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Effects of Combined Whole-Body Electromyostimulation and Protein Supplementation on Local and Overall Muscle/Fat Distribution in Older Men with Sarcopenic Obesity: The Randomized Controlled Franconia Sarcopenic Obesity (FranSO) Study

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Abstract

The primary aim of the project was to determine the combined effect of whole-body electromyostimulation (WB-EMS) and protein supplements on local and overall muscle/fat distribution in older man with sarcopenic obesity (SO). Community-dwelling (cdw) men ≥ 70 years with SO were randomly allocated to a WB-EMS and protein supplementation (n = 33) or a non-intervention control group (CG: n = 34). WB-EMS was conducted 1.5 sessions of 20 min/week for 16 weeks. Whey protein supplementation aimed to ensure a daily intake of 1.8 g/kg body mass. The primary study endpoint was muscle/fat distribution of the total intra-fascial volume of the mid-thigh as determined by MRI. The core secondary endpoint was appendicular muscle mass (ASMM) and trunk fat; subordinate secondary endpoint was lower-leg performance. Thigh lean muscle volume increased significantly in the WB-EMS&P (p < 0.001) and increased slightly in the CG (p = 0.435). In parallel, fat volume increased significantly in the CG (p < 0.001) and was maintained in the WB-EMS&P group (p = 0.728). Group differences for both parameters were significant (p = 0.033 and p = 0.002). ASMM and trunk fat also differed significantly (p < 0.001) between WB-EMS and CG, with significant positive changes in the WB-EMS&P (p < 0.001) and no relevant changes in the CG (p ≥ 0.458). Finally, changes of gait velocity, leg-extensor strength, and advanced lower extremity function of the WB-EMS&P group differed significantly from the CG (p ≤ 0.002). WB-EMS combined with whey protein supplements favorably affects local and overall muscle/fat distribution and lower limb functioning in cdw men 70+ with SO. Thus, this time-saving, joint-friendly, and highly customizable approach may be an option for people either unable or unmotivated to conduct intense (resistance) exercise protocols.

Trial registration number NCT02857660 on http://www.clinicaltrials.gov.

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Notes

  1. Franconia is the northern part of Bavaria.

  2. Appendicular skeletal muscle mass/body mass index.

  3. …As a marker for intramyocellular lipid content and corresponding fat infiltration of the myocytes.

  4. However, not all of these studies diagnosed sarcopenia or SO properly according to recent definitions, e.g., [15]. With respect to anthropometric parameters, most studies applied high cut-off points for SMI (e.g., [30,31,32,33]), (too) low cut-off points for PBF (e.g., [31]), or BMI-based obesity diagnosis [30, 34, 35].

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Acknowledgements

We would like to thank INKOSPOR (Roth, Germany) for providing the protein supplements for the FranSO Project. We further acknowledge the support of the health sport club “Netzwerk Knochengesundheit e.V.”

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Authors and Affiliations

  1. Institute of Medical Physics, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany

    Wolfgang Kemmler, Alexandra Grimm, Michael Bebenek & Simon von Stengel

  2. Faculty of Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany

    Matthias Kohl

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  1. Wolfgang Kemmler
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Correspondence to Wolfgang Kemmler.

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Conflict of interest

Wolfgang Kemmler, Michael Bebenek, Matthias Kohl, Alexandra Grimm, and Simon von Stengel declare that they have no conflict of interest.

Human and Animal Rights

The project was approved by the University Ethics committee of the FAU (Ethikantrag 67_15b) in April 2015 and fully complied with the Helsinki Declaration “Ethical Principles for Medical Research Involving Human Subjects.”

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All study participants gave their written informed consent.

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Kemmler, W., Grimm, A., Bebenek, M. et al. Effects of Combined Whole-Body Electromyostimulation and Protein Supplementation on Local and Overall Muscle/Fat Distribution in Older Men with Sarcopenic Obesity: The Randomized Controlled Franconia Sarcopenic Obesity (FranSO) Study. Calcif Tissue Int 103, 266–277 (2018). https://doi.org/10.1007/s00223-018-0424-2

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