Whole-body electromyostimulation and protein supplementation favorably affect sarcopenic obesity in community-dwelling older men at risk: the randomized controlled FranSO study

Figures & data

Figure 1 Diagram of participant flow through the different study phases.

Abbreviations: EMS, electromyostimulation; FU, follow-up; ITT, intention to treat; WB-EMS&P, whole-body EMS and protein supplementation.

Figure 2 WB-EMS equipment with operator device and electrodes (vest, arm-, leg-, gluteal-cuffs).

Abbreviation: WB-EMS, whole-body electromyostimulation.

Table 1 Baseline characteristics of the FranSO study

Variable	WB-EMS&P (n=33); MV ± SD	Protein (n=33); MV ± SD	CG (n=34); MV ± SD	P-value
Age (years)	77.1±4.3	78.1±5.1	76.9±5.1	0.571
Body height (cm)	170.3±5.0	170.2±5.9	171.5±6.3	0.909
Body weight (kg)	75.8±7.5	76.2±9.0	76.7±9.3	0.584
Soft LBM (kg)a,b	46.3±3.7	46.6±4.6	47.0±4.8	0.799
Sarcopenia (FNIH) (%)c	24	24	26	0.885
Sarcopenia (EWGSOP) (%)d	30	24	26	0.848
Habitual gait velocity (m/s)e	1.26±0.20	1.24±0.16	1.27±0.18	0.857
Number of diseases (n)	2.71±0.76	2.78±0.90	2.56±0.89	0.584
Hip or knee arthrosis (%)	24	29	36	0.560
Number of medications (n)	3.3±1.6	3.5±1.5	3.4±1.7	0.801
LLFDI (index)f	1.52±0.59	1.58±0.56	1.53±0.45	0.193
Physical activity (index)g	4.35±1.48	4.16±1.39	4.68±1.65	0.371
Training volume (min/week)	36±34	35±31	40±34	0.810
Energy intake (kcal/day)h	2,187±474	2,017±704	2,321±679	0.352
Protein intake (g/kg/day)h	1.17±0.33	1.01±0.32	1.21±0.43	0.066
CHO/fat/alcohol (g/kg)h	218/86/20	223/80/20	242/89/19	<0.239

Notes:

a (Soft) lean body mass.

b As determined by BIA (InBody 770, Seoul, Korea).

c According to the Foundation of the National Institutes of Health.¹⁷

d According to the EWGSOP.

e As determined over a 10-m track.¹⁸

f Late Life Function and Disability Instrument²⁵ (scale from [1] “no problem” to [5] “impossible”).

g Scale from (1) very low to (7) very high.²⁴

h As determined by a 4-day dietary record.

Abbreviations: BIA, bioelectrical impedance analysis; CG, control group; CHO, carbohydrates; EWGSOP, European Working Group on Sarcopenia in Older People; FNIH, Foundation of the National Institutes of Health; FranSO, Franconian Sarcopenic Obesity; LBM, (soft) lean body mass; LLFDI, late life function and disability instrument; MV, mean value; SD, standard deviation; WB-EMS&P, whole-body electromyostimulation and protein supplementation.

Table 2 Baseline values and changes of the Sarcopenia Z-Score according to FNIH in the study groups

	WB-EMS&P (n=33); MV (95% CI)	Protein (n=33); MV (95% CI)	CG (n=34); MV (95% CI)	P-value
Sarcopenia Z-Score
Baseline	−1.71 (−1.14 to −2.28)	−1.63 (−1.12 to −2.14)	−2.00 (−1.49 to −2.51)	0.566
Changes	−0.50 (−0.34 to −0.66)***	−0.23 (−0.07 to −0.39)**	−0.04 (−0.12 to 0.20)^ns	<0.001

Notes:

** P<0.01;

*** P<0.001.

Abbreviations: CG, control group; CI, confidence interval; FNIH, Foundation of the National Institutes of Health; MV, mean value; ns, nonsignificant; WB-EMS&P, whole-body electromyostimulation and protein supplementation.

Table 3 Baseline values and changes of secondary study outcomes in the study groups

	WB-EMS&P (n=33); MV (95% CI)	Protein (n=33); MV (95% CI)	CG (n=34); MV (95% CI)	P-value
Total body fat (%)
Baseline	31.6 (30.5 to 32.9)	31.4 (30.4 to 32.4)	31.4 (0.34 to 0.94)	0.967
Changes	−2.05 (−1.40 to −2.68)***	−1.13 (−0.48 to −1.78)***	0.30 (−0.24 to 0.12)^ns	<0.001
SMI (ASMM/BMI)
Baseline	0.709 (0.695 to 0.734)	0.703 (0.681 to 0.723)	0.710 (0.687 to 0.732)	0.730
Changes	0.018 (0.011 to 0.026)***	0.008 (0.001 to 0.015)*	−0.008 (−0.001 to −0.016)*	<0.001
Handgrip strength (kg)
Baseline	33.8 (31.0 to 36.6)	33.3 (31.2 to 35.4)	34.4 (31.1 to 36.6)	0.814
Changes	1.90 (0.99 to 2.82)***	0.90 (−0.03 to 1.83)^ns	−0.35 (−0.56 to 1.25)^ns	0.034

Notes:

* P<0.05;

*** P<0.001.

Abbreviations: ASMM, appendicular skeletal muscle mass; BMI, body mass index; CG, control group; CI, confidence interval; MV, mean value; ns, nonsignificant; SMI, skeletal muscle mass index; WB-EMS&P, whole-body electromyostimulation and protein supplementation.

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