***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Background Human ageing is a process characterized by loss of muscle mass , strength , and bone mass . We aim ed to examine the efficacy of low‐dose creatine supplementation associated with resistance training on lean mass , strength , and bone mass in the elderly . Methods This was a 12‐week , parallel‐group , double‐blind , r and omized , placebo‐controlled trial . The individuals were r and omly allocated into one of the following groups : placebo plus resistance training ( PL + RT ) and creatine supplementation plus resistance training ( CR + RT ) . The participants were assessed at baseline and after 12 weeks . The primary outcomes were lean mass and strength , assessed by dual energy X‐ray absorptiometry ( DXA ) and ten‐repetition maximal tests ( 10 RM ) , respectively . Secondary outcomes included the lumbar spine , right and left femoral neck , both femur and whole body bone mineral density ( BMD ) , and whole body bone mineral content ( BMC ) , assessed by DXA . Results The CR + RT group had superior gains in lean mass when compared with the PL + RT group ( P = 0.02 ) . Changes in the 10 RM tests in bench press and leg press exercises , body composition , BMD , and BMC of all assessed sites did not significantly differ between the groups ( P > 0.05 ) . Conclusions Twelve weeks of low‐dose creatine supplementation associated with resistance training result ed in increases in lean mass in the elderly Purpose To assess the effects of creatine supplementation , associated or not with strength training , upon emotional and cognitive measures in older woman . Methods This is a 24-week , parallel-group , double-blind , r and omized , placebo-controlled trial . The individuals were r and omly allocated into one of the following groups ( n=14 each ) : 1 ) placebo , 2 ) creatine supplementation , 3 ) placebo associated with strength training or 4 ) creatine supplementation associated with strength training . According to their allocation , the participants were given creatine ( 4 x 5 g/d for 5 days followed by 5 g/d ) or placebo ( dextrose at the same dosage ) and were strength trained or not .  Cognitive function , assessed by a comprehensive battery of tests involving memory , selective attention , and inhibitory control , and emotional measures , assessed by the Geriatric Depression Scale , were evaluated at baseline , after 12 and 24 weeks of the intervention . Muscle strength and food intake were evaluated at baseline and after 24 weeks . Results After the 24-week intervention , both training groups ( ingesting creatine supplementation and placebo ) had significant reductions on the Geriatric Depression Scale scores when compared with the non-trained placebo group ( p = 0.001 and p = 0.01 , respectively ) and the non-trained creatine group ( p < 0.001 for both comparison ) . However , no significant differences were observed between the non-trained placebo and creatine ( p = 0.60 ) groups , or between the trained placebo and creatine groups ( p = 0.83 ) . Both trained groups , irrespective of creatine supplementation , had better muscle strength performance than the non-trained groups . Neither strength training nor creatine supplementation altered any parameter of cognitive performance . Food intake remained unchanged . Conclusion Creatine supplementation did not promote any significant change in cognitive function and emotional parameters in apparently healthy older individuals . In addition , strength training per se improved emotional state and muscle strength , but not cognition , with no additive effects of creatine supplementation . Trial Registration Clinical trials.gov Abstract Purpose The present study evaluated the effects of creatine monohydrate ( CrM ) consumption post-exercise on body composition and muscle strength in middle to older males following a 12-week resistance training program  . Methods In a double-blind , r and omized trial , 20 males aged between 55 and 70 years were r and omly assigned to consume either CrM-carbohydrate ( CHO ) [ 20 g days−1 CrM + 5 g days−1 CHO × 7 days , then 0.1 g kg−1 CrM + 5 g CHO on training days ( average dosage of ~8.8 g ) ] or placebo CHO ( 20 g days−1 CHO × 7 days , then 5 g CHO on training days ) while participating in a high intensity resistance training program [ 3 sets × 10 repetitions at 75 % of 1 repetition maximum ( 1RM ) ] , 3 days weeks−1 for 12 weeks . Following the initial 7-day “ loading ” phase , participants were instructed to ingest their supplement within 60 min post-exercise . Body composition and muscle strength measurements , blood collection and vastus lateralis muscle biopsy were completed at 0 , 4 , 8 and 12 weeks of the supplement and resistance training program . Results A significant time effect was observed for 1RM bench press ( p = 0.016 ) , leg press ( p = 0.012 ) , body mass ( p = 0.03 ) , fat-free mass ( p = 0.005 ) and total myofibrillar protein ( p = 0.005 ) . A trend for larger muscle fiber cross-sectional area in the type II fibers compared to type I fibers was observed following the 12-week resistance training ( p = 0.08 ) . No supplement interaction effects were observed . Conclusion Post-exercise ingestion of creatine monohydrate does not provide greater enhancement of body composition and muscle strength compared to resistance training alone in middle to older males PURPOSE To determine whether low-dose creatine and protein supplementation during resistance training ( RT ; 3 d x wk(-1 ) ; 10 wk ) in older men ( 59 - 77 yr ) is effective for improving strength and muscle mass without producing potentially cytotoxic metabolites ( formaldehyde ) . METHODS Older men were r and omized ( double-blind ) to receive 0.1 g x kg(-1 ) creatine + 0.3 g x kg(-1 ) protein ( CP ; n = 10 ) , creatine ( C ; n = 13 ) , or placebo ( PLA ; n = 12 ) on training days . Measurements before and after RT included lean tissue mass ( air-displacement plethysmography ) , muscle thickness ( ultrasound ) of elbow , knee , and ankle flexors and extensors , leg and bench press strength , and urinary indicators of cytotoxicity ( formaldehyde ) , myofibrillar protein degradation [ 3-methylhistidine ( 3-MH ) ] , and bone resorption [ cross-linked N-telopeptides of type I collagen ( NTx ) ] . RESULTS Subjects in C and CP groups combined experienced greater increases in body mass and total muscle thickness than PLA ( P < 0.05 ) . Subjects who received CP increased lean tissue mass ( + 5.6 % ) more than C ( + 2.2 % ) or PLA ( + 1.0 % ; P < 0.05 ) and increased bench press strength ( + 25 % ) to a greater extent than C and PLA combined ( + 12.5 % ; P < 0.05 ) . CP and C did not differ from PLA for changes in formaldehyde production ( + 24 % each ) . Subjects receiving creatine ( C and CP ) experienced a decrease in 3-MH by 40 % compared with an increase of 29 % for PLA ( P < 0.05 ) and a reduction in NTx ( -27 % ) versus PLA ( + 13 % ; P = 0.05 ) . CONCLUSIONS Low-dose creatine combined with protein supplementation increases lean tissue mass and results in a greater relative increase in bench press but not leg press strength . Low-dose creatine reduces muscle protein degradation and bone resorption without increasing formaldehyde production Objectives Creatine and protein supplementation can enhance the training outcomes of young subjects , but it is not clear if there are benefits for older individuals . Therefore , the purpose of this study was to determine the effects of creatine and protein supplementation on strength gains following a traditional resistance training program for middle-aged and older men . Design , Setting , Participants This study assessed changes in strength of men aged 48–72 years following 14 weeks of resistance training supplemented with creatine and /or protein . A double-blind , r and omized , placebo-controlled design placed 42 males into one of four groups : Resistance Trained Placebo ( RTP , n=10 ) ; Resistance Trained Creatine ( RTCr , 5 g Cr , n=10 ) ; Resistance Trained Protein ( RTPr , 35 g whey Pr , n=11 ) ; or Resistance Trained Creatine and Protein ( RTCrPr , 5 g Cr and 35 g Pr , n=11).InterventionAll groups trained 3 days per week for 14 weeks . The resistance training program was based on progressive overload . Training loads corresponded to 80 % 1RM ( one repetition maximum strength ) , 3 sets of 8 repetitions for the following exercises : knee extension/knee flexion ; bicep curl/tricep extension ; military press ; lat pull down ; seated leg press ; and bench press . Measurements 1 RM for each exercise and measures of lean body mass were assessed prior to and following the 14 week program . Results Each group significantly ( p<0.05 ) increased strength and lean body mass , however , there were no significant group effects or group X trial interactions . Conclusion Resistance training in middle-aged and older men significantly increased muscular strength and added muscle mass with no additional benefits from creatine and /or protein supplementation This study examined the effects of long-term creatine supplementation combined with resistance training ( RT ) on the one-repetition maximum ( 1RM ) strength , motor functional performance ( e.g. , 30-s chair st and , arm curl , and getting up from lying on the floor tests ) and body composition ( e.g. , fat-free mass , muscle mass , and % body fat using DEXA scans ) in older women . Eighteen healthy women ( 64.9 ± 5.0 years ) were r and omly assigned in a double-blind fashion to either a creatine ( CR , N = 9 ) or placebo ( PL , N = 9 ) group . Both groups underwent a 12-week RT program ( 3 days week−1 ) , consuming an equivalent amount of either creatine ( 5.0 g day−1 ) or placebo ( maltodextrin ) . After 12 week , the CR group experienced a greater ( P < 0.05 ) increase ( Δ% ) in training volume ( + 164.2 ) , and 1RM bench press ( + 5.1 ) , knee extension ( + 3.9 ) and biceps curl ( + 8.8 ) performance than the PL group . Furthermore , CR group gained significantly more fat-free mass ( + 3.2 ) and muscle mass ( + 2.8 ) and were more efficient in performing submaximal-strength functional tests than the PL group . No changes ( P > 0.05 ) in body mass or % body fat were observed from pre- to post-test in either group . These results indicate that long-term creatine supplementation combined with RT  improves the ability to perform submaximal-strength functional tasks and promotes a greater increase in maximal strength , fat-free mass and muscle mass in older women Aging is associated with lower muscle mass and an increase in body fat . We examined whether creatine monohydrate ( CrM ) and conjugated linoleic acid ( CLA ) could enhance strength gains and improve body composition ( i.e. , increase fat-free mass ( FFM ) ; decrease body fat ) following  resistance exercise training in older adults ( > 65 y ) . Men ( N = 19 ) and women ( N = 20 ) completed six months of resistance exercise training with CrM (5g/d)+CLA ( 6g/d ) or placebo with r and omized , double blind , allocation . Outcomes included : strength and muscular endurance , functional tasks , body composition ( DEXA scan ) , blood tests ( lipids , liver function , CK , glucose , systemic inflammation markers ( IL-6 , C-reactive protein ) ) , urinary markers of compliance ( creatine/creatinine ) , oxidative stress ( 8-OH-2dG , 8-isoP ) and bone resorption ( Ν-telopeptides ) . Exercise training improved all measurements of functional capacity ( P<0.05 ) and strength ( P<0.001 ) , with greater improvement for the CrM+CLA group in most measurements of muscular endurance , isokinetic knee extension strength , FFM , and lower fat mass ( P<0.05 ) . Plasma creatinine ( P<0.05 ) , but not creatinine clearance , increased for CrM+CLA , with no changes in serum CK activity or liver function tests . Together , this data confirms that supervised resistance exercise training is safe and effective for increasing strength in older adults and that a combination of CrM and CLA can enhance some of the beneficial effects of training over a six-month period . Trial Registration . Clinical Trials.gov effect of oral creatine supplementation ( CR ; 5 g/day ) in conjunction with exercise training on physical fitness was investigated in men between 55 and 75 yr of age ( n = 46 ) . A double-blind r and omized placebo-controlled ( PL ) trial was performed over a 6-mo period . Furthermore , a subgroup ( n = 20 ) completed a 1-yr follow-up . The training program consisted of cardiorespiratory endurance training as well as moderate resistance training ( 2 - 3 sessions/wk ) . Endurance capacity was evaluated during a maximal incremental bicycle ergometer test , maximal isometric strength of the knee-extensor muscles was assessed by an isokinetic dynamometer , and 
    Output:
    
These studies suggest that any additive ergogenic creatine effects on upper and /or lower body strength , functional capacity , and lean mass in an older population would require a continuous and daily low-dose creatine supplementation combined with at least 12 weeks of resistance training .
The limited data suggested no additive effects of creatine over exercise alone on indices of mental health .
The beneficial effects of creatine supplementation are more consistent in older women than in men .
Conclusions : Creatine monohydrate is safe to use in older adults .