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Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults
Abstract
Creatine supplementation in conjunction with resistance training (RT) augments gains in lean tissue mass and strength in aging adults; however, there is a large amount of heterogeneity between individual studies that may be related to creatine ingestion strategies. Therefore, the purpose of this review was to (1) perform updated meta-analyses comparing creatine vs. placebo (independent of dosage and frequency of ingestion) during a resistance training program on measures of lean tissue mass and strength, (2) perform meta-analyses examining the effects of different creatine dosing strategies (lower: ≤5 g/day and higher: >5 g/day), with and without a creatine-loading phase (≥20 g/day for 5–7 days), and (3) perform meta-analyses determining whether creatine supplementation only on resistance training days influences measures of lean tissue mass and strength. Overall, creatine (independent of dosing strategy) augments lean tissue mass and strength increase from RT vs. placebo. Subanalyses showed that creatine-loading followed by lower-dose creatine (≤5 g/day) increased chest press strength vs. placebo. Higher-dose creatine (>5 g/day), with and without a creatine-loading phase, produced significant gains in leg press strength vs. placebo. However, when studies involving a creatine-loading phase were excluded from the analyses, creatine had no greater effect on chest press or leg press strength vs. placebo. Finally, creatine supplementation only on resistance training days significantly increased measures of lean tissue mass and strength vs. placebo.
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“Muscle creatine levels are typically lower in vegetarians [15–17] and the elderly who may not consume as much meat or seafood in their diet due to difficulty digesting these food products [18,19].”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [18]
In the citing paper
“there is substantial evidence that CrM (≥3 grams/day) and resistance training increases whole-body lean mass (primarily determined using dual energy x-ray absorptiometry) by ~1.2 kg more than resistance training alone in healthy, non-frail older adults [18,91,94–97,102].”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [18]
In the citing paper
“A 2021 meta-analysis review showed that a CrM loading phase (i.e. 20 grams/day for 5–7 days) followed by a CrM maintenance phase of >5 grams/day produced significant improvements in lower-body strength (SMD: 0.29; 95% CI: 0.04 to 0.54; p = 0 0.02) in older adults (n = 426).”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [18]
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“CrM consistently improves chest press and/or bench press strength [18,90,91,93–97] compared to resistance training alone”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [18]
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“Several meta-analyses have been performed showing that the combination of CrM (≥5 grams/day) and resistance training improves measures of muscle strength [18,90–92], a key factor in the diagnosis of sarcopenia in older adults.”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [18]
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Kreider, R. B., Jäger, R., & Purpura, M. (2022) · Nutrients · doi:10.3390/nu14051035 · Cited by 103
Burke, R., Piñero, A., Coleman, M., Mohan, A., Sapuppo, M., Augustin, F., Aragon, A. A., Candow, D. G., Forbes, S. C., Swinton, P., et al. (2023) · Nutrients · doi:10.3390/nu15092116 · Cited by 80
Self-citationdos Santos, E. E. P., de Araújo, R. C., Candow, D. G., Forbes, S. C., Guijo, J. A., de Almeida Santana, C. C., Prado, W. L. D., & Botero, J. P. (2021) · Nutrients · doi:10.3390/nu13113757 · Cited by 60
Self-citationCreatine monohydrate supplementation for older adults and clinical populations
Candow, D. G., Ostojic, S. M., Chilibeck, P. D., Longobardi, I., Gualano, B., Tarnopolsky, M. A., Wallimann, T., Moriarty, T., Kreider, R. B., Forbes, S. C., et al. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2534130 · Cited by 43
Self-citationAntonio, J., Brown, A. F., Candow, D. G., Chilibeck, P. D., Ellery, S. J., Forbes, S. C., Gualano, B., Jagim, A. R., Kerksick, C., Kreider, R. B., et al. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2024.2441760 · Cited by 33
Self-citationCreatine O'Clock: Does Timing of Ingestion Really Influence Muscle Mass and Performance?
Candow, D. G., Forbes, S. C., Roberts, M. D., Roy, B. D., Antonio, J., Smith-Ryan, A. E., Rawson, E. S., Gualano, B., & Roschel, H. (2022) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2022.893714 · Cited by 28
Self-citationSamadi, M., Askarian, A., Shirvani, H., Shamsoddini, A., Shakibaee, A., Forbes, S. C., & Kaviani, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19137992 · Cited by 15
Self-citationEffects of Supplementation in Masters Athletes and Older Adults: A Narrative Review
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Metadata
- Authors
- Forbes, S. C., Candow, D. G., Ostojic, S. M., Roberts, M. D., & Chilibeck, P. D.
- Affiliations
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB R7A6A9, Canada
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4SOA2, Canada
- Applied Bioenergetics Lab, Faculty of Sport and Physical Education, University of Novi Sad, Lovcenska 16, 21000 Novi Sad, Serbia
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK S7N 5B2, Canada
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2021-06-02
- Volume
- 13
- Issue
- 6
- Pages
- 1912
- ISSN
- 2072-6643
- Cited by
- 79
- References
- 27
- Language
- en
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