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

Abstract

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 m 2 [71.9-82.2] vs Protein 73.2 mL/min/1.73 m 2 [63.0-78.9] vs WB-EMS&P 74.6 mL/min/1.73 m 2 [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.

Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study

“…Nevertheless, the combination of high intense exercise and increased protein doses might lead to negative renal (or cardiac) consequences [80,81]. So far, we have not addressed this issue in FrOST, a recent study we conducted on whole-body electromyostimulation (WB-EMS) and protein supplementation (1.7-1.8 g/kg/body mass/d) generated no negative effects in a similar cohort of men with sarcopenic obesity [82]. Thus, in summary we consider our intervention to be safe and applicable in this cohort of older men with musculoskeletal limitations.…”

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“…However, post-training protein supplements did not demonstrate relevant substances regarding muscle mass increase, in relation to the elderly did not use this supplementation. On the other hand, other studies have observed a significant functional improvement in gait development and muscle strengthening, but not in increasing size and density (KEMMLER et al , 2020) .…”

“…In a study by Kemmler et al (2020), whole-body electrostimulation (WB-EMS), especially in combination with high protein supplements, was identified as an effective treatment for sarcopenia.…”

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“…Studies show that this can be due to an improvement of its mitochondrial bioenergetic profile and decreased oxidative stress (BUONDONNO et al, 2020). Dietary supplementation of BCAAs in humans showed an association between the sea level of isoleucine, leucine and valine with lower risk of dementia; on the other hand the energy deficitprotein can accelerate the loss of muscle mass and its functions and considering the age factor we have what we call sarcopenia, and once diagnosed leads to risks of falls, disability, fragility, loss of independence and increased risk of death (BUONDONNO et al , 2020;KEMMLER et al , 2020) .…”