Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women.

Randomized, placebo-controlled trial in postmenopausal women in Canada enrolled in a supervised resistance-training program. For the creatine arm, 23 participants were randomized and 15 were analyzed at 12 months; mean age was 57 (SD, 6) years.

Creatine monohydrate was given orally at 0.1 g/kg/day for 12 months, split as 0.05 g/kg before and after training sessions, or taken with two meals on nontraining days. It was taken with water, juice, or milk during a fully supervised resistance-training program performed 3 times per week, compared with placebo.

Creatine added to resistance training had a modest positive effect on bone health in postmenopausal women. Compared with placebo, creatine showed a greater preservative effect on femoral neck bone mineral density over 12 months (group-time interaction P < 0.05) and increased femoral shaft subperiosteal width (SPW) (P < 0.05). Other bone outcomes, including total hip, lumbar spine, whole body BMD, bone geometry at other sites, ultrasound measures, lean tissue mass, muscle thickness, and strength, did not differ meaningfully between groups. The intervention was reported to be safe, with no major abnormalities observed.

The analyzed creatine sample was small (n = 15 at 12 months), limiting precision and power. The trial was restricted to postmenopausal women in a supervised exercise setting, which limits generalizability. Most secondary outcomes were null, so the overall effect appears specific rather than broad.