Much has changed in medicine, with the hottest area being the use of GLP-1 agonists for weight loss. Regrettably, using this category of medication results in a significant loss of muscle mass (39-40% of weight loss was in lean mass)[i] [ii]. What may be even more staggering is that while these drugs are popular among obese individuals, calorie-restrictive dieting is even more prevalent. The issue with calorie-restrictive diets is not much different from those involving GLP-1 agonists regarding their impact on muscle health. Individuals using calorie restrictions also shed a significant portion of their lean mass, too, up to 35% in normal-weight individuals and 30% in those who are overweight or obese.[iii] This loss of skeletal muscle mass reduces strength[iv] and lowers resting metabolic rate (sometimes referred to as basal metabolic rate (BMR))[v]. BMR is the minimum number of calories the body needs to sustain life.
Why is muscle loss an issue? Simply put, muscle loss can lead to greater weakness, poor balance, and even frailty. Regardless of the type of weight management program someone chooses (GLP-1 agonist or calorie-restrictive), supporting muscle mass and health should be a top priority for overall well-being.
Supplemental Support for Muscle Health
Mobilee®
Mobilee® is a patented, naturally occurring matrix of hyaluronic acid, collagen, and sulfated polysaccharides. Multiple scientific studies, including those on muscle health, have demonstrated the benefits of Mobilee®. While it is often regarded for joint health, one study showed that not only did Mobilee® significantly reduced knee pain intensity and excess synovial fluid and improved joint function as evidenced by increased muscular strength.[vi] In another study, Mobilee® stimulated the formation of muscle cells under low nutrient conditions and counteracted the inhibition of muscle cell production caused by IL-6 and starvation-derived myotube atrophy[vii]. (Muscle fibers generally form through the fusion of precursor myoblasts into multinucleated fibers called myotubes.)
Protein
Protein is a critical macronutrient for muscle repair and growth, especially following physical exertion. High-quality proteins are rich in essential amino acids that help rebuild muscle fibers post-workout. Research has demonstrated that protein supplementation significantly enhances muscle protein synthesis after exercise.
BCAAs
Branched-chain amino acids (BCAAs), which include leucine, isoleucine, and valine, play a vital role in muscle metabolism. BCAAs are unique because they are metabolized in the muscle rather than the liver, allowing them to be used directly as a fuel source during exercise. Leucine may be the most critical of the BCAAs, as it stimulates muscle protein synthesis, which is the process of building muscle. It also helps prevent muscle breakdown during prolonged periods of exercise. Isoleucine and valine support energy production and muscle repair, making them essential for recovery after intense physical activity.
Creatine
Many studies showed that creatine supplementation increases strength, lean mass, and muscle morphology.The supplementation of creatine in the elderly also positively affected muscle mass and performance.[viii]
HMB- β-Hydroxy β-methyl butyrate (MyHMB)
HMB is produced by leucine metabolism in the body and has been identified to attenuate sarcopenia by promoting the protein synthesis pathway and suppressing the breakdown of proteins.[ix]
Probiotics
Research shows gut microbiota composition and diversity can determine skeletal muscle metabolism and functionality. This is true in catabolic (sarcopenia) or anabolic (exercise or in athletes) situations. Another paper stated, “Probiotic supplementation enhances both muscle mass and global muscle strength; however, no beneficial effects were observed in total lean mass.”
References
[i] Wilding J, Batterham R, Calanna S, Davies M, Van Gaal L, Lingvay I, McGowan B, et al., Once-Weekly Semaglutaide in Adults with Overweight or Obesity, New England Journal of Medicine Volume 384 • Number 11 • March 18, 2021, Pages: 989-1002, DOI: 10.1056/NEJMoa2032183
[ii] McCrimmon, R.J., Catarig, AM., Frias, J.P. et al. Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: a substudy of the SUSTAIN 8 randomised controlled clinical trial. Diabetologia63, 473–485 (2020). https://doi.org/10.1007/s00125-019-05065-8
[iii] Cava E, Yeat NC, Mittendorfer B. Preserving Healthy Muscle during Weight Loss. Adv Nutr. 2017 May 15;8(3):511-519. doi: 10.3945/an.116.014506. PMID: 28507015; PMCID: PMC5421125.
[iv] Santanasto AJ, Glynn NW, Newman MA, et al. Impact of weight loss on physical function with changes in strength, muscle mass, and muscle fat infiltration in overweight to moderately obese older adults: a randomized clinical trial. J Obes. 2011;2011:10. pii:516576
[v] Heilbronn LK, de Jonge L, Frisard MI, et al. Effect of 6-month calorie restriction on biomarkers of longevity, metabolic adaptation, and oxidative stress in overweight individuals: a randomized controlled trial. JAMA. 2006;295(13):1539–48
[vi] Moriña D, et al. Ann Nutr Metab 63 (suppl. 1): 1386
[vii] Torrent et al. The FASEB Journal 2015, Vol. 29 no. 1 Supplement 737.4
[viii] Jang YJ. The Effects of Protein and Supplements on Sarcopenia in Human Clinical Studies: How Older Adults Should Consume Protein and Supplements. J Microbiol Biotechnol. 2023 Feb 28;33(2):143-150. doi: 10.4014/jmb.2210.10014. Epub 2022 Oct 31. PMID: 36474318; PMCID: PMC9998208.
[ix] Oktaviana J, Zanker J, Vogrin S, Duque G. The Effect of beta-hydroxy-beta-methylbutyrate (HMB) on sarcopenia and functional frailty in older persons: A systematic review. J. Nutr. Health Aging. 2019;23:145–150. doi: 10.1007/s12603-018-1153-y