Tag Archives: creatine

Life Ultimately Judges You From The Neck Up

 

By Jose Antonio PhD FNSCA FISSN – The ISSN

You know what’s elementary?  The science behind creatine supplementation. I’ve always found it puzzling that folks who are otherwise educated have convinced themselves hanks and soccer ballcreatine supplementation is ineffectual and perhaps harmful or dangerous.  Creatine causes cramps, is bad for your kidneys, blah blah blah.  It reminds me of that inordinately vapid movie by Tom Hanks, “Cast Away.”  You know the one where he’s stuck on a deserted island after a crash landing.  He spends his time talking to himself and his soccer ball.  Now I can understand why he would be unaware of the benefits of creatine.  Have you been stuck on a deserted island?

Hence, if you have the attention span of a billy goat, at the very least read these 8 key points:billy goat

  1. Creatine is the single best dietary supplement in the history of mankind.
  2. There’s more supportive data on creatine than ‘whole grains.’
  3. Even if you don’t care about the effects on body composition, take creatine because it’ll help your brain.
  4. Creatine supplementation can alleviate traumatic brain injury.
  5. Creatine supplementation can help your memory.
  6. Kids as young as 1 years of age have been given creatine with no side effects.
  7. Pretty people rule the world from 18-30 years of age.  After 30 years, you’re better off focusing on your IQ than your abs.
  8. Exercise hard.  Exercise frequently.

Life ultimately judges you from the neck up. Except for the delightful Kate Upton.  As I always tell my kids:  “The worst thing you can be in life is a dumbass.”  I recently watched with Kate Uptonprofound amusement as my teenage daughter found a ‘wrinkle’ on her face.  Made me wonder if she needs glasses.  Wait 40 years.  She’ll find out what real wrinkles look like.  Anyhow, the shelf life of your brain will far exceed your body.  Sure the pretty people rule the world from 18-29 years of age.  But after that, it’s all about the abacus in your cranium.  There are supplements worth taking that’ll put the oomph back in your IQ.  Yep, that’s right.  Smart is the new sexy.  Try these to start.  Might help, might not.  But once you try these, there’s one supplement that Donald Trumps them all.

  • Omega-3 fatty acids – Indeed the omega 3 fats, especially EPA (eicosapentanoic acid) and DHA (docosahexanoic acid) are an awesome brain food that can improve cognitive performance.[1]
  • Huperzine A – this herb has been shown to lessen the loss the memory with age.  I need that stuff![2]
  • Alpha-GPC –  L-alpha-glycerylphosphorylcholine (alpha-GPC) can improve learning and memory capacity.[3]
  • Gingko – Of course this supplement always comes up.  Sure, there is some suggestive data showing it might help.[4]

Now those four supplements are nice and all.  But if you really want to be a mathlete and make mental mincemeat of your friends and foe alike, creatine may be what the doctor ordered.   You’ll find that magical supplement probably sitting next to your protein powder.  Oh shit, that sounds like something Dr. Oz would say.  Rewind.  The science on creatine is astounding.  Put it this way.  Compared to green coffee bean extract, creatine would be like driving a Ferrari.  Green coffee bean extract would be like riding a Big Wheel. mathlete

As a professor, I hear some of the silliest things regarding creatine.  Not to pick on the fairer sex, but come on, creatine supplementation won’t make you look like the bearded men of Duck Dynasty.  Heck, there are college guys who train harder than one-legged man in an ass-kickin’ contest, consume gobs and gobs of creatine, protein, beta-alanine, betaine, pizza, and beer.  And yet, they still look like the letter ‘i.’ There are plenty of college women who lament “I don’t want to get big and bulky; that’s why I don’t take creatine.”  And one of my favorites:  “Is creatine a steroid?”  Whiskey-Tango-Foxtrot.  Did you fall asleep in chemistry class?  There’s about as much chance of creatine being a steroid as a donkey winning the Nobel Prize for Medicine.  Though chances of winning the Nobel Peace Prize are 1:1. Either way, even if you don’t give a rat’s ass about gaining muscle mass, the BETTER reason to supplement with creatine is because of its profound effects on the brain.  Yeah.  That fat-filled organ sitting on top of your neck.

SIDE BAR – Creatine, Energy, and Neurological Diseases

“Creatine is a critical component in maintaining cellular energy homeostasis, and its administration has been reported to be neuroprotective in a wide number of both acute and chronic experimental models of neurological disease. In the context of this chapter, we will review the experimental evidence for creatine supplementation as a neurotherapeutic strategy in patients with neurological disorders, including Huntington’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, and Alzheimer’s disease, as well as in ischemic stroke, brain and spinal cord trauma, and epilepsy.”[5]

Listen Up Vegans

It makes sense that creatine is as important for your brain as it is for your muscles. 

Pauline is a big fan of creatine; therefore, you should be a big fan of Pauline.

Pauline is a big fan of creatine; therefore, you should be a big fan of Pauline.

Creatine, when combined with phosphate forms phosphocreatine (PCr).  Why is this important?  PCr acts as a reserve of high-energy phosphate (i.e. fuel). Creatine supplementation influences brain functioning as shown by various studies that have taken snapshots of brain function.  In a rarity, scientists examined young women (most studies are on men) who were vegetarians and meat-eaters.  These women consumed 20 grams of creatine (or a placebo) for 5 days.  In vegetarians but not in the meat-eaters, creatine supplementation resulted in better memory.[6]  More proof.  A study of 45 vegetarians found that creatine supplementation enhanced memory and intelligence, both tasks that require speed of processing.[7] Remember that creatine is naturally found in fish and meat.  So all you tree-huggin’, Birkenstock-wearin’, soy protein-lovin’ vegans should supplement with creatine.  Even if you take creatine ethyl ester, which BTW is an inferior form of creatine [i.e. creatine monohydrate is better], it can help cognitive performance too.[8]  Creatine supplementation helps old folks remember stuff.[9]  So next time you’re with grandpa, make sure you slip some creatine in his Metamucil.[9]

Good Night, Sleep Tight

I think one of the more fascinating roles of creatine is how it affects a sleep-deprived brain.  Sleep deprivation is something we all can relate to.  Whether it’s staying up late studying for exams (not me thank god), watching Monday Night Football milliondollarsaloonvig(on the East Coast), or hanging out at your favorite Gentlemen’s Club (or so I’ve heard from my fellow ISSN’ers), sleep often is in short supply.  So when you wake up the next day feeling like a Mack truck just played ping pong with your head, then you ought to reach for the creatine (after you reach for the java).  In fact, just taking 20 grams of creatine daily for 7 days is enough to lesson your sleep-deprived stupor.  Accordingly, scientists discovered that following 24 hours of sleep deprivation, creatine supplementation had a positive effect on mood state and tasks that place a heavy stress on the prefrontal cortex.[10]  The pre-frontal cortex is the part of the brain that is involved in abstract thinking and intricate analysis.  That’s a pretty important part of the brain.  Especially when deciding whether you should watch Game of Thrones or study for your Exercise Physiology midterm.  One reason why creatine may help your noggin is related to an increased oxygen utilization in the brain.[11]

Save the Brain

If you compete in a sport that may result in potential head trauma (i.e. football, boxing, MMA, soccer [yes even ‘futbol’]), then for Pete’s sake, open up the tub of white powder and take it.  Check this out.  In a study of 39 children and adolescents (ages 1 to 18 years) with TBI or Brain_4d5df2_1104245traumatic brain injury, scientists discovered that creatine supplementation protected the brain.  Yes sir indeed. If you’re incredulous, here’s a direct quote from the study. “The administration of Cr to children and adolescents with TBI improved results in several parameters, including duration of post traumatic amnesia (PTA), duration of intubation, intensive care unit stay. Significant improvement was recorded in the categories of headache (p<0.001), dizziness (p=0.005) and fatigue (p<0.001), aspects in all patients. No side effects were seen due to Cr administration.”[12]  Let’s hope you read the fine print.  They gave creatine to kids as young as 1 years of age with no side effects.  And yet soccer moms and dads around the world are afraid that if their teenage son takes it, it might cause harm.

After I told Mike that folks are scared of creatine, he busted out laughing say "that sssit ith funny.."

After I told Mike that folks are scared of creatine, he busted out laughing say “that sssit ith funny..”

Other intriguing studies have found that “creatine supplementation has the potential to improve neurofunction following neonatal brain damage” [13], can “rescue animals following brain damage,” [14] and may “reduce oxidative stress and afford neuroprotection” in an in vitro model.[15]

So there you have it.  Creatine does the brain good.  It’s really elementary.  

BIO – Jose Antonio PhD is the CEO of the ISSN, www.theissn.org.  He has been regularly supplementing with creatine for a score and 4 years.  If he didn’t take creatine, he’d have the memory of an aardvark.

Some Cool Creatine Studies

1.         Rachetti AL, Arida RM, Patti CL, Zanin KA, Fernades-Santos L, Frussa-Filho R, Gomes da Silva S, Scorza FA, Cysneiros RM: Fish oil supplementation and physical exercise program: distinct effects on different memory tasks. Behav Brain Res 2013, 237:283-289.

2.         Ye JW, Shang YZ, Wang ZM, Tang XC: Huperzine A ameliorates the impaired memory of aged rat in the Morris water maze performance. Acta Pharmacol Sin 2000, 21:65-69.

3.         Drago F, Mauceri F, Nardo L, Valerio C, Lauria N, Rampello L, Guidi G: Behavioral effects of L-alpha-glycerylphosphorylcholine: influence on cognitive mechanisms in the rat. Pharmacol Biochem Behav 1992, 41:445-448.

4.         Walesiuk A, Trofimiuk E, Braszko JJ: Gingko biloba extract diminishes stress-induced memory deficits in rats. Pharmacol Rep 2005, 57:176-187.

5.         Klein AM, Ferrante RJ: The neuroprotective role of creatine. Subcell Biochem 2007, 46:205-243.

6.         Benton D, Donohoe R: The influence of creatine supplementation on the cognitive functioning of vegetarians and omnivores. Br J Nutr 2011, 105:1100-1105.

7.         Rae C, Digney AL, McEwan SR, Bates TC: Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial. Proc Biol Sci 2003, 270:2147-2150.

8.         Ling J, Kritikos M, Tiplady B: Cognitive effects of creatine ethyl ester supplementation. Behav Pharmacol 2009, 20:673-679.

9.         McMorris T, Mielcarz G, Harris RC, Swain JP, Howard A: Creatine supplementation and cognitive performance in elderly individuals. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2007, 14:517-528.

10.       McMorris T, Harris RC, Swain J, Corbett J, Collard K, Dyson RJ, Dye L, Hodgson C, Draper N: Effect of creatine supplementation and sleep deprivation, with mild exercise, on cognitive and psychomotor performance, mood state, and plasma concentrations of catecholamines and cortisol. Psychopharmacology (Berl) 2006, 185:93-103.

11.       Watanabe A, Kato N, Kato T: Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation. Neurosci Res 2002, 42:279-285.

12.       Sakellaris G, Nasis G, Kotsiou M, Tamiolaki M, Charissis G, Evangeliou A: Prevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot study. Acta Paediatr 2008, 97:31-34.

13.       Allah Yar R, Akbar A, Iqbal F: Creatine monohydrate supplementation for 10 weeks mediates neuroprotection and improves learning/memory following neonatal hypoxia ischemia encephalopathy in female albino mice. Brain Res 2015, 1595:92-100.

14.       Iqbal S, Ali M, Iqbal F: Long term creatine monohydrate supplementation, following neonatal hypoxic ischemic insult, improves neuromuscular coordination and spatial learning in male albino mouse. Brain Res 2014.

15.       Cunha MP, Martin-de-Saavedra MD, Romero A, Egea J, Ludka FK, Tasca CI, Farina M, Rodrigues AL, Lopez MG: Both creatine and its product phosphocreatine reduce oxidative stress and afford neuroprotection in an in vitro Parkinson’s model. ASN Neuro 2014, 6.

 

Creatine and Kids

Essentials of Creatine cover 165 x 220 pixels (2)By Jose Antonio, Ph.D. – Random Note:  A question came up regarding the effects of creatine supplementation on blood pressure.  For the life of me I could not figure out why anyone would think creatine would adversely affect blood pressure.  Nevertheless, here is a reference that I’d suggest you read (Med Sci Sports Exerc.  2000.  Mihic et al.)

But enough of that.  Here’s my question.  If creatine is safe for kids who might be ill or sick, then why on Earth would it be harmful to a healthy adult?  To wit:  Walk around any mall in the heartland of America and you’ll find this common site.  Kids sitting at a brightly colored table in a Food Court peppered with all sorts of different fast foods.  Parents are more than willing to buy their kids French fries, donuts, fried chicken, cheeseburgers and other assorted Junk foodnot-so-good for you foods.  Let’s face it; it’s tough to get kids to eat salmon and broccoli right?  Nonetheless, it is socially acceptable to eat like sh#$ and therefore look like sh$%.  Though looking like sh$% seems to be less tolerated despite the fact that the two often go hand in hand.  However, the mere mention that kids should be consuming dietary supplements, in this case creatine, brings gasps of horror!  Creatine!  What about the kids?  Will it harm them?  Will their kidneys peeter out and die?  Egads!

Never has a supplement been studied so much yet misunderstood entirely by the general public.  Folks are often surprised to hear that creatine is naturally found in meats, especially fish.  So if you’re afraid of creatine, I’d suggest you avoid the sushi bar like a sailor avoids the confessional.  In a nutshell, creatine is probably the most studied dietary supplement in the history of mankind.  Out of the hundreds of studies performed on creatine, there is no evidence to show that it causes any harm.  In fact, there are studies in kids (even infants) showing no side effects.  So what are folks so scared?  Two reasons: they’re either idiots or they’re uninformed.   We fear what we don’t understand, right?

Background on Creatine – Creatine plays an important role in energy metabolism and is synthesized or made in the liver, kidney and pancreas. It is stored mainly in skeletal muscles, heart and brain.  There is scientific evidence which show a short and long-term therapeutic benefit of creatine supplementation in children and adults with gyrate atrophy (a result of the inborn error of metabolism with ornithine delta- aminotransferase activity), muscular dystrophy (facioscapulohumeral dystrophy, Becker dystrophy, Duchenne dystrophy and sarcoglycan deficient limb girdle muscular dystrophy), McArdle’s disease, Huntington’s disease and mitochondria-related diseases. Hypoxia and energy related brain pathologies (brain trauma, cerebral ischemia, prematurity) might benefit from creatine supplementation.[1]

Studies of Creatine in Kids

Creatine and Kids with Cancer – Nine children with ALL (acute lymphoblastic leukemia, a type of cancer) in the maintenance phase of treatment on the Dana-Farber Cancer Institute (DFCI) protocol 2000-2001 were treated with creatine monohydrate (CrM) (0.1 g/kg/day; equal to 6.8 grams for a 150 lb person) for two sequential periods of 16 weeks (16 weeks treat > 6 weeks wash-out > 16 weeks treat). A cohort of 50 children who were receiving the same chemotherapy at the same time served as controls. Despite the long course of corticosteroid treatment for ALL, children showed significant increases in height, bone mineral density, and fat free mass (i.e. muscle) over approximately 38 weeks during the study. There was an increase in body mass index over time, but children taking CrM had a reduction, while the control group showed an increase in % body fat.  Thus, children with ALL treated with corticosteroids as part of a maintenance protocol of chemotherapy showed an increase in % body fat; however, those consuming CrM demonstrated lesser body fat accumulation.[2]  No side effects were reported.

Creatine and Kids with Muscular Dystrophy – In another study, 30 boys with Duchenne’s Muscular Dystropy (DD) (50% were taking corticosteroids) completed a double-blind, randomized, cross-over trial with 4 months of CrM (about 0.10 g/kg/day), 6-week wash-out, and 4 months of placebo. Four months of CrM supplementation led to increases in fat free mass and handgrip strength in the dominant hand and a reduction in a marker of bone breakdown; furthermore, the supplement was well tolerated in children with this muscle disease.[3]

Creatine and Kids with Traumatic Brain Injury – In perhaps one of the more intriguing studies, creatine was given to kids with traumatic brain injury or TBI.  The effect of creatine was determined on 39 children and adolescents, aged between 1 to 18 years old, with TBI. The creatine was administered for 6 months, at a dose of 0.4 g/kg in an oral suspension form every day.  That’s a huge dose which is equal to 27 grams for a 150 lb person.  The administration of creatine to children with TBI improved results in several parameters, including duration of post-traumatic amnesia (PTA), duration of intubation, intensive care unit (ICU) stay, disability, good recovery, self care, communication, locomotion, sociability, personality/behavior and neurophysical, and cognitive function. Significant improvement was recorded in the categories of Cognitive, personality/behavior, Self Care, and communication aspects in all patients. No side effects were seen because of creatine administration.  Thus, there is evidence that creatine supplementation is beneficial to pediatric patients with traumatic brain injury.[4][5]Batman slaps Robin over Creatine

Creatine and Exercising Kids – Sixteen male fin swimmers (age:15.9 years) were randomly and evenly assigned to either a creatine (CR, 4×5 g/day creatine monohydrate for 5 days) or placebo group (P, same dose of a dextrose-ascorbic acid placebo) in a double-blind research. Before and after creatine supplementation, the average power output was determined by a Bosco-test and the swimming time was measured in two maximal 100 m fin swims. After five days of supplementation the average power of one minute continuous rebound jumps increased by 20.2%. The swimming time was significantly reduced in both first and second sessions of swimming in the CR group, but remained almost unchanged in the P group.  Thus, creatine supplementation enhances the dynamic strength and may increase anaerobic metabolism in the lower extremity muscles, and improves performance in consecutive maximal swims in highly trained adolescent fin swimmers.[6]  In another study, four weeks of creatine supplementation enhanced swim bench test performance.[7]

Creatine and Infants – According to researchers, hypoxic ventilatory depression in mice and muscle fatigue in adult humans are improved by creatine supplementation (CS).   However, a study in human infants found that creatine supplementation did not improve symptoms of apnea of prematurity in infants.  Interestingly though, no side effects were seen with creatine supplementation (equal to a 13.6 gram daily dose in a 150 lb person). [8]  In an  interesting case report, scientists studied and treated an infant with an inborn deficiency of guanidinoacetate methyltransferase (GAMT). Long-term oral administration of creatine-monohydrate (4-8 g per day) to this patient resulted in substantial clinical improvement, disappearance of magnetic resonance (MRI) signal abnormalities in the globus pallidus, and normalisation of slow background activity on the electroencephalogram (EEG). During the 25-month treatment period, both brain and total body creatine concentrations became normal.  Accordingly, oral creatine replacement has proved to be effective in one child with an inborn error of GAMT. It may well be effective in the treatment of other disorders of creatine synthesis.[9]  It is interesting that a dose of 4-8 grams per day in an infant would be equal to over 100 grams daily in an adult.

Conclusion – Supplementation of kids of varying ages with creatine has been shown to improve exercise performance, promote recovery post traumatic brain injury, help infants with inborn errors of metabolism, and ameliorate body fat gain secondary to corticosteroid treatment.  No side effects are reported in these investigations.  Thus, the preponderance of the evidence clearly shows that creatine supplementation may indeed be beneficial for kids with no side effects.

BIO – Jose Antonio Ph.D. is the CEO of the ISSN (www.theissn.org)

References

[1]         Evangeliou A, Vasilaki K, Karagianni P, Nikolaidis N. Clinical applications of creatine supplementation on paediatrics. Curr Pharm Biotechnol 2009;10 (7):683-90.

[2]         Bourgeois JM, Nagel K, Pearce E, Wright M, Barr RD, Tarnopolsky MA. Creatine monohydrate attenuates body fat accumulation in children with acute lymphoblastic leukemia during maintenance chemotherapy. Pediatr Blood Cancer 2008;51 (2):183-7.

[3]         Tarnopolsky MA, Mahoney DJ, Vajsar J, Rodriguez C, Doherty TJ, Roy BD, Biggar D. Creatine monohydrate enhances strength and body composition in Duchenne muscular dystrophy. Neurology 2004;62 (10):1771-7.

[4]         Sakellaris G, Kotsiou M, Tamiolaki M, Kalostos G, Tsapaki E, Spanaki M, Spilioti M, Charissis G, Evangeliou A. Prevention of complications related to traumatic brain injury in children and adolescents with creatine administration: an open label randomized pilot study. J Trauma 2006;61 (2):322-9.

[5]         Sakellaris G, Nasis G, Kotsiou M, Tamiolaki M, Charissis G, Evangeliou A. Prevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot study. Acta Paediatr 2008;97 (1):31-4.

[6]         Juhasz I, Gyore I, Csende Z, Racz L, Tihanyi J. Creatine supplementation improves the anaerobic performance of elite junior fin swimmers. Acta Physiol Hung 2009;96 (3):325-36.

[7]         Dawson B, Vladich T, Blanksby BA. Effects of 4 weeks of creatine supplementation in junior swimmers on freestyle sprint and swim bench performance. J Strength Cond Res 2002;16 (4):485-90.

[8]         Bohnhorst B, Geuting T, Peter CS, Dordelmann M, Wilken B, Poets CF. Randomized, controlled trial of oral creatine supplementation (not effective) for apnea of prematurity. Pediatrics 2004;113 (4):e303-7.

[9]         Stockler S, Hanefeld F, Frahm J. Creatine replacement therapy in guanidinoacetate methyltransferase deficiency, a novel inborn error of metabolism. Lancet 1996;348 (9030):789-90.

 

 

 

Out-Muscling Neurological Disorders with Creatine

By Chantal Isabela Charo, Ph.D.  Creatine is one of the most popular ergogenic aids in sports nutrition, used by athletes, bodybuilders, the military or anyone participating in a physical activity involving short bursts of high intensity exercise.  One of the mechanisms in which creatine improves exercise capacity is via an increase in the stored phosphagens (e.g. ATP and PCr).   In the human body, creatine exists in both the free and phosphorylated form (phosphocreatine or PCr) and more than 95% is contained within skeletal muscle.  Creatine is mostly known as a performance enhancer in sports nutrition; however, it has become more evident that creatine plays a role in in the central nervous system which will be reviewed in this article.  Several studies have shown a similar pattern of impaired creatine metabolism in psychiatric patients with neurological diseases such as Huntington and Parkinson’s which lead scientists and clinicians to question the therapeutic role of creatine in treating and/or preventing mental illnesses. Although many of the molecular mechanisms are not well understood, exogenous creatine supplementation has been proposed and/or proven to improve the outcome of neurodegenerative diseases such as Alzheimer’s, Parkinson’s, ALS, and Huntington’s.  Although the detailed mechanisms of the creatine-induced neuroprotection for each disease is different, the basic overall hypothesis is that creatine supplementation is improves the overall bioenergetics and/or mitochondrial deficits associated with each particular neurodegenerative disease.  A study done by Watanabe’s group in 2002, showed that creatine supplementation improved mental concentration, memory and learning in normal healthy subjects and early stage Alzheimer’s Disease patients. creatine_monohydrate_1_1Another group, conducted a study on Lou Gehring patients (another neurological disease caused by the degeneration of neurons in the central nervous system), showed  that buffering cellular energy with exogenous creatine might have a neuroprotective effect (Hervias etal, 2006). Strong support for exogenous creatine supplementation to be an effective neuroprotective agent comes from studies done on Huntington Disease (characterized by abnormal “dance like” body movements and lack of muscular coordination) which may ultimately improve and/or extend the quality of life for individuals afflicted with HD. Studies showed improved motor performance, extended survival, attenuated the loss in body weight and brain weight, reduced neuron atrophy, upon creatine supplementation (Ferrante et al. 2000; Andreassen et al. 2001; Dedeoglu et al. 2003). Additionally, some studies have found an association between creatine metabolism and cognitive function in schizophrenia, generating much interest in the role creatine plays in the pathogenesis of the disorder. In addition to its neuroprotective roles, research suggests that creatine might not only enhance physical performance. there has been a significant amount of research done on creatine supplementation as an enhancer of cognitive performance and brain function. Another study by Watanabe’s group showed that creatine supplementation reduced mental fatigue (Watanabe et al.,2002). Interestingly, recent emphasis has been on the role of creatine supplementation and depression in women. Studies from the University of Utah, brain institute, have shown that patients who combine creatine with an antidepressant respond to their medications faster and better than patients who take antidepressants alone. The eight-week study included 52 women with depression taking the antidepressant Lexapro. Researchers observed dramatic improvements in women’s brain chemistry after combining only 5 grams of creatine with their daily doses of antidepressant medications.

For those who don’t respond well to antidepressants, creatine could become an inexpensive way to improve treatment outcomes. Furthermore, exogenous creatine was shown to improve working memory and intelligence scores in human subjects with diminished phosphocreatine levels due to limited meat intake (Rae et al., 2003).
Creatine supplementation has been generally regarded as safe and has been used for extended periods of times by athletes with few reported side effects. Creatine is a constituent of a normal diet of protein-based foods, such as milk, meat, and nuts. It is not considered an essential nutrient because the kidneys, liver, pancreas, and possibly brain cells are able to synthesize about half of the body’s requirements of creatine from the amino acids arginine, glycine, and methionine (Andres et al., 2008; Béard and Braissant, 2010; Wyss and Kaddurah-Daouk, 2000).

Bottom line – Creatine is not only good for your muscles, but it’s pretty darn good for the brain.

BIO  –  Dr. Chantal Charo is an Asst. Professor of Physiology, a Sports Nutritionist and a Medical Writer from Miami, FL.  Her research particularly focuses on undestanding hormonal imbalances and sugar metabolism in pancreatic diseases. Dr. Charo is also involved in numerous clinical trial in her field and has most recently completed a trial on NSAIDs and pancreatic diseases. Chantal earned her Ph.Ds. in Biomedical Sciences and Cancer Biology from the prestigious University of Texas Houston and the UT MD Anderson Cancer Center. As a sports nutritionist Dr. Charo collaborated with leading supplement companies across the United States by researching ways to target insulin resistance and hormonal imbalance in women, as well as the Euthyroid Sick syndrome and the female athlete using functional nutrition and biomedicine. Chantal hosts a medical segment on a local daily talk show which aims at promoting awareness to women and combating health illiteracy. In support of her research, Chantal has received fellowships from National Cancer Institute, the National Institute of Health and more. She is a Fellow of the American Association of Cancer Researchers, the American Pancreatic Association and the American Breast Cancer Association, and was the recipient for many outstanding scientist awards. The link to Dr. Charo’s Sports and Functional Nutrition Clinic is www.facebook.com/sportsnutritionclinic

Creatine: The Truth behind the Chemical

The nutritional supplement industry is a multibillion-dollar industry full of products claiming enhanced performance, quick creatine-1weight loss, increased longevity, and better health. One of the ubiquitous supplements in the sports nutrition field is creatine. In the United States alone, creatine-containing dietary supplements make up a large portion of the estimated $2.7 billion in annual sales of sports nutrition supplements1. Despite its widespread use, creatine supplementation is still a controversy amongst athletes, researchers, and clinicians regarding its efficacy and safety.  In order for you to make a well informed stance on creatine supplementation I shall review the role of creatine in the body, the research surrounding its efficacy in performance enhancement, and the potential side effects of creatine supplementation. 

What is Creatine and What Does it Do?

Creatine is similar to protein in that it is a nitrogen-containing compound, but is not a true protein.  In the nutritional biochemistry world it is known as a “non-protein” nitrogen. It can be obtained in the food we eat (typically meat and fish) or formed endogenously (in the body) from the amino acids glycine, arginine, and methionine3.

Creatine is a key player in the phosphagen energy system, the primary source of ATP (the main energy substrate in our body) during short-term, high intensity activities. Creatine exists as both free form creatine and phosphocreatine in the body.  Phosphocreatine (PC) functions as a “storehouse for high energy phosphate”2. PC functions to replenish ATP in muscles that are rapidly contracting by transfering a phosphate group to the ADP that was formed from the hydrolysis of ATP for energy in the contracting muscle. When our muscles run out of creatine, our short-term, high intensity energy system shuts down and our muscles are no longer able to produce force.

Courtesy of Advanced Nutrition and Human Metabolism (citation 2)

Phosphocreatine and creatine do not remain in muscles for an extended period of time and are cyclized in a non-reversible reaction to form creatinine, which is then processed by the kidneys and expelled from the body in the urine2.

The use of creatine as an ergogenic aid is based upon the theory that one can increase the saturation of creatine in the muscle through supplmentation. Theoretically, increased creatine in the muscle will increase performance in short, high intensity exercise by increasing the capactiy of our phosphagen system.

What Does the Research Say?

Creatine is one of the most wide researched supplements. In fact, a google scholar search for the terms “creatine supplemenation” yielded 6,740 scholarly articles and a PubMed search yielded 562 articles. While a full analysis of these studies is beyond my capability the findings amongst the literature is relatively conclusion in regards to the efficacy of creatine as a ergogenic aid and its safety.

Supplementation and Muscle Creatine Levels

According to recent research, 10-40% increases in muscle creatine and PC stores have been observed with creatine supplmentation4,5. These results were observed after a specific “loading” protocol was observed. This protocol involves ingesting roughly .3 g/kg/day for between 5 and 7 days (roughly 20 grams a day in 5 gram increments) and 3-5 g/day following the first 5-7 day period5,6. While other protocols have been suggested that involve no loading phase and “cycling” on an off creatine supplemenation, they have not shown to be quite as effective in maintaining increased levels of muscle creatine levels7.

Supplementation and Performance           

Creatine supplementation appears to be the most effective legal nutritional supplement currently available in regards to improving anaerobic capacity and lean body mass (LBM).  The research surrounding the ergogenic effects of creatine supplementation is extensive with hundreds published studies looking exactly at those two outcomes. Approximately 70% of the research has reported a significant (P<.05 for the stats people out there) increase in exercise capacity, while none have reported an ergolytic effect8.

In both the short term and long-term, creatine supplementation appears to enhance the overall quality of training, leading to 5 to 15% greater gains in strength and performance8,9. In addition, Nearly all studies indicate that “proper” CM supplementation increases body mass by about 1 to 2 kg in the first week of loading. In the International Society of Sports Nutrition position stand on creatine the authors state, “The tremendous numbers of investigations conducted with positive results from CM supplementation lead us to conclude that it is the most effective nutritional supplement available today for increasing high-intensity exercise capacity and building lean mass”8. I guess the case is closed on that front.

Is Creatine Safe?

 For years the media has portrayed creatine as a dangerous, not well understood supplement and those that were using it will “pay the piper” in the end. Unfortunately for the mass media, they arrived at their conclusions from a small sample size, namely the ever famous experiment of “n=1”.  The claims in the news are often that creatine can cause dehydration, injury, GI distress, and even kidney or liver damage. However, to date there have been no controlled trials that have shown creatine supplementation to cause dehydration, GI distress, injury, nor kidney or liver damage. The only clinically reported side effect of creatine supplementation is weight gain, which typically, is a goal of creatine users.

The notion that long-term effects of creatine are still unknown and the supplement is not understood simply shows a lack of knowledge and doing some reading. It could be argued that “supplemental” creatine has been around since man began eating meat, which according to recent research was more than a million years ago11.  Research on creatine actually began more than 40 years ago when it was experimentally used to treat heart disorders and improve heart function during heart attacks12.

To wrap up this question I will simply say that the research has shown that creatine appears to be safe when it is used in healthy populations and taken within recommended guidelines. However, like anything else in life, it may be harmful if taken in excess.  In addition further research in this area would be beneficial to determine if it is safe in non-healthy populations.

1.     What is the role of creatine in the body?

Creatine acts to improve our anaerobic work capacity by rephosphorylating ADP to ATP during short-term, high intensity exercise.

2.     Is creatine effective in enhancing performance?

To date, creatine is the most effective legal supplement available for increasing high-intensity exercise capacity and building lean mass.

3.   Is creatine supplementation safe?

No controlled trials that have shown creatine supplementation to cause deleterious side effects, with the only clinical side effect recorded being weight gain.

Is Creatine Ethical?

The last point of contention surrounding creatine supplementation is whether it is ethical or not. As my minor in my Ph.D. program is “sport ethics” and my major professor, Dr. Sharon Stoll, is one of the most renowned sport ethicists in the country I do have some thoughts on the ethics of creatine use, but that is a whole separate story, and perhaps I can convince her to write a paper on it with me.

Unless you are an athlete under the jurisdiction of a specific governing body, i.e USADA, WADA, or the NCAA, whether or not you decide to take creatine is a choice for you to make. I do not believe there is a right or wrong answer here as each person has their own views and perspectives on things, something I value quite highly about humanity. However, hopefully after reading this you have a better idea behind the big questions regarding creatine supplementation and can make a fully informed, educated, and well thought out decision.

References

  1. NBJ (2009) Sports nutrition & weight loss report. Nutrition Business Journal, vol XIV, September edn., Boulder.
  2. Gropper, S. S., Smith, J. L., & Groff, J. L. (2005). Advanced Nutrition and Human Metabolism. Belmont, CA: Thomson Wadsworth.
  3. Williams MH & Branch JD. Creatine supplemenation and exercise performance: an update. J Am Coll Nutr. 1998, 17, 216-213.
  4. Greenhaff PL: Muscle creatine loading in humans: Procedures and functional metabolic effects. 6th International Conference on Guanidino Compounds in Biology and Medicine. Cincinatti, OH. 2001
  5. Kreider RB, Leutholtz BC & Greenwood M. Creatine. Nutritional Ergogenic Aids. CRC Press LLC: Boca Raton, FL, 2004,  p 81-104
  6. Stout J, Eckerson J, Ebersole K, et al. Effect of creatine loading on neuromuscular fatigue threshold. Journal of Applied Physiology. 2000;88(1):109–112.
  7. Candow DG, Chilbeck PD, Chad KE et al., Effect of ceasing creatine supplementation while maintaining resistance training in older men. J Aging Phys Act, 2004, 12, 219-231.
  8. Buford T, Kreider R, Stout J, et al. International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition. 2007;4(1):6.
  9. Kreider RB, Effects of creatine supplementation on performance and training adaptations. Mol Cell Biochem 2003. 244, 298-307.
  10. Kreider, RB, Creatine in sports. Antonio, J., Kalman, D., Stout, J. R., Greenwood, M., Willoughby, D. S., & Haff, G. G. (2008). Essentials of Sports Nutrition and Supplements. Humana Press.
  11. Domínguez-Rodrigo M, Pickering TR, Diez-Martín F et al., Earliest Porotic Hyperostosis on a 1.5-Million-Year-Old Hominin, Olduvai Gorge, Tanzania. PLoS ONE, 2012; 7.
  12. Neely, Rovetto M, Whitmer J, Morgan H. Effects of ischemia on function and metabolism of the isolated working rat heart. American Journal of Physiology. 1973;225(3):651–658.

BIO

Brad Dieter, MS, CISSN, CSCS is a Doctoral Student at the University of Idaho, Movement Sciences; BradD@uidaho.edu

Interview – Ralf Jäger PhD FISSN

SNI: We know that regular creatine supplementation enhances body composition and exercise performance. What are some of the other benefits of creatine supplementation?

Dr. Jäger: Creatine makes you stronger, faster and smarter. Yes, it does more than help build muscles and improve exercise performance. New science shows that it also boosts brainpower. It helps you stay physically strong and mentally sharp at all stages of your life. Creatine crosses the blood-brain barrier and creatine supplementation has been shown to increase brain  creatine concentrations by approx. 9%.  Consequently, creatine has been shown to improve cognitive performance that is temporarily impaired due to sleep deprivation or permanently impaired due to aging. Even short-term creatine supplementation benefits brain function, as 8g of creatine monohydrate for 5 days prevented mental fatigue in a serial calculation task.   

Creatine has marked neuroprotective effects and is being investigated in clinical trials of Parkinson’s and Huntington’s disease. Every day we are learning more about the non-energetic mechanism-of-action of creatine, such as the increase in the sodium pump activity. From our understanding of the sodium pump and its relevance to disease, creatine supplementation might be beneficial for neurological disorders, pulmonary conditions, diabetes and metabolic disorders, cardiovascular health or fetal development.  Creatine has been shown to be effective in animal models of asthma and to increase longevity of animals. In addition, creatine seems to make certain drugs more efficient. The addition of creatine to an antidepressant resulted in more rapid and efficacious responses in women with major depressive disorders.  If you break your arm or a leg, make sure to grab your creatine on the way to the hospital. Cast immobilization results in muscle disuse atrophy, the loss of muscle mass. Creatine supplementation has been shown to help maintain lean body mass, strength, and endurance during immobilization. 

SNI: Would you recommend creatine supplementation for endurance athletes?

Dr. Jäger: The answer is yes.  Creatine supplementation can improve the quality of endurance athletes’ workouts and improvements  in workout quality leads to improvements in competitive performance. In addition, creatine supplementation may reduce muscle damage and inflammation during endurance exercise and thereby facilitate recovery. Runners who took creatine for five days before running a 30km race exhibited less muscle soreness and inflammation afterwards compared to runners who took a placebo. But there is still that nagging problem of weight gain.  Sometimes, it’s beneficial, since athletes want to go into the race before the big race with additional weight; however, most of the time, it’s not. Endurance athletes want to be lean and don’t want to carry any additional weight around. Try to increase your creatine stores with lower doses over a little bit more time, since that has been shown to minimize the weight gain.

SNI: What are the benefits (if any) in using forms of creatine other than monohydrate?

Dr. Jäger: Newer forms of creatine have been marketed with alleged better bioavailability, efficacy and/or safety profiles than creatine monohydrate. However, there is little to no evidence that any of those newer forms are safer or more effective than creatine monohydrate.  I personally use 100-percent pure creatine monohydrate powder and will continue to do so until I can find a research article in a peer-reviewed journal showing physiologically meaningful improvements in a head-to-head comparison over creatine monohydrate. As for now, save money and buy creatine monohydrate powder and mix it with fruit juice. The sugar in the juice raises insulin levels, which helps increase creatine uptake into the muscle. You need about 70 grams of simple sugars for every five grams of creatine, that’s approx. 22 fl oz of orange juice.

Creatine monohydrate might be hard to dissolve in cold water and if there is residue at the bottom of your glass after you drink it, try a different brand, or look for products with increased solubility, a creatine salt like creatine citrate for example. The acidity of the citric acid increases the solubility of the creatine in water. You want the creatine to end up in your muscles, not to stay in the glass. I would take it easy on the esophagus and would stay ways from strong acids, maybe look for a buffered effervescent product.  Why anyone would use a creatine product that has its ingredients listed in a proprietary blend is beside me. Not listing the amounts of actives is even more reason to stay away from the product. Know what you are putting in your body. Say no to proprietary blends and products that do not specify the amount of creatine.

SNI: Does creatine supplementation have ANY negative side effects?

Dr. Jäger: Common side effects include gains in strength and improved brain function, which sometimes can lead to feeling overconfident. Besides that, creatine is one of the most researched supplements out there. If there were any major adverse side effects, after more than 20 years of research and widespread use, we should have seen them by now. One thing is almost certain, if you take creatine, you will gain weight. The initial weight gain of about 1 to 2 kilogram during the first week of supplementation is water; however,  hit the gym and subsequent gains are muscle mass due the heavier workload you can handle and the increase in muscle protein synthesis.  Anecdotal claims link creatine to an increase in the incidence of muscle cramps or muscle pulls, gastrointestinal distress, dehydration, or kidney and liver damage.  However, there are no controlled studies demonstrating such adverse effects. Does an athlete taking creatine cramp or pull a muscle once in a while? Absolutely yes, but research has shown that your chances of experiencing any of those symptoms are not greater, and potentially even lower in comparison to athletes not supplementing with creatine. When taken within the recommended usage guidelines, creatine monohydrate supplementation appears to be safe; however, we know little to nothing about the safety of chemically modified forms of creatine.

SNI: What are your thoughts on ‘cycling’ on/off creatine and on ‘loading of creatine?’

Dr. Jäger: Athletes want to see results fast. Load your muscles with creatine by consuming 5 grams of creatine three to five times per day for five days followed by a daily maintenance dose of 2 to 5 g. Similar increases in muscle creatine can be achieved by using 3 g per day for 28 days. Without a maintenance dose, creatine levels return to baseline after 3 to 4 weeks. The more the better? Not true for creatine. The body has a ceiling on the amount of creatine that it will store in skeletal muscles. Muscle creatine levels will stay elevated as long as you consume the maintenance dose. There is no scientific reason to cycle creatine. Creatine levels drop slowly, so if your wallet needs a break, take a week or two off and then go back on it again.

BIO – Dr. Ralf Jäger is co-founding partner of Increnovo LLC, a global independent consulting firm, based in Milwaukee, WI. A postdoctoral scholar in bio-organic chemistry at the California Institute of Technology (Caltech) in Pasadena, Calif., Dr. Jäger originally earned his Ph.D. in organic chemistry from the University of Bonn in Germany.  He began his professional career as a head of a laboratory for SKW/Degussa, the leading supplier of creatine products. He is an award-winning speaker and has authored numerous scientific papers on sports nutrition and brain, joint, heart, and gut health, for both peer-reviewed scientific journals and industry publications/mainstream media. He is a certified sports nutritionist (CISSN) and fellow of the International Society of Sports Nutrition (FISSN), and is a member of the editorial board of the leading peer-reviewed  Journal of International Society of Sports Nutrition (JISSN). In recent years, he has consulted with professional sports teams, elite athletes and Olympians in various athletic disciplines.

Idiots in the Mist – The Lowdown on Creatine

by Jose Antonio PhD.  For those of you who know me, you’re well aware that I’m pretty lazy when it comes to bs’ing you.  It takes too much work and frankly, it’s just a waste of time.  If you want a straight answer, I’ll give it.  If you want a sugar-coated answer that’ll make you feel better, go ask your Mommy.  So what’s with the sardonic prelude?  is-creatine-safe-how-the-king-of-supps-affects-your-organs-1

First a little edification.  I teach at Nova Southeastern University in Davie FL.  I try like a madman to instill lessons in critical thinking.  Any monkey can memorize and regurgitate information.  But true learning occurs when you can think critically and independently.  Sometimes the mark of a good thinker is when you realize the more you learn, the more questions you have.  Often, those who are uneducated don’t know enough to know what they don’t know.  Hence, they succumb to ‘bro-science.’

I implore students to think for themselves, look up the data, and not just believe what your buddy at the gym says.  When I read just plain stupid sh#* like “creatine supplementation is bad for your kidneys,” it would be like a rocket scientist at NASA reading “the Earth really is flat.”  Ask yourself, “is there data to support the statement?”  Certainly, if you are looking for 100% agreement on anything scientific, then you my friend are in the wrong field.  The only guarantees are death and taxes.  So how does one come to a reasonable and smart conclusion about sports nutrition? 

As they say on one of my favorite TV Shows “CSI,”  ‘just follow the data; the data will tell you the answer.’  So in essence you’re a sleuth looking at the evidence, the clues, and the data.  With regards to creatine, the data are so voluminous, so robust, so convincing that it would be idiotic to believe otherwise.  Unless of course you’re so skeptical that you think apples might rise tomorrow.

So here’s the lowdown on creatine. 

To wit:  I gave my two-cents worth of supplement advice vis a vis “The Creatine Report” by Nick Tumminello and Lou Schuler.  It is a nice, informative, and consumer-friendly piece on the most widely researched sports supplement in the history of mankind.  For a copy of the report, go to http://www.freecreatinereport.com/.  Nick and Lou did an excellent job outlining the facts and dispelling the myths associated with creatine.  One would think that with the HUNDREDS of randomized clinical trials on creatine the myths promulgated by the educated and uneducated would cease.  But alas, I am mistaken.

Apparently, one must never underestimate the stupidity of the general public (or the learned medical professional).  Nick was kind enough to share with me some of the questions/comments that he received regarding creatine.  To say some were just god-awful idiotic would be an insult to idiots.  Moreover, the gross ignorance demonstrated by so-called experts (i.e. the Mayo Clinic) is just plain embarrassing.  Below are some of the questions he received.  For me to answer each of them in detail would be like asking a physicist to explain why apples fall from a tree rather than rise.  Yep, we still have flat-earthers out there.  My response is easy to see.  It’s after my initials.

Questions from readers who slept through Biology 101.

– Is there any quality research showing Creatine doesn’t work? If so, should these results affect our decision to take creatine?

JA:  Of course there is good research out there that shows creatine does not have an ergogenic effect.  If you’re looking for 100% agreement in science, then you’re a fool.  Imagine giving aspirin to 100 individuals with a headache.  Ninety of them respond favorably and 10 do not.  And let’s say that’s the general pattern throughout the scientific literature.  So does that mean aspirin works (for treating headaches)?  Or not?  Scientific conclusions are based on the PREPONDERANCE of the evidence.  And it is clear that the preponderance of the evidence points to a robust ergogenic response from creatine supplementation.  Sure, it doesn’t work for everyone.  But then again what does?  For a scientific summary of creatine, please read the ISSN’s Position paper on creatine.[1]  http://www.jissn.com/content/4/1/6  

– Some people say creatine made them bloated. Is there any scientific evidence behind these claims? What do you say to people when they make (or repeat) this type of claim?

JA:  The problem with the word ‘bloated’ is that it has no scientific meaning.  How do you measure bloatedness?  If someone says they are bloated, how can you even argue against it?  If someone says they weigh more, that’s easy to measure.  If you ‘feel’ bloated (whatever that means to you) and that feeling bothers you, then by all means quit taking creatine. 

– There are also claims from people that creatine made them poop more often.  Any scientific validation to this claim? What do you say to folks who make (or repeat) this kind of claim?

JA:  What?  You gotta be kidding me.  Inasmuch as there hasn’t been a single study measuring ‘poop frequency’ and creatine use, it’s impossible to give a remotely scientific answer.  However, if you like pooping more, then by all means keep taking it (if that’s what creatine does to you).  If you don’t like it, then for chrissakes quit taking it.

Here are quotes verbatim from the Mayo Clinic: http://www.mayoclinic.com/health/creatine/NS_patient-creatine/METHOD=print; Sigh…

Mayo Clinic: Creatine has been associated with asthmatic symptoms. People should avoid creatine if they have known allergies to this supplement. Signs of allergy may include rash, itching, or shortness of breath.

JA:  There is animal data which suggests this.[2, 3]  However, with the hundreds of clinical trials in humans, there’s no evidence that creatine causes an allergic reaction in us bipeds. Hence, if you have a pet rodent, by all means don’t give it creatine.

Mayo Clinic:  There is limited systematic study of the safety, pharmacology, or toxicology of creatine. Individuals using creatine, including athletes, should be monitored by a healthcare professional. Users are advised to inform their physicians or other qualified healthcare professionals.

JA:  This is a bit of a straw man argument.  First of all, the data is ALWAYS LIMITED (i.e. ‘limited systematic study…’).  But my question is this.  How much data is sufficient to satisfy the naysayers?  If you do a NIH database search of ‘Creatine and Exercise,’ it turns up 597 peer-reviewed scientific publications.  If you search ‘Creatine and Health,’ it turns up 107 publications.  According to the hundreds of RCTs (randomized clinical trials), there is no evidence of harmful side effects vis a vis creatine supplementation.  And please, do not cite anecdotes or case studies as evidence to the contrary.  Physicians love using case studies.  But with hundreds of RCTs, it would be perverse to ignore the plethora of evidence supporting the safety and efficacy of creatine supplementation.  Again, read these papers for a good review of the literature.[1, 4]  http://www.ncbi.nlm.nih.gov/pubmed/21424716 and http://www.jissn.com/content/4/1/6  .

Mayo Clinic: Some individuals may experience gastrointestinal symptoms, including loss of appetite, stomach discomfort, diarrhea, or nausea.

JA:  Really?  And the double-blind, placebo-controlled trials that show this are published where exactly?  Now it is entirely possible that there are those who have idiosyncratic responses to creatine ingestion.  Is it within the realm of possibilities that some may experience GI distress?  Of course.  But then again, folks get that eating nachos and cheese, hot dogs, or white bread too. 

Mayo Clinic: Creatine may cause muscle cramps or muscle breakdown, leading to muscle tears or discomfort.

JA: This is one is just sheer fabrication.  Wouldn’t the hundreds of peer-reviewed studies that examined the effects of creatine supplementation on exercise performance have already shown this?  According to a study published in the British Journal of Sports Medicine, “Recent reports now suggest that creatine may enhance performance in hot and/or humid conditions by maintaining haematocrit, aiding thermoregulation and reducing exercising heart rate and sweat rate. Creatine may also positively influence plasma volume during the onset of dehydration. Considering these new published findings, little evidence exists that creatine supplementation in the heat presents additional risk, and this should be taken into consideration as position statements and other related documents are published.”[5] Another study found that “the incidence of cramping or injury in Division IA football players was significantly lower or proportional for creatine users compared with nonusers.”[6]  For the Mayo Clinic to post this on their website is at best irresponsible and at worst, just plain moronic.

Mayo Clinic: Strains and sprains have been reported due to enthusiastic increases in workout regimens once starting creatine. Weight gain and increased body mass may occur. Heat intolerance, fever, dehydration, reduced blood volume, or electrolyte imbalances (and resulting seizures) may occur.

JA: What?  Really?  Did the author of this Mayo Clinic piece fall asleep during ‘Science 101?’ Again as stated in the previous answer: “Recent reports now suggest that creatine may enhance performance in hot and/or humid conditions by maintaining haematocrit, aiding thermoregulation and reducing exercising heart rate and sweat rate. Creatine may also positively influence plasma volume during the onset of dehydration. Considering these new published findings, little evidence exists that creatine supplementation in the heat presents additional risk, and this should be taken into consideration as position statements and other related documents are published.”[5] Another study found that “the incidence of cramping or injury in Division IA football players was significantly lower or proportional for creatine users compared with nonusers.”[6]  I feel like a broken record at times (yes, that dates me huh?). 

Here’s another excerpt from a study:  “The incidence of cramping (37/96, 39%), heat/dehydration (8/28, 36%), muscle tightness (18/42, 43%), muscle pulls/strains (25/51, 49%), non-contact joint injuries (44/132, 33%), contact injuries (39/104, 44%), illness (12/27, 44%), number of missed practices due to injury (19/41, 46%), players lost for the season (3/8, 38%), and total injuries/missed practices (205/529, 39%) were generally lower or proportional to the creatine use rate among players. Creatine supplementation does not appear to increase the incidence of injury or cramping in Division IA college football players.”[7]  Hey Mayo Clinic, did you bother to read any of this? 

Mayo Clinic: Long-term administration of large quantities of creatine is reported to increase the production of formaldehyde, which may potentially cause serious unwanted side effects.

JA: One study from Medicine and Science in Sports and Exercise states: Low-dose creatine combined with protein supplementation increases lean tissue mass and… reduces muscle protein degradation and bone resorption without increasing formaldehyde production.[8]  A publication in the journal ‘Amino Acids’ states: “Even if there is a slight increase (within the normal range) of urinary methylamine and formaldehyde excretion after a heavy load of creatine (20 g/day) this is without effect on kidney function. The search for the excretion of heterocyclic amines remains a future task to definitively exclude the unproved allegation made by some national agencies. We advise that high-dose (>3-5 g/day) creatine supplementation should not be used by individuals with pre-existing renal disease or those with a potential risk for renal dysfunction (diabetes, hypertension, reduced glomerular filtration rate). A pre-supplementation investigation of kidney function might be considered for reasons of safety, but in normal healthy subjects appears unnecessary.”  Thus, if you are a normal healthy exercising individual (and that pretty much describes the demo of those who consume creatine), then you are perfectly okay taking it.

Mayo Clinic: Creatine may increase the risk of compartment syndrome of the lower leg, a condition characterized by pain in the lower leg associated with inflammation and ischemia (diminished blood flow), which is a potential surgical emergency.

JA: “A 7-day loading dose of CrM increased anterior compartment pressures after dehydration and immediately after the heat tolerance tests, but the changes did not induce symptoms and the pressure changes were transient.”[9]  Is it possible that in rare instances, creatine supplementation might increase the risk of compartment syndrome?  Well, in the realm of possibilities, anything is possible.  And you might get struck by lightning and bitten by a shark too.

Mayo Clinic: Reports of other side effects include thirst, mild headache, anxiety, irritability, aggression, nervousness, sleepiness, depression, abnormal heart rhythm, fainting or dizziness, blood clots in the legs (called deep vein thrombosis), seizure, or swollen limbs.

JA:  Depression?  With the millions of creatine users in North America alone, one would think you’d have the offices of clinical psychologists lined up with depressed patients.  Again, this is entirely taken out of context.  Here is an excerpt from the report in which this ‘depression’ is based:  “Eight unipolar and two bipolar patients with treatment-resistant depression were treated for four weeks with 3-5 g/day of creatine monohydrate in an open add-on design. Outcome measures were the Hamilton Depression Rating Scale, Hamilton Anxiety Scale, and Clinical Global Impression scores, recorded at baseline and at weeks 1, 2, 3 and 4. One patient improved considerably after one week and withdrew. Both bipolar patients developed hypomania/mania. For the remaining seven patients, all scale scores significantly improved. Adverse reactions were mild and transitory.  This small, preliminary, open study of creatine monohydrate suggests a beneficial effect of creatine augmentation in unipolar depression, but possible precipitation of a manic switch in bipolar depression.”  Did you read that?  They gave creatine to unipolar and bipolar patients!  Not exactly the demographic that walks into Vitamin Shoppe and buys creatine is it?   And this passes for ‘evidence’ that it may cause depression.  Now all the other nonsense listed by the Mayo Clinic is just that, nonsense.  Again, sounding like a broken record; please read these papers which give you a broad overview of the creatine literature.[1, 4] 

The Moral of the Story

Be smart; don’t be lazy; look up the data.  And please don’t believe all the silly comments you hear from your friends or read on the internet.  If you have questions about any sports nutrition topic, then for chrissakes, go to the original source.  Read the science!

Remember, if you eat a lot of fish, you are eating a fair amount of creatine.  Last time I checked, fish was one of the healthiest foods to consume on the planet.  So for the naysayers, if you’re going to condemn creatine, you might as well put fish (and other meats) in that category. 

Nonetheless, the data supporting creatine’s safety and efficacy is as clear as the Montana sky.  Do yourself a favor.  Read the peer-reviewed science on creatine.  Don’t succumb to the Google-induced idiocy when you do searches like “creatine and poop frequency,” or “creatine and repetitive TiVo watching of The View.”  Yep, you can pretty much find anything on the web.  If you’re convinced creatine supplementation causes a third eye to pop out in the middle of your forehead, then there’s no hope for you.

I’ll end this story with a quote by Dalbo et al:  “Creatine is one of the most popular athletic supplements with sales surpassing 400 million dollars in 2004. Due to the popularity and efficacy of creatine supplementation over 200 studies have examined the effects of creatine on athletic performance. Despite the abundance of research suggesting the effectiveness and safety of creatine, a fallacy appears to exist among the general public, driven by media claims and anecdotal reports, that creatine supplementation can result in muscle cramps and dehydration. Although a number of published studies have refuted these claims, a recent position statement by the American College of Sports Medicine (ACSM) in 2000 advised individuals who are managing their weight and exercising intensely or in hot environments to avoid creatine supplementation. Recent reports now suggest that creatine may enhance performance in hot and/or humid conditions by maintaining haematocrit, aiding thermoregulation and reducing exercising heart rate and sweat rate. Creatine may also positively influence plasma volume during the onset of dehydration. Considering these new published findings, little evidence exists that creatine supplementation in the heat presents additional risk, and this should be taken into consideration as position statements and other related documents are published.[5]”

References

1.            Buford TW, Kreider RB, Stout JR, Greenwood M, Campbell B, Spano M, Ziegenfuss T, Lopez H, Landis J, Antonio J: International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr 2007, 4:6.

2.            Ferreira SC, Toledo AC, Hage M, Santos AB, Medeiros MC, Martins MA, Carvalho CR, Dolhnikoff M, Vieira RP: Creatine activates airway epithelium in asthma. Int J Sports Med 2010, 31:906-912.

3.            Vieira RP, Duarte AC, Claudino RC, Perini A, Santos AB, Moriya HT, Arantes-Costa FM, Martins MA, Carvalho CR, Dolhnikoff M: Creatine supplementation exacerbates allergic lung inflammation and airway remodeling in mice. Am J Respir Cell Mol Biol 2007, 37:660-667.

4.            Jager R, Purpura M, Shao A, Inoue T, Kreider RB: Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids 2011, 40:1369-1383.

5.            Dalbo VJ, Roberts MD, Stout JR, Kerksick CM: Putting to rest the myth of creatine supplementation leading to muscle cramps and dehydration. Br J Sports Med 2008, 42:567-573.

6.            Greenwood M, Kreider RB, Greenwood L, Byars A: Cramping and Injury Incidence in Collegiate Football Players Are Reduced by Creatine Supplementation. J Athl Train 2003, 38:216-219.

7.            Greenwood M, Kreider RB, Melton C, Rasmussen C, Lancaster S, Cantler E, Milnor P, Almada A: Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem 2003, 244:83-88.

8.            Candow DG, Little JP, Chilibeck PD, Abeysekara S, Zello GA, Kazachkov M, Cornish SM, Yu PH: Low-dose creatine combined with protein during resistance training in older men. Med Sci Sports Exerc 2008, 40:1645-1652.

9.            Hile AM, Anderson JM, Fiala KA, Stevenson JH, Casa DJ, Maresh CM: Creatine supplementation and anterior compartment pressure during exercise in the heat in dehydrated men. J Athl Train 2006, 41:30-35.

 

 

Interview – Darryn Willoughby PhD FISSN

SNI: How much creatine is absorbed when you consume let’s say about 5 grams of it?

Darryn: There is an upper limit of muscle creatine content which can be accomplished by taking 3 grams/day of creatine for 30 days. However, after two days of loading (20 grams/day), maximal muscle creatine content occurs, and amounts at this dose beyond this time are unnecessary. Ingesting low doses (1 – 10  grams) of creatine will reach maximum concentration in the blood within 2 hours. In response to a 5 gram dose, the typical maximum absorption is approximately 100 mg, and occurs at 1 hour post-ingestion. This means that out of 5 grams of creatine ingested only about 2% is bioavailable.

SNI: Is an increase in urinary creatinine something that occurs after creatine consumption?

Darryn: Creatine is typically not found in urine since it has the ability to be reabsorbed in the kidneys. However, creatine is non-enzymatically degraded to creatinine, which is excreted in the urine. In the case of creatine over-consumption, as indicated in question #1, excess creatine will be converted to creatinine and released in the urine. Therefore, monitoring urinary creatinine levels can provide a general index of creatine absorption.

SNI:  Creatine consumption activates satellite cells.  What are satellite cells and why is that important?

Darryn: Satellite cells are muscle cells that have yet to fully develop. When they do become activated, they differentiate and then proliferate, not into actual new muscle fibers, but into myotubes where they will donate their nuceli to pre-existing mature muscle fibers. The overall result is that that our muscle fibers will end up with more nuclei, which contains DNA and genes critical to muscle protein synthesis. Heavy resistance training activates satellite cells, but creatine does also. The process of the differentiation phase of satellite cell activation is a highly-ATP dependent process and relies heavily on creatine phosphate. Creatine supplementation can provide the enhanced ability to facilitate the differentiation of activated satellite cells. In the end, this can result in increased muscle mass and performance.

SNI: What is the best form of creatine and why?  Creatine monohydrate?  Cr Nitrate?  CEE?

Darryn: At this point, creatine monohydrate is the best form of creatine. Many of the new form of have absolutely no research data to show their alleged effectiveness. Of the ones that do, such as CEE, the data is clear that creatine monohydrate is superior. The other thing to consider is that with many of these new forms of creatine, such as Cr Nitrate, etc. they are not able to traverse the creatine transporter; therefore, these compounds will most likely be degraded and the creatine molecule released and it absorbed into muscle as with creatine monohydrate. Therefore, in essence these different forms of creatine are no different to creatine monohydrate relative to mechanisms of muscle uptake.

SNI: What are your top 5 supplements for gaining muscle mass and why!?

Darryn:  Here ya go!

1. whey protein: stimulates muscle protein synthesis and minimizes protein damage/degradation

2. creatine monohydrate: stimulate muscle protein accrual through satellite cell activation and increases anaerobic energy and reduces muscle fatigue

3. leucine/BCAAs: stimulates muscle protein synthesis and minimizes protein damage/degradation

4. beta-alanine: stimulates increases in anaerobic energy and reduces muscle fatigue

5. curcumin: little human research yet, but very good rodent data showing this herbal extract to be a very robust anti-oxidant to reduce oxidative stress and local inflammation, thereby reducing the activity of ubiquitin-mediated protein degradation. More human work needs to be done, but I am very confident that this one shows great promise.

Bonus fun question 6.  If you could be a superhero, who would it be and why?

Superman because he possesses great physical strength while being incredibly intelligent, yet at the same time he is very humble, modest, and non-assuming.

BIO – Darryn Willoughby, Ph.D., FISSN holds BS and MEd degrees in Exercise Science from Tarleton State University and a PhD in Neuromuscular Physiology and Biochemistry with a sub-emphasis in Nutritional Biochemistry from Texas A&M University. He is a Fellow of the American College of Sports Medicine and International Society of Sport Nutrition (ISSN). He is also the current President of the International Society of Sports Nutrition, and is a Certified Strength and Conditioning Specialist from the National Strength and Conditioning Association and a certified exercise and sport nutritionist from the ISSN. Dr. Willoughby is an internationally recognized scholar and one of the top leaders in the field where his primary research focuses on the molecular mechanisms regulating muscle hypertrophy and atrophy and the effectiveness and efficacy of nutritional supplements in helping to support muscle hypertrophy, attenuate atrophy, and improve exercise and sport performance. He is well published in scientific research journals such as the Journal of Strength and Conditioning Research, Medicine and Science in Sports and Exercise, Journal of Sport Science and Medicine, and the International Journal of Sports Medicine. Dr. Willoughby gives invited presentations at numerous professional conferences regarding sport performance and muscle adaptation to training and nutritional supplementation.

 

Surviving An Ultra

By Michelle Adams M.P.H., CISSN, CSCS, IFBB Pro.

Ultra- endurance events are defined as any event longer than a marathon (26.2 miles or 42.16km).  These events are a challenge to every aspect of the human body.  Preparation for such an event is undoubtedly a demanding process.  Months of training logging hundreds of miles in preparation for one 30 or 50 mile race will simply NOT happen, or at least not SUCCESSFULLY happen, without a carefully laid out nutrition and supplementation plan.  Most people know the basics of nutrition as far as macronutrients go: carbohydrate (CHO), protein (PRO), fat, and water. Unfortunately, that is usually where the knowledge stops. Often times runners’ nutrition strategy is as simple as “I am a runner, I eat carbs.” Protein is usually an after thought and fat sometimes happens on accident- or as a late night ice cream binge after a long day with an even longer run.  What is usually completely omitted is any type of supplement plan.  “Supplements? I’m not a bodybuilder. Why would I need supplements?”  The answer is: to perform better, or at the very least to not suck.

So what are the top supplements I would recommend?

1. Fluids (water, electrolyte, and CHO delivery)

2. CHO

3. BCAA/EAA

4. Caffeine

5. Creatine

Fluids

Fluids may seem like a no brainer.  But optimizing your hydration with regards to how much, when, and what type can take some careful preparation.  Your body is composed of 60-80% water.  Body temperature regulation, blood volume, and heart rate are all affected by hydration status. Showing up to a race not optimally hydrated will start you off behind the eight ball.  This is something you will not be able to make up. Fluid intake during the event should be about 5-6 ounces every 15 minutes. Fluid should be comprised of 8-10% carbohydrate solution to allow for optimal gastric emptying and absorption rates and should contain electrolytes as well.

Carbohydrates

Carbohydrates are synonymous with endurance events. Unfortunately athletes are all too often focused on carbohydrate intake BEFORE the event with little attention paid to intake during the event.  The longer the duration of the event, the more your body relies on blood glucose for fuel.  Muscle glycogen stores may be depleted in a rather short time frame (1-2 hours). Races longer than this (pretty much ANY ultra-endurance event) will rely heavily on blood glucose as well as free fatty acids for fuel.  Exogenous carbohydrates ingested during an event can generally be oxidized at a rate of approximately 1g/min or more.  (Some studies show that mixing sources of carbohydrates may yield higher oxidation rates [1].) This means that ingesting carbohydrates at a rate of 45-60g/hour would be ideal in terms of providing a continuous source of exogenous CHO for oxidation. Taking in high glycemic index carbohydrates during the event will stave off the ‘hitting of the wall’ phenomenon that can occur when inadequate energy substrate is unavailable.  Popular carbohydrate supplements such as gels or GU typically contain 23-25g of high glycemic carbohydrates per serving. Trying to stomach nothing but GU or gel for 5, 6, 7 hours or more would be a feat in and of itself.  Most ultra events will require the athlete to eat some amount of solid food during the event.  Pretzels, power bars, cookies and candy are all commonly found at aid stations during such events.  It is wise to stick with lower fat, lower fiber choices as they will tend to be higher glycemic index and more readily available to your body for fuel.

Protein/Amino Acids

If there is one thing that most endurance athletes are deficient in, it is protein.  Protein, especially essential amino acids and branched chain amino acids, can be a great help not only during the training period, but also during an ultra event.  Many studies have shown that adding even a small amount of protein to a carbohydrate solution enhances glycogen replenishment post exercise.  Those same amino acids may also be used as an energy substrate during the event as well.  Branched chain amino acids (BCAAs), unlike other amino acids, may be used directly by the skeletal muscle for fuel.  They do not need to be transported to the liver to be broken down.  BCAAs can comprise up to 20% or more of the fuel used by the working muscles during exercise.  In addition to providing energy directly to working muscles, BCAAs are also an important player in helping to synthesize glucose (gluconeogenesis) thereby increasing time to exhaustion. Another benefit to BCAAs is their ability to delay central fatigue and mental exhaustion by way of blocking tryptophan transport to the brain.  The bottom line – to keep your muscles and your brain going strong take your BCAAs. Ten to twenty grams would be a great place to start when adding BCAAs to your race day hydration, especially as the hours wear on.

Caffeine

Caffeine often gets a bad rap, although I am not sure why since it has so many benefits. No, it will not dehydrate you.  In fact it is likely to enhance your performance.  Taking 3-6mg/kg of bodyweight about 15 minutes prior to an endurance event can not only increase central nervous system excitement, but also promote increased utilization of free fatty acids for fuel.  This increase in free fatty acid usage actually helps to spare muscle glycogen, leaving more in the tank for later in the race.

Creatine

Creatine isn’t just for bodybuilders.  In fact, some of the first studies done with creatine were conducted on endurance athletes measuring its effect on sprint times and anaerobic threshold (2, 3).  Increasing numbers of studies continue to demonstrate the positive impact creatine has on endurance athletes.  Beis et al. demonstrated creatine’s ability to help maintain a lower heart rate as well as core temperature with its ability to aid in hydration states, especially in hot environments, without affecting running economy (4).

Athletes should remember though that creatine must be taken at a minimum dose of 3g/d for at least 28 days before optimal intra-muscular creatine levels will be achieved.  Simply throwing creatine into race day nutrition will have little impact on performance or hydration.

So there you have it, the top five supplements to ensure your survival of an ultra endurance event.  You cannot shirk your training or proper nutrition during the training period and expect these supplements to carry you through. However when used properly they can help make the difference between a good race day performance and a great one.  Do your homework, train smart, recover, arrive well rested, well hydrated, stocked and ready to run.

References

1. Jentjens RLPG, Achten J, Jeukendrup A. High oxidation rates from combined carbohydrates ingested during exercise. Medicine & Science in Sport & Exercise 2004;36:9 1551-1558

2. Harris RC, Viru M, Greenhaff PL, Hultman E. The effect of oral creatine     supplementation on running performance during maximal short term exercise in man. J Physiol 1993;467:74P.

3. Smith JC, Stephens DP, Hall EL, Jackson AW, Earnest CP. Effect of oral creatine ingestion on parameters of the work-time relationship and time to exhaustion in high-intensity cycling. Eur J Appl Physiol 1998;77:360-365.

4. Beis LY, Polyviou T, Malkova D, Pitsiladis YP. The effects of creatine and glycerol hyperhydration on runnin economy in well trained endurance runners. JISSN 2011, 8:24

BIO

Michelle Adams BS, MPH, CISSN, CSCS. Originally hailing from western Massachusetts, Michelle Adams received both her Bachelor’s degree and Master of Public Health degree from the University of South Carolina.  With over 13 years’ experience in personal training, Michelle is a certified strength and conditioning specialist with the National Strength and Conditioning Association (NSCA CSCS), certified Sports Nutritionist with the International Society of Sports Nutrition (CISSN), certified sports performance coach with USA weightlifting as well as a kettlebell instructor.  Michelle is a competitive athlete herself having competed as a professional figure athlete in the IFBB with career highlights including a first place finish at the 2006 IFBB Toronto Figure Championships.  More recent endeavors have included marathon and ultra-marathon running.  Michelle currently lives in Florida but may also be seen throughout the United States serving as a spokesperson for General Nutrition Centers.

http://adamsadmonitions.blogspot.com/

http://www.runwithtfk.org/

 

Timely Advice from Smarty-Pants of All Kinds

Question:  What simple piece of nutrition/supplement/exercise advice would you give to a fitness enthusiast who wants to lose fat/gain muscle?

My advice is this:  – DO consume 5 g of creatine daily; DO consume a high-quality protein immediately post-exercise.  DO consume fish or fish oil regularly.  DON’T consume (or limit severely) processed carbs.  DON’T make sad sorry excuses.  And quit stuffin’ your face for Pete’s sake. – Jose Antonio PhD FACSM FNSCA FISSN –  Sports Nutrition Insider Editor in Chief

Words of Wisdom From The Expertseinstein1_7

Focus on protein at every meal (poultry, lean beef, fish, eggs, dairy or even a protein shake). – Jim Stoppani PhD – Muscle & Fitness

Eat foods that don’t have a label (fresh meats, fresh vegetables, fresh fruits) every 3 hours! – Juan Carlos Santana MEd FNSCA CSCS*D – Institute of Human Performance

5 fish meals/week!!  Remember all fish count; both fish protein and marine fats are uniquely able to enhance body composition. – Susan M. Kleiner PhD RD FACN CNS FISSN – author of Power Eating

Eat breakfast. It tells your body that you will not starve it and in turn your body will jumpstart your previously sleeping metabolism. If your body doesn’t trust that you will feed it-especially after hours of no food like when you were sleeping- it will hold on to any extra fuel (body fat!) like an old lady clutches her purse when she rides the subway! – Gunnar Peterson CSCS CPT – Beverly Hills-based Personal Trainer

Take caffeine pre-workout.  Supplement with creatine.  Stop eating so much sugar.  Cut back on all processed carbs.  And eat more protein!  – Jeff Stout PhD FACSM FNSCA FISSN – University of Central Florida

Macronutrient manipulation is the best way to improve body comp.  You don’t have to eliminate carbs or fat, just think about adding high quality protein to every meal/snack.  Shoot for a 2:1 or 1:1 (for rapid changes) CHO:PRO ratio. – Abbie Smith PhD CSCS*D CISSN – University of North Carolina

Pay close attention to your hunger and satiety cues. When you reach for food, ask yourself if you are really hungry or if you are eating for other reasons like boredom, stress or anger. – Marie Spano MS RD CSCS FISSN

Don’t be enchanted by the evangelistic tales of things falling or rising in the blood (testosterone), muscle (protein synthesis or breakdown), or metabolism (e.g. ‘fat burning’), which often are disconnected from what you are seeking. Ask for evidence on the ACTUAL PRODUCT, for what REALLY counts: increased muscle mass and/or decreased body fat. – Anthony L. Almada MSc FISSN 

Use common sense and stop the silly fad diets.  It’s not about low calorie, low sugar, fat free, gluten free or any other ‘label.’ It is as simple as eating a variety of natural foods in there natural form at the right times of the day and be mindful of proper portion sizes. You have choices: an apple or a candy bar, a had full of M&M’s or almonds, fast food or home cooked, water or soda, etc. You know the answers, apply them and you will look and feel amazing. It is that simple! – Kim Lyons NASM CPT – former trainer on The Biggest Loser

Consume whey protein. Numerous studies have shown how whey protein may prevent hunger, decrease inflammation and manage insulin better. If you can’t have the supplement, increase dairy food sources in your diet. – Marta Montenegro MF MS CSCS NSCA-CPT

For nutritional supplements, before spending a lot of money avoid all the marketing hype and try to focus on the actual ingredients and the science behind them. Seek out help if you need, it. Contact the ISSN. For your diet, try to eat as “clean” as possible by decreasing your carbohydrate and saturated fat intake and by trying to “chew” most of your daily calories as opposed to “drinking” them. – Darryn Willoughby PhD FACSM FISSN CSCS CISSN – Baylor University

A new year’s tip for a leaner 2012: Reduce (or eliminate) added sugar intake, increase lean protein intake, and take advantage of the power of caffeine! – Colin Wilborn PhD FISSN CSCS ATC – University of Mary Hardin Baylor

When all else fails, reduce your intake of starchy carbohydrates, and replace with fibrous carbohydrates like fruits and vegetables with high fiber and low energy density. – Tim N. Ziegenfuss PhD FISSN CSCS

You can use the best equipment and technology to fine-tune a high-end sports car, but without fuel it simple won’t perform.  To get the most out of your training, you need to consider your body a high-end sports car.  I mean you wouldn’t put water into the gas tank of a race car would you?  Then why put junk into your body?  – David Sandler MS CSCS*D FNSCA FISSN – National Strength and Conditioning Association

If you fail to plan, you plan to fail.  Preparing healthy meals in advance and keeping supplements organized is essential to staying on track and achieving your fitness goals. – Rehan Jalali Celebrity Nutritionist

Make sure each of your meals contains a wholesome, fiber-rich carbohydrate like fruit or a small portion of whole grains for energy and a lean protein to keep you feeling satisfied and to keep your muscles strong. Round out your meals with vegetables for fiber, nutrients and healing antioxidants for your exercised muscles. – The Nutrition Twins: Lyssie Lakatos RD LD CDN CFT and Tammy Lakatos Shames RD LD CDN CFT

I would recommend a high protein diet.  I took breads out of my diet in the last three weeks and lost five pounds.  I even eat chicken for breakfast with tea.  Have protein bars for snacks too.  My mind also just feels better and more energetic for working out.  – Suzy Favor Hamilton 3-time Olympian

Avoid processed, refined white flour, white sugar carbs. And don’t be afraid to eat fat! – Mona Rosene MS RDbruce-lee

There is no way to out-supplement a poor diet, nail your nutrition first. Dump the processed ‘foods’ and stick with lean proteins and veggies. – Michelle Adams MPH CISSN CSCS IFBB Pro

Measure your current body composition, set a specific goal composition, calculate the difference (in lean mass and body weight), then plan your training and diet accordingly. Focus on nourishment to build the body you want, instead of malnourishment to destroy the body you don’t – Damon Hayhow CISSN

Don’t be afraid to eat less than what you think that you need! – Douglas Kalman PhD RD FISSN FACN – Miami Research Associates

Protein throughout the day with the most important times being breakfast and post exercise (at least 20 grams). If you include at least one significant protein source with all meals and snacks you are on the right track as protein needs are increased relative to exercise effort – Rob Wildman PhD RD LD FISSN

Try to eat every 3-4hrs. In each meal try to include each of these three things: a lean protein (like chicken or fish, etc.), a fibrous carb (fruits and/or veggies), and a healthy fat (like avocado, nuts, etc.) – Nick Tumminello CPT CSCC

Success is never about the food. It’s all about having the skills, tools and the environment that ensures better choices are made consistently, but also the right choices are consistently available every time. Food proximity rules; if it’s easy to get to, eventually you’ll eat it! – Paul Cribb PhD – Metabolic Precision

Most importantly, have positive mindset about working out and eating clean. Get rid of all the junk food in your house, and be consistent with weight lifting and cardio. Especially women- do not be afraid to lift a little heavier than usual! – Liza Muravyeva MS RD

Start simple. Cut foods that are highly processed, high in sugar, high in saturated fat and low in nutrients. Drink 2 liters of water before noon. If you must have a late night snack, reach for a lean protein and step away from the bowl of ice cream. STOP blaming your parents for “making you fat”. Create a DO-ABLE nutritional plan and stick to it! – Jay Dawes, PhD CSCS Texas A&M Corpus Christi

Eat more protein working up to a minimum of 0.75 grams per pound of body weight .  This works to support muscle growth and keep you full longer so you shove less food into that hole below your nose. – Mike T Nelson PhD(c) CSCS MSME

Don’t just “wing it” when it comes to nutrition. Know your protein, carb and fat grams and limit your fat loss to no more than 1.5 pounds per week. – Raphael Calzadilla BA CPT ACE

There really is no substitute for a great training program and good clean, well-balanced diet. For the recreational fitness enthusiast interested in losing fat and gaining muscle, rather than looking for the ultimate quick fix that simply does not exist, focus your efforts on a strenuous training program and well-rounded diet. – Kristy Lee Wilson BS NSCA-CPT NASM-CPT PES CES

Even caloric distribution throughout the day, along with quality and balance, will positively impact body composition, glycogen storage, protein synthesis and immune system health. – Heidi Skolnik MS CDN FACSM 

To enhance body composition will require time; make sure you schedule time to shop and cook.  I train my client’s brain and brawn.  You must have a strong positive mindset; you cannot let other people drag you down or sabotage your own fitness and health goals.  In the end you control your health and well-being. – Nicole Moneer Guerrero NASM-CPT CISSN IFBB Pro

Regardless of what type of training you are doing, always eat something within 15 minutes following every training bout.  Ideally, this should include carbohydrates and a high quality protein source without excess dietary fat. – Lem Taylor PhD FISSN CISSN – The University of Mary Hardin Baylor

Of all of the 20 amino acids leucine is mainly responsible for driving skeletal muscle growth (or at least turning on protein synthesis).  To optimize this process consume 2-3 grams of leucine whether in supplement form (with 1.5 grams isoleucine and valine) or from high quality proteins each meal.  Milk based proteins are 10 % leucine, egg is about 9 %, and meats are about 8 % leucine.  This would amount to about 30 grams of high quality protein per meal for example from a milk based protein (3 grams of leucine). – Jacob M. Wilson PhD CSCS*D – University of Tampa

Eat like a caveman. Or to be PC, A cave-person. We’ve come full circle on this one. Eating wild game, fish and a variety of in-season vegetables, fruits, nuts and seeds proves to be our best bet for a lean, well-functioning body. And one more thing…SLEEP! Chronic sleep deprivation can cause weight gain by affecting hormones that control appetite as well as the way we store carbohydrates. – Gina Lombardi RDH NSCA-CPT *D – Host of Fit Nation

To transform your body, you must drink enough clean water, eat high quality REAL food 4-6 times daily and challenge your body with resistance.  And then plan the next day.  Consistency and planning lead to physical success.  The little things done daily make ALL the difference.  – Billy Beck CSCS CISSN

Don’t overcomplicate things…simply make only one small positive nutritional change at a time until that small change becomes a good habit, and then add the next small change. Over time this will work out much better than changing many things at once– (and the results will last longer too). Also, be sure to add protein to every meal that you eat! Our research has documented that this helps to promote fat loss and muscle mass gains. – Michael J. Ormsbee PhD CSCS CISSN – Florida State University

One “cheat meal” is ok, if your diet is typically on point. Don’t beat yourself up or stay too rigid. One salad doesn’t make an overweight person thin either. It’s about the long haul.  – Shawn Wells MPH RD CISSN

Enhancing body composition implies maximizing lean muscle mass and reducing stored body fat. In terms of maximizing lean muscle mass, supplement with creatine monohydrate. Not only is this supplement safe and inexpensive – it WORKS. – Bill Campbell PhD CSCS FISSN

The simplest beginning is to start cutting back carbs (e.g wheat, grains, potatoes, anything ‘white’; but not so much fruits and veggies).  Increase protein intake esp lean meats and egg whites.  Also, whey protein creatine and caffeine (pre workout) are proven supplements to help you achieve your goals.  – Ty Nordic CSCS

Pay attention to what you eat before, during and after your workouts and be sure that regardless of the goal a good bit of general advice is to eat at least 1-2g/kg of protein per day (especially when trying to lose to maintain the muscle you do have), healthy fats are wicked good for you and should be at least 30% of your macro breakdown for fat loss OR muscle gain and don’t be afraid of carbs!!! – Melissa Traynor CISSN ACSM CPT-HFS

Spend a small percentage (10%) of what you would on your fitness equipment, clothing etc and another 10% of the time you spend on your fitness endeavours on your food and food preparation. It will pay dividends over 10:1 in terms of performance and recovery in most cases. – David Driscoll MSc CSCS

If you want to lose fat and gain muscle, you need to eliminate the single nutrient that will stimulate fat storage: sugar. In a study conducted by researchers at UCONN, men who ate a high-protein, moderate-fat, zero carb diet lost significantly more fat and gained almost double muscle than men who ate more sugar and less protein. Rule of thumb: if it tastes sweet, only eat it after your workout, if at all. – Cassandra Forsythe-Pribanic PhD RD

Bump up your protein and reduce simple and extra complex carbs as much as possible- and make sure to consume some carb protein combination immediately post exercise!!  – Kelly Kennedy PhD CISSN ACSM-HFI

Cook and pack your own protein-rich meals and keep “emergency snacks” such as nuts of all kinds (e.g. walnuts, almonds, etc) in your car so you never skip a meal or are tempted to hit the McD’s drive-thru!  And wash every meal down with pure simple water! – Carla Sanchez NSCA-CPT IFBB Pro – Performance Ready Team

You have to just do it (i.e. nutrition and training) consistently.  You need proper nutrition (including appropriate, credible supplements) and a training plan tailore to suit your goals.  It must be a lifestyle not a quick fix. Quick fixes don’t work; because they are quick to come and quick to go. – Jenna Becker MS RD CISSN

Challenge your large muscle groups a couple of times a week by doing squats, throwing hay bales, or hoisting cinder blocks so that you are huffing and puffing and burning. Stay consistent, maintain good form and increase the resistance as you get fitter and stronger. – Tom Seabourne PhD CSCS

Shoot for 10 portions of fruit and vegetables daily, with most of the portions coming vegetables as sugars from fruit not helpful when aiming for weight loss. Vegetables are best juiced, steamed, lightly cooked and blended into soups, or raw; with stir-fries, roasted and casseroles thrown in for variety. Power this up with plenty of fresh or dried herbs. And how to achieve this? Add several colourful servings to EVERY meal and snack starting with breakfast. – Andrea Cullen

Adding lean protein is hands down the best way to promote muscle growth – it is the building block.   Losing fat and gaining muscle at the same time is a tall order, so also adding Branched chain aminos pre workout for preserving muscle is a good plan as well.  – And stay out of the Drive throughs…..;-) – Shannon Leroux Pro Figure Athlete

Track your food intake.  Often after a few days of tracking the realization usually is:  underestimation of overeating or overestimation of undereating. – Allison Ethier NSCA-CPT CanFitPro-PTS CISSN

My single piece of advice would be to get back to the basics. I think to often we are all trying to find the latest and greatest new things and forget about the tried and true. These include a clean, natural food diet with basic supplementation of protein, creatine monohydrate and EAAs. If it seems to good to be true, it probably is! – Lacy M. Puttuck RD CISSN CSCS

Increase your protein and vegetable intake, increase meal frequency, and decrease sugar, processed foods, and portion sizes. Three important supplements to begin taking are: a multivitamin, vitamin D, and fish oil. – Stephanie Svoboda CSCS CISSN

Change your mindset in how you view food. Every time you eat you have a choice to choose foods that provide the body with stable energy, enzymes, and nutrients to improve the efficiency of the body and decrease inflammation.  Get out of a diet mindset and make your food choices with those positive principles in mind. – Amanda Carlson-Phillips MS RD CSSD – Athletes’ Performance

Make sure your resistance training program is practical (nobody gets an ideal physique by doing bicep curls while balancing on an inflatable disk) and that the weight/load and/or volume are substantial, throughout any variations, to satisfy muscle building. Supplements (i.e. whey protein, caffeine, creatine and beta-alanine) and diet are complementary to body composition enhancement as well as exercise regimen progressions.  But don’t think for a minute that there is a magic pill, powder or potion that makes you exempt from eating cleaner and working harder!  – Anna Lepeley MS PhD(C) CSCS CISSN

Muscles lack the necessary enzymes to use alcohol as fuel.  It negatively affects reaction time, hand-eye coordination, balance, thermoregulation, fluid balance, glycogen conversion and muscle growth.  Alcohol decreases strength, power, speed, muscular endurance and cardiovascular fitness. For these reasons, the healthiest alternative is abstinence. – Robert Taylor Jr SCCC CSCS*D CES NSCA-CPT*D CSES

Everyone wants a simple explanation as to how they can gain muscle and lose fat.  The reality is that it’s a difficult process with no easy way from point A to point B. The best advice I can give you is that patience, dedication, and hard work are by far the key ingredients for changing body composition. The worst plan executed with the best work ethic is way better than the best plan executed with poor work ethic. – Layne Norton PhD IFPA and NGA Natural Pro Bodybuilder

Pick a goal, devise a system to reach that goal, and work toward it with both determination and patience. The opposite of training is beating the crap out of yourself every workout, with no goal beyond pain tolerance and bragging rights. It makes no more sense than the old advice to eat a low-fat diet and walk around the block a few times. Training is in the middle of those extremes: hard work, but with a plan and a purpose. – Lou Schuler

Success is a result of consistently doing the right thing. The client or athlete that fails to be successful is the one that simply will not adhere to what we know works. Their world is filled with excuses, whining about their lack of progress, yet they never realize that the blame for their failure rests solely on their shoulders. – Mark Myhal PhD

Have a whey protein shake preferrably an organic kind  like warrior whey to ensure highest quality nutrients, about 30 min pre-workout with about 20-30 grams with water or almond milk and ice and post-workout when hunger strikes within 30 min to an hour about 30 grams with a little fruit like berries, a little fat like almond butter, and organic greens like greens plus for vitamins, minerals and antioxidants. – Yarixa Ferrao

Take advantage of your post-exercise nutritional window–consume 1/4 gram/lb of whey protein as soon as possible following your workout.  It’s perhaps the easiest thing you can do to maximize muscle protein synthesis. – Brad Schoenfeld MSc CSCS – author of Look Great Naked

Set performance-related exercise (or sports) goals.  What you get out of workouts is proportional to what you put into them. Human beings are naturally performance oriented, and setting performance goals provides the motivation to put a lot into one’s training. –  Matt Fitzgerald, CISSN, author of Racing Weight: How to Get Lean for Peak Performance

A ship that’s overloaded and brought about far too sharply will likely capsize; so, too, will a person fail at achieving their goal if they attempt to make too many changes at once. Thus, be in it for the long-haul. Make one change, let your body respond and then begin to plateau before adding a second change. In this regard, the best and most simple way I’ve found to effectively change a person’s body and energy levels is to first have them change their breakfast. If you can control blood glucose from the moment you wake up, a large part of the battle has already been won. – Chris Lockwood, PhD, CSCS

Eat leafy greens at every meal, they contain omega-3 fats too! Think spinach & eggs with salsa for breakfast, a handful of mesclun greens tossed into a smoothie mid morning, a big composed salad of tuna & beans on a bed of arugula for lunch, romaine lettuce wraps filled with Greek yogurt, shredded carrots & olives midday, and steamed kale alongside a baked sweet potato & lean grass-fed beef or steamed fish for dinner. Power meals don’t come in containers. – Elizabeth Brown, MS, RD, CPT, CDE Certified Holistic Chef

Go for the “White-Out” approach to diet by eliminating the white’s: sugar, bread, rice, and pasta. Skip sugary soft drinks and fruit juices. Instead, get your carbs from fibrous veggies and some fruit. And by all means eat more protein with your meals! Mixing protein with carbs means less of an insulin spike and less fat storage — good news for your abs! – Rick Collins Esq FISSN

Exercise regularly; eat diet high in protein from lean meats and fish and supplement with fish oil. Supplement your diet with inexpensive whey protein (20 to 30 grams minimum) and simple creatine ( 3 to 5 grams a day). Cut back on carbs and use only complex carbs in diet. – Marv Heuer MD

Being able to gain fat is NOT a disease or a problem. It is actually evolution at its finest. Fat is the body’s way of ensuring its chances of survival during times of food scarcity. Once you accept that fact and learn to work with it, you… will find that losing excess fat and gaining muscle is not impossible. Remember that breakfast sets the “tone” for your metabolism for the rest of the day. So don’t skip it. Remember that your body does the majority of its muscle repair during rest, so stock up on some good protein before bedtime. And listen listen listen to your body as the day goes by. And don’t force yourself to shed off an enormous amount of body fat in a short amount of time. Not only will the results be short lived, you will lose muscle meanwhile. And my biggest advice to prevent fat loss problems in the future; don’t get fat in the first place ! – Josephine Dalton, aka ‘Trainer Jo.’  ACSM-NASM-APEX certified.

Make protein your number one nutrient source. Cut back or eliminate carbohydrates and focus on solid protein sources such as meat, fish and whole eggs and good fats such as avocados, and fish, olive and macadamia but oils.  Don’t skip meals and make sure the first thing you do when you get out of bed in the morning is consume at least 50 grams of protein. – John Romano – VPX Sports

 

 

Creatine and Kid’s Brains

By: Jose Antonio PhD

Date Published: October 2011

Do your kids play football?  Compete in MMA (mixed martial arts) or boxing?  Then you definitely need to protect those vulnerable little brains of theirs.  Did you know that besides helping you gain muscle mass and improve exercise performance, regular creatine supplementation can also protect your head from TBI or traumatic brain injury?  Is Siberia cold?  Is the Pope Catholic?

Here’s the proof.  Scientists conducted a study looking at the neuroprotective effects of creatine in 39 children and adolescents, aged between 1 and 18 years of age, with TBI.  Did you notice the age range?  One year to 18 years of age!  The creatine (Cr) was administered for 6 months, at a dose of 0.4 g/kg in an oral suspension form every day.   Just to compare, that dose is equal to 36.4 grams daily for a 200 pound individual.  That’s a whopping dose mi amigo.

What did they find?  Glad you asked.  The administration of Cr to children and adolescents with TBI improved results in several parameters, including duration of post traumatic amnesia (PTA), duration of intubation, and intensive care unit stay. Significant improvement was recorded in the categories of headache, dizziness and fatigue, aspects in all patients. And the punch line?  They found no side effects from the Cr administration.1

So let’s get this straight. You can give a boatload of creatine to kids with TBI and it helps with a whole host of issues and it’s safe.  Amen brotha.

Jose Antonio, PhD is an author, speaker, radio show host, sports nutrition scientist, and avid outrigger paddler.  www.theissn.org

 

 

 

Reference:

1. Sakellaris G, Nasis G, Kotsiou M, Tamiolaki M, Charissis G, Evangeliou A. Prevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot study. Acta Paediatr. Jan 2008;97(1):31-34.

 

 

 

Creatine monohydrate vs ethyl ester

By: Jose Antonio PhD

Date Published: July 2011
In the ongoing debate between which is better, creatine monohydrate versus creatine ethyl ester, the winner is? Creatine monohydrate!1 What’s odd about this debate is folks claiming CEE (creatine ethyl ester) as being superior to creatine monohydrate have NEVER produced evidence to show that it is even equal to CrMono (creatine monohydrate). NEVER. It’s like claiming to be the best team in pro football during the Pre-season. Folks, it just doesn’t work that way. So after years of waiting for a head-to-head comparison, science confirms what many have thought all along. CEE isn’t even on par with CrMono. In a study lead by one of the leading sports nutrition scientists West of the Mississippi, Dr. Darryn Willoughby and his band of merry men studied how a seven-week supplementation regimen combined with resistance training affected body composition, muscle mass, muscle strength and power, serum (blood) and muscle creatine levels, and serum creatinine levels in 30 non-resistance-trained males. Subjects were randomly assigned to a maltodextrose placebo (PLA), creatine monohydrate (CrMono), or creatine ethyl ester (CEE) group. The supplements were taken at a dose of 0.30 g/kg fat-free body mass (which is approximately 20 g/day) for five days followed by ingestion at 0.075 g/kg fat free mass (approximately 5 g/day) for 42 days. So it is your basic loading phase followed by a maintenance phase. By Day 6 and Day 48, CrMono produced higher levels of serum creatine than CEE. And interestingly, by Day 6 and Day 27, CrMono produced higher muscle creatne levels than CEE although by Day 48, CrMono was still higher (but it wasn’t statistically significant over CEE). One of the more telling results is the fact that CEE results in a much greater conversion to creatinine. Say it isn’t so! OMG! Yes, science has determined that by Day 6, 27 and 48, CEE produced 2 to 3 times more creatinine than CrMono. According to these eggheads, when compared to creatine monohydrate, creatine ethyl ester was not as effective at increasing serum and muscle creatine levels or in improving body composition, muscle mass, strength, and power.

Thus, one can reasonably conclude that CEE is not superior to CrMono. In fact, many of the markers of creatine metabolism suggest that CEE is in fact inferior to CrMono. Because the subjects in this study were untrained, this explains why there weren’t great differences in the training adaptations. One might reasonably conclude that in trained folks, you’re better off sticking to CrMono than CEE.

**One final comment: the beauty of science is in its ability to resolve disputes. For those of you on the CEE bandwagon, perhaps it’s time to jump off that ship.

Jose Antonio PhD is an avid outrigger paddler and the CEO of the International Society of Sports Nutrition (www.theissn.org).

 

 

 

Reference
1. Spillane M, Schoch R, Cooke M, et al. The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels. J Int Soc Sports Nutr. 2009;6:6.

Creatine and Kids

By: Jose Antonio PhD.
Date Published: Autumn 2009

Walk around any mall in the heartland of America and you’ll find this common site.  Kids sitting at a brightly colored table in a Food Court peppered with all sorts of different fast foods.  Parents are more than willing to buy their kids French fries, donuts, fried chicken, cheeseburgers and other assorted not-so-good for you foods.  Let’s face it; it’s tough to get kids to eat salmon and broccoli right?  Nonetheless, it is socially acceptable to eat like sh#$ and therefore look like sh$%.  Though looking like sh$% seems to be less tolerated despite the fact that the two often go hand in hand.

However, the mere mention that kids should be consuming dietary supplements, in this case creatine, brings gasps of horror!  Creatine!  What about the kids?  Will it harm them?  Will their kidneys peeter out and die?  Egads!
Never has a supplement been studied so much yet misunderstood entirely by the general public.  Folks are often surprised to hear that creatine is naturally found in meats, especially fish.  So if you’re afraid of creatine, I’d suggest you avoid the sushi bar like a sailor avoids the confessional.  In a nutshell, creatine is probably the most studied dietary supplement in the history of mankind.  Out of the hundreds of studies performed on creatine, there is no evidence to show that it causes any harm.  In fact, there are studies in kids (even infants) showing no side effects.  So what are folks so scared?  Two reasons: they’re either idiots or they’re uninformed.   We fear what we don’t understand, right?

Background on Creatine

Creatine plays an important role in energy metabolism and is synthesized or made in the liver, kidney and pancreas. It is stored mainly in skeletal muscles, heart and brain.  There is scientific evidence which show a short and long-term therapeutic benefit of creatine supplementation in children and adults with gyrate atrophy (a result of the inborn error of metabolism with ornithine delta- aminotransferase activity), muscular dystrophy (facioscapulohumeral dystrophy, Becker dystrophy, Duchenne dystrophy and sarcoglycan deficient limb girdle muscular dystrophy), McArdle’s disease, Huntington’s disease and mitochondria-related diseases. Hypoxia and energy related brain pathologies (brain trauma, cerebral ischemia, prematurity) might benefit from creatine supplementation.(1)

Studies of Creatine in Kids

Creatine and Kids with Cancer
Nine children with ALL (acute lymphoblastic leukemia, a type of cancer) in the maintenance phase of treatment on the Dana-Farber Cancer Institute (DFCI) protocol 2000-2001 were treated with creatine monohydrate (CrM) (0.1 g/kg/day; equal to 6.8 grams for a 150 lb person) for two sequential periods of 16 weeks (16 weeks treat > 6 weeks wash-out > 16 weeks treat). A cohort of 50 children who were receiving the same chemotherapy at the same time served as controls. Despite the long course of corticosteroid treatment for ALL, children showed significant increases in height, bone mineral density, and fat free mass (i.e. muscle) over approximately 38 weeks during the study. There was an increase in body mass index over time, but children taking CrM had a reduction, while the control group showed an increase in % body fat.  Thus, children with ALL treated with corticosteroids as part of a maintenance protocol of chemotherapy showed an increase in % body fat; however, those consuming CrM demonstrated lesser body fat accumulation.(2) No side effects were reported.

Creatine and Kids with Muscular Dystrophy
In another study, 30 boys with Duchenne’s Muscular Dystropy (DD) (50% were taking corticosteroids) completed a double-blind, randomized, cross-over trial with 4 months of CrM (about 0.10 g/kg/day), 6-week wash-out, and 4 months of placebo. Four months of CrM supplementation led to increases in fat free mass and handgrip strength in the dominant hand and a reduction in a marker of bone breakdown; furthermore, the supplement was well tolerated in children with this muscle disease.(3)

Creatine and Kids with Traumatic Brain Injury
In perhaps one of the more intriguing studies, creatine was given to kids with traumatic brain injury or TBI.  The effect of creatine was determined on 39 children and adolescents, aged between 1 to 18 years old, with TBI. The creatine was administered for 6 months, at a dose of 0.4 g/kg in an oral suspension form every day.  That’s a huge dose which is equal to 27 grams for a 150 lb person.  The administration of creatine to children with TBI improved results in several parameters, including duration of post-traumatic amnesia (PTA), duration of intubation, intensive care unit (ICU) stay, disability, good recovery, self care, communication, locomotion, sociability, personality/behavior and neurophysical, and cognitive function. Significant improvement was recorded in the categories of Cognitive, personality/behavior, Self Care, and communication aspects in all patients. No side effects were seen because of creatine administration.  Thus, there is evidence that creatine supplementation is beneficial to pediatric patients with traumatic brain injury.(4)(5)

Creatine and Exercising Kids
Sixteen male fin swimmers (age:15.9 years) were randomly and evenly assigned to either a creatine (CR, 4×5 g/day creatine monohydrate for 5 days) or placebo group (P, same dose of a dextrose-ascorbic acid placebo) in a double-blind research. Before and after creatine supplementation, the average power output was determined by a Bosco-test and the swimming time was measured in two maximal 100 m fin swims. After five days of supplementation the average power of one minute continuous rebound jumps increased by 20.2%. The swimming time was significantly reduced in both first and second sessions of swimming in the CR group, but remained almost unchanged in the P group.  Thus, creatine supplementation enhances the dynamic strength and may increase anaerobic metabolism in the lower extremity muscles, and improves performance in consecutive maximal swims in highly trained adolescent fin swimmers.(6)  In another study, four weeks of creatine supplementation enhanced swim bench test performance.(7)

Creatine and Infants
According to researchers, hypoxic ventilatory depression in mice and muscle fatigue in adult humans are improved by creatine supplementation (CS).   However, a study in human infants found that creatine supplementation did not improve symptoms of apnea of prematurity in infants.  Interestingly though, no side effects were seen with creatine supplementation (equal to a 13.6 gram daily dose in a 150 lb person).(8) In an  interesting case report, scientists studied and treated an infant with an inborn deficiency of guanidinoacetate methyltransferase (GAMT). Long-term oral administration of creatine-monohydrate (4-8 g per day) to this patient resulted in substantial clinical improvement, disappearance of magnetic resonance (MRI) signal abnormalities in the globus pallidus, and normalisation of slow background activity on the electroencephalogram (EEG). During the 25-month treatment period, both brain and total body creatine concentrations became normal.  Accordingly, oral creatine replacement has proved to be effective in one child with an inborn error of GAMT. It may well be effective in the treatment of other disorders of creatine synthesis.(9)  It is interesting that a dose of 4-8 grams per day in an infant would be equal to over 100 grams daily in an adult.

Conclusion

Supplementation of kids of varying ages with creatine has been shown to improve exercise performance, promote recovery post traumatic brain injury, help infants with inborn errors of metabolism, and ameliorate body fat gain secondary to corticosteroid treatment.  No side effects are reported in these investigations.  Thus, the preponderance of the evidence clearly shows that creatine supplementation may indeed be beneficial for kids with no side effects.

 

About the Author:

Jose Antonio is an author, speaker, radio show host, sports nutrition scientist, and avid outrigger paddler.  www.theissn.org

References

  1. Evangeliou A, Vasilaki K, Karagianni P, Nikolaidis N. Clinical applications of creatine supplementation on paediatrics. Curr Pharm Biotechnol 2009;10 (7):683-90.
  2. Bourgeois JM, Nagel K, Pearce E, Wright M, Barr RD, Tarnopolsky MA. Creatine monohydrate attenuates body fat accumulation in children with acute lymphoblastic leukemia during maintenance chemotherapy. Pediatr Blood Cancer 2008;51 (2):183-7.
  3. Tarnopolsky MA, Mahoney DJ, Vajsar J, Rodriguez C, Doherty TJ, Roy BD, Biggar D. Creatine monohydrate enhances strength and body composition in Duchenne muscular dystrophy. Neurology 2004;62 (10):1771-7.
  4. Sakellaris G, Kotsiou M, Tamiolaki M, Kalostos G, Tsapaki E, Spanaki M, Spilioti M, Charissis G, Evangeliou A. Prevention of complications related to traumatic brain injury in children and adolescents with creatine administration: an open label randomized pilot study. J Trauma 2006;61 (2):322-9.
  5. Sakellaris G, Nasis G, Kotsiou M, Tamiolaki M, Charissis G, Evangeliou A. Prevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot study. Acta Paediatr 2008;97 (1):31-4.
  6. Juhasz I, Gyore I, Csende Z, Racz L, Tihanyi J. Creatine supplementation improves the anaerobic performance of elite junior fin swimmers. Acta Physiol Hung 2009;96 (3):325-36.
  7. Dawson B, Vladich T, Blanksby BA. Effects of 4 weeks of creatine supplementation in junior swimmers on freestyle sprint and swim bench performance. J Strength Cond Res 2002;16 (4):485-90.
  8. Bohnhorst B, Geuting T, Peter CS, Dordelmann M, Wilken B, Poets CF. Randomized, controlled trial of oral creatine supplementation (not effective) for apnea of prematurity. Pediatrics 2004;113 (4):e303-7.
  9. Stockler S, Hanefeld F, Frahm J. Creatine replacement therapy in guanidinoacetate methyltransferase deficiency, a novel inborn error of metabolism. Lancet 1996;348 (9030):789-90.