Safety of a Combined WB-EMS and High-Protein Diet Intervention in Sarcopenic Obese Elderly Men
Received 8 February 2020
Accepted for publication 20 May 2020
Published 24 June 2020 Volume 2020:15 Pages 953—967
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Wolfgang Kemmler,1 Simon von Stengel,1 Matthias Kohl,2 Nicolas Rohleder,3 Thomas Bertsch,4 Cornel C Sieber,5 Ellen Freiberger,5 Robert Kob5
1Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; 2Faculty of Medical and Life Science, University of Furtwangen, Schwenningen, Germany; 3Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; 4Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany; 5Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
Correspondence: Robert Kob
Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, Nuremberg 90408, Germany
Tel +49 911 5302-96624
Fax +49 911 5302-96151
Purpose: Whole-body electromyostimulation (WB-EMS) especially in combination with a high-protein supplementation has been established as an efficient treatment against sarcopenia. However, there are several case reports of rhabdomyolysis after WB-EMS application. Thus, we asked if this training could potentially lead to deteriorations of the cardiac as well as the renal function.
Materials and Methods: One hundred sarcopenic obese men aged 70 years and older were randomly balanced (1-1-1) and allocated to one of the three study arms. During 16 weeks of intervention, these groups either performed WB-EMS and took a protein supplement (WB-EMS&P), solely received the protein supplement (Protein) or served as control group (CG). WB-EMS consisted of 1.5× 20 min (85 Hz, 350 μs, 4 s of strain to 4 s of rest) applied with moderate-to-high intensity while moving. We further generated a daily protein intake of 1.7– 1.8 g/kg/body mass per day. At baseline and 8– 10 days after completion of the intervention, blood was drawn and biomarkers of muscle, cardiac and renal health were assessed.
Results: Hereby, we found slight but significant elevations of creatine kinase (CK) levels in the WB-EMS group pointing to minor damages of the skeletal muscle (140 U/l [81– 210], p < 0.001). This was accompanied by a significant, low-grade increase of creatine kinase–muscle brain (CK-MB, 0.43 ng/mL [− 0.29– 0.96], p < 0.01) and high-sensitivity troponin T (hsTnT, 0.001 ng/mL. [0.000– 0.003], p < 0.001) but without a higher risk of developing heart failure according to N-terminal prohormone of brain natriuretic peptide (NT-proBNP, − 5.7 pg/mL [− 38.8– 24.6], p = 0.17). Estimated glomerular filtration rate (eGFR) was impaired neither by the high-protein supplementation alone nor in combination with WB-EMS (CG 76.0 mL/min/1.73 m2 [71.9– 82.2] vs Protein 73.2 mL/min/1.73 m2 [63.0– 78.9] vs WB-EMS&P 74.6 mL/min/1.73 m2 [62.8– 84.1], p = 0.478).
Conclusion: In conclusion, even in the vulnerable group of sarcopenic obese seniors, the combination of WB-EMS with a high-protein intake revealed no short-term, negative impact on the eGFR, but potential consequences for the cardiovascular system need to be addressed in future studies.
Keywords: electromyostimulation, high protein, sarcopenic obesity, rhabdomyolysis, CK-MB, hsTnT, cystatin C
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]