β-Hydroxy-β-methylbutyrate (HMB)-free acid attenuates circulating TNF-α and TNFR1 expression postresistance exercise

International society of sports nutrition position stand: β-hydroxy-β-methylbutyrate (HMB)

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on an analysis of the literature regarding the effects of β-Hydroxy-β-Methylbutyrate (HMB). The following 12 points have been approved by the Research Committee of the Society: 1. HMB is a metabolite of the amino acid leucine that is naturally produced in both humans and other animals. Two forms of HMB have been studied: Calcium HMB (HMB-Ca) and a free acid form of HMB (HMB-FA). HMB-FA appears to lead to increased appearance of HMB in the bloodstream when compared to HMB-Ca, though recent results are mixed. 2. The available safety/toxicity data suggest that chronic HMB-Ca and HMB-FA consumption are safe for oral HMB supplementation in humans up to at least one year. 3. There are no negative effects of HMB-Ca and HMB-FA on glucose tolerance and insulin sensitivity in humans. There may be improvements in glucose metabolism in younger adults. 4. The primary mode of action of HMB appears to be through its dual mechanism to enhance muscle protein synthesis and suppress muscle protein breakdown. HMB's activation of mTORC1 is independent of the leucine-sensing pathway (Sestrin2-GATOR2 complex). 5. HMB may help reduce muscle damage and promote muscle recovery, which can promote muscle growth/repair. HMB may also have anti-inflammatory effects, which could contribute to reducing muscle damage and soreness. 6. HMB consumption in close proximity to an exercise bout may be beneficial to increase muscle protein synthesis and attenuate the inflammatory response. HMB can provide a beneficial physiological effect when consumed both acutely and chronically in humans. 7. Daily HMB supplementation (38 mg/kg body weight) in combination with exercise training may improve body composition through increasing lean mass and/or decreasing fat mass with benefits in participants across age, sex, and training status. The most pronounced of these improvements in body composition with HMB have been observed in studies with robust resistance training programs and dietary control. 8. HMB may improve strength and power in untrained individuals, but its performance benefits in trained athletes are mixed and increase with an increase in study duration (>6 weeks). HMB's beneficial effects on athletic performance are thought to be driven by improved recovery. 9. HMB supplementation appears to potentially have a positive impact on aerobic performance, especially in trained athletes. The mechanisms of the effects are unknown. 10. HMB supplementation may be important in a non-exercising sedentary and aging population to improve muscle strength, functionality, and muscle quality. The effects of HMB supplementation with exercise are varied, but the combination may have a beneficial effect on the treatment of age-associated sarcopenia under select conditions. 11. HMB may be effective in countering muscle disuse atrophy during periods of inactivity due to illness or injury. The modulation of mitochondrial dynamics and lipid metabolism by HMB may be a potential mechanism for preventing disuse atrophy and aiding rehabilitation beyond HMB's effects on rates of muscle protein synthesis and degradation. 12. The efficacy of HMB in combination with certain nutrients may be enhanced under select conditions.

Functional and metabolic effects of omega-3 polyunsaturated fatty acid supplementation and the role of β-hydroxy-β-methylbutyrate addition in chronic obstructive pulmonary disease: A randomized clinical trial

INTRODUCTION

Short-term (4 weeks) supplementation with n-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has recently been shown to improve protein metabolism in a dose dependent way in normal weight patients with Chronic Obstructive Pulmonary Disease (COPD). Furthermore, EPA/DHA supplementation was able to increase extremity lean soft tissue but not muscle function. No studies are available combining n-3 PUFAs and the leucine metabolite β-hydroxy-β-methylbutyrate (HMB) supplementation in chronic clinical conditions. Whether adding HMB to daily EPA/DHA supplementation for 10 weeks enhances muscle and brain health, daily functional performance, and quality of life of patients with COPD by further improving their protein and amino acid homeostasis remains unknown.

METHODS

Patients with COPD (GOLD: II-IV, n = 46) received daily for 10 weeks, according to a randomized double-blind placebo-controlled three-group design, EPA/DHA (n = 16), EPA/DHA to which HMB was added (n = 14), or placebo (n = 16). The daily dose of 2.0 g of EPA/DHA or soy + corn oil as the placebo was provided via gel capsules, and 3.0 g of Ca-HMB or maltodextrin as placebo as powders. At pre- and post-intervention, a pulse mixture of multiple amino acids was administered to measure postabsorptive net protein breakdown (netPB as primary endpoint) and whole body production (WBP) and conversion rates of the amino acids. As secondary endpoints, lean soft tissue and fat mass were assessed by dual-energy X-ray absorptiometry, upper and lower muscle function by handgrip and single leg isokinetic dynamometry, brain (cognitive, wellbeing) health by assessments, daily functional performance by measuring 6-min walk distance, 4-m gait speed, and postural balance, and quality of life by questionnaire. Plasma enrichments and concentrations were analyzed by LC-MS/MS, and systemic inflammatory profile and metabolic hormones by Luminex.

RESULTS

HMB + EPA/DHA but not EPA/DHA supplementation increased postabsorptive netPB (p = 0.028), and WBPs of glutamine (p = 0.024), taurine (p = 0.039), and tyrosine (p = 0.036). Both EPA/DHA and HMB + EPA/DHA supplementation resulted in increased WBP of phenylalanine (p < 0.05). EPA/DHA but not HMB + EPA/DHA was able to increase WBP of arginine (p = 0.030), citrulline (p = 0.008), valine (p = 0.038), and conversion of citrulline to arginine (p = 0.009). Whole body and extremity fat mass were reduced after HMB + EPA/DHA supplementation only, whereas lean soft tissue was increased after EPA/DHA (p = 0.049) and HMB + EPA/DHA (p = 0.073). No other significant findings were observed. Reductions in several proinflammatory cytokines were observed in the HMB + EPA/DHA group including IL-2, IL-17, IL-6, IL-12P40, and TNF-β (p < 0.05).

CONCLUSIONS

Ten weeks of supplementation with 2 g of EPA/DHA daily is sufficient to induce muscle gain in COPD but HMB is needed to induce fat loss. Whether HMB is solely responsible for the fat mass loss or has a synergistic effect with EPA/DHA remains unclear. The increase in net protein breakdown observed with HMB + EPA/DHA supplementation may indicate a beneficial enhanced protein turnover cycling associated with increased lean soft tissue.

CLINICAL TRIAL REGISTRY

ClinicalTrials.gov; NCT03796455.

Harnessing immunomodulation to combat sarcopenia: current insights and possible approaches

Sarcopenia is a complex age-associated syndrome of progressive loss of muscle mass and strength. Although this condition is influenced by many factors, age-related changes in immune function including immune cell dynamics, and chronic inflammation contribute to its progression. The complex interplay between the immune system, gut-muscle axis, and autophagy further underscores their important roles in sarcopenia pathogenesis. Immunomodulation has emerged as a promising strategy to counteract sarcopenia. Traditional management approaches to treat sarcopenia including physical exercise and nutritional supplementation, and the emerging technologies of biophysical stimulation demonstrated the importance of immunomodulation and regulation of macrophages and T cells and reduction of chronic inflammation. Treatments to alleviate low-grade inflammation in older adults by modulating gut microbial composition and diversity further combat sarcopenia. Furthermore, some pharmacological interventions, nano-medicine, and cell therapies targeting muscle, gut microbiota, or autophagy present additional avenues for immunomodulation in sarcopenia. This narrative review explores the immunological underpinnings of sarcopenia, elucidating the relationship between the immune system and muscle during ageing. Additionally, the review discusses new areas such as the gut-muscle axis and autophagy, which bridge immune system function and muscle health. Insights into current and potential approaches for sarcopenia management through modulation of the immune system are provided, along with suggestions for future research directions and therapeutic strategies. We aim to guide further investigation into clinical immunological biomarkers and identify indicators for sarcopenia diagnosis and potential treatment targets to combat this condition. We also aim to draw attention to the importance of considering immunomodulation in the clinical management of sarcopenia.

How Does Altering the Volume-Load of Plyometric Exercises Affect the Inflammatory Response, Oxidative Stress, and Muscle Damage in Male Soccer Players?

Incorporating plyometric exercises (PE) into soccer players' conditioning routines is vital for boosting their performance. Nevertheless, the effects of PE sessions with diverse volume loads on inflammation, oxidative stress, and muscle damage are not yet clearly understood. This study aimed to examine the effects of altering the volume-loads of PE on indicators of oxidative muscle damage and inflammation. The study involved forty young male soccer players who were randomly assigned to three different volume-loads of PE (Low volume-load [100 jumps]: LVL, n = 10; Moderate volume-load [150 jumps]: MVL, n = 10; and High volume-load [200 jumps]: HVL, n = 10) and a control group (CON = 10). The levels of various biomarkers including delayed onset muscle soreness (DOMS), serum lactate dehydrogenase (LDH), creatine kinase (CK), 8-hydroxy-2-deoxyguanosine (8-OHdG), malondialdehyde (MDA), protein carbonyl (PC), leukocytes, neutrophils, interleukin-6 (IL-6), and C-reactive protein (CRP) were measured at different time points. These measurements were taken at rest, immediately after completion of PE, and 24-, 48-, and 72-hours post-PE. The CK, LDH, DOMS, 8-OHdG, MDA, and PC levels were significantly increased (p < 0.05) after the PE protocol, reaching their peak values between 24 to 48 hours post-PE for all the volume-loaded groups. The levels of leukocytes, neutrophils, and IL-6 also increased after the PE session but returned to resting values within 24 hours post-PE. On the other hand, CRP levels increased at 24 hours post-PE for all the treatment groups (p < 0.05). The changes observed in the indicators of muscle damage and inflammation in response to different volume-loads of PE was not significant. However, the HVL and MVL indicated significant differences compared to LVL in the 8-OHdG (at 48-hour) and MDA (at 72-hour). Athletes engaging in higher volume-loads demonstrated more pronounced responses in terms of biochemical variables (specifically, LVL < MVL < HVL); however, these changes were not statistically significant (except 8-OHdG and MDA).

Different effects of dietary β-hydroxy-β-methylbutyrate on composition of fatty acid and free amino acid, and fatty metabolism in the different muscles of broilers

In the study, 336 broiler chickens were selected to explore dietary effects of different β-hydroxy-β-methylbutyrate (HMB) levels (0 (control), 0.05, 0.10, and 0.15%) on the compositions of fatty acids and free amino acids, and lipid metabolism in the different muscles of broilers. In the breast muscle, dietary HMB supplementation hardly affected the free amino acid composition (P > 0.05). Compared to the control group, dietary 0.10 and 0.15% HMB supplementation decreased the content of C18:1n9c and thus the monounsaturated fatty acid (MUFA), and dietary 0.15% HMB supplementation increased the sum of saturated fatty acids (SFA) (P < 0.05). Moreover, compared to the control group, dietary 0.05 and 0.10% HMB increased the mRNA expression of proliferator activated receptor-γ and the activity of fatty acid synthase (FAS), and dietary 0.10% HMB increased the acetyl-CoA carboxylase activity (P < 0.05). In the leg muscle, dietary 0.10 and 0.15% HMB increased the MUFA content and decreased the polyunsaturated fatty acid (PUFA) content, the PUFA to SFA ratio, the mRNA expression of sterol regulatory element binding proteins-1c, and the activities of acyl-CoA oxidase 1 and acetyl-CoA synthetase (P < 0.05). Moreover, dietary 0.10% HMB decreased the activities of hydroxy-3-methylglutaryl-CoA synthase 1 and FAS in comparison to the control group (P < 0.05). Dietary 0.05% HMB decreased the contents of essential amino acids and nonessential amino acids (NEAA), and dietary 0.15% HMB decreased the NEAA content (P < 0.05). In summary, dietary 0.10% HMB supplementation had superior efficiency on lipogenesis in the breast muscle of broilers. However, dietary HMB supplementation, especially at the level of 0.05 and 0.15%, decreased meat nutritional values and the lipogenesis in leg muscles.

Acute physiological outcomes of high-intensity functional training: a scoping review

Background

Systematic reviews and meta-analyses related to high-intensity functional training (HIFT) have been conducted. However, due to a restricted pool of available research, these investigations are often limited in scope. As such, a scoping review investigating the present literature surrounding the acute physiological response to HIFT-based exercise was chosen as a more appropriate structured review.

Methodology

A scoping review was conducted following Arksey and O'Malley's framework. Three large scale databases were searched to reveal any article pertaining to HIFT and related exercise terminology.

Results

A total of 2,241 articles were found during the initial search. Following this, titles, then abstracts, and full-texts were reviewed to determine inclusion eligibility. A total of 60 articles which investigated a combined total of 35 unique HIFT workouts were included within this review.

Conclusions

A variety of physiological parameters and HIFT workouts have been examined. Markers of intensity (e.g., blood lactate concentrations, heart rate) have been most consistently assessed across all studies, and these support the idea that HIFT workouts are typically performed at high-intensity. In contrast, the inclusion of most other measures (e.g., hormonal, markers of inflammation and damage, energy expenditure, performance) has been inconsistent and has thus, limited the possibility for making generalized conclusions. Differences in study methodologies have further impacted conclusions, as different studies have varied in sample population characteristics, workouts assessed, and time points. Though it may be impossible to comprehensively research all possible HIFT workouts, consistent adoption of population definitions and workload quantification may overcome this challenge and assist with future comparisons.

Cold water immersion after a soccer match: Does the placebo effect occur?

Although cold water immersion (CWI) is one of the most widely used post-exercise strategies to accelerate recovery processes, the benefits of CWI may be associated with placebo effects. This study aimed to compare the effects of CWI and placebo interventions on time course of recovery after the Loughborough Intermittent Shuttle Test (LIST). In a randomized, counterbalanced, crossover study, twelve semi-professional soccer players (age 21.1 ± 2.2 years, body mass 72.4 ± 5.9 kg, height 174.9 ± 4.6 cm, V ˙ O_2max 56.1 ± 2.3 mL/min/kg) completed the LIST followed by CWI (15 min at 11°C), placebo (recovery Pla beverage), and passive recovery (Rest) over three different weeks. Creatine kinase (CK), C-reactive protein (CRP), uric acid (UA), delayed onset muscle soreness (DOMS), squat jump (SJ), countermovement jump (CMJ), 10-m sprint (10 mS), 20-m sprint (20 mS) and repeated sprint ability (RSA) were assessed at baseline and 24 and 48 h after the LIST. Compared to baseline, CK concentration was higher at 24 h in all conditions (p < 0.01), while CRP was higher at 24 h only in CWI and Rest conditions (p < 0.01). UA was higher for Rest condition at 24 and 48 h compared to Pla and CWI conditions (p < 0.001). DOMS score was higher for Rest condition at 24 h compared to CWI and Pla conditions (p = 0.001), and only to Pla condition at 48 h (p = 0.017). SJ and CMJ performances decreased significantly after the LIST in Rest condition (24 h: -7.24%, p = 0.001 and -5.45%, p = 0.003 respectively; 48 h: -9.19%, p < 0.001 and -5.70% p = 0.002 respectively) but not in CWI and Pla conditions. 10 mS and RSA performance were lower for Pla at 24 h compared to CWI and Rest conditions (p < 0.05), while no significant change was observed for 20 mS time. These data suggests that CWI and Pla intervention were more effective than the Rest conditions in recovery kinetics of muscle damage markers and physical performance. Furthermore, the effectiveness of CWI would be explained, at least in part, by the placebo effect.

Effects of β-hydroxy-β-methylbutyrate supplementation on recovery from exercise-induced muscle damage: a mini-review

PURPOSE

Several studies have reported that β-hydroxy-β-methylbutyrate (HMB) has beneficial effects on exercise-induced muscle damage (EIMD). Here, we examine the effects and mechanisms of HMB supplementation on exercise-induced muscle damage EIMD and provide guidelines for the application of supplementary HMB.

METHODS

For this review, we performed web searches using PubMed, Web of Science, and Wiley Online Library. Keywords used were 'HMB,' 'HMB and EIMD,' 'HMB and recovery,' 'HMB and resistance exercise,' and 'HMB and eccentric muscle contraction.'

RESULTS

Several previous studies have shown that HMB supplementation can reduce EIMD and promote recovery. In particular, reductions were detected in certain markers of muscle membrane damage, including creatine kinase and lactate dehydrogenase. There may be multiple mechanisms in which HMB supplementation reduces EIMD, including reducing muscle-damage-induced inflammation and oxidative stress and promoting cellular cholesterol synthesis by increasing the production of β-hydroxy-β-methylglutaryl-Co-A, a product of HMB metabolism. In general, the suggested daily intake of HMB is 3 g. In addition, the timing and duration of HMB intake can be classified as chronic [≥ 2 weeks, in which a total of 3 g is consumed daily (3 × 1 g taken at breakfast, lunch, and dinner)] or acute (taken 30-60 min before exercise). The timing of intake during exercise may vary depending upon whether the formulation is calcium HMB (60-120 min before exercise) or the free-acid form of HMB (30-60 min before exercise). Notably, the co-administration of HMB and creatine does not appear to be effective in reducing EIMD.

CONCLUSION

HMB supplementation can be considered as an effective nutritional strategy to minimize EIMD.

Nutritional Compounds to Improve Post-Exercise Recovery

The metabolic and mechanical stresses associated with muscle-fatiguing exercise result in perturbations to bodily tissues that lead to exercise-induced muscle damage (EIMD), a state of fatigue involving oxidative stress and inflammation that is accompanied by muscle weakness, pain and a reduced ability to perform subsequent training sessions or competitions. This review collates evidence from previous research on a wide range of nutritional compounds that have the potential to speed up post-exercise recovery. We show that of the numerous compounds investigated thus far, only two-tart cherry and omega-3 fatty acids-are supported by substantial research evidence. Further studies are required to clarify the potential effects of other compounds presented here, many of which have been used since ancient times to treat conditions associated with inflammation and disease.

Examination of Amorphous Calcium Carbonate on the Inflammatory and Muscle Damage Response in Experienced Resistance Trained Individuals

The effect of 3 weeks of amorphous calcium carbonate (ACC) supplementation (2000 mg per day) was examined on the recovery response to resistance exercise. Thirty men were randomized into a supplement (ACC) or placebo (PL) group. Following supplementation, participants performed six sets of 10 repetitions in the bench press (BP) and incline BP exercises, using 80% of maximal strength. Participants returned 24 (T4) and 48 h (T5) later and performed six sets of the BP exercise. Significant decreases in the number of repetitions (p < 0.001), peak power (p < 0.001), and mean power (p = 0.009) were noted over time, but no significant interactions were observed (p > 0.05). Magnitude-based inference analysis (MBI) indicated that the change in repetitions was possibly beneficial for ACC at T4 and likely beneficial at T5. No significant interaction was noted for general soreness (p = 0.452), but a trend toward an interaction was observed in upper body soreness (p = 0.089). Confidence intervals for mean percent change scores indicated significant differences between the groups at T4 and T5, and MBI analysis indicated that ACC was very likely or likely to be beneficial for reducing soreness at those time points. In conclusion, ACC supplementation may have a potential beneficial effect in attenuating the decline in performance, which is possibly due to the carbonate component.

Post-Match Recovery in Soccer with Far-Infrared Emitting Ceramic Material or Cold-Water Immersion

We investigated the effects of two common recovery methods; far-infrared emitting ceramic materials (Bioceramic) or cold-water immersion on muscular function and damage after a soccer match. Twenty-five university-level soccer players were randomized into Bioceramic (BIO; n = 8), Cold-water immersion (CWI; n = 9), or Control (CON; n = 8) groups. Heart rate [HR], rating of perceived exertion [RPE], and activity profile through Global Positioning Satellite Systems were measured during the match. Biochemical (thiobarbituric acid reactive species [TBARS], superoxide dismutase [SOD], creatine kinase [CK], lactate dehydrogenase [LDH]), neuromuscular (countermovement [CMJ] and squat jump [SJ], sprints [20-m]), and perceptual markers (delayed-onset muscle soreness [DOMS], and the perceived recovery scale [PRS]) were assessed at pre, post, 24 h, and 48 h post-match. One-way ANOVA was used to compare anthropometric and match performance data. A two-way ANOVA with post-hoc tests compared the timeline of recovery measures. No significant differences existed between groups for anthropometric or match load measures (P > 0.05). Significant post-match increases were observed in SOD, and decreases in TBARS in all groups (p < 0.05), without differences between conditions (p > 0.05). Significant increases in CK, LDH, quadriceps and hamstring DOMS (p < 0.05), as well as decreases in 20-m, SJ, CMJ, and PRS were observed post-match in all groups (p < 0.05), without significant differences between conditions (p > 0.05). Despite the expected post-match muscle damage and impaired performance, neither Bioceramic nor CWI interventions improved post-match recovery.

Branched chain amino acids-friend or foe in the control of energy substrate turnover and insulin sensitivity?

Branched chain amino acids (BCAA) and their derivatives are bioactive molecules with pleiotropic functions in the human body. Elevated fasting blood BCAA concentrations are considered as a metabolic hallmark of obesity, insulin resistance, dyslipidaemia, nonalcoholic fatty liver disease, type 2 diabetes and cardiovascular disease. However, since increased BCAA amount is observed both in metabolically healthy and obese subjects, a question whether BCAA are mechanistic drivers of insulin resistance and its morbidities or only markers of metabolic dysregulation, still remains open. The beneficial effects of BCAA on body weight and composition, aerobic capacity, insulin secretion and sensitivity demand high catabolic potential toward amino acids and/or adequate BCAA intake. On the opposite, BCAA-related inhibition of lipogenesis and lipolysis enhancement may preclude impairment in insulin sensitivity. Thereby, the following review addresses various strategies pertaining to the modulation of BCAA catabolism and the possible roles of BCAA in energy homeostasis. We also aim to elucidate mechanisms behind the heterogeneity of ramifications associated with BCAA modulation.

Dietary Beta-Hydroxy Beta-Methyl Butyrate Supplementation Alleviates Liver Injury in Lipopolysaccharide-Challenged Piglets

The current study was performed to investigate whether dietary β-hydroxy-β-methylbutyrate (HMB) could regulate liver injury in a lipopolysaccharide- (LPS-) challenged piglet model and to determine the mechanisms involved. Thirty piglets (21 ± 2 days old, 5.86 ± 0.18 kg body weight) were randomly divided into the control (a basal diet, saline injection), LPS (a basal diet), or LPS+HMB (a basal diet + 0.60% HMB-Ca) group. After 15 d of treatment with LPS and/or HMB, blood and liver samples were obtained. The results showed that in LPS-injected piglets, HMB supplementation ameliorated liver histomorphological abnormalities induced by LPS challenge. Compared to the control group, the activities of serum aspartate aminotransferase and alkaline phosphatase were increased in the LPS-injected piglets (P < 0.05). The LPS challenge also downregulated the mRNA expression of L-PFK, ACO, L-CPT-1, ICDH β, and AMPKα1/2 and upregulated the mRNA expression of PCNA, caspase 3, TNF-α, TLR4, MyD88, NOD1, and NF-κB p65 (P < 0.05). However, these adverse effects of the LPS challenge were reversed by HMB supplementation (P < 0.05). These results indicate that HMB may exert protective effects against LPS-induced liver injury, and the underlying mechanisms might involve the improvement of hepatic energy metabolism via regulating AMPK signaling pathway and the reduction of liver inflammation via modulating TLR4 and NOD signaling pathways.

Marine phytoplankton improves recovery and sustains immune function in humans and lowers proinflammatory immunoregulatory cytokines in a rat model

Purpose

This study investigated the effects of marine phytoplankton supplementation (Oceanix®, Tetraselmis chuii) on 1) maximal isometric strength and immune function in healthy humans following a oneweek high-intensity resistance-training program and 2) the proinflammatory cytokine response to exercise in a rat model.

Methods

In the human trial, 22 healthy male and female participants were randomly divided into marine phytoplankton and placebo groups. Following baseline testing, participants underwent a 14-day supplement loading phase before completing five consecutive days of intense resistance training. In the rat model, rats were randomly divided into four groups (n=7 per condition): (i) control, (ii) exercise, (iii) exercise + marine phytoplankton (2.55 mg/kg/day), or (iv) exercise + marine phytoplankton (5.1 mg/kg/day). Rats in the exercising groups performed treadmill exercise 5 days per week for 6 weeks.

Results

In the human model, marine phytoplankton prevented significant declines in the isometric peak rate of force development compared to placebo. Additionally, salivary immunoglobulin A concentration was significantly lower following the resistance training protocol in the placebo group but not in the marine phytoplankton group. Marine phytoplankton in exercising rats decreased intramuscular levels and serum concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) and intramuscular concentrations of malondialdehyde.

Conclusion

Marine phytoplankton prevented decrements in indices of functional exercise recovery and immune function. Mechanistically, these outcomes could be prompted by modulating the oxidative stress and proinflammatory cytokine response to exercise.

Tumor necrosis factor-α, TNF receptor, and soluble TNF receptor responses to aerobic exercise in the heat

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Aerobic exercise in the heat promotes modest increases in plasma TNF-α and STNFR1.

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Increases in TNF-α and STNFR1 are likely driven by changes in core temperature.

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TNFR1 and 2 expression on non-classical monocytes is blunted one hour post-exercise.

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TNFR1 expression on non-classical monocytes is elevated during exercise in the heat.

The purpose of this study was to evaluate the effects of aerobic exercise in the heat on circulating concentrations of tumor necrosis factor (TNF)-α, soluble TNF receptors (STNFR1&2), and surface expression of TNFR1&2 on monocyte subpopulations. Twelve recreationally active Caucasian men (24.4 ± 3.4 yrs.; 180.0 ± 6.8 cm; 81.5 ± 8.0 kg; 47.2 ± 4.8 mL·kg⁻¹·min⁻¹) completed an exercise protocol in three environmental conditions: high temperature/low humidity [HTLH; 35 °C, 20% relative humidity (RH)]; high temperature/moderate humidity (HTMH; 35 °C, 45%RH); and moderate temperature/moderate humidity (MTMH; 22 °C, 45%RH). Each protocol consisted of a 60-minute cycling trial at 60% VO₂max, a 15-minute rest, and a time-to-exhaustion trial at 90% VO₂max (TTE). Blood was sampled before (PRE), immediately after (POST) the 60-minute trial, immediately post-TTE (PTTE), and one-hour post-TTE (REC). Circulating TNF-α and STNFR1&2 were assayed. TNFR1&2 expression on monocyte subsets was measured by flow cytometry on a subset of participants (n = 8). TNF-α area under the curve with respect to increase (AUCi) was greater during HTMH compared to MTMH and HTLH. STNFR1 concentration was greater during HTMH compared to MTMH. With all trials combined, STNFR1 concentration increased from PRE to POST, PTTE, and REC. TNFR1 expression on non-classical monocytes was greater during HTMH compared to HTLH while TNFR2 expression was lower during HTLH compared to both MTMH and HTMH. Data suggest that exercise in the heat increases circulating TNF-α and STNFR1 concentration concomitantly. Furthermore, non-classical monocyte expression of TNFRs are impacted by temperature and humidity during exercise.

The effects of physical activity on adipokines in individuals with overweight/obesity across the lifespan: A narrative review

This narrative review summarizes current knowledge on the effects of physical activity (PA) on adipokine levels in individuals with overweight and obesity. Approximately 90 investigations including randomized control, cross-sectional and longitudinal studies that reported on the effects of a single session of PA (acute) or long-term PA (chronic) on adipokine levels in individuals with overweight/obesity were reviewed. The findings support the notion that there is consensus on the benefits of chronic exercise training-regardless of the mode (resistance vs. aerobic), intensity and cohort (healthy vs. diabetes)-on adipokine levels (such as tumour necrosis factor-alpha, interleukin-6, adiponectin, visfatin, omentin-1 and leptin). However, several confounding factors (frequency, intensity, time and type of exercise) can alter the magnitude of the effects of an acute exercise session. Available evidence suggests that PA, as a part of routine lifestyle behaviour, improves obesity complications by modulating adipokine levels. However, additional research is needed to help identify the most effective interventions to elicit the most beneficial changes in adipokine levels in individuals with overweight/obesity.

Oxidative and inflammatory effects of pulmonary rehabilitation in patients with bronchiectasis. A prospective, randomized study

Introduction

Background: systemic inflammation and oxidative stress are important factors in the pathogenesis of bronchiectasis. Pulmonary rehabilitation (PR) is recommended for bronchiectasis, but there is no data about its effect on the inflammatory and REDOX status of these patients. Aims: to investigate the effect of PR in non-cystic-fibrosis bronchiectasis (NCFB) patients, and to compare it with the effect of PR plus a hyperproteic oral nutritional supplement (PRS) enriched with beta-hydroxy-beta-methylbutyrate (HMB) on serum inflammatory and oxidative biomarkers. Materials and methods: this was an open randomized, controlled trial. Thirty individuals (65 years old or younger with a body mass index over 18.5, older than 65 years with a body mass index over 20) were recruited from September 2013 to September 2014, and randomly assigned to receive PR or PRS. Total neutrophils, and inflammatory and oxidative biomarker levels were measured at baseline, and then at 3 and 6 months. Results: in the PRS group neutrophil levels were decreased from baseline at 6 months. A significantly different fold change was found between the PR and PRS groups. In the PR group, IL-6 and adiponectin were increased by the end of the study while TNFα levels were decreased from baseline at 6 months. REDOX biomarkers remained stable throughout the study except for 8-isoprostane levels, which were increased from baseline at 6 months in both groups of patients. Conclusions: a PR program induced a pro-oxidative effect accompanied by changes in circulating inflammatory cytokine levels in NCFB patients. Our results would also suggest a possible beneficial effect of the HMB enriched supplement on neutrophil level regulation in these patients. The information provided in this study could be useful for choosing the right therapeutic approach in the management of bronchiectasis.

The Effects of β-Hydroxy-β-Methylbutyrate (HMB) on Chemotaxis, Phagocytosis, and Oxidative Burst of Peripheral Blood Granulocytes and Monocytes in Goats

Simple Summary

The main focus of industrial livestock production is to maximise production output without compromising the well-being of animals, which is why animal diets are supplemented with various feed additives. Feed additives boost immunity and protect animals against pathogens. The list of potential feed additives includes β-hydroxy-β-methylbutyrate (HMB) which occurs naturally in small quantities in citrus fruit, avocado, asparagus, cauliflower, selected fish species, red wine, milk, and alfalfa. However, its mechanism of action and effects on immune system cells have not been thoroughly investigated in animals, including goats. In the present study, the experimental goats whose diets were supplemented with HMB over a period of 60 days were characterised by higher levels of chemotactic and phagocytic activity and a higher rate of oxidative metabolism of peripheral blood granulocytes and monocytes than control group animals whose diets were not supplemented. Granulocytes and monocytes constitute the first line of defence against pathogens and protect animals against disease. They play a particularly important role in young animals which are more susceptible to viral and bacterial infections. Feed additives can deliver numerous benefits by boosting immunity and preventing the spread of infectious diseases in goats.

Abstract

The objective of this study was to determine the effect of β-hydroxy-β-methylbutyrate (HMB) on the chemotactic activity, phagocytic activity, and oxidative metabolism of peripheral blood granulocytes and monocytes in goats. Goat kids aged 30 ± 3 days were divided into two groups of 12 animals each: I—control, and II—experimental. Experimental group animals were fed a diet supplemented with HMB in the amount of 50 mg/Kg BW; whereas the diets of control goats were not supplemented. At the beginning of the experiment (day 0) and on experimental days 15, 30, and 60, blood was sampled from the jugular vein to determine and compare chemotactic activity (MIGRATEST^® kit), phagocytic activity (PHAGOTEST^® kit), and oxidative metabolism (BURSTTEST^® kit) of peripheral blood granulocytes and monocytes by flow cytometry. The analyses of the chemotactic and phagocytic activity of granulocytes and monocytes revealed statistically higher levels of phagocytic activity in the experimental group than in the control group, as expressed by the percentage of phagocytic cells and mean fluorescence intensity. HMB also enhanced the oxidative metabolism of both granulocytes and monocytes, expressed by the rate of oxidative metabolism and mean fluorescence intensity after stimulation with Escherichia coli bacteria and PMA (4-phorbol-12-β-myristate-13-acetate).

β-Hydroxy-β-Methylbutyrate Free Acid Attenuates Oxidative Stress Induced by a Single Bout of Plyometric Exercise

PURPOSE

The purpose of this study was to examine the effect of β-hydroxy-β methylbutyrate free acid (HMB-FA) ingestion on oxidative stress and leukocyte responses to plyometric exercise.

METHODS

In a randomized double-blind placebo-controlled design, physically active males were assigned to the HMB-FA (n = 8) or placebo (n = 8) groups that consumed either 1 g of HMB-FA or placebo 30 min prior to performing an acute plyometric exercise protocol (15 sets of 10 repetitions of maximal-effort vertical jumps). Blood was obtained pre-(T1), post-(T2), and 1-h post-(T3) exercise to determine changes in serum levels of 8-hydroxy-2-deoxyguanosine (8-OHdG), malondialdehyde (MDA), protein carbonyl (PC), and white blood cells (WBC).

RESULTS

The exercise protocol significantly elevated 8-OHdG (HMB-FA, T2 9.5 and T3 12.6%; placebo, T2 18.2 and T3 36.5%), MDA (HMB-FA, T2 11.6 and T3 25.2%; placebo, T2 11.8 and T3 41%) and PC (HMB-FA, T2 6.9 and T3 25%; placebo, T2 23.4 and T3 55.3%) at post- and 1-h post-exercise, respectively. However, at 1-h post-exercise, greater increases in oxidative stress markers (8-OHdG 36.5 vs. 12.6%; MDA 41 vs. 25.1% and PC 55.3 vs. 25%) were observed in the placebo group compared to the HMB-FA group (p < 0.05). In addition, the WBC level was greater for the placebo group in comparison to the HMB-FA group at post-exercise.

CONCLUSION

HMB-FA attenuated oxidative stress and leukocyte responses to plyometric exercise compared with placebo.

Sodium Reduction, Metabolomic Profiling, and Cardiovascular Disease Risk in Untreated Black Hypertensives

Dietary sodium restriction has multiple beneficial effects on cardiovascular health. The underlying mechanisms are not fully understood, and the roles of metabolomics have been rarely studied. We aimed to test the hypothesis that the reduction in dietary sodium intake would induce changes in metabolomic profiling among black hypertensives, and the changes would be associated with reduced blood pressure (BP) and improved skin capillary density. A total of 64 untreated black hypertensives were included from a randomized, double-blind, placebo-controlled cross-over trial of sodium reduction. The participants were given either 9 slow sodium tablets (10 mmol sodium per tablet) or placebo tablets daily for 6 weeks, they then crossed over to receive the other tablets for another 6 weeks, while on reduced sodium diet aiming at achieving daily sodium intake around 2.0 g. Untargeted metabolomic profiling was performed in paired serum samples, which were collected at the end of each period, so were BP and capillary density. Mixed-effects models were used. There were 34 metabolites identified with raw P's<0.05. Among those, 2 metabolites including β-hydroxyisovalerate and methionine sulfone were significantly increased with sodium reduction (false discovery rate =0.006 and 0.099, respectively). Increased β-hydroxyisovalerate was associated with reduced office systolic BP and ambulatory daytime systolic BP, whereas increased methionine sulfone was associated with reduced 24-hour diastolic BP, ambulatory nighttime diastolic BP, and increased skin capillary density. Our results suggest that dietary sodium reduction increases the circulating levels of β-hydroxyisovalerate and methionine sulfone. Further studies are warranted. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT00152074.

Leucine metabolites do not attenuate training-induced inflammation in young resistance trained men

Leucine metabolites may reduce training-induced inflammation; however, there is scant evidence for this assertion. We conducted a double-blind randomized controlled pragmatic trial where 40 male participants were allocated into 4 groups: α-hydroxyisocaproic acid group ([α-HICA], n = 10, Fat-free mass [FFM] = 62.0 ± 7.1 kg), β-hydroxy-β-methylbutyrate free acid group ([HMB-FA], n = 11, FFM = 62.7 ± 10.5 kg), calcium β-hydroxy-β-methylbutyrate group ([HMB-Ca], n = 9, FFM = 65.6 ± 10.1 kg) or placebo group ([PLA]; n = 10, FFM = 64.2 ± 5.7 kg). An 8-week whole-body resistance training routine (3 training sessions per week) was employed to induce gains in skeletal-muscle thickness. Skeletal muscle thickness (MT), one repetition maximum (1RM), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and tumour necrosis factor alpha (TNF-α) were assessed at baseline and at the end of weeks 4 and 8. Time-dependent increases were detected from baseline to week 8 for MT (vastus lateralis: p = 0.009; rectus femoris: p = 0.018), 1RM (back squat: α-HICA, 18.5% ± 18.9%; HMB-FA, 23.2% ± 16%; HMB-Ca, 10.5% ± 13.8%; PLA, 19.7% ± 9% and bench press: α-HICA, 13.8% ± 19.1%; HMB-FA, 15.5% ± 9.3%; HMB-Ca, 10% ± 10.4%; PLA, 14.4 ± 11.3%, both p < 0.001), IL-6, hsCRP (both p < 0.001) and TNF-α (p = 0.045). No differences were found between groups at any time point. No leucine metabolite attenuated inflammation during training. Additionally, backwards elimination regressions showed that no circulating inflammatory marker consistently shared variance with the change in any outcome. Using leucine metabolites to modulate inflammation cannot be recommended from the results obtained herein. Furthermore, increases in inflammatory markers, from training, do not correlate with any outcome variable and are likely the result of training adaptations.

Circulating Tumor Necrosis Factor Alpha May Modulate the Short-Term Detraining Induced Muscle Mass Loss Following Prolonged Resistance Training

Introduction

Tumor necrosis factor alpha (TNFα) is a pro-inflammatory cytokine that has been shown to modulate muscle mass, and is responsive to exercise training. The effects of resistance training (RT) followed by a short period of detraining on muscle size, architecture and function in combination with circulating TNFα levels have not been previously investigated in a young, healthy population.

Methods

Sixteen participants (8 males and 8 females) were randomly assigned to a training group (TRA; age 20 ± 3 years, mass 76 ± 7 kg), whilst fourteen participants (7 males and 7 females) age 22 ± 2 years, mass 77 ± 6 kg were assigned to a control group (CON). Measures of vastus lateralis (VL) muscle size (normalized physiological cross-sectional area allometrically scaled to body mass; npCSA), architecture (fascicle length; L_F, pennation angle Pθ), strength (knee extensor maximal voluntary contraction; KE MVC), specific force, subcutaneous fat (SF) and circulating TNFα were assessed at baseline (BL), post 8 weeks RT (PT), and at two (DT1) and four (DT2) weeks of detraining.

Results

Pooled BL TNFα was 0.87 ± 0.28 pg/mL with no differences between groups. BL TNFα tended to be correlated with npCSA (p = 0.055) and KEMVC (p = 0.085) but not specific force (p = 0.671) or SF (p = 0.995). There were significant (p < 0.05) increases in npCSA compared to BL and CON in TRA at PT, DT1, and DT2, despite significant (p < 0.05) decreases in npCSA compared to PT at DT1 and DT2. There were significant (p < 0.05) increases in L_F, Pθ and KE MVC at PT but only L_F and torque at DT1. There were no significant (p > 0.05) changes in SF, specific force or TNFα at any time points. There was a significant correlation (p = 0.022, r = 0.57) between the relative changes in TNFα and npCSA at DT2 compared to PT.

Discussion

Neither RT nor a period of short term detraining altered the quality of muscle (i.e., specific force) despite changes in morphology and function. TNFα does not appear to have any impact on RT-induced gains in muscle size or function, however, TNFα may play a role in inflammatory-status mediated muscle mass loss during subsequent detraining in healthy adults.

Recovery following Rugby Union matches: effects of cold water immersion on markers of fatigue and damage

We investigated the effect of postmatch cold-water immersion (CWI) on markers of muscle damage, neuromuscular fatigue, and perceptual responses within 72 h after a rugby match. Twenty-two professional male rugby players were randomized into CWI (10 °C/10 min; n = 11) or control (CON: 30 min seated; n = 11) groups. Activity profile from Global Positioning Satellite systems and postmatch rating of perceived exertion were measured to determined match load. Biochemical (tumor necrosis factor alpha (TNF-α), interleukin-6), neuromuscular performance (squat (SJ) and countermovement jumps (CMJ), peak power output (PPO), rate of force development (RFD), stiffness, 10- and 30-m sprint time, and perceptual markers (soreness, perceived recovery) were obtained before and immediately after the match, and then at 30 min, 24 h, 48 h, and 72 h after the match. Magnitude-based inference and Cohen’s effect size (ES) were used to analyze change over time and between groups. Thus, the higher/beneficial, similar/trivial, or lower/harmful differences were evaluated as follows: <1%, almost certainly not; 1% to 5%, very unlikely; 5% to 25%, unlikely; 25% to 75%, possible; 75% to 95%, likely; 95% to 99%, very likely; >99%, almost certainly. Changes were unclear for the match loads, sprint times, and perceptual markers between groups. Higher %ΔSJ at 24 h (very likely (ES = 0.75)) and in %ΔPPO_SJ at 48 h (likely (ES = 0.51)) were observed in CWI than in CON. Values in %ΔRDF_CMJ were higher immediately after (likely (ES = 0.83)), 30 min after (very likely (ES = 0.97)), and 24 h after the match (likely (ES = 0.93)) in CWI than in CON. Furthermore, %Δlog TNF-α were lower in the CWI group than in the CON group immediately after (almost certainly (ES = −0.76)), 24 h after (very likely (ES = −1.09)), and 72 h after the match (likely (ES = −0.51)), and in Δstiffness_SJ at 30 min after (likely (ES = −0.67)) and 48 h after the match (very likely (ES = −0.97)). Also, different within-groups effects throughout postmatch were reported. Implementing postmatch CWI-based strategies improved the recovery of markers of inflammation and fatigue in rugby players, despite no change in markers of speed or perceptual recovery.

Immunomodulatory role of branched-chain amino acids

Branched-chain amino acids (BCAAs) have been associated with immunomodulation since the mid-1970s and 1980s and have been used in the nutritional therapy of critically ill patients. Evidence shows that BCAAs can directly contribute to immune cell function, aiding recovery of an impaired immune system, as well as improving the nutritional status in cancer and liver diseases. Branched-chain amino acids may also play a role in treatment of patients with sepsis or trauma, contributing to improved clinical outcomes and survival. Branched-chain amino acids, especially leucine, are activators of the mammalian target of rapamycin (mTOR), which, in turn, interacts with several signaling pathways involved in biological mechanisms of insulin action, protein synthesis, mitochondrial biogenesis, inflammation, and lipid metabolism. Although many in vitro and human and animal model studies have provided evidence for the biological activity of BCAAs, findings have been conflicting, and the mechanisms of action of these amino acids are still poorly understood. This review addresses several aspects related to BCAAs, including their transport, oxidation, and mechanisms of action, as well as their role in nutritional therapy and immunomodulation.

Benefits of β-hydroxy-β-methylbutyrate supplementation in trained and untrained individuals

β-Hydroxy-β-Methylbutyrate (HMB) is a metabolite of the branched-chain amino acid leucine and its ketoacid α-ketoisocaproate. HMB has been widely used as an ergogenic supplement to increase muscle strength, muscle hypertrophy and enhance recovery. The physiological mechanisms that underlie these benefits are related to HMB's ability to stimulate muscle protein synthesis and minimize muscle breakdown. Although evidence supporting the benefits of HMB supplementation is not conclusive, many of these studies have suffered from methodological flaws including different formulations, supplement duration and population studied. HMB in its free acid formulation is suggestive of having a greater potential for efficacy in both trained and untrained populations than its calcium-salt form. However, the evidence regarding HMB's role in limiting muscle degradation and increasing muscle protein synthesis has created an exciting interest in examining its efficacy among untrained individuals. Recent investigations examining intense training have demonstrated efficacy in maintaining muscle mass and attenuating the inflammatory response.

A Review of the Effects of Leucine Metabolite (β-Hydroxy-β-methylbutyrate) Supplementation and Resistance Training on Inflammatory Markers: A New Approach to Oxidative Stress and Cardiovascular Risk Factors

β-hydroxy β-methylbutyrate (HMB) is a bioactive metabolite formed from the breakdown of the branched-chain amino acid, leucine. Given the popularity of HMB supplements among different athletes, specifically, those who participate in regular resistance training, this review was performed to summarize current literature on some aspects of HMB supplementation that have received less attention. Because of the small number of published studies, it has not been possible to conclude the exact effects of HMB on cardiovascular parameters, oxidative stress, and inflammatory markers. Thus, the interpretation of outcomes should be taken cautiously. However, the data presented here suggest that acute HMB supplementation may attenuate the pro-inflammatory response following an intense bout of resistance exercise in athletes. Also, the available findings collectively indicate that chronic HMB consumption with resistance training does not improve cardiovascular risk factors and oxidative stress markers greater than resistance training alone. Taken together, there is clearly a need for further well-designed, long-term studies to support these findings and determine whether HMB supplementation affects the adaptations induced by resistance training associated with the body’s inflammatory condition, antioxidative defense system, and cardiovascular risk factors in humans.

The Effects of Beta-Hydroxy-Beta-Methylbutyrate-Free Acid Supplementation and Resistance Training on Oxidative Stress Markers: A Randomized, Double-Blind, Placebo-Controlled Study

The aim of this study was to investigate the effects of 6-week beta-hydroxy-beta methylbutyrate-free acid (HMB-FA) supplementation on oxidative stress and biochemical variables in responses to resistance training. Sixteen healthy young males participated in this study and were randomly assigned to a HMB-FA supplementation group (n = 8) or a placebo supplementation group (n = 8). The resistance training program was applied for 6 weeks with two sessions per week. Blood samples were collected before and after training, and 8-hydroxy-2-deoxyguanosine (8-OHdG), malondialdehyde (MDA), protein carbonyl (PC), and biochemical variables, such as alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and the numbers of total white blood cells (WBC), neutrophils, lymphocytes, and monocytes were analyzed. Following intervention, both the HMB-FA and placebo supplementation groups showed significant decreases in MDA (effect size [ES]; &minus;0.39, &minus;0.33) and PC (ES; &minus;1.37, &minus;1.41), respectively. However, 8-OHdG did not change after 6 weeks of training in any of the groups. In addition, both groups showed similar training effects on biochemical variables after 6 weeks of intervention. It was concluded that HMB-FA supplementation during resistance training did not add further adaptive changes related to oxidative stress markers.

Oral Supplementation with Beta-Hydroxy-Beta-Methylbutyrate, Arginine, and Glutamine Improves Lean Body Mass in Healthy Older Adults

Oral intake of beta-hydroxy-beta-methylbutyrate (HMB), arginine, and glutamine may ameliorate muscle loss by stimulating protein synthesis and decreasing protein degradation while simultaneously decreasing inflammation. Previous studies provide evidence for improvement in body composition with dietary supplementation of these ingredients among patients with muscle-wasting diseases. The objectives of this study were to examine the effects of this amino acid mixture on lean body mass, muscle volume, and physical function among healthy older adults. Thirty-one community-dwelling men and women, aged 65-89 years, were randomized to either two oral doses of the amino acid supplement (totaling 3 g HMB, 14 g arginine, 14 g glutamine) or placebo daily for six months. At baseline and month six, lean body mass was measured by air displacement plethysmography, dual-energy X-ray absorptiometry (DXA), and four-compartment model. Muscle volume of quadriceps was quantified by magnetic resonance imaging (MRI), and participants performed a battery of tests to assess physical function. As compared to the placebo group, the treatment group exhibited improvement in a timed stair climb (p =.016) as well as significant increases in lean body mass by all methods of assessment (p <.05). Regional analysis by DXA revealed increased arm lean mass in the supplement group only (p =.035). However, no change was observed in MRI-derived quadriceps volume. Dietary supplementation with HMB, arginine, and glutamine improved total body lean mass among a small sample of healthy older adults. Further research is indicated to elucidate mechanisms of action and to determine whether supplementation may benefit frail elders. Registered under ClinicalTrials.gov identifier no. NCT01057082.

The short-term effect of high versus moderate protein intake on recovery after strength training in resistance-trained individuals

Background

Dietary protein intakes up to 2.9 g.kg⁻¹.d⁻¹ and protein consumption before and after resistance training may enhance recovery, resulting in hypertrophy and strength gains. However, it remains unclear whether protein quantity or nutrient timing is central to positive adaptations. This study investigated the effect of total dietary protein content, whilst controlling for protein timing, on recovery in resistance trainees.

Methods

Fourteen resistance-trained individuals underwent two 10-day isocaloric dietary regimes with a protein content of 1.8 g.kg⁻¹.d⁻¹ (PRO_MOD) or 2.9 g.kg⁻¹.d⁻¹ (PRO_HIGH) in a randomised, counterbalanced, crossover design. On days 8–10 (T1-T3), participants undertook resistance exercise under controlled conditions, performing 3 sets of squat, bench press and bent-over rows at 80% 1 repetition maximum until volitional exhaustion. Additionally, participants consumed a 0.4 g.kg⁻¹ whey protein concentrate/isolate mix 30 min before and after exercise sessions to standardise protein timing specific to training. Recovery was assessed via daily repetition performance, muscle soreness, bioelectrical impedance phase angle, plasma creatine kinase (CK) and tumor necrosis factor-α (TNF-α).

Results

No significant differences were reported between conditions for any of the performance repetition count variables (p > 0.05). However, within PRO_MOD only, squat performance total repetition count was significantly lower at T3 (19.7 ± 6.8) compared to T1 (23.0 ± 7.5; p = 0.006). Pre and post-exercise CK concentrations significantly increased across test days (p ≤ 0.003), although no differences were reported between conditions. No differences for TNF-α or muscle soreness were reported between dietary conditions. Phase angle was significantly greater at T3 for PRO_HIGH (8.26 ± 0.82°) compared with PRO_MOD (8.08 ± 0.80°; p = 0.012).

Conclusions

When energy intake and peri-exercise protein intake was controlled for, a short term PRO_HIGH diet did not improve markers of muscle damage or soreness in comparison to a PRO_MOD approach following repeated days of intensive training. Whilst it is therefore likely that moderate protein intakes (1.8 g.kg⁻¹.d⁻¹) may be sufficient for resistance-trained individuals, it is noteworthy that both lower body exercise performance and bioelectrical phase angle were maintained with PRO_HIGH. Longer term interventions are warranted to determine whether PRO_MOD intakes are sufficient during prolonged training periods or when extensive exercise (e.g. training twice daily) is undertaken.

Effects of beta-hydroxy-beta-methylbutyrate supplementation on strength and body composition in trained and competitive athletes: A meta-analysis of randomized controlled trials

OBJECTIVES

The aim of this meta-analysis was to examine the evidence for the effectiveness of beta-hydroxy-beta-methylbutyrate supplementation interventions on modification in strength and body composition in trained and competitive athletes.

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic search was performed using three databases: MEDLINE, EBSCO and Web of Science. The analysis was restricted to randomized controlled trials that examined the effect of HMB supplementation interventions on modification in bench and leg press strength, body mass, fat-free mass and fat mass. Effect sizes (ES) and 95% confidence intervals (CIs) were calculated using a fixed effect meta-analysis due to low value of the heterogeneity. The Egger test was used to determine the presence of publication bias, and the Q and I² statistics were used to assess heterogeneity among studies. Significance was set at p<0.05.

RESULTS

Six studies were selected for meta-analysis, as they fulfilled the inclusion criteria (n=193 participants). HMB supplementation interventions present a trivial non-significant ES in all variables studied (bench press ES=0.00, leg press ES=0.09, body mass ES=-0.01, fat-free mass ES=0.16, and fat mass ES=-0.20; all cases p>0.05, and null heterogeneity I²=0.0% p>0.05). These results remained constant even analyzing by subgroups (HMB doses, duration of intervention, training level and diet co-intervention).

CONCLUSIONS

This meta-analysis found no effect of HMB supplementation on strength and body composition in trained and competitive athletes.

The Effect of a 12-Week Beta-hydroxy-beta-methylbutyrate (HMB) Supplementation on Highly-Trained Combat Sports Athletes: A Randomised, Double-Blind, Placebo-Controlled Crossover Study

The aim of this study was to verify the effect of beta-hydroxy-beta-methylbutyrate (HMB) supplementation on physical capacity, body composition and the value of biochemical parameters in highly-trained combat sports athletes. Forty-two males highly-trained in combat sports were subjected to 12 weeks of supplementation with HMB and a placebo in a randomized, placebo controlled, double-blind crossover manner. Over the course of the experiment, aerobic and anaerobic capacity was determined, while analyses were conducted on body composition and levels of creatine kinase, lactate dehydrogenase, testosterone, cortisol and lactate. Following HMB supplementation, fat-free mass increased (p = 0.049) with a simultaneous reduction of fat mass (p = 0.016) in comparison to placebo. In turn, after HMB supplementation, the following indicators increased significantly in comparison to the placebo: the time to reach ventilatory threshold (p < 0.0001), threshold load (p = 0.017) and the threshold HR (p < 0.0001), as well as anaerobic peak power (p = 0.005), average power (p = 0.029), maximum speed (p < 0.001) and post-exercise lactate concentrations (p < 0.0001). However, when compared to the placebo, no differences were observed in blood marker levels. The results indicate that supplying HMB promotes advantageous changes in body composition and stimulates an increase in aerobic and anaerobic capacity in combat sports athletes.

Combined effect of Bacillus coagulans GBI-30, 6086 and HMB supplementation on muscle integrity and cytokine response during intense military training

The purpose of this study was to compare the coadministration of the probiotic Bacillus coagulans GBI-30, 6086 (BC30) with β-hydroxy-β-methylbutyrate (HMB) calcium (CaHMB) to CaHMB alone on inflammatory response and muscle integrity during 40 days of intense military training. Soldiers were randomly assigned to one of two groups: CaHMB with BC30 (CaHMBBC30; n = 9) or CaHMB with placebo (CaHMBPL, n = 9). A third group of participants served as a control (CTL; n = 8). During the first 28 days soldiers were garrisoned on base and participated in the same training tasks. During the final 2 wk soldiers navigated 25–30 km per night in difficult terrain carrying ~35 kg of equipment. All assessments (blood draws and diffusion tensor imaging to assess muscle integrity) were conducted before and ~12 h after final supplement consumption. Analysis of covariance was used to analyze all blood and muscle measures. Significant attenuations were noted in IL-1β, IL-2, IL-6, CX3CL1, and TNF-α for both CaHMBBC30 and CaHMBPL compared with CTL. Plasma IL-10 concentrations were significantly attenuated for CaHMBBC30 compared with CTL only. A significant decrease in apparent diffusion coefficients was also observed for CaHMBBC30 compared with CaHMBPL. Results provide further evidence that HMB supplementation may attenuate the inflammatory response to intense training and that the combination of the probiotic BC30 with CaHMB may be more beneficial than CaHMB alone in maintaining muscle integrity during intense military training.

NEW & NOTEWORTHY β-Hydroxy-β-methylbutyrate (HMB) in its free acid form was reported to attenuate inflammation and maintain muscle integrity during military training. However, this formulation was difficult to maintain in the field. In this investigation, soldiers ingested HMB calcium (CaHMB) with Bacillus coagulans (BC30) or CaHMB alone during 40 days of training. Results indicated that CaHMB attenuated the inflammatory response and that BC30 combined with CaHMB may be more beneficial than CaHMB alone in maintaining muscle integrity during intense military training.

Post-resistance exercise ingestion of milk protein attenuates plasma TNFα and TNFr1 expression on monocyte subpopulations

Attenuating TNFα/TNFr1 signaling in monocytes has been proposed as a means of mitigating inflammation. The purpose of this study was to examine the effects of a milk protein supplement on TNFα and monocyte TNFr1 expression. Ten resistance-trained men (24.7 ± 3.4 years; 90.1 ± 11.3 kg; 176.0 ± 4.9 cm) ingested supplement (SUPP) or placebo (PL) immediately post-exercise in a randomized, cross-over design. Blood samples were obtained at baseline (BL), immediately (IP), 30-min (30P), 1-h (1H), 2-h (2H), and 5-h (5H) post-exercise to assess plasma concentrations of myoglobin; tumor necrosis factor-alpha (TNFα); and expression of tumor necrosis factor receptor 1 (TNFr1) on classical, intermediate, and non-classical monocytes. Magnitude-based inferences were used to provide inferences on the true effects of SUPP compared to PL. Plasma TNFα concentrations were "likely attenuated" (91.6% likelihood effect) from BL to 30P in the SUPP group compared with PL (d = 0.87; mean effect: 2.3 ± 2.4 pg mL^-1). TNFr1 expressions on classical (75.9% likelihood effect) and intermediate (93.0% likelihood effect) monocytes were "likely attenuated" from BL to 2H in the SUPP group compared with PL (d = 0.67; mean effect: 510 ± 670 RFU, and d = 1.05; mean effect: 2500 ± 2300 RFU, respectively). TNFr1 expression on non-classical monocytes was "likely attenuated" (77.6% likelihood effect) from BL to 1H in the SUPP group compared with PL (d = 0.69; mean effect: 330 ± 430 RFU). Ingestion of a milk protein supplement immediately post-exercise appears to attenuate both plasma TNFα concentrations and TNFr1 expression on monocyte subpopulations in resistance-trained men.

Immunometabolic Responses to Concurrent Training: The Effects of Exercise Order in Recreational Weightlifters

Inoue, DS, Panissa, VLG, Monteiro, PA, Gerosa-Neto, J, Rossi, FE, Antunes, BMM, Franchini, E, Cholewa, JM, Gobbo, LA, and Lira, FS. Immunometabolic responses to concurrent training: the effects of exercise order in recreational weightlifters. J Strength Cond Res 30(7): 1960-1967, 2016-The relationship between immunometabolic response and performance is not well understood. This study evaluated the influence of concurrent strength and high-intensity aerobic sequence of exercise order between sessions on strength performance, metabolic, and inflammatory response. Eleven recreational weightlifters underwent the following 2 randomized sessions: (a) strength-aerobic exercise order (SA) and (b) aerobic-strength exercise order (AS). Blood samples were collected before (Pre) and immediately after the first exercise (Post-1) and the second exercise (Post-2) of each session. The SA condition presented a higher number of repetitions (SA: 54 ± 15 vs. AS: 43 ± 12) and total volume (SA: 7,265 ± 2,323 vs. AS: 5,794 ± 1846 kg) than the AS condition (both p = 0.001). Glucose was higher in Pre when compared with post-1 in both orders (p ≤ 0.05); changes in lactate were time-dependent in the different orders (p ≤ 0.05); however, AS post-2 lactate was lower when compared with SA post-2 (p ≤ 0.05). Interleukin-6 levels showed time-dependent changes for both exercise orders (p ≤ 0.05). Tumor necrosis factor alpha (TNF-α) level was increased only in AS post-1 (AS: pre = 21.91 ± 35.47, post-1 = 26.99 ± 47.69 pg·ml vs. SA: pre = 25.74 ± 43.64, post-1 = 29.74 ± 46.05 pg·ml, p ≤ 0.05). These results suggest that concurrent training order exhibits different immunometabolic responses and, at least in part, can be associated with the acute decline in strength performance induced by concurrent exercise. Our results point to a possible role of TNF-α (post-1 AS condition) as a trigger to restore the energy demand by providing substrates to help maintain contractile activity in skeletal muscle.

Muscle wasting and aging: Experimental models, fatty infiltrations, and prevention

Identification of cost-effective interventions to maintain muscle mass, muscle strength, and physical performance during muscle wasting and aging is an important public health challenge. It requires understanding of the cellular and molecular mechanisms involved. Muscle-deconditioning processes have been deciphered by means of several experimental models, bringing together the opportunities to devise comprehensive analysis of muscle wasting. Studies have increasingly recognized the importance of fatty infiltrations or intermuscular adipose tissue for the age-mediated loss of skeletal-muscle function and emphasized that this new important factor is closely linked to inactivity. The present review aims to address three main points. We first mainly focus on available experimental models involving cell, animal, or human experiments on muscle wasting. We next point out the role of intermuscular adipose tissue in muscle wasting and aging and try to highlight new findings concerning aging and muscle-resident mesenchymal stem cells called fibro/adipogenic progenitors by linking some cellular players implicated in both FAP fate modulation and advancing age. In the last part, we review the main data on the efficiency and molecular and cellular mechanisms by which exercise, replacement hormone therapies, and β-hydroxy-β-methylbutyrate prevent muscle wasting and sarcopenia. Finally, we will discuss a potential therapeutic target of sarcopenia: glucose 6-phosphate dehydrogenase.

Effects of 6-month supplementation with β-hydroxy-β-methylbutyrate, glutamine and arginine on vascular endothelial function of older adults

BACKGROUND/OBJECTIVES

Vascular endothelial function declines with advancing age, due in part to increased oxidative stress and inflammation, and this age-related vascular dysfunction has been identified as an independent risk factor for cardiovascular diseases. This double-blind, placebo-controlled trial investigated the effects of a dietary supplement containing β-hydroxy-β-methylbutyrate (HMB), glutamine and arginine on endothelial-dependent vasodilation of older adults.

SUBJECTS/METHODS

A total of 31 community-dwelling men and women aged 65-87 years were randomly assigned to two groups. The treatment group received two doses of the supplement daily (totaling 3 g HMB, 14 g glutamine and 14 g arginine) for 6 months, whereas the control group received an isocaloric placebo. At baseline and week 24, vascular endothelial function was measured by flow-mediated dilation of the brachial artery, and fasting blood samples were obtained to measure high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor-α (TNF-α).

RESULTS

Paired sample t-tests revealed a 27% increase in flow-mediated dilation among the treatment group (P=0.003), whereas no change was observed in the placebo group (P=0.651). Repeated-measures analysis of variance verified a significant time by group interaction (P=0.038). Although no significant changes were observed for hsCRP or TNF-α, a trend was observed for increasing hsCRP among the placebo group only (P=0.059).

CONCLUSIONS

These results suggest that dietary supplementation of HMB, glutamine and arginine may favorably affect vascular endothelial function in older adults. Additional studies are needed to elucidate whether reduced inflammation or other mechanisms may underlie the benefits of supplementation.

The addition of beta-hydroxy-beta-methylbutyrate and isomaltulose to whey protein improves recovery from highly demanding resistance exercise

OBJECTIVE

This study evaluated whether a combination of whey protein (WP), calcium beta-hydroxy-beta-methylbutyrate (HMB), and carbohydrate exert additive effects on recovery from highly demanding resistance exercise.

METHODS

Thirteen resistance-trained men (age: 22.6 ± 3.9 years; height: 175.3 ± 12.2 cm; weight: 86.2 ± 9.8 kg) completed a double-blinded, counterbalanced, within-group study. Subjects ingested EAS Recovery Protein (RP; EAS Sports Nutrition/Abbott Laboratories, Columbus, OH) or WP twice daily for 2 weeks prior to, during, and for 2 days following 3 consecutive days of intense resistance exercise. The workout sequence included heavy resistance exercise (day 1) and metabolic resistance exercise (days 2 and 3). The subjects performed no physical activity during day 4 (+24 hours) and day 5 (+48 hours), where recovery testing was performed. Before, during, and following the 3 workouts, treatment outcomes were evaluated using blood-based muscle damage markers and hormones, perceptual measures of muscle soreness, and countermovement jump performance.

RESULTS

Creatine kinase was lower for the RP treatment on day 2 (RP: 166.9 ± 56.4 vs WP: 307.1 ± 125.2 IU · L(-1), p ≤ 0.05), day 4 (RP: 232.5 ± 67.4 vs WP: 432.6 ± 223.3 IU · L(-1), p ≤ 0.05), and day 5 (RP: 176.1 ± 38.7 vs 264.5 ± 120.9 IU · L(-1), p ≤ 0.05). Interleukin-6 was lower for the RP treatment on day 4 (RP: 1.2 ± 0.2 vs WP: 1.6 ± 0.6 pg · ml(-1), p ≤ 0.05) and day 5 (RP: 1.1 ± 0.2 vs WP: 1.6 ± 0.4 pg · ml(-1), p ≤ 0.05). Muscle soreness was lower for RP treatment on day 4 (RP: 2.0 ± 0.7 vs WP: 2.8 ± 1.1 cm, p ≤ 0.05). Vertical jump power was higher for the RP treatment on day 4 (RP: 5983.2 ± 624 vs WP 5303.9 ± 641.7 W, p ≤ 0.05) and day 5 (RP: 5792.5 ± 595.4 vs WP: 5200.4 ± 501 W, p ≤ 0.05).

CONCLUSIONS

Our findings suggest that during times of intense conditioning, the recovery benefits of WP are enhanced with the addition of HMB and a slow-release carbohydrate. We observed reductions in markers of muscle damage and improved athletic performance.

TNF-α and TNFR1 responses to recovery therapies following acute resistance exercise

The purpose of this investigation was to compare the effect of two commonly used therapeutic modalities (a) neuromuscular electrical stimulation (NMES) and (b) cold water immersion (CWI) on circulating tumor necrosis factor alpha (TNF-α) and monocyte TNF-α receptor (TNFR1) expression following intense acute resistance exercise and subsequent recovery. Thirty (n = 30) resistance trained men (22.5 ± 2.7 y) performed an acute heavy resistance exercise protocol on three consecutive days followed by one of three recovery methods (CON, NMES, and CWI). Circulating TNF-α levels were assayed and TNFR1 expression on CD14+ monocytes was measured by flow cytometry measured PRE, immediately post (IP), 30-min post (30M), 24 h post (24H), and 48 h post (48H) exercise. Circulating TNF-α was elevated at IP (p = 0.001) and 30M (p = 0.005) and decreased at 24H and 48H recovery from IP in CON (p = 0.015) and CWI (p = 0.011). TNF-α did not significantly decrease from IP during recovery in NMES. TNFR1 expression was elevated (p < 0.001) at 30M compared to PRE and all other time points. No significant differences between groups were observed in TNFR1 expression. During recovery (24H, 48H) from muscle damaging exercise, NMES treatment appears to prevent the decline in circulating TNF-α observed during recovery in those receiving no treatment or CWI.

Effects of β-Hydroxy-β-methylbutyrate Free Acid Ingestion and Resistance Exercise on the Acute Endocrine Response

Objective. To examine the endocrine response to a bout of heavy resistance exercise following acute β-hydroxy-β-methylbutyrate free acid (HMB-FA) ingestion. Design. Twenty resistance trained men were randomized and consumed either 1 g of HMB-FA (BetaTor) or placebo (PL) 30 min prior to performing an acute heavy resistance exercise protocol. Blood was obtained before (PRE), immediately after (IP), and 30 min after exercise (30P). Circulating concentrations of testosterone, growth hormone (GH), insulin-like growth factor (IGF-1), and insulin were assayed. Data were analyzed with a repeated measures ANOVA and area under the curve (AUC) was analyzed by the trapezoidal rule. Results. The resistance exercise protocol resulted in significant elevations from PRE in testosterone (P < 0.01), GH (P < 0.01), and insulin (P = 0.05) at IP, with GH (P < 0.01) and insulin (P < 0.01) remaining elevated at 30P. A significant interaction was noted between groups in the plasma GH response at IP, which was significantly higher following HMB-FA compared to PL (P < 0.01). AUC analysis revealed an elevated GH and IGF-1 response in the HMB-FA group compared to PL. Conclusion. HMB-FA prior to resistance exercise augments the GH response to high volume resistance exercise compared to PL. These findings provide further support for the potential anabolic benefits associated with HMB supplementation.

The relative bioavailability of the calcium salt of β-hydroxy-β-methylbutyrate is greater than that of the free fatty acid form in rats

BACKGROUND

β-Hydroxy-β-methylbutyrate (HMB) supplementation has been demonstrated to enhance muscle protein synthesis and attenuate loss of muscle mass by multiple pathways. The beneficial effects of HMB have been studied by using either the calcium salt, monohydrate, of HMB (CaHMB) or the free acid form (FAHMB).

OBJECTIVE

The present study was designed to compare the pharmacokinetics and relative bioavailability of the 2 forms of HMB administered as a liquid suspension in male Sprague-Dawley rats.

METHODS

CaHMB at 30, 100, and 300 mg/kg and equivalent doses of FAHMB at 24.2, 80.8, and 242 mg/kg were administered orally as a liquid suspension to male Sprague-Dawley rats. A single i.v. dose of 5 mg/kg CaHMB, corresponding to an equivalent dose of 4.04 mg/kg FAHMB, was also administered. Plasma concentrations of HMB were analyzed by liquid chromatography tandem mass spectrometry, and pharmacokinetic variables and relative bioavailability of the 2 forms of HMB were determined.

RESULTS

After oral administration, the area under the plasma concentration time curve (AUC) from time 0 to time t (0-t) and from time 0 to infinity (0-∞) and the maximum (peak) plasma concentration (Cmax) for CaHMB were significantly greater than for FAHMB, whereas the time to reach Cmax did not differ from that of FAHMB. The relative bioavailability of CaHMB was 49%, 54%, and 27% greater than that of FAHMB for the 3 respective oral doses tested. After i.v. administration, the AUCs 0-t and 0-∞ of the calcium salt were significantly greater than those of FAHMB. The relative bioavailability of CaHMB was 80% greater than that of FAHMB. The higher relative bioavailability of CaHMB may be attributable to its low systemic clearance compared with FAHMB.

CONCLUSIONS

This study demonstrates the enhanced relative bioavailability of CaHMB compared with FAHMB. Further studies are warranted to understand the physiologic mechanisms contributing to the differences in systemic clearance.

Mediators of monocyte migration in response to recovery modalities following resistance exercise

Mediators of monocyte migration, complement receptor-3 (CR3), and chemokine ligand-4 (CCL4) were measured in response to recovery modalities following resistance exercise. Thirty resistance-trained men (23.1 ± 2.9 y; 175.2 ± 7.1 cm; 82.1 ± 8.4 kg) were given neuromuscular electric stimulation (NMES), cold water immersion (CWI), or control (CON) treatments immediately following resistance exercise. Blood samples were obtained preexercise (PRE), immediately (IP), 30 minutes (30 P), 24 hours (24 H), and 48 hours (48 H) after exercise for measurement of circulating CCL4 and CR3 expression on CD14+ monocytes, by assay and flow cytometry. Circulating CCL4 showed no consistent changes. Inferential analysis indicated that CR3 expression was likely greater in CON at 30 P than NMES (90.0%) or CWI (86.8%). NMES was likely lower than CON at 24 H (92.9%) and very likely lower at 48 H (98.7%). Expression of CR3 following CWI was very likely greater than CON (96.5%) at 24 H. The proportion of CR3+ monocytes was likely greater following CWI than NMES (85.8%) or CON (85.2%) at 24 H. The change in proportion of CR3+ monocytes was likely (86.4%) greater following NMES than CON from IP to 30 P. The increased expression of CR3 and increased proportion of CR3+ monocytes following CWI at 24 H indicate a potentially improved ability for monocyte adhesion to the endothelium, possibly improving phagocytosis of damaged tissues.

Effects of β-hydroxy-β-methylbutyrate free acid and cold water immersion on expression of CR3 and MIP-1β following resistance exercise

The inflammatory response to muscle-damaging exercise requires monocyte mobilization and adhesion. Complement receptor type 3 (CR3) and macrophage inflammatory protein (MIP)-1β enables monocyte recruitment, adhesion, and subsequent infiltration into damaged muscle tissue. The purpose of this study was to examine the effects of cold water immersion (CWI) and/or β-hydroxy-β-methylbutyrate free acid (HMB-FA) on CR3 expression and MIP-1β concentration after four sets of up to 10 repetitions of squat, dead lift, and split squat exercises at 70–80% 1-repetition maximum. Thirty-nine resistance-trained men (22.2 ± 2.5 yr) were randomly divided into four groups: 1) placebo (PL), 2) HMB-FA, 3) HMB-FA-CWI, and 4) PL-CWI. The HMB-FA groups ingested 3 g/day, and CWI groups were submersed into 10–12°C water for 10 min after exercise. Blood was sampled at baseline (PRE), immediately post- (IP), 30 min post- (30P), 24 h post- (24P), and 48 h post (48P)-exercise. Circulating MIP-1β was assayed and CR3 expression on CD14+ monocytes was measured by flow cytometry. Without treatment, CR3 expression significantly elevated at 30P compared with other time points ( P = 0.030–0.047). HMB-FA significantly elevated the percentage of monocytes expressing CR3 between IP and 24P ( P = 0.046) and between IP and 48P ( P = 0.046). No time effect was observed for MIP-1β concentration. The recovery modalities showed to attenuate the rise in CR3 following exercise. Additionally, supplementation with HMB-FA significantly elevated the percentage of monocytes expressing CR3 during recovery. Although the time course that inflammatory responses are most beneficial remains to be determined, recovery modalities may alter immune cell mobilization and adhesion mechanisms during tissue recovery.

Investigation of the presence of β-hydroxy-β-methylbutyric acid and α-hydroxyisocaproic acid in bovine whole milk and fermented dairy products by a validated liquid chromatography-mass spectrometry method

A simple, rugged, quantitative, and confirmatory method based on liquid chromatography-mass spectrometry was developed and comprehensively validated for the analysis of the leucine metabolites β-hydroxy-β-methylbutyric acid (HMB) and α-hydroxyisocaproic acid (HICA) in bovine whole milk and yogurt. Mean accuracy (90-110% for HMB and 85-115% for HICA) and total precision (<10% RSD in most cases, except for <20% RSD for HMB at the limit of quantitation) at four concentration levels across three validation runs have been determined. Limits of quantitation for HMB and HICA in whole milk were 20 and 5 μg/L, respectively. Measured concentrations of HMB and HICA were <20-29 and 32-37 μg/L, respectively, in bovine whole milk and <5 and 3.0-15.2 mg/L, respectively, in yogurt. These concentrations are insufficient by large margins to deliver any musculoskeletal benefits, and fortification of milk and dairy products with HMB and/or HICA appears to be justified.