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Davies TW, Watson N, Pilkington JJ, McClelland TJ, Azzopardi G, Pearse RM, Prowle J, Puthucheary Z. Creatine supplementation for optimization of physical function in the patient at risk of functional disability: A systematic review and meta-analysis. JPEN J Parenter Enteral Nutr 2024; 48:389-405. [PMID: 38417175 DOI: 10.1002/jpen.2607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND The efficacy of creatine replacement through supplementation for the optimization of physical function in the population at risk of functional disability is unclear. METHODS We conducted a systematic literature search of MEDLINE, EMBASE, the Cochrane Library, and CINAHL from inception to November 2022. Studies included were randomized controlled trials (RCTs) comparing creatine supplementation with placebos in older adults and adults with chronic disease. The primary outcome was physical function measured by the sit-to-stand test after pooling data using random-effects modeling. We also performed a Bayesian meta-analysis to describe the treatment effect in probability terms. Secondary outcomes included other measures of physical function, muscle function, and body composition. The risk of bias was assessed using the Cochrane risk-of-bias tool. RESULTS We identified 33 RCTs, comprising 1076 participants. From six trials reporting the primary outcome, the pooled standardized mean difference (SMD) was 0.51 (95% confidence interval [CI]: 0.01-1.00; I2 = 62%; P = 0.04); using weakly informative priors, the posterior probability that creatine supplementation improves physical function was 66.7%. Upper-body muscle strength (SMD: 0.25; 95% CI: 0.06-0.44; I2 = 0%; P = 0.01), handgrip strength (SMD 0.23; 95% CI: 0.01-0.45; I2 = 0%; P = 0.04), and lean tissue mass (MD 1.08 kg; 95% CI: 0.77-1.38; I2 = 26%; P < 0.01) improved with creatine supplementation. The quality of evidence for all outcomes was low or very low because of a high risk of bias. CONCLUSION Creatine supplementation improves sit-to-stand performance, muscle function, and lean tissue mass. It is crucial to conduct high-quality prospective RCTs to confirm these hypotheses (PROSPERO number, CRD42023354929).
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Affiliation(s)
- Thomas W Davies
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Naomi Watson
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - James J Pilkington
- Centre for Bioscience, Manchester Metropolitan University, John Dalton Building, Manchester, UK
| | - Thomas J McClelland
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Giada Azzopardi
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Rupert M Pearse
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - John Prowle
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Zudin Puthucheary
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
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Jaramillo AP, Jaramillo L, Castells J, Beltran A, Garzon Mora N, Torres S, Barberan Parraga GC, Vallejo MP, Santos Y. Effectiveness of Creatine in Metabolic Performance: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e45282. [PMID: 37720119 PMCID: PMC10503229 DOI: 10.7759/cureus.45282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 09/19/2023] Open
Abstract
Using the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this meta-analysis (MA) tried to figure out how well creatine (Cr) improves metabolic performance. We searched Google Scholar, PubMed, and the Cochrane Library to identify relevant randomized clinical trials (RCTs) exploring the various effects of Cr across different age groups compared to a placebo (PLA). We also investigated the synergistic effects of combining other supplements with Cr. In order to emphasize the different ways and sports where Cr has been used in the past years, we found from the selected articles that Cr demonstrated a more pronounced effect during aerobic or anaerobic exercise compared to PLA groups in the studies. Furthermore, in sports that demand significant cumulative energy, such as long-distance races, biking, or triathlons, athletes have observed performance enhancements with Cr supplementation. We also stipulate that Cr enhances resistance training in people over 50 years old and that adding other training supplements, such as β-hydroxy β-methylbutyrate (HMB), synergistically improves training outcomes when combined with Cr. The current MA was based on a thorough analysis of 10 separate studies. When these results were added together, we found that taking Cr supplements demonstrated statistically significant benefits over PLA. In conclusion, the present MA has found evidence that Cr has positive effects on metabolic outcomes for people who consume it.
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Affiliation(s)
| | - Luisa Jaramillo
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | - Javier Castells
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | - Andres Beltran
- General Practice, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | - Neyla Garzon Mora
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | - Sol Torres
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | | | - Maria P Vallejo
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
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Wong SA, Drovandi A, Jones R, Golledge J. Effect of Dietary Supplements Which Upregulate Nitric Oxide on Walking and Quality of Life in Patients with Peripheral Artery Disease: A Meta-Analysis. Biomedicines 2023; 11:1859. [PMID: 37509499 PMCID: PMC10376856 DOI: 10.3390/biomedicines11071859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
This systematic review pooled evidence from randomised controlled trials (RCTs) on the effectiveness of dietary upregulators of nitric oxide (NO) in improving the walking and quality of life of patients with peripheral artery disease (PAD). RCTs examining the effect of dietary upregulators of NO in patients with PAD were included. The primary outcome was the maximum walking distance. Secondary outcomes were the initial claudication distance, the six-minute walking distance, quality of life, the ankle-brachial pressure index (ABI), adverse events and risk of mortality, revascularisation or amputation. Meta-analyses were performed using random effects models. The risk of bias was assessed using Cochrane's ROB-2 tool. Leave-one-out and subgroup analyses were conducted to assess the effect of individual studies, the risk of bias and intervention type on pooled estimates. Thirty-four RCTs involving 3472 participants were included. Seven trials tested NO donors, nineteen tested antioxidants, three tested NO synthase inducers and five tested enhancers of NO availability. Overall, the dietary supplements significantly improved the initial claudication (SMD 0.34; 95%CI 0.04, 0.64; p = 0.03) but not maximum walking (SMD 0.13; 95%CI -0.17, 0.43; p = 0.39) distances. Antioxidant supplements significantly increased both the maximum walking (SMD 0.36; 95%CI 0.14, 0.59; p = 0.001) and initial claudication (SMD 0.58; 95%CI 0.26, 0.90; p < 0.001) distances. The dietary interventions did not improve the physical function domain of the Short Form-36 (SMD -0.16; 95%CI -0.32, 0.00; p = 0.38), ABI or risk of adverse events, mortality, revascularisation or amputation. Dietary NO upregulators, especially antioxidants, appear to improve the initial claudication distance in patients with PAD. Larger high-quality RCTs are needed to fully examine the benefits and risks of these treatments. PROSPERO Registration: CRD42022256653.
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Affiliation(s)
- Shannon A Wong
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Aaron Drovandi
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Rhondda Jones
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
- The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD 4814, Australia
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Creatine Supplementation for Muscle Growth: A Scoping Review of Randomized Clinical Trials from 2012 to 2021. Nutrients 2022; 14:nu14061255. [PMID: 35334912 PMCID: PMC8949037 DOI: 10.3390/nu14061255] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023] Open
Abstract
Creatine supplementation is the most popular ergonomic aid for athletes in recent years and is used for improving sport performance and muscle growth. However, creatine supplementation is not always effective in all populations. To address these discrepancies, numerous studies have examined the use of creatine supplementation for muscle growth. This scoping review aimed to investigate the effects of creatine supplementation for muscle growth in various populations, in which Arksey and O'Malley's scoping review framework is used to present the findings. For this study, we performed a systematic search of the PubMed, Embase, and Web of Science databases for theses and articles published between 2012 and 2021. A manual search of the reference lists of the uncovered studies was conducted and an expert panel was consulted. Two reviewers screened the articles for eligibility according to the inclusion criteria. Methodological quality was assessed using the National Heart, Lung and Blood Institute's (NHLBI's) quality assessment tool. A total of 16 randomized controlled trials (RCTs) were finally included. All the authors extracted key data and descriptively analyzed the data. Thematic analysis was used to categorize the results into themes. Three major themes related to muscle growth were generated: (i) subjects of creatine supplementation-muscle growth is more effective in healthy young subjects than others; (ii) training of subjects-sufficient training is important in all populations; (iii) future direction and recommendation of creatine supplementation for muscle growth-injury prevention and utilization in medical practice. Overall, creatine is an efficient form of supplementation for muscle growth in the healthy young population with adequate training in a variety of dosage strategies and athletic activities. However, more well-designed, long-term RCTs with larger sample sizes are needed in older and muscular disease-related populations to definitively determine the effects of creatine supplementation on muscle growth in these other populations.
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Di Renzo L, Gualtieri P, De Lorenzo A. Diet, Nutrition and Chronic Degenerative Diseases. Nutrients 2021; 13:nu13041372. [PMID: 33923865 PMCID: PMC8072879 DOI: 10.3390/nu13041372] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 12/28/2022] Open
Abstract
Chronic degenerative diseases (CDDs), represented mainly by obesity, cardiovascular disease (CVD), diabetes, chronic kidney disease (CKD), inflammatory bowel diseases, osteoporosis, sarcopenia, neurodegenerative diseases such as Huntington's disease (HD), rheumatoid arthritis (RA), chronic respiratory diseases, and many cancers, have been, up to now, the most frequent causes of prolonged disability and death worldwide [...].
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Affiliation(s)
- Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (P.G.); (A.D.L.)
- School of Specialization in Food Science, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (P.G.); (A.D.L.)
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (P.G.); (A.D.L.)
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