EFSA thumbs up for creatine & muscle strength in older adults

The article 13.5 claim​​ filed by German chemical firm AlzChem states: “Daily creatine consumption can enhance the effect of resistance training on muscle strength in adults over the age of 55”.​

Daily intake should be at least 3 g and be combined with regular resistance training of moderate intensity.

If authorised by the European Commission, the claim will join one other approved for creatine, which states the ingredient increases physical performance​​ in successive bursts of short-term, high intensity exercise when consumed by adults at a daily dose of at least 3 g.

11 other applications for creatine claims have fallen by the wayside, including that for improved mental attentiveness, physical working capacity at fatigue threshold, muscle function and anaerobic work capacity.  

Pitching products​

Nick Morgan, managing director at UK consultancy Sports Integrated and vice chair for the trade group European Specialist Sport Nutrition Alliance (ESSNA), told us this was “​a good claim, based on good evidence, relevant to an important population group”.​

Asked if the claim was a game changer for the sports nutrition and healthy ageing segment however, he said it was simply a reminder there were ingredients traditionally used in sports nutrition that had much wider applications.

“In truth, we've probably known this for some time with regards to creatine, in addition to the role of protein. The key challenge, of course, is finding the right product, format and positioning for this group, along with the necessary education.​

“As such, I'm not sure it’s a game changer for sports nutrition per se, as in reality this consumer group have a different set of motivations and barriers to use. This is perhaps more about the continued emergence of an active nutrition/healthy ageing segmentation that is a huge opportunity now, and in the future.”​

AlzChem supplies creatine under its trademark Creapure. 

Strength of evidence ​

The company submitted a total of 21 human intervention studies and two meta-analyses in its dossier, which came to EFSA via the Austrian authority.

EFSA’s Dietetic Products, Nutrition and Allergies (NDA) panel said “no conclusions”​ could be drawn from 11 of the studies and either meta-analysis.

However, weighing up the evidence it said overall the human intervention studies provided evidence for an effect of creatine under the proposed conditions of 3 g per day in combination with regular resistance training - three times per week for several weeks - of moderate intensity in over 55s.  

No such effect was seen when similar doses on a weekly basis were given on training days only three times per week, it said. 

Inconsistent assessment?

The managing director of UK consultancy Legal Foods, Dr Mark Tallon, was baffled by the NDA panel's conclusion.

“Although any authorised health claim is great news for industry what we need is consistency in the assessment and treatment of the health claims submissions. Here is a great example of inconsistent analysis by EFSA of the data.” ​

He questioned how EFSA had picked age 55 as the claim wording when of the 21 studies, only ten supported the health benefit, four showed no effect according to EFSA, and of the accepted six papers study populations for five were aged 60.

“As such how did EFSA pick age 55 as being reflective of what the claim wording should be?”​

He also pointed to flaws in the agreed dosage.

Of the six accepted studies three differed from the 3 g minimum finally approved.

“Three of the studies used creatine loading (high multiple daily dose) plus a maintenance phase (single dose/day) yet EFSA picks 3 g as representative of the study data. How?” ​

He added: “Of course we all know creatine is effective in enhancing performance and other beneficial health effects, but if we are to understand EFSA's analysis of data so subsequent submissions can be successful, then we need to see the data that is submitted treated correctly.” ​

The panel accepted the “plausible mechanism” ​put forward by the company.

“In relation to the mechanism by which creatine could exert the claimed effect, the Panel considers that an increase of the creatine phosphate pool in muscle cells following daily consumption of creatine can enhance the ATP [adenosine triphosphate] regeneration rate after intense muscle contractions,”​ the panel wrote in its opinion.

“Creatine consumption in combination with resistance training improves the muscle’s ability to train at higher intensities and this leads to higher muscle strength.”​ 

According the EFSA's register of questions, the authority began work on the dossier​​ last July. 

Article 13.5 claims relate to proprietary and emerging science.

AlzChem, headquartered in Trostberg, has over 1,400 employees and an annual revenue of over €295m across the fields of nutrition, renewable energies, fine chemicals, agriculture and metallurgy.