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Safety of a Combined WB-EMS and High-Protein Diet Intervention in Sarcopenic Obese Elderly Men

Authors Kemmler W, von Stengel S, Kohl M, Rohleder N, Bertsch T, Sieber CC, Freiberger E, Kob R

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

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