BCAAs Research
47 peer-reviewed studies · Evidence score: 9/10
Systematic review with meta-analysis: Branched-chain amino acid supplementation in liver disease
van Dijk AM et al. • European journal of clinical investigation (2023)
Prophylactic BCAA supplementation appears safe and might improve survival in cirrhotic patients.
- According to meta-analyses, long-term (at least 6 months) BCAA supplementation in cirrhotic patients significantly improved event-free survival (p = .008; RR .61 95% CI .42-.88) and tended to improve overall survival (p = .05; RR .58 95% CI .34-1.00).
- Prophylactic BCAA supplementation appears safe and might improve survival in cirrhotic patients.
- Further research warranted to confirm findings
The Role of Nutrition in the Treatment of Sarcopenia in Old Patients: From Restoration of Mitochondrial Activity to Improvement of Muscle Performance, a Systematic Review
Cochet C et al. • Nutrients (2023)
PROSPERO CRD42022332288.
- Mitochondrial function was significantly improved by the administration of BCAA alone (1 RCT) or in association with vitamin D (1 RCT).
- BCAA alone (2 RCTs) or PUFA (1 RCT) were not effective in improving muscle health.
- In conclusion, BCAA in association with vitamin D may be useful in the treatment of sarcopenia and boost mitochondrial bioenergetic and redox activity.
Causal Relationship Between Branched-Chain Amino Acids and Hypertension: A Mendelian Randomization Study
Cai S et al. • Journal of the American Heart Association (2024)
The increased levels of 3 BCAAs positively correlated with an increased risk of hypertension.
- As suggested by the meta-analysis results, elevated BCAA levels were associated with a higher risk of hypertension (isoleucine: summary odds ratio, 1.26 [95% CI, 1.08-1.47]; leucine: summary odds ratio, 1.28 [95% CI, 1.07-1.52]; valine: summary odds ratio, 1.32 [95% CI, 1.12-1.57]).
- The increased levels of 3 BCAAs positively correlated with an increased risk of hypertension.
- Particularly, elevated isoleucine level is a causal risk factor for essential hypertension.
Association of circulating branched-chain amino acids with risk of cardiovascular disease: A systematic review and meta-analysis
Wang Y et al. • Atherosclerosis (2022)
Evidence suggests that elevated concentrations of circulating Isoleucine were associated with increased risks of CVD, independent of traditional risk factors.
- Nine prospective studies were meta-analyzed and highlighted a 10% higher risk of CVD per study-specific SD difference for Isoleucine (pooled relative risk 1.10 [1.03-1.18]; I2 = 63.5%).
- Evidence suggests that elevated concentrations of circulating Isoleucine were associated with increased risks of CVD, independent of traditional risk factors.
- Further research warranted to confirm findings
Miscellaneous treatments for antipsychotic-induced tardive dyskinesia
Soares-Weiser K et al. • The Cochrane database of systematic reviews (2018)
This review has found that the use of valbenazine or extract of Ginkgo biloba may be effective in relieving the symptoms of tardive dyskinesia.
- Studies were primarily of short (three to six6 weeks) duration with small samples size (10 to 157 participants), and most (61%) were published more than 20 years ago.
- Two studies found moderate-quality evidence of a benefit of the intervention compared with placebo: valbenazine (RR 0.63, 95% CI 0.46 to 0.86, 1 RCT, n = 92) and extract of Ginkgo biloba (RR 0.88, 95% CI 0.81 to 0.96, 1 RCT, n = 157), respectively.
- This review has found that the use of valbenazine or extract of Ginkgo biloba may be effective in relieving the symptoms of tardive dyskinesia.
Metabolomics in Prediabetes and Diabetes: A Systematic Review and Meta-analysis
Guasch-Ferré M et al. • Diabetes care (2016)
In studies using high-throughput metabolomics, several blood amino acids appear to be consistently associated with the risk of developing type 2 diabetes.
- Glycine and glutamine were inversely associated with type 2 diabetes risk (0.89 [0.81-0.96] and 0.85 [0.82-0.89], respectively; both I(2) = 0.0%).
- In studies using high-throughput metabolomics, several blood amino acids appear to be consistently associated with the risk of developing type 2 diabetes.
- Further research warranted to confirm findings
Peripheral fatigue and hormone responses to branched-chain amino acids ingestion and exercise in recovery: a systematic review and meta-analysis
Pourgharib Shahi MH et al. • Minerva endocrinology (2024)
The advantages of BCAA administration relate to a reduction in cortisol concentration after 2h and ameliorated muscle function because of a probable attenuation of fatigue substances immediately after exercise.
- The advantages of BCAA administration relate to a reduction in cortisol concentration after 2h and ameliorated muscle function because of a probable attenuation of fatigue substances immediately after exercise.
- Published in Minerva endocrinology (2024)
- Further research warranted to confirm findings
Branched-Chain Amino Acids and Seizures: A Systematic Review of the Literature
Gruenbaum SE et al. • CNS drugs (2019)
The contradictory effects of BCAAs on seizure activity likely reflect differences in the complex mechanisms that underlie seizure disorders.
- The contradictory effects of BCAAs on seizure activity likely reflect differences in the complex mechanisms that underlie seizure disorders.
- Some of these mechanisms are likely mediated by BCAA's effects on glucose, glutamate, glutamine, and ammonia metabolism, activation of the mechanistic target of rapamycin signaling pathway, and their effects on aromatic amino acid transport and neurotransmitter synthesis.
- We propose that a better understanding of mechanisms by which BCAAs affect seizures and neuronal viability is needed to advance the field of BCAA supplementation in epilepsy.
Branched-chain amino acids for people with hepatic encephalopathy
Gluud LL et al. • The Cochrane database of systematic reviews (2017)
In this updated review, we included five additional trials.
- In a random-effects meta-analysis of mortality, we found no difference between BCAA and controls (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.69 to 1.11; 760 participants; 15 trials; moderate quality of evidence).
- BCAA had a beneficial effect on hepatic encephalopathy (RR 0.73, 95% CI 0.61 to 0.88; 827 participants; 16 trials; high quality of evidence).
- We found no small-study effects and confirmed the beneficial effect of BCAA in a sensitivity analysis that only included trials with a low risk of bias (RR 0.71, 95% CI 0.52 to 0.96).
The efficacy of dietary supplements on health status and performance of football players: a systematic review
Allahyari P et al. • Journal of basic and clinical physiology and pharmacology (2025)
Further studies are warranted to confirm the effects of the supplements on football players, to identify the appropriate dosage of the supplements and also to determine their mechanism of action.© 2025 Walter de Gruyter GmbH, Berlin/Boston.
- B vitamins reduce the level of blood lactate in the recovery periods.
- Vitamin E and vitamin C may improve performance by decreasing oxidative stress and increasing the antioxidant capacity and oxygen delivery to exercising skeletal muscles.
- Iron supplementation improves endurance capacity.
Gut microbiota and metabolites as predictors of biologics response in inflammatory bowel disease: A comprehensive systematic review
Wang C et al. • Microbiological research (2024)
All rights reserved.
- IBD patients who responded well to vedolizumab treatment had higher levels of specific bacteria that produce butyrate, along with increased levels of metabolites such as butyrate, branched-chain amino acids and acetamide following vedolizumab treatment.
- Crohn's disease patients who responded positively to ustekinumab treatment showed higher levels of Faecalibacterium and lower levels of Escherichia/Shigella.
- All rights reserved.
Metabolomics in acromegaly: a systematic review
Pînzariu O et al. • Journal of investigative medicine : the official publication of the American Federation for Clinical Research (2023)
Matrix-assisted laser desorption/ionization coupled with MS imaging confirmed the functional nature of GH-secreting PAs and accurately discriminated PAs from healthy pituitary tissue.
- MRS detected low hepatic lipid content in active acromegaly, which increased after disease control.
- The panel of metabolites of acromegaly deciphered by mass spectrometry (MS)-based techniques mainly included amino acids (especially branched-chain amino acids and taurine), glyceric acid, and lipids.
- The most altered pathways in acromegaly were the metabolism of glucose (particularly the downregulation of the pentose phosphate pathway), linoleic acid, sphingolipids, glycerophospholipids, arginine/proline, and taurine/hypotaurine.
The effect of branched-chain amino acid on muscle damage markers and performance following strenuous exercise: a systematic review and meta-analysis
Doma K et al. • Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme (2021)
BCAA does not accelerate recovery for muscle performance.
- In total, 25 studies were included, consisting of 479 participants (age 24.3 ± 8.3 years, height 1.73 ± 0.06 m, body mass 70.8 ± 9.5 kg, females 26.3%).
- However, no significant differences were identified between the BCAA and placebo conditions for muscle performance at 24 or 48 hours post-exercise (SMD = 0.08 ≤ d ≤ 0.21; p > 0.05).
- However, the potential benefits of BCAA for muscle performance recovery is questionable and warrants further investigation to determine the practicality of BCAA for ameliorating muscle damage symptoms in diverse populations.
Dietary Branched Chain Amino Acids Association with Cancer and Mortality: A Systematic Review and Meta-Analysis of Observational Studies
Tabesh M et al. • Nutrition and cancer (2024)
Our findings showed no significant association between dietary BCAAs and its components with BC and digestive cancers, BC and digestive cancers mortality, and all-cause mortality.
- The present study showed no statistically significant association between dietary BCAAs and its components with BC and digestive cancers (RRBCAA: 0.87, 95% CI: 0.68-1.10, RRLeucine: 0.74, 95% CI: 0.52-1.04, RRIsoleucine: 0.98, 95% CI: 0.93-1.04, RRValine: 0.76, 95% CI: 0.55-1.05).
- Eight articles (six studies on breast cancer (BC) and digestive cancers risk, and three studies on both BC and digestive cancers mortality, and all-cause mortality) were included.
- Further research warranted to confirm findings
Serum branched amino acids and the risk of all-cause mortality: a meta-analysis and systematic review
Teymoori F et al. • Amino acids (2023)
The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
- We extracted the reported hazard ratio (HR) with 95% confidence interval (CI) and odds ratio (OR) with 95%CI in cohorts and case-control studies, respectively, and computed the log HR or OR and its standard error.
- Then, we used the random-effects model with inverse variance weighting method for the present meta-analysis, to calculate the pooled effect size.
- The pooled results indicated that there was no significant association between serum BCAAs (RR: 1.17; 95% CI 0.85-1.60), isoleucine (RR: 1.41; 95%CI 0.92-2.17), leucine (RR: 1.13; 95% CI 0.94-1.36), and valine (RR: 1.02; 95%CI 0.86-1.22) and all-cause mortality.
Oral Branched-Chain Amino Acids Supplementation in Athletes: A Systematic Review
Martinho DV et al. • Nutrients (2022)
Moreover, most of the studies did not report the total protein intake across the day and, consequently, the benefits of BCAAs should be interpreted with caution.
- Although BCAAs tended to activate anabolic signals, the benefits on performance and body composition were negligible.
- On the other hand, studies that included resistance participants showed that BCAAs attenuated muscle soreness after exercise, while in endurance sports the findings were inconsistent.
- The protocols of BCAA supplements differed considerably between studies.
The Effect of Diet and Exercise Interventions on Body Composition in Liver Cirrhosis: A Systematic Review
Johnston HE et al. • Nutrients (2022)
While body composition in cirrhosis may improve with diet and exercise prescription, suitably powered RCTs of combined interventions, targeting overweight/obese populations, and using guideline-recommended body composition measures are needed to clarify if sarcopenia/sarcopenic obesity is modifiable in patients with cirrhosis.
- When guideline-recommended measures of body composition were used, the largest improvements occurred with combined diet and exercise interventions.
- These mostly employed high protein diets with aerobic and or resistance exercises for at least 8 weeks.
- Benefits were also observed with supplementary branched-chain amino acids.
The Association between Circulating Branched Chain Amino Acids and the Temporal Risk of Developing Type 2 Diabetes Mellitus: A Systematic Review & Meta-Analysis
Ramzan I et al. • Nutrients (2022)
We suggest the potential utility of BCAAs as an early biomarker for T2DM irrespective of follow-up time.
- Conclusion: Plasma BCAA concentrations are associated with T2DM incidence across all temporal subgroups.
- We suggest the potential utility of BCAAs as an early biomarker for T2DM irrespective of follow-up time.
- Further research warranted to confirm findings
Nutritional Interventions to Improve Cachexia Outcomes in Cancer-A Systematic Review
Braha A et al. • Medicina (Kaunas, Lithuania) (2022)
According to the GRADE methodology, no positive recommendation for these nutritional supplements may be expressed.
- Background and Objectives: The prevalence of cachexia has increased across all of the cancer types and accounts for up to 20% of cancer-related deaths.
- Conclusions: Although clinical trials relating to large numbers of nutritional supplements present promising data, many trials provided negative results.
- Further studies investigating the underlying mechanisms of action of these nutritional supplements in cancer cachexia are needed.
Efficacy of branched chain amino acids supplementation in liver cirrhosis: A systematic review and meta-analysis
Konstantis G et al. • Clinical nutrition (Edinburgh, Scotland) (2022)
Supplementation with BCAA seems to improve significant prognostic factors for patients with cirrhosis, with potential positive impact in mortality.
- Relative to other interventions BCAAs showed beneficial effect regarding muscle mass (SMD 0.21, 95% CI 0.01 to 0.4, I2 0%), but no effect regarding fat mass.
- Supplementation with BCAA seems to improve significant prognostic factors for patients with cirrhosis, with potential positive impact in mortality.
- Heterogeneity of study findings attributed to many factors limit overall conclusion and results require further assessment.