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 to 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 1.5x week for 20 min (85 Hz; 350 mus; 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). RESULT(S): 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(S): 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.

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