Tuesday, April 28, 2015

Creatine Will Protect Grandpa's Muscle Even if He Doesn't Train!? One More Reason "Everyone" Should Take Creatine

Creatine, the anti-wheelchair supplement?
If you are still looking for reasons to start taking or keep taking creatine monohydrate, I suggest you go on reading. Researchers from the Cardiff and Worcester Universities in the United Kingdom have recently conducted an extensive review of the literature to elucidate whether resistance training and creatine supplementation have an additive effect on muscle structure and function or can older adults receive the same degree of benefit by just partaking in one of these protocols?

Their results are, as the headline of today's SuppVersity article suggests, quite intriguing to say the least.
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You will be aware that the gym is where the anti-sarcopenic (=anti-age-induced muscle loss) magic happens. You will also have read that creatine supplementation can enhance these benefits (learn more | Moon. 2013). And you will have heard that creatine will - next to its beneficial effects on muscle - also have neuro- and atheroprotective effects in the elderly (Wyss. 2002).
Figure 1: Summary table of key studies investigating the effect of creatine supplementation on muscular strength and power, and body composition, in elderly individuals who undertake resistance training (Moon. 2015) | Cr = Creatine. LP = Loading phase. MP = maintenance phase. CLA = Conjugated linoleic acid. CrPr = Creatine and Protein. Pr = Protein. SD = significant difference. NS = no significant difference. — = Not measured. LMV = limb muscular volume. LTM = lean tissue mass..BMC = Bone mineral content. BMD = Bone mineral density.
In Table 2 you can see the overview of combined creatine + resistance training studies, Moon et al. compiled for their latest paper in the Journal of Nutrition and Health Sciences (Moon. 2015). As you can see, the beneficial effects varied from trial to trial, but in general it is safe to say that the combination of creatine and resistance training is a highly effective way to counter the loss of lean body mass, specifically in the weakest study participants ("Chrusch et al. (2001), for example, suggested a possible explanation for their lack of improvement was the initial higher level of upper body strength in the creatine group compared with placebo" | Moon. 2015).
Is creatine dangerous for my grandpa? If your grandpa has normal kidney function, it is very unlikely that he will experience any of the very few confirmed adverse effects confirmed [26], and thus may be both a safe and economical treatment option for elderly. While gastrointestinal disturbances and muscle cramps have been reported occasionally in healthy individuals, the effects are anecdotal. Similarly, the alleged cases of liver and kidney dysfunction have not been observed in any well controlled studies on the adverse effects of exogenous creatine supplemen- tation (Poortmans. 2000). To minimize even the small risk of side effects I would still recommend to stick to 3-5g of creatine monohydrate (preferable tested for purity, like CreaPure) per day.
In view of the previously raised question, whether even creatine alone could produce significant anti-sarcopenic effects, however, other studies are more relevant:
Figure 2: Increased bench press and leg press strength in response to one week supplementation w/ 0.3g/kg creatine monohydrate in thirty 58–71 year old women (Gotshalk. 2008).
"More recently, Gualano et al (2014) divided participants into four groups: a group taking creatine, a resistance trained group, a group supplementing creatine alongside training, as well as a placebo group.

They demonstrated upper limb strength being significantly increased when creatine supplementation was added to resistance training in comparison to all other groups, and interestingly, it was reported that the number of subjects suffering from sarcopenia were reduced in the creatine supplementation groups, with and without exercise, in comparison to placebo groups" (Moon. 2015)
As Ann Moon and her colleagues rightly point out the Gualano study clearly suggests that supplementation alone may be beneficial in reducing muscle loss, even without exercise. Similar benefits have been observed by Goltshalk et al (2002 & 2008). The corresponding study in which the researchers observed significant improvements in dynamic leg strength does yet have to replicated to know for sure whether the effects that would occur with creatine alone would be significant, as well.
Figure 2: Creatine alone can prevent a reduction in muscle mass in postmeno- pausal women aged ≥ 60 years with osteopenia or osteoporosis. The study by Gualano et al. (2014) does yet also indicate that it is (on it's own) not suffi- cient, to build muscle. Interestingly, the same is true for a resistance training in the absence of creatine supplemen- tation (PL+RT) in this subject group.
There is one caveat, however, while creatine alone appears to be sufficient to slow down, if not stall the development of sarcopenia, there is currently "not enough significant evidence to confidently conclude that creatine supplemen-tation increases LBM beyond that of the benefits well-known from a resistance training programme, and not to the same degree as a resistance programme can offer" (Moon. 2015).

In other words, while creatine alone may be better than nothing, it is very unlikely that someone with already established functional limitations would be able to regain his normal physical abilities without proper training; and that despite the fact that studies like Gualano et al. show that creatine alone may suffice to maintain lean mass in postmenopausal women aged ≥ 60 years with osteopenia or osteoporosis and thus one of the groups who are most likely to suffer from sarcopenia  | Comment on Facebook!
References:
  • Gotshalk, Lincoln A., et al. "Creatine supplementation improves muscular performance in older men." Medicine and science in sports and exercise 34.3 (2002): 537-543.
  • Gotshalk, Lincoln A., et al. "Creatine supplementation improves muscular performance in older women." European journal of applied physiology 102.2 (2008): 223-231.
  • Gualano, Bruno, et al. "Creatine supplementation and resistance training in vulnerable older women: A randomized double-blind placebo-controlled clinical trial." Experimental gerontology 53 (2014): 7-15.
  • Moon, Anna, et al. "Creatine supplementation: can it improve quality of life in the elderly without associated resistance training?." Current aging science 6.3 (2013): 251-257.
  • Moon, A., et al. "Creatine Supplementation in the Elderly: is Resistance Training Really Needed." J Nutr Health Sci 2.1 (2015): 103.
  • Wyss, Markus, and Andreas Schulze. "Health implications of creatine: can oral creatine supplementation protect against neurological and atherosclerotic disease?." Neuroscience 112.2 (2002): 243-260.