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BMC Geriatrics
Published in: BMC Geriatrics 1/2018

Open Access 01-12-2018 | Research Article

Effect of whole-body electromyostimulation and / or protein supplementation on obesity and cardiometabolic risk in older men with sarcopenic obesity: the randomized controlled FranSO trial

Authors: Wolfgang Kemmler, Matthias Kohl, Ellen Freiberger, Cornel Sieber, Simon von Stengel

Published in: BMC Geriatrics | Issue 1/2018

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Abstract

Background

Sarcopenic Obesity (SO) is characterized by low lean and high fat mass; i.e. from a functional aspect a disproportion between engine (muscle) and mass to be moved (fat). At present, most research focuses on the engine, but the close “cross talk” between age-associated adipose and skeletal muscle tissue inflammation calls for comprehensive interventions that affect both components alike. Protein and exercise are likely candidates, however with respect to the latter, the enthusiasm for intense and frequent exercise is rather low, especially in functionally limited older people. The aim of this study was therefore to evaluate the effect of whole-body electromyostimulation (WB-EMS), a time-efficient, joint-friendly and highly customizable exercise technology, on obesity parameters and cardiometabolic risk in men with SO.

Methods

One-hundred community-dwelling (cdw) Bavarian men ≥70 years with SO were randomly assigned to either (a) whey protein supplementation (WPS), (b) WB-EMS and protein supplementation (WB-EMS&P) or (c) non-intervention control (CG). Protein supplementation contributed to an intake of 1.7–1.8 g/kg/body mass/d, WB-EMS consisted of 1.5 × 20 min/week (85 Hz, 350 μs, 4 s of strain–4 s of rest) with moderate-high intensity. Using an intention to treat approach with multiple imputation, the primary study endpoint was total body fat mass (TBF), secondary endpoints were trunk fat mass (TF), waist circumference (WC) and total-cholesterol/HDL-cholesterol ratio (TC/HDL-C).

Results

After 16 weeks of intervention, TBF was reduced significantly in the WPS (− 3.6 ± 7.2%; p = 0.005) and WB-EMS&P (− 6.7 ± 6.2%; p < 0.001), but not in the CG (+ 1.6 ± 7.1%; p = 0.191). Changes in the WB-EMS&P (p < 0.001) and the WPS group (p = 0.011) differ significantly from the CG. TF decreased in the WB-EMS&P (p < 0.001) and WPS (p = .117) and increased in the CG (p = .159); WC decreased significantly in the treatment groups and was maintained in the CG. Lastly, the TC/HDL-C ratio improved significantly in the WB-EMS&P and WPS group and was maintained in the CG. Significant differences between WB-EMS&P and WPS were determined for waist circumference only (p = 0.015; TBF: p = 0.073; TF: p = 0.087; TC/HDL-C: p = .773).

Conclusion

Moderate-high dosed whey protein supplementation, especially when combined with WB-EMS, may be a feasible choice to address obesity and cardiometabolic risk in older cdw men with SO unable or unmotivated to exercise conventionally.

Trial registration number

ClinicalTrials.​gov NCT02857660; registration date: 05/01/2017.
Footnotes
1
Ethikkommission der Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91,054 Erlangen, Germany; phone + 49 9131 85–22,270; e-mail: ethikkommission@fau.de
 
2
Appendicular skeletal muscle mass (ASMM)/ body mass index (BMI)
 
3
E.g. WB-EMS training every Monday/Tuesday and every second Thursday/Friday
 
4
Briefly, the chemical score indicates the “quality” of the protein source. The chemical score is calculated from the content of the amino acid with the lowest occurrence in the protein to be tested.The reference used is egg protein (100%).
 
5
Primary endpoint: Changes of Sarcopenia Z-Score [22] from baseline to 16 week follow-up
 
6
However, differences between WB-EMS&P versus WPS were also not significant (p = 0.055) for SMI
 
7
However, we did not consider our cdw cohort as “frail”
 
8
Ethikkommission der Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91,054 Erlangen, Germany; phone + 49 9131 85–22,270; e-mail: ethikkommission@fau.de
 
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Metadata
Title
Effect of whole-body electromyostimulation and / or protein supplementation on obesity and cardiometabolic risk in older men with sarcopenic obesity: the randomized controlled FranSO trial
Authors
Wolfgang Kemmler
Matthias Kohl
Ellen Freiberger
Cornel Sieber
Simon von Stengel
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2018
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-018-0759-6

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