Creatine Supplementation During Resistance Training Does Not Lead to Greater Bone Mineral Density in Older Humans: A Brief Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 29740583 · doi:10.3389/fnut.2018.00027
What was done
Authors systematically reviewed randomized controlled trials from PubMed and SPORTDiscus evaluating the combined effect of creatine supplementation and resistance training versus resistance training alone on bone mineral density in adults over 50 years of age or postmenopausal. Included trials had a duration of at least 3 months. Meta-analyses were conducted for whole body, hip, femoral neck, and lumbar spine bone mineral density.
What was found
Five trials totaling 193 participants met inclusion criteria. Although two individual studies reported significant benefits, meta-analyses showed no statistically significant effect of creatine plus resistance training compared to resistance training alone on whole body bone mineral density (MD: 0.00, 95% CI -0.01 to 0.01, p = 0.50), hip bone mineral density (MD: -0.01, 95% CI -0.02 to 0.01, p = 0.26), femoral neck bone mineral density (MD: 0.00, 95% CI -0.01 to 0.01, p = 0.71), or lumbar spine bone mineral density (MD: 0.01, 95% CI -0.01 to 0.03, p = 0.32).
Why it matters
Despite interest in creatine for musculoskeletal health in aging, current evidence shows it provides no additional bone density benefit over resistance training alone.
Limits
The total sample size across the meta-analysis was small (193 participants across 5 trials). Included studies had intervention durations as short as 3 months, which may be insufficient to observe meaningful bone mineral density adaptations. The abstract notes a lack of trials lasting over 12 months or utilizing training frequencies of at least 3 times per week.