Evidence supporting the use of: Branched-chain amino acids
For the health condition: Wasting

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Branched Chain Amino Acids (BCAAs)—leucine, isoleucine, and valine—are used to support or treat muscle wasting (cachexia) in several clinical settings, such as chronic illnesses (e.g., cancer, liver disease) and age-related sarcopenia. The rationale for their use is rooted in their unique metabolic roles: BCAAs are essential amino acids that serve as important substrates for muscle protein synthesis and are preferentially taken up by skeletal muscle. Scientific studies, including randomized controlled trials, have shown that BCAA supplementation can help preserve lean body mass, improve nitrogen balance, and reduce muscle breakdown in patients at risk of wasting. For example, BCAAs are commonly included in medical nutrition for patients with liver cirrhosis to counteract protein catabolism and maintain muscle mass.

However, the overall quality and consistency of evidence is moderate. Meta-analyses suggest some benefit in specific populations—such as those with liver disease or undergoing hemodialysis—but effects are often modest. In cancer cachexia and general age-related muscle loss, results are mixed and may depend on baseline nutritional status and concurrent interventions (such as exercise or other nutritional support). Guidelines from professional societies sometimes recommend BCAAs as part of multimodal therapy, but they are rarely recommended as a sole intervention. Thus, while the use of BCAAs for muscle wasting is supported by scientific rationale and some clinical data, the strength of evidence is not definitive, warranting a rating of 3 out of 5.

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