Fat Mass Is Negatively Associated with Muscle Strength and Jump Test Performance.

BACKGROUND: It is known that maintenance of muscle mass cannot prevent loss of muscle strength in older adults. Recent evidence suggests that fat mass can weaken the relationship between muscle mass and functional performance. No information exists if fat mass can independently affect muscle strength and jump test performance in middle-aged and older adults. OBJECTIVE: To assess the independent relationships between fat mass, leg muscle mass, lower extremity muscle strength, and jump test performance in adults, 55-75 years of age. DESIGN: Cross-sectional. SETTING: University laboratory. PARTICIPANTS: Fifty-nine older adults (men, n = 27, age = 64.8 ± 6.5 years; women, n = 32, age = 62.5 ± 5.1 years) participated in this study. MEASUREMENTS: Dual energy X-ray absorptiometry was used to measure fat mass and leg muscle mass. An average of 3 maximal countermovement jumps was used to calculate jump power and jump height. Two leg press and hip abduction strength were assessed by 1-repetition maximum testing. RESULTS: Stepwise sequential regression analysis of fat mass and leg muscle mass versus jump test performance and measures of muscle strength after adjusting for age, height, and physical activity revealed that fat mass was negatively associated with jump height (p = 0.047, rpartial = -0.410) in men. In women, fat mass was negatively associated with jump height (p = 0.003, rpartial = -0.538), leg press (p = 0.002, rpartial = -0.544), and hip abduction strength (p < 0.001, rpartial = -0.661). Leg muscle mass was positively associated with jump power in women (p = 0.047, rpartial = 0.372) only. CONCLUSIONS: Fat mass has an independent negative relationship with jump test performance in middle-aged and older men and women. This has clinical implications for rehabilitating neuromuscular performance in middle-aged and older adults.

Relationship between muscle performance and DXA-derived bone parameters in community-dwelling older adults.

OBJECTIVES: To examine association between muscle strength, jump test performance, muscle mass, bone mineral density (BMD), and bone strength in older adults. METHODS: Sixty individuals (55-75 years) participated. Leg press strength and bilateral hip abduction strength were evaluated by one repetition-maximum testing. Jump power (JPow) and jump height (JHt) were assessed by jump test performance. Relative skeletal muscle mass index (RSMI), total hip BMD, femoral neck BMD, lumbar spine BMD, section modulus (Z), cross-sectional moment of inertia (CSMI), and bone strength index (BSI) were determined by DXA. RESULTS: After adjusting for age and gender, leg press strength 1) positively correlated with the total hip BMD, femoral neck BMD, and Z (all P⟨0.05). Also, leg press strength predicted the total hip BMD (P=0.013) and femoral neck BMD (P=0.021), after adjusting for age, gender, and RSMI. No associations were found between jump test performance and bone density or strength. CONCLUSION: Leg press strength is positively associated with bone density and bone strength in older population. It might serve as an additional tool to identify at-risk individuals for osteoporosis.

Acute bone changes after lower limb amputation resulting from traumatic injury.

Bone health is critical for lower limb amputees, affecting their ability to use a prosthesis and their risk of osteoporosis. We found large losses in hip bone mineral density (BMD) and in amputated bone strength in the first year of prosthesis use, suggesting a need for load bearing interventions early post-amputation. INTRODUCTION: Large deficits in hip areal BMD (aBMD) and residual limb volumetric BMD (vBMD) occur after lower limb amputation; however, the time course of these bone quality changes is unknown. The purpose of this study was to quantify changes in the amputated bone that occur during the early stages post-amputation. METHODS: Eight traumatic unilateral amputees (23-53 years) were enrolled prior to surgery. Changes in total body, hip, and spine aBMD (dual-energy X-ray absorptiometry); in vBMD, stress-strain index (SSI), and muscle cross-sectional area (MCSA) (peripheral QCT); and in bone turnover markers were assessed after amputation prior to prosthesis fitting (pre-ambulatory) and at 6 and 12 months walking with prosthesis. RESULTS: Hip aBMD of the amputated limb decreased 11-15%, which persisted through 12 months. The amputated bone had decreases (p < 0.01) in BMC (-26%), vBMD (-21%), and SSI (-25%) from pre-ambulatory to 6 months on a prosthesis, which was maintained between 6 and 12 months. There was a decrease (p < 0.05) in the proportion of bone >650 mg/cm3 (58 to 43% of total area) or >480 mg/cm3 (65% to 53%), suggesting an increase in cortical porosity after amputation. Bone alkaline phosphatase and sclerostin were elevated (p < 0.05) at pre-ambulatory and then decreased towards baseline. Bone resorption markers were highest at surgery and pre-ambulatory and then progressively decreased (p < 0.05). CONCLUSIONS: Rapid and substantial losses in bone content and strength occur early after amputation and are not regained by 12 months of becoming ambulatory. Early post-amputation may be the most critical window for preventing bone loss.

The acute muscular effects of cycling with and without different degrees of blood flow restriction.

The aim was to compare the acute effects of work matched high intensity (75% peak aerobic capacity) aerobic exercise to low intensity (40% peak aerobic capacity) aerobic exercise with different degrees of blood flow restriction (BFR) [40% estimated arterial occlusion (40 BFR) and 60% estimated arterial occlusion (60 BFR)] on variables previously hypothesized to be important for muscle adaptation. There were no meaningful changes in torque. Anterior thigh muscle thickness was increased from baseline with high intensity cycling and 40 BFR (~2 mm increase, p ≤ 0.008). A significant increase in lactate occurred in all exercise conditions but was greatest with high intensity cycling (~5.4 mmol/L increase). Muscle activation was significantly higher with high intensity cycling compared to low intensity cycling with BFR, regardless of pressure (~25% vs. ~12% MVC). Mean power frequency was not different between conditions but did increase from the first 5 minutes of exercise to the last 5 minutes (93% vs. 101%, p < 0.001). Ratings of perceived exertion (RPE) were higher with high intensity cycling but discomfort was similar between conditions. We wish to suggest that high intensity cycling produces greater muscular stress than that observed with work matched low intensity cycling in combination with BFR.

Effects of whole-body vibration on acute bone turnover marker responses to resistance exercise in young men.

OBJECTIVE: We investigated acute bone turnover marker (BTM) responses to high-intensity resistance exercise with and without whole-body vibration (WBV) in young men (n=10). METHODS: In this randomized crossover study, subjects performed 2 protocols separated by 2-week wash out periods: 1) resistance exercise only (RE) (3 sets 10 repetitions 80% 1RM for 9 exercises); and 2) WBV + RE (side-alternating vibration platform 5 intermittent, 1-minute bouts 20 Hz, 3.38 mm peak-to-peak displacement followed by RE). Fasting morning blood draws were taken before RE or WBV (PRE), immediately post RE (IP), and 30 minutes post RE (30P). WBV + RE also had a blood draw after the WBV exposure (POST WBV). Blood samples were analyzed for lactate, hematocrit, bone-specific alkaline phosphatase (Bone ALP, U/L), C-terminal telopeptide of type I collagen (CTX-I, ng/mL) and tartrate-resistant acid phosphatase 5b (TRAP5b, U/L). RESULTS: Lactate, hematocrit, and Bone ALP significantly increased (p<0.05) IP for both protocols. Bone resorption markers did not change during RE only. CTX-I significantly decreased POST WBV. TRAP5b increased POST WBV, then significantly decreased at 30P. CONCLUSIONS: Generally, BTM changes to RE only were not significant when adjusted for hemoconcentration. The WBV stimulus altered bone resorption marker but not bone formation marker responses.

One session of partial-body cryotherapy (-110 °C) improves muscle damage recovery.

To evaluate the effects of a single session of partial-body cryotherapy (PBC) on muscle recovery, 26 young men performed a muscle-damaging protocol that consisted of five sets of 20 drop jumps with 2-min rest intervals between sets. After the exercise, the PBC group (n = 13) was exposed to 3 min of PBC at -110 °C, and the control group (n = 13) was exposed to 3 min at 21 °C. Anterior thigh muscle thickness, isometric peak torque, and muscle soreness of knee extensors were measured pre, post, 24, 48, 72, and 96 h following exercise. Peak torque did not return to baseline in control group (P < 0.05), whereas the PBC group recovered peak torques 96 h post exercise (P > 0.05). Peak torque was also higher after PBC at 72 and 96 h compared with control group (P < 0.05). Muscle thickness increased after 24 h in the control group (P < 0.05) and was significantly higher compared with the PBC group at 24 and 96 h (P < 0.05). Muscle soreness returned to baseline for the PBC group at 72 h compared with 96 h for controls. These results indicate that PBC after strenuous exercise may enhance recovery from muscle damage.

Muscle damage after low-intensity eccentric contractions with blood flow restriction.

Discrepancies exist whether blood flow restriction (BFR) exacerbates exercise-induced muscle damage (EIMD). This study compared low-intensity eccentric contractions of the elbow flexors with and without BFR for changes in indirect markers of muscle damage. Nine untrained young men (18-26 y) performed low-intensity (30% 1RM) eccentric contractions (2-s) of the elbow flexors with one arm assigned to BFR and the other arm without BFR. EIMD markers of maximum voluntary isometric contraction (MVC) torque, range of motion (ROM), upper arm circumference, muscle thickness and muscle soreness were measured before, immediately after, 1, 2, 3, and 4 days after exercise. Electromyography (EMG) amplitude of the biceps brachii and brachioradialis were recorded during exercise. EMG amplitude was not significantly different between arms and did not significantly change from set 1 to set 4 for the biceps brachii but increased for the brachioradialis (p ≤ 0.05, 12.0% to 14.5%) when the conditions were combined. No significant differences in the changes in any variables were found between arms. MVC torque decreased 7% immediately post-exercise (p ≤ 0.05), but no significant changes in ROM, circumference, muscle thickness and muscle soreness were found. These results show that BFR does not affect EIMD by low-intensity eccentric contractions.

Blood flow restriction: effects of cuff type on fatigue and perceptual responses to resistance exercise.

Blood flow restriction (BFR) combined with low load resistance training has been shown to result in muscle hypertrophy similar to that observed with higher loads. However, not all studies have found BFR efficacious, possibly due to methodological differences. It is presently unclear whether there are differences between cuffs of similar size (5 cm) but different material (nylon vs. elastic). The purpose was to determine if there are differences in repetitions to fatigue and perceptual ratings of exertion (RPE) and discomfort between narrow elastic and narrow nylon cuffs. Sixteen males and females completed three sets of BFR knee extension exercise in a randomized cross-over design using either elastic or nylon restrictive cuffs applied at the proximal thigh. There were no differences in repetitions to fatigue (marker of blood flow) or perceptual ratings between narrow elastic and narrow nylon cuffs. This data suggests that either elastic or nylon cuffs of the same width should cause similar degrees of BFR at the same pressure during resistance exercise.

Blood flow restriction pressure recommendations: the hormesis hypothesis.

Blood flow restriction (BFR) alone or in combination with exercise has been shown to result in favorable effects on skeletal muscle form and function. The pressure applied should be high enough to occlude venous return from the muscle but low enough to maintain arterial inflow into the muscle. The optimal pressure for beneficial effects on skeletal muscle are currently unknown; however, preliminary data from our laboratory suggests that there may be a point where greater pressure may not augment the response (e.g. metabolic accumulation, cell swelling) but may actually result in decrements (e.g. muscle activation). This led us to wonder if BFR elicits somewhat of a hormesis effect. The purpose of this manuscript is to discuss whether pressure may be modulated to maximize skeletal muscle adaptation with resistance training in combination with BFR. Furthermore, the potential safety issues that could arise from increasing pressure too high are also briefly reviewed. We hypothesize that with BFR there is likely a moderate (∼ 50% estimated arterial occlusion pressure) pressure that maximizes the anabolic response to skeletal muscle without producing the potential negative consequences of higher pressures. Thus, BFR may follow the hormesis theory to some degree, in that a low/moderate dose of BFR produces beneficial effects while higher pressures (at or near arterial occlusion) may decrease the benefits of exercise and increase the health risk. This hypothesis requires long term studies investigating chronic training adaptations to differential pressures. In addition, how differences in load interact with differences in pressure should also be investigated.

Relationship between lifting performance and skeletal muscle mass in elite powerlifters.

AIM: Aim of the study was to examine the relationship between whole body skeletal muscle mass (SMM) and powerlifting performance in elite powerlifters. METHODS: Twenty elite male powerlifters, including 4 world champions, volunteered. Muscle thickness (MTH) and subcutaneous fat thickness (FTH) were measured by ultrasound at 9 sites on the anterior and posterior aspects of the body. FTH was used to estimate body fat and fat-free mass and SMM was estimated from ultrasound-derived prediction equations. Best lifting performance in the squat (SQ), bench press (BP), and dead lift (DL) was recorded from competition performance. RESULTS: Significant strong correlations (P<0.01) were observed between absolute and relative (divided by height) SMM and performance of the SQ (r=0.93 and r=0.94, respectively), BP (r=0.88 and r=0.87), and DL (r=0.84 and r=0.85). Relative lifting performance to SMM for squat (SQ/SMM ratio) and bench press (BP/SMM ratio) were constant throughout a wide range of weight classes (56kg-145kg) and there were no significant correlation between the SMM and those performances (r=0.21 for SQ and r=0.12 for BP). However, the DL/SMM ratio was negatively correlated to DL performance (r=-0.47, P<0.05). CONCLUSION: SMM is a good predictor of powerlifting performance throughout all weight classes.

The acute muscle swelling effects of blood flow restriction.

The purpose of this study was to investigate the potential mechanisms behind the blood flow restriction (BFR) stimulus in the absence of exercise. Nine participants completed a 10 minute time control and then a BFR protocol. The protocol was five, 5-minute bouts of inflation with 3-minutes of deflation between each bout. The pressure was set relative to each individual's thigh circumference. Significant increases in muscle thickness were observed for both the vastus lateralis (VL) [6%, p = 0.027] and rectus femoris (RF) [22%, p = 0.001] along with a significant decrease in plasma volume [15%, p = 0.001]. Ratings of discomfort during the BFR protocol peaked at 2.7 (light discomfort). There were no significant changes with whole blood lactate, electromyography (EMG), or heart rate (HR), however, there was a trend for a significant increase in HR during the 5th inflation (p = 0.057). In conclusion, this is the first study to demonstrate that the attenuation of both muscle atrophy and declines in strength previously observed with brief applications of BFR may have been mediated through an acute fluid shift induced increase in muscle size. This is supported by our finding that the changes in muscle thickness are maintained even after the cuffs have been removed.

Blood flow restriction: an evidence based progressive model (Review).

To remain independent and healthy, an important factor to consider is the maintenance of skeletal muscle mass. Inactivity leads to measurable changes in muscle and bone, reduces exercise capacity, impairs the immune system, and decreases the sensitivity to insulin. Therefore, maintaining physical activity is of great importance for skeletal muscle health. One form of structured physical activity is resistance training. Generally speaking, one needs to lift weights at approximately 70% of their one repetition maximum (1RM) to have noticeable increases in muscle size and strength. Although numerous positive effects are observed from heavy resistance training, some at risk populations (e.g. elderly, rehabilitating patients, etc.) might be advised not to perform high-load resistance training and may be limited to performance of low-load resistance exercise. A technique which applies pressure cuffs to the limbs causing blood flow restriction (BFR) has been shown to attenuate atrophy and when combined with low intensity exercise has resulted in an increase in both muscle size and strength across different age groups. We have provided an evidence based model of progression from bed rest to higher load resistance training, based largely on BFR literature concentrating on more at risk populations, to highlight a possible path to recovery.

Comparison of skeletal muscle mass to fat-free mass ratios among different ethnic groups.

BACKGROUND: Asians seem to have less skeletal muscle mass (SMM) than other ethnic groups, but it is not clear whether relative SMM, i.e., SMM / height square or SMM to fat-free mass (FFM) ratio, differs among different ethnic groups at the same level of body mass index (BMI). OBJECTIVE: To compare the SMM to fat-free mass (FFM) ratio as well as anthropometric variables and body composition among 3 ethnic groups. DESIGN, SETTING, AND PARTICIPANTS: Three hundred thirty-nine Japanese, 343 Brazilian, and 183 German men and women were recruited for this cross-sectional study. MEASUREMENTS: Muscle thickness (MTH) and subcutaneous fat thickness (FTH) were measured by ultrasound at nine sites on the anterior and posterior aspects of the body. FTH was used to estimate the body density, from which fat mass and fat-free mass (FFM) was calculated by using Brozek equation. Total SMM was estimated from ultrasound-derived prediction equations. RESULTS: Percentage body fat was similar among the ethnic groups in men, while Brazilians were higher than Japanese in women. In German men and women, absolute SMM and FFM were higher than in their Japanese and Brazilians counterparts. SMM index and SMM:FFM ratios were similar among the ethnic groups in women, excluding SMM:FFM ratio in Brazilian. In men, however, these relative values (SMM index and SMM:FFM ratio) were still higher in Germans. After adjusting for age and BMI, the SMM index and SMM:FFM ratios were lower in Brazilian men and women compared with the other two ethnic groups, while the SMM index and SMM:FFM ratios were similar in Japanese and German men and women, excluding SMM:FFM ratio in women. CONCLUSION: Our results suggest that relative SMM is not lower in Asian populations compared with European populations after adjusted by age and BMI.

ß2 Adrenoceptor signaling-induced muscle hypertrophy from blood flow restriction: is there evidence?

Skeletal muscle hypertrophy and increases in muscular function have been observed following low intensity/load exercise with blood flow restriction (BFR). The mechanisms behind these effects are largely unknown, but have been hypothesized to include a metabolic accumulation induced increase in muscle activation, elevations in growth hormone, and improvements in muscle protein balance. However, many of the aforementioned mechanisms are not present with BFR in the absence of exercise. In these situations, signaling through the ß2 adrenoceptor has been hypothesized to possibly contribute to the positive muscle adaptions, possibly in concert with muscle cell swelling. Signaling through the ß2 adrenoceptor has been shown to stimulate both muscle protein synthesis and an inhibition of protein degradation through increasing cyclic adenosine monophosphate (cAMP) or signaling via the Gßγ subunit, especially in situations where the basal rates of protein synthesis are already reduced. Every study that has investigated the catecholamine response to BFR in the absence of exercise or in combination with exercise has shown a significant increase above resting conditions. However, from the available evidence, it is unlikely that the norepinephrine response from BFR, particularly with exercise, is playing a prominent role with muscle adaptation in skeletal muscle that is not immobilized by a cast or joint injury.

The anabolic benefits of venous blood flow restriction training may be induced by muscle cell swelling.

Venous blood flow restriction (VBFR) combined with low intensity resistance exercise (20-30% concentric 1-RM) has been observed to result in skeletal muscle hypertrophy, increased strength, and increased endurance. Knowledge of the mechanisms behind the benefits seen with VBFR is incomplete, but the benefits have traditionally been thought to occur from the decreased oxygen and accumulation of metabolites. Although many of the proposed mechanisms appear valid and are likely true with VBFR combined with resistance exercise, there are certain situations in which benefits are observed without a large accumulation of metabolites and/or large increases in fast twitch fiber type recruitment. Cell swelling appears to be a likely mechanism that appears to be present throughout all studies. VBFR may be able to induce cell swelling through a combination of blood pooling, accumulation of metabolites, and reactive hyperemia following the removal of VBFR which may contribute to skeletal muscle adaptations that occur with VBFR. We hypothesize that cell swelling is important for muscle growth and strength adaptation but when coupled with higher metabolic accumulation, this adaptation is even greater.

Acute and chronic testosterone response to blood flow restricted exercise.

The American College of Sports Medicine recommends lifting a weight of at least 70% 1RM to achieve muscular hypertrophy as it is believed that anything below this intensity rarely produces substantial muscle growth. At least part of this recommendation is related to elevated systemic hormones following heavy resistance training being associated with skeletal muscle hypertrophy. Despite benefits of high intensity resistance training, many individuals are unable to withstand the high mechanical stresses placed upon the joints during heavy resistance training. Blood flow restricted exercise offers a novel mode of exercise allowing skeletal muscle hypertrophy at low intensities, however the testosterone response to this exercise has yet to be discussed. The acute and chronic testosterone response to blood flow restricted exercise appears to be minimal when examining the current literature. Despite this lack of response, notable increases in both size and strength are observed with this type of exercise, which seems to support that systemic increases of endogenous testosterone are not necessary for muscular hypertrophy to occur. However, definitive conclusions cannot be made without a more thorough analysis of responses of androgen receptor density following blood flow restricted exercise. It may also be that there are differing mechanisms underlying hypertrophy induced by high intensity resistance training and via blood flow restricted exercise.

Blood flow restriction: the metabolite/volume threshold theory.

Traditionally it has been thought that muscle hypertrophy occurs primarily from an overload stimulus produced by progressively increasing an external load using at least 70% of one's concentric one repetition maximum (1RM). Blood flow restricted exercise has been demonstrated to result in numerous positive training adaptions, specifically muscle hypertrophy and strength at intensities much lower than this recommendation. The mechanisms behind these adaptions are currently unknown but a commonly cited concept is that acute elevations of systemic hormones, specifically growth hormone (GH), play a large role with resistance training induced muscle hypertrophy, possibly through stimulating muscle protein synthesis (MPS). We hypothesize that the alterations in the intramuscular environment which results in the rapid recruitment of FT fibers, is the large driving force behind the skeletal muscle hypertrophy seen with blood flow restriction, whereas the external load and systemic endogenous hormone elevations may not be as important as once thought. It is further hypothesized that although skeletal muscle hypertrophy can be achieved at low intensities without blood flow restriction when taken to muscular failure, the overall volume of work required is much greater than that needed with blood flow restriction.

Potential safety issues with blood flow restriction training.

The focal point of previous literature was establishing the efficacy of blood flow restriction training with respect to muscular strength, muscular hypertrophy, and muscular endurance. After mounting evidence supporting the efficacy of low-intensity blood flow restriction training, research has shifted to the overall safety of this training modality. The aim of this review was to summarize the research on the overall safety of blood flow restriction training, focusing on the cardiovascular system (central and peripheral), muscle damage, oxidative stress, and nerve conduction velocity responses compared with those observed with regular exercise. Although still sparse, the blood flow restriction training research thus far is promising with respect to safety outcomes. Individuals respond similarly to blood flow restriction training and to regular exercise; however, longer term studies are required to better understand the chronic effects of low-intensity blood flow restriction training and possible safety issues.

Dose-response effect of 40 weeks of resistance training on bone mineral density in older adults.

UNLABELLED: Resistance training is becoming popular for maintaining bone health. Previous studies examined high intensity exercise; we compared high and low intensity resistance training performed 2 or 3 days per week in older adults. We found positive bone density responses for the hip and spine for all types of resistance training. INTRODUCTION: This study determined the dose-response effect of resistance training on lumbar spine, proximal femur, and total body bone mineral density (BMD) in older men and women (55-74 years). METHODS: Subjects included 45 men and 79 women who were assigned to one of the following training groups: 1-high intensity (80% 1RM), 2 days/week (2HI); 2-low intensity (40% 1RM), 2 days/week (2LI); 3-high intensity (80% 1RM), 3 days/week (3HI); and 4-low intensity (40% 1RM), 3 days/week (3LI). Bone scans (dual energy X-ray absorptiometry) were performed at baseline and after 40 weeks of training. Muscular strength (1-repetition maximum) was assessed every 5 weeks. RESULTS: There were significant trial (p < 0.05) effects but no significant trial × training group interactions for the BMD sites. Spine, trochanter, and total hip BMD increased from baseline to 40 weeks; however, the total body BMD site decreased in the 3LI group. Men and women exhibited similar improvements for the trochanter and total hip sites but the percent change in the spine tended (p = 0.054) to be higher for men (1.8%) than women (0.4%). CONCLUSIONS: The resistance training programs, regardless of intensity and frequency, were effective in improving BMD of the proximal femur and lumbar spine but not the total body. Both men and women responded similarly for the hip sites but men show a greater response at the lumbar spine than women.

The effects of supplementation with creatine and protein on muscle strength following a traditional resistance training program in middle-aged and older men.

OBJECTIVES: Creatine and protein supplementation can enhance the training outcomes of young subjects, but it is not clear if there are benefits for older individuals. Therefore, the purpose of this study was to determine the effects of creatine and protein supplementation on strength gains following a traditional resistance training program for middle-aged and older men. DESIGN, SETTING, PARTICIPANTS: This study assessed changes in strength of men aged 48-72 years following 14 weeks of resistance training supplemented with creatine and/or protein. A double-blind, randomized, placebo-controlled design placed 42 males into one of four groups: Resistance Trained Placebo (RTP, n=10); Resistance Trained Creatine (RTCr, 5g Cr, n=10); Resistance Trained Protein (RTPr, 35g whey Pr, n=11); or Resistance Trained Creatine and Protein (RTCrPr, 5g Cr and 35g Pr, n=11). INTERVENTION: All groups trained 3 days per week for 14 weeks. The resistance training program was based on progressive overload. Training loads corresponded to 80% 1 RM (one repetition maximum strength), 3 sets of 8 repetitions for the following exercises: knee extension/knee flexion; bicep curl/tricep extension; military press; lat pull down; seated leg press; and bench press. MEASUREMENTS: 1 RM for each exercise and measures of lean body mass were assessed prior to and following the 14 week program. RESULTS: Each group significantly (p < 0.05) increased strength and lean body mass, however, there were no significant group effects or group X trial interactions. CONCLUSION: Resistance training in middle-aged and older men significantly increased muscular strength and added muscle mass with no additional benefits from creatine and/or protein supplementation.