Candow · Medicine and science in sports and exercise 2008 · double-blind randomized controlled trial · n=35

Low-dose creatine combined with protein during resistance training in older men.

Cited 167 times in the scientific literature.

Level 2 - randomized trial

Individual randomized controlled trial

PubMed 18685526 · doi:10.1249/MSS.0b013e318176b310 · record verified 2026-08-26

What was done

Older men aged 59–77 years (n = 35) completed a 10-week resistance training program (3 days per week) and were randomized in a double-blind design to receive one of three supplements on training days: 0.1 g/kg creatine plus 0.3 g/kg protein (CP; n = 10), 0.1 g/kg creatine (C; n = 13), or placebo (PLA; n = 12). Outcomes measured pre- and post-training included lean tissue mass (air-displacement plethysmography), muscle thickness of elbow, knee, and ankle flexors/extensors (ultrasound), bench and leg press strength, and urinary markers of cytotoxicity (formaldehyde), myofibrillar protein degradation (3-methylhistidine, 3-MH), and bone resorption (cross-linked N-telopeptides of type I collagen, NTx).

What was found

Subjects in C and CP combined had greater increases in body mass and total muscle thickness than PLA (P < 0.05). Lean tissue mass increased more in CP (+5.6%) than in C (+2.2%) or PLA (+1.0%; P < 0.05). Bench press strength increased by +25% in CP compared to +12.5% in C and PLA combined (P < 0.05), with no difference between groups for leg press strength. Creatine recipients (C and CP combined) had a 40% decrease in 3-MH compared to a 29% increase for PLA (P < 0.05) and a 27% reduction in NTx versus a 13% increase for PLA (P = 0.05). Changes in urinary formaldehyde did not differ between groups (+24% in each).

Why it matters

This trial indicates that co-supplementing low-dose creatine with protein during resistance training can enhance lean mass and upper-body strength while attenuating muscle protein degradation and bone resorption in older men, without increasing formaldehyde production.

Limits

The total sample size was small (n = 35; 10 to 13 per arm), the duration was limited to 10 weeks, and the study included only older men. Some analyses pooled the creatine arms together rather than testing each arm independently.

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