Creatine Supplementation (3 g/d) and Bone Health in Older Women: A 2-Year, Randomized, Placebo-Controlled Trial

Abstract

Background Creatine supplementation could be a nonexpensive, safe, and effective dietary intervention to counteract bone loss. The aim of this study was to investigate whether long-term creatine supplementation can improve bone health in older, postmenopausal women. Methods A double-blind, placebo-controlled, parallel-group, randomized trial was conducted between November 2011 and December 2017 in Sao Paulo, Brazil. Two hundred postmenopausal women with osteopenia were randomly allocated to receive either creatine monohydrate (3 g/d) or placebo for 2 years. At baseline and after 12 and 24 months, we assessed areal bone mineral density (aBMD; primary outcome), lean and fat mass (through dual X-ray absorptiometry), volumetric BMD and bone microarchitecture parameters, biochemical bone markers, physical function and strength, and the number of falls and fractures. Possible adverse effects were self-reported. Results Lumbar spine (p < .001), femoral neck (p < .001), and total femur aBMD (p = .032) decreased across time; however, no interaction effect was observed (all p > .050). Bone markers, microarchitecture parameters, and the number of falls/fractures were not changed with creatine (all p > .050). Lean mass and appendicular skeletal muscle mass increased throughout the intervention (p < .001), with no additive effect of creatine (p = .731 and p = .397, respectively). Creatine did not affect health-related laboratory parameters. Conclusion Creatine supplementation more than 2 years did not improve bone health in older, postmenopausal women with osteopenia, nor did it affect lean mass or muscle function in this population. This refutes the long-lasting notion that this dietary supplement alone has osteogenic or anabolic properties in the long run. Clinical trial registry Clinicaltrials.gov: NCT: 01472393.

Muscular Atrophy and Sarcopenia in the Elderly: Is There a Role for Creatine Supplementation?

“…This means that creatine alone counteracted a decrease in lean mass that accompanied aging. These positive results were not reproduced in several other studies [58,59], including two recent large trials that included 109 [57] and 170 participants [56] who supplemented creatine for 1 and 2 years, respectively. Therefore, longer term creatine supplementation, if not accompanied by resistance training, seems to have little or no effect on muscle mass.…”

“…In line with the limited effects of creatine on muscle mass, it also appears that creatine supplementation alone does not substantially improve muscle function, although positive effects have been reported in some parameters [49,51,52,53,59,62,63]. More specifically, most [55,56,57,58,62] but not all [51,53] studies showed no effect of creatine supplementation on maximal strength. On the other hand, strong evidence indicates that creatine supplementation can delay muscle fatigue [49,51,59,62,63].…”

“…Several studies have examined the effects of creatine supplementation without exercise training on muscle function and mass. Most of these studies have failed to show a positive effect of long-term (>30 days) creatine supplementation on lean mass [56,57,58,59], although this was not the case in all studies, with some reporting increased lean mass [53,55]. Substantial variation does exist in both dosing protocol (1 g·d −1 to ~20 g·d −1 ) and the length of supplementation (7 days to 2 years), but it is unlikely that these differences alone explain this discrepancy in outcomes.…”

“…Interestingly, Wiroth et al [63] reported that creatine improved performance in sedentary but not trained old men, thereby providing evidence that fitness level might have some influence on the beneficial effects of creatine. In relation to functional tests related to activities of daily living (e.g., timed-stands and timed up-and-go), most [51,55,56,57] but not all [52,53] studies failed to show a positive effect of creatine supplementation alone on functional performance.…”

Beneficial Impact of Semicarbazide-Sensitive Amine Oxidase Inhibition on the Potential Cytotoxicity of Creatine Supplementation in Type 2 Diabetes Mellitus

“…[ 15 ]. Because of ergogenic aids, it represents a popular nutritional supplement for athletes [ 10 , 15 , 17 , 43 ]. Creatine monohydrate and nitrate are prominent supplements used for improving exercise performance [ 44 ].…”