Friday, May 22, 2015

Lean Mass Advantage of Post- vs. Pre-Workout Creatine Supplementation Confirmed. Older Trainees Benefit Most

As a SuppVersity reader you already know of the post-workout creatine advantage.
I am sure you will remember Jose Antonio's 2013 study on the effect of creatine timing in 19 male recreational bodybuilders (reread the SuppVersity article). The results indicated quite conclusively that taking creatine after the workout is a bit more effective than taking the same amount immediately before the workout.

In view of the fact that the effect did not reach statistical significance and an advantage was only "possible" or "likely", though, the debate about the importance or non-significance of creatine timing is far from being settled.
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The latest evidence that creatine timing counts comes from the University of Regina, where Darren Candow, Emelie Vogt, Sarah Johannsmeyer, Scott Forbes, and Jonathan P. Farthing conducted a
double-blind study that involved older adults (50-71 yrs) who were randomized to one of three groups:
  • Creatine-Before (CR-B: n=15; creatine [0.1g/kg] immediately before resistance training and placebo [0.1g∙kg-1 corn-starch maltodextrin] immediately after resistance training), 
  • Creatine-After (CR-A: n=12; placebo immediately before resistance training and creatine immediately after resistance training) or 
  • Placebo (PLA: n=12; placebo immediately before and immediately after resistance training)
The subjects remained on the respective protocol for 32 weeks. Prior to and following the study, body composition (lean tissue, fat mass; dual energy x-ray absorptiometry) and muscle strength (1-repetition maximum leg press and chest press) were assessed. The habitual dietary intake was evaluated by the means of 3-day dietary records during the first and final week of resistance training and supplementation, but significant and potentially relevant differences were not obeserved.
If you haven't already done so, review the results of J. Antonio's previous creatine timing study in "Creatine Before or After the Workout? Finally the Answer is Here! Study Says: Better Take it After for Mass & Strength" | read more
"Participants followed the same supervised whole-body resistance training program for 32 weeks in the same private laboratory. Training sessions were supervised as previous research has demonstrated greater gains compared to unsupervised training (Mazzetti et al. 2000). Prior to training sessions, but after the supplement was consumed, each participant performed a 5-minute stationary cycling warm-up at a self- selected intensity. Participants completed 3 sets of 10 repetitions to muscle fatigue with 1-2 minutes rest between sets for each exercise at an intensity corresponding to their 10- repetition maximum for each exercise. 
[...The machine-based program included the following exercises] leg press, chest press, lat pull-down, shoulder press, leg extension, leg curl, triceps extension, biceps curl, calf press, back extension and abdominal curl [all were performed in the given order]" (Candow. 2015). 
The participants had to maintain daily training logs where the load, number of sets and repetitions
were recorded. Resistance was increased by 2-10 kg once a participant could complete 3 sets of 10 repetitions to muscle fatigue for an exercise. Once the resistance was increased, participants maintained this load until a subsequent 3 sets of 10 repetitions to fatigue were completed.
Don't overestimate the power of timing: These days it appears as if every quack had his own *whatever* timing regimen of which he claims that it was an innovation that would revolutionize your nutrition regimen. If you look at the actual evidence on protein, nutrient and supplement timing, the "advantage" that may exist are yet hilariously small compared to what most people are missing due to not sticking to their diet and training regimen, forgetting about the importance of rest or not striving to increase the weights progressively. So, unless you've optimized all other areas of your diet and training regimen, it would be foolish to even suspect that "timing" may be what's holding you back.
A comparison of the results of the physical examination before and after the 32-week study shows that there was an increase over time for lean tissue mass and muscle strength and a decrease in fat mass (p<0.05) in all groups.
Figure 1: Only the creatine after (CR-A) group saw significantly greater muscle gains than the placebo group; the difference between before and after supplementation didn't reach stat. significance, though (Candow. 2015).
In that, the subjects who consumed their creatine after the workouts (CR-A) saw significantly greater improvements in lean tissue mass (∆ 3.0 ± 1.9 kg) compared to PLA (∆ 0.5 ± 2.1 kg; p < 0.025). The difference to the creatine before workout (CR-B) group, however, did - just as it was the case in the previously cited study in young trainees by Antonio et al. (2013) - not reach statistical significance, but in view of the fact that the CR-B group didn't saw significantly greater lean mass gains than the placebo group, creatine timing still seems to be more important for older than for young trainees.
Figure 2: The inter-group difference between the strength gains is less pronounced than the one between the mass gains in the creatine before (CR-B) and creatine after (CR-A) groups in this study.
A similar image emerges for the strength gains which were not significantly, but measurable more pronounced in the post-workout supplementation group (Leg Press: CR-B ∆ 36.6 ± 26.6 kg; CR-A ∆ 40.8 ± 38.4 kg; PLA ∆ 5.6 ± 35.1 kg; Chest Press: CR-B ∆ 15.2 ± 13.0 kg; CR-A ∆ 15.7 ± 12.5 kg; PLA ∆ 1.9 ± 14.7 kg; p < 0.025). 
This is by far not the only study which indicates that "Creatine is a potent anti-wheelchair supplement" for your grandpas and grandmas | more
Bottom line: While we do - once again - have evidence of the superiority of post-workout vs. pre-workout supplementation, the difference is too small to say that one would be stupid if he or she took his creatine before instead of after the workout. In view of the importance of lean mass gains in older individuals who are constantly fighting age-induced losses of muscle mass, the small and non-significant advantage of consuming your creatine after, instead of before your workouts is yet still reason enough to at least try to time your creatine intake appropriately.

What I still want to know, though, is taking creatine before and after a workout could not be even more (non-significantly ;-) better | Comment on Facebook!
References:
  • Antonio J, Ciccone V. The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. J Int Soc Sports Nutr. 2013 Aug 6;10(1):36. [Epub ahead of print]
  • Candow, Darren, et al. "Strategic ingestion of creatine supplementation and resistance training in healthy older adults." Applied Physiology, Nutrition, and Metabolism ja.