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Supplement shows promise for helping sick, elderly maintain muscle
By Dr. Ed Blonz | On Nutrition
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Published: 3/11/2009 12:01 AM

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Q. I am a diet-tech student and wanted to know if you have you heard about the supplement Juven, made by Abbott Nutrition. This product is marketed as a way to slow, halt or reverse wasting as a result of cancer, HIV or pressure ulcers. There are arguments for and against the efficacy of this product compared to its cost. Do you have any thoughts?

L.B., e-mails

A. The key ingredient in this product is beta-hydroxy-beta-methylbutyrate, also known as HMB. This compound is a metabolite of leucine, an essential amino acid. Studies report that HMB can have a range of beneficial effects in certain situations, including increasing lean body mass in the elderly; in post-traumatic situations, such as after surgery or an injury; in disease-related conditions, such as pressure ulcers; and muscle-wasting, which can occur with cancer and AIDS.

Studies have been done to see whether HMB might facilitate muscle-building in otherwise healthy people, but these studies have reported mixed results. All in all, HMB is a fascinating component, a metabolite of amino acid that seems able to accomplish more than the amino acid itself, or a complete protein that contains all the amino acids.

The Juven product contains HMB along with arginine and glutamine, two nonessential amino acids. I checked the Abbott Web site (tinyurl.com/bgpxwo) and found citations for three studies that affirm beneficial effects from the Juven formula with wound-healing in the elderly, and muscle-wasting associated with cancer and AIDS.

The story does not end there. A study published in the January 2007 issue of Journal of Trauma (tinyurl.com/d6kroq) tested the Juven formula against HMB in critically ill trauma patients. After 28 days of supplementation, the study reported that the HMB by itself was effective in slowing down muscle-wasting to the greatest degree.

Another study in the January 2009 issue of the Journal of Parenteral and Enteral Nutrition (tinyurl.com/cp9kyh) tested a formula using HMB together with arginine and lysine (a different formula). That yearlong study measured changes in elderly men and women and reported beneficial effects on protein turnover from this formula.

The bottom line is that there is exciting evidence supporting the efficacy of products like Juven, and it would appear that HMB is the critical element. To this, however, you have to factor in confidence in the quality of the product, as well as taste and patient acceptance.

There may be Web sites selling different HMB products at lower prices, but you can't always shop price. This is a product that will be used in a health-critical situation. You need assurances that what's on the label is actually in the bottle. These are important factors in deciding which product to use. The patient, the patient's family and the health care team need to make the decision as to what product would be best.

• Ed Blonz, Ph.D., is a nutrition scientist and the author. Write him at "On Nutrition," Ed Blonz, c/o Newspaper Enterprise Association, 200 Madison Ave., New York, NY 10016 or ed@blonz.com. Due to the volume of mail, personal replies cannot be provided.