Creatine & Resistance Training: Combat Sarcopenia Safely

A recent study published in the journal Frontiers in Physiology recommends combining resistance exercise with creatine supplementation as a safe and effective technique for preventing and treating sarcopenia.

Sarcopenia is an age-related musculoskeletal disorder marked by decreased functional capacity, muscle strength, and lean mass. It can have negative consequences, such as a reduced quality of life and impaired physical function, and it is also linked to cognitive decline in older people. Sarcopenia is reversible, and its prevalence rises with age. There are a variety of non-pharmacological therapies available to slow the progression of sarcopenia in older persons.

Physically inactive and sedentary older persons had a decreased myofibrillar protein synthesis response to dietary protein, hastening sarcopenia progression. Furthermore, muscle anabolic resistance due to age becomes more prominent with moderate/low protein consumption, which is a common dietary pattern in older adults. The study underlines the importance of consuming at least 1.0 g of protein per kilogram of body weight on a daily basis, which includes critical amino acids like leucine. In this perspective, the current study recommends combining resistance exercise with creatine supplementation as a successful technique for treating and preventing sarcopenia.

Creatine: Essential for Vitality

The skeletal muscle contains around 95% of creatine, with the remainder located in tissues with high energy demands. It occurs naturally in meat, poultry, and fish and is produced via reactions in the brain and liver. A 70-kg male’s creatine requirement is estimated to be around 2 g per day. Nonetheless, evidence suggests that endogenous creatine production may be insufficient in pathological or certain physiological situations.

Creatine monohydrate became popular as a dietary supplement in Europe and the United States (US) after a major study in 1992. It is permitted for use in dietary supplements in a number of countries, including Brazil, Australia, Canada, Japan, the European Union, and South Korea. Creatine monohydrate has been shown in studies to be both effective and safe for humans and the elderly.

Creatine monohydrate supplementation can safely increase exercise capacity and training responses, regardless of age, gender, or exercise interventions. Supplementation strategies, such as an initial loading phase of 20 g/day for 5-7 days, followed by a maintenance dose of 3-5 g/day, have consistently improved muscle performance and lean body mass. Increasing intracellular creatine levels through supplementation stimulates satellite cell activation, lowers protein breakdown, and boosts lean mass.

Creatine supplementation improves cellular bioenergetics, which affects not only musculoskeletal tissue but also the immune system, vascular system, brain, and heart. Furthermore, studies indicate that when creatine supplementation is paired with resistance exercise, the results can be clinically meaningful. Recent data suggests that creatine may have a function in treating neurodegenerative disorders, while further research is needed to standardize clinical assessments.

Resistance Training

Resistance training is a type of strength training that uses various external pressures to improve physical ability. It has numerous physical benefits, including increased endurance, power, muscle strength, and bone mineral density. Clinically, resistance exercise improves functionality, promotes cardiometabolic health, and aids in the prevention of mental health concerns and neurodegenerative illnesses.

Existing standards prescribe resistance training at least twice a week, with training intensities ranging from moderate to intense, and programs should include progressive weight training, with up to ten exercises targeting key muscle groups and 8-12 repetitions each. To maximize advantages in older persons, research suggests that resistance training should involve multi-joint motions as well as power/explosive training. Recent research has demonstrated that both high- and low-frequency resistance training can successfully enhance skeletal muscle mass, strength, and quality in elderly females with sarcopenia.

Benefits of Resistance Training and Creatine Supplementation

Creatine supplementation during resistance exercise can help to preserve both physical and mental capacities, as well as reduce sarcopenia and its associated hazards. For example, a recent meta-analysis discovered that creatine supplementation during weight training resulted in roughly 1.4 kg more lean mass increases than resistance training alone. Recent studies have also investigated creatine’s possible cognitive benefits, albeit more research is needed to identify the underlying mechanisms. Previously, the authors discovered potential biological regulators that mediate the effects of creatine supplementation.

They discovered that cellular allostasis is heavily reliant on the creatine kinase/phosphocreatine system, which is required to maintain the balance of cellular mechanics and subcellular energy generation. This dependency was clinically demonstrated in cerebral high-energy phosphates, processing speed, and cognitive performance following a large dosage of creatine monohydrate during sleep deprivation. Furthermore, one study suggested that creatine may function as a neurotransmitter. These findings point to a possible role for creatine supplementation in addressing age-related cognitive decline, albeit standardized testing measures are required to validate these effects.

Conclusion

In conclusion, creatine supplementation paired with resistance exercise is an effective and safe method of treating sarcopenia. Creatine monohydrate supplementation during a resistance training program boosts strength and lean mass in older individuals when compared to resistance training alone or a placebo, independent of dose or frequency. Public health initiatives should promote creatine-rich diets, such as fish and meat, as well as accessible resistance training programs designed for older persons. As a result, the authors advocate implementing public health efforts that encourage the consumption of creatine-rich foods in the diet.

For more information: Bonilla, D. A., Stout, J. R., Candow, D. G., Daniel, J., M., L., Forbes, S. C., Ostojic, S. M., & Kreider, R. B. (2024). The power of creatine plus resistance training for healthy aging: Enhancing physical vitality and cognitive function. Frontiers in Physiology, 15, 1496544. DOI: 10.3389/fphys.2024.1496544, https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2024.1496544/full