{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:03:25Z","timestamp":1790053405277,"version":"4.0.1"},"reference-count":25,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Morinaga Milk Industry Co., Ltd.","award":["2264"],"award-info":[{"award-number":["2264"]}],"id":[{"id":"https:\/\/ror.org\/05asq7780","id-type":"ROR","asserted-by":"crossref"}]},{"award":["2264"],"award-info":[{"award-number":["2264"]}],"id":[{"id":"https:\/\/ror.org\/05asq7780","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Sarcopenia contributes to frailty and functional decline in older adults; however, effective adjunctive strategies remain limited. Heat-killed Bifidobacterium breve B-3 (B-3HK), a postbiotic, has shown muscle-related effects in preclinical studies; however, clinical evidence in patients with established sarcopenia is scarce. This pilot trial aimed to evaluate these clinical effects. Methods: In this 24-week randomized, double-blind, placebo-controlled trial, adults aged 50\u201389 years with Asian Working Group for Sarcopenia (AWGS) 2019-defined sarcopenia received B-3HK (2 \u00d7 1010 cells\/day) or placebo daily. The primary outcome was the change in knee extension strength at week 24. Secondary outcomes included body composition measured using bioelectrical impedance analysis (BIA), dual-energy X-ray absorptiometry (DXA), physical performance, Eating Assessment Tool-10 (EAT-10), serum biomarkers, gut microbiota, and safety. Secondary outcomes were exploratory with nominal p-values and no adjustment for multiple comparisons. Results: Fifty participants were randomized, and 49 were included in the full analysis set. Compared with placebo, B-3HK did not significantly improve knee extension strength. Exploratory analyses showed between-group differences favoring B-3HK in the BIA-derived skeletal muscle mass index, limb muscle mass, EAT-10 score, and serum insulin-like growth factor-1 and 25-hydroxyvitamin D levels. These differences were primarily driven by the attenuation of the decline in the placebo group and were not corroborated by DXA-derived indices or functional outcomes. The gut microbiota composition did not differ between groups. No serious adverse events were observed. Conclusions: B-3HK did not improve muscle strength in patients with sarcopenia. Exploratory analyses identified nominal between-group differences in body composition and endocrine outcomes; however, these findings were unadjusted for multiplicity and should be regarded as hypothesis-generating rather than confirmatory evidence of efficacy. These data may help inform the design of future adequately powered trials, but confirmation is required before any therapeutic benefit can be inferred.<\/jats:p>","DOI":"10.3390\/nu18183074","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:50:03Z","timestamp":1789995003000},"page":"3074","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Heat-Killed Bifidobacterium breve B-3, a Postbiotic, on Muscle Mass-Related Parameters in Patients with Sarcopenia: A Randomized, Double-Blind, Placebo-Controlled Pilot Trial"],"prefix":"10.3390","volume":"18","author":[{"given":"Daisuke","family":"Asaoka","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Juntendo Tokyo Koto Geriatric Medical Center, Faculty of Medicine, Juntendo University, Tokyo 136-0075, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Biotics Research Institute, Morinaga Milk Industry Co., Ltd., Kanagawa 252-8583, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0765-1917","authenticated-orcid":false,"given":"Noriko","family":"Katsumata","sequence":"additional","affiliation":[{"name":"Biotics Research Institute, Morinaga Milk Industry Co., Ltd., Kanagawa 252-8583, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Iwabuchi","sequence":"additional","affiliation":[{"name":"Biotics Research Institute, Morinaga Milk Industry Co., Ltd., Kanagawa 252-8583, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naotake","family":"Yanagisawa","sequence":"additional","affiliation":[{"name":"Medical Technology Innovation Center, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6019-9240","authenticated-orcid":false,"given":"Toshitaka","family":"Odamaki","sequence":"additional","affiliation":[{"name":"Biotics Research Institute, Morinaga Milk Industry Co., Ltd., Kanagawa 252-8583, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-9086","authenticated-orcid":false,"given":"Jin-Zhong","family":"Xiao","sequence":"additional","affiliation":[{"name":"Morinaga Milk Industry Co., Ltd., Tokyo 105-7122, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3648-5452","authenticated-orcid":false,"given":"Tsutomu","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeo","family":"Koido","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Chiba 277-0004, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Ohkusa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Chiba 277-0004, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5979-4384","authenticated-orcid":false,"given":"Akihito","family":"Nagahara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Asaoka, D., Toda, K., Yoshimoto, S., Katsumata, N., Odamaki, T., Iwabuchi, N., Tanaka, M., Xiao, J.-Z., Nishikawa, Y., and Nomura, O. 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