The Role of Dietary Supplements in Supporting Muscle Mass and Physical Function

Can dietary supplements help preserve muscle health?

The use of dietary supplements has traditionally been associated with sports medicine, where they are used to increase muscle mass, improve physical performance, and accelerate recovery after exercise. In addition, healthy muscles are critically important for maintaining the quality of daily life, including activities of daily living (ADL), and for positive ageing. Healthy muscle activity supports such aspects of ADL as mobility, posture, and breathing.

However, most adults do not engage in sufficient physical activity. In recent years, researchers’ interest has also increasingly shifted toward other population groups — people with low physical activity, patients with chronic diseases, older adults, and women in the peri- and postmenopausal periods.

These are precisely the issues addressed in a review published in the journal Nutrients, in which the authors analysed current evidence on the effects of various dietary supplements on muscle function, strength, and muscle mass, recovery after physical exertion, and quality of life in adults who are not professional athletes.

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How does the body maintain muscle mass?

The authors note that skeletal muscle is a highly plastic tissue that can grow, through hypertrophy, and decrease, through atrophy, in response to a range of stimuli. Its condition is determined by the balance between muscle protein synthesis, or anabolism (Muscle Protein Synthesis, MPS), and muscle protein breakdown, or catabolism (Muscle Protein Breakdown, MPB). The rate of MPS is primarily driven by anabolic signals such as food intake, dietary protein, and physical activity. A key anabolic hormone is insulin, which is secreted by the pancreas in response to food intake.

When nutrient intake, physical activity, and hormonal status are adequate, synthetic processes predominate. Insulin and the PI3K–Akt–mTOR (mechanistic Target Of Rapamycin signaling) pathway play a key role in this process by activating the formation of new muscle proteins.

In disease, chronic inflammation, advanced cancer, physical inactivity, or ageing, the balance shifts toward catabolism. If protein breakdown begins to exceed protein synthesis, loss of muscle mass develops.

Why do we lose muscle with age?

The authors discuss sarcopenia, meaning progressive loss of muscle mass, in detail as a multifactorial disease.

Age-related changes are accompanied by reduced sensitivity of muscle tissue to anabolic signals, including the action of insulin. A gradual reduction in muscle mass begins approximately after the age of 30 and accelerates after the age of 50.

Sarcopenia develops under the influence of several factors:

• chronic inflammation;
• insufficient physical activity;
• age-related hormonal changes;
• inadequate nutrition;
• oxidative stress.

Particular attention is given to the combination of sarcopenia and obesity, known as sarcopenic obesity, which is becoming increasingly common among people older than 65 years.

The authors also draw attention to another modern problem — loss of muscle mass during obesity treatment with GLP-1 receptor agonists, such as semaglutide (Ozempic and Wegovy). Despite a pronounced reduction in fat mass, part of the weight loss involves lean body mass, including muscle, which may be clinically significant, particularly in older patients.

Loss of muscle mass is accompanied by reduced strength and impaired physical function, increased risk of falls, fractures, and overall mortality.

Why are women more likely to experience age-related loss of muscle mass?

According to the review, women are more susceptible to age-related loss of muscle mass.

This is promoted by:

• initially lower muscle mass;
• decreased oestrogen levels during the peri- and postmenopausal periods;
• more pronounced oxidative stress;
• chronic inflammation;
• reduced levels of physical activity.

The authors note that women have historically been underrepresented in studies devoted to sports nutrition and dietary supplements: only about 8% of such studies have been conducted exclusively among women.

How does chronic inflammation destroy muscle?

One of the key topics of the review is chronic inflammation.

The age-related increase in the concentration of pro-inflammatory cytokines, including TNF-α (tumour necrosis factor-α), IL-6 (interleukin 6), and C-reactive protein, has been termed inflammageing.

These mediators activate the intracellular NF-κB pathway, a protein transcription factor pathway, which enhances muscle protein breakdown and simultaneously suppresses muscle tissue repair processes.

Similar inflammatory mechanisms are observed not only in sarcopenia but also after intense physical exertion accompanied by exercise-induced muscle damage (EIMD).

For this reason, reducing chronic inflammation is considered by the authors to be one of the potential strategies for preventing age-related muscle loss.

The gut and muscles: a new concept

A large section of the article is devoted to the gut–muscle axis (The Gut–Muscle Axis).

The authors note that the gut microbiota influences muscle metabolism through several mechanisms:

• regulation of inflammation;
• effects on tissue sensitivity to insulin;
• involvement in energy metabolism;
• changes in nutrient availability;
• effects on mitochondrial function.

When the composition of the microbiota is disturbed, systemic inflammation increases, production of reactive oxygen species rises, and muscle protein synthesis deteriorates.

In addition, physical activity itself promotes increased diversity of the gut microbiota, which may additionally improve the condition of muscle tissue. Regular physical exercise, especially resistance exercise training (RET), remains a cornerstone of health in slowing muscle loss and preventing cognitive decline.

The authors emphasise that the relationship between the gut microbiota and muscle function is now considered a promising area of research. Sports activities involving strength and endurance contribute to positive changes in the intestinal environment and gut microbiota by increasing the diversity of the gut microbiota and the abundance of bacteria. Physical exercise and improved gut health may synergistically increase muscle growth and recovery.

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Which dietary supplements were analysed in the review?

Numerous potential dietary supplements are thought to have beneficial effects on skeletal muscle function, performance, mass/strength, and recovery associated with exercise and injury. The review analysed data on a large number of the most popular dietary supplements.

Protein

Protein supplements remain the most extensively studied method of nutritional support for muscles.

The authors note that protein is necessary for the synthesis of muscle tissue, and its effectiveness increases substantially when combined with resistance training.

Older adults may require more protein than previously assumed, because ageing is accompanied by the development of so-called anabolic resistance.

Special attention is given to whey protein, which rapidly increases the concentration of essential amino acids, especially leucine.

Leucine

Leucine is considered one of the most important amino acids stimulating muscle protein synthesis through activation of the mTOR signalling pathway.

The most pronounced effects have been observed in older patients with sarcopenia, although the maximum benefit is achieved when leucine is combined with physical exercise and adequate intake of other amino acids.

Creatine

Creatine remains one of the most extensively studied nutrients in sports medicine.

According to the presented data, it can increase strength and muscle mass in older adults, mainly when combined with resistance training.

Isolated creatine intake without physical exercise shows a substantially less pronounced effect.

HMB

β-hydroxy-β-methylbutyrate (HMB), a metabolite of leucine, is considered an agent capable of simultaneously stimulating protein synthesis and reducing protein breakdown.

The authors note that the most convincing results have been obtained when HMB is used together with training, as well as in patients with sarcopenia, cachexia, and age-related muscle weakness.

L-carnitine

Carnitine is involved in energy metabolism and the transport of fatty acids into mitochondria.

According to a number of studies, its use may reduce the severity of muscle damage after physical exertion, decrease muscle soreness, and improve indicators of physical performance. At the same time, the authors note the need for caution with uncontrolled use of high doses.

Vitamin D

The authors pay considerable attention to vitamin D.

Vitamin D deficiency is widespread and is associated with reduced muscle strength, impaired physical function, and increased risk of falls and sarcopenia.

Vitamin D is also considered a regulator of the immune response, inflammation, and the state of the gut microbiota.

Magnesium

Magnesium is involved in muscle contraction, energy metabolism, and protein synthesis.

When magnesium is deficient, physical performance deteriorates and inflammatory processes become more pronounced.

However, data on the benefit of additional magnesium intake in people without deficiency remain inconsistent.

Potassium

The authors note that potassium is involved in the regulation of muscle contractions, insulin sensitivity, and inflammation.

Insufficient potassium intake may contribute to the development of muscle weakness and age-related loss of muscle mass.

Curcumin

Curcumin has anti-inflammatory and antioxidant properties.

In studies, its use was accompanied by reduced delayed-onset muscle soreness, decreased inflammatory response, and accelerated recovery after physical exertion.

Omega-3 fatty acids

Despite convincing biological mechanisms of action, current meta-analyses do not confirm a significant effect of omega-3 fatty acids on increasing muscle mass.

At the same time, individual studies demonstrate a small improvement in muscle strength, especially when combined with resistance training.

Probiotics and prebiotics

The authors discuss in detail the role of probiotics and prebiotics as a potential tool for influencing the gut–muscle axis.

A number of studies show that modifying the composition of the gut microbiota may contribute to reduced inflammation, improved recovery after physical exertion, and maintenance of muscle function.

What conclusions did the researchers reach?

The authors conclude that some dietary supplements can indeed support muscle function, especially in the presence of nutrient deficiency and in combination with regular physical activity.

The most convincing evidence has been obtained for protein supplements, leucine, creatine, and HMB, whereas the effectiveness of many other nutraceuticals requires further investigation.

The authors emphasise that dietary supplements should not be considered an independent alternative to physical activity. Their potential benefit is most pronounced precisely when they are combined with exercise, above all resistance training.

Despite the growing number of studies, large long-term clinical trials are needed to determine the optimal dosages, duration of use, and clinical effectiveness of various nutraceuticals in patients of different age and clinical groups.

References

Brough L., Rees G., Drummond-Clarke L. et al. Can Dietary Supplements Support Muscle Function and Physical Activity? A Narrative Review. Nutrients. 2025.