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Review
, 8, 213-226
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Effect of Creatine Supplementation During Resistance Training on Lean Tissue Mass and Muscular Strength in Older Adults: A Meta-Analysis

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Review

Effect of Creatine Supplementation During Resistance Training on Lean Tissue Mass and Muscular Strength in Older Adults: A Meta-Analysis

Philip D Chilibeck et al. Open Access J Sports Med.

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.

Keywords: age; bench press; exercise; leg press; muscle; nutrition; sarcopenia.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Forest plots for lean tissue mass (A), chest press strength (B), and leg press stress (C). Notes: Some studies presented data on men and women separately, and on creatine and creatine + protein groups separately;, therefore, these studies are entered twice in the meta-analysis for these separate subgroups. One study also presented data on participants who received creatine before versus after resistance training programs; therefore, these subgroups are entered separately in the meta-analysis. Abbreviations: IV, inverse variance; Std, standardized; Cr, creatine.
Figure 1
Figure 1
Forest plots for lean tissue mass (A), chest press strength (B), and leg press stress (C). Notes: Some studies presented data on men and women separately, and on creatine and creatine + protein groups separately;, therefore, these studies are entered twice in the meta-analysis for these separate subgroups. One study also presented data on participants who received creatine before versus after resistance training programs; therefore, these subgroups are entered separately in the meta-analysis. Abbreviations: IV, inverse variance; Std, standardized; Cr, creatine.
Figure 2
Figure 2
Potential mechanisms by which creatine supplementation leads to muscle hypertrophy. Abbreviations: IGF-1, insulin-like growth factor 1; MRFs, myogenic regulatory factors; mTOR, mammalian target of rapamycin; PCr, phosphorylcreatine; ROS, reactive oxygen species; SC, satellite cells.
Figure 3
Figure 3
Forest plots for phosphorylcreatine content in muscle of young and older adults for all studies (A) and for studies of only vastus lateralis (ie, studies of gastrocnemius or tibialis anterior were excluded from the analysis) (B). Notes: One study presented data on men and women separately; therefore, these subgroups are entered separately in the meta-analysis. One study presented data for two different muscle groups; therefore, these are entered separately in the meta-analysis. Abbreviations: IV, inverse variance; Std, standardized; TA, tibialis anterior; VL, vastus lateralis.

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