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Creatine Supplementation and Lean Tissue
Creatine supplementation in conjunction with resistance training (RT) augments gains in lean tissue mass and strength in aging adults; however, there is a large amount of heterogeneity between individual studies that may be related to creatine ingestion strategies.
Approximately 10% of the adult population ≥60 years of age has sarcopenia , which has a profound negative effect on functional independence and overall quality of life . Several lines of research suggest that sarcopenia is caused by age-related changes in muscle protein kinetics, neuromuscular function and physiology, skeletal muscle morphology, inflammation, and mitochondrial dysregulation . In addition to these cellular and mechanistic changes, insufficient physical activity and nutritional intake also contribute to sarcopenia . Interestingly, dietary intake of creatine, a key component for muscular bioenergetics, decreases with age .
The combination of creatine supplementation and resistance training has the potential to serve as an effective countermeasure to the age-related loss in lean tissue mass and strength, possibly by influencing anaerobic energy metabolism, calcium and glycogen regulation, muscle protein kinetics, inflammation and oxidative stress . However, results from individual studies (n = 20) are mixed, with 10 studies showing beneficial effects on measures of lean tissue mass and/or strength (leg press, chest press) while 10 studies found no greater benefit from creatine vs. placebo (Table 1). Finally, 4 of the 20 studies had participants ingest creatine only on resistance training days. Therefore, these studies were likely unpowered to detect small differences in lean tissue mass and strength (leg press, chest press).
|First Author, Year||Population||Supplement Protocol||Resistance Training||Duration||Outcomes|
|Loading Protocol||Maintenance Dose|
|Lower-Dose/Absolute Studies (≤5 g/day)|
|Alves et al. ||N = 47; healthy women, Mean age = 66.8 years (range: 60–80 years)||CR 20 g/day for 5 days||CR (5 g/day) or PLA||RT = 2 days/wk||24 wks||↔ 1RM strength compared to RT + PLA|
|Aguiar et al. ||N = 18; healthy women; Mean age = 65 years||None||CR (5 g/day) or PLA||RT = 3 days/wk||12 wks||CR ↑ gains in fat-free mass (+3.2%), muscle mass (+2.8%), 1RM bench press, knee extension, and biceps curl compared to PLA|
|Bemben et al. and Eliot et al. ||N = 42; healthy men; age = 48–72 years||None||CR (5 g/day)||RT = 3 days/wk||14 wks||↔ lean tissue mass, 1RM strength|
|Bermon et al. ||N = 32 (16 men, 16 women); healthy; age = 67–80 years||CR 20 g/day for 5 days||CR (3 g/day) or PLA||RT = 3 days/wk||7.4 wks (52 days)||↔ lower limb muscular volume, 1-, 12-repetitions maxima, and the isometric intermittent endurance|
|Brose et al. ||N = 28 (15 men, 13 women); healthy; age: men = 68.7, women = 70.8 years||None||CR (5 g/day) or PLA||RT = 3 days/wk||14 wks||CR ↑ gains in lean tissue mass and isometric knee extension strength; ↔ type 1, 2a, 2x muscle fiber area|
|Deacon et al. ||N = 80 (50 men, 30 women); COPD; age = 68.2 years||CR 22 g/day for 5 days||CR (3.76 g/day) or PLA||RT = 3 days/wk||7 wks||↔ lean tissue mass or muscle strength|
|Eijnde et al. ||N = 46; healthy men; age = 55–75 years||None||CR (5 g/day) or PLA||Cardiorespiratory + RT = 2–3 days/wk||26 wks||↔ lean tissue mass or isometric maximal strength|
|Gualano et al. ||N = 25 (9 men, 16 women); type 2 diabetes; age = 57 years||None||CR (5 g/day) or PLA||RT = 3 days/wk||12 wks||↔ lean tissue mass|
|Gualano et al. ||N = 30; “vulnerable” women; Mean age = 65.4 years||CR 20 g/day for 5 days||CR (5 g/day) or PLA||RT = 2 days/wk||24 wks||CR + RT ↑ gains in 1RM bench press and appendicular lean mass compared to PLA + RT|
|Hass et al. ||N = 20 (17 men, 3 women with idiopathetic Parkinson’s disease); Mean age = 62 years||CR 20 g/day for 5 days||CR (5 g/day) or PLA||RT = 2 days/wk||12 wks||CR ↑ chest press strength, chair rise performance; ↔ Leg extension 1RM, muscular endurance|
|Neves et al. ||N = 24 (postmenopausal women with knee osteoarthritis); Age = 55–65 years||CR 20 g/day for 1 week||CR 5 (g/day) or PLA||RT=3 days/wk||12 wks||CR ↑ gains in limb lean mass. ↔ 1RM leg press|
|Pinto et al. ||N = 27 (men and women); healthy; age = 60–80 years||None||CR (5 g/day) or PLA||RT = 3 days/wk||12 wks||CR ↑ gains in lean tissue mass. ↔ 10 RM bench press or leg press strength|
|Higher-Dose/Relative Studies (>5 g/day)|
|Bernat et al. ||N = 24 healthy men; age = 59 ± 6 years||None||CR (0.1 g/kg/day; ~9.5 g/day) or PLA||High-velocity RT = 2 days/wk||8 wks||↔ muscle thickness, physical performance, upper body muscle strength. CR ↑ leg press strength, total lower body strength|
|Candow et al. ||N = 35; healthy men; age = 59–77 years||None||CR (0.1 g/kg/day; ~8.6 g/day) or PLA||RT = 3 days/wk||10 wks||CR ↑ muscle thickness compared to PLA. CR ↑ 1RM bench press ↔ 1RM leg press|
|Candow et al. ||N = 39 (17 men, 22 women); healthy; age = 50–71 years||None||CR (0.1 g/kg; ~7.7 g/day) before RT, CR (0.1 g/kg; ~8.8 g/day) after RT, or PLA||RT = 3 days/wk||32 wks||CR after RT ↑ lean tissue mass, 1RM leg press, 1RM chest press compared to PLA|
|Candow et al. ||N = 38; healthy men; age = 49–67 years||None||CR (On training days: 0.05 g/kg before and 0.05 g/kg after exercise; total ~9.3 g/day) + 0.1 g/kg/day on non-training days (2 equal doses)||RT = 3 days/wk||12 months||↔ lean tissue mass, muscle thickness, or muscle strength|
|Chilibeck et al. ||N = 33; healthy women; Mean age = 57 years||None||CR (0.1 g/kg/day; ~6.9 g/day) or PLA||RT = 3 days/wk||52 wks||↔ lean tissue mass and muscle thickness gains between groups. ↑ relative bench press strength compared to PLA.|
|Chrusch et al. ||N = 30; healthy men; age = 60–84 years||CR 0.3 g/kg/d for 5 days||CR 0.07 g/kg/day; ~6.2 g/day or PLA||RT = 3 days/wk||12 wks||CR ↑ gains in lean tissue mass. CR ↑ 1RM leg press, 1RM knee extension, leg press endurance, and knee extension endurance. ↔ 1RM bench press or bench press endurance.|
|Cooke et al. ||N = 20; healthy men; age = 55–70 years||CR 20 g/day for 7 days||CR 0.1 g/kg/day or ~8.8 g/day on training days||RT = 3 days/wk||12 wks||↔ lean tissue mass, 1RM bench press, 1RM leg press|
|Johannsmeyer et al. ||N = 31 (17 men, 14 women); healthy; age = 58 years||None||CR 0.1 g/kg/day; ~7.8 g/day or PLA||RT = 3 days/wk||12 wks||CR ↑ gains in lean tissue mass and 1RM strength in men only|
Collectively, results showed that creatine and resistance training increased measures of lean tissue mass by ~1.2 kg and strength (leg press, chest press) more than placebo and resistance training. However, no sub-analyses were performed to determine whether the dosage of creatine used or the frequency of ingestion (i.e., only on resistance training days) influenced measures of lean tissue mass and/or strength. Therefore, the purpose of this review was to (1) perform updated meta-analyses comparing creatine vs. placebo (independent of dosage and frequency of ingestion) during a resistance training program on measures of lean tissue mass and strength, (2) perform meta-analyses examining the effects of different creatine dosing strategies (lower: 5 g/day), with and without a creatine-loading phase (20 g/day for 5–7 days, and (3) perform meta-analyses determining whether creatine supplementation only on resistance training days influences measures of lean tissue mass and strength.
The entry is from 10.3390/nu13061912
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