Abstract
Purpose: Overweight and obesity are an increasing problem worldwide. However, most studies that focus on weight reduction by energy restriction and/or aerobic exercise reported considerable loss of muscle mass as well. Increased protein intake and/or resistance exercise might inhibit this detrimental effect during a negative energy balance. Whole-body electromyostimulation (WB-EMS), a time effective, joint-friendly, and highly customizable training technology, showed similar hypertrophic effects compared with high-intensity resistance training. The aim of this study is to evaluate the effect of WB-EMS on body composition during negative energy balance with maintained/increased protein intake in overweight premenopausal women.Patients and Methods: Ninety premenopausal, 25–50-year-old, overweight women were randomly assigned to three groups (n = 30 each). (1) Negative energy balance (−500 kcal/day) by energy restriction with compensatory protein intake (CG). (2) Negative energy balance (−500 kcal/day) by energy restriction (−250 kcal/day) and increased physical activity (−250 kcal/day) with increased protein intake (PA). (3) Negative energy balance (−500 kcal/day) due to energy restriction and increased physical activity with increased protein intake plus WB-EMS. The duration of the intervention was 16 weeks. Participants underwent restrictions in kcal per days and supplementation of protein (CG: 1.2 or PA/WB-EMS: 1.7 g/kg body mass/day) where needed. Bipolar WB-EMS was applied 1.5× week for 20 min (85 Hz; 350 μs; intermittent 6 s impulse, 4 s rest; rectangular). The primary study endpoint “lean body mass” (LBM) and secondary endpoint body fat mass (BFM) were assessed by bio-impedance analysis (BIA).Results: LBM decreased in the CG and PA group (CG: −113 ± 1,872 g; PA: −391 ± 1,832 g) but increased in the WB-EMS group (387 ± 1,769 g). However, changes were not significant (p > 0.05). Comparing the groups by ANOVA, no significant differences were observed (p = 0.070). However, pairwise adjusted comparisons determined significant differences between WB-EMS and PA (p = 0.049). BFM decreased significantly (p < 0.001) in all groups (CG: −2,174 ± 4,331 g; PA: −3,743 ± 4,237 g; WB-EMS: −3,278 ± 4,023 g) without any significant difference between the groups (ANOVA: p = 0.131).Conclusion: WB-EMS is an efficient, joint-friendly, and highly customizable training technology for maintaining muscle mass during energy restriction and can thus be considered as an alternative to more demanding resistance exercise protocols.
Highlights
IntroductionMore than 2.1 billion people worldwide are overweight or even obese (Smith and Smith, 2016)
Overweight and obesity represent an increasing problem worldwide
The general purpose of the study was to evaluate the effect of Whole-body electromyostimulation (WB-EMS) on body composition, under specific consideration of LBM changes, during negative energy balance, but increased protein intake in overweight 25- to 50-year-old premenopausal women
Summary
More than 2.1 billion people worldwide are overweight or even obese (Smith and Smith, 2016). This development is primarily a health problem for the person affected: overweight and obesity are crucial risk factors for hypertension, fat metabolism disorders, diabetes mellitus type 2, cardiovascular diseases, and some types of cancer (Wilson et al, 2002; Villareal et al, 2005; Renehan et al, 2008). Creating a negative energy balance via pure restriction of calorie intake without looking at the macronutrients seems to result in a loss of lean body mass of up to one third of the total loss of body mass (Miller et al, 1997). There is evidence that supplementation with protein might reduce the loss of muscle mass during energy restriction (Pasiakos et al, 2013, 2015)
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