Nutritional and Physical Intervention During Bed Rest (Bed-Plant)

The Impact of Protein Source and Neuromuscular Electrical Stimulation on Muscle Protein Synthesis During Bed Rest

Hospitalization often involves long periods of bed rest and reduced nutritional intake, which can lead to skeletal muscle loss and anabolic resistance. These effects slow recovery and increase the risk of complications, long-term disability and healthcare costs. Animal-based proteins are effective at stimulating muscle protein synthesis (MPS) because they contain all essential amino acids and have high bioavailability, but they are less sustainable. Plant-based proteins are more environmentally friendly but may be less effective for MPS due to lower essential amino acid content and lower digestibility. Combining different plant proteins may improve their quality, yet their impact during bed rest is still unclear. Neuromuscular electrical stimulation (NMES) may help counteract anabolic resistance by mimicking exercise, but its long-term effects in bedridden individuals are not well studied.

This prospective, randomized, controlled trial aims to assess the effects of a nutritional intervention (plant-dominant versus dairy-based protein) and a physical stimulus (NMES versus non-NMES) on MPS during 4 days of bed rest in healthy young adults.

Study Overview

• Status: Not yet recruiting
• Conditions: Muscle Protein Synthetic Response to Protein
• Intervention / Treatment: Dietary supplement: Nutritionally complete tube feed providing a sole source of nutrition with a plant-dominant protein mix; Device: Neuromuscular Electrical Stimulation (NMES); Dietary supplement: Nutritionally complete tube feed providing a sole source of nutrition with an animal-based protein mix

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Michèlle Hendriks; Phone Number: +31 43 388 1184; Email: michelle.hendriks@maastrichtuniversity.nl

Study Locations

• Netherlands
  • Maastricht, Netherlands, 6200 MD
    • Maastricht University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Healthy (assessed based on routine medical questionnaire)
• Male and female sexes
• Aged between 18 and 35 years inclusive
• BMI between 18.5 and 30.0 kg/m²

Exclusion Criteria:

• Vegan diet
• Allergies or intolerance to cow's milk products, fish, soy, and/or pea protein
• Galactosemia
• Smoking on a weekly basis (i.e., every week)
• Diagnosed diabetes mellitus
• Chronic corticosteroid use
• Severe kidney and/or liver failure
• Dialysis
• Bleeding disorders, including anticoagulant and antiplatelet therapy
• Currently pregnant

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Plant-dominant proteins	Dietary supplement: Nutritionally complete tube feed providing a sole source of nutrition with a plant-dominant protein mix; Containing plant-based proteins.; Device: Neuromuscular Electrical Stimulation (NMES); The protocol will consist of a warm-up period (5 min), a stimulation period (30min), and a cooling-down period (5min).
Active Comparator: Animal-based proteins	Device: Neuromuscular Electrical Stimulation (NMES); The protocol will consist of a warm-up period (5 min), a stimulation period (30min), and a cooling-down period (5min).; Dietary supplement: Nutritionally complete tube feed providing a sole source of nutrition with an animal-based protein mix; Containing animal-based proteins.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle protein synthesis rate	Muscle protein synthesis rate after 4 day exclusive enteral tube feeding that is nutritionally complete with plant-dominant proteins versus animal-based proteins. This is measured using the deuterated water (2H2O) method.	1-4 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle protein synthesis rate	Muscle protein synthesis rate after NMES versus non-NMES. This is measured using the deuterated water (2H2O) method.	1-4 days
Muscle fiber size in µm²	Muscle fiber size will be assessed using immunofluorescence staining.	Final intervention day (after 4 days of enteral feeding and 4 days of NMES)
Proportion (%) of muscle fiber types (type I and type II)	Fiber proportion will be assessed using immunofluorescence staining.	Final intervention day (after 4 days of enteral feeding and 4 days of NMES)
Myonuclei quantity	Myonuclei quantity will be assessed using immunofluorescence staining.	Final intervention day (after 4 days of enteral feeding and 4 days of NMES)
Mitochondrial Respiratory Capacity in Human Skeletal Muscle Assessed by High-Resolution Respirometry	Mitochondrial respiratory capacity will be quantified in skeletal muscle fibers using high-resolution respirometry (Oroboros O2k FluoRespirometer). Measurements will include oxygen flux rates across defined respiratory states.	Final intervention day (after 4 days of enteral feeding and 4 days of NMES)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Age in years	Heteroanamnesia	Baseline
Body mass in kg	Heteroanamnesia	Baseline
Height in m	Heteroanamnesia	Baseline
BMI in kg/m²	Calculated from height and body mass	Baseline

Collaborators and Investigators

• Sponsor: Maastricht University Medical Center
• Collaborators: Danone Global Research & Innovation Center

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2026
• Primary Completion (Estimated): January 1, 2028
• Study Completion (Estimated): January 1, 2029

Study Registration Dates

• First Submitted: November 20, 2025
• First Submitted That Met QC Criteria: December 10, 2025
• First Posted (Actual): December 12, 2025

Study Record Updates

• Last Update Posted (Actual): December 12, 2025
• Last Update Submitted That Met QC Criteria: December 10, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Keywords: NMES; muscle biopsy; tracer methodology
• Other Study ID Numbers: METC 25-020

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No