Objective: Oral amino-acid-combination supplements have become a common intervention to maintain or potentially increase the lean body mass (LBM) in the elderly. Our aim was to determine the tolerance and efficacy of the 8-week beta-hydroxy beta-methylbutyrate/arginine/glutamine (HMB/Arg/Gln) supplementation on anthropometrics, LBM, muscle strength, and gait speed in elderly patients.

Methods: In this longitudinal observational study, a total of 131 elderly patients were evaluated at two consecutive visits, including baseline (Week 0) and single follow-up (Week 8). The use of HMB/Arg/Gln was evaluated in terms of patient compliance, the efficacy on anthropometrics, LBM (kg, measured with bioelectrical impedance analysis-BIA), muscle strength (kg), gait speed, and safety.

Results: The mean (standard deviation, SD) age was 74.7 (6.8) years (57.3% of participants were males). Of the patients were diagnosed with malnutrition (according to the Subjective Global Assessment test). The main indications for the HMB/Arg/Gln supplementation were sarcopenia (45.8%) and cancer cachexia (42.0%). Only two patients stopped supplementation because of taste problem (1.5%). Overall, 79.4% of patients were still on HMB/Arg/Gln at the follow-up. The mid-upper-arm circumference (MUAC, 25.3–27.0 cm, p=0.017), mid-upper-arm muscle circumference (MUAMC, 21.7–22.2 cm, p=0.006), hand grip strength (16.0–19.0 kg, p=0.0001), and gait speed (0.5–0.7 m/sec, p=0.008) were increased after the HMB/Arg/Gln supplementation. The adverse events were reported in 14 (10.7%) patients. No serious adverse events were reported in association with HMB/Arg/Gln.

Conclusion: Our findings showed that 8 weeks of the HMB/Arg/Gln supplementation applied twice daily were well tolerated and safe in the elderly. The supplementation seems to improve the MUAC, MUAMC, muscle strength, and gait speed.

Keywords: Beta-hydroxy-beta-methylbutyrate, elderly, gait speed, muscle mass, strength, tolerability