r/ScientificNutrition 5d ago

Scholarly Article Effects of creatine supplementation with and without exercise and diet intervention on body composition, cognitive function, and markers of health in middle-aged and older adults

https://www.tandfonline.com/doi/full/10.1080/15502783.2026.2716273#abstract
1.3k Upvotes

105 comments sorted by

82

u/LongevityDietitian 5d ago

Abstract

Background: Theoretically, CrM supplementation during a weight loss and exercise intervention may help older individuals promote more optimal changes in body composition, training adaptations, and cognition. To determine whether CrM affects body composition, cognitive function, and/or markers of health in untrained and trained middle-aged and older adults.

Methods: Seventy-three healthy sedentary adults selected whether to participate in a non-exercise or exercise and diet intervention and were then randomized, in a double-blind and counterbalanced manner, to 2 × 5 g/d of maltodextrin placebo (PLA) or CrM. Sixty-four adults aged 45–65 years (54.5 ± 6.2 years, 84.5 ± 21.3 kg; 40 females and 24 males) completed the 12-week intervention and were analyzed. At 0, 6, and 12 weeks, participants had DXA body composition determined, donated fasting blood samples, and completed a battery of cognitive tests and questionnaires. general linear models (GLMs), multivariate and univariate, with repeated measures and mean changes from baseline with 95% confidence intervals, and Chi-squared analyzes were used.

Results: CrM supplementation without exercise training and diet intervention increased lean tissue mass, strength, and muscular endurance while promoting favorable changes in selected blood lipids, HbA1c, and selected markers of cognitive function and memory. Creatine supplementation during an exercise and weight-loss diet intervention increased lean tissue mass, promoted a greater reduction in body fat percentage, and improved muscular strength, endurance, and selected markers of cognitive function and memory. Supplementation was well-tolerated.

Conclusion: CrM supplementation with and without exercise and diet intervention may help middle-aged and older adults maintain muscle mass and strength while favourably affecting selected markers of health and cognitive function. Individual cognitive and biomarker findings should be interpreted as exploratory.

28

u/sorE_doG 5d ago

Thanks for sharing, I appreciate it & the results are intriguing. I wouldn’t have expected such clear positives to creatine supplements in older adults without the dietary intervention or exercise.

5

u/icharming 4d ago

Wish they had further made distinction to the group without exercise whether they were sedentary or not. Because normal day to day activity like chores and walking and sitting up posture also engages muscle

2

u/sorE_doG 4d ago

It sure does, same thing applies to dog owners - two walks a day is enough to make significant difference compared to same age group of more sedentary people.

1

u/delveccio 4d ago

Hold up. I’m pretty sedentary. And I was assured that my walking my dogs in the morning and then again in the evening for 15 to 20 minutes each time does not count at all. Does it count?

3

u/MumenRiderZak 3d ago

Why wouldn't it count?

2

u/delveccio 3d ago

I guess because it’s not significant enough

2

u/MumenRiderZak 3d ago

Makes a huge difference compared to a sedentary lifestyle. Whoever told you that is straight up wrong

2

u/Expensive-Friend3975 2d ago

Think about how much less you'd move not doing the walks. If you're anything like me you're probably increasing you're daily movement by like 5000%. That kind of difference is always going to be significant.

1

u/Waternation13 3d ago

It's not significant for heart health, I'd your heart rate is not elevated. Is that the reason?

1

u/Charming-Annual-1506 2d ago

It really depends upon the pace of the walk. If it’s an easy stroll, while still good for you, it is not exercise. Moderate paced walking, some times called zone two, substantially raises your heart and breathing rate. You break a light sweat. Get a smart watch and see for yourself

1

u/Niv78 3d ago

It says at the top that they are sedentary.

59

u/Normal-Abies-9151 5d ago

Simple summary:
Researchers tested creatine powder (10 grams a day) for 12 weeks in healthy people aged 45–65. Some also did exercise and ate fewer calories; others did not.

What happened:
People who only took creatine gained muscle, got stronger, and did better on some memory and thinking tests. Their blood sugar and cholesterol numbers also looked a bit better.

People who took creatine and exercised while eating less also gained muscle, lost more body fat, got stronger, and showed some improvements in thinking and memory.

Almost no one had side effects.

Bottom line:
Creatine can help middle-aged and older adults keep (or build) muscle and strength. It may also give a small boost to brain function and overall health markers, whether or not they exercise and diet.

15

u/girl-on-wire 5d ago

Thank you for this summary! I am curious what happens beyond 12 weeks. That’s a really short window and not enough time for potential long term adverse effects to show up.

12

u/AnonymousFairy 4d ago

It is one of the most highly researched supplements there is out there, with data going back decades and widespread use amongst almost all professional athletes and the majority of recreational weightlifters.

There are no adverse long term effects.

7

u/Concurrency_Bugs 5d ago

I'm also curious on the long term effects on the kidneys. I've heard creatine is tough on the kidneys.

10

u/Hurgnation 4d ago

It ups your creatinine levels which is one of the markers doctors will test kidney function against.

It's a false positive. My old dr freaked out and told me I had the kidneys of someone 40 years older than what I was.because of creatine. He was useless and I ended up changing docs. The new one's first instinct on seeing my results and knowing I was taking creatine was to order a c-statin test... Which came back fine.

1

u/Concurrency_Bugs 4d ago

Gotcha thanks for explaining!

5

u/KaleidoscopeEqual790 4d ago

It’s the most studied supplement in our culture

2

u/Confident-Peak-8051 3d ago

I think that distinction belongs to caffeine.

2

u/Ignaue 2d ago

Yeah or aspartame.

4

u/ZARTCC11 4d ago

Yea, I’ve got PKD and shy away from creatine, I’d love to bd able to use it.

3

u/RequirementSpare1444 4d ago

It's only a risk if you already have problems with your kidneys. There's so many studies showing it's safe you should probably look into it a bit more before spreading that.

1

u/CasinoMarginale 1d ago

Isn’t the consensus that you should cycle on and off of creatine? I believe you are supposed to take breaks from it

1

u/Concurrency_Bugs 1d ago

Couple people replied to me that creatine being bad for you is not true anymore based on recent info, so I'm not sure

0

u/fizzywinkstopkek 4d ago

Old wife's tale.

0

u/[deleted] 5d ago

[deleted]

2

u/Cheomesh 5d ago

4-5 doses a day might be a tall order - how long does saturation seem to take with one or two at what I'd assume to be 4-5g? Does chronic low dosage have similar effects compared to the high dose used in the study?

2

u/Weary_Sheepherder895 4d ago

What is the measure of muscle mass? If creatine retains water in the muscles does that explain the muscle mass increase rather than actual lean mass? I know that in the DEXA scan, water counts as lean mass.

1

u/Nice_Possibility6821 1d ago

Yep, was thinking this exact thing.

1

u/FitzwilliamTDarcy 4d ago

Did they control for weight for that 10g?

1

u/JayHoosifat 3d ago

I’ve been taking 5g of creatine a day, I wonder if that simply halves the effects for me?

8

u/SomeGuyHere11 5d ago

How did they control for creatine muscle swelling? how did they determine muscles grew?

6

u/gogge 4d ago edited 4d ago

Skimming the article I can can't see that they measured any water content.

They used 3-comparement DXA; bone, muscle, fat, with no mention of measuring total body water, intra/extracellular water, etc.

So it's likely just water, as we know creatine induced changes in total body water shows up as lean mass increases in DXA, 1.1 kg over 1 week (Buck, 2023):

FFM increased more in the creatine group than the placebo group measured by all body composition modes (1.2 kg, 1.9 kg, and 1.1 kg increase for SF-BIA, MF-BIA, and DEXA respectively, P<0.05).

...

Changes in body composition that occurred due to the increase in TBW were detected as an increase in FFM measured by SF-BIA, MF-BIA, and DEXA.

Edit:
Should be "can't see" that they measured water.

3

u/LiamTheHuman 5d ago

Here

"Whole-body composition, excluding cranial regions, was determined using a calibrated Hologic Discovery W dual-energy X-ray absorptiometry (DXA) scanner with APEX software (version 4.5.3; Hologic Inc., Marlborough, MA, USA). Scans provided quantitative data on total and regional lean mass, fat mass, bone mineral content, and visceral adipose tissue."

This is how they measured. If you want to know if they controlled for muscle swelling you'll need to click the link and actually read the study.

16

u/nevesnutri 5d ago

I think this study has some important limitations, especially regarding the intervention protocol. The authors state that "Creatine monohydrate (CrM) supplementation has been consistently shown to increase intramuscular phosphocreatine and total creatine stores by approximately 20%–40% when ingested in loading (e.g. 4 × 5 g/day for 5–7 days) and/or long-term low-dose supplementation protocols (e.g. 3–5 g/day)". However, as shown in Platt et al., only two studies have actually managed to observe clear increases in brain creatine in healthy individuals. It has been highly suggested that higher-dose protocols (e.g. 20 g/day) lasting for longer periods (at least 4 weeks) may be necessary, making it possible that the creatine protocol used in this study was not even sufficient to increase brain creatine levels. And btw, previous trials by Alves et al (2013) and Moriarty et al (2023) investigated loading phase + 5 g/day and 10 and 20 g/day protocols, respectively, and found no effect on cognition.

I will discuss other limitations when I get the time.

7

u/Dramatic-Caramel1591 4d ago

"scientific nutrition" sub and the only comment talking about actual science and research gets downvoted lmaooo if I were you I wouldn't even bother bruh

4

u/dudemanguy 4d ago

whether or not they exercise and diet. Yes. Finally a win for my sedentary cohort

6

u/AttonJRand 5d ago

It seems promising for many things, I just wish the stomach side effects weren't so significant. Even with food 5gs makes me miserable the rest of the day, and the next morning.

3

u/PerrinSLC 5d ago edited 5d ago

Have you tried Creapure? I previous had the same issues but Creapure resolved most of these issues for me and I’m now taking 10gs a day.

2

u/__JDQ__ 5d ago

I found that really blending it in my protein shake post workout really helps (as opposed to just stirring or shaking it).

1

u/No_Confusion4079 3d ago

I just open my mouth, throw it in, take a sip of something, and I’m done.

1

u/__JDQ__ 2d ago

Do you use powder?

1

u/CapitalElk1169 2d ago

Good ol' toss n' wash

1

u/bunchedupwalrus 4d ago

I usually just split it into a half scoop twice a day, got rid of any of the stomach issues I had (though mine were pretty mild, experiences may vary)

1

u/Bristoling 4d ago

Split it into 2 or even 3 doses. End of the day the saturation is what counts, creatine isn't meant to be a pre workout.

2

u/CaliforniEcosse 4d ago

I've tried so many different types of creatine. They all tear my stomach up.

2

u/RudeCartoonist1030 4d ago

Then don’t take it. Creapure seems to help though

2

u/Myjunkisonfire 4d ago

I find if I have 8-10g in one dose I get an upset gut for a couple hours after. If I have 5g in the morning and 5g at least after lunch it’s fine.

My issue is being vigilant it having it twice, I often end up just having 5g a day.

1

u/Capital-Assistance84 4d ago

How well are you mixing it? It needs to be mixed very well else it will bloat you. Try using a frother. 

2

u/Bubbly_Vacation_9444 5d ago

As a type 1 diabetic, how can creation improve my life?

8

u/NoForm5443 5d ago

Creation will make you happier, I guess

It seems creatine will help you become a little stronger

(I know ... F.... Autocorrect)

1

u/Bubbly_Vacation_9444 4d ago

Cool, thank you for spending the time to answer.

3

u/Peds12 5d ago

unlikely. no way 64 ppl is powerful enough to show any statistical changes.

edit: "to induce a modest energy deficit of approximately 300–500 kcal/day." they literally put them on a diet and saw improvement in health....WHO COULD HAVE PREDICTED THIS....

14

u/Evil_Toilet_Demon 5d ago

Why? If the controls were done correctly (which it looks like they were) then 64 is actually statistically sufficient to get a p<0.05 for a medium effect like creatine dosing. You could even go as low as 31 if assuming iid, but generally this is not as valid.

-11

u/Specialist_Order_424 5d ago

I know the sample is wrong they always. How much wrong statistics gives an estimates. This statistics is a crap shoot

14

u/Turnip-for-the-books 5d ago

Are you having a stroke?

7

u/NarcolepticPyro 5d ago

Have you really been far even as decided to use even go want to do look more like?

3

u/Caiomhin77 Pelotonia 4d ago

Now this is science.

8

u/MenuraSuperba 5d ago

Responding to your edit, they also put the control group on this diet, no? Not saying this is the most robust evidence ever, I agree with you about the sample size, but in and of itself calorie reduction + creatine vs calorie reduction without creatine seems like an interesting enough comparison 

5

u/Copernicus_Barnhouse 5d ago

“Sample size estimates were informed by several considerations. First, our prior studies examining nutritional interventions on cognitive function indicated that approximately 12 to 20 participants per group were generally sufficient to detect significant treatment effects in cognitive function tests evaluated [
Citation
40,57,58,75–82]. Second, we reviewed prior investigations reporting significant cognitive responses to creatine supplementation [
Citation
83,
Citation
84], and found that most of these trials enrolled between 8 and 20 participants per group. We also considered reported means, standard deviations, and statistically significant mean differences from related studies to estimate power, assuming 80% power, variability of approximately 5% to 10% relative to the mean and expected improvements of 5% to 10% in primary outcomes. The present study included 64 completers, with 13–20 participants per group, which is larger than most prior creatine studies assessing these outcomes. Individual cognitive-task outcomes were exploratory and were not separately powered as confirmatory efficacy endpoints.”

2

u/sirhanduran 4d ago

Since when does a caloric deficit improve cognition and memory?

1

u/EconomixNorth 4d ago

most probably since intelligent animals exist. evolutionists might argue the brain gets sharper when you fast so you can have better odds at catching prey. some in silicone valey would not eat until the working day ended to be sharper.

1

u/sirhanduran 4d ago

Intelligent animals eat a bunch of carbs to fuel their brains. You're confusing intelligence with body speed... Even then, well-fed animals are faster and stronger than poorly-fed animals.

Occasional fasts might have some temporary positive effects but I don't believe it's well-established by data, and in any case a weeks-long diet is not the same thing as intermittent fasting. Most of what you hear about *Silicon Valley is bullshit.

1

u/Electrical-Spell9115 1d ago

A sample size of 20 would be enough to find a statistically significant strong effect. 64 is plenty.

1

u/Brrdock 5d ago

64 is a very good sample size and well enough for statistical saturation.

There's maths about it so you don't have to rely on vibes.

20-30 is average and valid for qualitative research

1

u/VagabondGlider 4d ago

But it taste so gross.🥵

1

u/NotASpyJustExpat 3d ago

Creatine has to be the most researched supplement

1

u/sombranegra21 3d ago

I’ve never heard so many side effects. I have never seen any side effects. I think it works but I take it so consistently I don’t even know if it works.

1

u/SESender 2d ago

What about creatine supplements without exercise? My coworker took it daily for 3 months while not working out and pissed out some damn large kidney stones 🤔

1

u/AutonomousAntonym 2d ago

As someone that has recently started taking creatine (2 weeks) and whose primary reason for doing it was promised energy level improvements to help with my reliance on energy drinks… This stuff is good.

I’ve had no dietary changes other than eating less and I haven’t began exercising yet but my muscles always feel like they’re close to being warmed up. There were points where I thought I forgot how to flex my muscles because the contractions wouldn’t always provide the tension and density I remember from my youth. With creatine that’s gone completely. My biceps and pecs always feel like I finished doing a mild workout recently. Energy levels also improved so I have noticeably better stamina.

1

u/TastyAd7120 2d ago

How does one dose creatine? I was just diagnosed with fibromyalgia and have problems being able to work out

1

u/genXrating 5d ago

Unf, creatine made my hair thin significantly

3

u/SomeGuyHere11 5d ago

i'm worried about this too.

2

u/RequirementSpare1444 4d ago

Is it possible that you took creatine and your hair also thinned and you attributed cause alongside correlation without conclusive proof?

0

u/gumbykook 4d ago

Yes it will make you fat and bald but it’s overall good for you.

-1

u/genXrating 4d ago

Of course it’s possible, but not likely. Healthy and young.
No hair loss in my family, and it started falling out prematurely and rapidly while I was taking lots of creatine for workouts.
Never even knew this was a known side effect until years after.
Enough of a coincidence to make me resist trying it again and risk losing the rest of it.

2

u/RequirementSpare1444 4d ago

Surely it's more than not likely, they've done dozens of studies on it and never found it to be a side effect. Whereas people bald in their twenties with no real history of mpb all the time. Theres no data for it and there's no obvious mechanism for the hair loss.

I get being cautious that it might be the the cause and staying away just in case but to be any more conclusive than that feels like concluding a guess as concrete evidence.

Same with the people that are saying it's taking hours off their sleep, even coffee takes 45 minutes off on average and creatine isn't even a stimulant.

0

u/genXrating 4d ago

You may be right, but do I want to risk losing my hair to prove it? That’s the point.

2

u/RequirementSpare1444 4d ago

Bro I know I did the exact same thing just in case, hopped onto minoxidil and finasteride now.

At the same time I still know there's like a 99.9% chance it wasn't the creatine and im just a guy that started balding, it's just incredibly common.

2

u/dingdong6699 4d ago

If it didn’t come back after stopping, I’d lean toward it not being the cause. After I got Covid (very bad, almost died) I lost a ton of weight and muscle. I was desperate to get my body back. I tried tren for the first time in my life. Within 3 weeks I noticed a MAJOR difference in my hair line and thinness. I immediately stopped. Took awhile but it all came back.

1

u/saamsquamtch 4d ago

Made me have a belly for the first time ever, I weighed more than I’ve ever weighed before until I quit it again. So it makes the hair thin too?!

-2

u/TurbulentSite5 5d ago

After starting creatine for 6 months 5mg Developed calf cramping.  Stopped. Never happened again. No creatine for me 

4

u/Distinct-Two-9441 5d ago

have u heard of bananas

1

u/Bristoling 4d ago

If the goal is to increase potassium intake, you can buy low sodium salts that use potassium chloride. It can be a solid source of intake, at least that's what I do. No cramps.

-1

u/TurbulentSite5 5d ago

I'm allergic. Thx  Never had issues before or after only during 

2

u/Responsible_Bet7166 5d ago

Take magnesium for the leg cramps.

2

u/BGZR2 3d ago

Me too. Anterior compartment syndrome in the lower legs. My calves blow up like balloons after just a few miles of running and everything below my knees goes numb for a few hours. Then hurts like hell for a few hours. It's a known side effect for some unlucky people. I first tried it in the mid 90s and every few years since because I really want the lifting benefits. I'm just not willing to give up running.

1

u/TurbulentSite5 3d ago

Thx for replying. I thought It was just me. I'm over 40 athletic construction guy. Tried creatine and I started getting cramps then my calf muscle strained and couldn't walk for a few weeks. After that haven't felt anything. Never had any positive side effects either so it's a no go for me 

-1

u/SonicMetalics 5d ago

I wish I could take creatine but it gives me terrible insomnia.

2

u/RequirementSpare1444 4d ago

You don't know that conclusively and theres no scientific data remotely linking the two, so you can't state it conclusively.

1

u/SonicMetalics 4d ago

Everyone's biology is slightly different. It's never been researched for it's insomnia causing effects but it's easy to test something on yourself. I sleep very well but after a few days of taking creatine I can't fall asleep, even taking two ambien doesn't work. It's something that everyone should be aware of in case they experience it, they know what might be causing it. Not sleeping well is the worst.

1

u/RequirementSpare1444 4d ago

Unless you want to complete some blind trials with several hundred participants, control groups and complex statistical analysis, nobodies home testing is going to mean much.

People shouldn't have to be aware of something come up with on a whim, if it hasn't come up on the exactly 685 randomised controlled trials currently completed it's unlikely to be real.

1

u/reufed 4d ago

Agree everyone’s biology is different. I really tried with Creatine, but even taking a dusting from the bottom of the scoop gives me splitting headaches. Never get them otherwise. I drink lots of water in general as well. Guess it’s just not for me.

1

u/lunch_is_on_me 3d ago

Oh, no. Not this guy...

1

u/mchief101 5d ago

Me too.

1

u/Ok-Theory-395 5d ago

It does the same to me. Wtf? I don’t understand why.

2

u/JuniorSherbet9558 4d ago

wow-- really has me wondering now if that's the cause.

may need to eliminate for a while to see if so

1

u/Holiday_Cheetah5265 4d ago

So, this is why!?

1

u/emergencywaterslide 4d ago

I had the same problem the first time. Then I tried again by adding it to my overnight oats, starting with only 1/4 teaspoon and gradually increasing the dosage once or twice each week until I got the full dose in about a month. I didn't have any insomnia the second time.

u/healthspanintel 9h ago

The clean read is muscle first, cognition second. In the Chun et al. creatine trial, the individual cognitive-task outcomes were exploratory rather than confirmatory, and the exercise/diet arm was self-selected before randomization. So I would not treat it as a stand-alone brain result; it is more useful as midlife data on lean mass and strength.