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Purpose: Our primary purpose was to determine the effect of 12 months of creatine (Cr) supplementation during a supervised resistance training program on properties of bone in postmenopausal women.

Methods: Participants were randomized (double-blind) into two groups: resistance training (3 d[middle dot]wk-1) and Cr supplementation (0.1 g[middle dot]kg-1[middle dot]d-1) or resistance training and placebo (Pl). Our primary outcome measures were lumbar spine and femoral neck bone mineral density (BMD). Secondary outcome measures were total hip and whole-body BMD, bone geometric properties at the hip, speed of sound at the distal radius and tibia, whole-body lean tissue mass, muscle thickness, and bench press and hack squat strength. Forty-seven women (57 (SD, 6) yr; Cr, n = 23; Pl, n = 24) were randomized, with 33 analyzed after 12 months (Cr, n = 15; Pl, n = 18).

Results: Cr attenuated the rate of femoral neck BMD loss (-1.2%; absolute change (95% confidence interval), -0.01 (-0.025 to 0.005) g[middle dot]cm-2) compared with Pl (-3.9%; -0.03 (-0.044 to -0.017) g[middle dot]cm-2; P < 0.05) and also increased femoral shaft subperiosteal width, a predictor of bone bending strength (Cr, 0.04 (-0.09 to 0.16) cm); Pl, -0.12 (-0.23 to -0.01) cm; P < 0.05). Cr increased relative bench press strength more than Pl (64% vs 34%; P < 0.05). There were no differences between groups for other outcome measures. There were no differences between groups for reports of serum liver enzyme abnormalities, and creatinine clearance was normal for Cr participants throughout the intervention.

Conclusions: Twelve months of Cr supplementation during a resistance training program preserves femoral neck BMD and increases femoral shaft superiosteal width, a predictor of bone bending strength, in postmenopausal women.

(C) 2015 American College of Sports Medicine