Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis

Abstract

The loss of muscle mass and strength with aging results in significant functional impairment. Creatine supplementation has been used in combination with resistance training as a strategy for increasing lean tissue mass and muscle strength in older adults, but results across studies are equivocal. We conducted a systematic review and meta-analysis of randomized controlled trials of creatine supplementation during resistance training in older adults with lean tissue mass, chest press strength, and leg press strength as outcomes by searching PubMed and SPORTDiscus databases. Twenty-two studies were included in our meta-analysis with 721 participants (both men and women; with a mean age of 57–70 years across studies) randomized to creatine supplementation or placebo during resistance training 2–3 days/week for 7–52 weeks. Creatine supplementation resulted in greater increases in lean tissue mass (mean difference =1.37 kg [95% CI =0.97–1.76]; p<0.00001), chest press strength (standardized mean difference [SMD] =0.35 [0.16–0.53]; p=0.0002), and leg press strength (SMD =0.24 [0.05–0.43]; p=0.01). A number of mechanisms exist by which creatine may increase lean tissue mass and muscular strength. These are included in a narrative review in the discussion section of this article. In summary, creatine supplementation increases lean tissue mass and upper and lower body muscular strength during resistance training of older adults, but potential mechanisms by which creatine exerts these positive effects have yet to be evaluated extensively.

Effects of high-velocity resistance training and creatine supplementation in untrained healthy aging males

“…Following creatine supplementation, both type I and type II fibers exhibit an increase in total PCr and Cr concentrations, however, the greatest accumulation is observed in type II fibers (Casey et al, 1996a;1996b). Mechanistically, creatine may have a beneficial effect on muscle biology by influencing high-energy phosphate metabolism, muscle protein kinetics and inflammation (for reviews see Chilibeck et al, 2017;Gualano et al, 2016;Kreider et al, 2017).…”

“…Creatine supplementation has been reported to increase intracellular osmolarity which may upregulate gene and signaling pathways involved in protein synthesis (for reviews see Candow et al, 2012;Chilibeck et al, 2017). Creatine increases mRNA and protein expression of the myogenic transcription factors myogenin and MRF-4 (Willoughby and Rosene 2003) and increases satellite cell number and myonuclei concentration in muscle fibers following resistance exercise (Olsen et al 2006).…”

“…Another intervention which may have beneficial effects on aging muscle is creatine supplementation. Creatine, a naturally occurring nitrogenous compound found primarily in red meat and seafood, has been shown to increase aging muscle mass, strength, and tasks of functionality when combined with resistance training (for metaanalysis reviews see Chilibeck et al, 2017;Devries and Phillips, 2014). Mechanistically, creatine may influence high-energy phosphate metabolism, muscle protein kinetics and inflammation (for reviews see Chilibeck et al, 2017;Gualano et al, 2016;Kreider et al, 2017).…”

Beyond sports: Efficacy and safety of creatine supplementation in pathological or paraphysiological conditions of brain and muscle

“…Creatine dose ranged from 3 to 5 g/d, with or without a loading dose of 20 g/d for 5 to 7 days. This analysis, too, found that creatine supplementation increased the benefits of a resistance training protocol by improving the increase in lean tissue mass and various measures of muscle strength …”

“…This analysis, too, found that creatine supplementation increased the benefits of a resistance training protocol by improving the increase in lean tissue mass and various measures of muscle strength. 81 Moreover, the authors carried out an extensive discussion of the mechanisms by which creatine may exert its effect. The latter ones include • increase in phosphocreatine, which provides a greater energy charge of the muscle,…”