Creatine improves physical function and body composition in older adults Original paper

In this meta-analysis of randomized controlled studies, creatine with or without exercise improved some measures of muscle strength and lean body mass in older adults, but combining creatine and exercise was generally more effective.

The effects of creatine on physical function in adults who are at risk of functional disability.

The primary outcome was physical function measured using the sit-to-stand test. Secondary outcomes included measures of muscle strength (i.e., handgrip strength, leg press strength, chest press strength) and lean body mass.

A total of 1,076 older adults (aged 44–72).

Some of the participants had chronic health conditions including cardiac disease, chronic obstructive pulmonary disease, peripheral arterial disease, type 2 diabetes, osteoporosis, Parkinson’s disease, chronic kidney disease, osteoarthritis, colorectal cancer, human immunodeficiency virus (HIV), and rheumatoid arthritis.

A meta-analysis of 33 randomized controlled studies was performed.

The studies ranged in duration from 5 days to 32 weeks. A creatine loading dose of 7–20 grams per day for 5–14 days was used in 21 studies. The maintenance dose was 3–20 grams per day or 0.07–0.3 grams of creatine per kilogram of body weight per day. The control intervention was a placebo or no creatine. Some studies combined creatine with exercise: 17 studies used resistance training, 2 used pulmonary rehabilitation, 2 used combined aerobic and resistance exercise, and 1 used whole-body vibration training.

Creatine improved sit-to-stand test performance, bench press strength, handgrip strength, and lean mass, compared with the control.

Creatine increased lean mass with or without exercise, although it increased lean mass more when combined with exercise (+2.8 lb vs. +1.6 lb). Creatine only improve sit-to-stand performance and bench press strength when combined with exercise. Conversely, creatine only improved handgrip strength in studies not involving concurrent exercise.

Subgroup analyses looking at the interaction of creatine with exercise should be viewed with caution, as exercising vs. non-exercising groups often differed in significant ways (e.g., disease status).