Effect of Creatine+HMB and Creatine+GAA Supplementation in Presarcopenic and Sarcopenic Individuals

Sarcopenia (SAR) is the loss of strength and muscle mass caused by aging. It is accompanied by a progressive loss of physical and cognitive abilities, increasing the risk of falls. This loss of muscle mass leads to pathophysiological changes at the neuromuscular and tendon level as a consequence of, among others, alterations in the protein synthesis/degradation balance, inflammation (INF), or alterations in the anabolic/catabolic state (EAC). These alterations are caused by oxidative stress (OS), when reactive O2 species, toxic metabolites produced by cells using O2, exceed the defense capacity of the antioxidant mechanism. Therapeutic strategies to modulate SAR are based on exercise and nutrition programs. Multicomponent physical exercise program has shown improvements in sarcopenia-related parameters. Likewise, the use of nutritional supplements such as creatine (CRE) has shown improvements in muscle function in the elderly. CRE could reduce INF and EO in the general population. Guanidinoacetate (GAA, also known as guanidinoacetate acid or glucosamine) is a naturally occurring creatine precursor with advanced transportability and an innovative dietary supplement that may increase the rate of creatine turnover. The CRE-GAA mixture outperforms creatine in increasing brain and muscle performance in adult men and women, but whether this mixture improves muscle function and quality in people with sarcopenia has not been addressed so far. Similarly, whether this mixture may promote oxidative stress and inflammation in adults with sarcopenia has not been studied. Similarly, beta-hydroxy-beta-methylbutyrate (HMB) also appears to improve muscle function in older people by enhancing myogenesis. However, the effects of these supplements on the elderly have only been shown to be seen when used in isolation. In this regard, our research team observed that a 10-week combination of 3 g/day of CRE+3 g/day of HMB (CRE-HMB) improved muscle recovery (better EAC) and physical performance in athletes exposed to heavy muscle wasting. However, not aware that it has been addressed whether this mixture improves muscle function, EO, INF, and EAC in women with SAR. Therefore, the hypothesize would be that the CRE-HMB combination could improve muscle function and physical performance, as well as OE, INF, and EAC in people with high muscle wasting such as those with SAR. Therefore, a randomized double-blind study is proposed to analyze the effect of 12 weeks of co-supplementation of 3 g/day of CRE + 3 g/day of HMB (CRE-HMB) and 3 g/day of CRE and 3 g/day of GAA (CRE-GAA) with 3 sessions/week of multicomponent physical exercise on muscle function, EO, INF, and EAC in 81 women with SAR over 70 years of age. These 81 women will be divided into 3 groups of 27 (27 placebo group, 27 CRE-HMB group, and 27 CRE-GAA group). At the control points (at baseline and after 12 weeks) participants will have their body composition, nutritional intake, strength, and performance tests analyzed. Blood will also be drawn to determine biochemical values of EO, INF, and EAC. The expected results are that co-supplementation with CRE-HMB and CRE-GAA for 12 weeks together with multicomponent physical exercise in individuals diagnosed with SAR will improve muscle strength, muscle quantity, and performance. In addition, improved EO, INF, and EAC levels are expected.