GAA and creatine for elderly

New paper in Ann Nutr Metab
The objective of this pilot trial was to evaluate the effects of 8-week GAA-creatine supplementation versus placebo on skeletal muscle and brain creatine levels, cognitive function, functional outcomes, and safety biomarkers in men and women aged 65 years and older. We found that the mixture was significantly superior to placebo to improve gait speed test, 5XSST, and TUGT performance at post-administration. No differences were observed between treatment groups for safety biomarkers, except for increased serum creatinine after GAA-creatine intake comparing to placebo; no participants experienced clinically significant creatinine rise. Read the full paper here.

Annals of Nutrition and Metabolism
Guanidinoacetate-Creatine Supplementation Improves Functional Performance and Muscle and Brain Bioenergetics in the Elderly: A Pilot Study

During the past 2 decades or so, the scientific community continues to scrutinize various nutritional strategies aimed to attenuate aging-associated impairments in functional abilities and cognition. From individual micronutrients and nonnutrients to complete dietary interventions, previous studies identified several food components that might support healthy aging and reduce age-relateddisorders [1]. One purported candidate is creatine, which has been shown to have promise on improving disorders associated with skeletal muscle and brainaging [2]. However, several factors seem to limit the effectiveness of dietary creatine as a therapeutic intervention in the elderly, including restraints in transport-mediated kinetics or finite storagecapacity [3]. Guanidinoacetate (GAA, also known as guanidinoacetic acid or glycocyamine) is a naturally occurring creatine precursor with advanced transportability and an innovative dietary supplement that might increase the rate of creatine turnover. GAA-creatine mixture was found to outperform creatine in boosting brain and muscle performance in adult men andwomen [4], yetwhetherthis mixture facilitates tissue bioenergetics, and cognitive and functional performance in the elderly remains unaddressed so far. The objective of this pilot trial was to evaluate the effects of 8-week GAA-creatine supplementation versus placebo on skeletal muscle and brain creatine levels, cognitive function, functional outcomes, and safety biomarkers in men and women aged 65 years and older.

In this randomized controlled trial conducted in older men and women, co-administration of GAA and creatine resulted in significantly improved concentrations of the brain and muscle creatine, and functional mobility outcomes at 8-week follow-up compared with a placebo intervention. Our results largely confirm the findings from a recent human trial that demonstrated improved muscular performance and tissue bioenergetics with supplemental GAA-creatine when compared with creatine alone [4]. Interestingly, the mixture-driven augmentation of creatine levels in the skeletal muscle (also across the brain) in the elderly appears to be superior compared to younger counterparts in a previous study. This implies a possible age-specific response to the treatment, with the elderly may be more sensitive to GAA-creatine intervention due to lower levels of tissue creatine and/or favorable transport kinetics. A 3T phosphorus MRS (31P-MRS) is generally accepted as a gold standard for evaluating sources of metabolic energy, with increased sensitivity to changes [5]. We used here 1.5 T 1H-MRS yet no significant differences in the metabolite ratios were found between the 2 field strengths in the past studies [6], with1H-MRS remains the major clinically applied method in neurospectroscopy as it provides relevant information on metabolic activecompounds [5]. Although more studies are needed to corroborate our preliminary findings, GAA-creatine might be recognized as a nutritional intervention with the potential to tackle compromised tissue bioenergetics and functional impairments associated with aging.

Statement of Ethics
The study was conducted according to the guidelines of the Declaration of Helsinki. The ethical approval to conduct the study was granted by the local IRB at the University of Novi Sad (# 46-06-01/2020-1-CREGAAS). Informed consent was obtained from all participants.