HP-HMB oral nutrition,
does it really help with Reduced 90-day postdischarge mortality in malnourished older medical inpatients?
research showsThe prespecified primary composite failed, and only the secondary outcome of 90-day mortality was positive. The grade is C. NOURISH analyzed 622 participants who received at least some assigned product. Ninety-day mortality was 15/313 (4.8%) with HP-HMB versus 30/309 (9.7%) with placebo, RR 0.49 (95% CI 0.27 to 0.90). The primary death-or-nonelective-readmission composite was nonsignificant at 26.8% versus 31.1%, and the only direct trial was funded and analyzed by Abbott Nutrition, giving C with 54 points.
ads claimThis was not a trial of HMB tablets alone. Each 237-mL serving contained 350 kcal, 20 g protein, 1.5 g calcium-HMB, vitamin D, and multiple micronutrients, and participants used two servings daily. The mortality result cannot be assigned to HMB alone or generalized to muscle-maintenance marketing in healthy older adults.
Useful facts when choosing a product
- Each 237-mL study drink contained 350 kcal, 20 g protein, 1.5 g calcium-HMB, and 160 IU vitamin D; two drinks were prescribed daily.
- The placebo contained 48 kcal and 12 g carbohydrate per serving and matched presentation, but not energy, protein, or micronutrient content.
- Verdict 130 is C with 54 points for HMB and older-adult muscle outcomes; this verdict addresses 90-day mortality with a multi-ingredient drink after hospitalization.
What the research actually shows
Across 78 US sites, 652 malnourished inpatients aged 65 or older were assigned to HP-HMB, 328, or placebo, 324. The prespecified efficacy population comprised 313 and 309 participants who consumed any assigned product; clinical outcomes were completely unavailable for 18 and 19. Randomization used a centralized telephone system, and identical cartons plus opaque straws supported double blinding. The original primary outcome was 90-day nonelective readmission, but it was changed after interim analysis and before unblinding to the death-or-readmission composite. Abbott Nutrition developed the protocol and analyzed the data, followed by independent statistical review.
Why this is classified as C (54)
The prespecified primary composite failed, and only the secondary outcome of 90-day mortality was positive. The large hard-outcome reduction came from a single manufacturer-only trial, giving C with 54 points.
Counterpoint. The result is not absence of signal. It is a survival signal requiring independent confirmation in a narrow population of malnourished older adults hospitalized with selected medical diagnoses.
Rejudgment record. Cross-check applied — The NOURISH paper and NCT01626742 were checked for the efficacy denominator, original and final primary endpoints, event counts, funding, and analytical role
| Endpoint | H | Hard endpoint - actual events such as death |
| Replication | R1 | Single confirmatory trial |
| Independence | I0 | Evidence comes only from manufacturer studies |
| Effect size | E+ | Meets the clinically important threshold |
The scoring table and the verdict agree (C).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Reduced 90-day postdischarge mortality | C | The result was positive at 15/313 versus 30/309, but it was a component result from one manufacturer-run trial. |
| Reduced 90-day death or nonelective readmission | D | The primary composite was nonsignificant at 26.8% versus 31.1%. |
| Survival benefit from HMB alone | ? | Protein, calories, vitamins, and HMB were combined, so the effect of HMB alone was not isolated. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Study 1 | Multicenter randomized double-blind placebo-controlled trial | 309 | Funded by Abbott Nutrition, which developed the protocol and analyzed the data | Primary 90-day death-or-nonelective-readmission composite and mortality component | Composite 26.8% versus 31.1%, nonsignificant; mortality 15/313 (4.8%) versus 30/309 (9.7%), RR 0.49 (95% CI 0.27 to 0.90), P=.018. | Single direct trial with a failed primary composite and positive mortality component |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-08-15).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-15 · Corrections: none
Cite this verdict
[Chamgap] HP-HMB oral nutrition x reduced 90-day mortality in malnourished older inpatients — Evidence Grade C·54. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/antioxidant-aging/hp-hmb-oral-nutrition-90-day-mortality-malnourished-older-inpatients/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.