Effect of supplementation with a combination of l‐arginine, l‐glutamine, and hydroxy methyl butyrate on cachexia: A systematic review

Weight loss in the form of cachexia is a comorbid condition which is associated with delayed recovery, especially in cancer and human immunodeficiency virus (HIV)‐infected patients. Arginine (Arg), Glutamine (Gln), and the Leucine metabolite, Hydroxy methyl butyrate (HMB) are substrates which have been investigated due to their potential role in ameliorating muscle mass. We conducted a systematic review to appraise available studies assessing the effect of Arg, Gln, and HMB supplementation on improving body weight and muscle mass in those with pathological conditions. A comprehensive search for studies published between January 1990 and November 2017 was performed. The interested primary outcome of this systematic review was weight. Two reviewers independently searched databases and 125 papers were identified from the initial search, overall, we selected five studies that were suitable for our systematic review. The results of the studies shows that this combination can improve fat free mass, weight and immune function in cachexia and morbid weight loss patients. PRACTICAL APPLICATIONS: Cachexia is one of the main problems in many chronic diseases. Providing a nutritional support is usually the main concern in patients with severe weight loss due to the impaired appetite and gastrointestinal tract irritation. Among nutrition interventions, Protein and amino acid supplementation receive much attention due to the loss of muscle tissue and the negative balance of protein and nitrogen in patients with severe weight loss. Arg, Gln, and HMB (Arg/Gln/HMB) supplementation can improve weight gain and prevent weight loss in chronic diseases.