WO2013170189A1

WO2013170189A1 - Combination of beta - hydroxy - beta - methylbutyrate and beta - alanine for increasing muscle blood flow

Info

Publication number: WO2013170189A1
Application number: PCT/US2013/040608
Authority: WO
Inventors: Suzette L. Pereira; Neile K. Edens; Paul Willis JOHNS; Padmavathy KRISHNAN-DESAI
Original assignee: Abbott Laboratories
Priority date: 2012-05-11
Filing date: 2013-05-10
Publication date: 2013-11-14

Abstract

Methods of improving muscle energetics, muscle blood flow, and muscle health in humans, and specifically in adults and older adults, use nutritional compositions including a combination of beta-hydroxy-beta-methylbutyrate and beta-alanine. The combination of beta-hydroxy-beta-methylbutyrate and beta-alanine increases muscle vasculature and blood flow, resulting in increased heme concentration. Increased heme concentration increases oxygen supply to the muscle thereby improving muscle aerobic capacity, strength, performance, and endurance.

Description

COMBINATION OF BETA - HYDROXY - BETA - METHYLBUTYRATE AND BETA - ALANINE FOR INCREASING MUSCLE BLOOD FLOW

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to and the benefit of U.S. Provisional Patent Application No. 61/645,873, filed on May 11, 2012, which is incorporated by reference herein in its entirety.

FIELD OF THE DISCLOSURE

[0002] The present disclosure relates to the use of a combination of beta-hydroxy-beta- methylbutyrate and beta-alanine for improving muscle energetics in aged and/or dysfunctional muscles in an individual. More particularly, the present disclosure relates to methods of using beta-hydroxy-beta-methylbutyrate and beta-alanine to increase blood flow and heme levels in aged and/or dysfunctional muscles of an adult or older adult.

BACKGROUND OF THE DISCLOSURE

[0003] Aging has been associated with decreased muscle function and exercise performance. Further, prolonged muscle disuse has been related to decreased oxidative capacity, rapid muscle atrophy and muscle force loss. It is believed that atrophy and muscle force loss is generally exacerbated with aging as vascular alterations in muscle structure and function due to aging contribute to decreased muscle function and exercise performance through at least impaired blood flow. Also, age-related muscle loss may involve a decreased response to anabolic factors of muscle protein synthesis through dysregulation of translation factors. [0004] Additionally, mitochondrial dysfunction, which is prevalent in aged sarcopenic muscles, is known to contribute to low muscle functionality, low aerobic capacity, low muscle mass and low muscle quality. Particularly, skeletal muscle mitochondrial capacity, tissue blood flow capacity, and oxygen exchange capacity are related and have all been found to be affected by aging.

[0005] Loss of muscle mass, function, and force can impair mobility and may increase the susceptibility of an individual to further muscle or other injury. In older adults in particular, this may lead to a decrease in the independence and quality of life.

[0006] Conventionally, exercise during the recovery/reloading period after muscle disuse has been the primary intervention that has provided some muscle rebuilding benefits. Exercise, however, may not always be a feasible alternative, especially if a patient is elderly and/or recovering from severe illness or surgery.

[0007] As such, it would be desirable to formulate nutritional compositions that could be used to effectively improve muscle energetics and functionality by improving muscle vascularity (increased blood flow), oxidative and metabolic capacity, and mitochondrial function. It would also be beneficial if the nutritional compositions and methods could be used to improve muscle endurance and performance, reduce fatigue, and improve muscle aerobic capacity.

SUMMARY OF THE DISCLOSURE

[0008] The present disclosure is directed to methods of increasing muscle energetics in humans, and particularly in adults and older adults, using a nutritional composition that includes beta-hydroxy-beta-methylbutyrate (HMB) and beta-alanine. The combination of HMB and beta- alanine provides a number of physiological muscle-related benefits including increased muscle heme concentrations, increased muscle capillarity activity, increased muscle myoglobin levels, increased blood flow in muscles, increased muscle oxidative and aerobic capacity, and increased muscle energetics, recovery and function. The nutritional compositions including the HMB and beta-alanine may be particularly beneficial for improving the muscle status, health, and condition in older adults who commonly suffer from chronic muscle loss and related muscle-wasting and muscle deterioration issues. [0009] In one embodiment the present disclosure is directed to a method of increasing muscle blood flow in a human in need thereof. The method comprises administering to the human in need thereof a nutritional composition comprising beta-hydroxy-beta-methylbutyrate and beta- alanine.

[0010] In another embodiment the present disclosure is directed to a method of increasing muscle blood levels in a human in need thereof. The method comprises administering to the human in need thereof a nutritional composition comprising beta-hydroxy-beta-methylbutyrate and beta-alanine.

[0011] In another embodiment the present disclosure is directed to a method of improving muscle energetics in an older adult. The method comprises administering to the older adult a nutritional composition comprising beta-hydroxy-beta-methylbutyrate and beta-alanine.

[0012] In another embodiment the present disclosure is directed to a method of increasing muscle blood flow in a sarcopenic individual. The method comprises administering to the sarcopenic individual a nutritional composition comprising beta-hydroxy-beta-methylbutyrate and beta-alanine.

[0013] In another embodiment the present disclosure is directed to a method of increasing muscle heme concentration in a sarcopenic individual. The method comprises administering to the sarcopenic individual a nutritional composition comprising beta-hydroxy-beta- methylbutyrate and beta-alanine.

[0014] In another embodiment the present disclosure is directed to a method of improving muscle energetics in a sarcopenic individual. The method comprises administering to the sarcopenic individual a nutritional composition comprising beta-hydroxy-beta-methylbutyrate and beta-alanine.

[0015] It has been unexpectedly discovered that the use of HMB, and particularly calcium HMB (Ca-HMB), in combination with beta-alanine improves the general and overall muscle health of humans, including adults, and particularly older adults. The HMB and beta-alanine improves muscle energetics by at least increasing heme levels. An increase in heme levels results from an increase in muscle vasculature and blood flow. The HMB and beta-alanine combination has been found to be particularly beneficial for aged and/or dysfunctional muscle.

[0016] Increasing muscle vasculature may further lead to an increased oxygen supply to the muscle, thereby improving muscle aerobic capacity; decreased muscle fatigue by enhancing oxygen availability for muscle function; enhanced skeletal muscle regeneration and repair following muscle injury/insult; and improvement in mitochondrial function. Further, mitochondrial dysfunction contributes to low muscle functionality, low aerobic capacity, low muscle mass and low muscle quality. Accordingly, by improving mitochondrial function, an individual can improve muscle mass, quality and function.

[0017] Accordingly, the nutritional compositions including a combination of HMB and beta- alanine provide a nutritional alternative to exercise for improving muscle energetics and muscle blood flow, and particularly, muscle aerobic capacity, endurance, and performance in aged and dysfunctional muscles in humans.

DETAILED DESCRIPTION OF THE DISCLOSURE

[0018] The present disclosure is directed to methods for improving the muscle health, and particularly the muscle energetics and muscle blood flow, of a human, and particularly an adult or an older adult. The methods of the present disclosure improve muscle energetics by at least increasing heme concentration levels in an individual, thereby increasing blood flow, improving muscle aerobic capacity, decreasing muscle fatigue, and improving mitochondrial function. The methods utilize nutritional compositions including HMB and beta-alanine and provide an easy and effective manner for improving the overall muscle health of adults. The HMB and beta- alanine-containing nutritional compositions may be particularly beneficial for older adults who may suffer from chronic muscle dysfunction and/or muscle atrophy or wasting, including older adults with sarcopenia, cachexia, and/or other muscle wasting conditions, and who may be the least likely to be able to address these muscle issues through exercise.

[0019] These benefits are obtained in the methods of the present disclosure by using a combination of HMB, and particularly Ca-HMB, and beta-alanine in a nutritional composition. In some embodiments, the nutritional compositions further include additional components for improving muscle mass and function such as creatine, carnitine, amino acids, and Vitamin D.

[0020] These and other features of the nutritional compositions and methods, as well as some of the many optional variations and additions, are described in detail hereafter.

[0021] The term "improved muscle energetics" as used herein, and unless otherwise specified, refers to increasing the energy in muscle to make muscle more resistant to fatigue, to better perform the activities of daily living, to improve strength of the muscle, and to improve muscle recovery such as after injury or disuse.

[0022] The term "muscle recovery" as used herein, unless otherwise specified, refers to an increase in muscle mass and/or muscle force, power, and/or strength.

[0023] The term "period of muscle disuse" as used herein, unless otherwise specified, refers to a period of muscle inactivity, including extended muscle inactivity, or full or partial immobilization of a body muscle resulting from bed rest, hospitalization, casting, and the like.

[0024] The term "extended" when referencing "extended inactivity" or "extended disuse" as used herein, unless otherwise specified, refers to inactivity or full or partial immobilization of a body muscle resulting from bed rest, hospitalization, casting, and the like for a time period of at least 3 days, including at least 4 days, including at least 5 days, including at least 1 week, including at least 4 weeks, including at least 6 weeks, including at least 2 months, including at least 6 months, and including 1 year or more.

[0025] The term "dysfunctional muscles" as used herein, unless otherwise specified, refers to muscle that does not respond appropriately to anabolic stimulus (e.g., amino acids, exercise, etc.).

[0026] The term "older adult" as used herein, unless otherwise specified, refers to an adult at least 50 years of age, including at least 55 years of age, including from 55 to about 85 years of age.

[0027] The terms "retort packaging" and "retort sterilizing" are used interchangeably herein, and unless otherwise specified, refer to the common practice of filling a container, most typically a metal can or other similar package, with a nutritional liquid and then subjecting the liquid- filled package to the necessary heat sterilization step, to form a sterilized, retort packaged, nutritional liquid product.

[0028] The term "aseptic packaging" as used herein, unless otherwise specified, refers to the manufacture of a packaged product without reliance upon the above-described retort packaging step, wherein the nutritional liquid and package are sterilized separately prior to filling, and then are combined under sterilized or aseptic processing conditions to form a sterilized, aseptically packaged, nutritional liquid product.

[0029] The terms "fat" and "oil" as used herein, unless otherwise specified, are used interchangeably to refer to lipid materials derived or processed from plants or animals. These terms also include synthetic lipid materials so long as such synthetic materials are suitable for oral administration to humans.

[0030] The term "shelf stable" as used herein, unless otherwise specified, refers to a nutritional product that remains commercially stable after being packaged and then stored at 18-24°C for at least 3 months, including from about 6 months to about 24 months, and also including from about 12 months to about 18 months.

[0031] The terms "nutritional formulation" or "nutritional composition" as used herein, are used interchangeably and, unless otherwise specified, refer to nutritional liquids, nutritional powders, nutritional solids, nutritional semi-solids, nutritional semi-liquids, nutritional supplements, and any other nutritional food product as known in the art. The nutritional powders may be reconstituted to form a nutritional liquid, all of which comprise one or more of fat, protein and carbohydrate and are suitable for oral consumption by a human.

[0032] The term "nutritional liquid" as used herein, unless otherwise specified, refers to nutritional products in ready-to-drink liquid form, concentrated form, and nutritional liquids made by reconstituting the nutritional powders described herein prior to use.

[0033] The term "nutritional powder" as used herein, unless otherwise specified, refers to nutritional products in flowable or scoopable form that can be reconstituted with water or another aqueous liquid prior to consumption and includes both spray dried and drymixed/dryblended powders.

[0034] The term "nutritional semi-solid," as used herein, unless otherwise specified, refers to nutritional products that are intermediate in properties, such as rigidity, between solids and liquids. Some semi-solids examples include puddings, yogurts, gelatins, and doughs.

[0035] The term "nutritional semi-liquid," as used herein, unless otherwise specified, refers to nutritional products that are intermediate in properties, such as flow properties, between liquids and solids. Some semi-liquids examples include thick shakes and liquid gels.

[0036] The terms "susceptible" and "at risk" as used herein, unless otherwise specified, mean having little resistance to a certain condition or disease, including being genetically predisposed, having a family history of, and/or having symptoms of the condition or disease.

[0037] All percentages, parts and ratios as used herein, are by weight of the total composition, unless otherwise specified. All such weights, as they pertain to listed ingredients, are based on the active level and, therefore, do not include solvents or by-products that may be included in commercially available materials, unless otherwise specified.

[0038] Numerical ranges as used herein are intended to include every number and subset of numbers within that range, whether specifically disclosed or not. Further, these numerical ranges should be construed as providing support for a claim directed to any number or subset of numbers in that range. For example, a disclosure of from 1 to 10 should be construed as supporting a range of from 2 to 8, from 3 to 7, from 5 to 6, from 1 to 9, from 3.6 to 4.6, from 3.5 to 9.9, and so forth.

[0039] All references to singular characteristics or limitations of the present disclosure shall include the corresponding plural characteristic or limitation, and vice versa, unless otherwise specified or clearly implied to the contrary by the context in which the reference is made.

[0040] All combinations of method or process steps as used herein can be performed in any order, unless otherwise specified or clearly implied to the contrary by the context in which the referenced combination is made. [0041] The various embodiments of the nutritional compositions and methods of the present disclosure may also be substantially free of any optional or selected ingredient or feature described herein, provided that the remaining nutritional composition still contains all of the required ingredients or features as described herein. In this context, and unless otherwise specified, the term "substantially free" means that the selected nutritional composition contains less than a functional amount of the optional ingredient, typically less than 1%, including less than 0.5%, including less than 0.1 %, and also including zero percent, by weight of such optional or selected ingredient.

[0042] The nutritional compositions and methods may comprise, consist of, or consist essentially of the essential elements of the compositions and methods as described herein, as well as any additional or optional element described herein or otherwise useful in nutritional product applications.

Product Form

[0043] The nutritional compositions used in the methods of the present disclosure include a combination of HMB and beta-alanine and may be formulated and administered in any known or otherwise suitable oral product form. Any solid, liquid, semi-solid, semi-liquid, or powder product form, including combinations or variations thereof, are suitable for use herein, provided that such forms allow for safe and effective oral delivery to the individual of the ingredients as also defined herein.

[0044] The nutritional compositions used in the methods of the present disclosure are desirably formulated as dietary product forms, which are defined herein as those embodiments comprising the ingredients of the present disclosure in a product form that then contains at least one of fat, protein, and carbohydrate, and preferably also contains vitamins, minerals, or combinations thereof.

[0045] The nutritional compositions may be formulated with sufficient kinds and amounts of nutrients to provide a sole, primary, or supplemental source of nutrition, or to provide a specialized nutritional product for use in individuals afflicted with specific diseases or conditions or with a targeted nutritional benefit as described below. [0046] Some exemplary, non-limiting, examples of specific products that may be suitable for use in accordance with the present disclosure include adult nutritional formulas, older adult nutritional formulas, medical formulas, geriatric nutritional formulas, and the like.

[0047] Non-limiting examples of solid nutritional product forms suitable for use herein include snack and meal replacement products, including those formulated as bars, sticks, cookies or breads or cakes or other baked goods, frozen liquids, candy, breakfast cereals, powders or granulated solids or other particulates, snack chips or bites, frozen or retorted entrees and so forth. In certain exemplary embodiments, when the nutritional composition is a solid product, the serving is within a range of 25 grams to 150 grams.

[0048] Non-limiting examples of liquid product forms suitable for use herein include snack and meal replacement products, hot or cold beverages, carbonated or non carbonated beverages, juices or other acidified beverages, milk or soy-based beverages, shakes, coffees, teas, enteral feeding compositions, and so forth. These liquid compositions are most typically formulated as suspensions or emulsions, but can also be formulated in any other suitable forms such as clear liquids, solutions, liquid gels, and so forth.

[0049] In certain exemplary embodiments, when the nutritional composition is a liquid, the serving is within a range of 30 milliliters to 500 milliliters (~1 fl. oz. to ~17 fl. oz.). In certain other exemplary embodiments, when the nutritional composition is a liquid, the serving is 237 milliliters (~8 fl. oz.). In yet other exemplary embodiments, when the nutritional composition is a liquid, the serving is 125 milliliters (~4 fl. oz.). In certain other exemplary embodiments, when the nutritional composition is a liquid, the serving is 177 milliliters to 417 milliliters (~6 fl. oz. to —14 fl. oz.). In still other exemplary embodiments, when the nutritional composition is a liquid, the serving is 207 milliliters to 266 milliliters (~7 fl. oz. to ~9 fl. oz.). In certain other exemplary embodiments, when the nutritional composition is a liquid, the serving is 30 milliliters to 75 milliliters (~1 fl. oz. to ~ 2.5 fl. oz.).

[0050] In certain exemplary embodiments, the nutritional composition provides up to 1000 kcal of energy per serving or dose, including from 20 kcal to 900 kcal, from 25 kcal to 700 kcal, from 50 kcal to 500 kcal, from 100 kcal to 450 kcal, or from 150 kcal to 400 kcal per serving. [0051] Other non-limiting examples of suitable oral product forms include semi-solid or semi- liquid compositions (e.g., puddings, gels, yogurts), as well as more conventional product forms such as capsules, tablets, caplets, pills, and so forth. The quantity of the composition for providing an effective amount of the combination of HMB and beta-alanine to the targeted user may be contained in one or a plurality of individual dosage forms, e.g., in one tablet or a plurality of tablets that may be administered in single or multiple dosages per day.

[0052] For product forms such as lozenges, tablets (e.g. chewable, coated, etc.), pastes, or gels, the combination of HMB and beta-alanine may be formulated at concentrations most typically ranging from about 5 to about 50%, including from about 15 to about 33%, and also including from about 15 to about 25%, by weight of the product form, all in combination with excipients or other ingredients such as carbohydrates, acidulants, flavors, and colors.

[0053] In certain exemplary embodiments, the nutritional composition is formulated as a clear liquid having a pH ranging from 2 to 5, and also having no more than 0.5% fat by weight of the nutritional composition. The limited amount of fat contributes to the desired clarity and is compatible with a pH of 2 to 5 for certain embodiments of the nutritional composition. Typically, liquid nutritional compositions desired to be clear, or at least substantially translucent, are substantially free of fat. As used herein "substantially free of fat" refers to nutritional compositions containing less than 0.5%>, including less than 0.1 %, fat by weight of the total composition. "Substantially free of fat" also may refer to nutritional compositions disclosed herein that contain no fat, i.e., zero fat. Furthermore, embodiments of liquid nutritional compositions that have a desired acidic pH in the range of 2 to 5, e.g., juices, fruit juices, fruit- flavored beverages, etc., typically are substantially free of fat. Liquid nutritional compositions that are both clear and have a pH ranging from 2 to 5 are also typically substantially free of fat. In certain of the preceding embodiments, the pH of the nutritional composition may be from 2.5 to 4.6, including a pH of 3 to 3.5. In those embodiments of the nutritional compositions that are substantially free of fat but have some amount of fat present, the fat may be present as a result of being inherently present in another ingredient (e.g., a source of protein) or may be present as a result of being added as one or more separate sources of fat. Methods of Improving Muscle Energetics and Muscle Health

[0054] The methods of the present disclosure use a combination of HMB, and particularly Ca- HMB, and beta-alanine in a nutritional composition to improve the muscle health and muscle energetics of a human, and in particular the muscle health and muscle energetics of gastrocnemius muscle in a human individual. In some embodiments, the individual is an adult, whereas in other embodiments, the individual is an older adult, either or both of which may potentially have aged and/or dysfunctional muscles as described herein. As noted, muscle energetics is directed primarily to increasing heme concentration thereby increasing muscle vasculature and muscle blood flow. In some specific embodiments of the present disclosure, individuals, and particularly older adults, that have aged and/or dysfunctional muscles as described herein, may specifically benefit from the methods disclosed.

[0055] In one embodiment of the present disclosure, the nutritional compositions are administered to increase heme concentration or muscle blood levels in muscle in an adult or older adult. The increased heme concentration or muscle blood levels may be in healthy muscle, or may be in aged, dysfunctional, cachexic and/or sarcopenic muscle. Increased heme concentration or muscle blood levels results from increased muscle vasculature and muscle blood flow. It has been found that increasing blood flow within the muscle increases oxygen supply to the muscle, thus improving muscle aerobic capacity. Further, enhancing oxygen availability to the muscle, decreases muscle fatigue. Improvement in muscle aerobic capacity contributes to improvement in mitochondrial function, thereby improving overall muscle structure, quality, and function. Particularly, mitochondrial function contributes to improved muscle functionality, higher muscle aerobic capacity, higher muscle mass, and higher muscle quality.

[0056] Additionally, increased heme concentration and/or muscle blood levels in muscle can enhance skeletal muscle regeneration and repair following muscle injury/insult (e.g., resulting from strenuous exercise, immobilization, and the like) and/or muscle disuse. Thus, in some embodiments of the present disclosure, the individual (adult or older adult) to which the HMB and beta-alanine is administered may have reduced skeletal muscle, may be suffering from a muscle injury or insult, or may be suffering from muscle disuse, potentially due to injury. [0057] In another embodiment of the present disclosure, the nutritional compositions are administered to increase muscle blood flow and muscle myoglobin levels in an adult and/or an older adult. As noted, increased blood flow to the muscles, and particularly, skeletal muscles increases oxygen supply to the muscle, improving muscle aerobic capacity. Further, enhancing oxygen availability to the muscle enhances muscle strength, performance, and endurance.

[0058] Skeletal muscle mitochondrial capacity, tissue blood flow capacity, and oxygen exchange appear to be well connected and negatively affected by aging. The different skeletal muscle fiber types exhibit widely differing aerobic capacities, depending on activity level or exercise training. The reduction in aerobic capacity, commonly seen with aging, and particular, in the elderly, can be improved by increasing muscle mitochondria function and muscle vasculature. The increase in muscle blood flow contributes to the increased oxygen exchange capacity, thereby improving muscle endurance and performance.

[0059] The combination of HMB and beta-alanine may be administered to generally healthy individuals (including adults and older adults), or may be administered to a subset of individuals, including adults and older adults, specifically in need of improved muscle energetics, increased heme concentration, increased blood flow to muscle, increased muscle myoglobin levels, increased skeletal muscle mitochondrial capacity and/or individuals having sarcopenia, cachexia, and the like.

[0060] Some individuals that are in need of improved muscle energetics, increased heme concentration, increased blood flow to muscle, increased muscle myoglobin levels, and/or increased skeletal muscle mitochondrial capacity may include sarcopenic and/or cachexic individuals, including sarcopenic and/or cachexic adults or older adults (adults or older adults susceptible to or at elevated risk of sarcopenia and/or cachexia), arthritic (including osteoarthritic) adults or older adults (adults or older adults susceptible to or at elevated risk of arthritis or osteoarthritis), adults or older adults having extended periods of muscle disuse, adults or older adults suffering from muscle injury/insult, adults or older adults recovering from illness or surgery, adults or older adults participating in strenuous exercise, adults or older adults living a sedentary lifestyle, and the like. Adults and older adults may be susceptible to, or at risk of, or prone to, a condition or disease (e.g., sarcopenia, cachexia, muscle wasting) due to family history, age, environment, and/or lifestyle. Additionally, in some embodiments of the present disclosure, adults and older adults that are recognized as having a specific disease or condition (such as sarcopenia, cachexia, muscle wasting, muscle disuse, arthritis, muscle injury, and the like) may benefit from the methods of the present disclosure.

[0061] Based on the foregoing, because some of the method embodiments of the present disclosure utilizing the combination of HMB and beta-alanine are directed to specific subsets or subclasses of identified individuals (that is, the subset or subclass of individuals "in need" of assistance in addressing one or more specific diseases or specific conditions noted herein), not all individuals will fall within the subset or subclass of individuals as described herein for certain diseases or conditions.

[0062] In accordance with the methods disclosed herein, the individual desirably consumes at least one serving of the HMB and beta-alanine-containing nutritional composition daily, and in some embodiments, may consume two, three, or even more servings per day. Each serving is desirably administered as a single, undivided dose, although the serving may also be divided into two or more partial or divided servings to be taken at two or more times during the day. The methods of the present disclosure include continuous day after day administration, as well as periodic or limited administration, although continuous day after day administration is generally desirable. The methods of the present disclosure are preferably applied on a daily basis, wherein the daily administration is maintained continuously for at least 3 days, including at least 5 days, including at least 1 month, including at least 6 weeks, including at least 8 weeks, including at least 2 months, including at least 6 months, desirably for at least 18-24 months, desirably as a long term, continuous, daily, dietary supplement.

Beta-Hvdroxy-Beta-Methylbutyrate (HMB)

[0063] The nutritional compositions for use in the methods of the present disclosure comprise HMB (in combination with beta-alanine described herein), which means that the nutritional compositions are either formulated with the addition of HMB, most typically as a calcium monohydrate, or are otherwise prepared so as to contain HMB in the finished product. Any source of HMB is suitable for use herein provided that the finished product contains HMB, although such a source is preferably calcium HMB (Ca-HMB) and is most typically added as such to the nutritional products during formulation.

[0064] Although Ca-HMB monohydrate is one preferred source of HMB for use herein, other suitable sources may include HMB as the free acid, a salt, an anhydrous salt, an ester, a lactone, or other product forms that otherwise provide a bioavailable form of HMB from the nutritional product. Non-limiting examples of suitable salts of HMB for use herein include HMB salts, hydrated or anhydrous, of sodium, potassium, magnesium, chromium, calcium, or other nontoxic salt form. Ca-HMB monohydrate is commercially available from Technical Sourcing International (TSI) of Salt Lake City, Utah and from Lonza Group Ltd. (Basel, Switzerland).

[0065] The nutritional compositions as described herein include an amount of HMB in combination with beta-alanine that is sufficient and effective to improve an individual's, and specifically an adult's or older adult's, muscle health and/or muscle energetics; that is, the nutritional compositions described herein include a sufficient amount of HMB in combination with beta-alanine to allow an individual, and desirably, an adult or an older adult, to improve muscle function, strength, and performance as described herein.

[0066] When the nutritional product is a liquid, the concentration of HMB in the liquid may range up to 10%, including from about 0.1 % to about 8%, and also including from about 0.1 % to about 2%, and also including from about 0.1 % to about 5%, and also including from about 0.3% to about 3%, and also including from about 0.34% to about 1.5%, by weight of the nutritional liquid. In one specific embodiment the HMB is present in the liquid formulation in an amount of from about 0.1% to about 0.5% by weight of the nutritional liquid.

[0067] When the nutritional product is a solid, the concentration of HMB in the solid may range up to 15%, including from about 0.1% to about 10%, and also including from about 0.1% to about 2% and also including from about 0.2% to about 5%, and also including from about 0.3%) to about 3%), and also including from about 0.34% to about 1.5%, by weight of the nutritional powder. In a specific embodiment, the HMB is present in the powder formulation in an amount of from about 0.1% to about 0.5% by weight of the nutritional powder. [0068] Typically, the nutritional compositions provide from about 0.1 to about 10 grams/day, including about 1 to about 3 grams/day of HMB. Accordingly, the nutritional compositions may provide from about 0.5 to about 2.5 grams, including from about 1 to about 1.7 grams, including about 1.5 grams of HMB per serving, wherein an exemplary serving may be about 240 mL of ready to feed nutritional liquid or about 240 mL of reconstituted nutritional solid. An individual may be administered one serving per day, two servings per day, three servings per day, or four or more servings per day to receive the desired amount of HMB from the nutritional composition.

Beta-Alanine

[0069] In addition to the HMB, the nutritional compositions for use in the methods of the present disclosure further comprise the amino acid beta-alanine, which means that the nutritional compositions are either formulated with the addition of beta-alanine, or are otherwise prepared so as to contain beta-alanine in the finished product.

[0070] Any source of beta-alanine is suitable for use in the products described herein provided that the finished product contains beta-alanine at the desired level. Such sources may and typically do include free beta-alanine as well as other sources that provide free beta-alanine in the nutritional liquid during or after formulation. One suitable source of beta-alanine is commercially available from Compounds Solutions (Escondido, California).

[0071] The nutritional compositions as described herein include an amount of beta-alanine in combination with HMB that is sufficient and effective to improve an individual's, and specifically an adult's or older adult's, muscle health and/or muscle energetics; that is, the nutritional compositions described herein include a sufficient amount of beta-alanine in combination with HMB to allow an individual, and desirably, an adult or an older adult, to improve muscle function, strength, and performance as described herein.

[0072] The concentration of beta-alanine in the nutritional liquids may range from about 0.1% to about 3.0%, or even from about 0.1 % to about 2.0%, or even from about 0.1 % to about 1.0%, or even from about 0.1% to about 0.33% by weight of the nutritional liquid.

[0073] When the nutritional product is a solid, the concentration of beta-alanine in the solid may range up to 5%, including from about 0.1% to 5%, and also including from about 0.1% to about 2.0% and also including from about 0.1% to about 1.0%, and also including from about 0.1%) to about 0.33%), by weight of the nutritional powder. In a specific embodiment, the beta- alanine is present in the powder formulation in an amount of from about 0.1% to about 0.5% by weight of the nutritional powder.

[0074] In certain exemplary embodiments, the nutritional compositions provide from about 0.1 to about 5 grams/day, including from about 1.5 to about 5 grams/day, including from about 1.6 to about 2.4 grams/day of beta-alanine. Accordingly, the nutritional compositions may provide from about 0.5 to about 2.5 grams, including from about 1 to about 1.7 grams, including about 1.5 grams of beta-alanine per serving.

Vitamin D

[0075] In addition to the HMB and beta-alanine described above, the nutritional compositions for use in the methods of the present disclosure may further comprise in some embodiments Vitamin D to help maintain and build healthy muscle in the targeted user. Suitable Vitamin D forms include Vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol), or other forms suitable for use in a nutritional product. The amount of Vitamin D in the nutritional compositions most typically ranges up to 3000 IU, more typically up to 2000 IU, more typically up to 1000 IU, more typically from about 10 to about 600 IU, and more typically from about 50 to about 400 IU, per serving of the nutritional composition.

Macronutrients

[0076] The nutritional compositions including the combination of HMB and beta-alanine may be formulated to include at least one of protein, fat, and carbohydrate. In many embodiments, the nutritional compositions will include the combination of HMB and beta-alanine with protein, carbohydrate and fat.

[0077] Macronutrients suitable for use herein include any protein, fat, or carbohydrate or source thereof that is known for or otherwise suitable for use in an oral nutritional composition, provided that the optional macronutrient is safe and effective for oral administration and is otherwise compatible with the other ingredients in the nutritional composition. [0078] The concentration or amount of optional fat, carbohydrate, and protein in the nutritional composition can vary considerably depending upon the particular product form (e.g., bars or other solid dosage forms, milk or soy based liquids or other clear beverages, reconstitutable powders, etc.) and the various other formulations and targeted dietary needs. These optional macronutrients are most typically formulated within any of the embodied ranges described in the following tables.

Each numerical value preceded by the term "about"

Each numerical value preceded by the term "about" Carbohydrate

[0079] Carbohydrates suitable for use in the nutritional compositions may be simple, complex, or variations or combinations thereof, all of which are optionally in addition to the HMB and beta-alanine as described herein. Non-limiting examples of suitable carbohydrates include hydrolyzed or modified starch or cornstarch, maltodextrin, isomaltulose, sucromalt, glucose polymers, sucrose, corn syrup, corn syrup solids, rice-derived carbohydrate, glucose, fructose, lactose, high fructose corn syrup, honey, sugar alcohols (e.g., maltitol, erythritol, sorbitol), and combinations thereof.

[0080] Carbohydrates suitable for use herein also include soluble dietary fiber, non-limiting examples of which include gum arabic, fructooligosaccharide (FOS), sodium carboxymethyl cellulose, guar gum, citrus pectin, low and high methoxy pectin, oat and barley glucans, carrageenan, psyllium and combinations thereof. Insoluble dietary fiber is also suitable as a carbohydrate source herein, non-limiting examples of which include oat hull fiber, pea hull fiber, soy hull fiber, soy cotyledon fiber, sugar beet fiber, cellulose, corn bran, and combinations thereof.

[0081] The nutritional compositions may therefore further include a carbohydrate, wherein for solid embodiments of the nutritional compositions, the solid embodiments generally include carbohydrates in quantities ranging up to 75%, including from about 20% to about 70%>, and also including from about 50%> to about 70%>, and also including from about 55% to about 65%, and also including from about 58% to about 62%, by weight of the solid nutritional composition. Accordingly, in certain exemplary embodiments, the solid nutritional composition comprises up to about 115 grams of at least one source of carbohydrate per serving of the solid nutritional product. In certain other exemplary embodiments, the solid nutritional composition comprises from 15 grams to 90 grams of at least one source of carbohydrate per serving, including from 25 grams to 75 grams of at least one source of carbohydrate per serving, and also including from 45 grams to 55 grams of at least one source of carbohydrate per serving of the solid nutritional composition.

[0082] For liquid embodiments of the nutritional compositions, the liquid embodiments generally include carbohydrate in quantities ranging up to 30%, including from about 5% to about 25%), and also including from about 10%> to about 20%>, and also including from about 15% to about 18%, by weight of the liquid nutritional composition. Accordingly, in certain exemplary embodiments, the liquid nutritional composition comprises up to about 95 grams of at least one source of carbohydrate per serving of the liquid nutritional composition. In certain other exemplary embodiments, the liquid nutritional composition comprises from 5 grams to 75 grams of at least one source of carbohydrate per serving, including from 5 grams to 50 grams of at least one source of carbohydrate per serving, including from 10 grams to 40 grams of at least one source of carbohydrate per serving, and also including from 25 grams to 35 grams of at least one source of carbohydrate per serving of the liquid nutritional composition.

Protein

[0083] Proteins suitable for use in the nutritional compositions include hydrolyzed, partially hydrolyzed or non-hydrolyzed proteins or protein sources, and can be derived from any known or otherwise suitable source such as milk (e.g., casein, whey), animal (e.g., meat, fish, egg albumen, earthworm, insect), cereal (e.g., rice, corn), vegetable (e.g., soy, pea, potato), or combinations thereof. The proteins for use herein can also include, or be entirely or partially replaced by, free amino acids known for use in nutritional products, non-limiting examples of which include L-tryptophan, L-glutamine, L-tyrosine, L-methionine, L-cysteine, taurine, L- arginine, L-carnitine, and combinations thereof. In some embodiments, the nutritional compositions include, in addition to HMB and beta-alanine, L-glutamine, L-arginine, L-lysine, and combinations thereof.

[0084] The nutritional compositions may therefore further comprise a protein, wherein for solid embodiments of the nutritional compositions, the solid embodiments generally include protein in quantities ranging up to 30%, including from about 5% to about 25%, and also including from about 10% to about 20%, and also including from about 12% to about 16%, by weight of the solid nutritional composition. Accordingly, in certain exemplary embodiments, the solid nutritional composition comprises up to about 50 grams of at least one source of protein per serving of the solid nutritional composition. In certain other exemplary embodiments, the solid nutritional composition comprises from 5 grams to 40 grams of at least one source of protein per serving, including from 10 grams to 30 grams of at least one source of protein per serving, including from 10 grams to 25 grams of at least one source of protein per serving, and also including from 10 grams to 20 grams of at least one source of protein per serving of the solid nutritional composition.

[0085] For liquid embodiments of the nutritional compositions, the liquid embodiments generally include protein in quantities ranging up to 30%, including from about 1% to about 20%), including from about 1% to about 10%, including from about 5% to about 8%, and also including from about 3% to about 6%, by weight of the liquid nutritional composition. In certain exemplary embodiments, the liquid nutritional composition comprises up to about 25 grams of at least one source of protein per serving of the liquid nutritional composition. In certain other exemplary embodiments, the liquid nutritional composition comprises from 5 grams to 20 grams of at least one source of protein per serving, including from 5 grams to 15 grams of at least one source of protein per serving, including from 5 grams to 10 grams of at least one source of protein per serving, and also including from 8 grams to 13 grams of at least one source of protein per serving of the liquid nutritional composition. Fat

[0086] Fats suitable for use in the nutritional compositions include coconut oil, fractionated coconut oil, soy oil, corn oil, olive oil, safflower oil, high oleic safflower oil, high GLA- safflower oil, MCT oil (medium chain triglycerides), sunflower oil, high oleic sunflower oil, palm and palm kernel oils, palm olein, canola oil, marine oils, flaxseed oil, borage oil, cottonseed oils, evening primrose oil, blackcurrant seed oil, transgenic oil sources, fungal oils, marine oils (e.g., tuna, sardine), and so forth.

[0087] The nutritional compositions may therefore further include a fat, wherein for solid embodiments of the nutritional compositions, the solid embodiments generally include fat in quantities ranging up to 35%, including from about 5% to about 30%, and also including from about 10%) to about 25%>, and also including from about 15%> to about 20%>, by weight of the solid nutritional composition. Accordingly, in certain exemplary embodiments, the solid nutritional composition comprises up to about 50 grams of at least one source of fat per serving of the solid nutritional composition. In certain other exemplary embodiments, the solid nutritional composition comprises from 2 grams to 40 grams of at least one source of fat per serving, including from 4 grams to 20 grams of at least one source of fat per serving, including from 4 grams to 10 grams of at least one source of fat per serving, and also including from 6 grams to 10 grams of at least one source of protein per serving of the solid nutritional composition.

[0088] For liquid embodiments of the nutritional compositions, the liquid embodiments generally include fat in quantities ranging up to 30%>, including from about 1%> to about 20%>, and also including from about 1%> to about 10%>, and also including from about 5%> to about 9%>, by weight of the liquid nutritional composition. In certain exemplary embodiments, the liquid nutritional composition comprises up to about 25 grams of at least one source of fat per serving of the liquid nutritional composition. In certain other exemplary embodiments, the liquid nutritional composition comprises from 5 grams to 25 grams of at least one source of fat per serving, including from 5 grams to 20 grams of at least one source of fat per serving, including from 5 grams to 15 grams of at least one source of fat per serving, and also including from 5 grams to 10 grams of at least one source of fat per serving of the liquid nutritional composition. Other Optional Ingredients

[0089] The nutritional compositions as used in the methods of the present disclosure may further comprise other optional components that may modify the physical, chemical, aesthetic or processing characteristics of the products or serve as pharmaceutical or additional nutritional components when used in the targeted population. Many such optional ingredients are known or otherwise suitable for use in medical food or other nutritional products or pharmaceutical dosage forms and may also be used in the compositions herein, provided that such optional ingredients are safe for oral administration and are compatible with the essential and other ingredients in the selected product form.

[0090] Non-limiting examples of such optional ingredients include preservatives, emulsifying agents, buffers, creatine, fructooligosaccharides, galactooligosaccharides, polydextrose, and other prebiotics, probiotics, pharmaceutical actives, anti-inflammatory agents, additional nutrients as described herein, colorants, flavors, thickening agents and stabilizers, emulsifying agents, lubricants, and so forth.

[0091] The nutritional compositions may further comprise a sweetening agent, preferably including at least one sugar alcohol such as maltitol, erythritol, sorbitol, xylitol, mannitol, isomalt, and lactitol, and also preferably including at least one artificial or high potency sweetener such as acesulfame K, aspartame, sucralose, saccharin, stevia, and tagatose. These sweetening agents, especially as a combination of a sugar alcohol and an artificial sweetener, are especially useful in formulating liquid beverage embodiments having a desirable flavor profile. These sweetener combinations are especially effective in masking undesirable flavors, for example, as sometimes associated with the addition of vegetable proteins to a liquid beverage. Optional sugar alcohol concentrations in the nutritional product may range from at least 0.01 %, including from about 0.1% to about 10%>, and also including from about 1% to about 6%, by weight of the nutritional product. Optional artificial sweetener concentrations may range from at least 0.01 %, including from about 0.05%> to about 5%, also including from about 0.1% to about 1%), by weight of the nutritional product.

[0092] A flowing agent or anti-caking agent may be included in the nutritional compositions as described herein to retard clumping or caking of the powder over time and to make a powder embodiment flow easily from its container. Any known flowing or anti-caking agents that are known or otherwise suitable for use in a nutritional powder or product form are suitable for use herein, non-limiting examples of which include tricalcium phosphate, silicates, and combinations thereof. The concentration of the flowing agent or anti-caking agent in the nutritional composition varies depending upon the product form, the other selected ingredients, the desired flow properties, and so forth, but most typically range from about 0.1% to about 4%, including from about 0.5% to about 2%, by weight of the nutritional composition.

[0093] A stabilizer may also be included in the nutritional compositions. Any stabilizer that is known or otherwise suitable for use in a nutritional composition is also suitable for use herein, some non-limiting examples of which include gums such as xanthan gum. The stabilizer may represent from about 0.1 % to about 5%, including from about 0.5%> to about 3%, including from about 0.7% to about 1.5%, by weight of the nutritional composition.

[0094] The nutritional compositions may further comprise any of a variety of other vitamins or related nutrients, non-limiting examples of which include vitamin A, vitamin E, vitamin K, thiamine, riboflavin, pyridoxine, vitamin I½, carotenoids (e.g., beta-carotene, zeaxanthin, lutein, lycopene), niacin, folic acid, pantothenic acid, biotin, vitamin C, choline, inositol, salts and derivatives thereof, and combinations thereof.

[0095] The nutritional compositions may further comprise any of a variety of other additional minerals, non-limiting examples of which include calcium, phosphorus, magnesium, iron, zinc, manganese, copper, sodium, potassium, molybdenum, chromium, chloride, and combinations thereof.

Methods of Manufacture

[0096] The nutritional compositions used in the methods of the present disclosure may be prepared by any known or otherwise effective manufacturing technique for preparing the selected product solid or liquid form. Many such techniques are known for any given product form such as nutritional liquids or powders and can easily be applied by one of ordinary skill in the art to the nutritional compositions described herein. [0097] The nutritional compositions of the present disclosure can therefore be prepared by any of a variety of known or otherwise effective formulation or manufacturing methods. In one suitable manufacturing process, for example, at least three separate slurries are prepared, including a protein-in-fat (PIF) slurry, a carbohydrate-mineral (CHO-MIN) slurry, and a protein- in-water (PIW) slurry. The PIF slurry is formed by heating and mixing the oil (e.g., canola oil, corn oil, etc.) and then adding an emulsifier (e.g., lecithin), fat soluble vitamins, and a portion of the total protein (e.g., milk protein concentrate, etc.) with continued heat and agitation. The CHO-MIN slurry is formed by adding with heated agitation to water: Ca-HMB, minerals (e.g., potassium citrate, dipotassium phosphate, sodium citrate, etc.), trace and ultra trace minerals (TM/UTM premix), thickening or suspending agents (e.g., avicel, gellan, carrageenan). The resulting CHO-MIN slurry is held for 10 minutes with continued heat and agitation before adding additional minerals (e.g., potassium chloride, magnesium carbonate, potassium iodide, etc.), and/or carbohydrates (e.g., fructooligosaccharide, sucrose, corn syrup, etc.). The PIW slurry is then formed by mixing with heat and agitation the remaining protein and beta-alanine.

[0098] The resulting slurries are then blended together with heated agitation and the pH adjusted to 6.6-7.0, after which the composition is subjected to high-temperature short-time (HTST) processing during which the composition is heat treated, emulsified and homogenized, and then allowed to cool. Water soluble vitamins and ascorbic acid are added, the pH is adjusted to the desired range if necessary, flavors are added, and water is added to achieve the desired total solid level. The composition is then aseptically packaged to form an aseptically packaged nutritional emulsion. This emulsion can then be further diluted, heat-treated, and packaged to form a ready-to-feed or concentrated liquid, or it can be heat-treated and subsequently processed and packaged as a reconstitutable powder, e.g., spray dried, drymixed, agglomerated.

[0099] The nutritional powder, such as a spray dried nutritional powder or drymixed nutritional powder, may be prepared by any collection of known or otherwise effective technique, suitable for making and formulating a nutritional powder.

[00100] For example, when the nutritional powder is a spray dried nutritional powder, the spray drying step may likewise include any spray drying technique that is known for or otherwise suitable for use in the production of nutritional powders. Many different spray drying methods and techniques are known for use in the nutrition field, all of which are suitable for use in the manufacture of the spray dried nutritional powders herein.

[00101] One method of preparing the spray dried nutritional powder comprises forming and homogenizing an aqueous slurry or liquid comprising predigested fat, and optionally protein, carbohydrate, and other sources of fat, and then spray drying the slurry or liquid to produce a spray dried nutritional powder. The method may further comprise the step of spray drying, drymixing, or otherwise adding additional nutritional ingredients, including any one or more of the ingredients described herein, to the spray dried nutritional powder.

[00102] Other suitable methods for making nutritional products are described, for example, in U.S. Pat. No. 6,365,218 (Borschel, et al), U.S. Pat. No. 6,589,576 (Borschel, et al), U.S. Pat. No. 6,306,908 (Carlson, et al), U.S. Pat. Appl. No. 20030118703 Al (Nguyen, et al), which descriptions are incorporated herein by reference to the extent that they are consistent herewith.

EXAMPLES

[00103] The following examples illustrate experimental data and specific embodiments and/or features of the nutritional compositions for use in the methods of the present disclosure. The examples are given solely for the purpose of illustration and are not to be construed as limitations of the present disclosure, as many variations thereof are possible without departing from the spirit and scope of the disclosure. All exemplified amounts are weight percentages based upon the total weight of the composition, unless otherwise specified.

Example 1

[00104] In this Example, the effects of HMB, administered as calcium HMB (Ca-HMB), alone or in combination with beta-alanine on gastrocnemius muscles were analyzed and multiple metabolites produced evaluated.

[00105] Aged (20 months), Sprague Dawley male rats were chronically fed ad libitum one of the following diets for 8 weeks. These aged rats have significantly less muscle mass and strength as compared to younger counterparts and represent an accepted sarcopenia rat model. Group Diet Amount of Ca- Actual Dose Consumed

HMB and/or (averaged over 8 weeks) Beta-alanine

Control AIN-93 (American 0

(n=10) Institute of Nutrition

Rodent Diets)

2 (n=10) AIN-93M + Ca-HMB 340 mg/kg body 313 mg Ca-HMB/kg body

weight Ca-HMB weight

3 (n=10) AIN-93M + Ca-HMB + 340 mg Ca- 334.5 mg Ca-HMB/kg body

Beta-alanine HMB/kg body weight

weight 447 mg Beta-alanine/kg body 457 mg Beta- weight

alanine/kg body

weight

[00106] At the end of the 8-week period, the rats were sacrificed, muscles were isolated, and gastrocnemius muscle extracts were prepared to remove protein, dislodge small molecules bound to the protein and/or physically trapped in the precipitated protein matrix, and to recover metabolites using methodologies available from Metabolon, Inc. (Durham, North Carolina). Muscle extract samples were split into equal parts for analysis on GC/MS and LC/MS/MS platforms. Metabolon software was used to match ions to an in-house Metabolon library of standards for metabolite identification and quantification by peak area integration. The results are shown in the table below.

Metabolite Control HMB HMB + Ratio % Ratio %

Mean Mean Beta- HMB v. Change HMB + Change

Value Value alanine Control from Beta- from

Mean Control alanine Control

Value v.

Control

HMB 0.44 0.72 0.81 1.62* 62%† 1.84* 84%†

Carnosine 1.31 1.24 2.17 0.95 5%i 1.66* 66%†

Glucose 0.89 0.95 0.80 1.07 7%† 0.9^A 10%i

Glucose- 0.74 0.70 0.18 0.95 5%i 0.24* 76%l

6-P

Glucose- 0.32 0.39 0.13 1.0 — 0.42* 58%|

1-P

Fructose- 0.71 0.75 0.21 1.05 5%† 0.29* 71% j

6-P

Pyruvate 1.00 0.97 0.81 0.98 2%i 0.81* 19%i

Heme 0.74 1.18 3.04 1.59 59%† 4.09* 309%†

Ascorbate 0.41 0.71 0.90 1.74* 74%† 2.18* 118%†

Dehydro- 0.91 1.04 0.75 1.15 15%† 0.83 n%i ascorbate

GSH 0.68 0.83 1.17 1.22 22%† 1.73* 73%†

GSSH 0.84 0.80 0.75 0.96 4%i 0.90* 10%i

A- 0.58 0.72 1.31 1.24 24%† 2.25* 125%† tocopherol

Ratio of >1 indicates an increase in level of metabolite compared to Control

Ratio of < 1 indicates a decrease in level of metabolite compared to Control

* ρ < 0.05; ^Λ ρ < 0.1

[00107] The observed increase in heme levels in the aged sarcopenic gastrocnemius muscle of treated Group 3 (HMB + beta-alanine) is indicative of increased blood flow through the muscle due to increased muscle vasculature. Increased blood flow through the muscle results in increased oxygen to muscle, and thus, an increase in aerobic capacity of the muscle. Thus, the combination of HMB and beta-alanine significantly and unexpectedly contributes to improved muscle energetics, which has a major impact on enhancing muscle performance and reducing muscle fatigue.

[00108] In addition, muscles from treated Group 3 (HMB + beta-alanine) displayed improved glucose utilization and more efficient glycolysis as represented by decreased accumulation of glucose and various glycolytic pathway intermediates such as glucose-6-phosphate, glucose- 1- phosphate and fructose-6-phosphate. All of these intermediates are significantly increased in aged muscles due to the inhibition of the glycolytic pathway with age. Thus, the combination of HMB and beta-alanine had a positive effect on aged sarcopenic muscles by enhancing aerobic capacity through enhanced blood flow as well as by enhancing flux through the glycolytic pathway, which is the major energetic pathway in gastrocnemius muscles.

[00109] Group 3 (HMB + beta-alanine) also displayed an increase in antioxidants (GSH, ascorbate, and alpha-tocopherol) with a corresponding decrease in oxidized forms of the respective proteins (GSSH, dehydroxyascorbate). This is relevant to the functioning of red blood cells (RBC) as the tripeptide glutathione is required by RBCs for the reduction of hydrogen peroxide and organic peroxides in a reaction catalyzed by glutathione peroxidase. Glutathione is oxidized by these peroxides generated during this process. However, glutathione must be in its reduced state (GSH) to perform another important biological function; i.e., the maintenance of cysteine sulfhydryl groups of hemoglobin and other proteins of RBCs in their reduced states. Glutathione is maintained in its reduced state by glutathione reductase, an enzyme that requires both NADPH and FAD as cofactors. Glucose-6-phosphate dehydrogenase is thus essential for the proper function of RBC as the NADPH produced by this enzyme is the reducing agent for glutathione reductase. The results indicate that in Group 3 there is an increase in markers of glucose-6-phosphate dehydrogenase activity (glucose-6-phosphate, glucose- 1 -phosphate, fructose-6-phosphate). Taken together this indicates that the HMB + beta-alanine enhance the functionality and maintenance of RBCs in their optimal state in blood flowing through the muscles. In accordance with the heme data noted above, it can be concluded that HMB + beta- alanine enhances blood flow and RBC functionality, thereby enhancing muscle energetics in aged muscles.

[00110] Metabolomic analysis also verified that the treatment groups were adequately supplemented with HMB and beta-alanine (i.e., increase in carnosine levels), since the levels of these metabolites were significantly increased in muscles of their respective treatment groups. Examples 2-7

[00111] Examples 2-7 illustrate substantially clear nutritional liquids including calcium HMB and beta-alanine, the ingredients of which are listed in the table below. These liquids have a pH of between 2.9 and 4.0 and remain physically stable over a shelf life of about 18 months. All ingredient amounts are listed as gram per approximately 487 gram batch of product, unless otherwise specified.

Examples 8-11

[00112] Examples 8-11 illustrate nutritional powders including calcium HMB and beta- alanine, the ingredients of which are listed in the table below. These products are prepared by both dry mixing and spray drying methods in separate batches, are reconstituted with water prior to use to the desired target ingredient concentrations. All ingredient amounts are listed as kg per 1300 kg batch of product, unless otherwise specified. Ingredient Example 8 Example 9 Example 10 Example 11

Water Q.S. Q.S. Q.S. Q.S.

Isomaltulose 770.38 752.4 760.52 775.38

Whey Protein Isolate 280.20 285.20 274.90 280.50

Citric Acid 98.15 100.15 96.15 93.20

Beta-alanine 61.10 72.10 59.50 62.00

Calcium HMB 52.91 57.91 61.20 63.10

Silicone Dioxide 6.24 6.24 6.24 6.24

MCT Oil 4.81 4.81 4.81 4.81

Flavor 18.2 18.2 18.2 18.2

Color 1.12 1.12 1.12 1.13

Acesulfame K 3.64 3.64 3.64 3.63

Sucralose 3.25 3.25 3.25 3.25

Examples 12-15

[001 13] Examples 12-15 illustrate nutritional emulsion embodiments, the ingredients of which are listed in the table below. These nutritional emulsions are neutral pH emulsions having a pH of about 7.0. All amounts are listed as kilogram per 1000 kilogram batch of product, unless otherwise specified.

Potassium Phosphate dibasic 0.730 0.730 0.730 0.730

Potassium Chloride 1.04 1.04 1.04 1.04

Ascorbic Acid 0.235 0.235 0.235 0.235

Carrageenan 0 0 0 0.150

Potassium Hydroxide 0.136 0.136 0.136 0.136

TM/UTM Premix 0.1684 0.1684 0.1684 0.1684

Gellan Gum 0.050 0.050 0.050 0.050

Vitamin A, D, E Premix 0.0758 0.0758 0.0758 0.0758

Water Soluble Vitamins 0.0728 0.0728 0.0728 0.0728

Potassium Iodide 0.00022 0.00022 0.00022 0.00022

Chromium Chloride 0.000217 0.000217 0.000217 0.000217

Flavor 3.3 3.3 3.3 3.3

Claims

WHAT IS CLAIMED IS:

1. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine for use in the treatment of chronic muscle dysfunction or muscle wasting in a human in need thereof.

2. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine for use in increasing muscle blood flow, muscle blood levels, muscle energetics, or a combination thereof in a human in need thereof.

3. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of the preceding claims, wherein the combination of beta-hydroxy-beta-methylbutyrate and beta-alanine is administered daily.

4. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of claims 1-3, which is administered in a dosage of from 0.1 g/day to 10 g/day of beta- hydroxy-beta-methylbutyrate, and from 0.1 g/day to 5 g/day of beta-alanine.

5. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of claims 1-3, which is administered in a dosage of from 1 g/day to 3 g/day of beta-hydro xy- beta-methylbutyrate, and from 1.6 g/day to 2.4 g/day of beta-alanine.

6. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of the preceding claims, which is administered for a period of at least one year.

7. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of the preceding claims, wherein the human in need thereof is at least one of an older adult, a sarcopenic individual, a cachexic individual, an arthritic older adult, or an older adult suffering from muscle disuse.

8. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of the preceding claims, which is in a composition in a form selected from the group consisting of a nutritional powder, a solid nutritional product, a nutritional emulsion, and a clear liquid.

9. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to claim 8, which further comprises Vitamin D.

10. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to claim 8 or 9, which further comprises an amino acid selected from the group consisting of L-glutamine, L-arginine, L-lysine, and combinations thereof.

11. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of claims 8-10, which further comprises at least one source of protein.

12. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of claims 8-11, which further comprises at least one source of carbohydrate.

13. A combination of beta-hydro xy-beta-methylbutyrate and beta-alanine according to any one of claims 8-12, which further comprises at least one source of fat.