Abstract
BackgroundSarcopenic 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.MethodsOne-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).ResultsAfter 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).ConclusionModerate-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 numberClinicalTrials.govNCT02857660; registration date: 05/01/2017.
Highlights
Sarcopenic Obesity (SO) is characterized by low lean and high fat mass; i.e. from a functional aspect a disproportion between engine and mass to be moved
Vitamin D supplementation We provided participants of all study arms with cholecalciferol (Taxofit, Cologne, Germany)
Apart from the eligibility criteria-induced low skeletal muscle mass index (SMI) and high point of > 27% body fat (PBF), most of the parameters were representative for cdw German men 70 years+ [42, 43]
Summary
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). There is an ongoing debate as to which of the two parameters, sarcopenia or obesity, dominates the molecular process related to the pro-inflammatory status of SO [5], i.e. which is the cause and which is the effect [5], the optimum therapies for both conditions are still exercise and nutrition [6] With respect to the latter, a considerable amount of research (review in [7,8,9,10,11,12] concentrates on an optimum protein and amino acid intake in the elderly, predominately under the aspect of maintenance of muscle mass (and function). Whole-body electromyostimulation (WB-EMS), an effective, time-efficient, joint-friendly and highly customized further development of the recognized local EMS application predominately applied in therapy [16, 20,21,22,23,24,25,26,27], may be a good choice for older subjects at risk for sarcopenic obesity (SO)
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