting, nutrition intervention—commonly in the form of oral nutrition supplements (ONS)—has been shown to18-24:

  • Promote healthy weight gain/maintenance
  • Improve strength and energy
  • Preserve lean body mass
  • Support recovery due to illness or injury
  • Reduce pressure ulcer incidence
  • Reduce overall complications

Economic Impacts of ONS

Economic Outcomes

Health economics outcomes study using 44 million impatient episodes at 460 hospitals from 2000 to 201024-26

Impact on specific 65+ Medicare populations


*Hypothetical patient case.


1Dennison HJ, Cooper C, Sayer AA, Robinson SM. 2015. Prevention and optimal management of sarcopenia. Dove Press. 10:859-869. DOI

2Borsheim E, Bui QU, Tissier S, et al. Effect of amino acid supplementation on muscle mass, strength and physical function in elderly. Clin Nutr. 2008;27(2):189-195.

3Deer RR, Volpi E. 2015. Protein intake and muscle function in older adults. Curr Opin Clin Nutr Metab Care. May;18(3):248-53. doi: 10.1097/MCO.0000000000000162.

4May ME, Buse MG. Effects of branched-chain amino acids on protein turnover. Diabetes MetabRev. 1989;5:227-245.

5Willams JZ, Barbul A. Nutrition and wound healing. Surg Clin North Am. 2003; 83:571-596.

6Alon T, Bagchi D, Preuss HG. Supplementing with beta-hydroxy-betamethylbutyrate (HMB) to build and maintain muscle mass: a review. Res Commun Mol Pthol Pharmacol. 2002;111:139-151.

7Nissen S et al. Effect of leucine metabolite B-hydroxy-B-methylbutyrate on muscle metabolism during resistance-exercise training. J Appl Physiol. 1996:81:2095-2104.

8Smith HJ, Mukerji P, Tisdale MJ. Attenuation of proteasome-induced proteolysis in skeletal muscle by B-hydroxy-B-methylbutyrate in cancer-induced muscle loss. Cancer Res. 2005;65:277-283.

9Smith HJ, Wyke SM, Tisdale MJ. Mechanism of the attenuation of proteolysis-inducing factor stimulated protein degradation in muscle by B-hydroxy-B-methylbutyrate. Cancer Res. 2004;64:8731-8735.

10Deutz NE et al. Clin Nutr. 2013;32:704-712.

11Zhang Z, Rathmacher J, et al. Occurrence of B-hydroxy-B-methylbutyrate in foods and feeds. FASEB J. 1994;8:A464 [Abstract 2685].

12May PE, et al. Am J Surg. 2002;183:471-479.

13Clark RH, et al. JPEN. 2000;24:133-139.

14Flakoll P, et al. Nutrition. 2004;20:445-451.

15Vukovich MD et al. J Nutr. 2001;131:2049-2052.

16Kuhls DA et al. J Trauma. 2007;62:125-132.

17Hseih LC et al. J Clin Nutr. 2006;15:544-550.

18Anker SD, et al. Clin Nutr. 2006;25:311-218.

19Academy of Nutrition & Dietetics. Nutrition Care Manual. Accessed: March 25, 2015.

20Akrabawi SS, et al. Nutrition. 1996;12:260-265.

21Norman K, et al. Clin Nutr.2008;27:48-56.

22Stratton RJ, et al. Ageing Res Rev. 2005;4:422-450.

23 Milne AC, et al. Cochrane Database Syst Rev. 2009; Apr 16(2):CD003288. DOI:10.1002/14651858.

24Philipson TJ, et al. Am J Manag Care. 2013;19:121-128.

25Snider J, et al. The 19th Annual Meeting of the International Society of Pharmaceutical Outcomes Research; May 2014.

26Lakdawalla D, et al. The 35th Annual Meeting of the Society for Medical Decision Making; 2013.