Creatine Without Exercise: The 2026 Middle-Age Trial

Table of Contents

1. 1. Who Did the Study and How
2. 2. The Four Groups, the Exercise and the Diet
3. 3. Lean Tissue and Body Fat
4. 4. Strength, Endurance, Visceral Fat and Bone
5. 5. Memory, Attention and Mood (Exploratory)
6. 6. Blood Markers and Kidney Tests
7. 7. How Creatine Works, in Plain Language
8. 8. Press Release Versus Paper
9. 9. Earlier Research in Context
10. 10. Limits, Funding and What Remains Unknown
11. Key Research Papers
12. Connections

1. Who Did the Study and How

The paper is Chun J, Liu Y, Kibler GL, Lee H, Babakhani K, Rhoades N, Bivins I, Ko J, Dickerson B, Gonzalez DE, Sowinski RJ, Rasmussen CJ and Kreider RB, “Effects of creatine supplementation with and without exercise and diet intervention on body composition, cognitive function, and markers of health in middle-aged and older adults,” Journal of the International Society of Sports Nutrition 2026, volume 23, supplement 1, article 2716273. It is open access through PubMed Central. PubMed indexes it as a randomized controlled trial.

Who took part

• Healthy, sedentary, community-dwelling adults aged 45 to 65.
• 73 people were randomized; 64 completed the study and were analysed.
• The completers’ average age was 54.5 ± 6.2 years and average weight 84.5 ± 21.3 kg (about 186 lb). There were 40 women and 24 men.

What was randomized and what was not

This point matters for reading every result. Whether a participant exercised was self-selected, not randomized. People chose the exercise stratum or the no-exercise stratum. Within each stratum, the choice of creatine or placebo was randomized, double-blind (neither participants nor researchers knew who got which) and counterbalanced. Comparisons of creatine against placebo inside one stratum therefore rest on randomization. Comparisons across strata, such as the no-exercise creatine group against the exercise placebo group, do not.

Supplement and timing

• Creatine group: two 5 g servings of creatine monohydrate a day, 10 g/day in total.
• Placebo group: two 5 g servings of maltodextrin (a carbohydrate powder) a day.
• Duration: 12 weeks, with testing at weeks 0, 6 and 12.

What was measured

• Body composition by DXA (dual-energy X-ray absorptiometry), which separates fat, bone and “lean tissue.”
• Strength as one-repetition maximum (1RM) on the leg press and bench press.
• Aerobic capacity (VO₂peak) and time to exhaustion on a treadmill.
• A computerized battery of memory, attention and reaction-time tests, plus mood questionnaires.
• Fasting blood tests, including lipids, HbA1c, homocysteine, creatinine and estimated kidney function (eGFR).

The data were analysed with general linear models. The authors state that the individual cognitive and blood-marker outcomes were exploratory, that the study was not powered for them, and that they were not adjusted for multiple comparisons.

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2. The Four Groups, the Exercise and the Diet

• NoEx+PLA — no exercise programme, placebo: 13 completers (9 women).
• NoEx+CrM — no exercise programme, creatine 10 g/day: 13 completers (7 women).
• Ex+PLA — exercise programme, placebo: 18 completers (10 women).
• Ex+CrM — exercise programme, creatine 10 g/day: 20 completers (14 women).

The exercise programme

The exercise groups did supervised resistance training plus aerobic training three times a week for 12 weeks. Each session included about 20 minutes of aerobic work at 60–80% of heart-rate reserve. On other days participants had a target of 10,000 steps a day.

The diet, and an inconsistency in the paper

The diet described in the Methods is an energy deficit of about 300–500 kcal a day, with targets of 1,200–1,600 kcal a day split 55% carbohydrate, 15% protein and 30% fat.

The paper is not consistent about who followed it:

• The Methods say “All participants followed a diet plan.”
• The title says “with and without exercise and diet intervention,” and the groups are labelled as no exercise and diet intervention.
• The Results say energy intake “decreased in the exercise and diet groups, whereas [it was] maintained in the no-exercise or no-diet groups.”

Taken together, the most likely reading is that the no-exercise groups had no structured exercise and no diet change. The paper does not state this cleanly, so this page treats the diet status of the no-exercise groups as unclear.

What people actually ate

The paper reports that “Energy and carbohydrate intake in the NoEx+CrM group was significantly greater than in the remaining groups.” Average protein intake across participants was low, 74.3 g a day (0.94 g per kg of body weight). The higher energy intake in the no-exercise creatine group is a possible confounder for that group’s lean-tissue result.

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3. Lean Tissue and Body Fat

Results are mean change from baseline with the 95% confidence interval in brackets. A confidence interval that does not cross zero means the change was unlikely to be chance alone.

Lean tissue (DXA)

• NoEx+CrM: +0.99 kg [0.2, 1.8] at 6 weeks; +1.1 kg [0.2, 2.0] at 12 weeks (about 2.4 lb).
• Ex+CrM: +1.69 kg [1.0, 2.4] at 6 weeks; +1.27 kg [0.56, 1.98] at 12 weeks (about 2.8 lb).
• NoEx+PLA: −0.09 kg at 6 weeks; −0.16 kg at 12 weeks.
• Ex+PLA: −0.11 kg at 6 weeks; +0.14 kg at 12 weeks.

The gain in the no-exercise creatine group was statistically greater than in both placebo groups. Neither placebo group changed. In the exercise stratum, lean tissue held steady on placebo during a calorie deficit and rose on creatine.

“Lean tissue” on a DXA scan is everything that is not fat or bone, and it includes water. Creatine is known to draw water into muscle cells, and the paper does not separate water from new muscle protein. This page therefore says “lean tissue,” not “muscle.”

Body-fat percentage

• Ex+CrM: −2.04% at 6 weeks and −3.24% [−4.1, −2.4] at 12 weeks.
• Ex+PLA: −1.87% [−2.8, −0.9] at 12 weeks.
• NoEx+CrM and NoEx+PLA: −0.42% each at 12 weeks.

The fall in the exercise-plus-creatine group was significantly greater than in each of the other three groups, including the exercise-plus-placebo group. The authors write: “we believe that this is the first study to show that CrM supplementation during an exercise- and diet-induced weight-loss program promotes greater reductions in body fat percentage than exercise and diet alone.”

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4. Strength, Endurance, Visceral Fat and Bone

Strength

• Without training: creatine increased 1RM leg press and bench press. The comparison the Results section names as significantly better than the no-exercise placebo group is bench press 1RM.
• With training: creatine produced greater gains than placebo in leg press 1RM, bench press 1RM and treadmill time to exhaustion.

Aerobic capacity

Creatine had no significant effect on VO₂peak in either stratum. Treadmill time to exhaustion improved with creatine in the training group, but the underlying measure of aerobic capacity did not.

Visceral fat

Measures of visceral (deep abdominal) fat fell in the exercise groups. For the no-exercise creatine group, the paper reports that the change was “not statistically significantly different from Ex+PLA.” That is a non-difference between two groups that were not randomized against each other. It is not evidence that creatine on its own reduced visceral fat.

Bone

There was no effect on bone mineral content, bone area or bone mineral density in any group. Twelve weeks is a short time in which to detect changes in bone.

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5. Memory, Attention and Mood (Exploratory)

The authors label all of these outcomes exploratory. The study was not powered for them and they were not adjusted for multiple comparisons. With dozens of test scores, some differences are expected by chance alone.

Cognitive tests

• NoEx+CrM: more correct answers on delayed word recall at 6 weeks compared with placebo, plus some gains in word recognition and picture recognition.
• Ex+CrM: some gains in picture recall and choice reaction time.
• No effect of creatine on the Stroop test, the Corsi block test or the NeuroTracker test.
• False alarms tended to be higher in Ex+CrM than in NoEx+PLA, which the authors read as “a greater lapse in attention.”

The authors also note that people get better at repeated tests with practice, and practice effects cannot be excluded.

Mood

• Tension scores rose more in NoEx+CrM than in NoEx+PLA.
• In Ex+CrM, vigor scores were higher and total mood disturbance lower.

The mixed direction of these findings (some better, some worse) fits the authors’ caution. More on creatine and the brain is on the Creatine and Cognitive Function page.

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6. Blood Markers and Kidney Tests

Lipids and blood sugar (exploratory)

• The combined (multivariate) analysis of blood lipids was not significant.
• In change-from-baseline comparisons, the no-exercise creatine group showed modest favourable lipid changes, including higher HDL cholesterol than the exercise placebo group.
• HbA1c, a marker of average blood sugar over about three months, fell in the no-exercise creatine group. The authors state that this does “not establish a generalized glycemic effect.”

Kidney markers

• Serum creatinine: rose 6–8% (under 0.1 mg/dL) with creatine alone and 16–18% (under 0.16 mg/dL) with creatine plus exercise.
• Creatinine-based eGFR: fell 5–7% with creatine alone and 14–20% with creatine plus exercise.

Serum creatinine stayed below 1.0 mg/dL and eGFR stayed above 60 in all groups. Creatinine is the normal breakdown product of creatine, so taking creatine and adding lean tissue both raise blood creatinine, and the standard eGFR formula reads higher creatinine as lower kidney filtration. The study did not measure cystatin C or directly measured GFR, tests that do not depend on blood creatinine. The authors therefore state that these changes “should not be interpreted as evidence of reduced renal filtration.” How creatinine tests work is explained on the Kidney Function page.

Side effects

The authors report the supplement was “well tolerated,” with no clinically significant changes in side-effect reports between groups.

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7. How Creatine Works, in Plain Language

Creatine is made in the body from three amino acids (arginine, glycine and methionine), mainly in the kidneys and liver, and it is also eaten in meat and fish. About 95% of it is stored in skeletal muscle. There, part of it is bound to phosphate as phosphocreatine, a quick-release energy store that rebuilds ATP, the cell’s energy currency, during short bursts of effort.

A classic 1992 study by Harris, Söderlund and Hultman showed that taking creatine by mouth raises the creatine content of resting human muscle, especially in people who start with low levels. Higher muscle creatine is thought to work through several routes:

• More energy for each set. With more phosphocreatine, muscles can do slightly more work before tiring, which over weeks of training adds up to more strength. This route needs training to act on.
• Water in the muscle cell. Creatine draws water into muscle cells. This raises DXA “lean tissue” within days and is one likely reason lean tissue rose in the no-exercise group.
• Cell-swelling and growth signals. Laboratory work suggests that a better-hydrated cell signals for more protein building. Whether this alone adds real muscle protein in untrained people is not settled.
• The brain. The brain also uses phosphocreatine, which is why creatine is studied for memory and mental fatigue, especially in older adults and under sleep loss.

Muscle creatine and muscle mass both tend to fall with age. That is why researchers study creatine in middle-aged and older adults and in sarcopenia, the age-related loss of muscle (see Creatine for Aging and Sarcopenia). Food sources are listed on the Creatine Sources page.

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8. Press Release Versus Paper

Where the release matches the paper

• The lean-tissue figures: about 2.4 lb (1.1 kg) without exercise and “nearly three pounds” (1.27 kg) with exercise.
• The “first study” claim about body-fat percentage, which is the authors’ own wording.
• No aerobic-capacity benefit beyond what exercise alone produced.
• The large safety analysis of 685 trials it refers to (see section 9).

Where the release goes further than the paper, or leaves things out

• The meat-and-fish comparison. The release says reaching 10 grams a day from food alone “would require eating roughly five to 10 pounds of meat or fish each day.” That figure is not in the paper and was not checked for this page.
• “Lean tissue and strength” without exercise. This is consistent with the paper, but each no-exercise group had only 13 people; the significant strength result named for that comparison is bench press 1RM; the no-exercise creatine group ate significantly more energy and carbohydrate than the others; and DXA lean tissue includes water.
• The diet. The release says the exercise group “followed a diet that created a modest calorie deficit.” The paper’s Methods say all participants followed a diet plan, which contradicts its own group labels (see section 2).
• What the release does not mention. Exercise was self-selected rather than randomized; the brain and blood findings are exploratory and unadjusted; the trial was registered after it began; and the senior author holds an advisory role with the company that supplied the creatine. The release names only the foundation funder.

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9. Earlier Research in Context

Position stands and reviews

The International Society of Sports Nutrition’s 2017 position stand (Kreider and colleagues) reviewed the safety and efficacy of creatine supplementation in exercise, sport and medicine. A 2025 review by Candow, Ostojic, Chilibeck, Gualano, Tarnopolsky and colleagues covered creatine in older adults and clinical populations, where most trials pair it with resistance training.

Training versus no training

A 2025 meta-analysis by Ashtary-Larky and colleagues pooled 61 trials and found creatine added 1.39 kg [1.07, 1.70] of fat-free mass. The gain was 1.82 kg in trained lifters and 1.23 kg in novices, a difference that was not significant. All 61 trials involved resistance training. The 2026 paper cites this analysis in support of its no-exercise result, which is a loose fit, since none of the pooled trials tested creatine without training.

Safety across hundreds of trials

A 2025 analysis by Kreider, Gonzalez, Hines, Gil and Bonilla looked at 685 clinical trials with 12,839 participants on creatine and 13,452 on placebo, at an average of about 12.5 g a day for about 65 days. Side effects were reported in 13.7% of creatine groups and 13.2% of placebo groups (p = 0.776), a difference consistent with chance. This analysis has the same senior author, with the same advisory role, as the 2026 trial.

Kidney function

A 2024 Mendelian randomization study by Zhou and colleagues, which uses genetic variants to estimate long-term effects, examined creatine and kidney function. The 2026 paper cites it in its discussion of kidney markers. For this page the record was verified but the abstract was not read, so its findings are not summarised here.

Dosing forms and the wider safety literature are covered on the Creatine Forms, Dosing and Safety page.

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10. Limits, Funding and What Remains Unknown

Limitations the authors list

• The amount and length of supplementation, the population studied, compliance with exercise and diet, and the choice of measures.
• Exercise participation was self-selected.
• Exercise, supplement and diet may have acted together (synergistic effects), which makes them hard to separate.
• Practice effects from repeated cognitive testing cannot be excluded.
• No adjustment was made across the many exploratory outcomes.
• eGFR is influenced by creatine intake and by muscle mass.

Further points from the paper

• Each no-exercise group had 13 completers, and 9 of the 73 randomized participants did not finish.
• The no-exercise creatine group ate significantly more energy and carbohydrate than the other groups.
• DXA lean tissue does not distinguish water from muscle protein.
• The trial was registered (ISRCTN83081058) retrospectively: the first participant was enrolled on 10 July 2024 and the registry entry was submitted on 11 April 2025.
• Diet status in the no-exercise groups is described inconsistently.

Funding and conflicts of interest

The paper states the study was funded by an unrestricted gift from a private foundation to the Texas A&M Foundation. A creatine manufacturer supplied the creatine and placebo and paid for the homocysteine tests. The paper states: “The sponsors were not involved in data collection, analysis, or interpretation.” The senior author discloses that he chairs the scientific advisory board of that creatine manufacturer and serves on the advisory boards of two other supplement companies. The other authors report no conflicts.

What remains unknown

• Whether the lean tissue gained without exercise is muscle protein, water, or both.
• Whether the result holds in a trial where exercise is also randomized and food intake is matched.
• Whether the effects last beyond 12 weeks, or fade when creatine is stopped.
• Whether the exploratory memory, mood, lipid and HbA1c findings repeat in trials designed and powered to test them.
• What happens to kidney function measured with cystatin C or direct GFR.

The authors call for future studies on adding protein, on people with sarcopenia, on weight loss produced by medicines, and on higher doses in people with memory complaints.

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Key Research Papers

1. Chun J, Liu Y, Kibler GL, Lee H, Babakhani K, Rhoades N, Bivins I, Ko J, Dickerson B, Gonzalez DE, Sowinski RJ, Rasmussen CJ, Kreider RB (2026). Effects of creatine supplementation with and without exercise and diet intervention on body composition, cognitive function, and markers of health in middle-aged and older adults. J Int Soc Sports Nutr 23(sup1):2716273 — PubMed PMID: 42578920
2. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 14:18 — PubMed PMID: 28615996
3. Candow DG, Ostojic SM, Chilibeck PD, Longobardi I, Gualano B, Tarnopolsky MA, et al. (2025). Creatine monohydrate supplementation for older adults and clinical populations. J Int Soc Sports Nutr 22(sup1):2534130 — PubMed PMID: 40673730
4. Kreider RB, Gonzalez DE, Hines K, Gil A, Bonilla DA (2025). Safety of creatine supplementation: analysis of the prevalence of reported side effects in clinical trials and adverse event reports. J Int Soc Sports Nutr 22(sup1):2488937 — PubMed PMID: 40198156
5. Ashtary-Larky D, Mohammadi S, Hajizadeh L, Mousavi SAH, Forbes SC, Candow DG, et al. (2025). Creatine supplementation and resistance training: a comparison between novice and experienced lifters – a systematic review and dose-response meta-analysis. J Int Soc Sports Nutr 22(sup1):2586523 — PubMed PMID: 41433021
6. Harris RC, Söderlund K, Hultman E (1992). Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clin Sci (Lond) 83(3):367–374 — PubMed PMID: 1327657
7. Zhou B, Hong M, Jin L, Ling K (2024). Exploring the relationship between creatine supplementation and renal function: insights from Mendelian randomization analysis. Ren Fail 46(2):2364762 — PubMed PMID: 38874125

PubMed Topic Searches

1. PubMed: Creatine without exercise & lean mass
2. PubMed: Creatine & body composition in middle-aged and older adults
3. PubMed: Creatine & weight loss
4. PubMed: Creatine & cognition in older adults
5. PubMed: Creatine, creatinine & eGFR

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Connections

• All Amino Acids
• Creatine Benefits Hub
• Creatine Overview
• Creatine for Aging and Sarcopenia
• Creatine for Muscle Strength
• Creatine for Cognitive Function
• Creatine Forms, Dosing & Safety
• Creatine Food Sources
• News, October 11, 2026
• Protein and Weight Loss
• Kidney Function (Creatinine vs Creatine)

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